Hospital Medicine CME

Internal Medicine 2014 offered a rich program of courses in the area of Hospital Medicine. Many of the courses offered at Internal Medicine 2014 are available for sale in electronic formats.

Sessions from Internal Medicine 2014 that offer hospitalists the opportunity to earn CME credit include:

Delirium

This course answers the following questions:

  1. What are the risk factors for delirium? Are there reliable predictors of which patients will become delirious? What strategies work to prevent delirium?
  2. What work-up should be done for secondary causes of delirium that develops in the hospital setting?
  3. What management strategy should be used for hospital-acquired delirium? When are chemical and/or physical restraints indicated? When pharmacotherapy is indicated, what is the best approach?
  4. What are the expectations for long-term sequelae and survival for patients who develop delirium in the hospital?

 

Geriatrics for the Hospitalist

This course answers the following questions:

  1. How should the admitting evaluation of the geriatric patient differ from that of the nongeriatric patient?
  2. What is the best approach to hydration and nutrition issues in the elderly?
  3. Which medications should be avoided in the geriatric patient and which should be used with caution?
  4. How can the hospitalist minimize loss of function and falls in geriatric patients?
  5. What are the characteristics of a successful acute care for elders (ACE) unit? How can these principles be applied in hospitalists without an ACE unit?

 

Perioperative Medicine

This course answers the following questions:

  1. What common medications should be withheld and which should be continued in the perioperative period?
  2. How should anticoagulation be managed? What have we learned about managing newer oral coagulants? Who should be bridged, and how?
  3. Who should be given stress-dose steroids, and what is the best regimen?
  4. Who should receive a cardiac evaluation, and what is the best approach? Which cardiac risk score scheme is best?
  5. Which patients should receive a pulmonary evaluation, and what is the best approach?
  6. What are important perioperative considerations in cirrhotic patients?

 

How Sweet Is This?: Inpatient Management of Diabetes

This course answers the following questions:

  1. What is the best evidence for inpatient glucose targets? Should targets be adjusted for age or specific disease processes?
  2. Is there ever a role for oral treatment of diabetes in the hospital? What are the best insulin regimens for hospitalized diabetics? Is there a role for sliding scales?
  3. How should we approach management of new diagnosis of type 2 diabetes in the hospital? What is the best inpatient and outpatient treatment choice? How do age and comorbid conditions affect the choice of initial treatment of type 2 diabetes?
  4. How can we maximize safe transition to outpatient treatment for patients hospitalized for ketoacidosis, hyperglycemia, or treatment-related hypoglycemia?

 

Transfusion Medicine

This course answers the following questions:

  1. What is the evidence about appropriate target hemoglobin levels for critically ill patients, patients with active cardiac disease, patients with sickle cell disease, and patients with chronic kidney disease/end-stage renal disease? Have goals changed for patients with these or other comorbid conditions?
  2. What are the indications for transfusion of cryoprecipitate? Fresh frozen plasma? Whole blood?
  3. What are the potential harms of transfusion? What are the noninfectious harms? How can we attenuate these risks?

 

Congestive Heart Failure Update

This course answers the following questions:

  1. How should a patient presenting with new-onset CHF be evaluated?
  2. What is the best evidence-based approach to inpatient management of CHF? Is there a role for checking “routine” B-type natriuretic peptide (BMP) and echocardiography in the inpatient setting?
  3. Should our approach in management differ between heart failure with reduced ejection fraction compared with heart failure with preserved ejection fraction?
  4. Are there proven clinical pathways to decrease length of stay and re-admission rates for patients with CHF?

 

 

Palliative and Hospice Care

This course answers the following questions:

  1. What are the benefits of organized palliative care services in terms of measurable outcomes? What are the characteristics of a successful approach to comprehensive palliative care in a hospital setting?
  2. When and how should the topic of initiating palliative care be introduced in the inpatient setting? What are the barriers to doing so effectively? What are some tips for managing a family meeting?
  3. When and how should the topic of transitioning to hospice care be introduced in the inpatient setting? How can we manage the discussion in a cross-cultural world? How can we earn trust when we don’t have the benefit of a prior relationship?

 

Tuberculosis

This course answers the following questions:

  1. Which patients should be tested for tuberculosis? Who needs to be isolated? When is a PPD useful? When do I need “controls”? Who needs “2-step” PPD? When can quantiferon testing be used? When are three negative sputums required to discontinue isolation?
  2. What is the prevalence of multidrug-resistant tuberculosis? What are the patient populations where this is a concern?
  3. What are some extra-pulmonary manifestations of tuberculosis that are important for the hospitalist to recognize?
  4. What are the latest regimens for treatment of latent disease, active disease, and post exposure prophylaxis?

 

C. difficile Infection

This course answers the following questions:

  1. What is the epidemiology of C. difficile infection and how has it changed?
  2. What are the risk factors? Which are modifiable?
  3. What are the best approaches to reducing in-hospital transmission of C. difficile?
  4. What are common and uncommon presentations of C. difficile? When should diagnostic tests be ordered, which tests are best, and how should they be interpreted?
  5. What are the current treatment guidelines? For severe inpatients? For recurrent and refractory disease? When should fecal treatment be considered?

