JAAPA CME Post-Test December 2021

Adhesive Capsulitis: A Review for Clinicians

Adhesive capsulitis, a common primary care and orthopedic diagnosis often referred to as frozen shoulder, is a painful inflammatory process that leads to a mechanical block in active and passive range of shoulder motion. Risk factors include diabetes and thyroid dysfunction. Diagnosis is made based on physical examination, but can be augmented by diagnostic imaging. Nonsurgical management is the mainstay of treatment because the disease is self-limiting. However, some patients may need surgical intervention.

Learning Objectives

  • Summarize the pathologic basis of adhesive capsulitis of the shoulder 
  • Recognize when a patient is at increased risk for adhesive capsulitis of the shoulder 
  • Understand the treatment options available for patients with adhesive capsulitis

Understanding Resistant Hypertension

Resistant hypertension affects about 17% of the US population. However, it is difficult to diagnose because of multiple factors that influence adequate treatment of BP, including patient lifestyle and comorbidities, improper therapeutic regimens, and secondary mechanisms. Possible causes of resistant hypertension include nonmodulator hypertension, which affects patients who have an inappropriate response to elevated sodium through the renin-angiotensin-aldosterone system. Early identification and frequent follow-up can help patients achieve BP goals more rapidly and may reduce morbidity and mortality associated with complications of hypertension, including cerebrovascular accident, cardiovascular disease, and kidney disease.

Learning Objectives

  • Define resistant hypertension and list its major risk factors and common secondary causes 
  • Describe barriers to treatment, such as clinician resistance and patient resistance 
  • Identify common and novel treatment options 
  • Understand the role of PAs in diagnosing and treating patients with resistant hypertension

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