MER Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych 2026

Allergy & Immunology • Geriatrics • Psychiatry

July 4–6, 2026 | Big Sky Resort, Yellowstone, Montana

Strengthen your approach to common allergic, geriatric, cognitive, and psychiatric conditions with MER Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych 2026, a focused educational program from Medical Education Resources (MER).

The original conference was held July 4–6, 2026, at Big Sky Resort in Yellowstone, Montana.

This three-day primary care program combines practical updates in:

• Allergy & Immunology
• Geriatric Medicine
• Psychiatry
• Internal Medicine
• Primary Care

Major topics include:

• Adult ADHD
• Bipolar spectrum disorders
• Anxiety disorders
• Substance use disorders
• Asthma
• Allergic rhinitis
• Sinusitis
• Food allergy
• Hymenoptera / venom allergy
• Anaphylaxis
• Immunotherapy
• Urticaria
• Angioedema
• Atopic dermatitis / eczema
• Contact dermatitis
• Clinician burnout and wellness
• Comprehensive geriatric assessment
• Geriatric pharmacology
• Polypharmacy
• Osteoporosis
• DEXA
• FRAX fracture-risk assessment
• Alzheimer’s disease
• Other dementias
• Reversible causes of cognitive impairment
• Behavioral symptoms of dementia
• Non-pharmacologic dementia management

Course Details

• Course: Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych
• Provider: Medical Education Resources – MER
• Year: 2026
• Dates: July 4–6, 2026
• Duration: 3 Days
• Venue: Big Sky Resort
• Location: Yellowstone, Montana, USA
• Primary Focus: Internal Medicine / Primary Care
• Specialties: Allergy & Immunology / Geriatrics / Psychiatry
• Original Live Activity: 12 Credit Hours
• Original Pharmacotherapeutic Content: 5.50 ANCC Pharmacotherapeutic Contact Hours
• MedicalAmboss Delivery: Google Drive
• CME / Certificate with MedicalAmboss: Not Included
• Language: English

Course Overview

Primary care physicians routinely manage conditions that cross traditional specialty boundaries.

During a single clinic session, a clinician may evaluate:

• Poorly controlled asthma
• Chronic rhinitis
• Recurrent urticaria
• A suspected food allergy
• Cognitive decline in an older adult
• Polypharmacy
• Osteoporosis
• Adult ADHD
• Anxiety
• Bipolar disorder
• Substance use

The MER Allergy & Immuno/Geri/Psych 2026 curriculum provides a practical framework for approaching these common and sometimes overlapping presentations.

A useful clinical sequence is:

Recognize → Assess Severity → Build Differential → Select Treatment → Counsel → Monitor → Refer When Appropriate

Learning Objectives

Upon completion of the original educational program, participants should be better able to:

• Compare the benefits and side-effect profiles of pharmacologic treatment options for adult ADHD.
• Review psychosocial and pharmacologic treatment strategies for bipolar disorder.
• Recognize common psychiatric and medical comorbidities associated with bipolar spectrum disorders.
• Review evidence-based approaches to anxiety disorders.
• Identify and treat substance use disorders.
• Improve screening and clinical interviewing for substance use.
• Manage asthma efficiently in primary care.
• Review practical treatment of allergic rhinitis.
• Evaluate and manage sinusitis.
• Recognize and manage anaphylactic reactions.
• Understand appropriate indications for allergen immunotherapy.
• Review food allergy and Hymenoptera allergy.
• Recognize common forms of urticaria and angioedema.
• Review epidemiology and risk factors for atopic dermatitis.
• Distinguish common atopic and contact skin disorders.
• Apply strategies to improve clinician wellness and reduce burnout.
• Perform a comprehensive geriatric assessment.
• Review age-related changes affecting medication use.
• Identify potentially risky medication use in older adults.
• Interpret DEXA studies in osteoporosis evaluation.
• Apply FRAX fracture-risk assessment.
• Review current osteoporosis treatment options.
• Diagnose cognitive impairment and common dementias.
• Review Alzheimer’s disease.
• Recognize potentially reversible causes of cognitive decline.
• Apply non-pharmacologic approaches to difficult behaviors in dementia.
• Understand risks associated with psychotropic medication use in dementia.

