BHRT Part I Post test and Evaluation Feb 20-21, 2010
 

1. Default Section

 

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1. Please fill out your demographic data for the permanent record of your certificate.

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2. Medical Designation

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3. How many credit hours did you attend.
(60 minuts is 1 credit hour)

Maximum credit for both days is 16.5

The healthcare provider should only claim credit
commensurate with the extent of their participation in the activity.

POST TEST
CASE STUDY #1: A 53 year old (y/o) female presents with menopausal symptoms and desires HRT. She has a strong family history of heart disease and osteoporosis. To assure protection you should monitor hormone levels.

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4. For cardiovascular and musculoskeletal protection, serum estradiol levels should be maintained greater than 50 pg/ml.

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5. For endometrial protection, serum progesterone levels should be maintained to at least 2 ng/ml.

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6. Medroxyprogesterone acetate dosed at 2.5 mg per day provides optimal serum progesterone levels

CASE STUDY #2: A 55 y/o male has been taking testosterone prescribed by you for 6 months. A recent visit to his family physician for a physical exam resulted in abnormal lab tests that demonstrated an elevated HgB. He has been scheduled for a bone marrow analysis.

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7. Testosterone has been shown to cause polycythemia ruba vera.

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8. According to literature, elevated HgB caused by testosterone administration causes harm and requires periodic phlebotomy?

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9. Testosterone has proven beneficial affects all of the following lipid parameters EXCEPT?

Case Study #3: A family physician tells one of your hormone patients to stop hormones because they cause diabetes. You explain that this is not correct.

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10. Insulin resistance is decreased by which hormones?

CASE STUDY #4: A local OB/GYN evaluates your hormone patient for vaginal bleeding. An ultrasound demonstrates a thickened endometrial stripe. She is treated with high dose medroxyprogesterone acetate.

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11. The most efficacious treatment of endometrial hyperplasia is high dose MPA at 10 to 20 mg /day.

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12. Due to the fact that micronized progesterone is much weaker than MPA, it is not recommended for treating an increased endometrial stripe or hyperplasia.

Case Study #5: Your hormone patient’s family physician tells her not to take thyroid because it causes osteoporosis especially since she has a suppressed TSH level.

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13. A suppressed TSH level usually portends osteoporosis even if the T4 and T3 levels are maintained within the normal range

CASE STUDY #6: A 49 y/o woman presents with severe hot flashes and irregular periods. Her LMP was 2 weeks ago. The previous MP was a month before that. You are confused as she has fairly normal periods but hot flashes.

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14. The primary ovarian hormone that is responsible for the hot flashes and elevated FSH levels is estrogen

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15. Perimenopausal women with hot flashes would be expected to have what level of estradiol during a hot flash?

CASE STUDY #7: A 45 y/o woman requests thyroid hormone to feel better in spite of her normal lab tests. You question whether this is appropriate.

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16. Euthyroid patients that are treated with thyroid hormone to raise hormone levels to high normal levels, experience less depression and better memory and cognition?

COURSE EVALUATION

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17. How would you rate the overall course?

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18. How would your rate the impact of this course on your practice?

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19. Please rate the following faculty:

Neal Rouzier, MD

Knowledge of the subject:

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20. Neal Rouzier, MD

Ability to respond to questions:

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21. Neal Rouzier, MD

Did the speaker present, without bias, a balanced discussion of competing therapeutic options or treatment strategies?

22. Comments about Dr. Neal Rouzier

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23. Please rate Carolyn Rouzier.

Knowledge of the subject:

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24. Carolyn Rouzier
Ability to respond to questions

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25. Carolyn Rouzier

Did the speaker present, without bias, a balanced discussion of competing therapeutic options or treatment strategies?

