|
|
OUTPATIENT GERIATRICS ROTATION FOR
FAMILY MEDICINE AND INTERNAL MEDICINE RESIDENTS
PENN MEMORY
CENTER
Clinic
Location
Ralston-Penn Center
First floor, 3615 Chestnut Street, Philadelphia, PA 19104
telephone number: 215-662-7810
http://www.uphs.upenn.edu/ADC
Description of Clinic
Physician education
at the Alzheimer’s Disease Center involves in-clinic “hands-on” training, reading and formal didactics. Physicians will learn how to:
1) perform and interpret the tests of cognition, affect and health,
2) perform a focused history and physical,
3) diagnose, stage and treat dementia.
The following are course topics with the goals of each topic. To achieve
these goals, the student is expected to review the assigned readings and
lectures, and participate in the Penn Memory Center.
Course
Topics
- The epidemiology, differential
diagnosis and clinical course of dementia
- Describe the pathology,
clinical presentation and course of dementia
- Understand the controversies
and changing concepts in the nosology of dementia
- The work up of cognitive
complaints
- Have the skills to perform
an office-based assessment of the patient with cognitive complaints
- Understand the domains
of cognitive function
- Understand the instruments
available to measure the domains of cognitive function
- Understand the tests
available and that may become available to diagnose dementia
- The treatment of patients
with dementia: primary treatment
- Understand the difference
between disease slowing and symptomatic treatments for dementia
- Be able to describe
the symptoms of dementia
- Be able to identify
effective treatments for dementia
- The treatment of patients
with dementia: management of neuropsychiatric symptoms
- Understand the spectrum
of common neuropsychiatric symptoms
- Understand the role
of medications and non-medication strategy in the treatment of neuropsychiatric
symptoms
- The treatment of patients
with dementia: bioethical issues and caregiving
- Describe the four roles
of the caregiver of the patient with dementia
- Understand the impact
of dementia on each of the caregivers’ roles
- Understand the standards
for assessing a patient’s decisionmaking capacity
- Develop strategies to
practice effective decisionmaking with caregivers and patients:
focus on decisions about treatment, research, end-of-life care and
driving.
Methods
to achieve course topics.
1. Participation in Penn Memory Center
| Week
1: |
observe
psychometric testing and assessment of patient and review test scoring
and interpretation and physical exam |
| Week 2: |
observe follow-up
and initial patient visits, and review the structure of an interview
with a knowledgeable informant |
| Week 3: |
perform and
dictate a patient assessment |
| Week 4: |
perform and
dictate a patient assessment |
Students will provide Carol Edwards with their contact information so
they can receive results of the diagnostic work-up of their patients that
become available after they complete their clinic rotation.
2.
The following are the instructional materials organized by topic.
The student is responsible for reading and viewing these materials in
their off-clinic time. The papers and lectures are available via the
ADC web page http://www.pennadc.org. The web site is currently under
redesign. The links for these papers and the power point lecture on
staging are “causes,” “diagnosis,” and “treatment
and disease management” under the heading “Understanding
Alzheimers Disease and related dementias.”
Readings
Clark,
C.M., & Karlawish, J.H.T. Alzheimer disease: Current concepts and
emerging diagnostic and therapeutic strategies. Annals of Internal Medicine.
2003; 138: 400-410.
Karlawish
JHT & Clark CM. Diagnostic evaluation of elderly patients with mild
memory problems. Annals of Internal Medicine. 2003; 138: 411-419.
Power
point lecture with audio
Course
Director |
Administration |
|
|
Divison
of Geriatric Medicine |
|
Ralston
House |
|
3615
Chestnut Street |
|
Telephone:
215-898-8997 |
Telephone:
215-573-4634 |
Fax:
215-573-8684
|
Fax:
215-573-8684 |
|
