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2020 Conference Session Descriptions

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Sunday, September 6

EKG 101 (Lucas)
An electrocardiogram is a reflection of the heart’s electrical activity. The EKG is one of the most commonly used tests to assess electrical and muscular functions of the heart. While this is a simple test, the interpretation of EKG’s requires a significant amount of training. This presentation will teach a standardized approach to EKG interpretation. At the conclusion of the course, the attendee will be able to identify ischemia, ST-elevation myocardial infarction, and common arrhythmias.

Cardiac Arrhythmias (Greene)
Cardiac arrhythmia refers to any abnormal heart rhythm or heart rate. Approximately 14 million people in the United States have arrhythmias, accounting for 5% of the population. The rhythm of the heart is regulated by pacemakers cells located within the SA node. An arrhythmia occurs when the rhythm becomes too slow (bradycardia), too fast (tachycardia), or irregular. This presentation will review the most common arrhythmias and discuss management and treatment. We will discuss medical therapy with anti-arrhythmics as well as indications for cardioversion.

Acute Coronary Syndrome Overview – Case Studies and Panel Discussion (Walsh)
In the United States, more than 900,000 people have a sudden cardiac death or heart attack each year. Approximately 400,000 deaths each year are attributed to acute coronary syndromes (ACS). Most of these individuals have underlying coronary artery disease. While mortality has improved, coronary heart disease still causes one-third of all deaths in those older than 35. ACS is commonly associated with unstable angina (38%), STEMI (30%), or NSTEMI (25%). This presentation will review ACS in regard to clinical presentation, pathophysiology, diagnosis, treatment, and prevention. We will also review several case studies related to patients who presented with acute coronary syndromes and discuss their presentation, workup, and treatment plans.

Heart Failure and Cardiogenic Shock (Pierce/Welji)
According to the CDC, heart failure costs the nation approximately 30.7 billion dollars each year. The cost is comprised of healthcare services, medications, and missed workdays. Most heart failure patients are initially diagnosed and treated by their primary care provider. Early recognition of heart failure can decrease mortality rates and improve quality of life. If the provider is unable to recognize the progression of the disease, these patients are at an increased risk of delayed intervention, rapid disease progression, repeat hospital admissions, and ultimately cardiogenic shock.
Following the presentations, the attendees will be able to assess and manage different types of heart failure. As part of the presentation, we will have case presentations and an interactive discussion with our expert panel of Cardiac Advanced Practice Providers (APPs).

Rapid Response Cases – A Panel Discussion (Lefeber/Lucas)
What do you do when you get called to see a patient on the floor who has an acute change in clinical status? How do you approach your patient who has a sudden drop or rise in blood pressure, a change in heart rate or rhythm, acute respiratory failure, or crushing chest pain? What are your differential diagnoses? What is your patient assessment? What data can you collect at the bedside? Do you have time to manage this patient at the bedside or do they need emergent ICU transfer? This presentation will review several rapid response cases and discuss the best way to approach these patients.

Monday, September 7

Orthopedic Track

Solutions for Hip Pain in the Young Active Patient (Deshpande)
Hip pain in the young active patient can vary from an occasional nuisance to a debilitating problem. Symptoms around the hip can present at an early age and in various forms and etiologies consisting of:

  1. Soft tissue strains
  2. Femoroacetabular impingement (FAI)
  3. Hip dysplasia
  4. Arthritis.

This lecture will focus on various solutions for treating hip pain in the young, active patient that is too young for arthroplasty but has a debilitating hip disease.

Low Energy Trauma – Management of Common Orthopaedic Injuries (Deshpande)
Trauma can occur from any injury, either high energy or low energy, resulting in enough force to cause a fracture or significant damage within the body. This lecture will discuss the evaluation and management of common low energy injury fractures, sprains, and strains that may walk into an Urgent Care clinic and /or Emergency room setting.
At the conclusion of this lecture, attendees will be proficient in recognition of common low impact orthopedic injuries.
At the conclusion of this session, attendees will be able to evaluate common low impact Orthopedic trauma injuries and manage there care appropriately.

