Primed 2016 Notes

Most Notible Facts Learned:

1. Headache:
-. First Determine if Primary or secondary
-. If it is a primary: due to tension, Migrain, or cluster: try the following
-. Excedrine Migraine ASA 250 mg, Tylneol 250 mg and Caffeine 65mg (ok to take two at a time)
-. if A does work try Indomethicin (if not pregnant)
-. If A and B dont work can consider Sumatriptan
-. If really bad give antidopinargic: Reglan, Thorazine, or Compazine (IV or Im): Po is worthless
- Before given antidopinergic warm patient about dyskinesias

 

2. A good way to advised people about there cholesterol numbers are by using American Heart Association Risk Calculator
http://www.cvriskcalculator.com/

If 10 year risk is greater than 7.5 then statins are definitely indicated

If 10 year risk is 6.0 - 7.5 then treatment for dyslipidemia should be discussed

If 10 year risk is less than 6.0 then no treatment is indicated

Gemfibrozil is has been found to be of any benefit even is lowers cholesterol

3. There is now a test for IBS (with diarrhea) but not with (constiapation), The blood test is called "IBSchek". Most insruance we will not pay for this new test developed by a doctor at Cedar Sanai Hospital. More information is at www.ibscheck.com or call 866-427-2435.
This is a blood test that quest laboratory can do.

4. Other notible facts about irritable bowels disease:
- There is high mind to gut connection; therefore, stress is a major component
- Treatments that help to reduce stress are: Cognitive Behaviours Therapy, hypnosis, and medication
- old medications that seem to help are antispasmotics such as: Bentyl_
- old triccyclic medications also help: elavil, and notryptiline
- Consider a FODMAP diet: http://www.ibsdiets.org/fodmap-diet/fodmap-food-list/
- consider enteric coated peppermint oil

5. Probiotics - There are no absolute proven benefits but if someone asks
- If it is a bowel problems: Align which contains "bifiobacterium infantis 356624" $12 for 28 tabs at Wallgreens
- one 4 mg tablet perday for at least a month - to know if it is helpful
- If Vaginal yeast problems - a probiotic that contain a wide variety of Lactobacilus might be tried: Florajen 3 $40/month

6. Alzheimer's Association
- alz.org/findus
- Tracking devices: bracelets, shoes insoles, watches
- 888 - 572 - 8566
- 800 - 863 -3429
- medical alert

7. Influenza Vaccine:
- The high dose Flu vacine works about 20 - 25% better
- The high dose Flu vaccine is more important to give in those 75 years and older
- Remeber this is not the CDC guidelines
- remember that high dose Influenza does cover for a fourth possible flu strain each year

8. New Flu test is now available that is 98% sensitive and specific
http://www.alere.com/en/home/product-details/alere-i-influenza-ab.html
- this is the Alere i - influenza

9. Weight Loss suggestions:
- Most importantly must reduce calories
- Eating ~30 grams of Fiber a day will probably help: 1 cup baked beans, 16 grams, apple 3 grams fiber, orange 3 grams of fiber,
- Low carbohydrate diets are probably more effective than low fat diets (maybe because protein and fats takes longer to digest)
- food intake diary may also help
- In my opinion a person must put being the correct weight on the top of their list of goals

Thursday: April 28, 2016

8:55- 9:40 Preventing flu

9:45 - 10:25 Acute Coronary Syndrome

10:25 - 11:05 Varicose Veins and Venous Insufficiency

10:45 - 11:45 Common Hand injuries

1-1:40 UTI

2:15 - 3 pm Irritable bowel Syndrome

3:10 - 3:55 Unexplaned Abdominal Pain
- turned out to be Ann-gio edema

4-5 Advances in Stroke Prevention

5:20 - 6 pm Contraceptive Updates
- The rise of LARCs

FRIDAY April 29. 2016

8:55 - 9:40 Treating DVT and PE

9:45 Musculoskeletal Disorder In Primary Care

10:25 - 11:05 am Metabolic Syndrome, Knowing the risk

11:05 - 11:45 Headache a clinical Approach

12-12:45 Anticoagulation and reversal Therapy

1-1:45 Infectious Diseases

1:45- 2:30 Fevers from around the world

2:20 - 3:15 Infecitons in the Elderly

3:25 - 4:10 Mangement of Rosacea

4:15 - 4:55 Low testosterone Syndrome

4:55-5:35 Low Back Pain

5:35-6:15 Chronic Kidney Disease

SATURDAY

8:55-9:40 Probioitc and Fiber

9:45-10:25 Common Head and Neck Preoblems in Primary Care

10:25 - 11:05 The Dizzy Patient

11:05-11:45 Asthma Update 2016

11:55 - 12:40 Treatment of Hypogonadism

11:55 - 12:40 Skin Cancer

1:25 - 2:05 Gout

2:05-2:45 COPD Treatable