Las Vegas, NV CME Conference

9:45 – 11:15 AM

It’s Not Just a Base Tan

What are the long-term consequences of baby oil, tanning beds, and a lack of SPF? You guessed it…skin cancer! It’s the most common cancer in the US, and statistics show that 1 in 5 will develop skin cancer in their lifetime. This session will look at the most common skin cancers, and a few must not miss diagnoses. We’ll review actinic keratosis, BCC/SCC, Melanoma, Extramammary Paget disease, and CTCL.

12:30 – 2:00 PM

But, Is It Contagious? (Rx=0.50)

Contagious or not?! Does your patient need to avoid friends, family, or sexual partners? This session will look at common skin conditions patients present with and frequently wonder if they are contagious. Pityriasis Rosea, Condyloma, Zoster, Herpes, Hidradenitis Suppurativa, and plant dermatitis will be reviewed.

2:15 – 3:45 PM

I’ll Take Spots for 400

This session will look at common and not-so-common skin spots to help aid you in their diagnosis, treatment and refer to dermatology as warranted. This lecture will focus on identifying and treating benign lesions, including hemangiomas, SKs, LPLKs, Molluscum, Warts, Nevi, acrochordons, café o lait, and blue nevi.

3:45 – 4:45 PM

Let’s Make a Rash Decision (Rx=0.50)

It’s Friday at five, and your patient is red and itchy. What do you do? When, what, and where do you put that steroid? This session will look at the diagnosis and treatment of several common rashes and skin conditions to help relieve your patient and get you to happy hour on time. This session will include irritant and allergic contact dermatitis, eczema, psoriasis, tinea infection, scabies, drug eruptions, and life-threatening rashes. We will also review the basics of steroid use, including what, when, and where to use it.

7:30 – 8:30 AM

Breakfast & Learn: Topic To Be Determined

8:30 – 9:30 AM

Feeling Alright: Pain Management of Orthopedic Patients’ Part 1 (Rx=0.25)

This is the first of a 2-part lecture focusing on the evaluation of patients suffering from pain related to orthopedic conditions.  We will review basic and focused exams as well as what imaging and labs to order and when it is appropriate; highlight common associated diagnoses, discuss a variety of appropriate treatment options ranging from manual therapy to pharmaceutical and interventional therapy and review some cases of what you might see in a clinical setting.  The goal of both parts 1 and 2 will be to obtain some level of provider comfort in specialty and non-specialty settings when dealing with patients suffering from orthopedic pain.

9:45 – 11:15 AM

Feeling Alright: Pain Management of Orthopedic Patients’ Part 2 (Rx=1.00)

This lecture will build on part one of this two-part lecture.  We will focus more on pharmacological treatments and highlight the importance of the PDMP, knowledge of opioid equivalency, and safer non-opioid treatment options for patients suffering from both post-operative and chronic pain.  We will also discuss the hot topics of a variety of different opioid alternatives including the risks of serotonin syndrome and how these can all apply to treating patients with orthopedic pain. 

12:30 – 2:00 PM

Practice Makes Better: Case Studies in Orthopedics (Rx=0.25)

They say practice makes perfect, but, in this case, we are just working on getting better at clinical evaluation and decision-making for patients with orthopedic problems.  Therefore, we will review a selection of cases to help increase the comfort level of orthopedic presentations that are both common and rare.  The cases will range from entry-level to difficult and hopefully get your thoughts flowing and your problem-solving going.  Ultimately this should help providers evaluate and break down a case to help patients obtain better clinical outcomes.  

2:15 – 3:45 PM

“Back” to Basics: Managing Back Pain in the Orthopedic Patient (Rx=0.25)

While back pain can sometimes be a nerve-racking chief complaint, we see on the chart; it does not have to be.  This lecture will discuss risk factors, causes, examination, and identification of common orthopedic back presentations ranging from mild to emergent.  We will also discuss appropriate diagnostic testing and labs as well as a variety of appropriate treatment options.  The goal of this lecture is to help give providers a better comfort level so that they can bring more comfort to patients presenting with low back pain.  

3:45 – 4:45 PM

On the Road Again: Recognition and Management of Common Orthopedic Injuries of the Foot and Ankle (Rx=0.25)

They may not always be the most glorious part of our body, but without them, it would be tough to get around.  This lecture will cover common orthopedic injuries of the foot and ankle.  We will review the sometimes difficult and confusing foot and ankle anatomy, discuss a variety of injuries that often present to primary or urgent care, and formulate an understanding of basic treatment plans that will hopefully get our patients back “on the road again.”   