Fractures in the Elderly – from Osteoporosis to O.R. (Deshpande)

  • Each year over 300,000 people— 65 and older—are hospitalized for hip fractures.
  • More than 95% of hip fractures are caused by falling, and the most common mechanism is usually by falling sideways.
  • Women experience over 60% of all hip fractures.
    • Women fall more often than men.
    • Women have a higher incidence of osteoporosis, making them more susceptible to fractures.
  • The chances of breaking your hip increase as your age increases

It is hard to recover from a hip fracture and the condition is often life-altering. As the U.S. population gets older, the number of hip fractures is likely to go up. This lecture will discuss geriatric hip fractures and some periprosthetic fractures. At the conclusion of this session, attendees will understand the hard facts associated with hip fractures and treatment options. Attendees will be knowledgeable in fracture treatment pharmacology and DVT prophylaxis. At the conclusion of this session, attendees will also have a better understanding of clinical treatment for osteoporosis.

Women’s Health Track

Women’s Sexual Health Trivia

Ready to test your skills on women’s sexual health trivia? The audience will be asked to participate by assembling into teams to answer questions on topics ranging from anorgasmia, vulvodynia, hypoactive sexual desire disorder, dyspareunia, BDSM/Kink, and many more! Each question will encompass a clinical case presentation and follow with a discussion on diagnosis, lab/imaging testing, and treatment plan of care.  Bring your brain for some friendly competition with prizes awarded to the winning team!  You don’t want to miss this!

Prevention and Screening: Women’s Health Guidelines Update

Let’s start with a review of the clinically important updates to cervical cancer screenings, HPV testing and guidelines, CDC STI updates, breast cancer screening for the average risk woman, contraception, and clinical pearls for well-woman visits.
We will also take a more in-depth look at prevention and screening for interpersonal and domestic violence, sexual health and incontinence concerns, and HIV.

AUB: What’s “Normal” Anyways? 

With more than half of all women experiencing abnormal uterine bleeding (AUB) at some point in their life, we will discuss the importance of understanding the normal menstrual cycle and etiologies contributing to irregularities in bleeding.
This lecture will look at common causes of AUB through the use of the PALM-COEIN classification system. There will be clinical case presentations, including diagnostic work-up and treatment strategies for review and discussion.

To MENOPAUSE and Beyond!

More and more women in the United States are entering the menopause phase of their life with a laundry list of questions and concerns related to this change.  We will look at the normal physical, hormonal and emotional changes that occur through menopause, as well as discuss appropriate health evaluations, risk assessments, screening methods, and evidence-based treatment options for women in the perimenopause, menopause, and postmenopausal stages including hormone/non-hormone therapy options.  And lastly, we will examine appropriate counseling strategies and best clinical practices that lead to positive lifestyle changes for women at menopause and beyond.


Tuesday, September 8

The Pipes are Leaking – Bleeding Disorders (Platt)
Increased bleeding and bruising are common complaints in primary care including epistaxis, menometrorrhagia, GI bleeding, and post-procedure bleeding. Preoperative assessment of the clotting system is a very common task for primary care providers. A working knowledge of the clotting system is necessary for diagnostic work-up, laboratory interpretation, and treatment of common bleeding disorders.


Dermatology Track

General Dermatology Pearls (Cheyney)
In this lecture hour, we will be taking a look at the more common skin diagnoses seen in patients.  We will be breaking the session apart with a robust acne discussion and then transitioning into the common inflammatory and infectious disease seen daily.  We will be discussing the evaluation and management of these common diseases so that you can confidently treat these patients and increase their satisfaction in your clinical skills.

Cutaneous Malignancies and Simple Procedures (Cheyney)

In this lecture hour,  we will discuss the pathogenesis of skin malignancies and take a deep dive into the management of the common skin cancers seen in a busy practice.  We will then be taking a look at the appropriate biopsy and treatment techniques with video and photo examples.  We will also take a look at the more common skin procedures that can be utilized in a primary practice to enhance patient satisfaction.  This will lead to a better understanding and increase your confidence in the management of these sometimes complex cases.

Pediatrics Track

Pediatric Respiratory Infections (Wingrove)
Children frequently present to PAs in many settings – primary care, specialty care, ER, urgent care – with respiratory complaints. It can be challenging to differentiate among the varied respiratory infections that young children can have. It is important to recognize the different presentations of respiratory infections, whether croup, pneumonia, bronchiolitis, or a common cold. This presentation will look at these and other respiratory pathologies in children with a review of diagnostic modalities and up to date treatment strategies.

Chronic Cough in Children (Wingrove)
Cough is the most common chief complaint in the United States. A chronic cough in children is defined as a daily cough lasting for 4 weeks or longer. Diagnosing the underlying cause of a cough in children can be challenging and the differential diagnosis is extensive. A chronic cough can pose significant morbidity in children with missed days of school, interruptions in sleep, and an inability to play and engage socially. It is important to be able to recognize key elements in the history to guide PAs in treating these children, and knowing when to refer. This presentation will explore the differential for chronic cough in children, including diagnostic evaluation and management.

