Heat-related illness is on the rise. As record-breaking temperatures become the norm due to climate change, PAs in acute and primary care settings will more frequently encounter patients with heat-related conditions – from mild to deadly. This session will use memorable cases to cover the evidence-based fundamentals of diagnosis and management of conditions related to extreme heat, paying special attention to effects on vulnerable populations and practical approaches to patient education.  Objectives include:

1. Describe trends in heat-related illness, including effects on vulnerable populations. 
2. Compare features of systemic heat-related conditions and select a treatment plan for each. 
3. Differentiate the clinical presentations and management of heat-related dermatologic conditions. 
4. Provide effective patient education on heat-related illness, including prevention and when to seek medical care.

Chronic shortness of breath is a subjective clinical challenge causing frustration for both patients and their healthcare team. Dyspneic patients are not limited to a single etiology for their dyspnea. In this lecture, we’ll discuss a few of the top causes of chronic dyspnea and the rationale behind the common tests ordered to evaluate it. We will also discuss common diagnostic & therapeutic pitfalls and how to empower patients with non-pharmacologic tools to improve their ability to feel less breathless. Objectives include:

1. Summarize the association between socioeconomic status and current trends in dyspnea prevalence. 
2. List at least 3 common causes of chronic dyspnea. 
3. State the rationale for initial diagnostic tests used in the evaluation of chronic dyspnea. 
4. Discuss nonpharmacologic measures for the symptomatic management of chronic dyspnea.

This goal of this presentation is to describe an algorithmic approach to caring for the patient presenting with heartburn and reflux, including empiric treatment with acid-suppression therapy and a refined, data-driven approach to diagnostic testing. This presentation will also review the efficacy and safety profile of the widely available and commonly used proton pump inhibitors. Refining our approach to diagnostic testing provides the opportunity to decrease time to diagnosis, decrease cost of care, better control our patient’s symptoms, and limit complications of longstanding disease. Objectives include: 

1. Explain current practice guidelines for the diagnosis and treatment of gastroesophageal reflux disease.
2. Recognize diagnostic tools available to investigate the etiology for heartburn and reflux including EGD and pH catheters.
3. Review evidence-based lifestyle modifications for those with heartburn and reflux.
4. Identify pharmacologic therapies available for treating acid reflux including proton pump inhibitors, histamine receptor antagonists, and antacids.
5. Utilize strategies to reduce cost of care in individuals with chronic heartburn and reflux.

This lecture discusses how seemingly innocuous injuries in very young children are strongly correlated with more serious occult injuries from abuse, and/or precede escalating and potentially fatal abuse in the future. The lecture will also discuss how medical providers can use a validated decision-making tool when assessing injuries in these young children. In addition it will address how providers can acknowledge their explicit and implicit biases and work to prevent these from affecting their decision to act in these difficult situations.

This lecture will provide an evidence based approach to acute and chronic rhinosinusitis that also considers the nonmedical factors that influence health outcomes in order to reduce the economic impact on our patients and healthcare system.  Objectives include: 

1. Discuss the difference between viral rhinosinusitis, acute bacterial rhinosinusitis and chronic rhinosinusitis.
2. Describe an evidence approach for the use of medications in treatment of viral rhinosinusitis, acute bacterial rhinosinusitis and chronic rhinosinusitis.
3. Recognize the non-medical factors (SDOH) associated with viral rhinosinusitis, acute bacterial rhinosinusitis and chronic rhinosinusitis that may influence patient outcomes.

We will evaluate the expanded differential for pelvic pain and why sex may hurt for women.  We will go through this with a region based approach discussing diagnoses and treatment options.  We will also discuss the experience of Black women and how their pain is regarding in the medical community. Objectives include: 

1. List an inclusive differential for pelvic pain based on the 5 regions.
2. Explain the pathophysiology of hormonally mediated vestibulitis.
3. Evaluate the healthcare experience of Black women seeking help for pelvic pain.

