Scientific Sessions

Abnormal Thyroid Function Tests: What to Do?

• What are the most common causes of abnormal serum thyroid-stimulating hormone (TSH) results in a patient treated with a previously stable dosage of levothyroxine?
• What is the best approach to the evaluation and management of a high serum TSH in a patient treated with a previously stable dosage of levothyroxine?
• What is the best approach to the evaluation and management of a low serum TSH in a patient treated with a previously stable dosage of levothyroxine?

Challenges in Geriatric Medication Management: An Interactive, Case-Based Presentation

• How do we approach deprescribing for older patients? What are tools to assist with deprescribing?
• How can clinicians identify potentially inappropriate medications?
• Once a potentially inappropriate medication is identified, what safer therapies can clinicians use instead?

Colorectal Cancer Screening

• What are the correct and incorrect uses of stool-based testing?
• How do I know if my patient received a "high-quality" colonoscopy?
• What are the prospective benefits and pitfalls of new, noninvasive colorectal cancer screening tests and artificial intelligence–assisted colonoscopy?

Evaluation of the Outpatient With Chest Pain

• Which patients are suitable for stress testing versus computed tomography angiography (CTA)?
• What is the ideal office-based evaluation of chest pain?
• When should I refer a patient to the emergency department for evaluation of chest pain?

Nephrology in the Inpatient Setting: A Case-Based Approach

• When does acute kidney injury need an inpatient evaluation?
• What are the current criteria for inpatient initiation of dialysis?
• How can the inpatient clinician best manage the hospitalized patient who received home hemodialysis (HD) or peritoneal dialysis (PD)?

Syncope: An Evidence-Based Approach to Inpatient Evaluations

• Which patients presenting to the emergency department with syncope require hospitalization, and who can receive work-up in the outpatient setting?
• What is the appropriate work-up for a patient admitted for syncope, and which symptoms prompt specific diagnostic tests?
• When discharging a patient with syncope, how can pending or additional testing opportunities be triaged at the transition of care?

Artificial Intelligence: Ethics and Bias

• How can AI be ethically implemented in health care with concerns over data privacy, patient consent, and algorithmic transparency?
• What are frameworks and guidelines that can help ensure ethical and legal AI practices in health care?
• What is the potential for bias in AI algorithms, including how biased training data can lead to disparities in health care outcomes?
• What is the role of health care professionals in advocating for ethical AI practices and ensuring that AI tools are used to improve, not hinder, equitable patient care?
• What are the consequences of widespread reliance of AI tools for diagnosis and prognosis?

COVID-19, Influenza, and Respiratory Syncytial Virus: What's New?

• What are the current recommendations for vaccination and other pharmacologic preventive strategies among adults for respiratory syncytial virus (RSV), influenza, and COVID-19 infections?
• What treatment and point-of-care testing options are available?
• How effective are the available prevention and treatment options?

Inpatient Management of Diabetes for the Hospitalist

• In which patients should we consider continuing outpatient diabetes medications, including newer oral medications and newer formulations of insulin, during their admission?
• Which patients receiving sodium–glucose cotransporter-2 (SGLT2) are most at risk for euglycemic diabetic ketoacidosis (EDKA), and can it be distinguished from alcohol or starvation ketosis? Is it safe to continue SGLT2 in the hospital in some patients?
• For a new diagnosis of diabetes, how do we decide which medications to start at discharge?

Perimenopause: An Approach to Evaluation and Management

• How is perimenopause defined and diagnosed? Do you need to check hormones to establish the diagnosis?
• What are the symptoms associated with perimenopause that internal medicine physicians should monitor for? How can you tell them apart from other symptoms that need to be evaluated?
• What evidence-based treatment options are available, and are there special considerations that need to be taken into consideration for perimenopausal women versus postmenopausal women (e.g., need for contraception and role of intrauterine device)? Is there any evidence for alternative or over-the-counter treatments?

Systemic Lupus Erythematosus

• What are the current criteria for diagnosing lupus?
• What tests/studies should be ordered, and how should they be interpreted while waiting to see a rheumatologist?
• What are current and new therapies for lupus?

Update in Critical Care Medicine

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Opening Ceremony

Clinical Pearls: Gastroenterology and General Internal Medicine

• Test your clinical acumen by answering challenging patient management questions faced in practice.
• Compare your critical thinking with that of your colleagues.
• Amass a rich collection of "pearls" that can be applied to patient care.

Contemporary Lipid Management in a New Era of Options

• What is the target low-density lipoprotein (LDL) cholesterol level for patients with high-risk coronary artery disease (CAD)?
• How should I manage a patient with statin intolerance?
• What is the management of patients with elevated lipoprotein(a) levels?

