Kidney Disease kills more people than breast cancer, leukemia or prostate cancer. One in 3 of your patients is at risk for CKD; do you know who they are? HTN is the most common comorbidity and most kidney patients die of CV disease. After decades of just wringing our hands, we have NEW GUIDELINES!!!, NEW MEDICATIONS!!! and we can actually slow progression of kidney disease. When was the last time you found out you could change outcomes for your patients?! Come to CKD in 2026 to learn how to identify and manage CKD in the 21st century!

Objectives: 1) Define stages of CKD using the new race-neutral 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

Musculoskeletal symptoms are a common concern for persons presenting to healthcare providers. PAs must have an organized diagnostic approach when working with persons with arthralgias. An appropriate history and physical examination, coupled with proper ancillary studies, aids in determining the underlying cause of a person’s symptoms. This session will provide attendees with a diagnostic and treatment approach when persons present with polyarticular arthralgias. Recent updates from the medical literature related to rheumatology will be highlighted while providing foundational rheumatology principles to aid attendees in their medical specialty and setting.

Objectives: 1. Distinguish between inflammatory and non-inflammatory arthritis when considering common rheumatic disease presentations. 2. Describe the appropriate work-up, including laboratory and radiographic studies for persons with common rheumatic diseases. 3. Cite recent updates related to common rheumatic diseases. 4. Analyze the social determinants of health that affect the diagnosis and treatment of persons with rheumatic conditions.

Mast cell activation syndrome (MCAS) is an increasingly recognized yet frequently misdiagnosed condition characterized by episodic, multisystem symptoms driven by inappropriate mast cell degranulation. Despite its prevalence in clinical practice, many providers remain unfamiliar with the consensus diagnostic criteria, the breadth of the differential diagnosis, and the practical challenges patients face in obtaining a timely and accurate diagnosis. This presentation will equip Physician Associates with a working understanding of MCAS pathophysiology, a structured diagnostic approach, and a pragmatic management framework. Special attention will be given to the role of financial barriers in limiting access to confirmatory biomarker testing and how the consensus 2 diagnostic criteria can serve as an equitable and clinically valid diagnostic tool for patients who cannot afford serum tryptase or urine mediator studies.

Objectives: 1. Describe the pathophysiology of mast cell activation syndrome (MCAS), including IgE-mediated and non-IgE-mediated activation pathways and the clinical significance of mast cell mediator diversity. 2. Compare, contrast, and apply the Consensus-1 and Consensus-2 diagnostic criteria for MCAS to clinical case presentations. 3. Construct an appropriate differential diagnosis for patients presenting with multisystem, episodic symptoms consistent with MCAS, distinguishing it from mastocytosis, hereditary alpha tryptasemia, and other mast cell disorders. 4. Develop an evidence-informed, stepwise management plan for MCAS incorporating lifestyle interventions, antihistamines, mast cell stabilizers, and other pharmacologic agents. 5. Identify financial barriers to biomarker testing as a social determinant of health and apply the Consensus-2 diagnostic framework as a clinically valid, equity-conscious pathway for diagnosing MCAS in resource-limited patients.

Blood-Based Clarity: Navigating an Alzheimer’s Diagnosis with Confidence is a CME activity designed for primary care physicians, general neurologists, nurse practitioners, and physician associates involved in cognitive health care across the aging spectrum. As first-line health care professionals, these clinicians are well positioned to recognize early signs of Alzheimer’s disease (AD) yet often face challenges in distinguishing it from normal aging. Diagnostic uncertainty can delay appropriate intervention, care planning, and treatment. This activity explores the growing role of blood-based biomarkers (BBMs) in detecting early AD pathology and offers practical guidance on incorporating them into clinical workflows. Participants will learn how to identify appropriate patients for testing, interpret BBM results, and determine when referral to a specialist is warranted—supporting earlier diagnosis, informed decision-making, and improved outcomes.

Objectives: 1. Distinguish between normal aging and early cognitive decline associated with Alzheimer’s disease (AD) by integrating comprehensive evaluation frameworks in accordance with guideline recommendations 2. Describe the role of biomarkers in detecting pathological changes associated with early AD 3. Identify appropriate patients for blood biomarker testing to detect amyloid pathology 4. Interpret blood biomarker test results and determine when referral to a specialist is warranted for further evaluation

This is a lecture designed to help outpatient providers use the red light, yellow light green light method to decide where they need to go.