Sleep is as important for good health as diet and exercise. Quality sleep improves brain performance, mood, and health. Not getting enough quality sleep regularly raises the risk of many diseases and disorders ranging from heart disease and stroke to obesity and dementia. Adults ages 18 and 64 need seven or more hours of per night. Adults ages 65 or older need seven to eight hours. More than one-third of U.S. adults average less than seven hours of sleep per night. PAs and NPs are often the first line in recognizing and treating sleep disorders through medications and lifestyle interventions. Objectives include:

1. Discuss the need for sleep.
2. Identify socioeconomic impacts on sleep.
3. Describe methods for evaluation of sleep.
4. Compare and contrast sleep medications.
5. Discuss lifestyle interventions to improve sleep. 

With the introduction of new CKD staging (without the race modifier), KDIGO has released all new guidelines! New HTN goals, new testing and management of albuminuria, new diabetes guidelines, and new CKD medications. One in 3 of your patients is at risk for CKD; do you know who they are?  Come to Kidney Disease Update for 2024 to learn how to identify and manage CKD for the 21st century!  Objectives include: 

1. Define stages of CKD highlighting the removal of race in the eGFR calculator.
2. Review urinary testing needed to both stage and predict progression of CKD.
3. Discuss new KDIGO guidelines for management of CKD patients with a goal to slow disease progression.

Diabetes mellitus (DM), cardiovascular disease (CVD), and chronic kidney disease (CKD), collectively referred to as cardio-renal-metabolic diseases, are associated conditions with intertwined clinical outcomes. Despite advances in management of patients with cardio-renal-metabolic conditions, significant knowledge and care gaps exist. Primary care practitioners (PCPs) are uniquely positioned to diagnose and treat these conditions and can be instrumental in reducing cardiometabolic risk.  Objectives include: 

1. Identify CKD in patients with reduced kidney function, including in early stages of disease. 
2. Describe the link between DM and CVD, including the impact on health outcomes.
3. Select appropriate treatment for patients with DM, CVD, and/or CKD/DKD based practice guidelines and clinical evidence. 
4. Recognize the importance of multidisciplinary care when managing patients with cardio-renal-metabolic conditions.

Fragility fractures are a significant public health concern, often overlooked or misdiagnosed, but their impact on patients’ quality of life can be profound. This presentation is designed to shed light on this epidemic by emphasizing the importance of a collaborative, multidisciplinary approach to fragility fracture care, to ensure patients receive comprehensive and timely support and improve patient outcomes.  Objectives include: 

1. Define fragility fractures and review the incidence, causes and risk factors.
2. Recognize the signs and symptoms of fragility fractures and understand the importance of early detection.
3. Discuss the importance of timely referrals and implementing a collaborative, multidisciplinary approach aimed at reducing complications associated with fragility fractures.
4. Evaluate the relationship between low socioeconomic status and the increased risk of fragility fractures.
5. Integrate knowledge of fragility fracture recognition and management into clinical practice to improve patient outcomes.

Review the risk factors, epidemiology, and pathophysiology of PAD. Review some health disparities in PAD. Discuss the typical signs, symptoms, and physical exam findings of PAD. Discuss the diagnostic evaluation and the management of PAD.  Objectives include: 

1. Discuss the risk factors, epidemiology, and pathophysiology of peripheral arterial disease.
2. Discuss the typical clinical presentation and diagnostic evaluation of Peripheral arterial disease.
3. Review some key points on health disparities in peripheral arterial disease.
4. Summarize the management of Peripheral arterial disease.

Managing depression and anxiety in the elderly population can be challenging due to the presence of multiple comorbidities. Learning pearls about psychiatry medication options can facilitate better pharmacologic selection and lessen risks for adverse side effects.  Objectives include:  

1. Identify how Social Determinants of Health impact our geriatric population.
2. Recognize depression and anxiety in the geriatric population and describe some screeners commonly used.
3. Discuss how to choose a psychotropic medication by reviewing the benefits and risks of various commonly used pharmacological agents.
4. Review pertinent labs and tests that may be necessary when treating this population.