Diagnosis of Screen-Detectable Cancer in Adults Under the Age of 50

• Among adults younger than 50 years, what is the prevalence of screen-detectable cancers (e.g., breast, colon, and prostate), and which patient characteristics or risk factors are most commonly associated with earlier-onset disease?
• Given current guidelines, how can clinicians identify patients who meet established high-risk criteria and ensure they receive appropriate, timely screening?
• What practical approaches can clinicians use to provide support to patients who receive a diagnosis of cancer at a younger age?

Fluids With Early Use of Vasopressors for Septic Shock: Is It Safe?

• Is early use of vasopressors safe and effective for septic shock?
• Can I give vasopressor agents through a peripheral IV catheter, or do I always need a central line?
• What is the evidence that supports early use of vasopressors for septic shock?

Stroke: Common Challenges in the Hospital

• What are common stroke mimickers?
• What presentations of stroke are commonly missed?
• Who should and shouldn't receive thrombolytics and/or endovascular therapy?

Update in Endocrinology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Aging Out of Pediatric Care When Living With Pediatric and Congenital Conditions

• How can the transition from pediatric to adult outpatient care or hospitalization be facilitated for patients graduating from pediatric care?
• What are important clinical pearls for the care of adult patients with congenital or genetic conditions, such as congenital heart disease, sickle cell disease, and cystic fibrosis?
• When do patients with complex congenital conditions need to be cared for at, or transferred to, a tertiary center?

Aortic Stenosis: Evaluation and Management

• What are the cardinal symptoms of severe aortic stenosis?
• What is the appropriate evaluation and time for referral for aortic stenosis?
• As an internal medicine physician, how can I best serve my patients with a potential or existing prosthetic aortic valve?

Gastroenterology for the Inpatient Clinician

• What diagnostic advances exist for patients with unclear sources of gastrointestinal (GI) bleeding?
• Which patients with pancreatitis need more imaging than just the CT ordered in the emergency department?
• What are emerging testing and treatment opportunities for Clostridioides difficile (C diff) infection?

Multiple Small Feedings of the Mind: Endocrinology, Sleep Medicine, & Pulmonology/Critical Care

• Endocrinology
  • 1. What is the latest evidence for patients who might benefit from DEXA screening prior to age 65 years? How do you counsel patients who ask for screening before 65 years?
  • 2. For patients with high FRAX scores or osteopenia who are in their 50s, what are best practices for treatment, taking into consideration long-term management? How do you counsel about nonpharmacologic interventions beyond calcium and vitamin D?
  • 3. What are best practices for how primary care physicians should be incorporating vertebral fracture assessment in their routine osteoporosis screening?
• Sleep Medicine
  • 1. What is new in the diagnosis and treatment of narcolepsy, including the role of biomarker testing and newer medications?
  • 2. What is the diagnostic and treatment approach for excessive daytime sleepiness when a sleep study shows no sleep apnea? What are the clinical considerations for starting stimulants?
• Pulmonology/Critical Care
  • 1. How do you counsel patients about pulmonary risk from environmental factors, such as exposure to wildfire smoke, air pollution, and mold exposure? What historical or patient factors should prompt referral to a specialist for further evaluation and testing?
  • 2. Managing Post–Intensive Care Syndrome in Primary Care: What new evidence-based protocols exist for outpatient care? What should we be doing for our patients who don’t have access to specialized care centers?

New Meds in Primary Care

• Which newly approved medications are likely to be prescribed by internal medicine physicians?
• What are recent medications that have transitioned to generic status and the implications for cost, accessibility, and insurance coverage?
• What side effects of newly approved medications should internal medicine physicians be aware of?

Update in Infectious Diseases

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Assessment and Management of Frail Older Patients in the Hospital: A Case-Based Approach

• Are goals of care different for frail older patients?
• How do you assess fitness for surgery in frail patients?
• What strategies can we use to improve outcomes in frail patients in the hospital or undergoing surgery?

Case-Based Management of Obesity

• What are some case studies that illustrate different approaches to obesity management in primary care, including behavioral and pharmacologic?
• What is the role of multidisciplinary care in managing obesity, involving dietitians, exercise physiologists, psychologists, and other specialists?
• What are strategies for the long-term management of obesity, including maintaining weight loss, preventing weight regain, and addressing such comorbidities as diabetes, hypertension, and cardiovascular disease?

Chest Pain: Common Challenges in the Hospital

• Who can be discharged home from the emergency department?
• Who should get a coronary computed tomography angiography (CCTA) versus stress test versus left heart catheterization?
• Should medications for primary or secondary prevention be empirically added before discharge?

