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2018 Clinical Conference Evaluation & Post Test-Enduring Materials Format: Update in Stroke Management

Evaluation

JAN 30, 2018- EVALUATION & POST TEST - UPDATE IN STROKE MANAGEMENT, PRESENTED BY; MOUSSA YAZBECK, MD, NEURO CRITICAL CARE, ESTIMATED TIME TO COMPLETE THE ACTIVITY IS 45 MINUTES. ACTIVITY AND CONTENT EXPIRES: JAN 30, 2021
STATEMENT OF DISCLOSURE: THE PLANNERS AND FACULTY FOR THIS ACTIVITY HAVE NO RELEVANT FINANCIAL RELATIONSHIPS WITH COMMERCIAL INTERESTS. NO OTHERS INDIVIDUALS INVOLVED IN THE PLANNING OR PRESENTATION OF THIS ACTIVITY HAVE ANY RELEVANT FINANCIAL RELATIONSHIPS WITH COMMERCIAL INTERESTS TO DISCLOSE.
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CREDIT DESIGNATION STATEMENT: JOHN MUIR HEALTH DESIGNATES THIS ENDURING MATERIAL FOR A MAXIMUM OF ONE (.75) AMA PRA CATEGORY 1 CREDITS™.  PHYSICIANS SHOULD CLAIM ONLY THE CREDIT COMMENSURATE WITH THE EXTENT OF THEIR PARTICIPATION IN THE ACTIVITY.  
MINIMUM LEVEL OF ACHIEVEMENT:   MUST SCORE 75% CORRECT ON POSTTEST AND COMPLETE THE STATEMENT OF HOW YOU WILL IMPROVE YOUR PRACTICE AFTER PARTICIPATION IS MANDATORY. 
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1. Physician Info
This question requires a valid date format of MM/DD/YYYY.
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3. As a result of attending this CME activity, which of these do you plan to implement and/or change in your practice? *This question is required.
Space Cell DefinitelyMaybeNo Change
Differentiate between older and newer options for stroke management
Formulate and communicate treatment plans for the management of medically and socially complex patients
Apply best practice strategies to overcome co-morbidities in medically and socially complex patients
Utilize EBM Guidelines for a multitude of conditions that are encountered in primary care
Utilize Patient Centered Care skill to help patients become better informed and more involved in their health care decisions.
8. Was their evidence of commercial bias in this session? ​
9. A 67 year old African American male with atrial fibrillation on Apixaban (Eliquis), diabetes mellitus and hypertension woke up at 7:30 am with right hemiparesis and difficulty expressing himself. His wife heard him go to the bathroom around 5 am and exchanged some words with him at that time and he sounded at his baseline. On presentation to the emergency department, a CT head without contrast was negative for large territorial stroke or bleed and patient had further worsening of his symptoms. Pt is candidate for tPA.
10. A 78 year Caucasian female nursing home resident with history of breast cancer in remission and hypertension was noted during the routine morning rounds to be weak on the left, slurred but following commands with a right gaze preference. She was seen at her baseline 9 hours prior before she went to bed. In the emergency department, a CT head without contrast was non revealing. This was followed by a CT angiogram and CT perfusion of the brain. Patient was deemed not candidate for tPA. Similarly,  this patient will not be candidate for intervention and thrombectomy as her presentation exceeds the 6 hours rule.
11. An 80 year male with history of recent cold, and hypertension otherwise still functional at baseline presented to his PCP with vertigo, nausea and one episode of vomiting over the last 2 days. Patient wanted a prescription for “inner ear infection” as his wife had similar symptoms few years back. Upon evaluation by his PCP, patient didn’t appear to be toxic but had some nystagmus on exam. He had severe cerumen in both ear canals obstructing the view of his middle ears. At this time, the best course of action would be to treat his symptoms of vertigo and ask him to return to the office in 2 to 3 days if not improved.
12. It is more difficult to rehabilitate a right sided stroke resulting in left hemiparesis an neglect than a left sided stroke causing right hemiparesis and aphasia.