Nach Genre filtern
- 246 - #165 Peripheral Arterial Disease: 5 Pearls Segment
Why are we missing peripheral arterial disease (PAD)? How is it diagnosed using the Ankle-Brachial Index (ABI)? What treatments improve symptoms and reduce cardiovascular risks? When should revascularization be considered?
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Timestamps:
(02:23) | PEARL 1: When to suspect PAD? Risk factors?
(07:34) | PEARL 2: How to work up PAD?
(16:26) | PEARL 3: Improving symptoms and quality of life
(25:38) | PEARL 4: Approach to therapy: Preventing CV mortality
(33:53) | PEARL 5: Deeper Dive into Antithrombotic Therapy and Anticoagulation
(39:09) |PEARL 6: Who needs revascularization?
Tags: CoreIM, PAD, Peripheral Arterial Disease, ABI, claudication, vascular medicine, revascularization, internal medicine, smoking cessation, lipid management, primary care, physician assistant, nurse practitioner, cilostazol. supervised exercise therapy
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 Nov 2024 - 245 - #164 TPN/PPN Parenteral Nutrition: 5 Pearls Segment
How is TPN and PPN similar and how is it different? When should each be used? How does bacterial overgrowth lead to complications? Does TPN cause diarrhea?
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It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.
Timestamps:
(01:35) | PEARL 1: Basics of PN: What makes up parenteral nutrition?
(06:54) | PEARL 2: Indications and Contraindications for TPN and PPN: When should I order parenteral nutrition?
(13:40) | PEARL 3: Complications of parenteral nutrition: What are the common adverse effects of parenteral nutrition?
(19:41) | PEARL 4: Parenteral nutrition myths: What should patients know before they start TPN?
(23:56) | PEARL 5: Recap on Tube Feeds: How do we determine the amount of free water to give out patients on tube feeds?
Tags: IMCore, CoreIM, parenteral nutrition, TPN, PPN, clinical nutrition, nutritional support, complications, patient safety, gastrointestinal disorders, critical care, internal medicine, fluid management, ICU, Crit Care, GI, gastroenterology
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 14 Nov 2024 - 244 - #163 Urine Drug Screening Nuances: 5 Pearls Segment
Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?
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It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.
Timestamps:
(03:01) | PEARL 1:Basics to Urine Drug Screen (UDS)
(08:03) | PEARL 2: Types of urine drug tests, and what are immunoassays (IA)?
(18:44) | PEARL 3: What are gas chromatography/mass spectrometry (GC/MS)-based tests?
(26:51) | PEARL 4:How do you address unexpected test results on a UDS?
(30:29) | PEARL 5:Throwback to “5 Pearls on Stigma in Opioid Use Disorder” episode
Tags: IMCore, CoreIM, primary care, urine drug screening, opioid use disorder, substance use, harm reduction, addiction medicine, clinical toxicology, patient safety, compassionate care
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 30 Oct 2024 - 243 - #162 Hospice 102: Practical Tips and Nuances
What if a patient can't afford hospice? Which medications do you deprescribe when on hospice? What happens when patients who are on hospice return to the hospital or ED?
Behind the Scenes Youtube Interview:
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Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 16 Oct 2024 - 242 - #161 Transfusion Thresholds and the MINT Trial: Beyond Journal Club with NEJM Group
Can the MINT trial change how we treat anemia in acute MI? The largest trial of its kind compared liberal vs. restrictive transfusion strategies in patients with myocardial infarction.
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Timestamp:
01:29 History of Transfusion Guidelines/Studies06:49 Pathophysiology of Anemia in heart disease10:04 Transfusion in MI Studies13:45 MINT Trial22:20 Takeaways/DiscussionTags:Tags: CoreIM, IMCore, cardiology, internal medicine, myocardial infarction, anemia, transfusion, physician assistant, nurse practitioner, pharmacist, clinical trials, MINT trial, transfusion strategies, restrictive vs. liberal transfusion, heart attack
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 02 Oct 2024 - 241 - #160 Moral Distress Part 2: At the Bedside Segment
Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!
Timestamps:
(01:07) | Strategies for Addressing Moral Distress
(09:25) | Strategies for Address Moral Injury
(20:52) | Conclusion
Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethics
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 18 Sep 2024 - 240 - #159 Moral Distress Part 1: At the Bedside Segment
What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?
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Timestamps:
(04:59) | Definitions
(6:50) | Moral Distress
(09:01) | Moral Residue
(09:01) | Moral Residue
(11:34) | Moral Injury
(13:32) | Causes of Moral Distress and Moral Injury
(18:18) | Consequences
Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanism
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 11 Sep 2024 - 239 - #158 Diuretics Resistance Cases
Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”
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Timestamps:
(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension
(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output
(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion Pressure
Cardiorenal Considerations: 5 Pearls Segment
Tags:
IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical care
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Aug 2024 - 238 - #157 Handoffs: Contingency Planning
Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.
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Timestamps:
(2:44) What makes this patient different from others with similar symptoms or diagnosis?
(7:28) Does your covering team have the tools to follow up on tasks and information they need for success?
(16:06) Is the handoff updated?
(18:26) What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients?
(22:41) What are we still uncertain about?
(25:30) Closing thoughts
Tags:
IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalist
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 07 Aug 2024 - 237 - #156 Hospice 101: Nuts and BoltsWhat is the philosophy of hospice? (3:04)Who qualifies for hospice (6:13)Who makes up the hospice team (8:17)Who pays for hospice (17:24)What are the different levels of care (21:31)What are some limitations of the hospice medicare benefit? (31:57)
Behind the Scenes Youtube Interview:
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Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 24 Jul 2024 - 236 - #155 Microskills: Small Actions, Big Impact
Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention.
Book by Dr. Adaira Landry, Dr. Resa E. Lewiss:
MicroSkills: Small Actions, Big Impact
Tags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 03 Jul 2024 - 235 - #154 Does Invitation To Screening Colonoscopy Save lives? Beyond Journal Club with NEJM Group on the NordICC Trial
Does colonoscopy prevent colon cancer, and does it save lives? There has never been a randomized controlled trial on screening colonoscopies before NordICC trial, even though it is a guideline based recommendation for everyone over 45! How did this come to be? What do we tell our patients who are on the fence about undergoing screening colonoscopy? To find out, tune into the sixth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
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Timestamp:
00:00 Introduction02:28 Pathophysiology of Colorectal Cancer & Why Screening Makes Sense06:15 General Cancer Screening – Observational Studies09:17 General Cancer Screening – Randomized Controlled Trials14:40 NordICC Trial22:36 Implications for Patient CareTags: IMCore, CoreIM, primary care, gastroenterology, nurse practitioner, pharmacist, physician assistant, sigmoidoscopy, per protocol analysis and intention to treat analysis
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 19 Jun 2024 - 234 - #153 HFpEF: 5 Pearls SegmentWhat causes HFpEF? (1:59)Does diastolic dysfunction imply HFpEF? (11:22)Is the BNP levelhelpful in HFpEF? (19:21)What scoring systemscan be helpful in ruling in HFpEF? (25:06)What's the treatment for HFpEF? (32:03)
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Behind The Scenes videos on YouTube
Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, heart failure with preserved ejection fraction
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 05 Jun 2024 - 233 - #152 Immune Checkpoint Inhibitors & IRAEs 101: 5 Pearls SegmentHow do immune checkpoint inhibitors work? (01:56)How do you organize the different immune-related adverse events (irAEs)? (07:15)Generally, when do different adverse events can present? (13:42)What makes someone more likely to develop an adverse effect? (22:20)What role does complementary & alternative medicineplay in this patient population? (26:38)
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Tags: Side effects, oncology, cancer, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, pharmacology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 22 May 2024 - 232 - #151 Cardiorenal Considerations: 5 Pearls SegmentUrinalysis in a patient with AKI from purely cardiorenal syndrome? (~02:05)What is bioavailability, duration of action, and outcomes with furosemide, torsemide, and bumetanide? (~08:47)How can spot urine sodium measurementsbe used to assess diuretic response? (~18:08)What are the differences between thiazides (PO Metolazone vs. IV Chlorothiazide) and acetazolamide augment diuresis? (~27:35)Spaced Repetition: RAAS inhibitors or SGLT2 inhibitors as GMDT in CKD? (~35:08)
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Tags: nephrology, cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, diuretic resistance
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 13 May 2024 - 231 - #150 Rhythm Control in Afib: 5 Pearls Segment
What are the benefits of early rhythm control versus rate control alone? When is electrical cardioversion used and what information can it tell us? What side effects for amiodarone, dofetilide, and sotalol, propafenone and flecainide? When should catheter ablation be considered in patients with atrial fibrillation?