Precision Oncology: Breast Cancer as an Exemplar

• Which biopsy results guide breast cancer therapy?
• How can precision diagnosis de-escalate adjuvant or metastatic therapy?
• What are the common small molecule inhibitors used in treatment?
• What are the common chemoimmunotherapies?
• How is immunotherapy used in the adjuvant and metastatic contexts?

Sports Medicine for the Primary Care Physician

• What are the current best practices for managing concussions in athletes and nonathletes, including criteria for return to exercise and making appropriate postconcussion referrals?
• How can primary care physicians recognize and effectively counsel patients with regard to biomechanical abnormalities and muscle imbalances to prevent and rehabilitate injuries?
• What is the role of biologic injection therapies, such as platelet-rich plasma (PRP), in treating injuries, and what evidence supports their use in clinical practice?

Update in Ambulatory General Internal Medicine

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Acute Thrombosis: Common Challenges in the Hospital

• How should we decide among anticoagulants and thrombolytics for acute venous thromboembolism?
• Which patients with new pulmonary embolism can be sent home from the emergency department?
• When is it reasonable not to anticoagulate?
• How should we manage patients with thrombosis and bleeding?
• How should we manage patients with thrombosis while anticoagulated?

Consult Talk

• Join the Annals Consult Guys as they address a variety of clinical issues while using humor to deliver educational pearls related to the practice of internal medicine.

Food Allergy: Current Concepts

• What is the difference between food allergy and food intolerance?
• What are the clinical manifestations of food allergy?
• What is the current approach to managing food allergies?
• What are the key components of a food allergy diagnosis, and what diagnostic limitations exist?

Hypertension: How Low Should We Go and How Do We Get There?

• What is the goal blood pressure?
• How do I get there?
• What's new in the management of hypertension?

Obstructive and Restrictive Lung Disease: Challenges in the Inpatient Setting

• Are antibiotics always necessary for chronic obstructive pulmonary disease (COPD) exacerbations?
• How prevalent is obesity as a cause of restrictive physiology or chronic dyspnea?
• What tests should be considered for the patient with chronic hypercarbic and/or hypoxic respiratory failure of unclear cause?

Update in Women's Health

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Cirrhosis and Chronic Liver Disease

• How has the epidemiology of liver disease in the inpatient setting shifted?
• What are the most sensitive, specific, and practical ways to accurately diagnose new cirrhosis?
• What elements of high-value care are commonly missed in the hospital?

Hospital at Home and Creative Models to Reduce Length of Stay and Readmissions

• Who are good candidates for hospital at home?
• How do we monitor these patients remotely?
• What evidence exists for the benefits, risks, and costs of hospital at home?

Promoting Recovery From Critical Illness

• What are the long-term effects of critical illness?
• How do you promote recovery from critical illness and avoid readmission?
• What lessons can be learned from post–intensive care unit interventions?

Systemic Vasculitis: What the Internal Medicine Physician Should Know

• When should vasculitis be suspected as a cause for systemic symptoms?
• How do you approach the evaluation of suspected vasculitis?
• What are the most commonly used medications for vasculitis?

The Role and Risks of Psychedelics in the Management of Resistant Mental Health Disorders

• What is the current role of psychedelics in the treatment of resistant mental health disorders, and what evidence supports their use in clinical practice?
• How can primary care physicians identify patients who may benefit from referral to consider psychedelics?
• What are the potential risks, as well as the legal and ethical considerations, associated with prescribing psychedelics?

Urinary Tract Infections: From Asymptomatic Bacteriuria to Bacteremia

• When should urinalysis and culture be performed, and how are they interpreted?
• What treatment is recommended for simple versus complicated urinary tract infections (UTIs)?
• Are all oral agents equal in the management of bacteremia from a urinary source?

Addiction Medicine Essentials for the Inpatient Clinician

• How can the stability of an outpatient addiction treatment plan be continued when patients are admitted to the hospital?
• What is the current evidence for initiating medications for addiction treatment during hospital admission, and how can transition to outpatient care be facilitated?
• How can interdisciplinary teams be structured to best support patient safety and autonomy in the inpatient setting?

Contemporary Management of Atrial Fibrillation

• Do any patients benefit from atrial fibrillation (AF) ablation as the initial treatment strategy?
• Which patients are appropriate for left atrial appendage closure?
• How does age play a role in anticoagulation decisions?
• What other patient factors play a role in anticoagulation decisions?

