CAPACon 2022 Course Descriptions

General Medicine Track
Update from NCCPA: Focus on PANRE Alternative
Alicia Quella, PhD, PA-C

The National Commission on Certification of Physician Assistants (NCCPA) is launching an alternative recertification assessment next year. In addition to the traditional PANRE that is administered at Pearson VUE test centers, PAs will have an official longitudinal, take-at-home option called PANRE-LA. NCCPA also offers PAs the opportunity to show credentials for advanced expertise in a specialty through the Certificates of Added Qualifications (CAQ) program.

NCCPA Director of PA Relations, Alicia Quella, will use this session to:
  • Describe the options available for PANRE beginning in 2023 with many new details on PANRE-LA
  • Describe the CAQ program
  • Recognize the ways PAs contribute to the work of NCCPA and how NCCPA communicates and provides resources to PAs
Pain Management in the Patient with Opioid Use Disorder
Andrew Lowe, PharmD

Pain is one of the most common complaints that patients present with during an office visit or hospitalization. Currently, health practitioners resort primarily to the use of opioids, and often misdoes patients who have concomitant opioid use disorder. This often results in poor patient outcomes and dissatisfaction for both patients and providers. Dr. Andrew Lowe, an expert in pain management and substance use disorders, seeks to help PAs recognize opioid use disorder and provide multimodal analgesia.

Participants in this session will learn to:
  • Describe the differences between acute and chronic pain
  • Define opioid tolerance and physical dependence and discuss how they influence choices in therapy
  • Develop a plan for assessing and managing the analgesic regimen when given a case presentation of a patient with opioid use disorder complaining of pain
Menopause: Turn Down the Flames
Anita Nelson, MD

More than 50 million women are postmenopausal, with 75% of them experiencing some kind of menopausal distress. While these symptoms aren't life threatening, menopause increases women's risk for more serious illnesses such as hypertensions, cholesterol, diabetes, and osteoporosis. New insights and research shed light on the safety of hormonal therapies, which can help PAs improve the quality of life in their peri- and post-menopausal patients.

Women's health specialist, Dr. Anita Nelson will:
  • Differentiate the vasomotor symptoms during perimenopausal and postmenopausal periods
  • Outline the safety and efficacy of various treatment options
  • Present the newer understandings of NKDy neurotransmitters and the new therapeutic target for symptom relief
Treating Substance Use Disorders as Part of your Practice
Arianna Campbell, PA-C

A study done by AAPA and published in 2020 identified that PAs from all disciplines identified both a gap in education in diagnosis and treatment of substance use disorders as well as a desire for increased education. Given the significant rise in overdose deaths, exceeding 100,000 in the year ending April, 2021, PAs are vital to changing the system of care to more effectively address substance use disorders in everyday practice. California Bridge Program Director, Arianna Campbell, hopes that this lecture results in an increase in X-waivered PAs in the state.

At the end of this session, participants will be able to:
  • Understand the importance of treating substance use disorders as comorbidities and in all practice settings
  • Discuss current evidence-based treatments for substance use disorders, specifically buprenorphine for opioid use disorder
  • Describe an effective system to provide high quality care, including harm reduction, to drug-using patients
Joint Hypermobility and the Ehlers-Danlos Syndromes
Brianna Cardenas, PA-C, ATC

Ehlers-Danlos Syndrome (EDS) is widely unrecognized and frequently misdiagnosed. Patients experience chronic pain, frequent joint subluxations/dislocations, and multi-systemic comorbidities that significantly impact quality of life. As many as 1 in 2500 people have EDS, and untreated EDS poses a significant strain on patients and their care teams. PA Brianna Cardenas has hypermobile Ehlers-Danlos Syndrome (hEDS) and is passionate about educating others about this condition.