PSYCHIATRY

The Complexity of Adult ADHD

Adult ADHD can be difficult to recognize because concentration problems, restlessness, and impaired executive function may overlap with:

• Anxiety
• Depression
• Bipolar disorder
• Sleep disorders
• Substance use
• Medical illness
• Medication effects

The course reviews adult ADHD with emphasis on:

• Symptom identification
• Co-occurring conditions
• Psychiatric differential diagnosis
• Medical differential diagnosis
• Evidence-based treatment
• FDA-approved pharmacologic options

Adult ADHD Assessment

Evaluation should extend beyond the complaint:

“I cannot concentrate.”

A structured assessment may include:

• Childhood symptoms
• Persistence into adulthood
• Occupational impairment
• Academic history
• Relationship effects
• Executive dysfunction
• Impulsivity
• Comorbid psychiatric conditions
• Substance-use history

ADHD Pharmacotherapy

Treatment decisions may involve comparison of different medication approaches according to:

• Expected benefit
• Adverse-effect profile
• Cardiovascular history
• Substance-use risk
• Psychiatric comorbidity
• Patient preference

Medication treatment should be combined with appropriate clinical monitoring.

Bipolar Spectrum Disorders

The program reviews bipolar spectrum disorders in adults with attention to:

• Comprehensive history-taking
• Differential diagnosis
• Comorbid psychiatric disorders
• Medical comorbidities
• Mood stabilization
• Phase-specific treatment

Recognizing Bipolar Disorder

Bipolar illness may be missed when patients present primarily during depressive episodes.

Assessment can include a history of:

• Elevated or irritable mood
• Reduced need for sleep
• Increased activity
• Increased energy
• Impulsivity
• Risk-taking
• Episodic changes in functioning

Accurate diagnosis is important because treatment strategies differ from those used for unipolar depression.

Psychosocial & Pharmacologic Treatment

Treatment can involve:

• Mood-stabilizing medication
• Selected antipsychotic therapies
• Psychotherapy
• Sleep stabilization
• Patient education
• Relapse prevention
• Monitoring of comorbid illness

Treatment should be matched to the phase and severity of illness.

Anxiety Disorders

The course reviews several important anxiety disorders, including:

• Generalized anxiety disorder
• Panic disorder
• Social anxiety disorder
• Post-traumatic stress disorder

Generalized Anxiety Disorder

Patients may present with:

• Excessive worry
• Restlessness
• Fatigue
• Difficulty concentrating
• Irritability
• Muscle tension
• Sleep disturbance

Clinicians should also consider medical and medication-related causes of anxiety symptoms.

Panic Disorder

Panic attacks can cause sudden episodes of intense fear accompanied by physical symptoms.

Because symptoms may resemble medical emergencies, clinicians need to distinguish psychiatric from cardiopulmonary or other medical causes.

Social Anxiety Disorder

Social anxiety can substantially affect:

• Work
• Relationships
• Academic performance
• Social functioning

The course reviews diagnosis and available treatment approaches.

PTSD

Post-traumatic stress disorder may involve:

• Intrusive symptoms
• Avoidance
• Mood and cognitive changes
• Hyperarousal

Treatment planning should consider severity, comorbidities, trauma history, and patient preference.

Substance Use Disorders

The program reviews strategies for identifying and treating substance use disorders.

Key areas include:

• Substance-use history
• Encouraging honest disclosure
• Screening
• Diagnosis
• Brief intervention
• Recovery
• Treatment options
• Motivational interviewing
• Family dynamics
• Codependency

Screening for Substance Use

Primary care clinicians are well positioned to identify substance-related problems before severe complications develop.

A useful approach includes:

Ask → Screen → Assess Severity → Discuss Readiness → Intervene / Refer → Follow Up

Motivational Interviewing

Motivational interviewing is a collaborative technique used to help patients explore ambivalence and strengthen motivation for behavior change.