HIV and Sexually Transmitted Infections: Recommendations for Screening and Pre- and Post-exposure Prophylaxis

• What are the latest recommendations and options for HIV preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP)?
• What are the recommendations for doxycycline PEP?
• What are the current screening recommendations for patients receiving PrEP and PEP?
• How can clinicians lead inclusive, compassionate discussions and ensure equitable access to PrEP and PEP?
• What strategies should clinicians use to retain patients in care and adhere to monitoring recommendations?

Martin A. Samuels Memorial Lecture: Migraine Headaches

• What distinguishes migraine from other common and uncommon headache disorders, and how can clinicians recognize atypical migraine presentations?
• What are the best practices in migraine treatment that consider treatment effectiveness, side effects, and accessibility for patients?
• What steps should be taken when a patient with a presumed migraine diagnosis does not respond to standard treatments?

Thyroid Nodules: Initial Evaluation and Monitoring of One or More Nodules

• How useful is thyroid ultrasonography for predicting thyroid cancer?
• When should an internal medicine physician refer a patient with a thyroid nodule or multiple nodules for fine-needle aspiration or further evaluation by an endocrinologist?
• How often should thyroid nodules be followed with ultrasonography after the initial evaluations?

Update in Geriatric Medicine

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Annals of Internal Medicine Plenary

• TBD

Chronic Lymphocytic Leukemia: A Primer and What's New

• Is chronic lymphocytic leukemia (CLL) still diagnosed incidentally?
• How is CLL risk-stratified from observation to required therapy?
• Which new treatments should I be aware of?

Clinical Pearls: Addiction Medicine and Endocrinology

• Test your clinical acumen by answering challenging patient management questions faced in practice.
• Compare your critical thinking with that of your colleagues.
• Amass a rich collection of "pearls" that can be applied to patient care.

Cognitive Impairment: Evaluation and Management for the Internal Medicine Physician

• What is the current evidence for the use of disease-modifying agents for mild cognitive impairment?
• What is a high-value approach to the evaluation of a patient with suspected mild cognitive impairment, including biomarker testing?
• When is it appropriate to refer a patient to a neurologist for further diagnosis and management?

Heart Failure: Common Challenges in the Hospital

• When during the hospital stay should we start the individual components of goal-directed medical therapy (GDMT)?
• What are evidence-based strategies to monitor the daily effectiveness of intravenous (IV) diuresis in the hospital?
• When should we continue versus stop IV diuresis in the setting of worsening renal function?
• What is the role of sodium and fluid restriction when the patient is hospitalized?
• What is the care model and care transition at discharge for heart failure?

Irritable Bowel Syndrome Explained: Disorders of Gut–Brain Interaction

• What are the diagnostic criteria for disorders of gut–brain interaction?
• What "red flag" criteria mean that my patient does not have irritable bowel syndrome?
• What are the high-value testing and management options for disorders of gut–brain interaction?

Update in Nephrology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Acute Psychosis and Chronic Mental Health on the Wards

• How can acute psychosis from a psychiatric condition be distinguished from delirium?
• What medical testing is indicated for acute psychosis?
• How can patients with underlying psychiatric conditions be best managed and supported during medical admissions?

Asthma 2026: State of the Art

• What are the different bronchodilator and steroid inhaler types for asthma?
• What are the latest recommendations from the Global Initiative for Asthma?
• What are the data to support the use, efficacy, and cost of newer biologic treatments?

Inpatient Perioperative Medicine: High-Yield Pearls for Hospitalists

• What is a practical approach to the latest perioperative guidelines?
• Should surgery ever be delayed for cardiac testing?
• What patient optimization options exist in the inpatient setting that can prevent postoperative complications?

It's Not AFib: Management of Other Common Arrhythmias

• How do I evaluate a patient with frequent premature ventricular contractions (PVCs)?
• When is a pacemaker indicated in a patient with bradycardia?
• How should I use ambulatory heart monitoring and other wearable devices in patients with palpitations?

Multiple Small Feedings of the Mind: Pain Management, Medical Oncology, & Gastroenterology/Nutrition

• Pain Management
  • 1. When should acupuncture be considered in the management of pain? How do you counsel patients who are undergoing acupuncture treatment about expectations for symptom improvement?
  • 2. What are the most promising neuromodulation techniques relevant to conditions encountered in primary care, and how should we think about their role in clinical practice?
• Medical Oncology
  • 1. In the setting of an elevated or rising prostate-specific antigen, what is the role of prostate MRI and urinary biomarkers in guiding next steps from a primary care perspective?
  • 2. What is the current approach to preventing and managing treatment-related brain fog and cognitive issues in breast cancer survivors?
• Gastroenterology and Nutrition
  • 1. What are the latest evidence-based guidelines for initiating nutrition in hospitalized patients, and what are the potential harms of delayed or inadequate nutrition during acute illness? What is the current role of parenteral nutrition when oral or enteral options are not feasible?
  • 2. Given the efficacy of GLP-1 medications, which patients still have increased benefit from bariatric surgery?

