The Curbsiders Internal Medicine Podcast

By Matthew Watto MD, Stuart Brigham MD, Paul Williams MD

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Rate for this podcast

Subscribers: 1178
Reviews: 3

TG
 Jan 9, 2019
excellent podcast for internists. highly recommend


 Oct 21, 2018

Rachel Shemtov
 Oct 7, 2018

Description

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.

Episode Date
#243 Diabetes Triple Distilled
2801

Listen in as we recap four of our favorite diabetes episodes to bring you the pearls you need to stay up to date on type 2 diabetes management in the clinic.  We cover pitfalls of A1c testing, guidelines for A1C targets, when and how to use the newer medications SGLT-2 inhibitors and GLP-1 agonists.  We wrap up with a discussion of managing DM2 in patients with kidney disease and in which patients to consider de-intensifying treatment.  Feel confident managing diabetes with the latest data in 2020!

Listeners can claim 4 HOURS of Free CE credit for this episode through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written and Produced by: Molly Heublein, MD
  • Infographic and Cover Art: Isabel Valdez, PA
  • Show Notes: Isabel Valdez, PA; Molly Heublein, MD
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein, MD
  • Editors: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com


Sponsors:

ACP’s I Raise the Rates

Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.


VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.


Time Stamps

0:00 Intro,

2:45 Pitfalls of A1c testing,

7:00 Diabetes goals/A1c guidelines; Macrovascular vs Microvascular benefits,

16:20 Choosing between SGLT2 inhibitors vs GLP1 agonists,

19:10 Stuart rants on insulin for symptomatic hyperglycemia,

22:32 Start your patient on an SGLT2i and counsel them about potential adverse events,

30:30 GLP-1 agonists,

36:50 Deintensification; Diabetes Treatment in CKD,


Tags

Diabetes, hypoglycemia, SGLT2 inhibitors, GLP-1 agonist, metformin, CKD, primary care, assistant, doctor, education, family, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, physician, resident, student

Nov 23, 2020
#242 Wilderness Medicine: Prepare for Disaster
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Explore the essentials of Wilderness Medicine and prepare yourself for austere environments as we discuss Altitude Sickness, Frostbite, Animal Bites, Thermoregulation, Wound Care and the proper way to apply a tourniquet. Listen as our esteemed guest Dr. Thomas DeLoughery @Bloodman (OHSU) takes us through the fascinating, and at times chilling, world of Wilderness Medicine.  This episode is truly wild! 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME through VCU!

 

Credits

  • Written, Produced, and Infographic by: Avital O’Glasser MD, FACP, FHM
  • Show Notes: Deborah Gorth ScM and Avital O’Glasser MD, FACP, FHM
  • Cover Art: Kate Grant, MD
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
  • Guest: Thomas DeLoughery MD, MACP, FAWM

 

Sponsors:

Provider Solutions and Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.


VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.


Time Stamps

00:00 Intro, disclaimer, guest bio, 03:45 Guest one-liner, advice and Picks of the Week*, 08:10 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/, 09:00 Case of mountaineering; What is Wilderness Medicine?, 12:05 What’s in your first aid kit?, 21:36 Altitude sickness: acute mountain sickness, high altitude cerebral edema and High altitude pulmonary edema, 31:25 Hypothermia, 39:36 Frostbite, 47:25 Hyperthermia: Heat exhaustion and Heat stroke; How much water should you drink?, 51:55 Bat bites and rabies, 58:20 Snake bites, 66:03 Wound care and tourniquets, 75:40 Take Home Points; Outro; Bonus clip

Nov 16, 2020
#241 Chronic Cough - A Rational Approach to Cough with Dr. Brad Hayward
3461

Listen as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME through VCU Health CE!


Credits

  • Written (including CME questions) and Produced by: Cyrus Askin MD
  • Infographic by: Cyrus Askin MD
  • Cover Art: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Paul Williams MD, FACP
  • Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Brad Hayward MD


Sponsors:


Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC


VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.


Time Stamps

  • 00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week*
  • 06:23 Sponsor - Panacea Financial panaceafinancial.com
  • 07:30 Case of Post Infectious Cough; Basic definitions for cough
  • Important aspects of the history
  • Empiric therapies for post-viral cough
  • 22:50 Case of idiopathic chronic cough; Physical exam
  • 29:20 Basic testing and empiric therapy for the common causes of chronic cough
  • 41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds
  • 54:28 Take home message; Outro


Tags: Cough, Asthma, GERD, Chronic, Doctor, Internal medicine, hospitalist, primary care, family

Nov 09, 2020
#240 Elbow Pain: Straighten it out - A Dabble into Elbow Care with Dr Parks
3915

Returning guest expert Dr Ted Parks helps us get the elbow straight with a simple approach to common causes of elbow pain for primary care.  Listen as he guides Stuart through physical exam techniques (or watch them on YouTube) for epicondylitis and learn what the bursa is there for anyways. Find out what fracture you can treat in your office, why you shouldn’t stab straight into the olecranon bursa and when elbow pain should be referred.  Feel confident when your patient comes in with elbow pain! Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). 


Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced by: Molly Heublein, MD
  • Cover Art and Infographic: Edison Jyang
  • Hosts: Stuart Brigham MD, Matthew Watto MD, FACP; Molly Heublein, MD
  • Editor: Emi Okamoto, MD (written materials); Clair Morgan of Nodderly.com (audio/video)
  • Guest: Ted Parks, MD



Sponsors:

Provider Solutions and Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.


VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 04:00 Picks of the Week*
  • Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
  • 09:50 Medial and lateral epicondylitis case, Elbow anatomy
  • 13:00 Pathophysiology of epicondylitis, Epicondylitis exam, Epicondylitis treatment
  • 34:11 Olecranon bursitis, Bursitis diagnosis and aspiration
  • 46:12 Radial head fracture diagnosis, Radial head fracture treatment
  • 55:30 Cubital tunnel nerve entrapment
  • 57:45 Platelet rich plasma
  • 60:39 Take home points, Plug and Outro
  • 64:00 Bonus Pick of the Week



Tags: Elbow, orthopedics, olecranon bursitis, bursa, aspiration, septic joint, medial epicondylitis, lateral epicondylitis, Doctor, Internal medicine, hospitalist, primary care, family

Nov 02, 2020
#239 Sinusitis: It’s Not That Tricky - We Get Nose Deep into Rhinosinusitis with Dink Jardine MD
4498

A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL). 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli, Cover Art: Kate Grant MBChb, MRCGP, Infographic by:  Beth Garbitelli, Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio), Guest: Dink Jardine, MD

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Time Stamps

00:30 Intro 03:00 Pick of the Week*: Still Life by Louise Penny, SponsorNational Internal Medicine Day, The American College of Physicians, 09:30 Case 1 - Acute Viral Rhinosinusitis , 10:40 Rhinosinusitis vs. Sinusitis , 14:20 Physical exam in rhinosinusitis, 20:40 Counseling patients about viral vs. bacterial infection, 22:56  Sinus regimen/nasal irrigation - “Is there a sinus toilet”, 27:10 Intranasal medications , 29:40 Rhinitis medicamentosa, 30:40 Nasal spray positioning, 33:50 Case 1 - Double Sickening, 37:40 Worst case scenarios from rhinosinusitis, 40:40 Antibiotic treatment for bacterial rhinosinusitis, 43:20 Failed improvement on antibiotics? Second-line options, 49:30 Case 2 - Chronic rhinosinusitis , 52:28 Etiology of chronic rhinosinusitis, 53:33 Making a diagnosis of chronic rhinosinusitis, 55:25 Treating chronic rhinosinusitis , 58:40 Vasomotor rhinitis, 60:40 Sinus irrigation counseling and tips (YouTube), 65:30 Case 3 - Allergic Rhinitis , 70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis , 73:51 Take-home points


Oct 26, 2020
#238 DVT / PE Triple Distilled
1921

DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates. 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by: Matthew Watto MD, FACP
  • Cover Art by: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com



Sponsor:

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.