7:30 – 8:30 AM

Breakfast & Learn: Topic To Be Determined

8:30 – 9:30 AM

It’s More Than Numbers on a Glucometer: Current Priorities of Diabetes Management

In this session, we will address the new paradigm in approaching diabetes, in terms of diagnosis, setting appropriate glycemic targets, and intervention priorities: It’s a shift from a glucose-centric approach to a more personalized, morbidity (CVD) mitigation-centric approach. The talk will also provide tips on diabetes assessment & diagnoses, identification of various types of diabetes (e.g. LADA), overview of DM-related micro- & macrovascular complications, preserving beta-cell function, exploration of adiposity & insulin resistance, and how to evaluate blood glucose readings.

9:45 – 11:15 AM

Making a Good Start: Addressing Pre-Diabetes Meaningfully (Rx=0.25)

This session will focus on the most common presentation of diabetes in primary care  —“Pre-diabetes.” Diagnostic biomarkers for this disease will be addressed along with how to work- up, treat, and follow up with these patients. Meaningful ways to delay the progression of this disease and prevent beta-cell failure will be discussed.

12:30 – 2:00 PM

Practical Approaches to Using Current, Non-insulin Pharmacotherapy for T2dm (Rx=0.50)

In this session, we will compare and contrast available, non-insulin, diabetes medications, prioritize their use based on underlying cardiovascular status/risk, glycemic status, contraindications, cost etc. Case studies will be used to illustrate appropriate initiation and progression of pharmacotherapy.  

2:15 – 3:45 PM

Moving Past Your Comfort Zone: Insulin, DM Technology and More (Rx=0.75)

This session will introduce the use of basal & bolus insulin in the patient with T2DM & T1DM & contrast the pharmacokinetics among the available insulins. Case studies will be used to determine how to initiate and titrate insulin. How to best analyze glycemic data from finger sticks and CGM will be addressed as well as a brief discussion of various modes of insulin delivery systems.

3:45 – 4:45 PM

Managing Metabolic Madness: Diabetes, Adiposity and Cardiometabolic Disease (Rx=0.50)

During this session, we will explore the synergy between members of the terrible triad contributing to metabolic mayhem: (T2 diabetes, dysfunctional fat mass and cardiometabolic disease) and address relevant pathophysiology, assessment, and intervention priorities.  Weight loss strategies will be explored with regard to how they improve glycemic control and reduce cardiovascular disease risk.

7:30 – 8:30 AM

Chest Pain Evaluation: Red Herring or the Real Deal?

Chest pain is one of the most common chief complaints to the emergency departments, with a definitive diagnosis elusive in most cases. However, who gets to be sent home? Who requires admission? This presentation addresses those questions by reviewing the challenges in delineating cardiac vs. non-cardiac chest pain. A heavy emphasis will be placed on risk stratification methodologies for patients with suspected cardiac chest pain and an evidence-based approach to the initial evaluation. Finally, this presentation will review optimal testing strategies for cardiac and non-cardiac etiologies of chest pain, including current controversies and guidelines.

8:30 – 9:30 AM

Chest Pain Evaluation: Red Herring or the Real Deal? (cont’d) (Rx=0.50)

Chest pain is one of the most common chief complaints to the emergency departments, with a definitive diagnosis elusive in most cases. However, who gets to be sent home? Who requires admission? This presentation addresses those questions by reviewing the challenges in delineating cardiac vs. non-cardiac chest pain. A heavy emphasis will be placed on risk stratification methodologies for patients with suspected cardiac chest pain and an evidence-based approach to the initial evaluation. Finally, this presentation will review optimal testing strategies for cardiac and non-cardiac etiologies of chest pain, including current controversies and guidelines.

9:45 – 11:15 AM

Thinking Beyond COVID: Pulmonary Cases From the Wards

This presentation will provide an overview of different types of respiratory cases in hospitals and clinics. Topics will range from common to complex and include an overview of mechanisms, pathophysiology, diagnostic considerations, and up-to-date treatment protocols. Emphasis will be placed on respiratory failure, oxygen supplementation techniques, indications/contraindications for using NIPPV, COPD, and infectious etiologies. Finally, this presentation will provide an overview of acute respiratory distress syndrome, focusing on diagnostic criteria and a review of evidence-based treatment guidelines.