26. Comments about Carolyn Rouzier

Objectives:
Upon completion of this course the participant will be able to:
1. Demonstrate proficiency in the medical literature that supports biologically identical hormone replacement in contrast to chemically altered hormones and realize that “all hormones are not the same” as demonstrated in the literature.
2. Describe the diagnosis and treatment of adult onset growth hormone deficiency.
3. Identify the techniques used to administer acceptable levels of human growth hormone (HGH).
4. Examine and discuss possible side effects of HGH and how to properly adjust dosing.
5. Distinguish the different types of secretagogues and evaluate their effectiveness as an alternative to HGH therapy.
6. Implement therapeutic management of andropause based on studies reported in prestigious medical journals.
7. Identify the types, doses and methods to administer testosterone to men and women.
8. Determine the uses of testosterone for men and women, including complications, precautions, side effects and monitoring.
9. Discuss the uses of Finasteride, Dutasteride, Anastrozole in the management of testosterone administration.
10. Identify the uses of melatonin including correct dosing and monitoring.
11. Apply strategies for the effective uses of DHEA and pregnenolone including correct dosing and monitoring.
12. Determine how DHEA and pregnenolone benefit the physical and mental well-being of patients and overall quality of life.
13. Describe new evidence that contradicts the WHI Study on estrogen treatment in women.
14. Demonstrate an understanding of the health benefits of estrogen and progesterone in contrast to the health detriments of synthetic estrogen and progestin.
15. Describe the types, doses and methods used to administer estrogen and progesterone.
16. Discuss recent literature, questions and answers that demonstrate the beneficial effects of hormones in improved function and healing and a better quality of life.
17. Explain current concepts of thyroid replacement and compare and contrast different types of thyroid as supported in the medical literature.
18. Recognize various methods of testing for thyroid deficiencies and what labs and approaches are best.
19. Discuss and analyze interesting cases in bioidentical hormone replacement therapy.
20. Recognize the difference between “normal levels” and “optimal levels” of hormones and the benefits or detriments as demonstrated by current medical studies.
21. Apply current prescribing strategies for hormones to maintain adequate levels.
22. Implement best clinical practices in diagnosing, prescribing, monitoring and adjusting of BHRT for improved function and quality of life.
23. Develop and apply business management principles to set up a preventive medicine practice.
24. Analyze and review treatment protocols in case management and troubleshooting techniques used in BHRT.
25. Utilize the knowledge gained to improve patient outcomes in BHRT.
26. Describe how to write prescriptions for compounded hormones to pharmacies, and how different formulations can affect absorption, efficacy and side effects.
27. Adjust any inaccurate or inappropriately prescribed hormone therapy to conform to scientific standards as seen in medical literature.
28. Implement current strategies into your practice to improve the level of care and patient compliance in the treatment of adult hormone deficiencies.
29. Assure that prescribed hormones meet industry standards based on attaining adequate serum levels and symptom improvement.

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27. Were the objectives met?

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28. Did this CME Workshop provide you with additional tools to manage your patients using Bio Identical Hormone Replacement Therapy in the prevention and treatment of disease?

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29. Will you make any changes in your practice/patient care as a result of this activity?

30. If you answered "Yes", which changes will you make?

31. If you answered "No", please describe why:

32. If Barriers prevent you from making a change in your practice/patient care (Describe the barriers)

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33. Please identify topics on BHRT you would like to see presented in future workshops?

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34. Please identify 1 practice gap that needs to be addressed for each topic you identified in question #33.

Thank you for taking the time to answer all of our questions. Your feedback will empower us to continue to provide quality and important continuing medical education programs.

You will now be directed to your statement of credit which can be filled out and printed for your records.

After your certificate appears please fill out top section by clicking above first, last name and your medical designation and typing in the appropriate information in each of those sections.

Please also fill out the hours you ACTUALLY attended by clicking in that section and typing the # of credit hours you attended.

Then place your curser and click in the section that is appropriate to the credit you will be requesting (physician, nursing, pharmacy, or other)and a check mark will appear.

You can than print the certificate for your records.

After the certificate has printed you will need to sign your certificate on the signature line and if you are a pharmacist you will additionally need to fill in the date you printed the certificate.

Again we THANK YOU for your time and for attending this workshop.

Should you have any problems/issues please contact FCM at 425-821-9917 or email us at www.fcm.cme@verizon.net