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Geriatric CME

Internal Medicine 2014 offered a rich program of courses in the area of Geriatric Medicine.


Andropause: Truth, Fiction, or Both?

This course answers the following questions:

  • What are the best clinical indicators on history and physical exam of hypogonadism?
  • What is the best screening test for a patient with symptoms suggestive of hypogonadism?
  • What is the best confirmatory test for a patient with a positive screening test of hypogonadism?
  • Who should receive testosterone replacement therapy, and what are the common side effects and complications of treatment?

Professor: Kristen Gill Hairston, MD, MPH


Clinical Triad: Aging Issues

This course answers the following questions:

Segment A: Identifying the Unsafe Driver Learning Objectives:

1. What are the screening and assessment tools used to evaluate driving safety and how can these tools be incorporated into an efficient 10-minute examination?

2. What are the key points to address when counseling a patient to stop driving, and what strategies help manage challenging cases?

3. What are the physician's ethical and legal considerations related to reporting unsafe drivers?

Segment B: Preventing Financial Exploitation Learning Objectives:

1. What risk factors and clinical clues are associated with financial exploitation?

2. What is the health care provider's role in this issue?

3. How is an assessment of an individual's financial decision-making capacity performed and appropriately documented?

Segment C: Implementing the Advance Care Plan: POLST (Physician Orders for Life-Sustaining Treatments) Learning Objectives:

1. What are the limitations of common advance directives?

2. How does discussion of code status distract from other, more important end-of-life care issues?

3. How is POLST different from other advance directives, and what lessons have been learned from communities using POLST?

Moderator: Lisa Granville, MD, FACP, AGSF; Panelists: Kenneth Brummel-Smith, MD; Hollis D. Day, MD, MS, FACP; Robert E. Roush, EdD, MPH


Geriatrics for the Hospitalist

This course answers the following questions:

  • How should the admitting evaluation of the geriatric patient differ from that of the nongeriatric patient?
  • What is the best approach to hydration and nutrition issues in the elderly?
  • Which medications should be avoided in the geriatric patient and which should be used with caution?
  • How can the hospitalist minimize loss of function and falls in geriatric patients?
  • What are the characteristics of a successful acute care for elders (ACE) unit? How can these principles be applied in hospitals without an ACE unit?

Professor: Robert M. Palmer, MD, MPH, FACP

Mild Cognitive Impairment and Dementia

This course answers the following questions:

  • Should patients be screened for dementia? If so, which ones and with what instrument?
  • How should patients who report memory difficulties be evaluated? When should they be referred?
  • Which medications are most effective for treatment of dementia? When are they indicated? What side effects and problems should be anticipated?
  • When and how should capacity be assessed (e.g., ability to live independently, ability to make financial decisions, and ability to drive)?

Professor: David B. Reuben, MD, FACP


Osteoporosis: Controversies around Biophosphonate Tx

This course answers the following questions:

  • What are the indications for initiating bisphosphonate therapy, and what are the alternatives?
  • How can glucocorticoid-induced bone loss be minimized?
  • After how many years should a bisphosphonate be stopped? And in whom?
  • How should bone health be monitored when patients are off bisphosphonate treatment?
  • Under what conditions should restarting a bisphosphonate be considered?

Professor: Elizabeth A. Streeten, MD


Practical Skills Assessment in the Elderly

This course will help participants:

  • Recognize the importance of assessments for falls, cognition, and driving safety in the elderly.
  • Learn practical tools, history, and physical examination skills to concisely evaluate fall risk in the elderly.
  • Learn short evaluation tools to assess cognition in the elderly.
  • Develop a focused ability to appropriately assess at-risk elderly drivers through instructor-led, objective, structured clinical examination exercises and skills tests.

Director: N. Wilson Holland, MD, FACP; Co-Directors: Anna K. Mirk, MD, Member; Birju B. Patel, MD, FACP, AGSF


Promoting Successful Aging with Exercise

This course answers the following questions:

  • What is sarcopenia, and what can be done about it?
  • What is the evidence for exercise benefits in older patients?
  • What targeted exercises are indicated for specific, common medical conditions?
  • What assessment is indicated before initiating an exercise program?
  • How is an exercise prescription written?

Professor: Alice K. Pomidor, MD, MPH, AGSF


Reducing Falls and Injuries in Older Adults

This course answers the following questions:

  • What efficient falls screening strategies can be incorporated into the annual wellness visit?
  • What evidence exists for successful interventions to reduce falls and injuries?
  • What is the role of vitamin D supplementation for the prevention of falls and fractures?
  • How is a patient's need for vitamin D assessed?
  • What is the current thinking on the use of high and low dose vitamin D?

Professor: Bruce R. Troen, MD


Update in Geriatric Medicine CME

This course covers the following topics:

  • Dementia
  • Office screening for mild cognitive impairment
  • Proposed new therapies for Alzheimer's disease (vitamin E, statins)
  • Diabetes
  • New guidelines for glycemic control in older adults
  • Glucose control and dementia
  • Complications of drug therapy
  • Updated Beers List
  • Proton pump inhibitors, NSAIDS
  • Office-based falls assessment and management
  • Strategies to reduce 30 day hospital readmissions
  • New hypertension treatment guidelines

Moderator: William J. Hall, MD, MACP


Urinary Incontinence in Women

This course answers the following questions:

  • Should internists screen for urinary incontinence in women?
  • What nonpharmacologic approaches are proven to improve continence in women?
  • Are newer pharmacotherapies better than those available as generics?
  • When should a woman be referred to a specialist? What are the reasons to consult a urogynecologist compared with a urologist?
  • When is a procedure or surgery indicated, and what are the success rates of available options?
  • What type of evaluation should internists do before initiating treatment of urinary incontinence?

Professor: Catherine E. DuBeau, MD

Visit www.playbackacp.com to purchase Webcasts and recordings of select sessions from Internal Medicine 2014.