Update in Hematology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Annals of Internal Medicine: Recent Articles That You Should Know About

• Participants will become aware of recent studies with implications for internal medicine practice, research, and education.

Antiplatelet Agents in the Patient With Coronary Artery Disease

• How do I manage antiplatelet therapy in patients after a percutaneous coronary intervention (PCI)?
• How do I manage antiplatelet therapy in patients requiring anticoagulation?
• How do I assess bleeding risk in patients receiving dual-antiplatelet therapy?

Neuromuscular Disease Pearls for the Inpatient Clinician

• How does one differentiate the most common neuromuscular conditions encountered in the hospital?
• What inpatient-related complications are patients with neuromuscular diseases at risk for?
• How are emerging treatment options shifting the clinical landscape for neuromuscular diseases?

Ultrasound Controversy: Is the Physical Exam Obsolete?

• What diagnoses have point-of-care ultrasound (POCUS) been proved to aid in with regard to clinical reasoning and diagnostic decision making?
• What are the sensitivity and specificity of some common physical exam maneuvers, and how does this compare to POCUS?
• Are there some physical exam maneuvers that can be abandoned in the modern POCUS era?
• How difficult are these POCUS exam maneuvers to learn?

Vaginal Dryness During Menopause: Diagnosis and Treatment of the Genitourinary Syndrome of Menopause, Including After Breast Cancer

• What is the epidemiology of the genitourinary syndrome of menopause (GSM), and what are the impacts to women?
• What are the symptoms of, and how do you diagnose, GSM?
• What are the treatments for GSM, and do they differ for women after breast cancer or gynecologic cancer?

VITT and HIT: What Just Happened and What Did We Learn From It?

• Was vaccine-induced thrombocytopenia with thrombosis (VITT) new?
• How did VITT further understanding of heparin-induced thrombocytopenia (HIT)?
• How is HIT managed?

Artificial Intelligence: Use in the Practice Setting

• What are some case studies that demonstrate successful implementation of artificial intelligence (AI) in primary care, highlighting the impact on patient care and staff productivity?
• What are the various applications of AI tools in primary care, such as clinical decision support, predictive analytics, patient triage, and administrative automation to improve efficiency, accuracy, and patient outcomes in the primary care setting?
• What are best practices for integrating AI tools while maintaining patient-centered care and ensuring compliance with regulations and ethical guidelines?

Challenges in Prescribing in 2026: Drug Shortages, Prior Authorization, Drug Side Effects & Recalls

• What are the impacts of supply chain disruptions on medication availability?
• What are some of the most important side effects discovered t this year?
• What is the best way to handle prior authorizations?

Managing Behavioral Symptoms in Dementia

• What is "mild behavioral impairment" in patients with dementia?
• What are the behaviors we should target to reduce caregiver burden and functional decline in patients with dementia?
• How do we use pharmacologic and nonpharmacologic strategies for behavior management?

MASLD and MASH in Primary Care

• Who should be screened for metabolic dysfunction–associated steatotic liver disease (MASLD)/metabolic dysfunction–associated steatohepatitis (MASH), and how can we do it in primary care?
• How can we risk-stratify patients with MASLD/MASH, and when should they be referred to hepatology?
• What are the current and emerging management options for MASLD/MASH?

Nutrition Assessment and Interventions for the Internal Medicine Physician

• How can primary care physicians identify individuals and diets at risk for nutritional deficiency or malnutrition, including those living in food deserts, and what are the key strategies to screen and counsel these patients within limited time constraints?
• Who are the key stakeholders in setting nutrition guidelines (including federal agencies, medical societies, and the wellness industry), and what is the evidence base for high-value nutritional screening and interventions?
• How should primary care physicians respond when patients bring in functional medicine lab work related to diet and nutrition?

Update in Hospital Medicine

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Chronic Wound Management for Internal Medicine Physicians

• What are the fundamental principles of chronic wound assessment and management that internal medicine physicians should apply in both outpatient and inpatient settings?
• How can internal medicine physicians choose appropriate chronic wound care treatments and dressings based on the type of wound and its healing stage while considering the patient's overall health status and care setting?
• When should internal medicine physicians manage chronic wounds independently, and when is it necessary to involve specialists or refer to wound care centers?

Help, My Food Got Stuck!