Time Stamps

00:00 Intro, disclaimer, 01:40 Making the diagnosis of VTE, 09:07 Triage and risk stratify Pulmonary Embolism, 14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE, 21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight,  advanced CKD and in antiphospholipid syndrome, 28:22 IVC filters , 30:20 Outro


Links

Check out the full show notes from previous Curbsiders’ shows covering VTE.

  1. Dr Oren Friedman #92 Pulmonary Embolism for the Internist
  2. Dr Michael Streiff #154 DVT and PE Master Class
Oct 22, 2020
#237 Ophthalmology for Primary Care - Diabetic Eye Diseases and The 3 Vital Signs of Ophthalmology with Dr Nisha Chadha MD
3716

Fun, fluorescein, and fundoscopy unite as our esteemed guest, Dr. Nisha Chadha @iEducatorMD (Mount Sinai School of Medicine) brings us ophthalmology for primary care! Dr. Chadha is a medical educator and the content creator of the med-ed simulation website 20/20 Sim. She teaches us the 3-vital signs of ophthalmology, how to recognize common diabetic eye diseases, how to explain diabetic retinopathy to our patients, how to optimize a patient for cataract surgery and so much more. This episode is truly vision-ary!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

 

Credits

  • Written, Produced, and Infographic by: Carolyn Chan, MD
  • Cover Art: Kate Grant
  • Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD
  • Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Dr. Nisha Chadha



Sponsor

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

00:30 Intro, 03:21 Guest one-liner, Carolyn’s Pick of the Week , 09:05  Picks of the Week*, 10:13 Case from Kashlak, 3 - Vital Signs of Ophthalmology , 17:09  Ocular complications of diabetes, 20:22 Screening for diabetic retinopathy; Reports and Abbreviations, 26:07 Counseling Patients: The eye is a camera; Clinical symptoms of ocular complications , 32:07 Fluorescein Stain; Treatment Options for Diabetic Eye Disease: NPDR, PDR, VH, and RD , 41:16 Eye Vitamins for Macular Edema, 43:35 Cataracts , 47:22 Missing Glaucoma Drops , 50:50 Periop Optimization for Cataract Surgery, Anticoagulation and Other Medical Management , 58:14 Take Home Points, Plug: 20/20 Sim; Outro


Links*

  1. Mindset: The New Psychology of Success by Carol S.  Dwek
  2. Crackdown Podcast
  3. 20/20 Sim Site
Oct 19, 2020
#236 Physical Exam Series: Approach to Shortness of Breath
2488

Learn which exam maneuvers are worthwhile and which ones are worthless in your approach to shortness of breath. In our evidence based series on the physical exam, we discuss the approach to the dyspneic patient with Dr. Brian Garibaldi (Hopkins, SBM), associate professor of pulmonary and critical care medicine at Johns Hopkins, and co-president of the Society of Bedside Medicine. We discuss the physical exam’s effect on our differential diagnosis, maneuvers that are commonly taught, and some simple tests with great data that may go overlooked. Be prepared, this episode may take your breath away!

 

Credits

  • Written and Produced by: Justin Berk, MD, MPH, MBA and Sam Masur, MD 
  • Infographic: Sam Masur, MD, Beth Garbitelli
  • Cover Art: Beth Garbitelli
  • Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; and Paul Williams, MD, FACP
  • Editor:Justin Berk MD; Clair Morgan of nodderly.com
  • Guest(s): Brian Garibaldi, MD

 

Sponsors:

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

 

Time Stamps

00:00 Intro, disclaimer, guest bio, Sponsor – National Internal Medicine Day, The American College of Physicians, 03:47 Introduction to evidence-based exam, pre-test probability, and likelihood ratios, 05:29 Case from Kashlak Memorial , 06:51 Dr. Garibaldi’s initial maneuvers for the dyspneic patient, 11:33 Recapping the exam maneuvers, 14:05 Likelihood ratios for common maneuvers, 18:25 Over 6/Under 6 maneuvers, 25:30 Recap of Dr. Garibaldi’s go-to maneuvers, 28:19 Role of labs and diagnostic imaging, 31:03 Role of point-of-care ultrasound (POCUS), 34:10 Friday at 5pm, 36:31 Take home points, 39:25 Outro


Links*

  1. Stanford 25: Teaching and promoting bedside exam skills to students, residents and healthcare professionals both in person and online
  2. The 5 Minute Moment at the Society of Bedside Medicine
  3. The POCUS Atlas: Evidence Based Point of Care Ultrasound
Oct 12, 2020
#235 Spooky Cakes: Dapa-CKD, Turmeric for Knee Pain, Honey for URTI
3028

Time for spooky cakes with a side of candy corn. We discuss Dapagliflozin (SGLT2i) for CKD, Turmeric for knee pain and Honey for URTI (cough) on this halloween themed hotcakes with Rahul Ganatra MD, MPH @rbganatra

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

 

Credits

  • Producer: Sarah Phoebe Roberts
  • Written by: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH   
  • Cover Art: Matthew Watto MD, FACP
  • Hosts: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH   
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

 

Sponsors

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

00:00 Intro, disclaimer, Picks of the Week, 07:38 Sponsor – National Internal Medicine Day, The American College of Physicians, 08:40 Dapa-CKD, 20:00 Turmeric for Knee Osteoarthritis, 32:10 Honey for URTI and Cough, 46:32 Shout out to @votehealth2020 and PatientVoting.com , 48:25 Outro

Oct 05, 2020
#234 The Breast Lump, and Breast Cancer Screening with Nancy Keating MD, MPH
4648

Master your breast cancer screening spiel, cultivate your approach to the breast mass, and empower your patients with empathetic shared decision-making! Dr. Nancy Keating @NancyKeatingMD, policy wonk and primary care doc extraordinaire at Brigham and Women’s Hospital. Enjoy! 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Producer and Writer: Nora Taranto MD
  • Show Notes: Nora Taranto MD, Isabel Valdez PA 
  • Infographic: Nora Taranto MD
  • Cover Art: Kate Grant, MD 
  • Hosts: Stuart Brigham MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD   
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Reviewer: Arielle Medford MD 
  • Guest: Nancy Keating MD, MPH



Sponsors:

Provider Solutions & Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.


VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 


Time Stamps

00:00   Intro, 03:27   Guest one-liner, 05:27   Best Advice for Women in Medicine, 07:34   Picks of the Week, Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders., 10:00   Case 1: Brenda Cantwell and Breast Lump DDx, 13:39   Clinical Breast Exam vs Self Breast Exam, 17:26   Practical Tips for the Clinical Breast Exam, 21:50   Imaging to Evaluate the Breast Lump, 26:36   Demystifying BIRADS, 28:36   Epidemiology Potpourri, 33:02   Breast Pain without a Mass, 34:30   Case 2: Mammie Gram and Breast Screening, 46:03   Average Risk vs High Risk Screening, 47:18   Breast Risk Prediction Tools, 48:51   Breast Density, 53:16   Imaging Modalities, 61:28   Shared Decision Making in Screening  , 68:04 Case 3: Ms Britta Lumpworth and When to Stop Screening Mammograms, 74:42  Take Home Points and Outro

Sep 28, 2020
#233 Giving Effective Feedback with Drs. Abby Spencer and Alia Chisty - Is the feedback sandwich good enough to feed your brain hole?
4785

Listen to our medical education heroes, Dr. Abby Spencer, @abbyCCim (Cleveland Clinic), and Dr. Alia Chisty, @aliachisty (Penn State Health), school us on how to give effective and meaningful feedback! Topics include: the ADAPT framework, how to give difficult feedback, keywords and phrases when giving feedback, how to avoid gender and racial bias when giving feedback, giving feedback to your peers and how to solicit effective feedback as a team leader.   

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

 

Credits

  • Written and Produced by Paul Williams MD, FACP
  • Cover Art: Paul Williams, MD, FACP
  • Infographic: Edison Jyang
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guests: Abby Spencer MD and Alia Chisty MD

 



Sponsors

Provider Solutions & Development 

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.


VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

00:00 Intro, disclaimer, guest bio, pun, 04:00 Guest one-liners, Picks of the Week* (see links below), 10:25 Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders., 11:00 Case from Kashlak, Feedback definitions, 15:00 Addressing perceived barriers to feedback, 31:45 ADAPT model of feedback, 38:10 Addressing potentially gendered feedback; 42:45 Giving feedback to those who lack insight, 48:29 Feedback and racial bias, 52:25 Giving peer feedback, 58:10 Tips for soliciting feedback as a supervisor, 69:05 Does giving difficult feedback mean people won’t like you?, 75:10 Take home points and Outro

Sep 21, 2020
#232 Skinternship: Scalp & Face with Helena Pasieka MD
4395

Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest! Note: We had issues clearing images rights and will add to show notes page as soon as we clear the rights. 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

  • Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP, 
  • Cover Art and Infographic by:  Beth Garbitelli
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli  
  • Editor:  Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
  • Guest: Helena Pasieka MD, MS

Sponsors: Provider Solutions & Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org

Time Stamps

00:30 Intro, disclaimer, guest bio, 04:35 Guest one-liner, Picks of the Week*: Alexander Hamilton, Mac and Cheese, The Food Lab, Sponsor - 08:30 Case 1: Alopecia , 12:05 Assessing scalp for inflammatory changes and follicular drop-out, 13:10 Central Centrifugal Cicatricial Alopecia (CCCA), 14:00 Alopecia/hair loss non-scarring subtypes, 25:00 Alopecia Treatments, 28:55 Case 2:  Psoriasis vs. Seborrheic Dermatitis, 31:45 Looking for psoriatic plaques, 32:11 Seborrheic dermatitis hallmarks, 35:19 Treatment for Seborrheic Dermatitis,42:10 Rosacea vs. Acne, 50:40 Differentiating rosacea rash from SLE, 52:40 Rosacea management & treatment, 55:00 Identifying rosacea in Black skin, 56:50 Acne 59:10 Retinoid dermatitis, 60:30 Maskne, 62:29 More acne, rosacea, 66:15 Take homes

Sep 14, 2020
REBOOT #48 Hyponatremia Deconstructed
5325

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Original episode written and produced by: Matthew Watto MD, FACP
  • Show Notes and CME questions by: Deb Gorth ScM
  • Cover Art and Infographic by: Edison Jyang
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Molly Heublein (written materials); Matthew Watto MD (audio)
  • Guest: Joel Topf MD


Sponsor

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

  • 00:00 Intro
  • 03:30 Guest interview
  • 07:15 Pick of the week w/Dr. Topf
  • 16:20 Clinical case of hyponatremia
  • 17:48 False hyponatremia normal osmolality
  • 19:34 False hyponatremia high osmolality
  • 20:36 Understanding why osmolality matters
  • 23:28 Workup false hyponatremia
  • 24:45 Recap of discussion so far
  • 25:40 ADH dependent vs independent hyponatremia
  • 27:00 Psychogenic polydipsia
  • 289:15 Renal failure and hyponatremia
  • 30:03 Tea and toast, and Beer Drinker’s potomania
  • 35:22 ADH dependent hyponatremia
  • 38:15 Volume versus osmolality
  • 40:00 Volume status exam
  • 45:14 Additional testing with urine lytes and uric acid
  • 47:30 Treatment for SIADH
  • 52:42 Discussion of the vaptans
  • 58:21 Additional testing in SIADH
  • 62:50 When to admit patient for hyponatremia
  • 63:59 Clinical case of hyponatremia complications
  • 68:56 Fluids and rate of correction
  • 73:36 DDAVP clamp
  • 76:30 Moderate hyponatremia
  • 78:35 Diuretic dosing DOES matter!
  • 81:59 Loop diuretics for SIADH
  • 84:25 Take home points
  • 87:25 Outro
Sep 07, 2020
Cribsiders Ep 6: Become #1 in T1DM - A guide to the diagnosis, workup, and management with Dr. Hussein Abdullatif
3722

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot!

Listen: https://thecurbsiders.libsyn.com/cribsiders-ep-6-become-1-in-t1dm CME: https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively.


Credits

  • Written and Produced by: Shannon Snellgrove
  • Infographic: Shannon Snellgrove
  • Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders)
  • Hosts: Justin Berk MD and Christopher Chiu MD
  • Editor:Justin Berk MD; Clair Morgan of nodderly.com
  • Guest(s): Hussein Abdullatif MD


Sponsor

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org or cribsiders.vcuhealth.org to claim credit for select episodes. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.


Time Stamps

  • Diagnosis of T1DM 6:50
  • Presentation of T1DM 10:10
  • Explaining T1DM to a parent 12:00
  • Genetic Predisposition to Diabetes 15:20
  • T1DM Antibodies 17:10
  • Initial work-up for concomitant autoimmune disease 21:10
  • Atypical Presentation of T1DM 22:44
  • Treatment of T1DM 29:10
  • Dietary Modifications in T1DM 33:10
  • Checking blood sugars 39:50
  • Honeymoon Period 42:25
  • Hypoglycemia 44:00
  • Sports, Sickness, Alcohol and Glucose levels 48:25
  • Periop glucose management 51:10
  • Long-term complications of T1DM 53:50
  • Closed Loop System and Future Treatments 56:10
Aug 31, 2020
#231 U Talkin’ UTIs Re: Me? - Golden Tips re: Urinary Tract Infections with Dr Boghuma Titanji
4101

Are U Talkin’ UTIs Re: Me? Infectious Diseases expert, Dr Boghuma Titanji MD, PhD  @boghuma (Emory; TED) schools us on the diagnosis and management of urinary tract infections: updated definitions of complicated and uncomplicated UTI, pitfalls of the urinalysis, first line antibiotics, duration of therapy and which agents to use for complicated UTI. This episode is liquid gold!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by: Matthew Watto MD, FACP
  • Cover Art and Infographic by: Edison Jyang
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
  • Guest: Boghuma Kabisen Titanji MD, PhD