This is a high risk EKG session using a case based review.  Objectives include: 

1. Recognize bradycardia that needs to be treated with a pacemaker. 
2. Develop a system to approaching reading EKG's to not miss the high risk findings.
3. Describe the 5 NEW STEMI Equivalents.

This is a two-part lecture that examines and presents multiple aspects of the discipline of dermatology for knowledge and application for the non dermatologist clinician.  Objectives include: 

1. Review basic dermatological terminology and anatomy.

2. Illustrate appropriate examination skills and techniques for routine evaluation of skin, hair, and nails.

3. Assess signs and symptoms for identifying cutaneous skin lesions and need for referral.

4. Compare common procedural dermatology techniques for diagnostic and management of common skin lesions and rashes.

5. Apply culturally sensitive patient assessment techniques in evaluating skin of color and different ethnic groups and identify health care inequities based upon ethnicity.

Case study discussion of differences between PTSD, complex PTSD and developmental trauma and the intricacies of optimal treatment approaches. Objectives include: 

1. Learner will be able to correctly identify and diagnose the difference between PTSD, complex PTSD and developmental traumas for optimal treatment and collaborative treatment approaches.
2. Be able to recognize and distinguish adverse child events as they relate to common psychiatric disorders such as oppositional defiance disorder (ODD), ADHD, major depressive disorder (MDD), anxiety disorders, impulsivity and conduct disorders (CD), substance use disorders and more. 
3. Identify populations at greatest risk for adverse childhood events; lower socio-economic, undereducated and single-parent family homes and/or gender-diverse, transgender individuals, ethnoracial minorities.

This lecture will explore the unique dynamics at play for child sexual abuse (CSA) Attendees will explore how PAs can be prepared to recognize risk for CSA, respond to a disclosure, and support victims and their families. As an Adverse Childhood Experience (ACE), CSA has the potential to negatively impact a child’s life well into adulthood. This lecture will explore the interplay between CSA and social determinants of health, and how PAs can promote prevention efforts.  Objectives include: 

1: Define child sexual abuse (CSA).

2. Discuss how child sexual abuse differs from sexual assault.

3. Explain how and why children disclose or fail to disclose CSA.

4. Explain how to respond to a child's disclosure.

5. Identify social determinants of health that are related to an increased risk of CSA.

Cancer health disparities persist in both cancer incidence and outcome. Multiple factors contribute, including socioeconomic, socio-environmental, behavioral, and biological. Additionally, increasing amounts of evidence underscore the contribution of comorbidities, chronic social stress, and even the microbiome may contribute to health disparities in cancer risk and survival.  In this lecture we will examine disparities and associated factors in the most common cancer types (breast, prostate, lung and colon).  Cancer treatment outcomes, enrollment in clinical trials, and quality of life among cancer survivors will also be discussed thru the lens of health equity.  Finally, we will focus on the role that advanced practice providers can have in addressing cancer health disparities regardless of specialty.  This session is best suited for all patient facing practitioners and those who participate in clinical research.  Objectives include: 

1. Develop increased awareness of the disparities that exist regarding the diagnosis, treatment, and outcome of common cancer types.
2. Explain how the lack of participation in clinical trials has created barriers to effective treatment for diverse/minority populations. 
3. Appreciate that racial and ethnic minority cancer survivors experience a disproportionate burden of the adverse effects of cancer and cancer treatment.  
4. Devise at least one actionable task they can take in their own practice to address the structural, environmental, or institutional factors that contribute to cancer health disparities.

This lecture will provide a survey of infectious diseases that are emerging (or reemerging) in the US. Objectives include:

1. Describe multiple infectious diseases that have newly emerged in the US or reemerged as threats to the public.
2. Identify the following as emerging or reemerging diseases in the US.
3. Address the diagnosis and treatment of these new and reemerging diseases.
4. Discuss the role of social determinants of health such as poverty, suboptimal housing, poor sanitation, and differences in rates of vaccination on the prevalence of new and reemerging infectious diseases.

