Bluish Pink, Nontender Lesion Worries Patient’s Mother
A 12-year-old girl is brought to dermatology by her mother for evaluation of a lesion on her arm. It’s been there for... More
Girl, 10, Asks Tough Questions About Skin Problem
A 10-year-old girl is seen in dermatology for evaluation of dry skin. She reports few if any symptoms but expresses... More
Obstructive Sleep Apnea: Evaluation and Management
Patients with undiagnosed/untreated OSA are at increased risk for cardiovascular and cerebrovascular consequences.... More
Parents Frightened by Son's Thigh Lesion
The asymptomatic lesion has been present for three months, and antifungal meds have not helped.
Interpretation: Humans, 1; Machine, 0
A 72-year-old woman presents with a racing heart and a likely diagnosis. Does the ECG support her assertion?
Elective Craniotomy Results in Respiratory Disease
What is the cause of the patient's sudden mild-to-moderate dyspnea and tachypnea?
Fall From Trail Leaves Woman in Pain
She dropped 4 ft from an embankment, landing on her left hip and elbow.
Driver Partially Ejected From Vehicle
He wasn't wearing a seatbelt when his truck went into a ditch; his leg was caught in the window. What is the extent of... More
Woman Blacks Out Repeatedly, Doesn't Remember Doing So
Her fellow residents at the skilled nursing facility say it's happened three times during their card games. What does... More
Foot Rash + Gnarly Toenails = Man in Need of a Diagnosis
For several years, a 66-year-old man has had an itchy rash on his right leg; recently, it has become more bothersome.... More


Bonnie A. Dadig, EdD, PA-C, Morgan Edwards, PA
Expires August 31, 2016 Nearly 22 million Americans are affected by obstructive sleep apnea (OSA), making it the most common sleep disorder. Patients with undiagnosed and untreated OSA are at increased risk for cardiovascular and cerebrovascular he... More »

CE/CME Activities

Sara Freeman, Bianca Nogrady, Tara Haelle, Mary Ann Moon, Bruce Jancin
Topics include: Intensive therapy for psoriatic arthritis • Subclinical hyperthyroidism and fracture risk • Oral contraceptives and VTE risk • Statins, fibrates, and stroke in the elderly • Cystic fibrosis­­–related di... More »

CE/CME Activities

Mary Ann Moon, Amy Karon, Gregory Twachtman, Bianca Nogrady
Topics include: COPD exacerbation guidelines • GI symptoms in Parkinson disease • Measles vaccine • Cardiac screening in low-risk patients • Diabetes and acute MI • Risk for zoster in psoriasis... More »


Natalie Long, MD, Liz Nguyen, MD, James Stevermer, MD, MSPH
Guidelines recommend collecting an early-morning sample to compensate for the natural diurnal variation in testosterone levels. But for men 45 and older, this is unnecessary.... More »

Malpractice Chronicle

David M. Lang, JD, ­PA-C
In March 2009, a 63-year-old man was diagnosed with stage IV gastric carcinoma with metastasis to the liver. His treating oncologist gave him a prognosis of about 10 months’ life expectancy with chemotherapy. The patient’s family searched for alt... More »


ClinicalEdge provides succinct summaries of the latest “must-read” news and research. Here are several updates on food allergy and anaphylaxis.... More »


Joe R. Monroe, MPAS, PA
A 6-year-old boy is brought in by his mother, referred to dermatology for evaluation of a lesion on his right thigh that manifested three months ago. Although asymptomatic, the lesion has frightened the boy’s parents. They first took him to a local... More »

ECG Challenge

Lyle W. Larson, PhD, PA-C
A 72-year-old woman with recurring palpitations and a rapid heart rate presents for evaluation stating that her heart started racing early yesterday morning. It began while she was sleeping, which is normal for her, but while the problem usually reso... More »

Radiology Review

Nandan R. Hichkad, PA-C, MMSc
A 60-year-old woman undergoes an elective craniotomy for clipping of a nonruptured aneurysm. The perioperative course is uneventful, and the aneurysm is clipped without complication. The patient is extubated and sent to the recovery room. Within 30 m... More »

Endocrine Consult

Ji Hyun Chun, PA-C, BC-ADM
Secondary diabetes may be underestimated due to "misdiagnosis" as type 2 diabetes.... More »


Amy L. Hazel, RN, MSN, CNP
Q) I have been treating a 60-year-old man with a long history of microscopic hematuria and waxing/waning proteinuria. What could be the cause of his hematuria? Hematuria is a consequence of erythrocytes, or red blood cells (RBCs), in the urine. Thi... More »


Amy L. Hazel, RN, MSN, CNP
Q) My hematuria patient had more significant proteinuria recently, so the nephrologist sent him for kidney biopsy. It was read as IgA nephropathy: “classic mesangial staining on IF with moderate-advanced chronic injury (15/32 gloms globally scleros... More »

From the PA Editor-in-Chief

Randy D. Danielsen, PhD, PA-C, DFAAPA
After 40 years as a PA (including 21 in academia), tucking myself safely into my seventh decade of life, I was feeling fairly invincible. Yes, I was experiencing increased fatigue and intermittent dizziness, but I attributed those to normal aging and... More »

From the NP Editor-in-Chief

Marie-Eileen Onieal, PhD, CPNP, FAANP
As our editorialist explains, “You can’t sit on the outside and complain if you don’t like something—go in and change it.” Here’s how she wants you to take action.... More »

Letter to the Editor

Janet Evans Emery, RN, MSN, CFNP
This article is a response to Randy D. Danielsen's editorial "Online Entry-Level Education: The Jury Is Still Out!" from the June 2015 issue of Clinician Reviews. Dear Dr. Danielsen, Thank you for addressing this latest controversy in PA/... 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 »