Time stamps:
02:05 Pearl 1 - Rhythm control11:23 Pearl 2 - Electrical cardioversion17:53 Pearl 3 - Class III antiarrhythmics and side effects26:31 Pearl 4 - Class Ic antiarrhythmics and side effects31:55 Pearl 5 - Catheter ablationTags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillation
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 24 Apr 2024 - 230 - #149 Asthma Management and the MANDALA Trial: Beyond Journal Club with NEJM Group
Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care.
Time Stamps
01:47 Evolving story of asthma management03:26 Pathophysiology of asthma management06:01 Key players & terms08:56 Story of asthma through the decades17:55 MANDALA TrialTags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalers
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 10 Apr 2024 - 229 - #148 Iron Deficiency Treatment: 5 Pearls Segment
How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula? What is a Fishbane reaction? And how is it different from anaphylaxis?
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Behind the Scenes video - Treatment of Iron Deficiency
Behind the Scenes video - IV Iron Infusion Reactions
Time stamps:
02:09 | Spaced repetition from the last Gray Matters Episode
05:29 | Choosing between oral and IV iron
11:17 | Considerations with oral iron repletion
24:02 |Considerations with IV iron repletion
32:36 | Complications and side effects of IV iron
Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 Mar 2024 - 228 - #147 Iron Deficiency: Grey Matters Segment
What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history?
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Time stamps:
03:43 Iron deficiency labs and interpretation in inflammation16:08 Heavy menstrual bleeding evaluation27:04 When should a premenopausal woman with iron deficiency have endoscopy?35:15 RecapTags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosis
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 13 Mar 2024 - 227 - #146 Tube Feeds: 5 Pearls Segment
Uncover many blind spots on tube feeds!
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Youtube Interviews:
What is venting aka decompression?
Timestamp
02:21 Indications for tube feeds09:36 Routes of enteral access19:20 Components of tube feeds7:03 Tube feeds complications34:50 Counseling patients before discharge and medication interactionsTags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feeds
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Feb 2024 - 226 - #145 Heart Failure in Older Adults & Guardianship: Gray Matter Segment
How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship?
Sponsor: Echonous, the maker of Kosmos, is redefining point-of-care ultrasound at half the price (or less) of comparable carts. Mention Core IM at the Demo to get a free A.I application of choice!
Behind The Scenes videos
Limitation and value of individualism
Timestamp
04:03 Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult?11:55 Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship?28:30 Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred?33:27 Reflections37:06 RecapTags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case management
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 14 Feb 2024 - 225 - #144 RSV & What Makes Vaccine Trials Different: Beyond Journal Club on the RENOIR and AReSVi Trials
How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more
Time Stamps
02:30 Epidemiology of RSV03:46 Development of RSV vaccine05:55 Vaccine trial design12:22 ARESVI and RENOIR Trials18:18 Who should we recommend the RSV vaccine to?19:50 What don’t we know?Tags: IMCore, CoreIM, primary care, infectious disease, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 31 Jan 2024 - 224 - #143 Hypomagnesemia and Hypophosphatemia: 5 Pearls Segment
When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement?
Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more
Youtube interview on key points on magnesium
Youtube interview on key points on phosphate
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp
01:37 Pearl 1: Magnesium09:39 Pearl 2: Framework for hypomagnesemia16:53 Pearl 3: Magnesium repletion22:39 Pearl 4: Phosphorous28:36 Pearl 5: Phosphorous repletionTags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renal
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 17 Jan 2024 - 223 - #142 Managing Conflict: At the Bedside Segment
Sharpen your de-escalation skills!
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Timestamps:
02:26 Difficult Patients10:25 Mediation Toolkit17:20 Maxims of Mediation26:46 When the Conversation Still Breaks Down35:11 ConclusionTags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnout
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 Dec 2023 - 222 - #141 Do Steroids Have a Role in Community-Acquired Pneumonia? Beyond Journal Club on the CAPE COD Trial
In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
01:50 Pathophysiology of Steroids and Infection03:50 Steroids in PNA Studies08:56 CAPE COD Trial14:13 Discussion of CAPE COD Trial18:36 Takeaways/DiscussionTags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 06 Dec 2023 - 221 - #140 Bonus Pacemaker & ICDs: 5 Pearls Segment
Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!
Sponsor: Post Investment: Real Estate Syndications
Timestamps:
01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?06:31 Pearl 2: Considerations for patients with implantable devices before surgery.12:26 Pearl 3: Considerations for patients with implantable devices before MRI.14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-rayTags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 29 Nov 2023 - 220 - #139 CKD Staging (Cr vs. Cystatin C, Albuminuria & more): Mind The Gap Segment
Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria?
Sponsor: Panacea Financial Student Loan Consultation
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp:
00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage
04:20" What's wrong with how we estimate GFR?
06:50 Why is creatinine flawed as an estimator of GFR?
10:52 Enter new contender...Cystatin C!
16:16 Importance of the A Stage!
20:21 Which patients should you measure proteinuria in?
22:10 Treatments for albuminuria!
24:27 Summary and Closing
Tag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 08 Nov 2023 - 219 - #138 Incorporating Cancer Genetics into Your Practice: Lynch Syndrome and Beyond!
Check out the original interview on Youtube:
Essentials on Genetic Counselor | Lynch Syndrome
Who should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting!
Timestamp
03:13 Part 1: Who should be referred to genetic counseling?11:23 Part 2: How do we set up genetic counselors for success?22:38 Part 3: Genetic counseling myth busting!Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 25 Oct 2023 - 218 - #137 Hypokalemia & Potassium Repletion: 5 Pearls Segment
See some of the original interviews on Youtube!
What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?!
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp
01:45 Pearl 1: Evidence for potassium repletion 09:10 Pearl 2: Framework for hypokalemia17:09 Pearl 3: Repletion goals23:00 Pearl 4: Options for hypokalemia treatment29:13 Pearl 5: Frequency of lab checks and repletionTags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional education
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 18 Oct 2023 - 217 - #136 How Did Diabetes Medications Become Obesity Meds? Beyond Journal Club on SURMOUNT-1 Trial
What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?
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02:08 Framework for thinking about obesity03:42 History of obesity treatment06:29 Gila monsters and GLP and GIP mechanisms08:29 Story of how medications for diabetes were found to have a weight loss benefit12:50 SURMOUNT-1 trialTags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant
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With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers?
Sponsors: Hellofresh | Pranay's Effective Living Formula Course
Pranay's Free Masterclass(Sept 20 and 27th at 5pm PST)
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamps
01:54 Pearl 1 – Recap of GDMT and CKD09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate 20:59 Pearl 3 – Ivabradine 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT30:55 Pearl 5 – Ejection Fraction RecoveryTags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiology
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What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?
Timestamps
01:00 System 1 vs. System 207:46 Cognitive Biases13:46 Case for Knowledge18:29 Other Practices to Decrease Error28:26 ConclusionCME: http://bit.ly/CIMCME || Show Notes & Transcript
This episode is made in part of ACP’s Diagnostic Excellence curriculum
Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflection
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What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection?