Diabetes Track

What Do I Do After Metformin? A Review of Pharmacologic Approaches to Glycemic Treatment in Type 2 Diabetes (Butts)
30.3 million Americans live with diabetes and 84.1 million have prediabetes. Diabetes is a growing epidemic in the United States. Despite the rates of diabetes remaining high, we have a decline in endocrinologists available in the U.S. to treat the patients. Diabetes is a primary care disease. Physician assistants will be responsible for treating many people with type 2 diabetes. Individualization to care is imperative for the patient with type 2 diabetes. This presentation will focus on the 2020 ADA Standards of Care pharmacologic approaches to glycemic treatment. It will focus on helping the physician assistant to evaluate the patient to guide their decision making for treatment management.

Insulin Initiation and Intensification (Butts)
Type 2 diabetes is a progressive disease. It has been shown that beta-cell function declines with prolonged duration of disease. All or most patients may require insulin initiation and/or intensification during the disease state. Type 1 diabetes requires intensive insulin management. The decline in endocrinologists puts physician assistants at the forefront of treating type 1 and type 2 diabetes. The presentation will review how to initiate and titrate basal insulin therapy. It will also help physician assistants in how to intensify insulin therapy with prandial insulin and alternative postprandial glucose-lowering options.

 


Wednesday, September 9

Stop the Clot – Hypercoagulable States (Platt)
Hypercoagulable states can cause MIs, DVTs, PEs, and Thromboembolic strokes. AFib is one of the most common reasons for anti-coagulation therapy to prevent stokes. PAs need to know the common presentations, diagnostics, prevention, and therapy for hypercoagulable states. The pharmacology and indications of antiplatelet, anticoagulation, and thrombolytic drugs will be discussed.


Urgent Care Track

Urgent Care in A Nutshell – Part 1 & 2 (Gaylor)
Urgent care is shaking up the landscape of traditional medicine. By the year 2020, there will be nearly 10,000 urgent care centers in the United States, many of which are staffed with physician assistants and nurse practitioners. Interest in the on-demand, affordable option of urgent care continues to grow. Health care providers in this trend need the skills, tools, and strategies to make urgent care shifts as fun, safe, and productive as possible. Whether you are a newbie or a seasoned crustacean, this rapid-fire, two-hour workshop will include a wide-ranging variety of information, including the approach to the urgent care patient and why it’s such a fun, but intense specialty, and how to make it as safe as possible for you and your patients, regardless of your level of experience. We will cover hoofbeats and zebras and what that expression means in the urgent care setting, the importance of disposition and follow up and how this guides your decision making, what constitutes an emergency vs an urgency, bread, butter, and jam, how to deal with overwhelm and multitasking, and your ownership of patients, for better and for worse. We will discuss topics including the skin and its contents, we will take you back to the basics, we will address the antibiotic dance, we will remind you that sometimes a headache is a brain tumor, we will cover coughing and sneezing and buggers (oh my), heartaches, belly aches, waterworks, bones, and groans, and then there’s the fun stuff, including kids (more fun stuff), procedures, and drugs, as well as what to do when you don’t know what to do. After attending this workshop, you will leave with a toolbox full of skills and a much better understanding of the nuances and joys of urgent care medicine.

Emergency Medicine Track

What Could Go Wrong? A Differential of Right Lower Quadrant Pain (Sparkes)

In general, Abdominal pain is one of the most difficult symptoms to evaluate. As a clinician, it is important to determine the location of the pain during history taking when establishing a differential diagnosis as this will guide the continued evaluation. Abdominal pain can be classified into 3 classifications: visceral pain, parietal pain, and referred pain.

Criteria for diagnosis, management, and common pitfalls will be discussed during this lecture. At the conclusion of this lecture, clinicians will be confident in their ability to formulate a differential diagnosis and work up the patient who resents with RLQ pain.

 

I’m Feeling A Little Short of Breath – A Differential of Pulmonary Disease. Men as Minimizers and Why We Need to Interview the Wife (Sparkes)

During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing and complain of shortness of breath. Pulmonary diseases are some of the most common medical conditions in the world. Tens of millions of people suffer from pulmonary disease in the U.S. If all types of lung disease were grouped, it is the number three killer in the United States.

