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: Sensible Prescribing Practices for the Elderly - Upon completion of this session, the participant should be able to:

1. Recognize the limits of studies on drug safety and efficacy as they apply to the elderly. 
2. Appreciate the subtle but significant drug side effects in the elderly. 
3. Describe undesirable prescribing practices and better approaches.

TOPIC 2: Newer Antibacterial Agents - Upon completion of this session, using FDA publications and approvals as well as IDSA and SHEA evidence-based guidelines, the participant should be able to:

1. Relate the antibacterial spectrum of activity. 
2. Describe the pharmacology of the agents. 
3. List the indications and dosing recommendations. 
4. Identify the side effects, adverse reactions and drug interactions.

TOPIC 3: Adult Health Screening and Immunizations – Evidence-Based Approach - Upon completion of this session, using the USPSTF and Cochrane Abstract Database, the participant should be able to:

1. Describe the evidence-based recommendations for preventive screening tests for adults. 
2. List the routine immunizations recommended for adults. 
3. Describe the common side effects of adult immunizations. 
4. List the contraindications for each adult immunization. 
5. Discuss when screening tests can be discontinued in adults.

TOPIC 4: Treatment of Primary Headache Syndromes - Upon completion of this session, the participant should be able to:

1. Appreciate the role of abortive therapy for migraine, tension-type, and cluster headache. 
2. Recognize the range of options for pharmacologic preventive therapy for migraine, tension-type, and cluster headache. 
3. Develop non-pharmacologic treatment strategies for migraine.

TOPIC 5: Evaluation of Abnormal Liver Enzymes in the Primary Care Setting - Upon completion of this session, the participant should be able to:

1. Describe a diagnostic approach to assess patients with asymptomatic elevations in liver studies. 
2. Describe the common causes of asymptomatic elevations in transaminase levels. 
3. Review the natural history of hepatitis B infection, including serologic markers and indications for treatment. 
4. Review the epidemiology, evaluation and potential treatment options for nonalcoholic steatohepatitis.

TOPIC 6: Thyroid Case Studies - Upon completion of this session, the participant should be able to:

1. Review the etiologies and pathogenesis of hyper and hypothyroidism. 
2. Apply cost effective principles in the laboratory evaluation of thyroid conditions. 
3. Design effective treatment protocols for various thyroid conditions.

TOPIC 7: Lung Cancer - Primary lung cancer remains a major cause of morbidity and mortality. A number of new approaches to diagnosis and therapy have been developed. Upon completion of this session, the participant should be able to:

1. Discuss the epidemiology of lung cancer. 
2. Define the major types of lung carcinoma, particularly small cell and non-small cell cancer. 
3. Characterize the basic clinical aspects of both small cell and non-small cell cancer including staging, natural history, and associated extrapulmonary syndromes. 
4. Outline a diagnostic strategy for patients with suspected lung cancer. 
5. Identify current treatment options for small cell and non-small cell lung cancer.

TOPIC 8: Interstitial Lung Disease - The focus of the discussion will be on sarcoidosis and idiopathic pulmonary fibrosis. These are two disorders a primary care provider should be familiar with. We will review the recent literature so that upon completion of this session, the participant should be able to:

1. Characterize the spectrum of interstitial lung disease. 
2. Develop a basic understanding of the diagnostic work-up, which can include high resolution CT scanning and tissue biopsy. 
3. Identify the clinical and radiographic manifestations of sarcoidosis. An overview of management will be provided. 
4. Outline the typical presentation of idiopathic pulmonary fibrosis as well as management issues. 
We will present a variety of cases with x-rays, CT scans and pathology to illustrate important features. The discussion will focus on basic concepts and will include guidelines on specialist’s referral.

TOPIC 9: Integrative Medicine: Common Therapies - Upon completion of this session, using systematic reviews of clinical evidence, the participant should be able to:

1. Identify the ten most commonly used natural products. 
2. Discuss the science of the use of these natural products. 
3. Review the indications and contraindications for the use of these natural products and potential drug interactions.

TOPIC 10: Chronic Anovulation - Upon completion of this session, the participant should be able to:

1. Discriminate between the hypothalamic, pituitary and ovarian causes of anovulation. 
2. Investigate associated health risks. 
3. Formulate an appropriate treatment regimen.

TOPIC 11: Evaluation and Initial Management: Benign Breast Disease - Upon completion of this session, using the American Cancer Society guidelines as well as the Cochrane Abstract Database, the participant should be able to:

1. Describe benign breast disease. 
2. Evaluate for various conditions such as breast pain, breast lumps, and nipple discharge. 
3. Describe findings associated with breast cancer.

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

1. Outline several clinical points related to rheumatic diseases which emphasize efficient diagnosis and treatment.

TOPIC 13: Spondyloarthropathies - Upon completion of this session, the participant should be able to:

1. Differentiate the clinical features of the different spondyloarthropathies to improve diagnostic accuracy. 
2. Describe treatment modalities.

TOPIC 14: Abnormal Uterine Bleeding - Upon completion of this session, the participant should be able to:

1. Define abnormal uterine bleeding. 
2. Differentiate between functional and organic causes. 
3. Manage most non-surgical etiologies of this problem.

TOPIC 15: Anemia: A Finding, Not Yet a Diagnosis - Upon completion of this session, using the Cochrane Abstract Database, the participant should be able to:

1. List the most common anemias and their usual etiology. 
2. Compare the diagnostic evaluation needed to determine the etiology of the anemia. 
3. Identify the therapeutic options for each of the identified anemias. 
4. Describe the follow-up plans for assessing the efficacy of treatment for each anemia.

TOPIC 16: The Most Common Dermatology Referrals - Upon completion of this session, the participant should be able to:

1. Identify the most common dermatology referrals 
2. Develop referral strategies for the common dermatology referrals. 
3. Initiate treatment regimens for the common dermatology referrals.