Shame is a ubiquitous human emotion that there are not many conversations about.  Shame is a corrosive emotion that can inhibit our growth in medicine.  In medical learners, shame was associated with disengagement with learning, impaired empathy, diminished psychological and physical wellness, reduced self-regulation, and unprofessional behavior.  Since medicine is ever evolving, PAs continue to learn throughout their career along with interacting with students.  Understanding shame vs guilt can help us navigate our own careers as well as help our colleagues navigate successfully through the landscape of medicine.  

By the end of this session, attendees will be able to: 

1. Define and contrast shame and guilt.
2. Understand why we have shame and why is it important.
3. Identify what a shame reaction encompasses. 
4. Tips to help with the growth of ourselves and learners in medicine by understanding and navigating shame.

This is a review of the management of three common pediatric illness visits.  At the end of this presentation, participants will be able to: 

1. Identify the pathology of three of the most common viral processes in the pediatric population--RSV, Flu and HFM.
2. Recognize hallmark symptoms and physical exam findings in these common viruses. 
3. Familiarize themselves with different management techniques and currently accepted treatment options for the pediatric population affected by these viruses.

This is a lecture that will cover the recent chest pain guidelines update and what EKG findings are now STEMI equivalents and what findings need emergent cath. This is designed for any practice setting who has chest pain complaints.

1. Recognize Dewinters T waves on the EKG and why they are dangerous.
2. Identify Wellens T waves and what they mean. 
3. Describe the 5 findings that will be read as nonspecific but mean that there is a left anterior descending artery occlusion. 

Continuous Glucose Monitoring is making a big impact on diabetes care – and patient outcomes. Learn more about the practicalities of bringing CGM into your practice and making it work for your staff, your colleagues, and your patients. At the end of the presentation, participants will be able to:

1. Prepare the clinical practice for CGM. 
2. 2Understand options available to the practice for professional and personal CGM. 
3. Locate and interpret CGM data, using the Ambulatory Glucose Profile (AGP) to assess if the patient is achieving targets established by the International Consensus on Time in Range. 
4. Modify the treatment plan based on CGM data to improve patient outcomes.

Obesity is a complex, multifactorial chronic condition. Forty percent of US adults are living with obesity. It has been correlated with 6 of the 10 top causes of death in industrialized nations and impacts the lives of 2 of every 3 patients a PA will see. Stigma against fat individuals impacts health outcomes and must be addressed to successfully care for all our patients.  At the end of this activity, participants will be able to:  

1. Discuss prevailing evidence about the clinical treatment of obesity 
2. Define obesity stigma and discuss its impact on health outcomes for fat patients
   1. Identify evidence-based best practices for treating obesity while destigmatizing care

Basic overview of common fracture vocabulary, identification and treatment options.  At the end of this session leaners will be able to: 

1. Evaluate radiographs for potential fractures.
2. Accurately describe a fracture to someone who cannot visually see the radiograph in question.  
   1. Identify the types of fractures thta can be treated non surgically and what types require further referrals/evaluations beyond ED/PCP/urgent care settings.

Restless Legs Syndrome (RLS) is easy to miss and easier to misdiagnose. This can lead to years of misery and frustration for both the patient and their healthcare team. Why aren't they better since treating their sleep apnea? Why aren't the sleep pills or stimulants helping? Why can't we catch a break in helping this person feel better? In this lecture you'll learn ways to keep RLS from sneaking past you in clinic, while increasing your management confidence for this twitchy sleep disorder.  At the end of this lecture, attendees will be able to: 

1. State how Restless Legs Syndrome is different from Periodic Limb Movement Disorder (PLMD).
2. Discuss testing recommendations in the setting of suspected or confirmed RLS/PLMD.
3. Use patient-centered factors to assist in choosing a pharmacologic agent for treatment of RLS/PLMD.
4. List nonpharmacologic strategies which may benefit the patient with RLS/PLMD.

Review the differences b/w OA and RA as well as other inflammatory arthritides.  At the end of this session the learner will be able to:  

1. Understand the term "arthritis" and what entities fall under this umbrella, including their similarities and differences.
2. Complete a basic evaluation of someone with joint complaints and order appropriate diagnostics.
   1. Initiate a treatment plan or appropriate referral for someone with joint complaints.

Chronic kidney disease (CKD) represents a substantial health burden for a sizeable proportion of the US population. Nearly 40 million adults are estimated to be affected. Despite advances in strategies for managing patients with CKD, many patients still have residual risk of kidney disease progression and elevated cardiovascular risk. Newer therapies for CKD and DKD, including sodium-glucose cotransporter-2 (SGLT-2) inhibitors and nonsteroidal mineralocorticoid receptor antagonists (MRAs), have recently been incorporated into evidence-based guidelines, representing substantial shifts in the treatment paradigm.

