Media: Audio CD, or MP3

Original Release Date: July 1, 2010
Expiration Date: July 1, 2013
20 AMA PRA Category 1 Credits™

OVERALL OBJECTIVES: Upon completion of this CME activity, through the use of clinical vignettes emphasizing Guidelines and Evidence-Based Medicine, the physician or healthcare provider should be able to formulate a differential, make a diagnosis and develop a plan for the prevention and/or therapeutic management of the various disorders presented.

SPECIFIC OBJECTIVES FOR EACH TOPIC

TOPIC 1: Pericarditis and Myocarditis: How Can 2 Diseases Sound So Similar and Act So Differently? - Upon completion of this session, the participant should be able to:

1. Discuss the pathophysiology and clinical presentation of these two entities. 
2. Review the potential pitfalls in the diagnosis and management of these diseases. 
3. Discuss the commonalities and differences of these closely related diseases. 
4. Describe the evidence-based work-up and treatment options for pericarditis and myocarditis.

TOPIC 2: Abdominal Pain: The Black Box of the Belly - Upon completion of this session, the participant should be able to:

1. Review some challenging cases of abdominal pain. 
2. Explore diagnoses of abdominal pain in the absence of abdominal pathology. 
3. Discuss the utility of various tests, including labs, ultrasound and CT scan in the diagnosis of abdominal pain.

TOPIC 3: Abdominal Pain Imaging: A Site Specific Approach to Diagnosis - Upon completion of this session, the participant should be able to:

1. Identify which diagnoses are most likely given the site of the patient’s presenting abdominal pain. 
2. Identify which radiographic studies should be performed based on location of presenting symptoms. 
3. Describe and recognize radiographic signs of common causes of abdominal pain.

TOPIC 4: Migraine and Chronic Daily Headache - Upon completion of this session, the participant should be able to:

1. Review five sub-types of chronic daily headaches. 
2. Describe the pathophysiology of headache and migraine. 
3. Review medication and non-pharmacologic strategies. 
4. Recognize the prevalence of medication overuse headaches in daily practice.

TOPIC 5: Hypertension: Just the Facts! - Upon completion of this session, the participant should be able to:

1. Review the emergency department "essentials" for the assessment of the patient with hypertension. 
2. Provide a rational framework for the ED treatment of acute hypertension. 
3. Review highlights of the current guidelines: "Prevention, detection, evaluation, and treatment of high blood pressure."

TOPIC 6: Meningitis and Meningoencephalitis - Upon completion of this session, the participant should be able to use the evidence-based guidelines of the IDSA, and the CDC to:

1. Describe the epidemiology of meningitis and the different types of meningitis. 
2. Identify clinical signs and symptoms of different types of meningitis. 
3. Describe the indications for lumbar puncture (LP) and interpretations of LP results. 
4. Summarize treatment options and the need for hospitalization and public health notification.

TOPIC 7: Neurologic Emergencies - Upon completion of this session, the participant should be able to:

1. Recognize status epilepticus, coma, and subarachnoid hemorrhage. 
2. Identify pupillomotor function in CNIII Palsies and prognosis. 
3. Discuss appropriate testing. 
4. Apply principles of treatment using evidence-based medicine.

TOPIC 8: Evaluation of the GU Tract with CT - Upon completion of this session, the participant should be able to:

1. Identify which studies are most appropriate to order when evaluating the patient with flank pain. 
2. Describe other diagnoses besides renal calculi that may present with flank pain. 
3. Describe the current role of CT urography.

TOPIC 9: Treatment of Sexually Transmitted Infections - Upon completion of this session, using the CDC guidelines and the Cochrane Abstract Database, the participant should be able to:

1. Describe the therapeutic approach to evaluating a patient for a sexually transmitted infections. 
2. Describe the treatment of STIs. 
3. Describe the appropriate follow-up care for patients treated for an STI.

TOPIC 10: PE and DVT in the Emergency Department - Upon completion of this session, the participant should be able to:

1. Identify the scope of the problem of thromboembolic disease in the ED. 
2. Discuss the latest diagnostic algorithms and adjuncts available to aid the clinician in the diagnosis of thromboembolic disease. 
3. Review the evidence-based treatment of thromboembolic disease based on the latest applicable literature. 
4. Recognize the limitations of current diagnostic modalities for these diseases.

TOPIC 11: Domestic Violence - Upon completion of the session, the participant should be able to:

1. Recognize the potential domestic violence victim in your office. 
2. Consider domestic violence from the victim's point of view and reasons she/he may not wish to act on it. 
3. Develop an awareness for the frequency of domestic violence and specific risk factors to consider. 
4. Discuss effective methods for addressing domestic violence as a problem.

TOPIC 12: Thyroid Emergencies - Upon completion of this session, the participant should be able to:

1. Describe the presentation of life-threatening hyperthyroid states to the Emergency Department. 
2. Prepare a comprehensive treatment plan for patients with thyroid storm and thyrotoxicosis. 
3. Describe the presentation of myxedema coma. 
4. Justify the use of intravenous thyroid hormones in the potentially hypothyroid patient.
 
TOPIC 13: Early Goal-Directed Therapy For Sepsis: Why all the Fuss? - Upon completion of this session, the participant should be able to:

1. Describe the pathophysiology of sepsis and the sepsis syndrome. 
2. Appreciate the scope of the problem regarding effective management of sepsis in the ED. 
3. Review the principles of early goal-directed therapy in the treatment of sepsis. 
4. Appreciate the potential gains that can be realized, as well as the pitfalls to avoid, in the management of sepsis utilizing early goal directed therapy.
 
TOPIC 14: Gynecologic Emergencies - Upon completion of this session, the participant should be able to:

1. Recognize the more common and significant gynecologic emergencies. 
2. Formulate a rapid and concise treatment plan for various emergencies, such as:
a. Ectopic pregnancies, 
b. Uterine hemorrhage, 
c. Gynecologic infections. 
3. Provide follow-up care to the post-gynecologic emergency patient.
 
TOPIC 15: CA-MRSA: Evidence-Based Management - Upon completion of this session, the participant should be able to:

1. Identify risk factors for CA-MRSA infection. 
2. Recognize the management of skin and soft tissue infections in the era of drug resistance. 
3. Discuss both pharmacologic and non-pharmacologic management strategies for this disease entity. 
4. Demonstrate familiarity with the latest treatment guidelines for CA-MRSA.
 
TOPIC 16: Ophthalmologic Emergencies - Upon completion of this session, the participant should be able to:

1. Develop an algorithm for the differential diagnosis of the red eye. 
2. Create a diagnostic strategy for sudden monocular and binocular blindness. 
3. Review the treatment plans for emergent ophthalmic conditions, including glaucoma, and retinal vein and artery occlusions. 
4. Develop a treatment strategy for ophthalmic trauma.