Events

2019 Summer Conference Session Descriptions

Tuesday, July 16

Cardiology Track
Jennifer Carlquist, PA-C

EKG 123
This is a basic, condensed 12 lead review to include normal cardiac conduction, normal intervals, and wave morphology and how they can provide clues to the patient’s diagnosis. We will use the PQRST model of EKG interpretation, discuss what “normal” is so we can focus on what abnormal is. We will also discuss “Where’s the STEMI?”

Be Still My Heart: A Targeted Workup of Palpitations
This course will review how to do a targeted history, choosing the right labs, diagnostics, and imaging for your patient with palpitations. We will also focus on using a “chief complaint-based approach” to reading EKG’s to prevent missing things like Brugada, Wolf Parkinson’s White, etc. We will review high-risk findings for a sudden cardiac arrest to include HOCM and how to not miss this during a sports physical.

Cardiology Conundrums:
A deeper look into prolonged QT and how this affects your clinical practice, what to do when a patient has a fresh stent and develops AFIB that requires anticoagulation, how to deal with patients that are not compliant with their medications and how to spot them. How to deal with patients that have hyperlipidemia but don’t want to take a statin. Bonus round: What to say to your patient to make sure they will want to take a statin. What to do with the patient who consults Dr. Google before they see you and they are convinced they are dying but they aren’t.

EKG Potpourri:
This is a case-based review of cases that will answer the age-old question of “How much should I worry About the EKG?” Included are: sneaky MIs that were almost missed, acute widowmaker occlusions that the machine interpreted as “non-specific t wave changes” that ended up going to the cath lab.

Behind the Scenes of Your Cardiac Consult:
A review of the workup for hypertension including tips and tricks of management. Review the workup of chest pain including the lexiscan stress test, stress testing, and stress echo. A deeper look into bundle branch blocks and how important they are. A behind the scenes look into pacemakers and ICD’s and how to tell if it is malfunctioning


Wednesday, July 17

CME Session – Keynote
Sharon Kelley, MS, PhD

Street & Designer Drugs:  The Opioid & Synthetic Epidemic
Drug abuse is at epidemic levels and continues to climb.  Recognizing signs and symptoms of abuse from various opioids and synthetics is not only crucial to appropriate patient management but also critical to the safety of PA’s in the treatment environment.  

This presentation will provide the PA with enhanced tools for identifying specific drugs of abuse many of which are not detected in conventional drug testing.  In addition to review of current treatment protocols, an emphasis will be placed on protecting the PA from dangers associated with fentanyl exposures and synthetic drug induced psychosis.  Participants can also receive a certificate for naloxone training by attending this presentation.

Orthopedic Track
Dudley Phipps, PA-C, CCD, FLS
Orthopedics is a pain! Both literally and figuratively for not only your patient but also you as a clinician. One of the biggest challenges faced is wading through the pool of diseases/injuries that have a profound effect on a patient’s quality of life at all ages.

The 1-2-3’s of The Walking Wounded
Working on the front line is a challenge in orthopedics. Is pain a helpful sign? The jury is still out. Orthopedic injuries can be overwhelming, especially for patients that may have trouble participating in examination because of pain. We will review a number of tips, tricks, and pearls to help take the challenge out of a variety of “walking” orthopedic injuries including sprains, strains, lacerations.

Next Patient, BACK PAIN!
I’ll take back pain for 1000 please – and only because that’s close to a number of differential diagnosis for back pain. We will help you develop the skills to “know when to hold them, and know when to fold them” when facing the challenges of back pain.

So You Have Arthritis?
Arthritis presentation can be subtle as sunlight or as devastating as a plague for the patient. There is an ever-expanding palate of treatment options for several types of arthritis. Finding the correct one for your patient will make you the hero, or the zero, in maintaining the patient’s quality of life.