At the end of the presentation, participants will be able to: 

1. Detect and recognize CKD in patients with reduced kidney function to improve opportunities for early intervention. 
2. Implement screening for albuminuria in patients with diabetes in clinical practice to identify CKD as early as possible. 
3. Initiate therapy with evidence-based therapies, including SGLT-2 inhibitors and nonsteroidal MRAs, for patients with DKD when indicated. 
4. Compare and contrast differences between steroidal MRAs and nonsteroidal MRAs, including physiologic effects, therapeutic indications, and clinical outcomes.

The vast majority of primary care practitioners treat patients with pain. Acute pain is generally understood to have a specific cause, frequently injury or surgery, and can often resolve itself when underlying causes are addressed, usually in less than six months. That said, when left untreated, or treated outside of established guidelines, acute pain can easily turn into chronic pain, lasting years or more. Opioids had, until recent years, been the most-prescribed treatments for acute pain, and while clearer understandings of the dangers of opioid misuse and abuse have led to fewer prescriptions of this class of drugs, prescribers have been less aware of current guidelines for recommended therapies, including opioid agonists and non-steroidal anti-inflammatory drugs (NSAIDs).  At the end f this lecture, attendees will be able to: 

1. Recognize and diagnose acute pain. 
2. Understand the history and challenges of acute pain management. 
3. Use newer therapies for acute pain management.

This will be an update on OTP Legislation.  Attendees will: 

1. Learn about where NC is with its OTP initiative.
2. Learn how PAs and NPs can stay current on new legislation and regulations.
3. Learn how PAs and NPs can stay compliant with state laws and regulations.

This is a review of STI presentations and treatments.  At the end of this lecture, attendees will be able to:

1. Identify five most commonly diagnosed STIs in the US (chlamydia, trichomoniasis, HSV, HPV, gonorrhea.
2. Review risk factors for and presentation of these STIs.
3. Apply screening guidelines for these STIs. 
4. Apply current treatment guidelines of these STIs. 
5. Locate resources for monitoring screening and treatment guidelines. 

According to an emerging body of literature, there is an increased prevalence of burnout among PAs. Furthermore, the unprecedented challenges related to the COVID-19 pandemic have only exacerbated feelings of burnout, resulting in the increased risk of having a negative impact on patient care. The purpose of this presentation is to discuss the recent trends and causes of burnout among PAs and describe the current strategies employed to decrease burnout and improve well-being. Additionally, the presentation will highlight the importance of financial literacy as an intervention for combatting provider burnout. Participants will leave with strategies to improve financial literacy by recognizing reputable resources.  At completion of this session, learners will be able to: 

1. Identify emerging trends of burnout among providers and the related consequences to patient care. 
2. Describe current strategies to address provider burnout and well-being. 
3. Discuss how financial literacy can be utilized as an intervention for decreasing burnout among providers.
4. Develop strategies to improve financial literacy by recognizing reputable resources.

This lecture will include how to correct common coding misnomers, a review of how to appropriately chart and document.  Information on Coding Challenges that have been published for Evidence-Based Urgent Care online journal and the Journal of Urgent Care Medicine will also be shared.  At the end of this lecture, attendees will be able to:

1. Correct common coding errors.
2. Appropriately chart and document you office notes.  
3. Identify what is Modifier 25 and when to use it. 
4. Document Laceration Repairs. 

Nephrotic vs nephritic is every PA student’s nightmare. And most PA-Cs do not like it either! And yet, nephrotic syndrome is out there and very often missed in primary care. When it is easy to catch, it should be on every differential and is the number 3 cause of kidney failure after diabetes and HTN. Using a series of real-life cases makes the trip through GN a fun ...and funny trip. Join us as we travel through the wilds of nephrotic, nephritic and glomerulonephritis.  At the end of this session, learners will be able to: 

1. Identify and explain nephrotic vs nephritic.
2. Review and identify incidence of glomerulonephritis diseases including how to diagnose.
3. Using cases, identify and review each type of GN. 

ost-COVID conditions can include a wide range of ongoing health problems that can last weeks, months, or years. Clinicians in all arenas need to learn to recognize signs and symptoms as well as assist patients in dealing with these conditions.  At the end of this lecture, attendees will be able to: 

1. Describe the impacts of post-COVID conditions.
2. Discuss the diagnosis of post-COVID conditions.
3. Develop treatment plans for patients with post-COVID conditions.  