The term lung disease refers to many disorders affecting the lungs, such as asthma, COPD, infections like influenza, pneumonia and tuberculosis, lung cancer, and several other breathing problems. Many lung diseases can lead to respiratory failure. Smoking, infections, and genetics are responsible for most Pulmonary diseases.

 


Workshop Descriptions

Saturday, September 5

Basic Suturing (Gordon)
This workshop is designed for the practitioner who has limited training or experience in wound care and suture wound closure. Detailed discussion in basic wound care, tetanus immunization, medical glue wound closure, simple interrupted and corner stitch suture technique will begin the workshop. Participants will be provided with a basic suture instrument set to practice the suture techniques on pig feet. The instrument set will leave with the participant. Individual attention for each participant is the goal of the workshop. Participants are encouraged to join in the discussion, “there is no such thing as a stupid question.” T-shirts and shorts are suggested.

Abdominal Ultrasound (McGuigan)
Point-of-care ultrasound (POCUS) is becoming an increasingly essential component of patient care.  GAPA has partnered with SonoSite, and would like to invite you to join us for a workshop dedicated to understanding and improving diagnostic ultrasound skills. With several applications, such as aiding in local anesthetic placement, and helping determine and prevent post-operative complications, perioperativists will find POCUS to be an invaluable tool in helping provide better patient outcomes. Common perioperative ultrasound applications include hemodynamic monitoring & volume status management, identification of pericardial effusion or tamponade, detection of cardiopulmonary pathology including pneumothorax, ET Tube Placement/airway management, focused assessment of transthoracic echocardiography (FATE exam), assessment of gastric contents, evaluation of hemodynamic instability (FAST exam), and ultrasound-guided nerve blocks. Through hands-on practice sessions and question-and-answer opportunities with onsite experts, you’ll learn how the integration of point-of-care ultrasound into your practice can benefit you and your patients.

Board Review (Gilboy) (Rx=0.5)
Joe has been giving the PANCE/PANRE review class for 29 years throughout California and the country. This class will teach you how to prepare for the PANCE/PANRE and we will go over the following topics:

  1. Cardiac Pharmacology
  2.  Antiplatelets
  3. Heart Murmurs
  4. Community-Acquired Pneumonia
  5. COPD
  6. Pulmonary diseases
  7. Renal

Will go over test questions and how to approach them by doing high-quality habits

Advanced Suturing (Gordon)
This workshop is designed for the practitioner who has some experience in basic wound care and suture wound closure. Detailed discussion in techniques to include vertical mattress, horizontal mattress, buried simple suture, continuous running suture, locking running suture, staple closure, “dog ear” correction, and various defect repair techniques will begin the workshop. A special discussion on lip laceration repair will end the discussion part of the workshop. Participants will be provided with a basic suture instrument set to practice various suture techniques on pig feet. Defect repair techniques cannot be practiced on the pigskin. The instrument set will leave with the participant. Individual attention for each participant is the goal of the workshop. Participants are encouraged to join in the discussion, “there is no such thing as a stupid question.” T-shirts and shorts are suggested.

ACLS/BLS (Fullard)
Advanced cardiac life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, this course covers the key changes in advanced cardiovascular life support, reflecting the 2018 American Heart Association Guidelines. Basic life support skills, including effective chest compressions, use of a bag-mask device and early management of respiratory and cardiac arrest Recognition and early management of per-arrest conditions such as symptomatic bradycardia BLS with ALS has the availability of improving survival outcomes in cardiac arrest. This course will be reviewing changes in 1 &2 rescuer CPR, adult, child, and infant. As well as use of the AED and FBOA.

Clinical Skills In the Acute Care Setting: Includes HEENT, Dental (Gordon)
This workshop is designed for the practitioner who has limited experience in the various skills to diagnose and treat conditions in the acute care setting. Detailed discussion to include instruments and techniques to address these conditions will begin the workshop. Conditions such as foreign body in the ear, otitis media, bullous myringitis, cerumen impaction, Bell’s Palsy, epistaxis, nasal packing, septal hematoma, peritonsillar abscess, Ludwig’s Angina, dental abscess, various nerve blocks, local anesthesia issues, abscess treatment, ring removal, auricular hematoma drainage, indirect inguinal hernia reduction, ingrown toenail treatment, fish hook removal, paronychia drainage, wrist ganglia aspiration and injection, Bartholin gland abscess, reduction of rectal prolapsed, penis foreskin in zipper treatment, are all part of the agenda. Hands-on practice will be included for specific conditions. Participants are encouraged to join in the discussion, “there is no such thing as a stupid question”