Core principles include:

• Empathy
• Reflective listening
• Supporting autonomy
• Avoiding confrontation
• Reinforcing self-efficacy

ALLERGY & IMMUNOLOGY

Asthma, Allergic Rhinitis & Sinusitis for Primary Care

This session focuses on developing a practical and cost-effective approach to three common problems:

• Asthma
• Allergic rhinitis
• Sinusitis

Asthma

Asthma management begins with accurate assessment of:

• Symptoms
• Trigger pattern
• Exacerbation history
• Current medications
• Treatment adherence
• Inhaler technique
• Comorbid allergic disease

The clinical goal is not simply to treat acute symptoms but to achieve sustainable disease control.

Allergic Rhinitis

Allergic rhinitis can substantially affect:

• Sleep
• Concentration
• Productivity
• Asthma control
• Quality of life

Management may involve:

• Allergen avoidance when practical
• Pharmacologic therapy
• Patient education
• Immunotherapy in selected patients

Rhinitis Differential Diagnosis

Not every patient with nasal symptoms has allergic rhinitis.

Potential alternatives include:

• Nonallergic rhinitis
• Medication-related rhinitis
• Structural disease
• Chronic rhinosinusitis
• Infection

History and examination help guide appropriate treatment.

Sinusitis

The program reviews efficient diagnosis and treatment of sinusitis within primary care.

An important objective is distinguishing:

Viral / Self-Limited Disease

from presentations that may require further evaluation or different treatment.

Food Allergies

The course includes a primary care review of food allergy.

Clinicians should distinguish true food allergy from:

• Food intolerance
• Nonimmune adverse reactions
• Patient-perceived food sensitivity

Accurate history is critical before extensive testing or dietary restriction.

Hymenoptera Allergy

The program also reviews hypersensitivity to insect venom.

Clinicians should understand:

• Recognition of systemic reactions
• Risk assessment
• Acute management
• Referral considerations
• Role of venom immunotherapy when appropriate

Anaphylaxis

Anaphylaxis is a potentially life-threatening systemic hypersensitivity reaction.

Rapid recognition is essential.

Potential manifestations can involve:

• Skin
• Respiratory tract
• Cardiovascular system
• Gastrointestinal tract

Emergency management should follow current clinical guidance.

Immunotherapy

The course reviews indications for immunotherapy in appropriate allergic disease.

Treatment selection depends on:

• Confirmed allergy
• Clinical relevance
• Symptom severity
• Response to conventional management
• Patient-specific risk
• Availability of specialist care

Urticaria

Urticaria commonly presents as transient pruritic wheals.

Evaluation should consider:

• Acute vs. chronic presentation
• Trigger history
• Medication exposure
• Infection
• Associated angioedema
• Systemic symptoms

Angioedema

Angioedema involves deeper tissue swelling and can require different evaluation depending on whether it occurs with or without urticaria.

Airway involvement requires urgent assessment.

Eczema / Atopic Dermatitis

The program reviews:

• Epidemiology
• Risk factors
• Etiology
• Clinical recognition
• Practical management

Atopic dermatitis is a chronic inflammatory skin disorder in which barrier dysfunction and inflammatory mechanisms play important roles.

Contact Dermatitis

Contact dermatitis can be:

Irritant

caused by direct damage to the skin barrier.

Allergic

caused by delayed hypersensitivity to a specific allergen.

Exposure history and distribution are particularly useful diagnostically.

Atopic Skin Disease in Primary Care

The combination of:

• Urticaria
• Angioedema
• Eczema
• Contact dermatitis

provides a practical review of common skin presentations that may initially be evaluated outside dermatology or allergy specialty clinics.

Provider Wellness & Burnout

One distinctive topic in this MER program is:

Burnout and Provider Wellness

The session focuses on strategies healthcare professionals can use to address the pressures of contemporary clinical practice.

Rediscovering Joy in Medicine

Clinician wellbeing can affect:

• Professional satisfaction
• Patient communication
• Team relationships
• Burnout
• Career longevity

The course explores practical ways to reconnect with meaningful aspects of clinical practice.

GERIATRICS

Approach to the Geriatric Patient

Older adults often require assessment beyond a disease-specific problem list.