Sponsor - VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

  • 00:30 Intro, disclaimer, guest bio
  • 02:50 Guest one-liner, Picks of the Week*: Urban gardening, Behave (book) by Robert Sapolsky
  • 08:54 Defining UTI; Framework for UTI
  • 16:35 Case 1 - Cath Foley; Acute uncomplicated cystitis; Interpreting the Urinalysis
  • 28:00 Women with recurrent UTIs
  • 38:55 Case 2 - UTI in a man
  • 47:15 Treatment of complicated infections; Duration of therapy
  • 52:27 Case 3 - Catheter associated UTI; MRSA UTI
  • 61:25 Duration of therapy for bacteremia from UTI
  • 64:40 Take home points, plugs and outro

 

Aug 24, 2020
#230 Kittleson Rules Acute Heart Failure
4329

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea?  Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by: Deborah Gorth ScM
  • Cover Art and Infographic by: Edison Jyang
  • Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
  • Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
  • Guest: Michelle Kittleson MD, PhD


Sponsor - VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

  • 00:00 Intro
  • 02:40 Guest one-liner; Picks of the Week
  • 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic)
  • 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction?
  • 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?!
  • 28:36 Labs to trend during an ADHF admission
  • 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes
  • 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2?
  • 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB)
  • 56:05 Who needs a right heart cath?
  • 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care
  • 64:04 SGLT2i in heart failure
  • 68:15 Take home points and outro
Aug 17, 2020
#229 Hotcakes: COVID on steroids, statins over 75, short duration DAPT
2639

Join us for an extra-hot summer episode featuring our critical appraisal expert, Rahul Ganatra MD, MPH @rbganatra. Prepare to marvel as he breaks down his recent tweetorial on the RECOVERY trial of dexamethasone for COVID-19; to gasp as Paul Williams updates us on statins and ASCVD prevention and to be enthralled by the dulcet tones of Matt Watto explaining the latest research on DAPT vs. monotherapy with ticagrelor. Bonus: a new hotcakes rating scale has arrived!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Producer: Sarah Phoebe Roberts
  • Show Notes by: Sarah Phoebe Roberts
  • Writer: Rahul Ganatra MD, Sarah Phoebe Roberts, Matthew Watto MD, Paul Williams MD
  • Cover Art: Matthew Watto MD
  • Hosts: Rahul Ganatra MD, Matthew Watto MD, Paul Williams MD
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com


Sponsor: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

  • 00:00 Intro
  • 02:15 Picks of the Week
  • 06:15 New Hotcakes rating scale
  • 09:20 RECOVERY trial
  • 17:30 Rapid home-testing for COVID
  • 20:15 Statins and ASCVD prevention
  • 32:30 Ticagrelor monotherapy after ACS
  • 41:30 Outro

Picks of the week

  1. Paul: U Talkin' Talking Heads 2 My Talking Head podcast
  2. Sarah: New hotcakes scale!
  3. Rahul: Chromeo’s new Quarantine Casanova album
  4. Watto: 30 Rock season 1, episode 3 “Blind Date
Aug 10, 2020
#228 Thyroid on Fire! Hyperthyroidism with Dr. Eve Bloomgarden
4327

Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by: Tima Karginov and Matthew Watto MD, FACP
  • Infographic by: Tima Karginov
  • Cover Art: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
  • Guest: Eve Bloomgarden MD


Sponsors: Pediatrics On Call podcast by the American Academy of Pediatrics

If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here.

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.


Time Stamps

  • 00:00 Intro
  • 03:15 Guest one-liner, favorite failure, Picks of the Week*
  • 08:50 Sponsor
  • 10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs
  • 14:20  Case from Kashlak, Symptoms of Hyperthyroidism
  • 25:00 Grave’s eye disease: exam, therapy and counseling
  • 32:35 Thyroid exam and ultrasound
  • 38:55 Thyroid Stimulating Immunoglobulin
  • 41:00 Biotin
  • 44:30 Thyroid Scintigraphy
  • 49:00 Causes of Thyrotoxicosis
  • 52:00 Treatment & Adherence to antithyroid medication (methimazole)
  • 56:20 Beta Blockers in thyrotoxicosis
  • 64:50 Subclinical Hyperthyroidism
  • 67:00 Take Home Points, Outro
Aug 03, 2020
Cribsiders Episode 3: Back to School Special - COVID Edition
3532

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year!


Credits

  • Producers & Writers: Edward Corty, Nicholas Lee MD
  • Infographic: Nicholas Lee MD
  • Cover Art: Chris Chiu MD
  • Hosts: Justin Berk MD, Chris Chiu MD, Edward Corty
  • Editor:Justin Berk MD; Chris Chiu MD
  • Guest(s): Joshua Sharfstein MD


Sponsors: Pediatrics On Call


Sponsor: VCU Health Continuing Education - to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org or cribsiders.vcuhealth.org


Time Stamps

  • Introduction 1:00
  • How to answer “What do you think about school openings?” 11:30
  • Risk Assessment of School Re-openings 14:40
  • Evidence of Transmission among Children 17:10
  • What Other Countries Have Done 19:40
  • Community Threshold for Re-Opening and Using Protocols 20:30
  • The Reasons to Cohort 22:45
  • How to Address Scenarios 24:20
  • Health Disparities and Return to School 27:00
  • Existing Inequities and Children’s Sacrifice of Education 29:00
  • “Opting Out” of School Return and Feeling Safe 31:30
  • How Can Governments Help Support the Return 35:50
  • Guidance to give as PCP 37:50
  • School Alternatives / Innovations to Going Back 40:10
  • The Difference Between Equity and Equality 42:50
  • Testing in Schools 43:45
  • Resources to Follow For More Information 46:00
  • Take-Away Points 47:10
  • Optimism 48:25
  • Picks of the Week 53:50
Jul 29, 2020
#227 Baffled by NAFLD?
4586

Swim through the sea of acronyms as Dr Scott Matherly (@liverprof) helps us become a little less baffled by the thought of NAFLD. We discuss the initial diagnosis of fatty liver disease, indications for additional evaluation with imaging and/or biopsy, and potential treatment options. With a quarter of the world affected, it’s crucial to understand the various forms of disease and how to counsel patients about this all-too-common condition!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by: Elena Gibson MD
  • Infographic and Cover Art: Elena Gibson MD
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Scott Matherly MD

Sponsor: Pediatrics On Call


Sponsor:  VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

  • 00:00 Intro
  • 03:15 Guest one-liner; Picks of the Week*
:
  • 08:15 Sponsor
  • 08:50 Case from Kashlak part 1; What is hepatic steatosis?
  • 11:43 NAFLD acronyms and definitions
  • 18:20 Alcohol and Fatty Liver
  • 23:15 Initial Evaluation of NAFLD
  • 35:12 Dr Matherly’s piel to patients with fatty
  • 41:11 NASH/Fibrosis Risk Assessment
  • 48:54 Outcomes in NASH with Fibrosis
  • 51:20 Statins are safe in liver disease
  • 56:15 Treatment Options (surgery, Vitamin E, Pioglitazone, SLGT2 inhibitors and GLP1 agonists; Coffee?!)
  • 71:42 Take home points and Outro
Jul 27, 2020
#226 Kidney Boy on Acute Kidney Injury: Myths & Musings - Tips and Tricks from Joel Topf MD
4237

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium. 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written (including CME questions) and Produced by: Cyrus Askin, MD
  • Infographic by: Cyrus Askin, MD
  • Cover Art: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
  • Guest: Joel Topf, MD