Timestamps
02:41 Types of Immunosuppression14:31 Medication Reconciliation22:36 AKI in the Transplant Patient31:53 Infections in the Transplant Patient40:00 Transplant rejection, cancer after transplantCME: http://bit.ly/CIMCME || Show Notes & Transcript
Tags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressive
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In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.
How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.
Access to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.
Timestamps
00:50 Question REVIVED addressed01:44 Revascularication in HFrEF06:32 Revascularization in stable CAD10:02 REVIVED trial12:20 Summary and takeawaysTags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicine
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Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories !
Listen to the original July Stories: https://bit.ly/3Y4n8jG
Behind The Scenes videos on YouTube
Subscribe to our new Youtube Channel !
Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedback
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BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?
Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
Behind The Scenes video on YouTube
Subscribe to our new Youtube Channel !
Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue
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How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?
Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
Subscribe to our new Youtube Channel !
Use this link for CME-MOC credit with ACP
Time Stamps
02:59 Types of Corticosteroids14:31 Side Effects of Steroids21:15: Prophylaxis 27:32 Steroid Weaning 33:38 Steroid Weaning LimitationsTags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndrome
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Jun 2023 - 209 - #128 Cirrhosis Bleeding Risk, FFP and Indwelling Pleural Catheters: Gray Matters Segments
In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?
Time Stamps
02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis05:35 Deep Dive 2: FFP effect on bleeding risk15:43 Deep Dive 3: Risks of FFP19:45 Deep Dive 4: Indwelling pleural catheters30:31 RecapTags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonary
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How long can fatigue last for after radiation? Are all patient post radiation immunocompromised? What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?
Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
Use this link for CME-MOC credit with ACP
Whiteboard Animation Video of Radiation Physiology
Time Stamps
02:37 Systemic Radiation Side Effects14:29 Lung Radiation Side Effects18:22 Breast Radiation Side Effects21:45 Prostate Radiation Side Effects24:54 Brain Radiation Side EffectsTags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapy
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 31 May 2023 - 207 - #126 Radiation Oncology Part 1: 5 Pearls Segment
What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?
Whiteboard Animation Video of Radiation Physiology
Time Stamps
02:04 What is radiation?03:17 How does radiation therapy work?04:50 How is today’s radiation different from the past?05:40 What role does radiation play in cancer treatment?07:48 What are the different types of radiation?15:34 How do you write a rad onc one-liner as an internist?19:59 What is palliative radiation and how/when should we use it?Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 24 May 2023 - 206 - #125 Learning Habits, Time Management, and Leadership: Wisdom from Dr. Kelly Graham
What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?
Time Stamps
01:12 Learning Journey05:58 Lifelong Learning11:14 Time Management16:38 Role Modeling19:59 Re-Calibrating FailureTags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time management
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 15 May 2023 - 205 - #124 A1c & Glucose Measurements: Mind the Gap Segment
What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric?
Show notes, Transcript and References
Time stamps
00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test03:03 Hemoglobin A1c08:26 Fructosamine and Glycated Albumin10:50 Continuous Glucose Monitoring15:44 The Overlooked Issue of Insulin Resistance19:11 SummaryTags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complication
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When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?
Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps
02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?21:28 How to determine which type of device your patient has?25:10 What can a device interrogation tell you and doesn't tell you?32:13 Do all patients with bacteremia need their implantable cardiac devices taken out? 38:44 End-of-life considerations with pacemakers vs. ICDsTags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacing
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How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?
Use promo code COREIM for 1 month of free access to Glass Proat https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps
03:49 Episode start07:13 Dialysis vs. kidney transplant morbidity and mortality11:44 Eligibility for kidney transplant and when to refer21:34 Pre-transplant evaluation process25:38 How long are wait times on the transplant list?36:21 What benefits of living donation? What are risks to the kidney donor?Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidney
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What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation?
Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im
Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E10
Show notes, Transcript and References:
https://www.coreimpodcast.com/2023/03/08/trac/
Time stamps
2:56 Trach Components
12:47 Trach Complication Management
27:48 Airway Clearance
34:53 Speaking Valve
38:54 Decannulation
Tags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacy
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Why are safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care?
Show notes, Transcript and References:
https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/
Timestamps:
0:00 Hahnemann University Hospital
4:36 What is a Safety Net Hospital?
11:11 The Origins and Paradox of the Safety Net Hospital
Links to other episodes:
A Complex Patchwork of Supplemental Payments:
https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/
The Future of Safety Net Hospitals & Payment Policies:
https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/
Tags: IM Core, CoreIM, health policy, health disparities, insurance, medicare and medicaid
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 02 Mar 2023 - 200 - #100 Top 10 Telemedicine Tips - 2021 SGIM Recap
What are some tricks to help you perform a virtual physical exam? What role do these visits play in our overall care for the patient? What tools do we have at our disposal for a more thorough evaluation?Show notes, Transcript and References: https://www.coreimpodcast.com/2022/03/09/telemedicine-and…-2021-sgim-recap/ (https://www.coreimpodcast.com/2022/03/09/telemedicine-and-health-2021-sgim-recap/)Tags: IM Core, CoreIM, tele visit, gizmos, history taking, virtual, physical exam, assessment, functional status, tips Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 09 Mar 2022 - 199 - #99 Bleeding vs. Clotting Risk: Gray Matters Segment
How long should you anticoagulant for a PE? When can you safely stop anticoagulation for thrombogenic patients who need an urgent biopsy? Should an IVC filter be placed to prefer further embolization of a DVT? What percentage of patients with cancer associated blood clots will have progression while on anticoagulation?Show Notes, Transcript, and References: https://www.coreimpodcast.com/2022/02/23/24433/ (https://www.coreimpodcast.com/2022/02/23/24433/)Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im)Time Stamps:* 02:40 Deep Dive #1 Anticoagulation* 08:50 Deep Dive #2 DOACs* 14:08 Deep Dive #3 IVC Filter* 17:49 Deep Dive #4 Biopsy* 25:00 RecapTags: Core IM, IM Core, Anticoagulation, Bleeding, DOACs, IVC, reflections, clots Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 23 Feb 2022 - 198 - #91 Oral Diabetes Medications Inpatient: Mind the Gap Segment
