Episode notes
COPD guidelines have changed—and if you’re managing COPD in primary care, there are a few updates worth knowing. In this episode, I walk through how to approach a patient with COPD at a routine visit, especially when you’re seeing them for the first time or inheriting their care from another provider. We’ll cover how to confirm the diagnosis with spirometry, how to think about GOLD 1–4 alongside the ABE assessment, and how the mMRC and CAT scores fit into your assessment. We’ll also talk about alpha-1 antitrypsin deficiency testing, blood eosinophils and inhaled corticosteroids, initial…
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Real World NP
Hi, I’m Liz Rohr: family nurse practitioner, wife, parent, and founder of Real World NP, a continuing education company for new nurse practitioners in primary care. I’m on a mission to equip and guide new nurse practitioners so they can feel confident and capable through comprehensive, concise, an
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S5 · E8 · 8 Oct 2026 · 13 min
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S5 · E6 · 28 Aug 2026 · 58 min
GI Specialist Interview: H. pylori, GERD, Celiac, Constipation & When to Refer
What does a GI specialist wish primary care providers knew before sending a referral? In this episode, I’m joined by family nurse practitioner Paige Sosebee, who has worked in gastroenterology since 2019 at a large academic medical center. We talk through some of the most common GI concerns we see in primary care—and what happens on the other side of the referral. Paige shares practical pearls on H. pylori testing and treatment, GERD and PPI trials, evaluating abnormal liver tests, celiac testing, chronic constipation, SIBO and intestinal methanogen overgrowth (IMO), and how primary care can…
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S5 · E5 · 13 Aug 2026 · 1 hr 1 min
Interview with a Nephrologist: CKD, Dialysis & When to Refer
When should you refer a patient with CKD to nephrology—and what should you do before they get there? In this episode, I’m joined by nephrologist and medical educator Dr. Rachel Hilburg to talk through the questions that come up all the time in primary care: interpreting proteinuria and hematuria, deciding when a nephrology referral is urgent, what labs and imaging to order before referral, and what we can actually do to slow CKD progression. We also talk about the Kidney Failure Risk Equation, cystatin C, kidney-protective medications, preparing patients for dialysis and transplant, caring…
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S5 · E4 · 30 Jul 2026 · 32 min
Structural Heart Disease in Primary Care: When to Suspect Valve Disease & When to Refer
Valvular heart disease often presents gradually— often slowly becoming more fatigued, less active, or more short of breath over time— making it easy for symptoms to be attributed to aging or deconditioning. In this episode, Liz Rohr sits down with structural heart nurse practitioner Christy Cantey, FNP, to discuss how primary care clinicians can recognize subtle symptoms of valve disease, know when an echocardiogram is appropriate, and understand what happens after a patient is referred to a structural heart program. They also discuss modern transcatheter valve procedures—including TAVR and…
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S5 · E3 · 16 Jul 2026 · 9 min
How to Use the PREVENT Risk Calculator
The PREVENT Risk Calculator is a newer cardiovascular risk assessment tool developed by the American College of Cardiology (ACC) and American Heart Association (AHA). Designed to replace older pooled cohort equations, it provides a more comprehensive estimate of cardiovascular risk, including both atherosclerotic cardiovascular disease (ASCVD) and heart failure risk. In this episode, Liz Rohr breaks down what the PREVENT calculator is, how to use it in clinical practice, and why it's becoming an increasingly important part of cardiovascular risk assessment in primary care. Timestamps: 00:00…
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S5 · E2 · 2 Jul 2026 · 56 min
New Hypertension Guidelines: Practical Updates with Dr. Jordy Cohen
Hypertension Guidelines Updates: Practical Pearls for Primary Care with Dr. Jordy Cohen What actually changed in the newest hypertension guidelines—and what should nurse practitioners be doing differently in clinic? In this episode, Liz Rohr, MSN, FNP-BC, sits down with Dr. Jordy Cohen , nephrologist, hypertension specialist, researcher, and member of the hypertension guideline writing committee, to break down the updates that matter most for primary care. Rather than reviewing every recommendation, this conversation focuses on the clinical decisions that can make the biggest difference in…
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