The Clinical Advisor

The Clinical Advisor Stay in touch with the latest information about diagnosing, treating, managing, and preventing conditions seen in a typical office-based primary-care setting.
The Clinical Advisor is a monthly journal for nurse practitioners and physician assistants in primary care.

After presenting to his clinician for altered mental status, a patient is sent to the #ER due to concern regarding his p...
05/22/2020
Mole Patrol: A Case of Disseminated Melanoma - Clinical Advisor

After presenting to his clinician for altered mental status, a patient is sent to the #ER due to concern regarding his progressive functional decline over the past several weeks, particularly in the previous 2 weeks. http://ow.ly/15bL50zNSPE

The clinical presentation of melanoma varies between patients, stage of diagnosis, subtype, and may initially present the same as any other pigmented macule or patch on the skin.

A 66-year-old man presents to the emergency department with a 3-day history of gradually worsening pain and swelling in ...
05/21/2020
Case Study: Pain and Swelling in the Knee - Clinical Advisor

A 66-year-old man presents to the emergency department with a 3-day history of gradually worsening pain and swelling in his left #knee. He denies any injury other than a scrape sustained approximately 1 week ago. He reports no #fever, redness or warmth to the knee, additional injuries, or other complaints. What's your diagnosis?

A man presents to the emergency department with a 3-day history of gradually worsening pain and swelling in his left knee.

Chronic migraine and episodic migraine negatively affect the quality of life of approximately 1 in 6 individuals in the ...
05/18/2020
Novel Class of Preventive Treatments for Migraine - Clinical Advisor

Chronic migraine and episodic migraine negatively affect the quality of life of approximately 1 in 6 individuals in the United States, and #migraine ranks as the number one cause of years lived with disability within the 15- to 49-year-old age group.

Anti-calcitonin gene-related peptide monoclonal antibodies are the first approved pharmacologic treatments developed explicitly for the prevention of migraine.

The dramatic and rapid expansion in #telemedicine has left many clinicians scrambling to institute this new means of con...
04/30/2020
Seven Things to Consider When Transitioning to Telemedicine During COVID-19 - Clinical Advisor

The dramatic and rapid expansion in #telemedicine has left many clinicians scrambling to institute this new means of conducting medicine; and even more seasoned providers who had been using telemedicine in their practice must learn to move telemedicine from the periphery to front and center of their practice.

The dramatic and rapid expansion in telemedicine has left many clinicians scrambling to institute this new means of conducting medicine; and even more seasoned providers who had been using telemedicine in their practice must learn to move telemedicine from the periphery to front and center of their....

We surveyed our #NP and #PA audiences to see how the #COVID-19 pandemic has impacted their clinicial practice.  American...
04/24/2020
How Has the COVID-19 Pandemic Affected Your Practice? - Clinical Advisor

We surveyed our #NP and #PA audiences to see how the #COVID-19 pandemic has impacted their clinicial practice. American Academy of PAs American Association of Nurse Practitioners

We surveyed our nurse practitioner and physician assistant audience to assess the impact of the 2019 novel coronavirus on their clinical practice.

A difference of opinion between a nurse and a police officer leads to an arrest, a firing, a settlement, and a potential...
04/21/2020
Refusal to Draw Blood From Comatose Patient - Clinical Advisor

A difference of opinion between a nurse and a police officer leads to an arrest, a firing, a settlement, and a potential ongoing lawsuit.

What happens when a police officer and nurse have a difference of opinion over whether blood can be drawn from an unconscious patient?

A woman presents with a 4-day history of worsening pain and clear drainage of her right eye; she also complains of a 2-d...
04/17/2020
Case Study: Eye Pain and Drainage, Headache, and Blurry Vision - Clinical Advisor

A woman presents with a 4-day history of worsening pain and clear drainage of her right eye; she also complains of a 2-day history of right-sided gradual-onset headache associated with intermittent blurry vision.

An older woman presents with a 4-day history of worsening pain and discharge in her right eye followed by a headache and blurry vision.

Institutional restrictions due to the #COVID-19 pandemic are taking a large toll on patients with hematologic cancers as...
04/10/2020
COVID-19 Pandemic Delaying Treatments of Hematologic Cancers - Clinical Advisor

Institutional restrictions due to the #COVID-19 pandemic are taking a large toll on patients with hematologic cancers as some facilities are cancelling scheduled treatments.

Some US medical centers have canceled treatments and all centers have altered their policies and procedures out of precaution related to the COVID-19 pandemic.