This lecture will discuss lipid management in high risk patients to include the use of newer therapies like PCSK9 inhibitors.  Objectives include: 

1. Discuss current lipid guidelines as they pertain to at risk groups.

2. Discuss current therapy options to treat high LDL cholesterol.

3. Identify care gaps among high risk patients.

4. Develop new strategies for clinicians to implement the most effective therapies to treat high risk ASCVD patients.

This is a two-part lecture that examines and presents multiple aspects of the discipline of dermatology for knowledge and application for the non dermatologist clinician.  Objectives include: 

1. Review basic dermatological terminology and anatomy.

2. Illustrate appropriate examination skills and techniques for routine evaluation of skin, hair, and nails.

3. Assess signs and symptoms for identifying cutaneous skin lesions and need for referral.

4. Compare common procedural dermatology techniques for diagnostic and management of common skin lesions and rashes.

5. Apply culturally sensitive patient assessment techniques in evaluating skin of color and different ethnic groups and identify health care inequities based upon ethnicity.

This lecture will include the epidemiology and common risk factors of Osteoporosis.  It will summarize some of the social determinants identified to reduce health disparities and improve screening and care, clinical evaluation focusing primarily on the DXA/DEXA test, and outline the management of osteoporosis.  Objectives include: 

1. Discuss the epidemiology of Osteoporosis

2. Identify the common risk factors for the development of Osteoporosis

3. Recognize some social determinants to reduce health disparities in screening and management of Osteoporosis.

4. Discuss the clinical evaluation focusing on Dual X-ray Absorptiometry tests scans.

5. Summarize the treatment options to manage Osteoporosis.

Anemia is encountered in all areas of medicine. It is important to know how to identify anemia and how to best approach it in the specific field of medicine you are practicing. This lecture aims to provide an overview of anemia and how to approach it from a general practitioner's standpoint. This is done through real life case studies to engage the viewer and apply the textbook information into clinical practice. It also aims to help providers identify when a formal hematology evaluation is needed.  Objectives include:

1. Discuss how to identify anemia

2. Discuss the various causes of anemia

3. Discuss typical laboratory and clinical findings

4. Identify various treatment options for anemia for patients with various social determinants of health. 

5. Identify when to refer to Hematology

Chronic pain is particularly common and problematic in older adults (≥age 65). Untreated pain in older adults often contributes to poor quality of life, social isolation, impaired physical activity, and dependence in performing daily activities. According to 2021 data, more than 55.8 million adults ages 65 and older live in the U.S., accounting for about 16.8% of the nation's population. This is a significant patient population needing recognition of issues and treatment.  Objectives include:

1. Identify common causes of pain in the older adult. 

2. Discuss population specific parameters, including socioeconomic and ethnic barriers to pain treatment.

3. Formulate a treatment plan for pain relief in the geriatric patient including pharmacologic and non-pharmacologic methods.

This presentation is designed to provide an overview of psoriatic arthritis and its place in the hierarchy of rheumatic disease along with the current ACR diagnostic criteria.  The goals of this presentation are to provide participants with the essential information required to develop a differential diagnosis as well as a better understand of the current guidelines for and pitfalls in care for patients with psoriatic arthritis.  Objectives include: 

1. Compare the common features of psoriatic arthritis with other types of seronegative spondyloarthropathies.

2. Describe the factors underlying the pathogenesis of psoriatic arthritis using the ACR diagnostic guidelines.

3. Recognize early signs and symptoms of psoriatic arthritis versus other types of inflammatory joint disease.

4. Develop a strategy to manage patients with psoriasis and psoriatic arthritis and disease comorbidities.

5. Define the course and prognosis of psoriatic arthritis.

Muscle strains, ligament sprains, tendon tears, joint dislocations, and fractures are common orthopedic injuries that can have lasting adverse effects.  Critical emergent orthopedic injuries such as large bone fractures, open fractures, and compartment syndrome have pronounced risk factors for complications.  Suppose these injuries are not initially treated and rehabilitated adequately.  The patient can suffer from repeat injuries of the same joint, chronic pain, and functional impairment. This lecture will explore these emergent orthopedic injuries, their clinical presentations and findings, treatment, and complications in depth.  It presents several mnemonics that aid non-orthopedic physician assistants in assessing, describing, and treating orthopedic cases. Objectives include: 

1. Discuss the acute and lasting effects of the most common orthopedic injuries: muscle strains, ligament sprains, tendon tears, joint dislocations, and fractures.  

