CME - Critical Care and Pulmonary Medicine: An Update and Review

Venue: Hyatt Regency Sarasota

Location: Sarasota, Florida, United States

Event Date/Time: Dec 14, 2009 End Date/Time: Dec 18, 2009
Registration Date: Dec 14, 2009
Early Registration Date: Nov 14, 2009
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SPECIFIC OBJECTIVES FOR THIS COURSE: DAY 1 - COPD – PATIENT MANAGEMENT. Definition and pathophysiology. Natural history and clinical features. Adverse health effects of cigarette smoking and recommendations for helping patients “kick the habit”. Outpatient management including long term oxygen therapy, pulmonary rehabilitation, pharmacologic treatment. Treatment algorithm and indications for specialist referral. Surgical treatment options for emphysema. PULMONARY FUNCTION TESTING - Components of PFTs including spirometry, lung volumes, diffusion. Indications for PFTs. When bronchodilator and bronchoprovocation studies are useful. Approach to PFT interpretation and distinguish common patterns. Different patterns of upper airway obstruction. Actual PFTs will be presented for interpretation and review. ASTHMA UPDATE - Pathophysiology. Typical and atypical clinical presentations, cases. Diagnostic modalities. Approach to treatment including bronchodilators, corticosteroids, methylxanthines. New agents and alternative therapies. Patient compliance. Proper inhaler technique, peak flow monitoring. Patient who is not responding, indications for subspecialty referral. DAY 2 - DISORDERS OF SLEEP – OBSTRUCTIVE SLEEP APNEA AND OTHERS - Epidemiology of obstructive sleep apnea. Clinical presentation and how to take a thorough “sleep history.” Diagnostic work-up including overnight polysomnography. Treatment modalities including CPAP, dental appliances, surgery, others. Obesity hypoventilation syndrome, central sleep apnea, Cheyne Stokes breathing, narcolepsy, periodic leg movements of sleep. PLEURAL DISEASES – Anatomy of the pleural space and physiology of pleural fluid formation. Imaging modalities including plain chest radiography, ultrasonography, CT scanning. Indications and contraindications for thoracentesis. Characterize pleural fluid in a cost effective manner with an emphasis on differential diagnosis. Indications for pleural biopsy, diagnostic pleuroscopy. Treatment modalities. Cases will be presented demonstrating common and not so common causes of pleural effusion. APPROACH TO THE PATIENT WITH CHRONIC COUGH – Pathophysiology and clinical aspects of the most common etiologies of cough. Features of a focused history and physical. Evidence-based and cost effective approach to diagnosis, treatment. PREOPERATIVE PULMONARY ASSESSMENT - Respiratory effects of anesthesia and surgery, emphasis on at-risk complications. Perioperative risk factors associated with post-op pulmonary complications. Elements of preoperative evaluation including the role of spirometry. Preoperative and post-operative measures that can minimize postoperative respiratory complications. DAY 3 - APPROACH TO ACID-BASE DISTURBANCES - Primary metabolic and respiratory acid- base disturbances and compensatory mechanisms. Approach to interpretation of any acid-base problem. Differential diagnosis of the major simple and mixed acid-base disturbances. Illustrative case studies will be discussed. ACUTE RESPIRATORY FAILURE AND MECHANICAL VENTILATION - Pathophysiology and differential diagnosis of acute hypoxemic and hypercapnic respiratory failure. Basic concepts of management for patients on mechanical ventilation. Commonly used ventilator modes. Use of positive end expiratory pressure (PEEP). Indications for and complications of mechanical ventilation. Principles and strategies for liberation from mechanical ventilation. SHOCK AND HEMODYNAMIC MONITORING - Shock and the causes. Pathophysiology of common entities. Basic resuscitation techniques including volume replacement and use of vasopressors. Early goal directed therapy. Controversies surrounding use of invasive hemodynamic monitoring. New treatments for septic shock. Use of activated protein C and the role of corticosteroids. COMMUNITY ACQUIRED PNEUMONIA – Categorize patients with respect to severity of illness. Strategy to triage patients - outpatient therapy, hospitalize, ICU. Pathogens that commonly cause community acquired pneumonia. Status of diagnostic work-up including the use of cultures, gram stains, serology, bronchoscopy. How to properly use antibiotics for community acquired pneumonia. Old and new agents. Cases will be presented with chest x-rays, gram stains. DAY 4 - Tuberculosis - Epidemiology. Clinical presentations including pulmonary and extrapulmonary tuberculosis. ATS/CDC criteria for positive tuberculin skin test. Treatment of LTBI based on current evidence-based ATS/CDC guidelines. Diagnostic options including the role of sputum analysis, bronchoscopy. Evidence-based ATS/CDC/IDSA Guidelines for TB therapy. Specific agents and their toxicities, formal treatment regimens. Problem of multi-drug resistant tuberculosis and implications for therapy. LUNG CANCER - Epidemiology. Major types of lung carcinoma, particularly small cell and non-small cell cancer. Clinical aspects of both small cell and non-small cell cancer including staging, natural history, associated extrapulmonary syndromes. Diagnostic strategy for suspected lung cancer. Treatment options for small cell and non-small cell lung cancer. CRITICAL CARE CASES FOR REVIEW - X-rays and other diagnostic studies will be shown in an attempt to emphasize some of the common problems seen in the ICU. Cases will include a pulmonary as well as non-pulmonary topics and evidence-based sources will be referenced. Evaluate a patient with occupational asthma. Differential diagnosis and approach to a patient with a nonresolving infiltrate. Causes and evaluation of a solitary pulmonary nodule. DAY 5 - INTERSTITIAL LUNG DISEASE - Focus of the discussion will be on sarcoidosis and idiopathic pulmonary fibrosis. Characterize the spectrum of interstitial lung disease. Diagnostic work-up, high resolution CT scanning, tissue biopsy. Clinical and radiographic manifestations of sarcoidosis. Typical presentation of idiopathic pulmonary fibrosis, management issues. Cases with x-rays, CT scans, pathology.. PULMONARY CASES FOR REVIEW Cases will be discussed. Also some new evidence-based information that was not formally covered in the previous sessions. Session will be interactive. HEMOPTYSIS - Causes. Severity of a bleeding episode. Diagnostic modalities. Acute basic therapy, indications for specialist referral. PULMONARY THROMBOEMBOLIC DISEASE - Evidence based approaches to diagnosis, treatment of DVT and PE, including ACCP guidelines, will be presented. Epidemiology, risk factors, & clinical presentation of PE & DVT. Role of DVT and PE prevention and recommendations to accomplish it. Diagnostic work-up including V/Q scanning, lower extremity studies, CT scanning, pulmonary angiography and others. Treatment modalities including anticoagulation, thrombolysis & vena cava filters.


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Additional Information

Physician Fees $745.00 Regular Registration (30 days prior to seminar start date) $795.00 Late Registration Non Physician/Resident* Fees $645.00 Regular Registration (30 days prior to seminar start date) $695.00 Late Registration