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As the proportion of older adults increases, providing up to date and quality care to them is of great importance to general internists, who provide the bulk of their primary care. Update in Geriatrics will review important advances in the clinical care of older adults published recently. Topics will include advances in the diagnosis and management of geriatric syndromes, management of multi-morbidity, and systems of care. Chronic disease treatment trials focused on older adults or with a significant proportion of older adults will also be included. The strength of the evidence will be discussed as well as potential impact the work could have on current clinical practice and education. Articles selection criteria will emphasize high quality studies that may be immediately applicable in practice.

Fatigue is a very common presenting symptom in primary care but a small subset of patients with chronic fatigue syndrome have persistent fatigue accompanied by multisystem complaints of unrefreshed sleep, post-exertional malaise, orthostatic symptoms, and cognitive impairment. Those with widespread pain and tenderness fit an alternative diagnosis of fibromyalgia. Both are severely debilitating illnesses of uncertain cause. This lecture discusses the evolving concepts regarding CFS and its relationship to FM. Diagnosis and treatment are discussed.

This presentation will hone in on the practical overlap between psychiatry and medicine in diagnosis and treatment. The speaker will cover (1) the interview, establishing rapport, and the efficient use of time; (2) major areas of psychiatric dysfunction and how they interact with other aspects of health; (3) differential diagnosis of anxiety, psychosis, depression, mood instability, and cognitive problems; (4) behavioral risk, especially suicide; and (5) pharmacological and nonpharmacological treatments.

This series of interactive cases will provide an opportunity for the learner to increase their knowledge in the management of people with type 2 diabetes on insulin therapy. The cases will illustrate expert guidelines and general strategies around use of insulin and combinations of injectables for type 2 diabetes, including a practical approach to the initiation and intensification of basal insulin. You will learn the advantages and disadvantages of combination injectable medications as well as how to use them safely and appropriately.

This talk will review the pathophysiologic mechanisms of pain and how to best address them.

Screening recommendations issued by the USPSTF in the past year will be summarized and reviewed. The most significant and controversial topics will be prioritized. Within the past year, the USPSTF has issued screening recommendation statements on the following topics: cervical, prostate, and ovarian cancer; osteoporosis; CVD; atrial fibrillation; syphilis among pregnant women; adolescent idiopathic scoliosis; and vision problems among young children.

Most physicians are consumers of commercial air travel, and half of physicians have responded to a medical emergency on an airplane. Responding to a medical problem on an aircraft is one of the purest expressions of our Hippocratic Oath but provokes anxiety in many providers because of patient populations and conditions outside our normal scope of practice and the haphazard environment of an aircraft. Medical emergencies on flights are becoming more common as air travel is more accessible, people fly greater distances in larger aircrafts, and the inflight population ages. This talk will cover the pathophysiologic stress of commercial air travel, the approach to a midair patient and common inflight emergencies, interventions that can be performed in response to a medical emergency, the equipment available on the aircraft, as well as preparatory flight strategies for physicians. We will also discuss management considerations if asked to serve in other community medical emergencies such as encountering a motor vehicle accident.