Sponsor: Pediatrics On Call 


Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

  • 00:00 Intro
  • 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame);
  • 08:45 Sponsor
  • 09:15 Definition of acute kidney injury (AKI) and fundamentals
  • 11:00 Cardiorenal syndrome
  • 12:24 Schema for AKI
  • 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities
  • 21:22 AKI in the otherwise-healthy patient;
  • 32:20 Rhabdomyolysis
38:21 Vancomycin
  • 41:43 Acute interstitial nephritis (AIN)
  • 44:52 Contrast induced nephropathy (CIN)
  • 50:37 Gadolinium in AKI and/or CKD
  • 52:53 Timing of dialysis
  • 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors;
  • 62:01 Is Ultrasound necessary in AKI
  • 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology
Jul 20, 2020
#225 Women in Medicine: COVID Edition
4454

Listen as our expert guests, Kelly Graham, MD, MPH (@KellyGrahamMD) and Lekshmi Santhosh, MD MAEd (@LekshmiMD), detail the professional and personal challenges faced by women in medicine during the COVID-19 pandemic.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

 

Credits

  • Produced by: Leah Witt MD & Shreya Trivedi MD 
  • Written by: Molly Heublein MD, Isabel Valdez PA-C, Leah Witt MD & Shreya Trivedi MD
  • Infographic & Cover Art: Edison Jyang
  • Hosts: Leah Witt MD & Shreya Trivedi MD, Justin Berk MD, MPH, MBA
  • Editor: Molly Heublein MD and Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guests: Kelly Graham, MD, MPH; Lekshmi Santhosh, MD MAEd 

 

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

 

Episode Breakdown

  • Intro, disclaimer
  • Introduction and bio for Kelly Graham, MD, MPH
  • Introduction and bio for Lekshmi Santhosh, MD MAEd
  • One-liner for Kelly Graham, MD, MPH
  • One-liner for Lekshmi Santhosh, MD MAEd
  • Gender Awakening Moments
  • Picks of the Week*
  • Case from Kashlak
  • Difficulty with lack of childcare while working
  • Hippocratic Oath paradox
  • Dr. Santhosh’s 3 Ps
  • Motherhood penalty-fatherhood bonus
  • Two Pandemics, One Response
  • Breadwinner-homemaker bias
  • Female physician burnout
  • Minority Tax
  • Silver Linings
  • Take home points and Outro
Jul 16, 2020
#224 Hospital Addiction Medicine with Dr Melissa Weimer
3590

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter.  In this episode we talk to addiction medicine expert, Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Topics include: the management of polysubstance withdrawal,  approaching acute pain management for a person with opioid use disorder, and inpatient harm reduction strategies. After this episode listeners will gain new tools to help them best care for hospitalized patients with substance use disorders.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits

  • Writers and Producers: Carolyn Chan MD, Deb Gorth, and Nora Taranto MD
  • Cover Art and Infographics by: Carolyn Chan, MD
  • Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Carolyn Chan MD
  • Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Dr. Melissa Weimer

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

  • Intro, disclaimer, guest bio : 00:00
  • Guest one-liner:    03:00
  • Picks of the Week*:   08:20
  • Case from Kashlak:  10:30
  • Urine Toxicology Screens 11:30
  • Discussing Urine Toxicology Screens with Patients  13:20
  • Management of Polysubstance Withdrawal 16:16
  • Tapering Benzodiazepines   19:56
  • Acute Pain Management and Opioid Use Disorder 30:35
  • Active Drug Use in the Hospital 38:52
  • Harm Reduction 40:00
  • Discharges - Planned 43:43
  • Perioperative Buprenorphine and Methadone: 46:50
  • QT Prolongation and Methadone - 52:53
  • Outro 56:21
Jul 13, 2020
Cribsiders Episode #1: Cystic Fibrosis Licked-ty Split with Dr. Whittney Warren
3620

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas. Show notes: https:/www.thecribsiders.com/.

 

Credits

  • Writer, Producer, Infographic, CME Questions: Clara Mao 
  • Cover Art: Christopher Chiu MD
  • Hosts: Justin Berk MD, Christopher Chiu MD, and Matthew Watto MD
  • Editor: Justin Berk MD; Clair Morgan of nodderly.com
  • Guest: Whittney Warren DO 

 

Time Stamps

  • Intro / Disclaimer 0:00
  • Guest bio 2:25
  • Guest one-liner, picks of the week 3:15
  • Explaining CF to patients, life expectancy  7:00
  • Types of CF mutations and phenotypes 11:50
  • Presentation of CF in older patients 15:20
  • Screening and diagnosis 16:40
  • PFTs and airway clearance 25:20
  • Nutrition and the “CF diet” 29:10
  • CF exacerbations and antibiotic selection 32:25
  • Extrapulmonary manifestations 39:35
  • Transition of care for CF adolescents (alcohol, exercise, sex) 43:50
  • CFTR modulator therapy 51:35
  • Lung transplantation 54:45

 

Goal

Listeners will develop a systematic approach towards long-term management and acute exacerbations of cystic fibrosis.

 

Learning objectives

After listening to this episode listeners will…  

  1. Explain the pathophysiology underlying cystic fibrosis.
  2. Identify maintenance therapies that optimize pulmonary function and nutritional status in patients with cystic fibrosis.
  3. Choose evidence-based practices in the management of cystic fibrosis-associated pulmonary exacerbations.
  4. Jul 06, 2020
#223 Hot COVID Cakes: COVID19 Disparities, Steroids, Hormones for Depression, Probiotics
2840

This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening.  Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written and Produced by: Rahul Ganatra MD, MPHl Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD
  • Show Notes and CME questions by: Deborah J. Gorth ScM
  • Cover Art: Deborah J. Gorth ScM
  • Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Utibe Essien MD, MPH


Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Netflix; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page!
  • 07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19
  • 26:10 Dexamethasone for COVID-19
  • 28:55 Hormonal therapy for depression
  • 38:16 Probiotics
  • 45:00 Outro
Jul 02, 2020
#222 Addressing Anti-Black Racism in Medicine Utibe Essien MD, MPH
3239

Listen as our esteemed guest Dr. Utibe Essien @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD
  • Cover Art: Hannah Abrams MD
  • Infographic: Beth Garbitelli
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD
  • Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com
  • Guest: Utibe Essien MD


Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:40 Guest one-liner, Picks of the Week*: Just Mercy
  • 09:20 Statement from the show; Importance of discussing racism in medicine
  • 14:11 Definitions
  • 18:06 Identifying how racism manifests in the clinical setting
  • 37:46 Ideas for advocacy
  • 49:50 Take points and Outro
Jun 25, 2020
#221 Interstitial Lung Disease with Erin Narewski DO - Breathtaking knowledge and other words of inspiration
3944

Throw out your down pillows and join The Curbsiders for this lively discussion on interstitial lung disease. While the hundreds of interstitial lung disease types make this topic a bit overwhelming, breathe easy knowing that pulmonologist, Dr. Erin Narewski @erinnarewski (Temple), can boil things down to an easy to approach framework in less time than it takes to complete a few 6-minute walk tests. In this episode, we walk through the classification, relevant patient history, workup, and management of interstitial lung disease.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written and Produced by: Paul Williams, MD, FACP; Nicole Kus, David Madnick, and Peter Wikoff
  • Infographic and Cover Art: Edison Jyang
  • Show Notes: Deborah Gorth
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Paul Williams MD, FACP (written materials); Clair Morgan of nodderly.com
  • Guest: Erin Narewski DO, FCCP

Sponsor: ACP membership acponline.org/member


Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

Jun 22, 2020
#220 Social Determinants of Health with Karen DeSalvo MD
2408

We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written and Produced by: Emi Okamoto MD
  • Cover Art: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Karen DeSalvo MD, MPH, MSc


Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account!


