Against Medical Advice (AMA): Clinical Pearls Blog

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Emergency Medicine, Family Medicine, Internal Medicine, Nurse Practitioner, Pediatric Medicine, Urgent Care

against medical advice AMA discharge

When a patient leaves against medical advice – or AMA, the patient is leaving before their treating physician recommends discharge or despite medical advice to the contrary. This definition implies the patient received and understood the medical advice given. In practice, the term “AMA” is often used regardless of whether medical advice was given or not.  Patients may lack the … Read More

Asymptomatic Bacteriuria: Clinical Pearls Blog

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Family Medicine, Internal Medicine, Nurse Practitioner

Asymptomatic Bacteriuria positive urine culture

Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities or those who have bladder catheters inserted for an extended period.  Asymptomatic bacteriuria is a condition in which larger than normal numbers of bacteria are present in the urine but symptoms do not result. A 76-year-old woman with Alzheimer’s disease, hypertension, … Read More

Heel Pain: Clinical Pearls Blog

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls

Heel pain pearl of wisdom cover

Heel pain is defined as physical discomfort on the back or the underside of the heel that may make walking uncomfortable or difficult. Heel pain can have causes that aren’t due to underlying disease. Examples include poorly fitting shoes, wearing high heeled shoes, prolonged period on feet, overuse such as long walks or marathons, sprains, strains, or trauma. Try this … Read More

Clinical Pearl Blog: Contrast-Induced Nephropathy

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Emergency Medicine, Family Medicine, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Urgent Care

Pearls in the prevention of contrast-induced nephropathy CIN AKI

Test your clinical knowledge with this clinical pearl of the month review question. A 78-year-old man with type 2 diabetes and chronic kidney disease presents with substernal chest discomfort that radiates to the left arm and neck, present intermittently over a period of a day, with symptoms made worse by exertion. His EKG shows lateral S-T depression and T-wave inversion. … Read More

Clinical Pearl Blog: 54-year-old male w/ fever, malaise, cough

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Emergency Medicine, Family Medicine, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Urgent Care

Clinical Pearl Blog from MedChallenger medical education

Test your clinical knowledge with this clinical pearl of the month review question. A 54-year-old man presents in follow-up from an emergency department (ED) visit a day prior. He was told to see his doctor for a recheck, after presenting to the ED with fever, malaise, and occasional cough. The patient is a long-time smoker of a pack per day. … Read More

Clinical Pearl of the Month – Pediculosis

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Medical News

Clinical pearls of the month

Test your clinical knowledge with this clinical pearl of the month review question. A 5-year-old girl has been frequently scratching her scalp and has been complaining of severe pruritus. She is otherwise healthy, has had no major medical problems, and has no allergies. She was noted to have lice by her kindergarten teacher during the school day. Examination of the … Read More

Clinical Pearl of the Month – Breast Cancer Prevention

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Medical News

Clinical Pearl of the Month

Today’s Clinical Pearl of the Month question comes from the desk of Med-Challenger Family Medicine Editor, Gerard Kiernan, MD, FAAFP, FHM. Test your skills with this review question. A 43-year-old white woman presents for health maintenance visit. She has history of menarche at age 12, first childbirth at age 28, and has a family history of breast cancer in her … Read More

Clinical Pearl of the Month – Urine Drug Testing

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Medical News

Clinical Pearl of the Month

Today’s Clinical Pearl of the Month question comes from the desk of Med-Challenger Family Medicine Editor, Gerard Kiernan, MD, FAAFP, FHM. Test your skills with this review question. A 48-year-old man presents as a new patient, transitioning from a colleague who is retiring. He had a motor vehicle crash ten years prior, and, since then, has suffered from chronic low … Read More

Clinical Pearl of the Month – Mild Cognitive Impairment

Kelly SeagravesClinical Pearls, Medical News

Clinical Pearl of the Month

Today’s Clinical Pearl of the Month question comes from the desk of Med-Challenger Family Medicine Editor, Gerard Kiernan, MD, FAAFP, FHM. Test your skills with this review question. A 73-year-old woman complains of worsening memory, and reports that her husband and adult children have been worried about her recall as well. She denies depression. Her medical history includes hypertension and … Read More