GPCE Workshop SynopsesWA TYPE 2 DIABETES – appraise & share experiences & actions in type 2 diabetes – a novel clinical behaviour appraisal workshop
Participating in this workshop will enable you to compare your type 2 diabetes Mx decisions with those of your peers & experts – focusing on problematic clinical situations. It will provide insight into current type 2
diabetes Mx trends; facilitate review & discussion of recent evidence for the various type 2 diabetes therapeutic options; & utilise the complex networks of knowledge that develop with clinical experience.
Sessions 4,5,9,10,11 GlaxoSmithKline WA OSTEOPOROSIS, calcium & Vit D – Mx & new approaches to risk prevention
Calcium and Vitamin D play an important role in developing healthy bones for future life. Unfortunately the latest statistics indicate that many people, including children, may be deficient in receiving their daily requirements. This interactive workshop will look at the importance of routine assessments of calcium & Vit D in all patients with, or at risk of osteoporosis. At the end of the workshop, participants should be aware of the latest guidelines on the recommended daily intakes of calcium & Vit D & be better equipped to identify & manage patients at risk for osteoporotic fractures where calcium &/or Vit D deficiency is a contributing factor.
Sessions 2,7,8,13 Procter & Gamble WA HEARING LOSS – new technology update
A look at the different types of hearing loss, how to manage, and the latest technological advances in hearing devices. Which hearing aid is most suitable for which patient, and hearing loss. Sessions 3,6,12 Australian Hearing WB KIDNEY HEALTH – CKD
1. Haematuria and urinary infection Microscopic haematuria occurs in about 2-3% of adults. The investigation & best Mx pathway for microscopic haematuria is somewhat complex & under-recognized. Symptomatic urinary infection is the most frequent reason why adults seek help for disease of the kidneys & urinary tract. This workshop addresses the practical issues that arise in managing these conditions. Sessions 3,8,13
2. Slowing the progression of CKD in general practice General practice has an important role in managing CKD to slow or even halt its progression. This workshop covers areas relevant to the early detection &
Mx of Stages 1 – 3 CKD in general practice. Sessions 4,9,14 Kidney Health Australia WB STROKE /TIA- optimising antiplatelet therapy Mx in secondary prevention
This workshop will highlight the prevalence of stroke within the Australian community and the cross-risk associated with atherothrombotic disease. The interactive session will include how to risk assess & manage patients for recurrent stroke and the antiplatelet therapies available. Sessions 1,2,6,7,11,12 Sanofi-Aventis WC COMPLEMENTARY MEDICINE
1. Necessary nutrients for GPs – beyond the basics An overview of important areas of nutrient shortfalls in the Australian population, focusing on iodine, vitamin D, calcium, folic acid & B12. The GP can expect to leave with knowledge of the missing nutrients, the patients that suffer from this, how to make the DD, & how to restore normal nutritional levels. Dr Mark Donohoe Sessions 1,6,12
2. The GP, the naturopath, and the patient – natural remedies in gp for chronic disease management Case presentations involving the patient already using alternative therapies. An expert in natural health will provide an evidence-based review on managing chronic diseases with complementary medicines. GPs will be invited to ask questions on areas such as benefits, side effects, efficacy and contraindications to other medications or diseases. These workshops will equip GPs with information on these medicines, and inspire further thought as to how they may integrate complementary therapy into daily practice. Sessions 4,9,14
Blackmores WC PATHOLOGY
1. Autoantibodies in chronic disease Autoimmune diseases (AID) comprise the 3rd largest clinical burden (5-6% of Caucasians) after cancer & heart disease. AID are classified into 2 broad groupings: organ-specific AID & systemic AID. AID of single endocrine organs (autoimmune endocrinopathy) comprise an important subset & are accompanied by circulating autoantibodies to that particular organ, e.g autoimmune thyroiditis, pernicious anemia & type 1 diabetes. Anti-receptor autoimmunity characterised by autoantibodies to cell surface receptors make up another subset & include thyrotoxicosis & myasthenia gravis characterised respectively by antibodies to the TSH & Ach receptor. Other organ-specific AID are associated with autoantibodies that may or may not be restricted to that particular organ, e.g. Coeliac disease. Others in this