Time Stamps

  • Intro, disclaimer, guest bio 0:44
  • Dr Desalvo’s one-liner 3:34
  • Picks of the Week*- The Great Influenza book by John M Barry  5:01
  • Dr Desalvo’s advice and past experience 6:10
  • Case from Kashlak 10:30
  • What about the evidence for social determinants? 13:40
  • What to do about this in the clinic, and is it worth screening? 16:06
  • Approaching as a team and with the community 19:40
  • How do we affect the upstream, before the downstream consequences? 22:40
  • NAM recommendations and framework 26:00
  • The role of technology 30:00
  • What are Social Determinants of Health (SDOH), and who they affect 34:00
  • Start paying attention to SDOH 37:00
  • Outro 38:49
Jun 18, 2020
#219 Post-Op Fever and Complications with Avital O’Glasser MD
3565

Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written: Hannah Abrams MD, Avital O’Glasser MD
  • Produced by, Infographic and Cover Art by: Hannah Abrams MD
  • Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com
  • Guest: Avital O’Glasser MD

Sponsor: ACP - acponline.org/member


Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

  • 00:00 Intro
  • 02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students
  • 09:28 Sponsor
  • 10:17 Kashlak case; How to collaborate with our surgical colleagues
  • 13:45 Questions to ask at the time of transfer
  • 23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea
  • 44:25 Co-managing Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis
  • 57:55 Outro
Jun 15, 2020
#218 Trauma-Informed Care with Megan Gerber MD
4035

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.”  We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment,  modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Producer/Writer/Graphics: Beth Garbitelli
  • Co-Producer: Paul Williams MD
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
  • Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
  • Guest: Megan Gerber MD, MPH, FACP


Sponsor: ACP - Visit acponline.org/member


Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!


Time Stamps

  • Intro, disclaimer, guest bio (0:00 - 3:15)
  • Guest one-liner (3:30)
  • Kashlak Cases (13:45)
  • Epidemiology of trauma (15:18)
  • Trauma and #MeToo (18:10)
  • Defining Trauma-Informed Care (TIC) (19:00)
  • Integrating TIC into primary care (22:48)
  • Screening in TIC (25:00)
  • Containment and retraumatization (29:00)
  • Inquiring about trauma (30:45)
  • Recap and Office Visit Mechanics (35:30)
  • Building the Relationship (38:00)
  • Common Inquiry Mishaps (38:52)
  • TIC Physical Exam (40:20)
  • Resources for Patients (44:30)
  • Office Environment (48:00)
  • Provider Burnout (50:00)
  • TIC in Covid-19 (52:30)
  • Take-home Points (56:20)
Jun 08, 2020
Curious Clinicians Episode 1 - Clubbing
1308

Introducing our friends, The Curious Clinicians:

Why do human bodies work how they do? Why do medications work, or not work? Do you miss digging into the “why” behind what we do every day? Join Hannah Abrams (@hannarabrams), Tony (@tony_breu), and Avi (@AvrahamCooperMD) in the Curious Clinicians podcast as they delve into these questions & more, starting with episode 1: Why does fingernail clubbing happen in so many different diseases? https://curiousclinicians.com/

Check out their website and subscribe on your favorite podcast player.

Jun 03, 2020
#217 COVID Cakes the Fourth: ACTT-1, Triple Therapy, PCR, Serology
3127

Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums  about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross!

 

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

 

 

Credits

  • Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD
  • Cover Art: Deborah J. Gorth ScM
  • Hosts: Matthew Watto MD, Rahul Ganatra MD MPH, Emi Okamoto MD, and Sarah P. Roberts MPH
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

 

Sponsors: ACP and VCU Health CE

 

Time Stamps

  • 00:00 Sponsors
  • 00:30 Intro, disclaimer
  • 02:40 Fomites, groceries and killer rats
  • 08:22 Sponsor
  • 09:22 ACTT-1 trial of remdesivir
  • 18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon
  • 33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests?
  • 44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics
  • 50:30 Outro
Jun 01, 2020
#216 Homeless Healthcare with Stefan Kertesz MD
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Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!).  Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by Nora Taranto MD
  • Infographics by Nora Taranto MD
  • Cover Art by Kate Grant MBChB, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD
  • Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com
  • Guest: Stefan Kertesz MD


Sponsor: VCU Health CE


Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 3:17 Guest one-liner
  • 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/
  • 10:07 Case from Kashlak
  • 10:56 Language: How to ask where a patient lives?
  • 13:25 Terminology: Persons Experiencing Homelessness:
  • 14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors
  • 20:44 How to start the visit, and how to establish trust early on?
  • 27:40 Why is the mortality rate higher?
  • 35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C
  • 54:15 COVID and homeless healthcare
  • 57:00 Care Models
  • 62:30 Take Home Points and Outro
May 28, 2020
#215 Medical Myths: Challenge Dogma with Dr. Douglas Paauw
3048

Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written and Produced by: Justin Berk, MD MPH MBA
  • Infographic and Cover Art: Beth Garbitelli
  • Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Douglas Paauw, MD


Sponsor: VCU Health CE



Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories!
  • 06:15 Medical Myth Definitions
  • 10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol
  • 19:09 Expired Medications; Military Stockpiling Study
  • 24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap
  • 31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%)
  • 41:07 Epinephrine in extremity; RCT of Epi in Extremities
  • Study showing Experts use it; Podiatry journal
  • 48:39 Take home points and Outro
May 25, 2020
#214 COVID Cakes 3: Llamas, Remdesivir, Strokes, Predicting the Future, and More!
3125

Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD
  • Cover Art: Beth Garbitelli
  • Hosts: Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD , Sarah P. Roberts MPH,
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com


Sponsor: VCU Health CE



Time Stamps

  • 00:00 Intro
  • 02:10 Fun animal facts: Llama antibodies
  • 09:10 Remdesivir RCT by Wang et al
  • 12:40 Power and Sample Size
  • 16:32 Baseline Characteristics, Results and Author’s conclusions
  • 19:15 Rahul’s conclusions: How chance and bias affected the results
  • 24:00 Right censoring; Viral load and timing of antivirals
  • 30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial
  • 33:53 Are patients really having fewer strokes and heart attacks?
  • 38:20 Awake proning
  • 43:30 Paul teaches us not to use the term “happy hypoxemic”
  • 45:00 CIDRAP viewpoint on future waves and exit strategies
  • 50:22 Outro
May 18, 2020
#213 Fatigue for Primary Care with Nina Mingioni MD - A Common Sense Framework
3517

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams
  • Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
  • Guest: Nina Mingioni MD, FACP


Sponsor: VCU Health CE


Time Stamps

  • 00:00 Intro, disclaimer, guest bio and a bad pun
  • 03:00 Guest one-liner
  • 07:10 Case from Kashlak, Defining fatigue; Taking a general history
  • 11:36 Most common causes of fatigue and how to elicit them from the history
  • 20:39 Physical exam for fatigue; Medications that cause fatigue;
  • 25:25 Exam findings and LRs for anemia; Sleep apnea
  • 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme
  • 47:55 Spiel to the patient when no answer is found
  • 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis
  • 55:09 Take home points and Outro
May 11, 2020
#212 Inpatient Alcohol Withdrawal: Sober Talk with Joji Suzuki, MD
3527

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal!  Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!).