• What questions should be asked of patients with dysphagia?
• What are the high-yield and "can't-miss" referrals for upper gastrointestinal evaluation?
• What is the optimal diagnostic evaluation for patients with symptoms of an upper gastrointestinal motility disorder?

Hypoglycemia in Patients Without Diabetes Mellitus: How to Evaluate?

• What medications commonly cause hypoglycemia?
• What is the initial evaluation of hypoglycemia?
• When should an internal medicine physician refer a patient with possible hypoglycemia to an endocrinologist (or initiate a full diagnostic evaluation) for endogenous hyperinsulinemia or non–islet cell tumor?

Managing Hypertension in Special Populations

• What is the current blood pressure treaatment goal for pregnant women with hypertension?
• How should I evaluate patients with resistant hypertension?
• How should I manage hypertension in older adults?

Radiation Oncology for the Internal Medicine Physician

• What are the fundamentals of radiation therapy, including its types (e.g., external beam, brachytherapy, and stereotactic) and common indications?
• What are the potential acute and chronic side effects of radiation therapy, including skin reactions, fatigue, gastrointestinal issues, and long-term risks like secondary cancers?
• What are strategies for primary care physicians to recognize, manage, and provide supportive care for patients experiencing these side effects, ensuring coordinated care with radiation oncologists?

Shock: Recognition and Triage

• What history, exam, and point-of-care ultrasound (POCUS) findings help us distinguish cardiogenic shock from other common causes of shock, including the use of POCUS?
• How can we identify the different stages of cardiogenic shock, and how does this influence management?
• How can internal medicine physicians recognize mixed patterns of shock?

Endocrine Challenges in the Hospital Setting

• How can hyperthyroidism or hypothyroidism be diagnosed and managed in the inpatient setting?
• What are practical management strategies for fragility fractures in the hospital (e.g., medications and transitions of care)?
• Which patients should receive stress-dose steroids based on their risk for adrenal insufficiency?
• How should we approach inpatient management of thyroid storm or myxedema coma?
• Inpatient pituitary management: perioperative and postoperative management recommendations.

Female Sexual Dysfunction: Evaluation and Treatment

• What is the epidemiology of female sexual dysfunctions (FSD), and what are the consequences of undiagnosed and untreated FSD in women?
• How to screen for FSD in general medicine? What is a biopsychosocial approach to the evaluation of FSD?
• What treatment options are available to treat pre- and postmenopausal hypoactive sexual desire disorder (HSDD), including the role of testosterone in postmenopausal women, and when is it appropriate to refer?

Managing Uncertainty in Clinical Reasoning

• What are common sources of uncertainty in clinical reasoning, such as incomplete information, ambiguous test results, and complex patient presentations?
• What are techniques for improving clinical reasoning in uncertain situations, such as probabilistic thinking, Bayesian analysis, and shared decision making with patients?
• What are effective communication strategies to convey uncertainty to patients and set realistic expectations about diagnosis and treatment?

Radiologic Correlation Required: High-Value Care Approach to the Incidental Abdominal Mass

• How common are incidentalomas of the liver, kidney, and pancreas on routine abdominal imaging, and is it important for internal medicine physicians to follow up on these findings?
• Which specific imaging features or patient history factors should prompt immediate additional imaging for these lesions, and what methods are most appropriate for further characterization?
• For lesions that remain indeterminate after initial assessment, what criteria should guide the selection of follow-up method, the appropriate interval between studies, and the determination of when it is safe to discontinue surveillance imaging?

Update in Cardiology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Volume Assessment and Fluid Management in the Hospital

• What are the evidence-based strategies for accurate volume status assessment?
• What is the optimal fluid choice for patients with hypovolemia?
• What is the difference between volume-tolerant versus volume-responsive patients?
• What are the evidence-based indications for albumin?
• What are the indications for maintenence fluids and how should they be ordered?
• What is the evidence for point-of-care ultrasound in volume status assessment and management?

Adolescents and Young Adults With Common Mental Health Disorders

• How do you diagnose common mental health conditions such as depression, anxiety, and attention-deficit hyperactivity disorder?
• What is the most effective method of screening for suicide?
• What medications are used for the treatment of common mental health conditions such as depression, anxiety, and attention-deficit hyperactivity disorder?
• How do you assess for accomodations in common mental health conditions?

Approach to Soft Tissue Masses

• How should internal medicine physicians approach the initial assessment of a patient presenting with a soft tissue mass, such as a neck, breast, or extremity mass?
• What are the indications for using physical examination, point-of-care ultrasound (POCUS), and other imaging techniques in the evaluation of soft tissue masses, and how can these tools be used to deliver high-value care?
• When should internal medicine physicians reassure patients versus referring them to surgery, and what criteria should guide these decisions to ensure both safety and adherence to best practices?