Participants in this session will learn to:
  • Recognize signs and symptoms of EDS
  • Diagnose hEDS
  • Implement management strategies for patients with EDS
Diabetes: An Evidence-Based Approach to the Follow Up Visit
Curtis Fowler, DMSC, PA-C

Providers managing patients with type II diabetes are often put in the position of only managing medications.  However, the follow up visit should be an opportunity to reinforce all aspects of care related to preventing complications. This session will present a review of evidence-based standards and discuss a framework for incorporating them into a routine visit.

PA Fowler, adjunct professor at the University of the Pacific, will cover how to:
  • Review key components of the 2021 ADA Standards of Medical Care in Diabetes
  • Recognize measures to prevent microvascular complications
  • Recognize measures to prevent macrovascular complications
Teeth- Turns out they are Attached to the Body
Fadra Whyte, DDS

Oral health has historically been separated from systemic health. This mindset is changing and integrating oral health with overall health is becoming the standard of care. It is important for primary care providers to have an understanding of preventative oral health measures as well as the impact oral health has on a patient’s systemic health. Pediatric dentistry specialist, Fadra Whyte, DDS, strives to develop ways PAs and dentists can collaborate on broad issues such as nutrition and preventative medicine.

After this session, participants will be able to:
  • Diagnose basic oral health conditions, prescribe antibiotics correctly, and know when to refer to a dental team
  • Provide anticipatory guidance and preventive measures to their patients to prevent dental disease
  • Understand how their patient’s oral health impacts other health outcomes (obesity, cardiology, oncology, and obstetrics)
Nailed It! Management of Common Nail Pathologies
Jed Grant, DMSC, PA-C

Abnormalities of the fingernail are often encountered clinically.  While many are benign, certain nail findings indicate a more serious disease process in the patient. Differentiating serious from benign examination findings can guide further diagnostic workup.  Appropriate management of common nail disorders can preserve cosmesis and avoid long term complications.

Vice-Chair of the Department of Physician Assistant Education at the University of the Pacific, Dr. Jed Grant will teach participants how to:
  • Recognize benign findings on examination of the nails
  • Identify signs of internal disease as expressed in the nails
  • Describe appropriate treatment of common nail problems
Integrative Medicine and Dermatology: The Influence of Nutrition, Mind-Body, and the Microbiome
Jessica Maloh, ND & Raja Sivamani, MD, MS, AP

The influence of nutrition and the mind-body connection on inflammation and stress is a source of many questions during patient care encounters. Because of the dearth of training in this area, there is a knowledge gap around the influence of nutrition, mind-body, and the microbiome in relation to inflammation and common skin conditions. Naturopathic doctor, Jessica Maloh, and Dermatologist, Raja Sivamani, will team up for this lecture to provide PAs with practical approaches to incorporate these concepts into their practice.

Participants in this session will learn to:
  • Describe the mechanisms for how nutrition and the gut microbiome communicate to the body and skin
  • Discuss the evidence for the influences of mindfulness and mind-body in inflammation and inflammatory skin conditions
  • Evaluate the use of supplements and probiotics to address stress and inflammation for common skin conditions
The Fountain of Youth in the Palm of Your Hand: Medical Aesthetics
John Beuerle, MD

Medical aesthetics is a rapidly growing field, and many medical providers are exploring opportunities to incorporate medical aesthetic treatments into their practice. It is important to be aware of the medical and legal requirements, training opportunities, breadth of services, and potential risks and pitfalls in the practice of medical aesthetics. Dr. Beuerle will provide PAs with an understanding of what next steps to take to transition their practice into medical aesthetics.

Participants in this session will:
  • Develop an understanding of the medical and legal requirements for practicing medical aesthetics in California
  • Be able to describe techniques and clinical indications for common treatments performed in medical aesthetics
  • Develop an awareness of risks and potential pitfalls in the practice of medical aesthetics
Gender-Affirming Genital Surgery
Kayla McLaughlin, PA-C

Passage of the Affordable Care Act allowed a wider array of individuals, most notably underserved and underrepresented populations, to have the choice to access gender-affirming surgical care. This impact on the healthcare system requires PAs to provide such specialty care. PA McLaughlin provides inclusive care to patients undergoing surgical genital transition and hopes that this session will help participants become more comfortable with transgender patients and genital surgery.