Broken Bones, What’s Next?
Come to spin the wheel and let’s see what you’ve broken! Your patient may never be the same, and they’re counting on you. We will look behind the surgical drapes at pre-op, peri-operative and post-operative expectations for multiple fracture types. Managing expectations is essential in guiding your patients through the swamp of fractures. How, why when and what to do as you look at prevention of the next fracture.

Women’s Health Track
Elyse Watkins, DHSc, DFAAPA

Trending Topics from Across the Reproductive Lifespan

HR, PR, HER-2, KI67. What Does It All Mean?
Clinical guidance organizations cannot seem to agree on mammography guidelines, and pathology reports from breast tissue biopsies are starting to look like mini PhD dissertations! How do you help your patient navigate the murky waters of initial diagnostics and prognostics? Using a case-based approach, this session will help you gain a solid understanding of the basic principles of initial breast cancer presentations, diagnostics, and classifications. We will also discuss the current state of the evidence regarding treatments and prognostic indicators of non-metastatic breast cancer in women.

The Amazing Uterus: What Can Go Wrong?
The uterus is an incredible organ, and the physiology of menstruation is an astonishing example of the intricacies regarding positive and negative feedbacks through various hormonal pathways in our bodies. What can possibly go wrong? This session is designed to provide an overview of the most commonly encountered uterine disorders in women of reproductive age. We will also discuss the presentation, diagnostics, and evidence-based treatment options for each disorder.

Menagerie of Menopause Mentation
No more worrying about pregnancy, tampons, and PMS! Now comes the fun part – menopause. Let’s talk about memory loss, bone loss, cardiovascular health, and of course, sex! The average age of menopause has not changed, but management options have. This session will provide an overview of the current state of the evidence regarding the care of women during peri- and post-menopause so that you can provide your patients with the best options to help ensure a healthy transition to the next phase of their lives.

The Parasitic Placenta: Preeclampsia and Other Hypertensive Disorders of Pregnancy
Current theories about the evolution of preeclampsia and gestational hypertension vary from genetic factors to a placenta that functions parasitically. After a brief overview of the leading theories of the pathophysiology of preeclampsia and gestational hypertension, we will work through an overview of the classification of hypertensive disorders of pregnancy, evidence-based screening tests, and current recommendations regarding the management of each disorder.


Thursday, July 18

Dermatology Track
Kara Roman, MMS, PA-C

Mastering Dermatologic Diagnosis: It’s All About Morphology and Distribution
Refresh your dermatology terminology as you review the primary lesions and secondary changes in the skin associated with common dermatologic diagnoses.

Which “It Is” Is It?: Deciphering Dermatitis
Contact, seborrheic, atopic dermatitis…they all look the same to me. This case-based presentation will keep you guessing and present a practical approach to differentiating the papulosquamous conditions in primary care.

See Spot Kill: Updated on Melanoma and Non-Melanoma Skin Cancers
Skin cancer is on the rise and it’s the perfect time to bolster your skills at recognizing these important lesions. Early recognition can save lives when it comes to dermatologic malignancies. What should you biopsy and when should you refer? This presentation will help answer those important questions.

Countdown the Top Ten Pediatric Rashes
Rashes are ubiquitous in kids. This case-based presentation will let you test your skills at making these important diagnoses in our littlest patients.

Tackling Topical Therapeutics
Topical medications are often prescribed for dermatologic conditions. This session will arm you with the tools you need to confidently utilize topical corticosteroids, antimicrobials, emollients, and other medications unique to dermatologic management.

Pediatrics Track
Daniel Wood, PA-C
There is an increasing amount of information that requires physician assistants who practice in pediatrics, family practice and emergency medicine to obtain through, up-to-date information on a wide range of clinical topics involving children. The Pediatric Track will highlight recent changes in pediatrics. This course is presented in a “Ted-style” format with each lecture lasting approximately 20 minutes highlighting the recent changes in pediatrics. The mini-seminar will end with case studies to emphasize the take-home points and will allow time for interaction with the faculty.

