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A comprehensive patient history is often the key to a correct and timely diagnosis. This activity, an update of a Perspectives article first published in 1999, examines some of the issues that may arise when physicians try to address a patient’s medical concern or problem without having a complete patient history. Case studies from Coverys’ closed files are used to illustrate the potentially grievous impact that an incomplete history can have upon the health or life of a patient. Risk mana...

The Pediatric Musculoskeletal Medicine course represents a unique collaboration of pediatric orthopaedics, pediatric rheumatology and pediatric sports medicine. Knowing how to perform a good musculoskeletal assessment is very important in allowing pediatricians to effectively triage the patient, narrow the diagnostic possibilities, and know whether a referral to a specialist is needed. Making the right diagnosis and the correct referral in a timely manner will most certainly improve patient ca...

Evidence-based clinical decision-making consistent with the patient/client management model will be the foundation upon which a physical therapy differential diagnosis is made. The physical therapy diagnosis begins with a screening component. In turn, screening for systemic disease begins with a well-developed client history and interview. The foundation for these skills is presented in this course. A large part of the screening process is identifying red flag histories and red flag signs a...

Objectives 1. Name four consequences or outcomes of COPD and some of the tools currently available to clinicians to assess COPD progression. 2. Describe interventions that have changed the natural history of COPD. 3. Explain the effect of smoking cessation on the rate of decline of FEV1 and other important clinical outcomes. 4. Illustrate the impact of pharmacotherapy on patient-centered outcomes. 5. Review the long-term effects of lung volume reduction surgery on surviva...

Identifying the potential causes, as well as the appropriate assessments and any treatment required, is critical to intervening or consulting in a timely and meaningful way. This course provides a discussion of the differential diagnosis of a few of the many hemorrhagic conditions that may present during pregnancy, including the incidence and potential causes of early pregnancy loss and second and third trimester bleeding. Furthermore, nonobstetric causes of genital bleeding in pregnancy shoul...

In this first of a series of grand rounds presentations, widely recognized multiple myeloma (MM) expert Dr. G. David Roodman invites you to join him in discussions of a “real-world” newly diagnosed MM patient. The case focuses on clinical features, required diagnostic work-up, patient staging, and risk-stratification. It also addresses common comorbidities including treatment prioritization, goals, and patient response assessment according to International Myeloma Working Group (IMWG) univ...

This course, Screening for Systemic Disease: The Neck and Back, is designed for physical therapists working with clients in all settings and at all levels from beginner to advanced. This particular section will review clues suggesting systemic or viscerogenic neck or back pain and take you through each system that can refer pain or symptoms to the neck or back. This will include GI, pulmonary, renal and urologic, gynecologic, and vascular (both peripheral and cardiovascular) causes of neck or ...

View Registration Information After completing this CME module, participants will be able to 1. Discuss the musculature and vasculature of the lower leg as it relates to the differential diagnosis and treatment of chronic leg pain in athletes. 2. Recognize and explain the role of abnormal foot and leg biomechanics in the etiology of chronic leg pain in running athletes. 3. Apply patient history questions and physical examination tests for a differential diagnosis of chronic le...

A complete skin assessment and accurate documentation of the assessment findings are critical elements of the nurse's role in patient care. Nursing staff must be able to perform a thorough head-to-toe skin assessment and accurately document their findings. In order to do this, nurses should have a working knowledge of the general characteristics of the skin, its functions, and the changes that occur in the skin throughout an individual's life span. Identifying patients at risk for pressure ...

History & Principles of MR Mammography

After reading this article, the physician should be able to: * Assess the likelihood of acute aortic dissection from patient history, physical exam, and chest radiograph. * Choose an appropriate confirmatory imaging study. * Discuss the utility of D-dimer in the diagnosis.

At the completion of this activity, the participant will be able to: 1.Define areas in the assessment of geriatric patients where pharmacists can make significant impact; 2.Review physical assessment techniques that pharmacists can adopt in their patient interactions/assessments; 3.Review the appropriate techniques employed in physical assessment, such as blood pressure measurement, to assure that the most accurate data is obtained.

After completing this CME module, participants will be able to 1. Describe the prevalence and natural history of spondylolysis and spondylolisthesis in adolescents and children. 2. Classify the different types of spondylolisthesis using the Wiltse system. 3. Recognize typical signs/symptoms of spondylolysis and spondylolisthesis from patient history and physical examination findings. 4. Identify imaging studies helpful in confirming the diagnosis of spondylolisthesis and in g...

After completing this CME module, participants will be able to 1. Describe the pathophysiology, diagnosis, and management of some common causes of leg pain in running athletes: stress fractures, iliotibial band friction syndrome, medial tibial stress syndrome, and Achilles tendinitis/tendinosis. 2. Identify extrinsic and intrinsic risk factors for stress fractures in running athletes. 3. Explain the role of abnormal foot and leg biomechanics in the etiology of leg pain in running...

CMS issued new Conditions for Coverage that every freestanding ambulatory surgery center (ASC) must meet if the ambulatory surgery center wants paid for Medicare and Medicaid patients. The standards apply to all patients treated in the ASC including worker comp and patients with commercial insurance. These standards became effective on May 18, 2009 and contained 167 pages and 267 tag numbers. CMS amended these on December 30, 2009. There are 12 sections to the new regulations including one on ...

