Primary Care Commons^™

The Limping Child, Bob Wiley, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Review the definition of limp
• Describe the approach to initial evaluation of a limping child, including key items in the history and physical exam
• Appreciate the broad differential that one must keep when evaluating a limping child
• Understand the different types of limp and how they can be used to formulate a differential
• Recognize red flag signs and symptoms which require more urgent evaluation
• Use cases to demonstrate some of the common presentations that are seen by the GP

Hospice Care For The Primary Physician, Katie Mechler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Palliative vs Hospice Care
• History of Hospice Care
• Description of the Hospice Benefit
• Review of Hospice Eligibility
• Discussing Hospice with your Patients

A Study In Sodium: Or... "If I Look Confused, It's Because I'M Thinking...", Gregory A. Jaffe, Md, Msed

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Describe the three questions we ask when approaching a patient with hyponatremia.
• Identify how your history and physical can aid in the diagnosis of hyponatremia.
• Recall how we treat different types of hyponatremia

Smoking Cessation, Julita Mitchell, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

● Appreciate the significance of addressing smoking cessation

● Learn a brief interventional model for cessation counseling

● How to structure a quit plan

● Understand the role/risks/benefits of

• Pharmacologic therapy
• Behavioral therapy
• Electronic cigarettes

● Learn practical tips and hear sample language

● Watch a sample intervention

Perinatal Maternal Mood Disorders, Sarah Elizabeth Hirsh Cokenakes, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. To identify the spectrum of peripartum mood disorders, their features, diagnostic criteria, and treatments.
2. To review FDA pregnancy safety categories and lactation categories for commonly prescribed mood medications.
3. To identify the role of family physicians in identifying and treating peripartum mood disorders.

Epidemiology, Biostatistics, And Population Health Concepts, Allison R. Casola, Phd, Mph, Mches

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Study Designs

• Overview

Epidemiology and Biostatistics

• Vocabulary Review
• Reliability, Variability, and Bias
• Diagnostic Testing and Measures of Association

Population Health

• Evidence Based Medicine
• Interpreting and Evaluating Literature
• Clinical Decision Making

Preventive Care: Controversies, Challenges And Upcoming Changes In Guidelines, Randa Sifri, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Organizations who make guidelines
• Current guidelines for average-risk adults, with a focus on guidelines with differing recommendations and challenges to implementation/operational issues
• Preview of upcoming changes in guidelines
• Cases to illustrate some of the common questions that come up in delivering office-based preventive care
• Some disclaimers

Cardiac Stress Testing, Michael Bozzi, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Learning Objectives

-- Questions to be answered:
• What is a stress test?
• Who should I send for a stress test?
• Which kind of stress test should I order?
• How do I interpret these results?

-- 4 Cases

Female Sexual Dysfunction In Older Adults, Madeline Taskier, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. Review female sexual response and anatomy/physiology of the older female adult
2. Define different types of sexual dysfunction and risk factors
3. Review approaches to screening for sexual dysfunction in the primary care setting
4. Discuss practical approaches to treatment or referral in the primary care setting

Primary Care In A Pandemic: A Qualitative Study On The Impact Of Covid-19 On Workplace Wellness, Oriana Pando, Amy Cunningham, Erin Kelley, Randa Sifri, Kelsey Smith

Phase 1

Introduction:

On March 16, 2020, the city of Philadelphia announced a state of emergency due to the COVID-19 global pandemic. The Primary Care Department of Thomas Jefferson Hospital had to alter operations to protect patients, providers and staff. These changes included an increase in telehealth, personal protective equipment (PPE), spacing in-person visits, and working from home. This study was designed to qualitatively assess how these changes have impacted providers and staff in Jefferson’s primary care settings.

Methods:

We conducted 31 qualitative semi-structured interviews with employees of Jefferson Primary Care practices. Though, our population was heavily skewed toward clinical staff (N=9), …

Approach To Ruq Pain, Jose Medina, Md, Msw

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Highlight the prevalence of RUQ pain
• Review the anatomy relevant to RUQ pain
• Discuss the broad differential associated
• Walk through important history, physical exam, and lab work components of the work up for RUQ pain
• Review the appropriateness/clinical utility of different imaging modalities
• Highlight common US findings associated with RUQ pain
• Case review and management of common RUQ diagnoses

Day In The Life: Indian Health Service - Zuni, Nm, Rebecca Simon, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline:

• Zuni Pueblo (Geographics/ Demographics/ History and Culture)
• Rural Medicine (Full spectrum/ Day in the Life)
• Working for the Indian Health Service
• New Mexico Living

Exercise Prescriptions In Primary Care, Caitlyn Haines, Pgy-2

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives:

●Review the health benefits of physical activity.

●Recognize barriers on the part of the provider that limit our discussion of exercise with our patients.

●Understand the current recommendations for physical activity including: time per week, exercise intensity, and recommendations for pregnant patients and those with chronic disease.

●Understand the current recommendations for screening prior to exercise in patients with chronic medical conditions.

●Help patients devise strategies to introduce physical activity into their routine.

●Become familiar with resources to connect our patients with for exercise in their area.

Updates In Cervical Cancer Screening, Sarah Cokenakes (Hirsh), Md - Pgy 3

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives:

• To review the incidence of cervical cancer in the United States and the relationship between the HPV virus and invasive cervical cancer.
• To review the 2019 ASCCP guidelines and how they differ from 2012 guidelines.
• To discuss use of technology to aid in appropriate decision making and management.