Should we use oral diabetes agents in our hospitalized patients? Do you hold metformin for fear of lactic acidosis? Do you typically order an insulin sliding scale? When can you comfortably restart PTA meds?Time Stamps:* 02:25 Can we give metformin in the hospital?* 10:50 Incretin-based therapies* 14:49 Sodium Glucose Cotransporter-2 Inhibitors* 16:27 Sulfonylurea & Thiazolidinediones* 18:00 Basal Insulin inpatientShow notes, Transcript and References: https://www.coreimpodcast.com/2021/10/13/oral-diabetes-medications-in-hospitalization-mind-the-gap-segment/ (https://www.coreimpodcast.com/2021/10/13/oral-diabetes-medications-in-hospitalization-mind-the-gap-segment/)ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im)Tags: Core IM, IM Core, glucose, insulin, hospitalized patients, oral medications, sliding scale, DPP-4, GLP-1 Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 13 Oct 2021 - 197 - "Best of" | SNF, SAR, NH, ALF and More Discharge Options
What are the differences in resources, nursing and clinician oversight and who pays for what?! Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/ (https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/) ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) Time stamps: * 04:07 SAR vs SNF * 13:35 Long term Nursing Home Care * 18:30 Assisted Living Facility * 24:40 Acute rehab * 26:11 LTACH * 27:49 Home Tags: Subacute rehab, skilled nursing facility, long-term acute care hospital, CoreIM, Core_IM, hospital medicine, family medicine, emergency medicine, physician assistant, nurse practitioner, interprofessional education Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 25 Aug 2021 - 196 - #81 Treating Friends & Family: At the Bedside Segment
How can I best answer my families medical questions? How can I give my loved ones the best care without providing it directly for them? What boundaries should I have in place? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/01/13/treating-friends-family/ Time Stamps: 02:45 The tension, the push and pull 05:45 Prevalence 06:32 Stances of societies/professional organizations 08:18 Concerns 10:35 How to respond 17:52 Favors for physician/trainee colleagues, self-doctoring 22:26 Formal vs informal, documentation 23:55 Long-term care Tags: patient care, advocate, advice, healthcare, Core IM, IM Core, medical ethics, medical humanities Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 13 Jan 2021 - 195 - #70 A 40M with Fever and Confusion from the 19th Century: Hoofbeats Segment
Unpack a famous historical legend's medical dilemma on a special "Historical CPC" episode! Show notes, transcript and references: https://www.coreimpodcast.com/2020/07/08/22729/ (https://www.coreimpodcast.com/2020/07/08/22729/) Time Stamps: * 02:55 HPI * 07:33 Past Medical History * 04:25 Physician Exam findings * 24:22 Historical Figure Revealed * 26:30 Reflections on top 3 diagnosis Tags: cognitive and neuropsychiatric disturbances, rabies, mercury poisoning, cholera, delirium, COREIM, IMCORE, clinical reasoning case Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 08 Jul 2020 - 194 - #66 Outpatient Advance Care Planning with COVID19
How do you navigate new challenges with goals of care with your patients in clinics? Show Notes, Transcript, References: https://www.coreimpodcast.com/2020/05/06/outpatient-advanced-care-planning-during-covid-19/ (https://www.coreimpodcast.com/2020/05/06/outpatient-advanced-care-planning-during-covid-19/) Time Stamps * 01:32 COVID Crisis as an Outpatient and Advance Care Planning (ACP) * 08:06 The virtual visit * 12:44 Vital Talk Mnemonic: “CALMER” * 22:03 Challenges to Outpatient COVID Care * 26:03 Parting Thoughts Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 06 May 2020 - 193 - #49 Smoking Cessation: 5 Pearls Segment
Practical tips on smoking cessation! Get CME Credit (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) with ACP! Full Transcript with References and Show Notes (https://www.coreimpodcast.com/2019/09/18/5-pearls-on-smoking-cessation/) Time Stamps * 04:50 What questions are important to ask after a patient who contemplative about quitting tobacco? * 07:00 Is quitting abruptly on a quit date or gradual cessation to a quit date better? * 08:10 How can technology help support patients who are trying to quit? * 08:49 How should we prepare patients who quit smoking and are worried about weight gain? * 11:06 How can we try to convince patients to use medication as assistance to quit smoking? * 11:50 What is the most effective nicotine replacement approach? * 13:54 What are the potential side effects of the nicotine patch? * 15:00 What should we prescribe for patients who smoke Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 18 Sep 2019 - 192 - #48 AMA Discharges: At the Bedside Segment
Do we have to sign the AMA form? Do insurances deny payment for patients who leave AMA? What is your approach to AMA discharges? Core IM At the Bedside speaks to ethics researcher, Dr. David Alfandre, author of Things We Do For No Reason (https://www.journalofhospitalmedicine.com/jhospmed/article/147925/hospital-medicine/things-we-do-no-reason-against-medical-advice-discharges): Against Medical Advice Discharges Show Notes, Full Transcript and References (https://www.coreimpodcast.com/2019/09/04/ama-discharges/) Time Stamps * 3:03 Demographics of AMA discharges * 5:59 Clinician/System related factors of AMA discharges * 10:30 Strategies for mitigating AMA Discharges * 15:59 Do we have to make patients sign the AMA form? * 18:27 Do insurances deny payment for patients who leave AMA? * 23:09 Take Away Points Tags: shared-decision making, harm reduction Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 04 Sep 2019 - 191 - #47 Stories of Women in Medicine
We hope these stories can make us more introspective and open minded on how these concepts can affect each one of us differently. Let's continue the discussion on the Women in Medicine (https://twitter.com/womeninmedchat)Twitter chat on 8/25 at 9pm EST ! Full Transcript and Show Notes (https://www.coreimpodcast.com/2019/08/21/stories-of-women-in-medicine/) Time Stamps * 2:07 Introduction to one woman’s journey * 3:00 Stereotype Threat * 6:15 Not all Anger is Created Equal * 10:17 Asking and Writing Your Own Job Description * 13:08 Imposter Syndrome * 15:50 Breaking Points to Self Care * 18:50 Work Life Integration * 21:40 Support Networks Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 21 Aug 2019 - 190 - #46 A 45F with Persistent Bleeding: Hoofbeats Segment
20 Qs with Core IM Team vs. Expert Discussant ! Full Transcript and Show notes (https://www.coreimpodcast.com/2019/08/07/a-45f-with-persistent-bleeding-20qs-core-im-team-vs-expert/) Get CME-MOC Credit (https://www.acponline.org/cme-moc/online-learning-center/45f-with-persistent-bleeding-hoofbeats-segment)for listening to this episode (live at 09:00 am EST on 8/7) Time Stamps * 00:20 The game of medical Twenty Questions * 04:37 Case introduction * 05:50 The CoreIM team attempts to solve the case * 15:36 The discussant’s diagnostic schema for abnormal bleeding * 23:37 Primary versus secondary hemostasis * 30:33 The pathology report ! * 37:38 Criteria for the final diagnosis * 38:46 Dissecting a diagnostic coup * 49:42 Conclusion Do you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.com Tags: Coagulopathy, Bleeding Disorder, Diagnostic Schema, Von Willebrand's Disease, Clinical Reasoning Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 07 Aug 2019 - 189 - #45 Statins: Prescribing Meds Day vs. Night Part 2 Mind the Gap Segment
Night and Day… join us for part II of our exploration into why we prescribe medications in the morning vs. at night, featuring statins! 03:28 How do statins and cholesterol synthesis work again, anyway? 04:00 Power in numbers - what do the meta-analyses say about timing of statins? 04:40 The long and short of it - how half-life may dictate when to take your statin. 07:35 Effect magnitude - does medication timing actually really impact patient outcomes? 10:30 Practical matters - so what should we tell patients? 11:05 Review of teaching points Show notes, transcripts and references (https://www.coreimpodcast.com/2019/07/24/statins-prescribing-meds-day-vs-night-part-2/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 24 Jul 2019 - 188 - #44 Coronary Calcium Score and CTAs: 5 Pearls Segment