group include the liver autoimmunity group, ANCA-associated inflammatory diseases of small blood vessels (vasculitis), & autoimmune skin diseases. The liver autoimmunity group comprises autoimmune hepatitis & primary biliary cirrhosis. There are new tests such as Autoantibody to F-actin for autoimmune hepatitis, anti-nuclear antibody to gp210, sp100 & PML for primary biliary cirrhosis. In the ANCA-associated vasculitis group, antibody to MPO is typically associated with pauci-immune glomerulonephritis while antibody to PR3 segregates with Wegeners granulomatosus. In contrast, systemic AID are characterised by concurrent diseases of multiple organs e.g. systemic lupus erythematosus (SLE), RA & scleroderma. Newer tests for SLE include antibodies to nucleosomes & ribosomal P proteins while antibodies to cyclic citrullinated peptide (CCP) is a relatively new test for RA. The anti-phospholipid syndrome characterised by lupus anticoagulant, anti-cardiolipin antibody & antibody to 2-glycoprotein 1 may be a secondary accompaniment of the systemic AID, in particular with SLE. Prof Ban-Hock Toh Sessions 2,7,11 Gribbles Pathology
2. Melanocytic skin lesions To date, a microscopic tissue DD still remains an essential prerequisite for clinical Mx of various skin cancers. A correct diagnosis is made on adequate macroscopic & microscopic morphological assessment as well as appropriate clinico-pathological correlation. Proliferative melanocytic lesion has always been & will continue to be a challenge for pathologists. A good clinician-pathologist interaction is needed for difficult neoplastic skin lesions. Dr Leonard Wu Sessions 3,10,13 3. Chronic leukaemias and indolent lymphomas Although this group of disorders may present with symptoms such as tiredness & lymphodenopathy, they are often detected by the GP as part of a routine screening FBE. Judicious use of a few useful tests can lead to a quicker DD. Complications of these disorders can also be detected on screening blood tests. Using clinical examples, the correct approach to diagnosis & early Mx will be discussed. Dr Paul Turner Sessions 5,8,15 Gribbles Pathology WD EMERGENCY MEDICINE
1. Airway – Basic and Advanced This is a one hour hands on workshop with the following stations: basic bag valve mask ventilation – use of the ventilation bag & basic mask skill; use of laryngeal mask – use of the ventilating – non-airway protecting laryngeal mask; intubating laryngeal mask – conversion of a non-protected to a protected airway; basic Intubation; the surgical airway – use of pigs tracheas to teach a simple surgical cricothyrotomy technique used in life salvage. Dr Peter Kas Sessions 3,8,13
2. I’ve got rhythm – simulation arrhythmia scenarios The recognition & Mx of resuscitation scenarios involving arrhythmias. Arrhythmias covered will be: ventricular tachycardia; ventricular fibrillation; supraventricular tachycardia; third degree heart block. This workshop will involve the teaching & approach to a resuscitation of arrhythmia including drug therapy & defibrillation. Dr Peter Kas Sessions 4,9,14 WE
SUTURING 1 – Introductory: very basic and for the rusty attendees, including deep and jagged lacerations. Sessions 4,7,13
SUTURING 2 – Advanced: corner sutures and large wound closure, and biopsy techniques. Sessions 5,8,9,14
Suturing 2 attendees must have either attended Suturing 1 or be competent proceduralists. Dynek & Australasian College of Cosmetic Surgeons WE FLAP REPAIR FOR SKIN CANCER SURGERY
Principles of flap repair with an introduction to advancement flaps and angle sutures. This workshop will give you ample opportunity to practise these versatile flaps using pigs’ trotters and seek practical advice from experienced doctors where necessary. Session 2,6,11 Australasian College of Skin Cancer Medicine WF
ENT 1:THE EAR: Ear trauma, foreign bodies, the blocked ear, otitis media and the management of the person with dizziness/tinnitus. Sessions 2,7,12
ENT 2: THE NOSE & THROAT: clinical assessment & practical Mx of rhinitis and sinusitis, snoring and sleep disorders, hoarse voice and neck lumps. Sessions 3,8,13 WG SPORTS MEDICINE – lower limb: Achilles tendinopathy, plantar fascia pain & medial tibial stress syndrome