Objectives: 1. Review and discuss how some females do not get triaged appropriately and how this can delay care 2. Discuss how the EKG will help you triage where the patient will go next - green light (home), Yellow light to cardiology and Red light to the ER 3. Review cases of PE and acs

This educational initiative is intended for PAs involved in the care of patients with chronic pain.

Objectives: 1. Recognize the origin(s) and types of pain as they relate to pain management and opioid use disorder (OUD). 2. Fully assess persons experiencing pain, including risk for OUD. 3. Develop safe and effective pain management plans using nonpharmacologic and pharmacologic (non-opioid or opioid) options. 4. Partner with patients to reduce risks when taking opioid therapy.

This lecture will discuss potential clinical applications in which point-of-care ultrasound can aid clinical decision-making.

Objectives: 1. Differentiate the ultrasound basics of physics, knobs, terminology, image quality, probe selection and orientation, and imaging artifacts. 2. Describe the proper patient positioning and scanning techniques required for examining the lungs, gallbladder, kidneys, urinary bladder, lower extremity vasculature, and muscles, skin, and soft tissue. 3. Distinguish normal ultrasound anatomy and identify pathological differences. 4. Analyze the impact of using point-of-care ultrasound on the care of your patient population.

The Wake-Up Workshop Initiative: Your Practical, Comprehensive Guide to Obstructive Sleep Apnea is designed to equip primary care physicians (PCPs), nurse practitioners (NPs), and physician associates (PAs) with the practical knowledge and tools needed to identify, diagnose, and manage obstructive sleep apnea (OSA). With up to 80% of obstructive sleep apnea (OSA) cases going undetected, millions of patients remain at risk for serious comorbidities—often without knowing it. This continuing education activity empowers providers with actionable, evidence-based strategies to spot the warning signs, confidently screen and diagnose OSA, and guide patients through effective obesity management and long-term treatment monitoring.

Objectives: 1. Discuss the importance of diagnosing obstructive sleep apnea (OSA), including its relationship to disease associated complications 2. Screen patients for and diagnose OSA using evidence-based guideline recommendations 3. Develop guideline-directed obesity management plans for patients with OSA as part of an evidence-based OSA treatment strategy 4. Monitor treatment for OSA and modify therapy, as appropriate

Designed to help providers in any role treat these complex patients.

Objectives: 1. Empower clinicians to help females with POTS 2. Review the 5 types of pots and how they are treated differently 3. Discuss how to make this diagnosis and the requirements for testing 4. Review actionable items for patient education that are past compression socks and fluids

Vaginitis is one of the most common yet frequently misdiagnosed conditions in clinical practice, often leading to persistent symptoms and patient frustration. This session provides a practical, case-based approach to differentiating common causes of vaginitis through targeted history, symptom patterns, and key physical exam findings. Attendees will explore the impact of comorbid conditions on treatment success and review evidence-based management strategies for recurrent or refractory cases. By the end of this session, learners will be equipped to confidently diagnose, treat, and individualize care for patients presenting with vaginitis in a variety of clinical settings.

Objectives: 1. Identify the most common types of vaginitis and differentiate between presenting symptoms. 2. Discuss the impact of co-morbid conditions that interfere with successful treatment of vaginitis. 3. Describe physical findings associated with each type of vaginitis. 4. Construct a treatment plan for a patient presenting with vaginitis. 5. Evaluate how social determinants of health influence access to care, diagnostic accuracy and treatments in patients with vaginitis.

Retirement: it happens to all of us. Whether you have had time to plan or it just falls into your lap, there are things that can make the last ¼ of your life fun and enjoyable. Join Kim as she reviews the cardinal rules of retirement…you cannot do bucket list trips every week and you’ll need other ideas. This is as much of an interactive discussion as a lecture.

