This course is aimed at advanced and more experienced colleagues, who are comfortable with routine management of medical cases. We’ll demonstrate how developing a rigorous problem orientated approach to more complex medical cases, the use of diagnostic tests and information presented in the literature can help you in your daily practice. Case examples are used throughout with the opportunity to interact. New and controversial areas of internal medicine are included in a case based manner.

• Join Ian Battersby and Rebecca Littler for three 2-hour online sessions and discover how a methodical problem orientated approach can help in the diagnosis and treatment of complex medical disorders
• Comprehensive notes to downloaded
• Self-assessment quizzes to ‘release’ your 8 hours CPD certification (don’t worry, you can take them more than once if you don’t quite hit the mark first time)
• A whole year’s access to recorded sessions for reviewing key points
• Superb value for money – learn without travelling
• Watch the recordings on your iPad!
• This Mini Series was originally broadcast in July 2016.

Programme

The Problem Orientated Approach to Medicine – What It Is and How It Can Help

This session reviews the problem orientated approach to medicine, allowing you to develop a robust logical approach to medical cases that can mimimise unnecessary testing and produce logical outcomes for your patients. This approach allows you to localise pathology to both body system and disease aetiology, and thus targeted use of diagnostic testing. Assessing the evidence from both diagnostic tests and the literature is reviewed, and the important concepts of positive and negative predictive values discussed. We will look at what the results of diagnostic tests can and can’t tell us and emphasise the need to look for what is there and what’s not. Alongside these concepts we will examine when advanced imaging and more invasive diagnostics may be indicated. The session includes case based examples. Interaction is encouraged!

What you’ll learn:

• How to use problem orientated medicine to localise disease aetiology anatomically and categorically
• How to assess evidence from the literature and diagnostic testing to see when to test and when to believe your results
• How to review positive and negative predictive values to assess laboratory test information in your clinic
• How to evaluate what testing can and can’t tell us about your patient’s disease

Endocrine Challenges – How to Stop Hormones Catching You Out

Endocrine disorders form a large part of any medical practitioner’s case load. Unfortunately hormonal disease seldom presents as described in a text book, or if it does it is unlikely to get as far as an advanced practitioner’s second opinion case load. This session will focus on more unusual and challenging endocrine cases, using real case material and encouraging participation from delegates. We’ll focus on how a logical problem orientated approach can get a correct diagnosis for these patients. We’ll examine new approaches to diagnostic testing and special consideration on how to apply them, including advanced imaging. We’ll look at problem diabetics and how to sort them out. We’ll evaluate thyroid disease – a uniquely over and under diagnosed condition – and consider adrenal disease, both hypo and hyperadrenocorticism. We’ll also examine the controversial topic of atypical Cushing’s and its implications for diagnosis and treatment of our patients.

What you’ll learn:

• Review how the problem orientated approach to medicine can help in complex endocrine cases in a case based interactive manner
• New approaches to diagnosis of unusual cases
• Problem diabetics – what can be done to sort them out
• Thyroid disease – unusual presentations to catch you out
• Atypical Cushing’s – the debate so far

Gastrointestinal Disease – Vomiting (When It Is and When It’s Not!) and Diarrhoea (How to Stem the Flow!)

We’ll review the problem orientated approach and how it helps to localise disease within the gastrointestinal system, including differentiation and diagnosis of regurgitation and vomiting combined with a thorough general investigation of gastrointestinal disease. We’ll examine dysphagia and regurgitation in greater depth with case examples. We’ll also discuss newer and advanced diagnostic techniques with relevance to these cases. The literature surrounding the rational use of antiemetic will be explored in both oesophageal and gastrointestinal disease. We’ll also present you with new thoughts on the pathogenesis, diagnosis and treatment of inflammatory bowel disease, including case examples of when this does and doesn’t work. Finally we will ask you in a case based challenge, after three weeks of problem orientated medicine, would you rather use Occams razor or Hickam’s dictum?

What you’ll learn:

• How to use the problem orientated approach to localise gastrointestinal disease both anatomically and by likely cause
• How to investigate how to differentiate vomiting and regurgitation in more difficult cases
• Explore new methods of diagnosing gastro oesophageal reflux
• How to evaluate rational use of antacids and anti emetics
• How to diagnose inflammatory bowel disease
• Different treatment regimes in inflammatory bowel disease
• Does problem orientated medicine work? Occam’s razor vs Hickam‘s dictam