Cardiorenal Syndrome: The Path to Decongestion

• What is the cause of acute kidney injury in acute decompensated heart failure?
• What is diuretic resistance, and how do I overcome it?
• What do I do if renal function worsens with decongestive therapy?

Dr. Ananda Prasad Lecture in Physiology: GLP and Other Gut Hormones—Pathophysiologic Insights

• How do GLP-1 agonists cause weight loss and loss of appetite?
• What is the mechanism and role for GLP agonists in the treatment of addictive disorders for overweight/obese patients with prediabetes or diabetes?
• What are the mechanism for the cardioprotective and nephroprotective benefits of GLP-1 analogs?
• What is the role for GLP-1 agonists in the treatment of male and female reproductive disorders such as hypogonadism, oligomenorrhea, or infertility?
• Beyond the effects of weight loss, are the specific qualitative and quantitative effects of GLP-1 agonists on bone or muscle?

Immune Checkpoint Inhibitors: Things to Know in the Inpatient Setting

• How have immunomodulators shifted the cancer care landscape, especially in terms of reasons to need hospital admission for cancer-related care?
• How should immunomodulators be managed around transitions of care when patients are admitted for nononcologic reasons?
• What are the most common severe adverse effects of immunotherapy that result in hospitalization?
• What adverse effects of immunomodulators must inpatient clinicians be aware of even if they are not the cause for admission?

Update in Gastroenterology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Antiphospholipid Syndrome: Too Complicated to Diagnose?

• What are the minimum clinical requirements to consider antiphospholipid syndrome (APS)?
• What are the clinical criteria for the diagnosis of APS?
• What are the laboratory criteria for the diagnosis of APS?

Artificial Intelligence in Hospital Medicine

• What artificial intelligence (AI) tools are currently available to help me and/or my hospitalized patients?
• Are there evidence-based outcomes for AI use in acute medical illness?
• What are examples of AI's anticipated uses in hospital medicine?
• What are the risks of AI in the inpatient setting?

Clinical Pearls: Neurology and Infectious Diseases

• Test your clinical acumen by answering challenging patient management questions faced in practice.
• Compare your critical thinking with that of your colleagues.
• Amass a rich collection of "pearls" that can be applied to patient care.

Innovations in Obstructive Sleep Apnea

• What are the challenges in diagnosing and managing obstructive sleep apnea (OSA) in women?
• How do you improve adherence to positive airway pressure devices?
• What are the novel airway devices for OSA?
• What is the role of emerging pharmacotherapy?

Medical Implications of Substance Use Disorder: Best Practices for the Patient and the Disease Process

• What are the latest data on oral antibiotic treatment and surgical options for endocarditis or osteomyelitis?
• How can treatment opportunities for hepatitis C be identified in the inpatient setting and then transitioned to the outpatient setting?
• When should alcohol use disorder be on the differential diagnoses for neurocognitive symptoms?
• What are diagnostic and management options for methamphetamine and alcohol-induced cardiac pathologies?

Update in Rheumatology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Chronic Pancreatitis: Challenges in Diagnosis and Management

• What are the clinical features and diagnostic criteria for chronic pancreatitis?
• How to control pain in chronic pancreatitis?
• What are the challenges in diagnosis and management of exocrine pancreatic insufficiency?
• How to monitor additional complications such as diabetes, micronutrient deficiencies, and metabolic bone disease?

Continuous Glucose Monitoring in Patients With Diabetes Mellitus

• When should an internal medicine physician consider ordering continuous glucose monitoring (CGM)?
• What are the clinical benefits of CGM for patients with diabetes?
• What is a systematic method of interpreting CGM data?

Inpatient Bleeding and Anemia Management

• What are the reversal agents for anticoagulation, and when are they clinically indicated?
• Beyond platelets, what else can I transfuse to stop bleeding?
• When do I order bleeding diathesis labs?
• What patients should be considered for intravenous (IV) iron infusion, and should we avoid iron in patients with sepsis?