Achilles tendinopathy, plantar fascia pain & medial tibial stress syndrome are probably 3 of the more common lower limb presentations in gp. Case presentations will be aimed at accurate DD & differential DD of these problems. Physiotherapists will provide an overview of biomechanical assessment skills & simple initial rehab related to these findings that GPs can utilise in their practice, supported by recent research evidence. Sessions 2,9,13 Rob Brandham & Andrew Wynd Sports Medicine Australia (VIC) WG SPORTS MEDICINE – hamstring injury
In elite AFL competition, hamstring strains are the most common injury, resulting in the greatest number of lost playing days. The recurrence rates are also high & > 30% recur within the season, despite concentrated
rehabilitation and prevention efforts. A clinical study where a physical examination consisting of 2 flexibility tests, a manual muscle test, an active slump test & palpation was compared to an MRI investigation in hamstring injured AFL footballers examined within 3 days of injury. This study showed that MRI is not required for estimating the duration of rehabilitation of an acute strain. This workshop will discuss this
study, how AFL & Sports Physiotherapists assess hamstring strains, how to assess severity, when to expect to return to competition, how to recognise those at risk of reinjury, how they are successfully rehabilitated, & when is an MR appropriate? Price Warren Sessions 3,8,14 Sports Medicine Australia (VIC) WG SPORTS MEDICINE – common shoulder presentations to a GP clinic
Outline of common shoulder presentations: supraspinatus impingement; biceps tendonitis; adhesive capsulitis; common traumatic presentations (dislocations, subluxations, labral tears, AC pathology); cervical-related shoulder pain & relationship to posture. Including brief cover on pathology, presenting history & recommended investigations. Also covered will be findings upon shoulder examination & definitive tests to differentiate between common presentations; Rx options – conservative referral; specialist opinion; evidence-based practice in physiotherapy, and future directions on physiotherapy rehabilitation. Sam Leslie Sessions 1,6,11 Sports Medicine Australia (VIC) WG SPORTS MEDICINE – acute knee & ankle injuries
Common problems in both contact and non-contact sports & the more acute injuries in sports such as football, AFL, basketball and netball will be outlined in this workshop. Appropriate examination, findings and Mx options will be discussed. Dr Anik Shawdon & Dr Peter Fuller Sessions 4,5,7,12 WH PATIENTS IN PAIN: assessing and managing the spectrum of pain 1. Back, neck and shoulder pain Part 1 & 2 Back pain is one of the most common, and frequently frustrating, conditions seen by GPs. This module examines back, neck and shoulder pain, focussing on assessment of patients – including identification of yellow flags (factors that might lead to development of chronic pain) and red flags (requiring follow-up of underlying pathology) – and management of nociceptive and neuropathic components of pain. Sessions 1 & 2 or 8 & 9 2. Painful diabetic neuropathy Part 1 & 2 For people with painful diabetic neuropathy, pain can be the most debilitating aspect of their diabetes. This module highlights the impact of painful diabetic neuropathy and explores practical techniques for assessing patients. Therapeutic options for treatment of this neuropathic pain condition are discussed, and a treatment algorithm examined. Sessions 4 & 5 or 11 & 12 3. Chronic pain Part 1 & 2 Patients in pain can be difficult to manage. Modern medicine cannot always provide a definitive diagnosis, and sometimes patients have to learn to live with a degree of pain. This module looks at the biopsychosocial model of chronic pain, then focuses on managing patient expectations and self-help options as well as pharmacotherapy for chronic pain. Sessions 6 & 7 or 13 & 14 Developed and supported by Pfizer AustraliaWI DERMOSCOPY for GPs
Basic dermoscopy using the 3 point checklist algorithm will be explored. Some of the advanced algorithms – Menzies technique, Stolz’s ABCD & 7 point checklist will be outlined. Dermoscopy features of BCC, melanoma, Bowen’s SCC in situ, seborrhoeic keratosis and other common lesions will be reviewed. In addition, a segment will be devoted towards a choice of suitable demoscopes appropriate for a particular practice. This will explore issues of polarising versus non-polarising dermoscopy and handheld versus digital dermoscopy. Sessions 1,2,6,7,11,12 Molescan WI WOUND Mx – acute, chronic, infected in young and elderly