The course reviews:

• Demographics of aging
• Physiologic changes
• Medication use
• Pharmacokinetic changes
• Pharmacodynamic changes
• Medication adherence
• Potentially risky medications

Comprehensive Geriatric Assessment

A structured geriatric assessment may include:

Medical

• Chronic disease
• Medication burden
• Pain
• Sensory impairment

Functional

• Activities of daily living
• Mobility
• Fall risk
• Independence

Cognitive

• Memory
• Executive function
• Decision-making

Psychological

• Mood
• Behavioral symptoms

Social

• Living environment
• Caregiver support
• Safety
• Access to care

Geriatric Pharmacology

Age-related physiologic changes can alter:

• Drug distribution
• Metabolism
• Excretion
• Drug sensitivity

Older adults may therefore have a greater risk of:

• Adverse drug reactions
• Drug-drug interactions
• Drug-disease interactions
• Polypharmacy complications

Medication Review in Older Adults

A useful medication review asks:

• Is each medication still needed?
• Is the dose appropriate?
• Are there duplications?
• Is a medication causing a new symptom?
• Could treatment increase fall risk?
• Can the regimen be simplified?

Osteoporosis in the Older Adult

The course provides a focused review of:

• Epidemiology
• Pathophysiology
• Fracture risk
• DEXA
• FRAX
• Therapeutic options

DEXA

Dual-energy X-ray absorptiometry is widely used to evaluate bone mineral density.

Interpretation should be integrated with:

• Age
• Fracture history
• Clinical risk factors
• Medication exposure
• Other contributors to bone loss

FRAX Risk Assessment

FRAX incorporates clinical risk factors to estimate fracture probability.

The objective is to move beyond asking only:

“What is the T-score?”

and instead ask:

“What is this patient’s overall fracture risk?”

Osteoporosis Treatment

Treatment may include:

• Lifestyle measures
• Fall prevention
• Adequate calcium and vitamin D where clinically appropriate
• Pharmacologic therapy
• Monitoring

Choice of treatment depends on fracture risk and patient-specific factors.

Alzheimer’s Disease & Other Dementias

The course reviews:

• Normal cognitive aging
• Memory disorders
• Dementia
• Mental status examinations
• Alzheimer’s disease
• Other dementia types
• Reversible causes
• Treatment
• Clinician responsibilities

Normal Aging vs. Cognitive Impairment

Not every memory complaint represents dementia.

Clinical assessment should examine:

• Progression
• Functional impairment
• Mood
• Sleep
• Medication effects
• Sensory impairment
• Neurologic symptoms

Mental Status Examination

Cognitive screening tools can support assessment but have limitations.

Results may be influenced by:

• Education
• Language
• Hearing
• Vision
• Cultural factors
• Baseline function

Screening should therefore be interpreted within the full clinical context.

Types of Dementia

Accurate diagnosis is important because cognitive impairment may result from:

• Alzheimer’s disease
• Vascular dementia
• Lewy body dementia
• Frontotemporal disorders
• Mixed dementia
• Other neurologic or systemic conditions

Potentially Reversible Dementias

Assessment should consider potentially treatable contributors such as:

• Medication effects
• Depression
• Metabolic disease
• Endocrine abnormalities
• Nutritional deficiencies
• Sleep disorders
• Delirium
• Other medical illness

Managing Behavior Problems in Dementia

Behavioral disturbances may include:

• Agitation
• Aggression
• Wandering
• Repetitive behavior
• Sleep disturbance
• Resistance to care
• Anxiety

The MER curriculum emphasizes behavioral strategies that may reduce unnecessary reliance on psychotropic medications.

Non-Pharmacologic Management

A useful framework is:

Identify Trigger → Address Medical Cause → Modify Environment → Simplify Communication → Support Caregiver → Reassess

Potential interventions can include:

• Structured routines
• Environmental modification
• Pain management
• Sleep optimization
• Reduced overstimulation
• Caregiver education

Psychotropic Medication Risks

When psychotropic medication is considered for behavioral symptoms, clinicians should carefully evaluate:

• Severity
• Safety risk
• Potential adverse effects
• Drug interactions
• Non-pharmacologic alternatives

The objective is not simply to suppress behavior but to understand its cause.

Cross-Specialty Clinical Connections

One of the strengths of this MER program is the overlap among its three major clinical areas.

