Continuing Medical Education Programs

Continuing Medical Education Programs
Dr. Anika Niambi Al-Shura, Lecturer Copyright 2014 Niambi Wellness. All rights reserved

Integrative Examination in Cardiovascular Disease
Copyright 2014 Niambi Wellness. All rights reserved

Physical Examination in
This course is approved by the following agencies: National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for 9 PDA points and Florida State Board of Acupuncture for 12 CEUs. The companion textbook: Physical Examination in Cardiovascular Chinese Medicine must be ordered at Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved
Course Description This course focuses on the basic cardiac patient examination routine using protocols of both western medicine and TCM. Copyright 2014 Niambi Wellness. All rights reserved

Course Objectives Understand the basics of how to take a cardiac patient history and triage vitals. Understand blending of basic western and TCM methods for examining cardiovascular patients in the clinic. Copyright 2014 Niambi Wellness. All rights reserved

Chapter 2: Weight Measurement

The Body Adiposity Index (BAI) is a method of measuring body fat without considering body weight. The body mass index (BMI) is a method of measuring body fat by including weight. Copyright 2014 Niambi Wellness. All rights reserved

According to the textbook
Classify lipoprotein disorders in Chinese medicine. Explain two risk factors linked to heart failure. List the genetic causes of high lipids in some patients? Explain the significance of waist circumference. Copyright 2014 Niambi Wellness. All rights reserved

According to the course
How is BAI calculated? How is BMI calculated? What are the differences between BAI and BMI for fat calculation across ethnic groups? Copyright 2014 Niambi Wellness. All rights reserved

Chapter 3: Blood Pressure Errors

Terminal digit preference
This is the rounding off of numbers to the nearest zero, which can increase the reading and cause misdiagnosis. Using an automatic blood pressure cuff rather than a manual one may reduce errors. Copyright 2014 Niambi Wellness. All rights reserved

Stethescope How the stethoscope is used is important in other areas of the body. However, the bell or diaphragm are both common to use in blood pressure measurement. One does not provide better sound quality over the other. Copyright 2014 Niambi Wellness. All rights reserved

Underestimating true blood pressure
Rounding down the to the nearest 0, could cause a loss of around 5 mmHg. The consequences: under-treatment of an underlying serious heart condition ie: myocardial infarction or stroke. Copyright 2014 Niambi Wellness. All rights reserved

Overestimating true blood pressure
Rounding up the to the nearest 0, could cause a padding of around 5 mmHg. The consequences: over-treatment of a minor condition, a non-existent condition or white coat hypertension. Copyright 2014 Niambi Wellness. All rights reserved

White-coat hypertension
A rise in blood pressure in the clinic, under competently acquired readings, which is different from a normal blood conducted at home. Copyright 2014 Niambi Wellness. All rights reserved

If an initial blood pressure reading is elevated and a second reading is lower, the initial reading may be higher because of doctor-related white-coat effect. Copyright 2014 Niambi Wellness. All rights reserved

Part 2: Proper Technique

Sitting measurement The patient's back is supported.
The cuff is a proper size and placed securely over a bare upper arm.

The arm is supported on a table and positioned at heart level.
Both feet are on the floor.

Standing measurement This should be a routine measurement for elderly patients ≥70 years old. Also for all patients who are taking anti-hypertension medications and for patients with dizziness or orthostatic hypertension. Copyright 2014 Niambi Wellness. All rights reserved

Standing systolic pressure may decrease blood pressure by ≥20 mmHg in elderly patients. A blood pressure reading this low could constitute orthostatic hypotension. Copyright 2014 Niambi Wellness. All rights reserved

The patient should wait 2-3 min
The patient should wait 2-3 min. in the standing position before blood pressure is measured.

The arm should be supported by being placed on a table or held.

Placing a cuff which is too big or small can increase or decrease the systolic pressure by 10mmHg. Forearm pressure is often 3.6/2.1 mmHg higher than upper arm pressure. Copyright 2014 Niambi Wellness. All rights reserved

. List two main tools used to measure and examine the blood pressure. Describe the common and genetic factors to consider in hypertension? Describe the moment during the procedure when systolic pressure can be measured? Describe the moment during the procedure when diastolic pressure can be measured? Copyright 2014 Niambi Wellness. All rights reserved

. Indicate blood pressure ranges at each stage of hypertension according to JNC7 classification. Indicate the differences between the average heart rates of athletes, adults and children of age 12 and above. Copyright 2014 Niambi Wellness. All rights reserved

What are the dangers of over-estimating/underestimating a blood pressure reading? List the proper sitting and standing blood pressure measurements. List the common patient and cuff errors Copyright 2014 Niambi Wellness. All rights reserved

Chapter 3: Temperature Errors

The temperature is divided into core temperature and peripheral temperature. Core temperature is within the body. Peripheral can be measured at different areas of the body which maintains stable temperatures. Copyright 2014 Niambi Wellness. All rights reserved

The differences between core and peripheral temperatures is called clinical bias. Clinical bias is also the result of inaccurate temperature readings due to device failure or procedure failure. Copyright 2014 Niambi Wellness. All rights reserved

Part 2: Description of Devices

Temporal Artery Temperature

Sublingual Temperature

. 1. Describe the purpose of recording body temperature. 2. Explain the problems associated with hyperthermia. 3. Explain the problems associated with hypothermia. Copyright 2014 Niambi Wellness. All rights reserved

Module 1 Review Questions

Please continue on to Module 3

Continuing Medical Education Programs

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