NEUROLOGY SNAPSHOT
ADHD: “More than I think I have a little ADHD”
Attention deficit hyperactivity disorder (ADHD) is a disorder that manifests in childhood with symptoms of hyperactivity, impulsivity, and/or inattention. The symptoms affect cognitive, academic, behavioral, emotional, and social functioning. Treatment includes behavioral and medication and the approach may vary depending on the child’s age. This lecture will address management strategies for providers who care for children with ADHD.

Concussion Update: Beyond Bell Ringing
A concussion is defined as trauma-induced brain dysfunction without demonstrable structural injury on standard neuroimaging. Concussion results from a rapid rotational acceleration of the brain. Children and adolescents who sustain a concussion may manifest a variety of acute clinical findings. Discussion of the diagnosis of concussion and when to return to play will be discussed.

– Neurology Cases Studies

CARDIOVASCULAR SNAPSHOT
Arrhythmia in Children: Hop, Skip and Jump
The child with an irregular heart rhythm is a common problem that has numerous etiologies ranging from normal benign variants to malignant arrhythmias. Determining the underlying cause of an irregular rhythm is important, as it may be a life-threatening or serious condition. In most cases, the cause of an irregular heart rhythm is identified by an in-depth history, physical examination, and electrocardiogram, which can be completed by the primary clinician. We will review the top 5 cardiac arrhythmias in children.

Syncope in Children: When is it the heart?
Syncope is a sudden, brief loss of consciousness associated with loss of postural tone from which recovery is spontaneous. Up to 15 percent of children experience a syncopal episode prior to the end of adolescence Although the etiology of syncopal events in children is most often benign, syncope can also occur as the result of more serious disease with the potential for sudden death. The vast majority of cases of syncope in the pediatric age group represent benign alterations in vasomotor tone. Life-threatening causes of syncope typically have a cardiac etiology.

– Cardiovascular case studies

BREAD AND BUTTER PEDIATRICS SNAPSHOT
Bronchiolitis Management: When is Albuterol Inappropriate?
Bronchiolitis is an acute inflammatory injury of the bronchioles that is usually caused by a viral infection which is most commonly respiratory syncytial virus. Typically, this condition affects children less than 2 years old. Initially, clinical manifestations may be subtle and difficult to make the correct diagnosis, and laboratory and imaging may not be necessary. Children and infants will be managed in an inpatient or outpatient setting. Treatment for severe bronchiolitis may require a trip to the emergency department or inpatient setting. Supportive care which includes maintenance of adequate hydration, respiratory support, and monitoring disease progression and anticipatory guidance are the mainstays of management of bronchiolitis.

Acute Otitis Media Management: When are Antibiotics Indicated?
Acute Otitis Media (AOM) is the most frequent diagnosis in sick children visiting clinicians’ offices and the most common reason for administration of antibiotics. AOM occurs at all ages but is most prevalent between 6 and 24 months of age, after which it begins to decline.

The diagnosis of acute otitis media requires bulging of the tympanic membrane or other signs of acute inflammation and middle ear effusion. The choice of initial treatment with antibiotics or observation depends upon the age of the child and the laterality and severity of illness. Choice of a second line antibiotic will also be discussed.

– Bread and Butter case studies

GASTROENTEROLOGY SNAPSHOT
Pediatric Abdominal Pain: Constipation and Beyond
Abdominal pain is common in children and adolescents. The evaluation of the child or adolescent with non-acute abdominal pain requires an understanding of the pathogenesis of abdominal pain. The most common causes of abdominal pain in children and adolescents, and the typical patterns of presentation. Two major categories of causes for abdominal pain in children and adolescents are organic disorders and functional disorders. The initial evaluation will include a thorough history and evaluation and at times laboratory and imaging. Patients with alarm findings require additional evaluation for organic disorders. Treatment depends on the cause and will be directed toward the cause after evaluation of all data.