Objectives: 1) Discuss the non-financial aspects of retirement 2) Highlight how to maximize knowledge gained as a PA into a part-time job 3) Discuss the medical considerations of retirement to include SDOH

Primary care clinicians are increasingly responsible for initiating and managing basal insulin therapy in patients with type 2 diabetes (T2D), yet many remain unfamiliar with emerging once-weekly basal insulin options and their potential role in simplifying care. This CME activity equips PCPs, NPs, and PAs with the knowledge and confidence needed to incorporate these next-generation therapies into clinical practice. Through an evidence-based review, faculty will compare the mechanisms and pharmacokinetic/pharmacodynamic profiles of once-weekly versus once-daily basal insulins, interpret the latest efficacy and safety data, and explore how these agents may help overcome treatment inertia and improve adherence. Participants will learn practical strategies for developing individualized treatment plans, including best practices for initiation, dosing, and titration. Insights from recent learner feedback highlight a strong need for continued, hands-on education in insulin management, titration guidance, and patient follow-up—needs directly addressed by this program to support more effective and convenient diabetes care.

Objectives: 1. Compare the mechanisms and pharmacokinetic/pharmacodynamic properties of once-weekly and once-daily basal insulins to anticipate their potential clinical us. 2. Interpret the efficacy and safety data for emerging once-weekly basal insulins and apply this knowledge to anticipate their potential role in managing type 2 diabetes. 3. Develop individualized evidence-based treatment plans for patients with type 2 diabetes who require basal insulin that incorporates best practices for initiation, dosing, and titration.

This interactive, case-based activity will explore barriers to effectively managing and treating obesity or overweight in the primary care setting. Specifically, the barriers discussed are those pertaining to the health care provider, such as lack of skills and confidence to discuss weight with your patients, clinician perceptions and biases, and lack of confidence in managing obesity treatment. Learners will actively participate in this session and practice behaviors and skills as they are discussed. Objectives: 1. Prioritize the management of obesity in treatment plans for patients with obesity or overweight and comorbid complications 2. Utilize evidence-based strategies to establish treatment plans with patients with obesity or overweight 3. Modify treatment plan for patients with obesity or overweight based on composite medical outcomes, including comorbidities and cardiometabolic risk measures

Basic Dermatology, including common dermatologic conditions and how to start treatment.

Objectives: 1) Recognize and become more comfortable with standardized lesion morphology 2) Recognize morphologies of common non-melanotic and melanotic skin cancers and associated treatments 3) Recognize common rashes/eruptions eg acne, pseudofolliculitis barbae, seborrheic dermatitis, etc. 4) Understand basic treatment frameworks for common rashes/eruptions 5) Understand the impact of dermatology Telehealth on addressing Social Determinants of Health including transportation-disadvantaged, poorer, and patients with young children, as well as addressing health disparities including include older, patients with chronic illnesses, and patients with disabilities.

Dysautonomia refers to a group of disorders involving dysfunction of the autonomic nervous system and may present with a wide range of symptoms including palpitations, dizziness, temperature dysregulation, fatigue, exercise intolerance, gastrointestinal dysmotility, early satiety, and bladder dysfunction. Because these symptoms are often nonspecific and affect multiple organ systems, many patients experience prolonged diagnostic delays before the underlying condition is recognized. In recent years, dysautonomia has gained increasing clinical attention, particularly in the setting of post viral syndromes and long COVID. Despite this growing recognition, many clinicians remain unfamiliar with the clinical features and evaluation of autonomic dysfunction. This presentation will provide a practical clinical overview of dysautonomia with emphasis on recognition in primary care and urgent care settings. Participants will review key aspects of autonomic physiology and learn to recognize clinical presentations associated with conditions such as Postural Orthostatic Tachycardia Syndrome (POTS), neurogenic orthostatic hypotension, and autonomic neuropathy. Through case-based examples, clinicians will identify historical clues, physical exam findings, and initial evaluation strategies that may prompt consideration of autonomic dysfunction. The session will also address diagnostic delays and health disparities experienced by patients with dysautonomia. The goal is to provide clinicians with a practical framework for recognizing dysautonomia earlier in clinical practice and guiding appropriate evaluation and referral.

