JAAPA CME Post-Test July 2018
Identifying and Treating Traumatic Hand and Wrist Injuries | Evaluating and Managing Chronic Idiopathic Urticaria in Adults
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Identifying and Treating Traumatic Hand and Wrist Injuries

Michelle Kavin, PA-C; Frederic E. Liss, MD

Proper identification and management of traumatic hand and wrist injuries is critical to preventing loss of function, nerve damage, joint instability, persistent pain, and delay in indicated surgery. This activity uses case studies to help clinicians make accurate diagnoses and treatment plans. Physical examination findings, radiograph results, and treatment plans are reviewed for four traumatic hand and wrist fractures or dislocations.

Learning Objectives

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

  • Describe the presentation and key diagnostic findings of the following injuries to the hand and wrist: ulnar collateral ligament injuries, MCP and perilunate dislocations, and injury to the scaphoid bone.
  • Distinguish injuries to the hand and wrist that can be managed conservatively from those that require urgent referral to a hand surgeon.

Evaluating and Managing Chronic Idiopathic Urticaria in Adults

Lindsay Webster, MPAS, PA-C; Nicholas L. Rider, DO; Mark E. Archambault, DHSc, PA-C, DFAAPA

Chronic idiopathic urticaria (CIU), also known as chronic spontaneous urticaria, is characterized by the presence of hives on most days of the week, for 6 weeks or longer, and without an identifiable or consistent cause. Evaluation is clinical and based on the presence of episodic urticarial lesions. Although patients are subject to overtesting during the diagnosis of CIU, guidelines suggest starting with three basic laboratory tests. Treatment is a stepwise approach, involving second-generation antihistamines, histamine2 antagonists, leukotriene receptor antagonists, first-generation antihistamines, and potent antihistamines. Refractory CIU requires adding alternative agents such as omalizumab, antiinflammatory agents, and immunosuppressants.

Learning Objectives

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

  • Describe the key elements of the history, physical examination, and workup needed to aid in the diagnosis of chronic idiopathic urticaria.
  • Discuss the stepwise approach involved in the treatment of chronic idiopathic urticaria.
  • Compare the different treatment options available for refractory chronic idiopathic urticaria.

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 credit. PAs should only claim credit commensurate with the extent of their participation. Approval is valid through July 31, 2019. 

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:

Michelle Kavin practices at the Rothman Institute’s Limerick, Pa., location. Frederic E. Liss is an orthopedic surgeon at the Rothman Institute’s Limerick, Pa., location. Acknowledgment: The authors would like to thank Barry Hutchinson, MD, and Diane Deely, MD, of Thomas Jefferson Hospital for assistance with radiographs. Lindsay Webster practices at Novant Health–Wallburg Family Medicine in Winston-Salem, N.C. Nicholas L. Rider is an associate professor of pediatrics at Baylor College of Medicine, Texas Children’s Hospital, in Houston, Tex. Mark E. Archambault is an associate professor in the doctor of medical science program, PA education concentration, at Lynchburg (Va.) College. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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Type:     Journal-based CME
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