Solidify your knowledge on Coronary calcium scores and Coronary CTAs! ACP members can claim CME-MOC Credit (https://www.acponline.org/cme-moc/online-learning-center/podcasts) ! Quiz yourself on the 5 pearls we will be covering below: * 3:10 What are the big picture differences of functional stress tests and anatomical cardiac tests? * 7:48 What is the role of coronary artery calcium scores in managing coronary artery disease (CAD)? * 16:20 How do coronary CTAs compare to stress tests? * 24:28 When should we avoid CTA? * 29:33 How do we communicate coronary CTA results with patients? * 36:02 Recap Full transcript, infographics and show notes (https://www.coreimpodcast.com/2019/07/10/calcium-scores-and-coronary-ctas-5-pearls-segment/) ! Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 10 Jul 2019 - 187 - #43 "Difficult" Patients: At the Bedside Segment
In ‘At The Bedside’, our newest podcast segment, we tackle important topics that *aren’t* easily indexable in guidelines and UpToDate article – topics that are better discussed…well…at the bedside. Our first episode examines the all-too-common trope of the ‘difficult’ patient. * 01:13 Introduction * 05:27 Question 1: What makes a patient difficult for you? * 13:22 Question 2: What is a “good outcome” when working with difficult patients? * 23:05 Question 3: What have you learned from your difficult patients? * 31:56 Conclusion Show notes, Transcript, Further Reading (https://www.coreimpodcast.com/2019/06/26/difficult-patients/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 26 Jun 2019 - 186 - #42 July Stories
Transitions can be hard. Laugh, commiserate and be inspired by these July stories in medicine! Very big thank you to everyone who told their stories (https://www.coreimpodcast.com/2019/06/12/july-stories/) ! Let's help each other feel a little less alone in the struggle, be more understanding and compassionate or laugh at ourselves. Please share this episode with colleagues. Do you have a July story? Email us at hello@coreimpodcast.com (mailto:hello@coreimpodcast.com). Lets continue conversation over social media. Which stories moved you? Which July stories can you relate to? Tweet us (https://twitter.com/COREIMpodcast), find us on instagram (https://www.instagram.com/core.im.podcast/) at coreimpodcast or Facebook (https://www.facebook.com/COREIMpodcast/?__tn__=kC-R&eid=ARADFLD0RWKMem224lXxNguMrGvkUhP_ayvJG8kpusNN-FMg5ytfF-xpHcPVj2NcpHGbaJQ5P5kKtqIg&hc_ref=ARQVlNLcCGuZSu7Xshjkp88FcogWfiDpYiASwcigKABJ21hq-PtISbcyGLtKiq9Rkrs&fref=nf&__xts__[0]=68.ARDR43ZkTOAGKtkLHSLOaEbobF9z8Ng6-NwQS-mlw1qtV8MaYqL5QYA3LKFk82R9YeLw6NNOehqX5bgZvN0bKQtr4OKW9TRSrJCo0gCWVr8wnVCfFhNHv_UNd5il_6SVrF6Ficg8yfP50KNFbcPyj6dhjrLea8sqCWqhkhU0A6j64GrqfFbLZPm8ZSdoVqdSRh-EqX9t4SCKxjZrcUR75SN3o4atrKOPnkTMeD9I7FtNcNBkirof6oGo9eIdefSmeKmFbiWVLwIEfNgm-FuWM6v0GdbKs4WZFL4-q0nAmteHklWGM4_xjRBfvgsyZ3MVIMxJqUBVBd-4n7r55a95Y_Y). Good luck this coming July ! Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 12 Jun 2019 - 185 - #41 A 23M with AMS and Fever: Hoofbeats Segment
Dissect clinical reasoning and dive deeper into an interesting case! * 02:04 Initial Presentation * 03:03 The Core IM team tackles the case * 09:30 Social History * 16:05 Physical Exam * 22:47 An exercise in Bayesian inference * 36:35 Pre-mortem * 43:37 Revealing the diagnosis * 48:57 How do we define diagnostic success? Full transcript with references and show notes (https://www.coreimpodcast.com/2019/05/22/hoofbeats-a-23m-with-ams-and-fever/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 22 May 2019 - 184 - #40 Prescribing Meds Day vs. Night Part 1: Mind the Gap Segment
Dive deeper into why we prescribe medications in the morning vs. at night ! * Why do we dose warfarin at night? (2:45) * Back to the basics - what are the pharmacodynamics of warfarin and how does vitamin K intake matter? (4:28) * Practical matters - so what should we tell patients (6:14) * Dippers and non-dippers - what happens to blood pressure (BP) at night? (9:32) * The surprising link between dipping and cardiovascular outcomes (11:15) * Timing is everything… or is it? The evidence behind taking BP meds at night (11:58) * Review of teaching points (15:58) What is your prescribing practice with blood pressure medications? Leave a comment (https://www.coreimpodcast.com/2019/05/08/medications-daytime-vs-nighttime-part-1/), tweet (https://twitter.com/COREIMpodcast) us or share with us on instagram (https://www.instagram.com/core.im.podcast/) or facebook (https://www.facebook.com/COREIMpodcast/) on how you dose BP meds? Transcript with references and show notes (https://www.coreimpodcast.com/2019/05/08/medications-daytime-vs-nighttime-part-1/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 08 May 2019 - 183 - #39 Stress Testing: 5 Pearls Segment
Solidify your knowledge on stress tests! Quiz yourself on the 5 pearls we will be covering: * What are the indications for a stress test? (2:18) * How to choose stress protocol in a stress test? (8:29) * How to choose diagnostic modality in a stress test? (14:46) * How do we interpret results from stress tests, and how should this be communicated to patients? (24:08) * Pearl Recap (31:13) * Risk of contrast induced nephropathy between arterial and venous contrast load (36:02) For full transcript, infographic and show notes: https://www.coreimpodcast.com/2019/04/24/stress-testing/ Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 24 Apr 2019 - 182 - #38 A 66M w RUQ pain, a 41M in Afib w RVR and a 50M w Syncope: Hoofbeats Segment
Dissect 3 interesting cases and improve your clinical reasoning skills! Time Stamps: * New features in this episode [0:30] * Case one: 66M w RUQ pain [1:09] * Case two: 41M w Afib in RVR [9:26] * Case three: 50M w Syncope [14:33] * Reveal [19:57] * Retrieving illness scripts [22:29] * Typical versus Atypical presentation of diseases [26:12] For full transcript and show notes: https://www.coreimpodcast.com/?p=21028 (https://www.coreimpodcast.com/?p=21028) Tag: medical education, clinical cases, expert clinicians, internal medicine podcast Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 10 Apr 2019 - 181 - #37 Unstable Angina: Mind the Gap Segment
Check out part 1: Acute Coronary Syndrome and TIMI Risk Score (http://bit.ly/UnstableAnginaPart1) Lets go deeper into 1) How the chest pain history correlates with pathophysiology? [2:40] 2) How has high-sensitivity troponin changed the way we think about unstable angina? [7:34] For transcript, infographic and show notes: https://www.coreimpodcast.com/2019/03/27/unstable-angina/ (https://www.coreimpodcast.com/2019/03/27/unstable-angina/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 27 Mar 2019 - 180 - #36 Pain Management: 5 Pearls Segment
Solidify your knowledge on inpatient pain management! Quiz yourself on the 5 pearls we will be covering: * How effective are non-opioids? ( 3:17) * Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51) * What are the best practices for patients who require opioid analgesia? (19:00) * When prescribing opioids at discharge what can we do to minimize harm? (25:02) * Throwback to mechanism of acetaminophen and NSAIDs (27:14) * How do we believe tylenol works and how does that compare to NSAIDS? (28:27) For full transcript of the audio and show notes: https://www.coreimpodcast.com/2019/03/13/5-pearls-on-pain-management/ Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 13 Mar 2019 - 179 - #35 Acute Coronary Syndrome and TIMI Risk Score: Mind the Gap Segment
Let's go deeper into the world of ACS and the origin of the TIMI score and major adverse cardiac events "MACE" outcomes! * The basics – what is acute coronary syndrome? (4:08) * Clinical context matters – angina pectoris, atypical chest pain, and troponins (5:22) * You can’t just “cath” everyone – risk stratification to identify patients with high mortality risk (9:42) * TIMI isn’t perfect – the issues with the score and MACE outcomes (14:00) * Review of teaching points (17:58) For full transcript and show notes: https://www.coreimpodcast.com/2019/02/27/acute-coronary-syndrome-acs-and-the-timi-score/ (https://www.coreimpodcast.com/2019/02/27/acute-coronary-syndrome-acs-and-the-timi-score/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 27 Feb 2019 - 178 - #34 47M with chest pain : Hoofbeats segment