Wound Mx is a common clinical scenario in gp, whether it be acute following trauma or chronic as is more common in the elderly – with venous leg ulcers. The type of wound dressing & Mx is important in promoting more rapid healing. This workshop will look at the Mx from the simplest to the more complicated infective & chronic wound. What to do, how to differentiate, what dressings (gel, foam, antimicrobial, impregnated etc.) and when to apply. Sessions 5,8,14 Paul Hartmann Pty Ltd WI BANDAGES, STOCKINGS & DRESSINGS for venous disease
Compression is required for patients with symptomatic venous disease, leg oedema or venous complications. The compression required depends on the severity of venous hypertension – compression needs to control pressures in the standing ambulatory position. Compliant or non-compliant systems are indicated in different conditions & these will be demonstrated, as will bandaging techniques. Prof Ken Myers Sessions 3,4,9,10,13 Australasian College of Phlebology WJ EMERGENCY MEDICINE – CPR
This course is designed for GPs and provides participants with the knowledge and skills necessary to make them confident & competent to perform cardiopulmonary resuscitation. The course will cover Mx of the unconscious casualty, resuscitation techniques & infection control and you will be provided with Emergency First Aid: A Quick Guide booklet. Participants receive a Statement of Attainment for the following units of competency:– 70104NT – Course in Cardiopulmonary Resuscitation. Sessions 1,2,4,5,6,7,9,10,11,12,14,15 Red Cross WK INTEGRATIVE MEDICINE
1. Requirements for effective nutritional supplements Supplements come in all manner of colours & shapes with different preparations & potencies. The estimated prevalence of adult dietary supplement use in countries like US was estimated to be about 73% in 2002. This w/shop is intended to review clinically relevant issues related to the widespread use of dietary supplements, with emphasis on regulatory oversight & safety. Prof Robert Allen Sessions 3,7
2. Probiotics and gastrointestinal health for successful ageing A probiotic is a live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance. Probiotics hold the key to intestinal health & have been shown to impact positively on the immune system & indirectly enhance health. Within this foundation probiotics could positively enhance longevity. A/Prof Luis Vitetta Sessions 9,12
3.The effect of positive thinking, diet, meditation & psychosocial support on psychological & physical wellbeing of cancer patients The increasing popularity of non-mainstream cancer Rxs raises complex
ethical & practical issues for both patients & the medical profession. This w/shop will present evidence-based approaches that may benefit the patient diagnosed with a neoplastic disease. A/Prof Luis Vitetta Sessions 10,14 Bioceuticals & Unit of Health Integration, School of Medicine, University
of Queensland WK WOMEN’S HEALTH
1. Investigation of menstrual problems Women commonly present to their GP with menstrual problems ranging from amenorrhoea to oligomenorrhoea to polymenorrhoea & this may be associated with perceived increase in menstrual blood loss (menorrhagia) and associated primary or secondary dysmenorrhoea. History & clinical examination will form the basis of the initial assessment followed by investigations that may include a haematological profile including clotting studies as well as endocrinological workup & ultrasound scan. Further invasive investigations may be required including diagnostic laparoscopy, hysteroscopy & endometrial sampling. The GP is ideally placed to assess women presenting with menstrual problems & organise the relevant investigations. Further Mx may require specialist referral. Dr Anthony Lawrence
Session 8 2. Identification and treatment for polycystic ovaries Polycystic ovaries – in approx. 20% of women – are the commonest cause of irregular periods in the reproductive age group. Polycystic ovarian syndrome is
the name given to a condition in which polycystic ovaries are associated with a number of other significant symptoms & signs. Investigation hinges on ultrasound scan assessment of the ovaries as well as gonadotrophin hormone assessment. Rx depends on the desired end point which may include menstrual regulation, pregnancy & therapy directed towards hirsutism & skin changes. Dr Anthony Lawrence