12:30 – 2:00 PM

Acute and Chronic Kidney Disease: Seeking Better Outcomes (Rx=0.50)

With kidney disease on the rise, the patient presenting to the emergency department with different types of kidney injury (acute and chronic) will continue to increase. This case-based presentation will allow participants to confidently assess and classify patients with suspected kidney injury, identify the most common precipitants of acute kidney injury, differentiate between acute and chronic disease, and understand the first-line therapy for the treatment of acute kidney injury. Indications for urgent dialysis will also be reviewed.

2:15 – 3:45 PM

Syncope: What You Don’t Know Can Harm You

This presentation will review the common cause of syncope and the pathophysiologic mechanisms that commonly lead to syncope. With a focus on initial evaluation and management, this presentation will review the guidelines and risk stratification tools available to aid in diagnosis. Finally, this presentation will provide an evidence-based approach to disposition and follow-up.

7:30 – 8:30 AM

Chronic Pain Conditions – A Deeper Dive Into the Usual Suspects (Rx=0.25)

Millions of American experience chronic pain, and over 4% of the population reports having high-impact chronic pain. Chronic pain is a common complaint and has considerable comorbidities, sequelae, and costs. This session will review some of the more common chronic pain conditions, including a review of symptoms, signs, and supportive diagnostic information. Some conditions to be covered include chronic low back pain, neck pain, joint pain, and neuropathies. Attendees will enhance their confidence in diagnosis, which, with a patient-specific treatment plan, will improve treatment outcomes.

8:30 – 9:30 AM

Pain Pathophysiology Part 1 – Bridging the Mechanism of Action of Non-opioid Medications (Rx=0.25)

Without a single therapeutic option achieving complete efficacy and safety for those experiencing chronic pain, clinicians are presented with a significant diversity of pharmacologic options to consider. Treatment guidelines have consistently put forward strong recommendations to leverage the analgesic properties of non-opioid medications, but how does one decide between a calcium channel modulator, a serotonin-norepinephrine reuptake inhibitor, or a non-steroidal anti-inflammatory? Attendees of this session will explore the basic neuroanatomy and physiology of nociception, focusing on the mechanism of action of non-opioid medications. By connecting the pharmacologic site of action to a patient’s underlying pain condition, a more rational approach will occur in selecting non-opioid medications.

9:45 – 11:15 AM

Pain Pathophysiology Part 2 – Bridging the Mechanism of Action of Opioid Medications (Rx=0.25)

With the isolation of a specific opiate from opium in 1805, the foundation of modern opioid pharmaceuticals was set. Globally, opioids remain important medications, with their position secured on the World Health Organization’s list of essential medicines. Since their initial discovery, a number of opioids have been formulated. The obvious question is, “Are all opioids the same?” This session will review the underlying neuroanatomy and physiology specific to opioids. Building upon the mechanism of action of opioids, specific effects of pharmacogenetics, metabolism-based drug interactions, and opioid receptor binding actions will be uncovered. Individual opioids, especially synthetic opioids, will challenge the concept that all opioids are equivalent.

12:30 – 2:00 PM

Aberrant Behaviors and Patient Monitoring (Rx=0.50)

Despite advances in non-pharmacologic treatments and non-opioid medications for patients with chronic pain, many patients have inadequately managed pain and may be appropriate candidates for opioid therapy. For these patients, careful monitoring is essential and clinical guidelines support using tools such as urine drug monitoring and prescription drug monitoring program data. Like every medical test, these tools have specificities and sensitivities that may yield results that are either consistent or inconsistent with the clinical impressions. This session will examine the various laboratory technologies of drug monitoring, including screening and definitive testing. Connections will be drawn between the laboratory results and unexpected and expected findings from individual opioids, including the impact of pharmacogenetics, drug interactions, and manufacturing impurities. Other monitoring tools, including prescription drug monitoring programs, will be discussed. Finally, attendees will have the opportunity to apply the content to a review of actual case studies of patient aberrant behaviors. Some circumstances are what they seem, and some are not.