Allergy + Psychiatry

Symptoms such as:

• Dyspnea
• Palpitations
• Chest tightness

may occur in asthma, anaphylaxis, or anxiety-related conditions.

Appropriate clinical evaluation is therefore important before assuming a psychiatric or allergic cause.

Geriatrics + Psychiatry

Older adults may present with:

• Cognitive impairment
• Depression
• Medication effects
• Behavioral changes

These conditions can overlap substantially.

Geriatrics + Allergy

Older patients may have greater medication burden and comorbid disease, which can complicate treatment of:

• Asthma
• Rhinitis
• Urticaria
• Allergic reactions

Polypharmacy + Mental Health

Medication adverse effects can sometimes contribute to:

• Cognitive problems
• Sleep disturbance
• Anxiety
• Falls
• Functional decline

Medication review therefore connects geriatric and psychiatric care.

Major Allergy & Immunology Topics

• Asthma
• Allergic Rhinitis
• Sinusitis
• Food Allergy
• Hymenoptera Allergy
• Venom Allergy
• Anaphylaxis
• Immunotherapy
• Urticaria
• Angioedema
• Atopic Dermatitis
• Eczema
• Contact Dermatitis
• Hypersensitivity

Major Geriatrics Topics

• Comprehensive Geriatric Assessment
• Physiology of Aging
• Geriatric Pharmacology
• Pharmacokinetics
• Pharmacodynamics
• Polypharmacy
• Medication Adherence
• Risky Medications
• Osteoporosis
• DEXA
• FRAX
• Cognitive Impairment
• Alzheimer’s Disease
• Dementia
• Reversible Cognitive Impairment
• Behavioral Problems in Dementia

Major Psychiatry Topics

• Adult ADHD
• ADHD Pharmacotherapy
• Bipolar Spectrum Disorders
• Mood Stabilization
• Anxiety Disorders
• Generalized Anxiety Disorder
• Panic Disorder
• Social Anxiety Disorder
• PTSD
• Substance Use Disorders
• Motivational Interviewing
• Addiction
• Provider Burnout
• Clinician Wellness

Who Should Take This Course?

The original MER activity was designed for office-based primary care providers and other healthcare professionals seeking practical updates in adult medicine.

It is particularly relevant for:

• Primary Care Physicians
• Internal Medicine Physicians
• Family Medicine Physicians
• Allergists
• Immunologists
• Geriatricians
• Psychiatrists
• General Practitioners
• Hospitalists
• Residents
• Fellows
• Nurse Practitioners
• Physician Assistants / Associates
• Clinicians caring for older adults
• Clinicians managing common allergic disease
• Clinicians treating adult psychiatric conditions

Why This Course Is Useful

MER Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych 2026 combines three areas frequently encountered in everyday outpatient practice.

The program can help learners:

• Improve asthma management
• Review allergic rhinitis and sinusitis
• Recognize food and venom allergies
• Review anaphylaxis
• Understand immunotherapy indications
• Improve management of urticaria and angioedema
• Review atopic dermatitis and contact dermatitis
• Diagnose adult ADHD
• Review bipolar spectrum disorders
• Improve anxiety-disorder management
• Identify substance use disorders
• Apply motivational interviewing
• Address provider burnout
• Perform comprehensive geriatric assessment
• Review medication risks in older adults
• Interpret DEXA and FRAX
• Update osteoporosis management
• Diagnose cognitive impairment
• Review Alzheimer’s and other dementias
• Manage behavioral problems with non-pharmacologic strategies

The curriculum can be summarized as:

Allergic Disease → Mental Health → Healthy Aging → Cognitive Care

within a practical primary-care framework.

Original Conference Accreditation

The official MER activity was listed as:

Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych – 12 Credit Hours

with:

5.50 ANCC Pharmacotherapeutic Contact Hours

Important CME / Certificate Notice

These credits applied to eligible participation in the original MER educational activity and its applicable completion requirements.

The MedicalAmboss product states that:

CME points and certificate are not included.

Therefore, do not advertise the MedicalAmboss product as:

• 12 CME Credits Included
• 5.50 Pharmacology Hours Included
• Official MER CME Included
• MER Certificate Included

unless official MER participation and credit eligibility are actually included.