Objectives: 1. Review the basic physiology of the autonomic nervous system and its role in regulating multiple organ systems. 2. Recognize common clinical presentations of dysautonomia including Postural Orthostatic Tachycardia Syndrome (POTS), neurogenic orthostatic hypotension, and autonomic neuropathy. 3. Identify key historical features and bedside findings that should prompt consideration of dysautonomia in primary care and urgent care settings. 4. Discuss the impact of diagnostic delays and health disparities affecting patients with dysautonomia. 5. Apply a structured approach to the evaluation of patients with suspected dysautonomia.

Physician Associates frequently encounter patients affected by substance use across outpatient and acute care settings. This session provides an overview of common substances of use, current trends, and their clinical presentations and health impacts, with emphasis on practical recognition and assessment. Participants will review evidence-based screening tools and core characteristics of addictive substances to support early identification and intervention.

Objectives: 1. Describe common substances of use and associated trends, with emphasis on alcohol use and alcohol-related harms. 2. Explore the common characteristics of addictive substances and factors associated with the development of substance use disorders. 3. Describe the clinical presentation and health impacts of alcohol in outpatient and acute care settings. 4. Identify some of the most common evidence-based screening tools used to support early identification and intervention for substance use disorders, including alcohol use disorder. 5. Explore how stigma, trauma exposure, barriers to healthcare access, and socioeconomic stressors contribute to substance use patterns and engagement in care.

Fever, fatigue, bone pain are symptoms seen every day in pediatric practice. What happens when these “routine” complaints are anything but benign? This session challenges providers to look beyond the obvious and recognize when common presentations may signal an underlying malignancy. Special attention will be given to how social determinants of health can influence delayed diagnosis, equipping providers with strategies to deliver more equitable, timely care when it matters most.

Objectives: 1. Recognize common pediatric presenting symptoms that may represent underlying malignancy rather than benign conditions 2. Differentiate between typical self-limited pediatric illnesses and clinical “red flags” that warrant further evaluation for cancer. 3. Assess how social determinants of health may impact the timely recognition, evaluation, and referral of pediatric patients with potential malignancy. 4. Apply evidence-based diagnostic approaches when pediatric cancer is suspected in primary care settings.

A review of male reproductive hormone physiology, causes of male factor infertility, the role of the semen analysis as a proxy for overal health in addition to evaluating fertility, and understanding how lifestyle factors and access to care can impact male reproductive health.

Objectives: 1. Describe the normal physiology of the hypothalamic-pituitary-gonadal axis and identify common mechanisms that disrupt male reproductive hormone function. 2. Recognize the prevalence and clinical significance of male factor infertility and explain its role in the evaluation of couples attempting to conceive. 3. Identify the role of the semen analysis as a proxy for overall health and when abnormal findings warrant further evaluation or referral to a reproductive specialist. 4. Discuss medications, supplements, and lifestyle exposures that negatively impact spermatogenesis and male fertility. 5. Apply patient counseling strategies that address lifestyle factors and social determinants of health that may influence male fertility and timely evaluation.

Cardiometabolic Disease is a leading cause of morbidity and mortality in North Carolina and across the United States, with disproportionate burdens in rural communities and among certain racial and ethnic minority groups. While Hemoglobin A1c remains a central marker of glycemic control, it captures only one narrow dimension of cardiometabolic health. Despite therapeutic advances, many patients with diabetes continue to face elevated cardiovascular risk due to coexisting, undertreated risk factors and underuse of evidence?based screening tools and medications. Physician Associates are increasingly responsible for managing obesity, type 2 diabetes, chronic kidney disease (CKD), and cardiovascular disease within limited visit times and resource?variable settings. This session will equip participants with evidence?based, guideline?aligned strategies to assess and manage cardiometabolic risk factors and support early initiation of medications with proven cardiovascular and renal benefits used as first?line therapy when appropriate, independent of A1c levels. I will incorporate case?based learning to identify high?risk patients, apply validated risk calculators, and individualize treatment plans that prioritize long?term cardiovascular and renal outcomes. Emphasis will be placed on practical implementation, including EMR screening tools, medication selection, and side?effect management. The session will also address the role of social determinants of health in shaping cardiometabolic outcomes and highlight strategies to reduce inequities in care.