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME


Credits

  • Written and Produced by Nora Taranto MD
  • Infographic and Cover Art by: Nora Taranto MD
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Joji Suzuki MD


Sponsor: VCU Health CE



Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film)
  • 08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk
  • 17:32 Outpatient Versus Inpatient Treatment
  • 25:27 Gabapentin for alcohol withdrawal
  • 27:10 Indicators for ICU level Care
  • 31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs
  • 36:55 And which benzo?
  • 39:47 A Natural History of Withdrawal
  • 44:10 Banana Bags and Thiamine Deficiency
  • 48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing
  • 56:36 Outro and Bonus clip
May 07, 2020
#211 COVID Cakes: Remdesivir, Anticoagulation, and Transmission
3022

In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!


Credits

  • Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD
  • Writer: Emi Okamoto MD, Rahul Ganatra MD MPH,
  • Cover Art: Chris Chiu MD
  • Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com


Sponsors: Apollohct.com and VCU Health CE



Time Stamps

  • 00:30 Intro, disclaimer
  • 02:30 Picks of the Week
  • 6:36 Remdesivir trial rundown
  • 21:52 Thrombosis in COVID-19
  • 29:50 Asymptomatic/Presymptomatic transmission
  • 41:42 Quick takes
  • 49:00 Outro
May 01, 2020
#210 Kidney Transplant for the Internist with Freely Filtered (NephMadness)
4453

It’s NephMadness! Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from the Freely Filtered Podcast led by Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist. Topics: indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME


Credits

  • Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew
  • Infographic: Cyrus Askin MD
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com


Sponsor: VCU Health CE



Time Stamps

  • 00:00 Announcement, Intro to Freely Filtered and NephMadness
  • 04:00 Case of advanced CKD; Who/when to refer for transplant
  • 12:05 Benefits of renal transplant
  • 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors
  • 20:40 Medications after transplant; Drug-drug interactions
  • 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness
  • 32:07 Calcineurin inhibitor levels
  • 36:42 Prophylaxis for long term complications
  • 40:21 Allograft rejection; BAMF criteria
  • 50:40 Cardiovascular risk; Statins
  • 56:11 Malignancy after kidney transplant
  • 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy
  • 72:23 Outro
Apr 27, 2020
#209 LIVE! Twitter, Social Media and Digital Scholarship
3173

LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media.  Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

  • Written and Produced by: Matthew Watto MD, FACP
  • Infographic: Michelle Brooks MD
  • Cover Art: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Clair Morgan of nodderly.com
  • Guest: Michelle Brooks MD


Sponsor: VCU Health CE



Time Stamps

  • 00:00 Guest one liner, favorite failure, career advice,
  • 08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series)
  • 11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles
  • 23:04 Negative aspects of social media
  • 26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer
  • 37:14 Pros and Cons of #medtwitter
  • 42:02 Tweetorials
  • 44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media
  • 51:34 Outro
Apr 23, 2020
#208 Hypothyroidism Master Class with Susan Mandel MD - How to dominate the diagnosis and management
4140

Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Credits

  • Written and Produced by: Elena Gibson MD
  • Cover art and Infographic by: Dr Kate Grant MBChb MRCGP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com
  • Guest: Susan Mandel MD, MPH



Sponsor: VCU Health CE



Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice
  • 09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms
  • 13:20 When to Test for Hypothyroidism
  • 17:43 Biotin interaction
  • 19:49 Which thyroid tests should we order?
  • 26:15 Subclinical hypothyroidism
  • 29:00 Etiology/Types of hypothyroidism
  • 33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam
  • 37:10 Levothyroxine replacement time of administration
  • 42:10 TSH goal
  • 46:00 Levothyroxine manufacturers
  • 48:33 Dosing in older adults
  • 50:27 T3 treatment
  • 56:52 Pregnancy
  • 59:42 Dose adjustments
  • 61:43 Estrogen and thyroid binding protein
  • 63:33 Who needs a referral?
  • 65:40 Plugs, Outro
Apr 20, 2020
#207 How to create a medical podcast: Tales from The Curbside
2581

Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

 

Credits

  • Written and produced by: Matthew Watto MD
  • Cover art and Infographic by Matthew Watto MD
  • Hosts: Matthew Watto MD and Paul Williams MD
  • Editor: Clair Morgan of Nodderly.com

 

Time Stamps

  • 00:00 Announcement, Intro, Disclaimer
  • 02:53 Our top podcasting pearls
  • 07:01 Find your niche
  • 09:46 Logistics
  • 13:25 Business, finances and legal matters
  • 14:40 Equipment
  • 21:48 Recording and editing
  • 24:56 Website, web and media hosting
  • 28:53 How to setup and record your podcast
  • 35:08 Editing software
  • 35:58 Search engine optimization
  • 37:45 Post-processing
  • 39:49 Take home points and outro

 

Apr 16, 2020
#206 Airway Management for the Non-Intensivist
4339

Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management  in these challenging times. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD
  • Show Notes: Cyrus Askin MD
  • Infographic: Elena Gibson, MD
  • Cover Art: Dr. Kate Grant MBChB DipGUMed
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
  • Guest: COL Kevin Chung, MD, FACP


Sponsors: McGraw Hill



Time Stamps

  • 00:00 Intro
  • 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice
  • 07:40 Sponsor
  • 08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs
  • 16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation
  • 23:40 Proning patients for hypoxemia
  • 29:15 ARDS basics: diagnostic criteria, Brief Recap
  • 33:22 Mechanical ventilation: Initial settings, following the blood gas
  • 40:55 Peak and plateau pressure, Lung compliance and  Troubleshooting a high pressures
  • 51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs
  • 62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19
  • 68:10 Take home points; Plugs; Outro
Apr 13, 2020
#205 COVID Cakes and Hot Takes with Rahul Ganatra MD
2673

Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston). Plus, @Paulnwilliamz and @cjchiu give us  some telehealth along with the usual antics. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com



Credits

  • Written, Produced, Hosted by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Cover Art and Show Notes by: Matthew Watto MD, FACP
  • Editor: Matthew Watto MD
  • Guest: Rahul Ganatra MD



Time Stamps

Apr 10, 2020
#204 NephMadness 2020: SGLT2 Inhibitors
3088

Get under the hood of SGLT2 inhibitors! Listen as our guests Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf give us a tour through the NephMadness 2020 SGLT2i region! How do these promising drugs work, and what evidence is there for using them in non-diabetic kidney disease or kidney transplant patients. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced by: Hannah R. Abrams
  • Cover Art and Infographic by: Hannah R. Abrams
  • Hosts: Hannah R Abrams, Matthew Watto MD, FACP
  • Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written)
  • Guests: Harish Seethapathy MD; Matthew Sparks MD; Joel Topf MD


Sponsor: McGraw Hill



Time Stamps

  • 00:00 Sponsor
  • 00:26 Intro, disclaimer, guest bio
  • 02:57 Guest one-liner and Picks of the Week*: Michael Pollan audiobook on Coffee and Caffeine Addiction
  • 03:52 SGLT2i definition, background, and why we now consider CV endpoints in diabetes
  • 11:16 Sponsor
  • 12:00 Tubuloglomerular feedback; Balloon analogy
  • 17:40 Other mechanisms for SGLT2i
  • 23:05 Back to the case; Risks from SGLT2i; Counseling and Monitoring
  • 34:18 SGLT2i for non-diabetic kidney disease; Possible mechanisms: Joel’s caution against early adoption
  • 41:42 SGLT2 inhibitors in kidney transplant
  • 45:20 Take home points and picks for the SGLT2 inhibitor region
  • 49:50 Outro
Apr 06, 2020
#203 How to Create an Online Curriculum for Medical Education
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Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced by: Paul Williams MD, FACP
  • Cover art and Show notes by: Matthew Watto MD, FACP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Kat Zechar MD and Amreet Sidhu MD