Level 4 Visit, George Valco, Md

Department of Family & Community Medicine Presentations and Grand Rounds

• Medicare guidelines specifically with regard to PATH rules ( Physicians At Teaching Hospitals).
• Specific Documentation is a requirement for reimbursement under Medicare, Medicaid, and any 3rd party payers who refer to Medicare guidelines.
• Resident participation & documentation is incorporated by the Teaching Physicians (TP).

Brief Psychotherapy In Primary Care, Geoffrey Mills, Md, Phd

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Overview Case

Thread Goals

• Acknowledgement
• Rationale
• Background ‘theory’
• Framework(s) Practical applications

Mental Health Care Transitions From Incarceration, Graham Stratton, Md

Department of Family & Community Medicine Presentations and Grand Rounds

The scope of the problem of mental health and incarceration

• Case & Consideration 1: Severe Mental Illness ○ Brief history of de institutionalization and re institutionalization ○ Philadelphia’s jails at a glance
• Case & Consideration 2: Violence and trauma
• Consideration & Consideration 3: Addiction and substance use
• Models of transitions of care for reentry
• Community teams and resources
• Next steps for a Family Medicine physician

The Tuskegee Syphilis Experiment: The Implications Of Its Legacy, Joshua Barash, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Discuss details of the Tuskegee Study
• Summarize ethical issues
• Explore the legacy of Tuskegee: Distrust of the Medical Establishment

Physicians Caring For Physicians As Patients, Olivia Seecof, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline

• Introduction
• Application to family medicine
• Ethics
• Literature supported rewards & challenges
• Navigating the physician/physician-patient relationship
• Summary and questions

Objectives

• Critically examine the physician-physician patient relationship through evidence in the literature
• Use cases to reflect on personal experiences
• Learn how to apply new strategies to navigate the visit with a physician-patient

Journal Club - Dapa-Hf Trial, Emma De Louw, Pgy-3

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Fad Diets, Simon Newsom, Pgy-3

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

• Brief history of dieting

• Overview of different types of fad diets

• Conditions affected by specific dieting

• Physicians role in dieting

Hiv/Hcv/Sti Cases, Marshal Miller, Md, Aahivs

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Discuss approach to Syphilis testing and management in persons infected with HIV and HIV negative patients
• Review strategies to improve ART adherence
• Review ART options and considerations for initiating and modifying ART and clinically relevant Rx-Rx interactions
• Assess patients for HCV treatment and review simplified treatment strategies for patients with chronic HCV infection

Caring For Aging Patients With Idd/Asd/Spmi, E. Adel Herge, Otd, Otr/L, Faota, Rachelle Rene, Phd, Mary M. Stephens, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Objectives:

• What are we talking about?
• Prevalence and associated co-morbidities
• Healthy aging pearls for special populations
• A case: Dr. Herge. . . . From the OT perspective
• Best practices for referral and resources
• A case: Dr. Rene. . . .From the behavioral health perspective
• Best practices for referral and resources

Core Topic: Anemia, Marisyl De La Cruz, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Agenda

• Diagnosis and evaluation
• Approach to anemia
• Hypoproliferative
• Hyperproliferative
• Management of common anemias
• Cases
• Q & A

• Become familiar with signs and symptoms of anemia
• Use laboratory findings to differentiate anemias
• Review pathophysiology of anemia and recognize anemia as a symptom of other conditions
• Understand management of common anemias seen in primary care

Evaluation And Management Of Common Anorectal Complaints, Krys Foster, Md, Mph

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Review the anatomy of the rectum and anus
• Learn skills to perform an appropriate H&P for anorectal complaints
• Appreciate key diagnostic features to common anorectal diagnoses
• Recognize risk factors and red flag signs/symptoms that prompt further evaluation and possible referral

Chronic Muscle Pain, Michael Bozzi, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives ●How to approach the patient with chronic muscle pain ●How a complete history and physical can prevent extraneous testing and unnecessary or premature referrals ●Treatment strategies

Post Traumatic Stress In Families With Pediatric Illness, Olivia Seecof, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline

• Behavioral Science Topic
• Introduce post traumatic stress in parents and children
• Talk specifically about post traumatic stress in families with pediatric (Cancer diagnoses, Type 1 diabetes diagnoses, Traffic accidents)
• Discuss relationship of PTSS in parents, children and siblings
• Apply what we’ve learned (Trauma-informed care)

Head And Neck Injuries For The Pcp, Greta Bires, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Define and recognize common symptoms and treatments of head and neck injuries
• Become more familiar and comfortable with the history and physical exam techniques of common head and neck injuries
• Know when to seek a higher level of care for certain common head and neck injuries

Sports Medicine Update For The Primary Care Physician, Joshua V. Okon, Md

Department of Family & Community Medicine Presentations and Grand Rounds

AGENDA:

• OA vs Degenerative meniscal tear
• Review of OA diagnosis
• Degenerative Meniscal tears
• Management of degenerative meniscal tears and OA
• Rotator Cuff Pathology

Depression In Primary Care: With A Focus On First-Line Medications, Michael Danielewicz, Md

Department of Family & Community Medicine Presentations and Grand Rounds

This Lecture Will Cover:

• An overview of selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), bupropion and mirtazapine
• Appropriate selection and dose adjustments of first-line agents for depressive disorders in a primary care setting
• Monitoring and tapering first-line antidepressants
• Special considerations in treatment
• Future directions for antidepressant treatment