Objectives: 1. Identify cardiometabolic risk factors in people with prediabetes and type 2 diabetes and explain how each contributes to cardiovascular and renal risk. 2. Apply guideline based screening tools to stratify cardiometabolic risk and integrate results into shared decision making with patients. 3. Develop an individualized cardiometabolic risk-reduction treatment plan that integrates pharmacologic interventions and lifestyle recommendations, addressing weight management, blood pressure control, lipid control, and renal protection for patients with prediabetes and type 2 diabetes, independent of baseline A1c . 4. Compare GLP-1 receptor agonists, dual agonists, and SGLT2 inhibitors based on cardiovascular, renal and weight-related benefits. 5. Identify disparities in cardiometabolic disease burden among racial/ethnic subgroups, rural communities, and low?income populations, and implement social determinants of health informed strategies to reduce inequities in care.

Behavioral and psychological symptoms of dementia (BPSD) are nearly universal and often drive the use of psychotropic medications—frequently with limited benefit and significant risk. This session provides a practical, evidence-based framework for evaluating and managing BPSD while minimizing overmedication and preserving patient safety, dignity, and quality of life. Using real-world cases and the DICE approach (Describe, Investigate, Create, Evaluate), participants will learn to identify reversible causes such as delirium, pain, medication effects, and environmental triggers before initiating pharmacologic treatment. The session emphasizes person-centered, non-pharmacologic strategies as first-line interventions and outlines when medications are appropriate, how to select them thoughtfully, and how to monitor and deprescribe safely. Attendees will leave with actionable tools to reduce polypharmacy, improve care outcomes, and confidently manage complex behavioral presentations in patients with dementia.

Objectives: 1. Analyze the impact of social determinants of health (SDOH) and health disparities on behavioral and psychological symptoms of dementia (BPSD) by identifying at least three contributing factors and integrating at least two practical strategies within the PA scope of practice to reduce disparities and improve patient-centered outcomes. 2. Apply the DICE (Describe, Investigate, Create, Evaluate) framework in the assessment of BPSD by identifying at least two reversible or modifiable contributors (e.g., delirium, pain, medication effects, environmental triggers) and developing a targeted, non-pharmacologic management plan. 3. Evaluate and implement appropriate pharmacologic interventions for BPSD when indicated by performing a risk–benefit analysis, selecting evidence-based treatment, and establishing a monitoring and deprescribing plan that includes defined safety parameters and reassessment timelines.

An overview on the recently passed legislation and regulation that affects PA practice. A comprehensive review of statues and rules thePAs and NPs practice under.

Objectives: 1. Define North Carolina OTP legislation and Rules set by the North Carolina Medical Board 2. Demonstrate how these new laws will affect certain populations across North Carolina 3. Discuss PA and NP utilization across North Carolina 4. Learn new laws and regulations that effect PA and NP practice

Anxiety is increasingly problematic among children and adolescents, with rising prevalence and significant impacts on functioning at home, school, and in relationships. This presentation reviews how anxiety presents across developmental stages, how to distinguish normal fears from anxiety disorders, and evidence-based strategies—including therapy, medication, and attention to social context—to support effective and equitable care.1. Identify common presentations of anxiety across developmental stages 2. Differentiate normative fears from clinical anxiety and describe key pediatric anxiety disorders 3. Evaluate the influence of social context and access to care on pediatric anxiety and identify clinician strategies to support more equitable mental health treatment. 4. Review evidence-based non-pharmacologic interventions, including therapeutic modalities and family-centered approaches 5. Review pharmacologic treatment options for pediatric anxiety and key considerations for clinical decision-making

Objectives: 1. Identify common presentations of anxiety across developmental stages 2. Differentiate normative fears from clinical anxiety and describe key pediatric anxiety disorders 3. Evaluate the influence of social context and access to care on pediatric anxiety and identify clinician strategies to support more equitable mental health treatment. 4. Review evidence-based non-pharmacologic interventions, including therapeutic modalities and family-centered approaches 5. Review pharmacologic treatment options for pediatric anxiety and key considerations for clinical decision-making

Chronic disease management.

Objectives: 1. Describe a functional assessment. 2. Discuss the importance of coordinating care and planning ahead. 3. Identify ways to support caregivers of individuals with chronic illnesses. 4. Discuss the impacts of social determinants of health in the lives of individuals with a chronic illness.