Learning objectives for this session include to:
  • Define language and terminology pertaining to sexual orientation, gender identity, and sexual practices
  • Evaluate World Professional Association for Transgender Health (WPATH) Version 7 guidelines and recommendations for gender-affirming surgery
  • Discuss pre-operative, intra-operative, and post-operative care pertaining to gender-affirming surgical procedures
Anemia in Chronic Kidney Disease
Kim Zuber, PA-C

Anemia is a common complication of chronic kidney disease (CKD), causing significant patient burden and increasing risk for negative outcomes. Managing anemia in CKD with guideline-recommended therapies can help alleviate symptoms and improve outcomes. Additionally, emerging treatments may offer clinicians other options for treating anemia in CKD, if approved. Primary care practitioners are often the first clinicians to encounter patients presenting with anemia in CKD, and thus they can improve the timely identification and treatment of these patients.

At the end of this session, participants will be able to:
  • Discuss methods to improve recognition of anemia in CKD in primary care and explain the importance of early management to reduce symptoms and adverse outcomes
  • Implement appropriate treatment for patients with anemia in CKD who can be adequately managed in the primary care setting
  • Describe evidence for emerging agents being studied in clinical trials for anemia in CKD
The Role and Utility of MRAs in Diabetic Kidney Disease
Kim Zuber, PA-C

The incidence of diabetic kidney disease (DKD) continues to rise, and with it, the need for more effective treatment options. Mineralocorticoid receptor antagonists (MRAs) are making a difference in the care of patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), with recent FDA approvals offering additional therapeutic options. While steroidal MRAs have been available for many years, the introduction of finerenone, a non-steroidal MRA, has shown significantly improved benefits in reducing DKD progression.

PA Zuber will teach participants how to:
  • Appropriately screen for the presence of CKD in patients with T2DM
  • Initiate evidence-based therapy to slow the progression of kidney disease in patients with T2DM and CKD
  • Describe mineralocorticoid receptor antagonists and their role in the treatment of patients with DKD
Cannabis: Management of Use and Misuse of THC
Linda Hill, MD, MPH

Both recreational and medicinal cannabis (THC) use has increased since the passage of Prop 64. Patients are sometimes hesitant to reveal cannabis use to their clinicians, which limits clinicians’ ability to identify side effects and drug interactions. Dr. Linda Hill’s lecture will provide information on eliciting a THC use history, managing side effects and drug interactions, and the status of medical research on the use of THC to treat medical conditions.

During this session, PAs will learn to:
  • Understand the epidemiology of cannabis use in California
  • Describe THC effectiveness, side effects, and drug interactions
  • Appropriately counsel patients on THC use and misuse
Lucy Horton, MD, MPH

COVID-19 is a multi-organ disease and can cause a broad spectrum of manifestations or symptoms. Large numbers of patients who have been infected with SARS-CoV-2 continue to experience a constellation of symptoms long past the time that they’ve recovered from the initial stages of COVID-19 illness. Often referred to as “Long COVID”, these symptoms can persist for months and range from mild to incapacitating. It is important for PAs to educate patients on post-COVID syndromes, understand testing and treatment options, and know how to manage care.

Board-certified infectious disease specialist Dr. Horton will provide participants with the knowledge to:
  • Identify signs and symptoms of Long COVID and educate patients about post-COVID syndromes
  • Determine potential multidisciplinary teams for patient care of Long COVID
  • Describe common challenges to post-acute COVID-19 care
Endocrinology Pearls for the Primary Care PA
Matthew Levine, MD, FACE

Endocrinologists often rely on primary care providers to effectively recognize endocrine pathology symptoms and initiate a proper workup, even in patients that require specialty consultation. It is thus critical for primary care PAs to properly investigate endocrine pathology and have a collaborative relationship with endocrinology specialists. American Association of Clinical Endocrinology board member, Dr. Matthew Levine seeks to help establish this partnership to improve patient care.