Multiple Small Feedings of the Mind: Cardiology, Women’s Health, & Sports Medicine

• Cardiology
  • 1. What is your approach to cardiovascular risk assessment and management for patients under age 40 years with dyslipidemia or other risk-enhancing factors?
  • 2. In what clinical situations, if any, do you use coronary computed tomography angiography (CCTA) to risk-stratify asymptomatic patients?
  • 3. When would you use CCTA instead of computed tomography/coronary artery calcium?
• Women’s Health
  • 1. What are best practices for evaluating and confidently diagnosing perimenopause?
  • 2. What does the latest evidence say about the risks and benefits of hormone therapy in different patient populations, specifically early use in perimenopause, use in asymptomatic postmenopausal patients, and delayed initiation more than 10 years after menopause for persistent vasomotor symptoms?
• Sports Medicine
  • 1. What is the short- and long-term efficacy of nonsurgical or biologic interventions for patients with chronic knee pain?
  • 2. What’s new in preoperative optimization from a sports medicine lens in patients awaiting elective joint surgery?

Palliative Care

• What are the latest advances in symptom management in palliative care that can be applied in clinical practice by both palliative medicine physicians and primary care physicians?
• How can primary care physicians integrate individualized advance care planning with their patients in a busy practice setting?
• For patients in the inpatient setting, how can hospitalists best assess goals of care in the context of new serious illness and/or clinical deterioration?

Update in Oncology

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Approach to the Patient With Chronic Sinusitis

• What is a high-value care approach to evaluating and treating recurrent nasal congestion?
• How should the internal medicine physician differentiate between allergic rhinitis and chronic sinusitis?
• What is the role of biologics in chronic sinusitis?
• What is the approach to management of allergic rhinosinusitis, with attention to use of glucocorticoids in addition to other management?

Chronic Pain at a Crossroads: Opioid Risks, Cannabis Guidance, and Controversies

• How should pain type and pathophysiology guide opioid and non-opioid treatment selection?
• What do current data show on long-term opioid risks and benefits, and how should this shape prescribing?
• What is the role of medical cannabis, naltrexone, and non-pharmacological approaches in light of new guidelines and policies?

Delirium During Hospitalization

• What are the most common causes and presentations of delirium in the hospital setting?
• What should a hospitalist know about the management and prevention of delirium, including the misuse of antipsychotics?
• What implications does an episode of inpatient delirium have for postdischarge cognitive trajectory?

Procedural Bleeding Risk Assessment and Management: DOACs and Liver Disease

• Which procedures require no prior intervention?
• Can an elevated international normalized ratio (INR) from significant liver disease be corrected? Should it be?
• Can a low platelet count from significant liver disease be corrected? Should it be?
• How are direct oral anticoagulants (DOACs) managed before and after procedures?

Update in Pulmonary Medicine

• Presentation of 6 to 12 papers published during the past 12 to 15 months that, in the view of the presenter, have made the most difference in the practice or understanding of the subspecialty.

Approach to Patients Who Are Transgender and Gender-Diverse in Primary Care

• How can primary care clinicians and practices improve the clinical environment for safe and nondiscriminatory care for patients who are transgender and gender-diverse (TGD)?
• What are the current gender-affirming hormone therapies and their physiologic effects/side effects for the TGD population?
• What are high-value areas of routine health maintenance for patients who are TGD?
• What are additional diagnostic and care considerations for TGD patients?

Autonomics for Internal Medicine Physicians

• What are the diagnostic criteria and basic therapies for postural tachycardia syndrome (POTS)?
• What is the management of patients with orthostatic hypotension and/or supine hypertension?
• How do I evaluate and manage a patient with vasodepressor syncope?

Oncologic Emergencies for Inpatient Clinicians

• What oncologic emergencies must the hospitalist be prepared to diagnose in the inpatient setting?
• What are diagnostic challenges regarding oncologic emergencies?
• What are the treatment options and best practices for oncologic emergencies?

Pneumonia and Other Respiratory Infections in the Hospital

• Which patients with community-acquired pneumonia (CAP) should receive broad-spectrum antibiotics for multidrug-resistant organisms?
• Which patients with pneumonia should receive steroids for bacterial pneumonia?
• Is there a role for procalcitonin in diagnosing or managing pneumonia?

Sarcopenic Obesity in Older Adults: Does Weight Loss Mean Muscle Loss?

• What is sarcopenic obesity, and how do we identify this in our older patients?
• What are the consequences of sarcopenic obesity in older adults?
• Are there management strategies for sarcopenic obesity? Does weight loss help or hurt? Should weight loss drugs be used in older patients?

Internal Medicine Meeting 2026 Highlights and Doctor's Dilemma®: The Finals (Session not eligible for CME credit.)

• Hear three outstanding clinician–educators share what they think are Internal Medicine Meeting 2026’s most important take-home messages. Then, join the excitement of the final round of Doctor’s Dilemma®. The “Final Five” teams of residents who survive the Thursday and Friday competitions will face off in the championship round of this Jeopardy-style test of knowledge. The winner takes home the Osler Cup—ACP’s coveted trophy.