 

 

Health Care-Associated Pneumonia (HCAP)

This course answers the following questions:

  1. What are the diagnostic criteria that distinguish health-care associated pneumonia (HCAP) from community-acquired pneumonia (CAP)?
  2. How do we assess the risk for resistant organisms?
  3. When do we consider more imaging?
  4. What are the newer pathogens we need to be concerned about?
  5. What is the best empiric treatment for HCAP?

 

Acute Kidney Injury

This course answers the following questions:

  1. What are the risk factors for acute kidney injury (AKI) and how can AKI risk be reduced in hospitalized patients?
  2. What are the best approaches for evaluating and managing patients with AKI?
  3. What are the consequences of AKI and how can renal recovery be enhanced?

 

Inpatient Management of the Patient with Cirrhosis

This course answers the following questions:

  1. What are common clinical presentations of spontaneous bacterial peritonitis (SBP)? How should SBP be diagnosed and treated? Is there a role for prophylaxis?
  2. When should coagulopathy be treated? What is the best approach? Should patients with cirrhosis be given VTE prophylaxis?
  3. What is the best pharmacologic approach to variceal bleeding in patients with cirrhosis?
  4. What is the definition and pathophysiology of hepatorenal syndrome? What is the best management strategy?

 

Vent Management

This course answers the following questions:

What are the characteristics of common ventilator modes?

How are volume control and pressure control set up?

What are the weaning parameters we should consider?

What should be considered before extubation is attempted?

 

Inpatient GI Sampler: A Case-Based Discussion

This course answers the following questions:

  1. Gastrointestinal bleeding: What is the evidence for restarting aspirin? What are the concerns in cardiac patients? What is the evidence for nasogastric tubes, PPIs, and endoscopic treatment?
  2. Inflammatory bowel disease: Which patients need further work-up for exacerbation of symptoms, and what tests should be done? When are steroids indicated? What other pharmacotherapy might be indicated in the acute setting? What scoring systems can predict outcome?
  3. Pancreatitis management: What’s new?
  4. Cholecystitis and cholangitis: What is the optimal timing for surgery and ERCP? What are the roles of MRCP and EVS?

 

Chest Pain in the Hospital

This course answers the following questions:

  1. What is the best approach to evaluation of patients presented to the emergency department with chest pain?
  2. When does a patient have “demand ischemia”? What further evaluation and treatment are indicated?
  3. Which patients should have a stress test? How should the type of stress test be selected? When is it safe to refer patients for stress testing as an outpatient?
  4. Which patients should have cardiac catheterization? Is there any role for the coronary CT angiogram?

 

Hyponatremia

This course answers the following questions:

  1. What is the best approach to evaluation of hyponatremia in the inpatient? Is identifying patients as “ADH-appropriate” versus “ADH-inappropriate” a useful strategy?
  2. What is the best approach to patients who do not respond to fluid restriction? When and how should 3% saline be given? What are the risks of vaptans, and when and how should they be used?
  3. How does a diagnosis of hyponatremia affect prognosis for patients with CHF, cirrhosis, and other comorbid conditions?

 

Atrial Fibrillation Management

This course answers the following questions:

  1. What evaluation should be performed for inpatients with atrial fibrillation? When should cardiology consultation be obtained?
  2. What therapies are most safe and effective to treat atrial fibrillation with rapid ventricular rate? What are the indications, contraindications, and side effects of each?
  3. What are the appropriate inpatient goals for rest and exercise heart rate in patients with atrial fibrillation?
  4. Which patients require anticoagulation or antiplatelet therapy? When can anticoagulation safely be started orally as outpatient? Which anticoagulants are indicated and in what situations?

 

Surviving Sepsis Campaign: 2013

This course answers the following questions:

  1. What is the definition of sepsis? Septic shock?
  2. What are the standards of care for identification, initial evaluation, and management of the septic patient? What are the current controversies?
  3. What are “care bundles”? Is there evidence that they improve outcomes in sepsis? If we deploy care bindles, what are the best strategies to use them effectively?
  4. What is the future of sepsis management?

 

Primum Non Nocere: A Primer on Safety

This course answers the following questions:

  1. How do we define harm in the hospitalized patient?
  2. How is patient safety recognized and rewarded in the Affordable Care Act?
  3. What are proven institutional strategies to avoid harm in hospitalized patients? What

can I personally and specifically do?

 

Quality Metrics: The Good, the Bad, and the Ugly

This course answers the following questions:

  1. How is “quality”currently defined?
  2. Why should I care about metrics? How are we being monitored as individuals and as institutions?
  3. How can I tell good data from bad?
  4. Why does my institution look good for one group but bad to another?
  5. How will the Affordable Care Act affect quality initiatives?

 

Anticoagulation: Everything You Always Wanted to Know But Were Afraid to Ask

This course answers the following questions:

  1. What are the indications, risks, benefits, and costs for the use of newer oral anticoagulants? When should they replace warfarin and/or parenteral anticoagulants?
  2. What are the best protocols for stopping and restarting anticoagulants for invasive procedures, including surgery? What is the evidence for risks and benefits of bridging? Which patients should be bridged?
  3. What are the risks of combining anticoagulant and antiplatelet therapy? What is the best evidence-based approach to assessing clotting compared with bleeding risk?
  4. What adjustments need to be made in anticoagulant choice and dosing in renal and liver patients?
  5. What drug interactions are most common, and how should these interactions affect dosing and choice of anticoagulant?

 

Update in Hospital Medicine

 

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