Participants in this sessional will learn how to properly:
  • Evaluate for hypothyroidism and hyperthyroidism
  • Treat disorders of thyroid dysfunction
  • Evaluate hypogonadism in a male with suggestive symptoms
Integrating Nutrition Therapy into Patient Care
Nancy Hamler, DMSC, MPA, RDN, PA-C

Research has shown that a significant number of medical providers, including PAs, have had little to no formal education on nutrition or lifestyle. Yet, many patients look at clinicians for nutrition advice as a first line or complementary option to their treatment. To provide holistic patient-centered care, healthcare providers must gain and expand their evidence-based nutrition knowledge. Prior to becoming a PA, Nancy Hamler worked as a dietitian and has continued her involvement as an Assistant Professor in clinical nutrition education at University of the Pacific.

After this session, participants will:
  • Recognize nutrition therapy as a complementary approach
  • Demonstrate a greater understanding of nutrition-focused interventions
  • Integrate basic nutrition therapy into patient care
What You Should Really Know About Peripheral Arterial Disease
Robert Ross, PA-C

What has increasingly been recognized is that if an individual has blocked arteries in the legs, they are also very likely to have blocked arteries in the heart and the brain. Peripheral Arterial Disease (PAD) is a very strong independent predictor of having heart attacks and strokes. Orchestrated efforts among healthcare providers, researchers, expert organizations, and healthcare organizations will be needed to increase awareness and understanding of PAD and improve the diagnostic approaches, management, and prognosis of PAD.

In this lecture, cardiology and endocrinology expert Robert Ross, PA-C, will cover the following to help primary care providers develop an excellent cardiovascular prevention program for all their at-risk patients:
  • Review the risks as defined by the American Heart Association (AHA), American College of Cardiology (ACC) and American Diabetes Assocation (ADA) for patients who have potential PAD
  • Present a test for PAD that is 95% accurate
  • Present treatments for patients with PAD
Osteoporosis: Latest in Diagnostic and Treatment Options
Robert Ross, PA-C

Osteoporosis, traditionally defined as a disease characterized by low bone mass, is now acknowledged to be a nongender-specific “skeletal disorder characterized by compromised bone strength, predisposing a person to an increased risk of fracture.” Identified early, osteoporosis can be effectively treated and fracture risk can be reduced. However, it often remains undiagnosed until significant bone lone or fracture has occurred.

PA Ross will provide case histories of patients with osteoporosis to illustrate practical issues faced by clinicians in diagnosis and treatment while also helping participants:
  • Identify modifiable and nonmodifiable risk factors for osteoporosis and fracture
  • Diagnose and strategize treatment plans for patients with osteoporosis
  • Identify ways to improve adherence to treatment regimens
Early Identification and Diagnosis of Axial Spondyloarthritis
Soha Dolatabadi, MD

Patients with axial spondyloarthritis (axSpA) typically present with chronic back pain and often seek treatment from their primary care providers. To facilitate the assessment of patients who may have axSpA by a rheumatologist, it is essential for PAs to be sufficiently familiar with axSpA and know when to refer. Unfortunately, existing data suggest that non-rheumatologist clinicians who manage patients with back pain often do not have adequate knowledge of axSpA symptoms, spectrum of disease, and epidemiology.

Participants that attend rheumatologist Dr. Dolatabadi’s session will:
  • Develop an awareness of the typical presentation of axSpA
  • Understand appropriate testing for a patient with chronic back pain suspected of axSpA and apply criteria for referral to rheumatology
  • Gain knowledge of basic principles of diagnosis and treatment of axSpA as applied by rheumatologists