Acknowledgement: This course is supported by educational grants from Celera and the Applera Charitable Foundation. There are several genetics diagnoses that can present with complete heart block. However, complete heart block in the context of a family history of muscle weakness and stiffness (myotonia) can be indicative of myotonic dystrophy. Myotonic dystrophy is the most common inherited neuromuscular disorder presenting in adults. This patient has classic myotonic dystrophy type 1 (DM1)...

The Cardiac MRI Series features Dr. Stephen J. Pomeranz's most intense and detailed review of cardiac MR applications as they relate to anatomy and microanatomy of the heart. The interpreter will learn how to master the assessment of pericardial disease, functional assessment, infarct sizing, mass assessment, and cardiac anomalies. Particularly critical to the Cardiac MRI Series is an understanding and grasp of cardiac MRI technique. The viewer will master key technical issues that allow consi...

Anxiety disorders are frequently encountered in medical practice, often presenting in masked form as somatic complaints. This course describes the differential diagnosis of anxiety disorders, notes the common comorbid medical conditions and medications that can cause anxiety and highlights other psychiatric disorders that often coexist with anxiety disorders. The course describes in detail the key elements of anxiety disorders, such as panic disorder, obsessive compulsive disorder and generali...

Acknowledgement: This course is supported by educational grants from Celera and the Applera Charitable Foundation. This case study illustrates a common clinical scenario (i.e., renal cystic disease in a proband with an inconclusive family history) and many issues related to diagnosis and management of polycystic kidney disease.

This lecture will provide a broad, evidence-based understanding of the best management options for women with the Pap interpretation of high-grade squamous intraepithelial lesion (HSIL). High-grade squamous intraepithelial lesion (HSIL) is a Pap test report that suggests the presence of cervical intraepithelial neoplasia (CIN) 2,3, a precancer of the cervical squamous epithelium. Understanding the epidemiology and natural history of HSIL and CIN 2,3 is critical for all obstetrician-gynecolo...

Upon completion of this program, you will be able to: * List the different types of colon polyps with serrated architecture * Describe the salient architectural features of each type of serrated colon polyp * Apply a pragmatic approach to the assessment and diagnosis of serrated polyps * Communicate the diagnosis of serrated polyps and their associated malignancy risk to clinical colleagues

After reading this article, the physician should be able to: * Practically apply trauma assessment and management principles to the pregnant patient. * Understand the physiologic basis for variations of trauma care for the pregnant patient. * Utilize a practical bedside tool to assist in assessment and management of these patients. * Utilize the tool to help in establishing emergency.

Because medications to treat acute illness due to influenza are just recently appearing, there is a tendency to accept the existence of influenza and to forget the fact that 36,000 Americans die annually from the flu and its complications. In addition, the resulting hospitalizations and medical care cost the healthcare system $12 billion each year. Sadly, there are underused vaccines that can prevent many of the hospitalizations and deaths, thus lessening the suffering and financial burden of ...

View Registration Information After completing this CME module, participants will be able to 1. Discuss the pathophysiology and multiple proposed etiologies of scoliosis. 2. List common nonidiopathic causes of scoliosis. 3. Describe the standard three-part classification of idiopathic scoliosis. 4. Conduct an appropriate history of a patient with scoliosis. 5. Identify and apply physical examination tests used to confirm the diagnosis of idiopathic scoliosis. 6. Id...

The state of today’s health care environment makes it critical for physical therapists to be well-versed in determining when referral to a physician is necessary. Physical therapists must also be able to identify signs and symptoms of systemic disease that can mimic neuromuscular or musculoskeletal dysfunction. Screening for systemic disease is now part of the physical therapy evaluation leading to a physical therapy diagnosis. Evidence-based clinical decision making consistent with the pati...

Treating chronic pain patients is a complex challenge. In 2011, the Institute of Medicine (IOM) released a comprehensive report assessing the impact of pain in America. The report indicates that for the 116 million Americans living with chronic pain, these challenges include not only uncertain diagnosis and social stigma, but also shortcomings in the availability of effective analgesics. In addition, treatment challenges are often compounded by inadequate knowledge among both clinicians and pa...

New Product, Free Shipping, Free CME On the Peds Boards, you have to be able to recognize and differentiate a host of details in syndromes and diseases. These Pediatrics Flash Cards are an excellent way to self-test your ability to sort through those details in patient presentations and point you to correct diagnosis and management. 830 flash cards to help you master the many fine points of pediatric diseases, syndromes, histories, physicals, tests, and more. Color-coded cards allow topi...

Human papillomavirus (HPV) is the cause of almost all preneoplastic and neoplastic disorders of the epithelium that lines the lower genital tract. For that reason, understanding the epidemiology and natural history of HPV is critical for all obstetrician-gynecologists, family practitioners, advanced practice clinicians, and dermatologists concerned with the general welfare of their patients, as well as pathologists who supervise residents and fellows and physicians with administrative responsi...

Multiple myeloma (MM), a malignant neoplasm of plasma cells that accumulate in bone marrow, is a small population cancer with only some 20,000 patients diagnosed annually, which means that nurses may have relatively little experience with the appropriate management of patients with this disease. While not curable at this time, the introduction of novel agents like bortezomib, lenalidomide, and thalidomide have increased life expectancy and quality of life for multiple myeloma patients and this...

A large part of the physical therapy screening process is identifying red flag histories and red flag signs and symptoms. Cancer screening is a major part of the overall screening process. Anyone with a past medical history of cancer is at risk for cancer recurrence. Clinical manifestations of cancer can mimic NMS dysfunction. This is true whether it’s primary cancer or cancer that has recurred or metastasized. Physical therapists must be able to identify signs and symptoms of systemic di...