Dissect an interesting case and improve your clinical reasoning skills! Time Stamps: * New features in this episode [00:25] * Data point 1: Early hypothesis generation? [03:20] * Data point 2: Pertinent negatives? [11:18] * Data point 3: Representativeness heuristic over-represented in medical education? [13:28] * Data point 4: Economical hypothesis generation by expert clinicians [19:20] * Data point 5: Diagnosing diagnostic error [22:10] * Data point 6: Moving toward a final diagnosis [27:11] * Case resolution [29:50] For full transcript and show notes: https://www.coreimpodcast.com/2019/02/13/hoofbeats-47m-with-chest-pain/ Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 13 Feb 2019 - 177 - #33 Barrett's Esophagus: 5 Pearls
Solidify your knowledge on Barrett's Esophagus and more! Quiz yourself on the 5 pearls we will be covering: * What is Barrett’s esophagus and why should we care? (4:12) * Who do we screen for Barrett’s, and why? (8:41) * How do we screen for Barrett’s and counsel? (13:50) * How do we treat and monitor Barrett’s esophagus? (18:21) * Take Aways (21:45) * Throwback to trending troponins (23:05) For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2019/01/30/5-pearls-on-barretts-esophagus/ (https://www.coreimpodcast.com/2019/01/30/5-pearls-on-barretts-esophagus/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 30 Jan 2019 - 176 - #32 A 34M with Fever, HA, Myalgias
Dissect an interesting case and improve your clinical reasoning skills! Time stamps: * Player three has entered the game! [0:15] * Case presentation, part 1 [1:20] * First impressions [3:24] * Rethinking another provider’s diagnosis [4:36] * Interpreting the test of treatment [8:48] * Keeping your instincts on a leash? [10:58] * Case presentation, part 2 [12:33] * Diagnostic schemas [14:30] * Our discussant’s differential and the final diagnosis [17:46] * Shira’s cognitive autopsy [23:02] For full transcript and show notes: https://www.coreimpodcast.com/2019/01/16/hoofbeats-34m-with-fever-headache-and-myalgias/ (https://www.coreimpodcast.com/2019/01/16/hoofbeats-34m-with-fever-headache-and-myalgias/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 16 Jan 2019 - 175 - #31: Troponins: 5 Pearls Segment
Solidify your knowledge on troponins and more! Quiz yourself on the 5 pearls we will be covering: * What aspects of the history are concerning in a patient with a positive troponin? (4:00) * What is the difference between the TIMI, GRACE, and HEART scores, and how should we use them in the evaluation of a patient with an elevated serum troponin? (8:42) * How does the change in troponin over time help with diagnosis, and what should we consider in a patient with uptrending troponins but an unremarkable ECG? (14:48) * What can a “negative but detectable” troponin tell you about any patient, not just those with suspected ACS? (21:31) * Pearls Recap (25:26) * Throwback – what are the first-line medications for alcohol use disorder? (28:36) For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2019/01/04/5-pearls-on-troponins/ (https://www.coreimpodcast.com/2019/01/04/5-pearls-on-troponins/) Tags: chest pain, cardiology, myocardial infarction, acute coronary syndrome Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 02 Jan 2019 - 174 - #30 Acetaminophen/Fevers Pathophysiology and Patient Outcomes: Mind the Gap Segment
Let's dive deeper into the world of acetaminophen and fever and how it may work and patient outcomes Time Stamps: What data is there to support the use of acetaminophen as a fever reducer? (2:08) Does acetaminophen improve patient outcomes? (4:30) How does acetaminophen compare to other medications like NSAIDs? (9:56) What is the mechanism of acetaminophen action? (10:50) Review of teaching points (16:02) For full show notes and transcript of audio: https://www.coreimpodcast.com/2018/12/19/mind-the-gap-on-acetaminophen-fevers-pathophysiology-and-patient-outcomes/ (https://www.coreimpodcast.com/2018/12/19/mind-the-gap-on-acetaminophen-fevers-pathophysiology-and-patient-outcomes/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 19 Dec 2018 - 173 - #29 A 43M with Diarrhea: Hoofbeats Segment
Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here: Time stamps: * Case [1:19] * Diagnostic weight [8:42] * Hypothesis driven reasoning [12:26] * Anomalous clinical data [19:30] * Final diagnosis [22:20] * Take away points [31:21] Human Dx Case link: https://www.humandx.org/o/co7yrer3dim2y59t5c0sbd370?s=FEED (https://www.humandx.org/o/co7yrer3dim2y59t5c0sbd370?s=FEED) For show notes: https://www.coreimpodcast.com/2018/12/05/hoofbeats-43m-with-diarrhea/ (https://www.coreimpodcast.com/2018/12/05/hoofbeats-43m-with-diarrhea/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 05 Dec 2018 - 172 - #28 What Would You Tell Your Younger Self?
Women in medicine inspire us with what they would tell their younger selves. Some of the speakers with Shreya Trivedi MD @ShreyaTrivediMD at the Women in Medicine GirlMedLive Conference: Qaali Hussein MD @QaaliHussein1 Clinical Pearl @ClinicalPearl Marguerite Duane MD @mduanemd Kate Prior MBBS @doctorwibble C. Nicole Swiner MD @docswiner Carmen Landrau MD @DrLandrau Jessica Willett MD @jkwillettmd Ilene Brenner MD @irb123 Joannie Yeh MD @BetaMomma Karen Davidson, Esq karend@kdavidsonlaw.com Suzanne Feigofsky MD @DrSuzyFeigofsky GirlMedLive: https://www.girlmedmedia.com/ (https://www.girlmedmedia.com/) Episode page: https://www.coreimpodcast.com/2018/11/21/what-would-you-tell-your-younger-self/ (https://www.coreimpodcast.com/2018/11/21/what-would-you-tell-your-younger-self/) Tags: career development, professional development, lifelong learning, burnout, imposter syndrome, mentorship, worklife balance Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 21 Nov 2018 - 171 - #27 Treatment of Alcohol Use Disorder: 5 Pearls Segment
Solidify your knowledge on Alcohol Use Disorder (AUD) treatment and more! Quiz yourself on the 5 pearls we will be covering: * Throwback: At what levels of drinking does unhealthy alcohol use start, and how do you screen for unhealthy alcohol use? (1:47) * What does the brief intervention and counseling part of SBIRT entail? (4:43) * What are the first line medications for AUD and contraindications to them? (11:11) * What are the second-line medications for AUD and their limitations? (18:14) * What new therapies are being studied for for alcohol use disorder? (22:09) * Pearls Recap (25:06) For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2018/11/07/5-pearls-on-treatment-of-alcohol-use-disorder/ (https://www.coreimpodcast.com/2018/11/07/5-pearls-on-treatment-of-alcohol-use-disorder/) tag: naltrexone, acamprosate, gabapentin, topiramate, SBIRT, neuromodulation, nalmafene, psychaedelics, audit-c Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 07 Nov 2018 - 170 - #26 A 85F with AMS Part 2: Hoofbeats Segment
Dissect a working diagnosis through a process of validation! Time Stamps: * Your collective differential [0:40] * The test results (that you asked for) are in... [2:13] * The hospital course, and the diagnosis (or is it?) [7:10] * Validating a diagnosis: Base rate, adequacy, and coherence [8:30] * Revisiting the differential [14:44] * What to do when there is no final diagnosis? [17:39] For full show notes: https://www.coreimpodcast.com/2018/10/24/hoofbeats-85f-with-acute-ams-part-2/ (https://www.coreimpodcast.com/2018/10/24/hoofbeats-85f-with-acute-ams-part-2/) Tags: Clinical reasoning, Diagnostic Uncertainty Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 24 Oct 2018 - 169 - #25 A 85F with AMS Part 1: Hoofbeats segment