Sessions 6,11 3. Identification and treatment of endometriosis Up to 40% of women with infertility &/or pelvic pain suffer from endometriosis. It is a debilitating disease & one of the leading causes for loss in work productivity. Despite this, there is an average delay of 9 years between first onset of symptoms & final diagnosis. Studies in the US have also indicated that the economic health burden for endometriosis is higher than that for hypertension & not much lower than that for diabetes & rheumatoid arthritis. Awareness for this often overlooked condition amongst GPs is crucial if we want to decrease the impact on the patient & wider
community. In this workshop participants will be presented with a summary of the latest news from the World Endometriosis Society held in Melbourne in March 2008. Dr Luk Rombauts Sessions 1,13 4.Techniques for GPs to maximise & preserve male & female fertility Infertility affects 1 in 6 Australian couples. Now that IVF has become so successful, it is often forgotten how changes in lifestyle factors can be a very important first step towards improving a couple’s fertility. The increasing trend for women to conceive at an older age has put an extra burden on GPs to make sure referral for infertility Rx is not delayed. Finding a balance is often not easy. This workshop will provide an update on useful lifestyle interventions to improve fertility & simple algorithms to assist with the decision on when to refer for specialist advice. Dr Luk Rombauts Session 2 5. Adolescent women’s health including contraception The principle reason that adolescents visit their GPs with gynaecological or women’s health issues is menstrual problems or contraceptive advice. The
absence of periods by the age of 16 needs to be investigated. Heavy and painful periods can often be managed by oral contraceptives, and there is no contra-indication to introducing these if indicated. Contraception for teenagers is usually best managed by hormonal methods. The “Double Dutch” method of using condoms in addition should be encouraged to decrease the risk of STI transmission. The diagnosis of PCO should be considered in young women who present with acne. These women benefit from early advice on lifestyle, with respect to diet and exercise. Prof Gab Kovacs Session 5 Monash IVF WL APPROPRIATE PHYSICAL ACTIVITY FOR CHRONIC DISEASE
Obesity and physical inactivity are being increasingly recognised as important risk factors for poorer outcomes in patients with chronic diseases such as cancer or type 2 diabetes. This workshop will bring you up-to-date with the latest clinical research findings & discuss how engaging in physical activity of the appropriate intensity will help your patients better manage their chronic disease. A/Prof Luis Vitetta, Paul Hedger, Jason McLaren Sessions 1,6,13 Healthy Pond WL STRAPPING TECHNIQUES & exercise prescription
1. Foot & ankle: practical examination, exercise prescription & strapping techniques Session 3
2. Shoulder: practical examination, exercise prescription & strapping techniques Session 9
3. Knee: practical examination, exercise prescription & strapping techniques Session 14
Healthy Pond WL MEDICO-LEGAL
1. Melanoma risk modification framework Avant has established a clinical risk modification framework to reduce the likelihood of risk of missed & delayed diagnosis in melanoma. This consists of (1) a series of risk guidelines that have been established by a series of facilitated workshops harnessing the best available evidence & the wisdom of experts in dermatology, pathology, surgery, gp & skin cancer clinics and (2) a
series of risk indicators. These indicators will be collected on a regular basis (4 times/year) & reflect the reality of their practice & compliance with the risk guidelines & provide them with an opportunity to compare with themselves & their peer group over time. In this way, clinical & administrative staff at practice level have better awareness of risk & have a clear process to manage to in a practical manner. This session will discuss the framework & the guidelines contained in it. Sessions 2,7 2. Foetal ultrasound risk modification
Avant has established a clinical risk modification framework to reduce the likelihood of risk of missed & mid-diagnosis of foetal ultrasound. The framework consists of (1) a series of risk guidelines that have been