Ortho Exams: Knee, Ankle & Upper Extremities (Vacala) (Rx=0.25)
It is essential to perform an accurate Orthopedic exam and formulate a comprehensive differential diagnosis. Clinicians must be able to evaluate, assess and formulate a differential diagnosis efficiently and effectively in order to expedite management options and treatment plans. This workshop will be a hands-on workshop demonstrating and explaining basic evaluation techniques for the knee, ankle, and shoulder joints. Participants will be proficient in their ability to accurately diagnose the most common orthopedic injuries upon completion of this workshop. Please wear shorts and tank tops to allow for hands-on partner exams.


Sunday, September 6

Joint Injections (Vacala)
Basic injection and aspiration techniques are a MUST for clinicians. Patients routinely present with effusions, hemarthrosis, and unknown causes of swollen tender joints. Clinicians have to be confident and capable of aspirating joints to ensure that the effusion is not a septic joint or a more ominous diagnosis.
This workshop will discuss at length the indications and contraindications for joint injections and aspirations. Various techniques for shoulder, knee, elbow, ankle and foot will be presented in detail. Clinicians will be confident and proficient in these techniques at the conclusion of this hands-on workshop.
Anatomical models will be provided for hands-on practice sessions.


Monday, September 7

Basic Fractures & Splinting in the Acute Care Setting (Vacala)
“This Basic Course is designed to provide the participant with a fundamental knowledge of clinical treatment of fractures. Fracture management can be divided into nonoperative and operative techniques. The nonoperative approach consists of a closed reduction if required, followed by a period of immobilization with casting or splinting. Closed reduction is needed if the fracture is significantly displaced or angulated. Pediatric fractures are generally much more tolerant of nonoperative management, owing to their significant remodeling potential. Nondisplaced fractures all require a period of healing that may or may not involve cast care. In this time of aggressive operative treatment, only simple nondisplaced fractures of long bones or joints may be treated with nonoperative cast care; the rest are treated with emergency operative care so as to allow for early motion to prevent stiffness of adjacent joints. This course will cover basic Non-operative fracture x-ray management utilizing X-rays and casting/splinting. Attendees will have an opportunity to practice putting on splints and one cast each.


Tuesday, September 8

PALS/BCLS (Fullard)
The PALS Course is for healthcare providers who respond to emergencies in infants and children. PALS covers 1- and 2-rescuer child CPR and AED use 1- and 2-rescuer infant CPR Cardiac, respiratory and shock case discussions and simulations Key changes in pediatric advanced life support, reflecting the new science from the 2018 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Management of respiratory emergencies Resuscitation team concept Rhythm disturbances and electrical therapy Systematic Approach to Pediatric Assessment Vascular access. BLS provided in the field increases the time available for higher medical responders to arrive and provide ALS care. An important advance in providing BLS is the availability of the automated external defibrillator or AED. This improves survival outcomes in cardiac arrest. This course will be reviewing changes in 1 &2 rescuer CPR, adult, child, and infant. As well as use of the AED and FBOA.

Night Shift In The ED: Case-Based Radiology
This workshop is designed to discuss various cases requiring x-rays encountered in the ED or acute care setting. A brief discussion on normal anatomy will begin the workshop. Cases will be presented, participants encouraged to suggest x-rays necessary for diagnosis then results discussed. Cases presented will include chest, abdomen, face, neck, shoulder, pelvis, femur, knee, tibia/fibula, ankle, foot, elbow, radius/ulna, wrist, hand. Films presented will include “perfect” to “suboptimal” such as encountered in the real world. Discussion on how to present the findings found will encourage the participants to polish their skills when consulting with their peers.

MSK Ultrasound (McGuigan)
GAPA has partnered with SonoSite, and would like to invite you to join us for a workshop dedicated to understanding and improving diagnostic ultrasound skills. This course is designed for the novice wishing to focus on diagnostic, rather than guided injection ultrasound techniques. Diagnostic ultrasound is noninvasive and offers real-time imaging, allowing for examinations of structures at rest and in motion. This ability to capture the movement of musculoskeletal components differentiates it from other imaging modalities and can permit diagnoses that are more accurate. Other advantages for your patient include its portability, which allows for point-of-care application and interpretation. Through hands-on practice sessions and question-and-answer opportunities with onsite experts, you’ll learn how the integration of point-of-care ultrasound into your practice can benefit you and your patients.

 

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