Boy Has Had “Bald Spot” Since Birth
He's 8 now and the object of teasing by his classmates. Can anything be done to help him?
What Does This Man Need (Besides Milk & Cookies)?
The medical assistant at his skilled nursing facility noticed the patient's heart rate was slow. How does an ECG round... More
An Incidental Finding During Neuro Evaluation
The patient presents for evaluation of a brain tumor. While reviewing imaging studies, you notice something on her... More
Woman, 64, With Eye Pain, Swelling, and Tearing
A 64-year-old woman presented to the clinic with a two-to-three-week history of significant pain, swelling, and... More
Pediatric T2DM: A Growing Threat to US Health
The increasing prevalence of type 2 diabetes requires effective lifestyle intervention and vigilant disease... More
Oral Anticoagulants and Nonvalvular A-fib: A Balancing Act
Patients with nonvalvular atrial fibrillation (A-fib) have a fivefold greater risk for ischemic stroke than those... More
Lesions’ Pattern Helps Line Up Diagnosis
Antifungal treatments haven't stopped this 6-year-old boy's asymptomatic lesions from spreading. What diagnostic clue... More
Modern Realities of Kidney Stones
To learn more about the diagnosis and management of kidney stones, visit our topic channel.

CE/CME Activities

Ashlyn Smith, PA-C
Expires March 31, 2016 The increasing prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is a serious health threat that urgently requires effective lifestyle intervention in at-risk patients, vigilant disease management for ... More »

CE/CME Activities

Deedra Harrington, DNP, MSN, APRN, ACNP-BC, Janis R. Guilbeau, DNP, RN, FNP-BC,
Expires February 29, 2016 Patients with nonvalvular atrial fibrillation (A-fib) have a fivefold greater risk for ischemic stroke than those without. Newer oral anticoagulants reduce this risk—but also increase risk for serious bleeding, including... More »

CE/CME Activities

Amy Chandler, MS, NP-C, Mary Parsons, EdD, MS, FNP-BC
Expires January 31, 2016 Hyperactivity, impulsivity, disruptive behavior, lack of focus—the symptoms of attention-deficit/hyperactivity disorder can negatively impact children and their families. Primary care providers have the opportunity to bri... More »

Grand Rounds

Jacqueline B. Broadway-Duren, DNP, MSN, FNP-BC
A 64-year-old woman presented to the clinic with a two-to-three-week history of significant pain, swelling, and excessive tearing of the left eye. The patient had a persistent cough but denied wheezing or shortness of breath. Medical history was rem... More »

What Is Your Diagnosis?

Brian J. Pottorf, MD, John T. Moore, MD, Harris W. Hollis Jr, MD
A 26-year-old Hispanic woman presents to the emergency department with myalgia and weakness. What does further evaluation reveal?... More »

Malpractice Chronicle

David M. Lang, JD, ­PA-C
A 28-year-old man presented with a low-grade fever, nonproductive cough, and dizziness. PE was considered but ruled out. How did this case go wrong?... More »

Radiology Review

Nandan R. Hichkad, PA-C, MMSc
A 65-year-old woman is transferred to your facility from an outlying hospital for evaluation of a brain tumor. Family members found the patient sitting on the sofa, with a decreased level of consciousness. There was reported “seizure-type activity.... More »

ECG Challenge

Lyle W. Larson, PhD, PA-C
A 74-year-old man has been a resident of a skilled nursing facility for seven years and is well known to the staff. This morning, when the medical assistant performed a routine vital sign check, she noticed the patient’s heart rate was in the 40s. ... More »


Joe R. Monroe, MPAS, PA
Since birth, this 8-year-old boy has had a “bald spot” on his scalp. The pediatrician who attended the birth suggested trauma as the cause, since forceps were used to facilitate delivery. But the problem has failed to resolve, leaving the boy an ... More »


Joe R. Monroe, MPAS, PA
Two months ago, a tender lesion manifested on the dorsum of a 14-year-old boy’s right foot. Before it appeared, there was a tiny papule in the same spot; the boy’s mother says they thought it was a wart and attempted to remove it. As a result, th... More »


Joe R. Monroe, MPAS, PA
A month ago, a 33-year-old woman noticed skin changes on her arms and face. The affected areas have recently begun to itch and burn—particularly, the patient notes, since she spent an extended period in the sun over the weekend. She has used an ant... More »


Cynthia A. Smith, DNP, APRN, FNP-BC
Q) One of my patients came in and said he had read that vitamin D supplementation will help with hypertension. Now he wants to quit his blood pressure meds and use vitamin D instead. Do you have any background on this? Vitamin D is critical for util... More »

Guest Editorial

Kevin Ballard, DNP, APRN, FNP, FAANP, Stacey Pfenning, DNP, APRN, FNP
The authors make a case for improved scope of practice acts, based on the unintended consequences of the reclassification of hydrocodone from Schedule III to Schedule II.... More »

Letter to the Editor

Maribelle Guloy, MSHS, CCRP
This article is a response to Randy D. Danielsen's editorial "Going for the Gold" from the February 2015 issue of Clinician Reviews. Hello Dr. Danielsen, Your statement about the profit-driven health system captured my attention. The ... More »

From the PA Editor-in-Chief

Randy D. Danielsen, PhD, PA-C, DFAAPA
Both the PA and NP professions will celebrate their 50th anniversaries this year. Here are six key areas in which both groups need to grow in the next half-century.... More »

MEDS 2014

Joe Largay, PA-C, CDE
Many diabetic patients also have disorders such as arthritis that require treatment with steroids—but there are adverse effects, particularly in people with diabetes. What are they?... More »

MEDS 2014

Joe Largay, PA-C, CDE
Most of the adult population that develops diabetes is diagnosed with type 2—but anywhere from 10% to 30% of adults may have type 1. Here's what you need to know to tell the difference, make the correct diagnosis, and offer effective treatment.... More »

MEDS 2014

What causes some patients with glucose problems to develop heart disease? Here are five risk factors that you need to be aware of.... More »


Naseem Miller
Enterovirus D68, which has been spreading rapidly across the nation causing mild to severe respiratory illnesses, is now under investigation for a possible link to several cases of paralysis in children. On Sept. 26, the Centers for Disease Control... More »