Our sister brand NACECME has been awarded accreditation with commendation by Accreditation Council for Continuing Medica...
04/06/2020
NACE Awarded Accreditation with Commendation by ACCME - Clinical Advisor

Our sister brand NACECME has been awarded accreditation with commendation by Accreditation Council for Continuing Medical Education - ACCME. This is the highest level of accreditation awarded by the ACCME.

Learn more: http://ow.ly/dTMS50z4Cxp

The National Association for Continuing Education (NACE), a part of Haymarket Media, Inc., has been reviewed by the Accreditation Council for Continuing Medical Education (ACCME®) and awarded Accreditation with Commendation for six years as a provider of continuing medical education (CME) for physi...

At The Clinical Advisor we know how hard you are working—and will be working—during this unprecedented pandemic. We will...
03/30/2020

At The Clinical Advisor we know how hard you are working—and will be working—during this unprecedented pandemic. We will never truly understand the sacrifices you are making for all of us right now on the frontlines of this crisis.

So we would like to say thank you. https://www.clinicaladvisor.com/the-covid-19-crisis-a-thank-you/ #HCWShoutOut

You still have time to nominate a woman clinician or researcher for Cancer Therapy Advisor's first-ever Women of Distinc...
03/26/2020

You still have time to nominate a woman clinician or researcher for Cancer Therapy Advisor's first-ever Women of Distinction in Oncology Awards! Details on how to nominate are at the link. Nominations are due April 1st: https://www.womenofdistinctioninoncology.com/

Patients with #CVD diagnosed with #COVID19 are urged to continue taking their ACEi and ARB medications as prescribed, ac...
03/24/2020
Joint Statement Issued Addressing Concerns Over COVID-19 and ACE Inhibitor, ARB Use - Clinical Advisor

Patients with #CVD diagnosed with #COVID19 are urged to continue taking their ACEi and ARB medications as prescribed, according to a statement from the American Heart Association Heart Failure Society of America - HFSA American College of Cardiology

Patients with cardiovascular disease diagnosed with novel coronavirus (COVID-19) are urged to continue taking their angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) medications as prescribed.

The statute of limitations protects a family nurse practitioner #FNP fter a patient delays testing and seeks the advice ...
03/23/2020
Saved by the Statute of Limitations - Clinical Advisor

The statute of limitations protects a family nurse practitioner #FNP fter a patient delays testing and seeks the advice of a plaintiff's attorney after she undergoes surgery. Read the full case in this month's Legal Advisor.

Keeping accurate notes that reflect each time a test, procedure, or referral is recommended and then refused by a patient helps protect clinicians from malpractice claims.

The effectiveness of #COPD therapy requires the correct use of inhaler devices. #Practitioners can play a vital role in ...
03/18/2020
COPD: Importance of Educating Patients on Proper Inhalation Technique - Clinical Advisor

The effectiveness of #COPD therapy requires the correct use of inhaler devices. #Practitioners can play a vital role in providing education and training on correct inhalation techniques to enhance therapeutic benefit and optimal medication delivery.

Practitioners can play a vital role in providing education and training on correct inhalation techniques to enhance therapeutic benefit and optimal medication delivery. Overall, the goal for the provider is to be confident when educating patients on proper use of inhalation technique, emphasize the....

Individuals with #depression may present for evaluation in the primary care setting; however, a meta-analysis found that...
03/13/2020
Mental Health Update: Recognizing and Treating Depression in Primary Care - Clinical Advisor

Individuals with #depression may present for evaluation in the primary care setting; however, a meta-analysis found that primary care providers failed to diagnose depression in nearly 50% of individuals who met the criteria for major depressive disorder #MDD.

A number of barriers prevent identification of depression in primary care settings, including time constraints of providers and a lack of established screening and diagnostic protocols.

May-Hegglin anomaly is a rare, congenital, autosomal-dominant disorder; characteristics of the disease include #hearing ...
03/09/2020
Case Study: Understanding May-Hegglin Anomaly - Clinical Advisor

May-Hegglin anomaly is a rare, congenital, autosomal-dominant disorder; characteristics of the disease include #hearing loss, low platelet counts, bleeding abnormalities, and #kidney disease.

During a routine physical examination, a clinician suspects May-Hegglin anomaly because of the patient's low platelet count and hearing loss.