– GI case studies

ADOLESCENT SNAPSHOT
Social Media and Children: Anticipatory Guidance for Those You Take Care of Digital Natives.
Today’s youth are digital natives with a screen just a reach away. Media may have a positive or negative impact on youth. Benefits identified from the use of digital and social media include early learning, exposure to new ideas and knowledge, Risks of such media include negative health effects on sleep, attention, and learning; a higher incidence of obesity and depression. This lecture reviews the literature regarding these benefits and risks, with tips for the framed for the busy PA to deliver to patients.

Sexual Minority Youth: PA Role in Management
Sexual minority youth who are those who identify as gay, lesbian, or bisexual or who have sexual contact with persons of the same or both sexes are diverse, representing all races, ethnicities, socioeconomic statuses, and parts of the country. Many sexual minority youths may have difficulty with the transition from childhood to adulthood. Initial conversations may be made with the primary care provider. This lecture will define terminology and discuss how strategies that work and strategies that do not work when confronted with a sexual minority youth.

– Adolescent case studies


Friday, July 19

Emergency Medicine Track
Hany Atallah, MD

Epidemic Flu 2017-2018: What in the World Happened and What Did We Learn?
The 2017-2018 season one of the longest in recent years. During the 2017-2018 season, the percentage of deaths attributed to pneumonia and influenza was at or above the epidemic threshold for 16 consecutive weeks. As of August 25, 2018, a total of 180 pediatric deaths had been reported to CDC during the 2017-2018 season. This number exceeds the previous highest number of flu-associated deaths in children reported during a regular flu season. With the media aggressively covering the lethality of influenza this past season there were historically sustained surges in the emergency department (ED volumes across the country that hadn’t been seen in the past. Expectations for EDs to treat their usual high volumes plus the surge in influenza patients as well as the worried well saw innovative developments in managing surges in volume. During this presentation, the learner will understand some of the causes of the historical 2017-2018 flu season, the impact on emergency departments and will learn about novel techniques that were used to manage these surges. Finally, the learner will develop an understanding of how these techniques can be applied to sustained pandemics or epidemics.

Just Order A Through Z and Give Me A Call Back: Resource Utilization 101
U.S. health care spending grew 4.3 percent in 2016, reaching $3.3 trillion or $10,348 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 17.9%. With all this spending on healthcare, the US was last among wealthy nations in outcomes. Multiple efforts to curb spending on healthcare has been ineffective thus far. The objectives for this talk include learning about different payment models and causes for our increasing healthcare costs. Finally, the learner will understand methods of cost savings and there will also be a case discussion highlighting higher-value care for patients.

Common Clinical Errors
To Err is Human. Crossing the Quality Chasm. Reports from the Institute of Medicine that address the quality and safety of healthcare that we provide to patients in the United States. To Err Is Human documented the fact that we have substantial errors that occur in health care. It focused on hospitals and in-patient settings, and errors that lead to the death of an estimated 44,000 to 98,000 patients a year. Urgent change is warranted to address this challenge. Improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policymakers. Providers must do a better job understanding the limits of the test that they order and ensuring that these limits are incorporated into their practice to ensure that they are providing safe, effective patient care. Using case-based scenarios, the learners will understand some common clinical errors and how to ensure that risks to patients are minimized. Critical thinking skills will be discussed and how the provider can incorporate these skills into their practice.

Fixing Your Front End: Rapid Care in the ED…It Is Possible
As administrators evaluate potential approaches to improve cost, quality, and throughput efficiencies in the emergency department (ED), “front-end” operations become an important area of focus. Interventions such as immediate bedding, bedside registration, advanced triage (triage-based care) protocols, physician/practitioner at triage, dedicated “fast track” service line, tracking systems, wireless communication devices, kiosk self-check-in, and personal health record technology (“smart cards”) have been offered as potential solutions to streamline the front-end processing of ED patients, which becomes crucial during periods of full capacity, crowding, and surges. The learner will understand techniques to keep the waiting room decompressed and to ensure high quality, timely care during high volume situations.

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