Continuous Glucose Monitoring is crucial to the management of your patients with diabetes, and there are challenges with translating the resulting data into practical treatment decisions in primary care. This presentation will dive into those challenges, as well as considering what’s next in the world of CGM, and using CGM to ease the patient burden.

Objectives: 1. Apply accurate strategies for interpreting CGM data to inform diabetes treatment decisions and support integration of CGM into clinical practice 2. Integrate CGM into routine care of patients with diabetes in primary care settings who would benefit from CGM use 3. Describe new and emerging CGM technologies, such as OTC CGM devices and continuous ketone monitoring, including how they can be integrated into clinical practice 4. Collaborate with the multidisciplinary health care team for diabetes care and incorporation of CGM into diabetes management.

Almost all cisgender women will experience symptoms of menopause. This lecture will consider the pathophysiologic mechanisms responsible for vasomotor symptoms and genitourinary syndrome of menopause as well as hormonal and non-hormonal methods of treating symptomatic menopause.

Objectives: 1. List pathophysiologic mechanisms that are believed to be responsible for menopausal symptoms 2. Discuss racial disparities in the care of symptomatic menopausal patients 3. Discuss hormonal and non-hormonal systemic management of vasomotor symptoms 4. Discuss hormonal local management of genitourinary syndrome of menopause

This lecture offers a review of the cranial nerves (I–XII), covering their primary functions and examination techniques. Attendees will learn to identify and interpret common abnormal findings associated with cranial nerve disorders. The session will also highlight prevalent barriers to health care access and discuss practical strategies to address these challenges.

Objectives: 1. Describe the primary functions of each cranial nerve (I–XII) 2. Demonstrate step-by-step methods for performing a comprehensive cranial nerve examination. 3. Identify and interpret common abnormal findings associated with cranial nerve disorders. 4. Discuss some prevalent barriers to accessing health care, and strategies to address each barrier.

Recent advances in disease-modifying therapies have intensified the need for targeted education on the evaluation and management of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Expanding knowledge will strengthen routine cognitive assessment, promote appropriate use of diagnostic tools such as biomarker testing, deepen understanding of available treatments, and clarify when referral to specialty care is appropriate. At the same time, the growing demand for dementia care specialists underscores the essential role of primary care clinicians in recognizing and managing early symptomatic Alzheimer’s disease—including MCI due to AD and mild AD dementia.

Objectives: 1. Implement structured approaches to screening and evaluating diagnosing MCI and dementia due to AD in adults at risk for cognitive decline. 2. Select appropriate AD biomarker tests and interpret their results to guide eligibility and referral amyloid-targeting therapies in patients with MCI or mild dementia due to AD. 3. Formulate individualized pharmacologic treatment plans for MCI and mild dementia due to AD, based on patient characteristics and preferences.

Shares the latest updates in the growing subspecialty as presented at the 2025 National Curriculum on Reproductive Psychiatry conference. Included topics such as risk screening, anticipatory guidance, treatment and collaboration strategies.

Objectives: 1. Recognize windows of risk in a woman’s life 2. Differentiate between menstrual cycle, perinatal and perimenopause disorders and normal physiological states 3. Identify how to properly manage psychiatric disorders during the perinatal period 4. Understand risk assessment and anticipatory guidance for women in windows of risk 5. Assess for trauma and understand how this and other social determinants of health affect windows of risk 6. Identify resources for patient management

Resistant Hypertension (HTN) is a common condition, frequently managed in primary care. Primary care clinicians (PCCs) are often the first to identify clinical features that raise suspicions of hypercortisolism in their patients. The interconnected relationship between resistant HTN and hypercortisolism raises a critical need for primary care involvement in the identification, screening, and diagnosis of hypercortisolism in patients with HTN. There is limited familiarity with appropriate screening and diagnostic pathways for hypercortisolism in patients with HTN. As such, PCCs are a critical target audience for this educational initiative.

Objectives: 1. Describe the key pathophysiologic mechanisms by which hypercortisolism contributes to HTN and associated cardiometabolic risks. 2. Identify clinical features and risk factors that should prompt evaluation for hypercortisolism in patients presenting with resistant HTN. 3. Apply recommended screening methods and diagnostic pathways for suspected hypercortisolism in patients with HTN, including test selection, interpretation, and criteria for specialty referral.