This lecture will consider the physiology of menopause, indications and contraindications for pharmacologic management, and treatment modalities. At the conclusion of this presentation, the attendee will be able to:

1. Discuss the significance of the Women's Health Initiative on the approach to management of menopausal symptoms.
2. List contraindications to hormonal treatment of menopausal symptoms.
3. Describe hormonal and non-hormonal methods of management of menopausal symptoms.

This lecture serves as an introduction to aid learners in differentiating hyponatremia in both the inpatient and outpatient setting based on history, exam, and lab work up. Afterwards, we will discuss guideline directed treatment options for different types of hyponatremia and common pitfalls.  At the end of this session attendees will be able to:

1. Differentiate hyponatremia based off history, exam, and lab work up.
2. Understand the role of ADH in maintaining fluid and electrolyte homeostasis.
3. Discuss common treatment options for hyponatremia.
   1. Understand how to prevent osmotic demyelination syndrome while treating hyponatremia. 

Presenting guidelines about prescribing benzodiazepines in the inpatient and outpatient settings, with review of pharmacologic concepts.  By the end of this session, attendees will be able to: 

1. Recognize the pharmacodynamics and pharmacokinetics of benzodiazepines. 
2. Interpret current literature around prescribing controlled substances in North Carolina. 
3. Articulate best practices for prescribing and monitoring benzodiazepines. 
4. Clarify the use of benzodiazepines in the in-patient setting. 

The incidental discovery of suspected fatty liver disease based upon routine laboratory results and/or imaging is one of the most common reasons for primary care referrals to Gastroenterology specialists. With increased knowledge on how to exclude additional hepatic disease as well as potential complications and monitoring parameters, many cases of fatty liver disease can be managed within the spectrum of primary care, resulting in decreased emotional and financial burden on patients.  At the end of this session, attendees will be able to: 

1. Recognize risk factors for the development and progression of fatty liver disease, including both alcoholic and non-alcoholic etiologies.
2. Discuss the approach to diagnostic testing to further evaluate potential fatty liver as well as exclude other underlying hepatic pathology.
3. Review indications which warrant referral to a specialist.
4. Summarize the most important aspects of patient education as it relates to the improvement and prevention of progression of fatty liver.

Discuss the pathophysiology and common risk factors for Parkinson disease (PD).  Highlight the typical clinical features (motor and nonmotor), key exam components and findings to establish and/or support the diagnosis of PD. Review the management, including DBS, discuss the common side effects and adverse effects of the medications and briefly discuss common complications of PD.  Attendees will: 

1. Discuss the pathophysiology and risk factors for  Idiopathic Parkinson Disease.
2. Recognize the typical clinical presentation and review essential physical exam skills to support the diagnosis of Idiopathic Parkinson disease.
3. Discuss the management of Idiopathic Parkinson disease.

This comprehensive lecture will delve into the latest recommendations on high cholesterol, hypertension, smoking cessation, and diabetes. Get insights into primary and secondary prevention of cardiac risk factors, discover the major risk factors behind first myocardial infarction, and learn about the best practice clinical application of society recommendations.  Attednees will: 

1. Understand how pretest probability assists us in patient care (Bayes’ Theorem.)
2. Review the diagnosis of hypertension, secondary hypertension and first line medications.
3. Understand the diagnostic criteria for diabetes (NIDD) as well as initial medications.
4. Review the evidence for optimizing a patient quitting smoking.
5. Evaluate hypercholesterolemia and treatment options.

Emerging data surrounding SGLT2 inhibitors and MRAs exists, but uptake remains low. This talk will discuss the current clinical evidence and supporting guidelines.  At the end of this session, attendees will be able to: 

1. Identify gaps in current treatment of cardiovascular disease.
2. Discuss the pharmacokinetics of SGLT2 inhibitors and MRAs.
3. Discuss latest guidelines and emerging data surrounding SGLT2 inhibitor and MRA utilization.
4. Develop new clinical strategies to help their individual patients with cardiovascular disease and CKD associated with type 2 diabetes mellitus.

An overview of the future value artificial intelligence (AI) holds for improvement in healthcare system processes and outcomes with a focus on clinical problem solving.  At the end of this activity, attendees will be able to: 

1. Recognize the problem-solving value of AI in healthcare.
2. Evaluate opportunities for AI within the clinical context.
3. Discuss the different categories of AI available for application in the healthcare setting.
4. Analyze introductory principles of machine learning design and applications for healthcare.
5. Examine the components of AI deployment and the regulatory process for AI implementation.