established by a series of facilitated workshops harnessing the best available evidence and the wisdom of experts in radiology, obstetrics, sonagraphy & practice managers and (2) a series of risk indicators. These indicators will be collected on a regular basis (4 times/year) & reflect the reality of their practice & compliance with the risk guidelines & provide them with an opportunity to compare with themselves & their peer group over time. In this way, clinical & administrative staff at practice level have better awareness of risk & have a clear process to manage it in a practical manner. This session will share the implementation strategy & provide early data from the program that started in May 2008. Sessions 4,11 WL 3. Becoming a high performing team* – lessons from ancient Rome
This session will demonstrate some of the features of high performing teams & consider ways in which this might be implemented in practice. Issues of mentoring, communication & managing the challenge of being busy are discussed. *model provided by Ms Bernie Harrison, Clinical Excellence Commission reproduced with permission Sessions 8,12 Avant WM
OPHTHALMOLOGY 1: Update on common ocular emergencies & problems, and their practical hands-on Mx, including appropriate examination. Topics will include the red eye, trauma, corneal ulcer, foreign bodies, pterygium, abrasion & acute glaucoma. Sessions 1,7,12
OPHTHALMOLOGY 2: Cysts, lid lesions, BCCs, ophthalmoscopy and retinopathy – a practical approach Sessions 3,9,13 Alcon & presented by RANZCO WN MEDICAL DIRECTOR
1. PracSoft – basic functions & on-line claiming. Learn basic functions for when your practice manager is away – including making an appointment, billing, on-line claiming streamlined, batching, how to audit & check your figures & make reports. Sessions 1,6,11
2. Creating registers and Recall and Reminders systems for CDM Sessions 4,12
3. Letter writer – Basic – learn how to create templates for managing your patients with chronic disease Session 3
4. Care Plans – how to utilise MD3 for your GPMP and TCA. (Basic letter skills essential)Sessions 8,13
5. Pathology management – including setup of pathology request for CDM, managing your results & recalling patients Session 9
6.Tips and tricks – end some of that frustration – 20 features of MD3 that can make for much more efficient use Sessions 5,10
7. Progress Notes Sessions 2,7
Health Communications Network WO COSMETIC DERMATOLOGY
Often the GP is presented with a patient complaining about spots, pigmentations or unsightly veins. This presentation will look at the DD & when laser technology can help in relation to vascular, hair removal, tattoo removal, pigmentation. Will include demonstrations on actual lesions/patients. Sessions 1,2,6,7,11,12 Device Consulting WP
1. HIV overview An interactive workshop featuring risk assessment – epidemiology, primary HIV infection, diagnosing HIV, natural history of HIV, HIV Rx, opportunistic infections, referral pathways and HIV transmission issues. Sessions 4,6
2. COMMON STIs – testing and Mx His interactive workshop will look at key points about STIs viz. chlamydia, HPV, syphilis & gonorrhoea – especially so since the incidence has been increasing in Victoria.
Sessions 1,10,15
3. HEPATITIS C This interactive workshop will look at testing and Mx of hepatitis including epidemiology, natural history, identifying people at risk, testing, prevention of transmission, risk factor reduction & Rx options. Sessions 7,12 General Practice Victoria WP BP & CARDIOVASCULAR RISK Mx – a practical approach
24hr ambulatory blood pressure (ABP) studies provide the clinician with a comprehensive 24hr BP profile, but with hypertension research and Rx guidelines traditionally based on clinic (resting) readings, two questions arise: How do you interpret the 24hr data and what guidelines do you use to implement Rx based on this information? These workshops will cover the current clinical evidence and recommendations regarding the use of 24hr ABP monitoring as a frontline diagnostic tool in gp. You will also: discuss and compare the significance of 24hr BP studies vs in-clinic readings; improve your ABP interpretation skills; and use this knowledge to better treat hypertension in your practice. The workshop will also address better utilisation of, and confidence in ECG acquisition, troubleshooting & interpretation. You will also explore how best to use simple technology to enable dialogue with cardiologists on-line for Mx difficulties. Sessions 2,3,8,9,13,14 Medevco
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