JAAPA CME Post-Test July 2024

Irritable Bowel Syndrome: Clinical Practice Update

Irritable bowel syndrome (IBS) is a common and burdensome disorder characterized by chronic recurrent abdominal pain and altered bowel habits. IBS remains misunderstood, leading to delayed diagnosis, impaired quality of life, and substantial healthcare costs. Advancing clinicians’ understanding of this complex biopsychosocial process, using a positive diagnostic strategy rather than a diagnosis of exclusion, and incorporating a multimodal treatment approach expedite time to diagnosis, facilitate symptom relief, and reduce financial expenditure.

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Describe the pathophysiology of IBS and its role in patient-centered management
  • Explain how the Rome IV symptoms-based diagnostic criteria and selective testing are used to support a positive diagnostic strategy
  • Describe a multimodal treatment approach

The Role of Primary Care in Improving Health Outcomes in Young Foster Children

Children removed from their biological families because of abuse, neglect, and/or violence have increased healthcare needs and are susceptible to poor health outcomes compared with children who are not in the child welfare system. Developmental delays occur in about 75% of children in foster care. Up to 80% of children entering out-of-home care have at least one physical health problem and more than 40% experience educational challenges. In most U.S. states, newly removed children are required to have a medical evaluation shortly after placement in a foster or kinship family. The initial evaluation is important for identifying urgent concerns and developing a rapport with children who may not have had regular medical care. In addition, the child’s complete social, trauma, and medical history may be unknown because of system barriers such as inconsistent medical care by biological parents, privacy laws protecting records, and unavailability of birth histories and biological parents’ medical and psychosocial histories. As a result, a series of visits is required to fully evaluate the child’s development and healthcare needs. This activity provides guidance for PAs who provide care to children in foster care.

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Discuss the national prevalence and common health challenges of children in foster care
  • Describe the team of people involved in the care of children removed from their biological parents
  • Contrast typical neurodevelopment of young children with the neurodiversity that characterizes children in foster care
  • Identify key elements of primary care for foster children

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