The Clinical Advisor's cover photo
03/06/2020

The Clinical Advisor's cover photo

Our sister brand, National Association for Continuing Education, kicked off their 4th Annual Conversations in Primary Ca...
03/06/2020
NACE Presents 4th Annual Conversations in Primary Care series - Haymarket

Our sister brand, National Association for Continuing Education, kicked off their 4th Annual Conversations in Primary Care series last month. Join them for the next conversation March 14, 2020. Learn more:

The National Association for Continuing Education (NACE) is proud to announce the 2020 Conversations in Primary Care season kicked off on Saturday, February 8, 2020 with a record number of live attendees.   Over 1,000 primary care clinicians joined NACE online for the first of 9 virtual CME activit...

A 32-year-old woman presents to the emergency department for evaluation of a worsening #rash that begins at her navel an...
03/05/2020
Case Study: Itchy and Painful Lesions on Legs - Clinical Advisor

A 32-year-old woman presents to the emergency department for evaluation of a worsening #rash that begins at her navel and continues down both of her legs. Can you diagnose her condition?

A patient presents with a worsening rash on both of her legs that has persisted for 10 days.

In light of the rise in psychological problems such as anxiety, depression, and stress during the #COVID-19 epidemic, pu...
03/02/2020
Mental Health Concerns Arise Amid COVID-19 Epidemic - Clinical Advisor

In light of the rise in psychological problems such as anxiety, depression, and stress during the #COVID-19 epidemic, public health advocates and government officials can learn from previous shortcomings to develop better responses.

The COVID-19 epidemic has underscored potential gaps in mental health services during emergencies, while also testing the resilience of healthcare workers and medical systems.

A man presents to his primary care provider complaining of recent, recurrent episodes of #angioedema. The patient previo...
02/25/2020
Case Study: Episodes of Angioedema in a 51-Year-Old Man - Clinical Advisor

A man presents to his primary care provider complaining of recent, recurrent episodes of #angioedema. The patient previously had gone to the emergency department for facial swelling associated with consuming spicy food. However, the swelling persisted after eliminating such foods from his diet.

Alpha-gal syndrome is a tick-borne disease that causes allergic reactions to red meat.

A patient presents with pain and deformity of her right third toe after striking her foot against a corner wall. What is...
02/19/2020
Ortho Dx: Dislocation of the Third Toe - Clinical Advisor

A patient presents with pain and deformity of her right third toe after striking her foot against a corner wall. What is the best course of treatment based on the imaging?

A patient presents with pain and deformity of her third toe after striking her foot against a wall.

Faulty memory, incomplete notes, a broken computer system, and poor-follow-up all lead to a 2-year delay in a #cancer di...
02/14/2020
Overlooked Results and Poor Follow-up Delay Diagnosis - Clinical Advisor

Faulty memory, incomplete notes, a broken computer system, and poor-follow-up all lead to a 2-year delay in a #cancer diagnosis. Read the whole story in this month's Legal Advisor.

Faulty memory, incomplete notes, a broken computer system, and poor-follow-up all lead to a 2-year delay in a cancer diagnosis.

We are pleased to announce that our partner brand  Haymarket Medical Education (HME) was accredited as a provider of Joi...
02/14/2020
Haymarket Medical Education Receives Interprofessional Joint Accreditation for the Healthcare Team

We are pleased to announce that our partner brand Haymarket Medical Education (HME) was accredited as a provider of Joint Accreditation for Interprofessional Continuing Education (IPCE) by Accreditation Council for Continuing Medical Education - ACCME (ACCME), Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Association (ANCC).

HME received a six-year accreditation as a provider of interprofessional continuing education for the health professions having achieved compliance with all core criteria for accreditation. A six-year accreditation is the highest number of years awarded to an IPCE provider #ContinuingEducation #MedicalEducation http://ow.ly/xMzl50ymyt8

Caroline O. Pardo, Ph.D., General Manager for Haymarket Medical Education, is pleased to announce that HME, based in Paramus, NJ, has been accredited as a provider of interprofessional continuing education by the Accreditation Council for Continuing Medical Education, the Accreditation Council for P...

#Rural Americans have a lower life expectancy than their #metropolitan counterparts.The higher rate of premature death c...
02/04/2020
Health Disparities in Rural America: Current Challenges and Future Solutions - Clinical Advisor

#Rural Americans have a lower life expectancy than their #metropolitan counterparts.The higher rate of premature death can be traced to a higher incidence of heart disease, #cancer, unintentional injury, respiratory disease, and stroke. Our latest feature takes a deeper dive into the health disparities found in rural American communities.

Rural America is falling behind in many of the top health categories, including heart disease, cancer, and lower life expectancy.

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