The correct distinction is:

Original MER Activity: 12 Credit Hours

and separately:

MedicalAmboss Product: CME / Certificate Not Included

Product / Delivery Information

• Product: MER Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych 2026
• Provider: Medical Education Resources – MER
• Dates: July 4–6, 2026
• Venue: Big Sky Resort
• Location: Yellowstone, Montana
• Specialties: Allergy & Immunology / Geriatrics / Psychiatry
• Original Activity: 12 Credit Hours
• Original Pharmacotherapeutic Content: 5.50 ANCC Contact Hours
• Delivery: Google Drive
• CME Points: Not Included
• Certificate: Not Included

4. Short Description

MER Internal Medicine for Primary Care: Allergy & Immuno/Geri/Psych 2026 provides a practical three-day update in allergy and immunology, geriatrics, and psychiatry.

Topics include adult ADHD, bipolar spectrum disorders, anxiety, substance use disorders, asthma, allergic rhinitis, sinusitis, food and Hymenoptera allergies, anaphylaxis, immunotherapy, urticaria, angioedema, atopic dermatitis, provider wellness, comprehensive geriatric assessment, geriatric pharmacology, osteoporosis, DEXA/FRAX, Alzheimer’s disease, dementia, and non-pharmacologic management of behavioral symptoms.

Topics

• The Complexity of Adult ADHD: ADHD in adults with an emphasis on symptom identification; Co-occurring conditions; Psychiatric and medical differential diagnosis; evidence-based and FDA approved pharmacological treatments.

• Bipolar Spectrum Disorders: Bipolar spectrum disorders in adults as compared to youth; Comprehensive history-taking; Differential diagnosis; Co-occurring psychiatric and medical conditions; Phase specific treatment considerations and interventions.

• Anxiety Disorders: The nature of anxiety; Generalized anxiety disorder, panic disorder, social anxiety disorder and post-traumatic stress disorder; etiology and diagnosis; Co-occurring conditions; Treatment options for these disabling conditions.

• Asthma, Allergic Rhinitis, and Sinusitis for Primary Care: Lecture focused on gaining a working knowledge of how to efficiently and cost effectively manage patients with asthma, rhinitis, and sinusitis.

• Food Allergies and Hymenoptera Allergies: Primary care focused discussion of food and venom allergies including gaining a working knowledge of how to efficiently and cost effectively manage patients with hymenoptera hypersensitivity.

• Urticaria, Angioedema, Eczema and Contact Dermatitis: Lecture focused on gaining a working knowledge of how to efficiently and cost effectively manage patients with various atopic skin conditions.

• Burnout and Provider Wellness: Strategies that clinicians and healthcare providers can institute with ease to combat the challenges and pitfalls of the current healthcare system.

• Substance Use Disorders: Substance abuse history-taking to encourage patient honesty; Accurate diagnosis; Use of screening tools; Brief intervention; Recovery and treatment options; Motivational interviewing; Family symptoms and codependency.

• Approach to the Geriatric Patient: The demographics of aging and the physiologic changes in the elderly patient; Medication use in the elderly including changes in age-related pharmacokinetics and pharmacodymamics and medication adherence; Review of risky medications often used in elderly patients.

• Osteoporosis in the Older Adult: Review the epidemiology and pathophysiology of osteoporosis along with interpretation of DEXA scans and FRAX risk assessment; up-to-date therapeutic options.

• Alzheimer’s & Other Dementias: Review of normal age-related changes in cognitive function as well as disorders of memory and cognition as part of dementing illness; Mental status exams, including their limitations in evaluating memory; Various types of dementia and the importance of an accurate diagnosis; Current treatment options for various kinds of dementia; Potentially reversible dementias; The responsibilities of healthcare providers in managing patients with dementia.

• Managing Behavior Problems in Dementia Patients: Review of common behavior disorders often seen in patients with dementia; Behavioral techniques which have shown to be effective in managing some of the behavior disorders in patients with Alzheimer’s and other dementias, focusing on the management of these patients without the use of psychotropic medications; Examples of behavior disturbances along with the behavior management technique which was effective in managing the patient with the behavior problem; Review of the potential adverse effects of the psychotropic medications usually used to manage behavior.