JAAPA CME Post-Test April 2018
Beyond Skin Deep: Managing Pressure Injuries | Sandifer Syndrome
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Beyond Skin Seep: Managing Pressure Injuries

Daniel Podd, MPAS, PA-C

Pressure injuries (previously called pressure ulcers) are a common finding among patients in acute, long-term, or home settings. Numerous pathophysiologic and risk mechanisms factor into the development of pressure injuries. The timely recognition of these injuries is imperative. Many treatments exist for pressure injuries but the focus of patient management should be on preventing injury-related complications.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Define the pathophysiology of pressure injuries and the risks for their development.
  • Describe available strategies for managing pressure injuries and their benefits and drawbacks.

Sandifer Syndrome

Debora M. Moore, MPAS, PA-C; Denise Rizzolo, PA-C, PhD

Sandifer syndrome is a rare complication of gastroesophageal reflux disease that may be more common than reported. This syndrome was first mentioned more than 50 years ago with minimal documentation in the medical literature. Because of the presentation, the patient may be referred for lengthy, expensive, and unnecessary neurologic testing. This may lead to a missed or delayed diagnosis, mismanagement, and the use of inappropriate medication. Providers should be aware of Sandifer syndrome when evaluating a child with torticollis or unusual posturing that is not associated with neuromuscular disease or injury.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Differentiate the features of Sandifer syndrome from epileptic events.
  • Describe the association between Sandifer syndrome and GERD and hiatal hernia.
  • Provide a treatment strategy for a patient diagnosed with Sandifer syndrome, starting with nonpharmacologic approaches, followed by medical management and surgery.

Accreditation Statement


This activity has been reviewed by the AAPA Review Panel and is compliant with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid through April 30, 2019. PAs should only claim credit commensurate with the extent of their participation.

Disclosure Policy Statement

It is the policy of AAPA to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following:

Daniel Podd is an associate professor at St. John’s University in Queens, N.Y., and practices with Doctors on Call/Comprehensive Geriatric Care and at Long Island Queens Medical Center. Debora M. Moore practices at Dawes Family Medicine in Santa Maria, Calif. Denise Rizzolo is an assistant clinical professor of the Pace Completion Program in the Department of Physician Assistant Studies in New York City, an associate professor in the School of Nursing at Kean University in Union, N.J., and an assessment specialist for the Physician Assistant Education Association. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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Type:     Journal-based CME
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