Submit your diagnosis or differential for this episode's case at HumanDx.org (free registration required): http://hdx.org/2VP (http://hdx.org/2VP) ! Part 2 (releasing 10/24) will have the final diagnosis! Time stamps: * A new challenge and the rules of the game (1:13) * Introduction to Human Dx (3:06) * The case: An 85 year-old woman with paranoid delusions (5:28) * What exactly is problem representation? (15:15) * Building the differential (19:53) For full show notes: https://www.coreimpodcast.com/2018/10/10/hoofbeats-85f-with-acute-ams/ (https://www.coreimpodcast.com/2018/10/10/hoofbeats-85f-with-acute-ams/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 10 Oct 2018 - 168 - #24 Meet the Producers
Join us in this episode with Doctors Who Create where we explore how Core IM was started and some things that happen behind the scenes! Episode page: https://www.coreimpodcast.com/2018/09/27/meet-the-producers/ (https://www.coreimpodcast.com/2018/09/27/meet-the-producers/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Thu, 27 Sep 2018 - 167 - #23 UTIs and Delirium: Mind the Gap Segment
Let's go deeper into the world of UTIs and delirium! The basics – what are the official (IDSA) definitions for bacteriuria, pyuria, and UTI? (02:07) The lay of the land – how common are bacteriuria and delirium? (07:09) The big money question – do UTIs really cause delirium and what does the evidence tell us? (10:50) Review of teaching points (15:59) Full show notes: https://www.coreimpodcast.com/2018/09/12/mind-the-gap-uti-delirium/ (https://www.coreimpodcast.com/2018/09/12/mind-the-gap-uti-delirium/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Tue, 11 Sep 2018 - 166 - #22 Proton-Pump Inhibitors: 5 Pearls segment
Solidify your knowledge on Proton-Pump Inhibitors (PPIs) and more! Quiz yourself on the 5 pearls we will be covering: * What are associated adverse effects for patients are on long-term PPIs? (2:02) * What are strategies to get your patient off PPIs? (10:57) * How do histamine-2 (H2) receptor antagonists blockers work and how can it explain why H2 blockers might not be as effective as PPIs? (13:30) * How should you educate patients to take PPIs to get the maximize benefit? (16:48) * How do you manage ongoing symptoms in patients on PPIs? (21:41) For full transcript of the podcast and references: https://www.coreimpodcast.com/2018/08/29/5-pearls-on-ppis/ (https://www.coreimpodcast.com/2018/08/29/5-pearls-on-ppis/) (https://www.clinicalcorrelations.org/?p=18833) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 29 Aug 2018 - 165 - #21 57F with confusion: Hoofbeats segment
Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here: * Case history and exam 00:40 * Causal models 11:24 * Facets versus diagnoses 13:25 * Problem representation 16:37 * Part two of the case 17:10 * Occam’s razor, Hickam’s dictum, and Crabtree’s bludgeon 23:00 * Diagnostic uncertainty 27:10 * Learning points 34:24 For show notes: https://www.coreimpodcast.com/2018/08/15/hoofbeats-57f-with-confusion/ (https://www.coreimpodcast.com/2018/08/15/hoofbeats-57f-with-confusion/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 15 Aug 2018 - 164 - #20 Vancomycin: Mind the Gap Segment
Lets go deeper into the misunderstood side of Vancomycin! * Where did vancomycin come from, and why is it so controversial? (0:28) * What is vancomycin-induced nephrotoxicity and how common is it? (4:37) * Vancomycin trough monitoring – what is it good for? (7:28) * AUC to MIC ratio – the real math behind vancomycin dosing (7:53) * Review of teaching points (10:27) Full show notes: https://www.coreimpodcast.com/2018/08/01/mind-the-gap-vancomycin/ (https://www.coreimpodcast.com/2018/08/01/mind-the-gap-vancomycin/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 01 Aug 2018 - 163 - #19 Unhealthy Alcohol Use: 5 Pearls segment
Solidy your understanding of unhealthy alcohol use! Quiz yourself of the 5 Pearls we will be covering: * What is alcohol use disorder (AUD), and how is it different from unhealthy alcohol use? * Who should we screen for unhealthy alcohol use, and which screening tools are preferred? * What are the consequences of unhealthy alcohol use? * Can moderate alcohol be good for patients, and if so, how much is “moderate”? * Who, how and how often should patients with chronic hepatitis B infection be screened for hepatocellular carcinoma? For full show notes: https://www.coreimpodcast.com/2018/07/11/5-pearls-unhealthy-alcohol-use/ (https://www.coreimpodcast.com/2018/07/11/5-pearls-unhealthy-alcohol-use/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 11 Jul 2018 - 162 - #18: A 54M with diarrhea: Hoofbeats segment
Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here: * Part one of case (0:56) * Cognitive ease and strain (03:51) * Metacognition and routine diagnostic timeout (08:15) * Think outside the box of organ systems (11:19) * Illness behavior (12:30) * Part two of case (14:06) * Algorithms (17:57) * Fast thinking & pattern recognition (19:30) * Slow thinking & analytical reasoning (21:31) * Diagnosis (25:15) * Takeaways (26:52) For full show notes: https://www.coreimpodcast.com/2018/06/27/hoofbeats-54m-with-diarrhea/ (https://www.coreimpodcast.com/2018/06/27/hoofbeats-54m-with-diarrhea/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 27 Jun 2018 - 161 - #17: Celebrating #ProudtobeGIM
Be inspired by why so many are proud to be in General Internal Medicine (GIM)! Episode page: https://www.coreimpodcast.com/2018/06/23/celebrating-proudtobegim/ (https://www.coreimpodcast.com/2018/06/23/celebrating-proudtobegim/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 20 Jun 2018 - 160 - #16 Steroids in COPD: Mind the Gap Segment
Let’s take your breath away… with a review on steroids in treating COPD exacerbations! Time Stamps * How does GOLD (Global Initiative for Chronic Obstructive Lung Disease) define a COPD exacerbation? (2:44) * What outcomes do steroids actually improve in treating a COPD exacerbation? (5:08) * What is the evidence behind a 5 day steroid “burst”? (7:20) * Are IV steroids more powerful than PO? (9:00) For full show notes: https://www.coreimpodcast.com/2018/05/30/mind-the-gap-steriods-in-copd/ (https://www.coreimpodcast.com/2018/05/30/mind-the-gap-steriods-in-copd/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 30 May 2018 - 159 - #15 Contrast-Induced Nephropathy: 5 Pearls segment
Solidify your understanding of contrast-induced nephropathy (CIN)! Quiz yourself on the 5 pearls we will be covering: * Are there diagnostic criteria for CIN? (2:11) * Is there a difference between exposure to intra-arterial vs. intra-venous contrast in terms of risk of CIN? (6:28) * What are the biggest risk factors for CIN? (14:48) * What preventive measures have been shown to best reduce the risk of CIN? (19:41) * Can ESRD patients on hemodialysis still suffer from CIN? (23:32) * Recap (25:49) For full show notes: https://www.coreimpodcast.com/2018/05/16/5-pearls-contrast-induced-nephropathy/ (https://www.coreimpodcast.com/2018/05/16/5-pearls-contrast-induced-nephropathy/) (https://www.clinicalcorrelations.org/?p=17613) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 16 May 2018 - 158 - #14 A 36F with weakness: Hoofbeats segment
Dissect an interesting case and think about the way clinicians think! So many clinical reasoning pearls here: * Part 1 Case (2:05) * Framing bias (7:07) * Data-driving reasoning (11:48) * Hypothesis-driven approach (12:38) * Periodic paralysis syndromes (16:08) * Representativeness heuristic (17:26) * Part 2 Case (20:51) * Pivot Points (31:36) * Diagnosis (35:55) * Take aways (37:20) Check out the key teaching points: https://www.coreimpodcast.com/2018/05/02/hoofbeats-a-36f-with-weakness/ (https://www.coreimpodcast.com/2018/05/02/hoofbeats-a-36f-with-weakness/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 02 May 2018 - 157 - #13 Chronic Adrenal Insufficiency: 5 Pearls segment
Solidify your knowledge on adrenal insufficiency! Quiz yourself on the 5 pearls we will be covering: * What are signs and symptoms of chronic adrenal insufficiency (AI)? What is the most sensitive? (2:02) * How do we diagnose and differentiate types of adrenal insufficiency? (6:05) * How sensitive and specific are the diagnostic tests for AI & at what cutoffs? (12:06) * Can we both test and treat adrenal insufficiency at the same time? (16:40) * Throwback: How do hypokalemia and hepatic encephalopathy connected? (24:55) * Dr. Nidhi Agrawal Recap (19:20) For full show notes: https://www.coreimpodcast.com/2018/04/18/5-pearls-chronic-adrenal-insufficiency/ (https://www.coreimpodcast.com/2018/04/18/5-pearls-chronic-adrenal-insufficiency/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 18 Apr 2018 - 156 - #12 Latent TB: 5 Pearls segment
