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AMS CME meetings are held in both Sarasota, FL , San Diego, CA, and other cities throughout the US in the Summer months. All are designed for Primary Care Practitioners in the specialties of Family Medicine, Internal Medicine, Emergency Medicine, and even Specialists who would like practical and clinically relevant reviews and updates in Primary Care Medicine.
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NARRATIVE DESCRIPTION
Following this course, the participant should be able to implement practical and cost-effective methods available in making a preliminary diagnosis; employ effective history and physical exam techniques; differentiate when they should treat certain disorders versus when to refer for specialist care. This activity is expected to result in improved competence in making an appropriate diagnosis and providing effective treatment and referral or follow-up care with the overall goal of improving patient outcomes.
The emphasis will be on aligning physician behavior with current guidelines and evidence-based medicine, as indicated within each topic’s specific objectives, with a focus on diagnosis, treatment and when to refer. Since the specialty of Neurology is one that demands great clinical acumen, this course was designed as a review and update for all practitioners at the level of a practicing physician in an effort to improve their skills in making appropriate clinical decisions and diagnoses without excessive testing.
SPECIFIC OBJECTIVES
Day 1
The Neurological Examination.
Upon completion of this session, the participant should be able to: COMP,EBM
1. Organize the disparate parts of the neurologic examination into a personally relevant, manageable and reproducible diagnostic tool.
2. Perform a concise screening neurologic exam for asymptomatic patients.
3. Perform a problem-tailored neurologic exam for patients with neurologic complaints such as altered mental status and gait disturbances using evidence-based medicine.
4. Obtain maximum yield from the examination of a patient with an altered mental status.
Seizures and Epilepsy – Diagnosis.
Upon completion of this session, the participant should be able to: COMP,EBM
1. Differentiate among the major types of seizures.
2. Apply epidemiologic aspects to the diagnosis of epilepsy.
3. Employ AAN and AES practice guidelines regarding sudden unexpected death in epilepsy. (SUDEP)
4. Distinguish seizures from syncope.
5. Formulate a plan for diagnostic investigation.
Seizures and Epilepsy – Management.
Upon completion of this session, the participant should be able to: COMP, EBM
1. Determine when treatment with anticonvulsant medication is warranted using evidence-based medicine.
2. Choose among the many available anticonvulsant medications.
3. Manage problems confronted by women with epilepsy.
4. Counsel patients regarding their driving privileges.
Stroke, Part I – An Evidence-Based Review of Risk Factors and Prevention.
Upon completion of this session, the participant should be able to: EBM, GL, COMP
1. Identify risk factors and apply prevention strategies.
2. Apply the CHA2DS2-VASc Score to assess risk of stroke with Atrial Fibrillation and guide treatment plan.
3. Plan when to refer patients for carotid endarterectomy.
4. Determine use of aspirin, clopidogrel, dipyridamole, warfarin and novel anticoagulants, carotid endarterectomy and stenting.
Stroke, Part II – TIA and Acute Stroke.
Upon completion of this session, the participant should be able to: GL, COMP
1. Apply risk stratification to TIA.
2. Employ a protocol for evaluation and treatment of TIA and stroke.
3. Apply inclusion criteria and vascular imaging for thrombolysis and interventional clot retrieval.
4. Review AHA Guidelines for Wake-Up stroke.
Day 2
An Approach to the Dizzy Patient.
Upon completion of this session, using evidence-based medicine, the participant should be able to: COMP, EBM
1. Detect common presentations of dizziness.
2. Assess the pathophysiology of vertigo and nystagmus.
3. Apply bedside techniques to distinguish dizziness subtypes and identify dangerous causes.
4. Utilize potentially curative treatment for benign positional vertigo.
Syncope and Autonomic Dysfunction.
Upon completion of this session, using evidence-based medicine, the participant should be able to: COMP, EBM
1. Discuss the causes and natural history of syncope and Postural Orthostatic Tachycardia Syndrome (POTS).
2. Apply bedside tilt and tilt table testing.
3. Define treatment strategies for orthostatic hypotension.
Migraine and Chronic Daily Headache.
Upon completion of this session, the participant should be able to: COMP, GL
1. Differentiate between the five sub-types of chronic daily headaches.
2. Appraise the pathophysiology of headache and migraine.
3. Develop a plan for appropriate medication for intractable headache.
4. Assess the prevalence of medication overuse headaches in daily practice and employ the non-pharmacologic guideline for migraines.
Sleep Disorders – Insomnia and Obstructive Sleep Apnea.