2. Recall the most critical emergent orthopedic injuries: large bone fractures, open fractures, and compartment syndrome and their pronounced risk factors for complications.  

3. Understand whether there are discrepancies in emergent orthopedic injury care.

4. Remember the clinical presentations, findings, treatment, and complications of emergent orthopedic injuries.  

5. Learn several mnemonics that aid non-orthopedic physician assistants in assessing, describing, and treating orthopedic cases.

Effective and timely ways to address, screen, treat and code for substance use disorder in primary care medicine.  You will hear about how my family was personally affected by substance use disorder (SUD). Objectives include:

1. Recognize health disparities when treating substance use disorder. 
2. Illustrate effective ways to talk to your patients and patient's families about substance use disorder.
3. Apply the current and readily available screening tools in your practice.
4. Demonstrate how to appropriately treat patients with SUD beyond the need for a DEA(x) number and applying the appropriate ICD-10 codes.
5. Identify ways to reduce SUD stigma in patient assessment and care. 

Using a clinical case, this lecture includes the presentation, diagnosis, and treatment of acute respiratory failure.  Objectives include: 

1. Review pathophysiology of acute respiratory failure.

2. Recognize common radiographic and sonographic findings in ARF.

3. Understand the indication for and interpretation of arterial and venous blood gasses

4. Identify appropriate oxygen delivery modalities for ARF

5. Summarize an approach to treating ARF.

6. Explore how social determinants of health can impact risk of acute illness.

In this 1-hour lecture will discuss the prevalence and diagnosis of Alcohol Use Disorder (AUD). Learners will build their understanding of medication-based and nonpharmacologic treatment options in an outpatient setting.  Objectives include:

1. Understand terminology and diagnostic criteria encompassing the spectrum of alcohol use.

2.Discuss outpatient management of alcohol withdrawal and appropriate risk stratification of patients who could be considered for outpatient detoxification.

3. List treatment strategies for Alcohol Use Disorder in the primary care setting with emphasis on Medication Assisted Treatment options.

4. Explore presentation of Alcohol Use Disorder in special populations and potential for health disparities.

On December 30, 2022, the DATA X-Waiver requirement to prescribe medication for opioid use disorder (MOUD) was eliminated by the federal government under the Mainstreaming Addiction Treatment (MAT) Act, section 1262 of the Consolidated Appropriations Act of 2023. Additionally, in 2022, the CDC updated guidance on opioids for acute and chronic pain.  This presentation will review the updated guidance and describe evidence-based practices to treat opioid use disorder, including with FDA-approved medication for opioid use disorder (MOUD), while exploring the impacts of socialized stigma and bias towards individuals with OUD and providing tools for prescribers to improve access to care including harm reduction.  Objectives include: 

1. Describe Opioid Use Disorder and discuss the new law eliminating the X waiver.?

2. Identify and apply 2022 CDC guidelines for prescribing opioids for acute, subacute, and/or chronic pain.?

3. Describe how to start buprenorphine for a patient with opioid use disorder.?

4. Examine how socialized stigma and biases affect care of people with substance use disorders.

5. Examine opportunities for improving access utilizing a harm-reduction & low barrier model.

This lecture will focus on medical coding.  Objectives include:   

1. Understand the impact of medical coding on your healthcare system.

2. Know the difference between an acute, uncomplicated illness from an acute illness with systemic symptoms.

3. Define the criteria needed for a level 3 and a level 4 office visit.

4. Recognize the importance of documentation when choosing the correct level of service.

5. Define Social Determinants of Health and how it factors into the risk of patient management.