Isolated neutropenia is a common laboratory finding encountered on a patient's CBC across all ages.  The causes vary from transient or benign to serious systemic diseases.  The extent of the work up and ultimately the need for intervention requires a systematic approach to patients with findings of isolated neutropenia.  In this session we will review some of the various etiologies of neutropenia across the lifespan. This will include an in-depth review of congenital and acquired causes.  Participants will develop increased confidence about appropriate referrals for neutropenia as well as the acuity of the evaluation.  We will conclude by discussing the treatment of various etiologies of isolated neutropenia, including growth factors and chemotherapy. At the end of this session participants will:

1. Have increased confidence in building an appropriate differential diagnosis for a patient presenting with isolated neutropenia.
2. Develop a systematic work-up and disposition for patients that present with new onset neutropenia.
3. Recognize the appropriate referral criteria and urgency of referral to hematology. 
4. Increase understanding of some of the most commonly used agents in treating isolated neutropenia including nutritional replacement, antibiotic prophylaxis, growth factors, and chemotherapy.   

Thirty Million Americans, and 400 million people world wide have COPD.  Yet half of them have never been diagnosed.  How can this be the 3rd most common chronic condition, 3rd leading cause of admission, and 3rd leading cause of death, ... yet be hidden in plain site.  Healthcare providers on the front lines have the opportunity to ask the question, 'Could this be COPD?', and crack the code on the invisible epidemic.  At the end of this activity, learners will be able to: 

1. Recognize patients at high risk for COPD
2. Iidentify screening tools and methods to confirm their index of suspicion.
3. Lead a 'find the missing millions' in their place of service.
4. Advise patients where they should or could go next for confirmatory testing, and more information.
5. Identify social determinants of health that predispose patients to the risk of COPD.

Colon and rectal cancers (CRC)  remains the fourth most commonly diagnosed cancer in the United States with over 150,000 new cases diagnosed each year. While observed rates of new cases in older individuals has decreased in recent years, there has been an unusual increase in the rate of CRC in people under the age of 50. In this lecture we will look at CRC from screening to survivorship.  We will begin by reviewing the most recent guidelines for screening as well as examining risks factors and possible explanations for the rise in CRC in younger patients. We will review the similarities and differences for diagnosing and staging colon vs. rectal cancers. We will discuss treatment modalities by stage for each process, including a brief review of the most common chemotherapeutic agents employed for advanced disease. We will conclude the session by looking at some of the most common issues that arise during the survivorship period and their respective treatments. At the end of this session participants will: 

1. Be able to apply the most recent USPSTF guidelines for colorectal cancer screening in individual at average and high risk for colorectal cancer. 
2. Become more familiar with some of the more commonly named reasons that colorectal cancer rates are rising in adults under 50.  
3. Appreciate the differences in the work up for a newly diagnosed colon vs. rectal cancer as well as the differences in treatment for advances disease.  
   1. Develop treatment plans for commonly encountered survivorship issues including: chemotherapy induced neuropathy, bowel dysfunction, and body image issues associated with the creation of an ostomy.  

Discuss the typical clinical presentation of Streptococcal pharyngitis. Review some life-threatening conditions that may present with the symptom of sore throat. Summarize the physical exam findings, diagnostic evaluation, and management of the medical conditions covered.  Attendees will: 

1. Discuss the typical presentation of Streptococcal pharyngitis.
2. Review some life-threatening conditions that may present with the symptom of sore throat.
3. Summarize the typical clinical exam findings and exam findings of some life-threatening conditions presenting with the symptom of sore throat.
4. Summarize the diagnostic approach when suspecting some life-threatening condition presenting with the symptom of sore throat.

This lecture will provide an overview of the history of illicit substance use and abuse in the United States, especially within the adolescent population.  It will then explore common myths and contradictory reality of adolescent substance use and abuse. The lecture will examine the morbidity and mortality rates of adolescent substance use and also the abuse of adult-legal substances.  It defines several terms used when discussion and evaluating abuse and addiction.  The lecture provides several tools clinicians can use to identify adolescent addiction behavior and aid in recovery and discussion of what providers can do if they suspect use or abuse history in their patients. Finally, there is a review the effectiveness of substance rehabilitation treatment.  Objectives include: 

1. Briefly inspect the history of US illicit drug use, substance use vocabulary, and terms. 
2. Explore the myths and reality of adolescent substance use and abuse.
3. Examine the morbidity and mortality rates of adolescent substance use and abuse of adult-legal and illicit substances. 
4. Explain the tools clinicians can use to identify adolescent addiction behavior and aid in recovery.
5. Review the effectiveness of substance rehabilitation treatment.