2:15 – 3:45 PM

Innovations in Interventional Pain Management

Although pharmacologic treatments remain a common component of managing pain, significant advances in interventional pain management have reached a point where patients may successfully reduce medications or may not require them at all. This session will review some of the longstanding approaches, such as epidural steroids and radiofrequency neurotomies, but also increase awareness of understanding of interventional treatment options for joint pain of the knee, hip, and shoulder as well as advances in minimally invasive pain, reliving surgical treatments within the scope of pain management. Attendees will also be introduced to the innovative advances in neuromodulation and targeted intrathecal drug delivery.

7:30 – 8:30 AM

Treasure the Bones: Osteoporosis and Fracture Prevention Strategies in Men and Women: Part 1 (Rx=0.50)

This session will introduce a comprehensive approach to the identification of women and men at risk for fracture based on bone densitometry and their 10-year fracture risk using the FRAX calculation. There will be a discussion on who should be screened and then interpretation of results of the bone density and FRAX calculation. There will be discussion of the approach to patients based on whether they are at high or very high risk for fracture. In session part 1, there will be a discussion of the initial workup of patients, non-pharmacologic therapy, and initial therapy of the osteoporotic patient at high risk for fracture with pharmacologic therapy. Treatment of patients at high risk due to therapy such as aromatase inhibitors and androgen deprivation therapy will be discussed. Case studies will be presented for managing osteoporotic patients at high risk for fracture.

8:30 – 9:30 AM

Treasure the Bones: Osteoporosis and Fracture Prevention Strategies in Men and Women: Part 2 (Rx=0.25)

This session will review the approach to patients who are at very high risk for fracture based on their bone density or FRAX calculation. This will include discussion of sequencing of pharmacologic therapy with bone building anabolic agents followed by maintenance with anti-resorptive agents. Current controversies will be discussed including long-term use of bisphosphonates, adverse events including osteonecrosis of the jaw (ONJ) and atypical subtrocanteric femur fractures and drug holidays. Concerns about discontinuation of rank ligand inhibitors and the risk for a rapid increase in vertebral fractures will be discussed.  Case studies will be presented for managing osteoporotic patients at very high risk for fracture.

9:45 – 11:15 AM

Menopause Magic: Learn Tricks for the Management of Women at Midlife and Beyond (Rx=0.50)

This session will provide the attendee with an overview of the menopause transition into the post-menopause with an emphasis on symptom management.  There will be an update on guidelines for hormone therapy including issues of long-term use and use after the age of 65. The concept of a window of opportunity for treating women early in the post menopause with less cardiovascular risk than older women will be discussed There will be discussion of FDA approved hormonal and non-hormonal therapy and dietary supplement options for the treatment of hot flashes.  There will be a discussion of the identification and treatment of the genito-urinary syndrome of menopause (GSM).  Case studies will be utilized to provide clinical management decision-making.

12:30 – 2:00 PM

Capture Current Cervical Cancer Prevention Guidelines: New Screening and Risk-Based Management 

Cervical cancer prevention has changed significantly in recent years with less frequent screening and the addition of HPV testing as a stand-alone test along with the option for the Pap and HPV test together as cotesting.  This session will review the appropriate use of Pap testing, the rationale for HPV testing along with the Pap (co-testing) in women 30 and older and the use of HPV testing as a primary screen (stand-alone test) in women 25 and older by two of the FDA approved HPV tests.  There will be a discussion of the new American Cancer Society Guidelines for screening and a review of the new 2019 ASCCP Risk-Based Management Consensus Guidelines for management of abnormal screening and subsequent follow-up with case studies.  These guidelines are a shift from results-based to risk-based management relative to the risk of an existing CIN 3 (pre-cancer).  

2:15 – 3:45 PM

Alphabet Soup: AUB and PALM COEIN for Systematic Diagnosis and Management of Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) presents due to both structural and non-structural reasons and AUB is a symptom and not a diagnosis.  This session will review a systematic approach to the identification and classification of AUB, leading to a diagnosis using the Palm-Coein classification system.  This system allows the clinician to assess structural diagnoses including polyps, adenomyosis, leiomyoma, and malignancy.  Non-structural diagnoses include coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified. There will be a review of the appropriate workup and the subsequent options for management of AUB, including both medical and surgical interventions.  This will include symptom management and use of newer GnRh antagonists for heavy menstrual bleeding due to fibroids.  These agents expand the options for management by the NP and PA in practice before referral to gynecology for possible surgical options including myomectomy, endometrial ablation, and hysterectomy.