Solidify your knowledge on latent TB! Quiz yourself on the 5 pearls we will be covering: * Who should be screened for latent tuberculosis infection (LTBI)? (1:45) * What screening tests are available and how do they differ? (6:30) * What are the LTBI treatment options available? (10:24) * What are the major adverse drug effects to consider? (13:28) * How frequently should you check liver function tests in a patient being treated for LTBI? What do you do with the results? 17:43 * Dr. Caplan-Shaw Recap (21:29) For full show notes: https://www.coreimpodcast.com/2018/03/28/5-pearls-latent-tuberculosis-infection/ (https://www.coreimpodcast.com/2018/03/28/5-pearls-latent-tuberculosis-infection/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 28 Mar 2018 - 155 - #10 Albuminuria: 5 Pearls segment
Solidify your knowledge on albuminuria! Quiz yourself on the 5 Pearls we will be covering: * How good is a dipstick, urinalysis and UACR in detecting albuminuria? (1:42) * What conditions that lead to transient proteinuria? What is the appropriate interval to recheck and how should be it be repeated? (5:14) * Who should be screened for albuminuria and can it prognosticate risk for cardiovascular mortality? (7:47) * Does increasing RAAS inhibition improve renal outcomes? (10:57) * Throwback Question: How do you prescribe oral iron and what tips do you tell your patients? (13:11) For full show notes: https://www.coreimpodcast.com/2018/02/28/5-pearls-albuminuria/ (https://www.coreimpodcast.com/2018/02/28/5-pearls-albuminuria/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 28 Feb 2018 - 154 - #9 COPD Classifications: Mind the Gap segment
Let’s go deeper into to why we think about diseases the way we do: COPD Classifications through the years! Time Stamps: * How did prior understanding of COPD pathophysiology lead to COPD classifications in the past? (3:25) * How is COPD diagnosed? (6:13) * How has COPD been classified and why? (6:42) For full show notes: https://www.coreimpodcast.com/2018/02/14/mind-the-gap-copd-classifications/ (https://www.coreimpodcast.com/2018/02/14/mind-the-gap-copd-classifications/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 14 Feb 2018 - 153 - #8 Chronic Hepatitis B (Part 2) Management: 5 Pearls segment
Quiz yourself on the following 5 Pearls on Chronic Hepatitis B (HBV) Management! * What is the focused history, physical and lab workup in a patient with chronic HBV? (1:40) * What is the best imaging to evaluate for intermediate stages of liver fibrosis? (4:06) * What scoring tools can you use to estimate fibrosis and what are their limitations? * What factors do you use to assess which patients get treatment? (7:41) * What drugs are available for HBV treatment and how do you choose? (11:18) * Which chronic HBV patient should be screened for HCC, and how often? (14:45) For full show notes: https://www.coreimpodcast.com/2018/01/31/5-pearls-on-chronic-hepatitis-b-2/ (https://www.coreimpodcast.com/2018/01/31/5-pearls-on-chronic-hepatitis-b-2/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 31 Jan 2018 - 152 - #7: Chronic Hepatitis B Part 1: 5 Pearls segment
Solidify your knowledge on Chronic Hepatitis B (HBV) screening and vaccinations! Quiz yourself on the 5 Pearls we will be covering: * Who do you screen for HBV? (3:37) * How is HBV transmitted and who is at risk for HBV reactivation? * What tests do you order when screening for HBV? (10:48) * In which populations is HBV vaccination recommended? * What are the four possible meanings of an isolated positive total anti-HBc? (13:55) * In an asymptomatic adult, is it necessary to send an anti-HBc IgM to distinguish acute from chronic HBV infection? (15:01) * What are the implications of seroconversion of HBeAg from positive to negative? (16:19) For full show notes: https://www.coreimpodcast.com/2018/01/17/5-pearls-on-chronic-hepatitis-b/ (https://www.coreimpodcast.com/2018/01/17/5-pearls-on-chronic-hepatitis-b/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 17 Jan 2018 - 151 - #6 The Wonderful World of Albumin: Mind the Gap segment
Let's go deeper as to why we do what we do: albumin in spontaneous bacterial peritonitis (SBP) ! Time Stamps:1. How much albumin is recommended in SBP? (1:45)2. What antibiotics are used for the treatment of SBP? (2:30)3. Why do we give albumin in SBP? (4:15) - How does albumin compare to crystalloid? (7:15) - Do we always have to give to albumin? (9:00) For full shownotes: https://www.coreimpodcast.com/2018/01/03/mind-the-gap-albumin-in-sbp/ (https://www.coreimpodcast.com/2018/01/03/mind-the-gap-albumin-in-sbp/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 03 Jan 2018 - 150 - Hepatic Encephalopathy: 5 Pearls Edition Ep3
Cement your knowledge on Hepatic Encephalopathy (HE)! Quiz yourself on the following 5 Pearls we’ll be covering on HE: Time Stamps * What are other causes of altered mental status in cirrhotics? (1:45) * What are common precipitants for an acute episode of HE? * What is asterixis? (6:10) * What is the diagnostic utility of a cirrhotic with asterixis? * How do lactulose & rifaximin reduce symptoms of HE? (11:00) * What are their indications? * What is the connection between hypokalemia and HE? (14:10) * What is the discriminatory power of an ammonia level in HE? (16:40) * In what situation does the NH3 has stronger predictive value? For full shownotes: https://www.coreimpodcast.com/2017/12/13/5-pearls-on-hepatic-encephalopathy/ (https://www.coreimpodcast.com/2017/12/13/5-pearls-on-hepatic-encephalopathy/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 13 Dec 2017 - 149 - Mind The Gap Ep2: Part 2 of Paracentesis
Part 2 on Abdominal Paracentesis ! Let's go deeper Time Stamps Should a cirrhotic’s INR and platelets deter you from doing a paracentesis? (3:15) Do generalist have worse procedure complications than specialists? (5:40) Do you need to send ascites fluid in blood culture bottles? (6:10) For full shownotes: https://www.coreimpodcast.com/2017/11/29/mind-the-gap-abdominal-paracentesis-2/ (https://www.coreimpodcast.com/2017/11/29/mind-the-gap-abdominal-paracentesis-2/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 29 Nov 2017 - 148 - 5 Pearls Ep2: Iron Deficiency Anemia
Solidify your knowledge on iron deficiency anemia! Quiz yourself on the 5 Pearls we will be covering: * Should patients be screened for iron deficiency? If so, who and how often? (1:40) * What are the indications for diagnostic endoscopy in iron deficient patients? (3:23) * How should you advice patients to take oral iron? (5:53) * What is optimal dosing for oral iron? * In which patients would you consider IV iron? What are the risks? (11:41) * Throwback Question: What is a medication-overuse HA? (14:44) For full shownotes: https://www.coreimpodcast.com/2017/11/15/5-pearls-on-iron-deficiency-anemia/ (https://www.coreimpodcast.com/2017/11/15/5-pearls-on-iron-deficiency-anemia/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 15 Nov 2017 - 147 - CORE IM podcast: Mind The Gap on Admission Paracentesis
You have always been told to do a diagnostic paracentesis on admission in cirrhotics with ascites, but why? Can you just get away with clinical judgement to rule out SBP? Is faculty judgement any better? And if you’re going to do a paracentesis on admission, do you need to do it right away? Go deeper with Dr. Steve Liu and Dr. Janine Knudsen! Click the link for the full show notes: https://www.coreimpodcast.com/2017/11/01/mind-the-gap-admission-paracentesis/ (https://www.coreimpodcast.com/2017/11/01/mind-the-gap-admission-paracentesis/) Time Stamps * What do guidelines say about diagnostic paracentesis in cirrhotics with ascites? (1:51) * Can we just use clinical judgement to decide if paracentesis is warranted? (3:13) * Do attendings have better clinical judgement than residents to rule out SBP? * Does timing of paracentesis on admission matter for mortality? (6:33) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Wed, 01 Nov 2017
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