Upon completion of this session, the participant should be able to: COMP, EBM
1. Appraise the normal structure and function of stages of sleep.
2. Formulate a diagnostic and therapeutic approach to insomnia using best practice recommendations from the American Academy of Sleep Medicine and American Geriatric Society.
3. Detect clinical features and initiate management of sleep apnea.
4. Evaluate patients for comorbidities of obstructive sleep apnea.
Sleep Disorders – Restless Legs Syndrome, Narcolepsy and Others
Upon completion of this session, the participant should be able to: COMP
1. Diagnose restless legs syndrome in under a
minute.
2. Manage restless legs syndrome using practice guidelines.
3. Diagnose and treat narcolepsy.
4. Determine the prognosis of, and treat, REM-sleep behavior disorder.
Day 3
Dementia.
Upon completion of this session, the participant should be able to: COMP
1. Evaluate patients with mild cognitive impairment or dementia.
2. Diagnose the major syndromes associated with common causes of dementia.
3. Distinguish the conditions that frequently mimic dementia.
4. Manage major complications of dementia.
Multiple Sclerosis.
Upon completion of this session, the participant should be able to: COMP,EBM
1. Recognize the typical clinical features of multiple sclerosis.
2. Initiate an appropriate series of diagnostic investigations.
3. Formulate an approach to abortive and prophylactic therapy of multiple sclerosis using evidence-based medicine.
4. Anticipate common medical complications of multiple sclerosis.
Peripheral Neuropathy and Neuropathic Pain Management.
Upon completion of this session, the participant should be able to: COMP, EBM
1. Define the spectrum of neuropathic signs, symptoms, and causes.
2. Develop an approach to bedside examination.
3. Discuss the mechanism of neuropathic pain.
4. Apply effective therapies using evidence-based medicine.
Confessions of a Mostly Happy Doctor – Strategies for Reducing Physician Burnout.
Upon completion of this session, the participant should be able to: COMP
1. Review current literature re: physician burnout.
2. Incorporate strategies to reduce clerical burdens of EMR.
3. Adopt strategies for improved patient satisfaction.
4. Apply techniques for managing complex and time intensive patient interactions.
Libby Zion’s Lesson: Serotonin Syndrome and P450 Drug Interactions.
Upon completion of this session, using evidence-based medicine, the participant should be able to: COMP
1. Define the clinical features of common drug interactions.
2. List the features of serotonin syndrome and distinguish from other Neurologic drug toxicities.
3. Recognize potential drug interactions and determine how to predict them.
4. Apply a simple clinical algorithm for anticipating and avoiding drug interactions.
Day 4
Cobalamin (B-12) Deficiency and Other Neurologic Disorders of Gastrointestinal Function.
Upon completion of this session, using evidence-based medicine, the participant should be able to: COMP
1. Define recent advances in B-12 deficiency, Post-Gastroplasty Neuropathy, and Copper deficiency.
2. Examine the changing clinical presentation of this illness.
3. Apply newer laboratory techniques to the diagnosis.
4. Apply an algorithm for the diagnosis and treatment of B-12 deficiency.
Concussion and Sports: A Guide for Primary Care
Upon completion of this session, using Cochrane EBM sources and guidelines from the 3rd International Symposium on Concussion in Sports, the participant should be able to: EBM, GL, COMP
1. Describe the pathophysiology and, using evidence-based medicine, review the emergency treatment of concussion.
2. Apply an evidence-based medicine approach to decisions regarding imaging after minor head trauma.
3. Demonstrate use of currently recommended management approaches for assessment, follow up, and return to play.
Parkinson’s Disease and Essential Tremor.
Upon completion of this session, the participant should be able to: COMP, GL
1. Assess the clinical features of the syndrome of parkinsonism.
2. Evaluate other important typical features of Parkinson’s disease.
3. Select treatment options for management of Parkinson’s disease.
4. Distinguish among common types of tremor and devise a therapeutic plan for a patient with essential tremor using American Academy of Neurology evidence-based guidelines.
Psychogenic Neurologic Disorders.
Upon completion of this session, the participant should be able to: COMP
1. Evaluate common neurologic manifestations of psychogenic disorders.
2. Direct the laboratory investigation of a patient with suspected psychogenic nonepileptic seizures.
3. Conduct an interview of a patient with a suspected psychogenic disorder.
4. Formulate a plan for management of a psychogenic illness.
Spasticity, Ataxia, and Gait Disorders.
Upon completion of this session, the participant should be able to: COMP
1. Detect the major clinical features of spasticity.
2. Institute a diagnostic investigation of cervical spondylosis.
3. Assess ataxia and the other major clinical features of cerebellar dysfunction.
4. Evaluate different types of gait disorders