Time Stamps

  • 00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020.
  • 01:22 Intro, disclaimer and guest bios
  • 03:38 Guest one-liners, Picks of the week
  • 09:30 Why you might need an online meded curriculum
  • 16:33 Overview of Amreet and Kat’s online curriculum
  • 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment
  • 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org)
  • 46:35 Time commitment
  • 50:55 Take home points and Outro
Apr 02, 2020
#202 LIVE! Lymphadenopathy: Taking Your Lumps - with Carrie Thompson MD
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LIVE! from Mayo Clinic, a practical approach to lymphadenopathy with Carrie Thompson MD @cathompsonmd (Hematology Oncology, Mayo Clinic). Dr. Thompson provides her simplified approach to the history, differential diagnosis, high yield lab testing, imaging, how to counsel patients with adenopathy and tips on when, where and how to biopsy!

The Curbsiders are insanely grateful to the Mayo Clinic  Internal Medicine Residency Chief Residents @mayomn_imres (@JasonEckmannMD @SamiRyanMD @BHuffmanMD @CourtHarrisMD) and their amazing program director @AmyOxentenkoMD for an amazing trip to Rochester!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced by: Carrie Thompson MD and Matthew Watto MD, FACP
  • Infographic: Matthew Watto MD, FACP
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Carrie Thompson MD


Time Stamps

  • 00:00 Announcement: We’re looking for Medical Student members. Send applications to thecurbsiders@gmail.com by April 10, 2020.
  • 01:20 Intro, guest bio, one-liner, career advice; Pick of the week*: In Shock by Rana Awdish
  • 07: 00 Lymphatic system
  • 09:19 Differential diagnosis for lymphadenopathy
  • 11:38 Taking a history (ALL AGES mnemonic), Red Flags
  • 19:15 Physical exam for lymphadenopathy
  • 22:30 Which labs to order; Flow cytometry
  • 26:05 Imaging
  • 28:30 Counseling patients with LAD
  • 31:10 Biopsy: How to choose type and location
  • 37:35 Take Home Points
  • 39:00 Audience Questions
  • 42:25 Outro
Mar 30, 2020
#201 COVID Narratives: Stories from Physicians at the Front Lines
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Listen as the pioneers of the COVID pandemic share their experiences taking care of some of the first COVID patients in the US. Our guests have a broad range of expertise and experiences. This episode features hospitalist Dr. Francisco Alvarez (University of California at San Francisco, @fnalvarez), Infectious Disease fellow Dr. Karolina Maciag (University of Washington, @KMaciag), Critical Care and Pulmonology Fellow Dr. David Furfaro (Columbia University, @david_furfaro

) and intensivist and founder of onepagericu.com, Dr. Nick Mark (Seattle, WA). Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced: Justin Berk MD MPH MBA
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Justin Berk MD MPH MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Dr. Francisco Alvarez, Dr. Karolina Maciag, Dr. Dave Furfaro, Dr. Nick Mark


Sponsors: Cayuga


Time Stamps

  • 00:00 Intro
  • 04:28 Francisco: Process leading up to first case
  • 07:42 Karolina: The perspective of the consultant- calm in the storm
  • 11:40 (Karolina) Seattle Flu Study as early warning
  • 16:00 Dave: ICU patients
  • 20:30 Nick: making decisions with a moving target
  • 25:05 Sponsor
  • 25:53 Francisco: data available on Twitter
  • 28:00 Francisco: the role of generalist during the COVID pandemic
  • 31:15 Karolina: on vulnerable populations during pandemic
  • 38:26 Dave/Nick: how generalists should be preparing themselves
  • 45:16 Avoiding aerosolized procedures / nebulizers
  • 47:46 What was the big surprises
  • 54:20 How do you address the anxiety
  • 60:12 Plugs
  • 64:20 Outro
Mar 26, 2020
#200 COVID-19 with Paul Sax MD - Transmission, quarantine, PPE, diagnosis and management
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Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com


Credits

  • Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP
  • Cover Art and Infographic by: Beth Garbitelli
  • Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
  • Guest: Paul Sax MD


Sponsor: Cayuga



Time Stamps

  • 00:00 Intro
  • 04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza
  • 07:00 Rahul highlights areas of caution interpreting COVID cases studies
  • 12:35 Sponsor
  • 13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms
  • 18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity
  • 21:15 Who merits testing for COVID-19
  • 23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine
  • 25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital
  • 30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible?
  • 32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine
  • 36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces?
  • 40:20 Do exposed HCWs without symptoms require quarantine?
  • 41:30 Personal Protective equipment (PPE)
  • 45:00 COVID-19 in pregnancy
  • 47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.)
  • 50:45 Where should you get your COVID-19 information?
  • 52:30 Closing remarks and outro
Mar 22, 2020
#199 NephMadness: Hyperkalemia, Diet, Potassium Binders, Exercise
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NephMadness 2020 is here! Listen as Dr. Ryann Sohaney (@ryannsohaney), Dr. Deborah Clegg and Dr. Joel Topf (@kidney_boy) discuss this year’s first Nephmadness topic, Hyperkalemia in CKD. They will (1) review the use of potassium binders for management of hyperkalemia in CKD (2) identify the potential health benefits of dietary potassium and challenge the use of low-potassium diets in CKD, and (3) describe how exercise influences serum potassium and consider exercise recommendations in CKD.

Check out the regions and fill out your brackets for NephMadness 2020 here! Sign-up as a part of The Curbsiders team!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Elena Gibson MD 
  • Infographic: Caitlyn Vlasschaert MD 
  • Cover Art: Elena Gibson MD
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan Nodderly.com (audio)
  • Guest: Ryann Sohaney, MD; Deborah Clegg, PhD; Joel Topf, MD 

Sponsors

AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders.

Time Stamps

  • 00:00
Mar 16, 2020
#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD
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Polycystic ovary syndrome (PCOS) is more common than we think!  Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Molly Heublein, MD
  • Cover Art and Infographic: Kate Grant MBChB DipGUMed 
  • Hosts: Matthew Watto MD, FACP; Molly Heublein, MD
  • Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest: Katherine Sherif, MD

Sponsors

AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders.

 

Primary Care Physician Opportunity in beautiful Ithaca, NY! Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/

Time Stamps

  • 00:00 Sponsors - AccessMedicine.com (McGraw-Hill) Mar 09, 2020
#197 Pulmonary Nodules and Lung Cancer Screening with Denitza Blagev MD
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Join us as we demystify the world of pulmonary nodules & lung cancer screening. During this episode, Dr. Denitza Blagev (@mybetterdoctor) makes her triumphant return to The Curbsiders to help us tackle this topic. She is currently the Medical Director for Quality/Specialty-Based Care at Intermountain Healthcare and a Pulmonary & Critical Care physician. We learn to take command of the recommendations for lung cancer screening, disambiguate the terms used by pulmonologists and radiologists, and appreciate some of the nuances of lung cancer screening all with the hope of making YOU a better primary care physician!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by:  Cyrus Askin MD & Leah Witt, MD
  • Infographic: Leah Witt, MD
  • Cover Art: Dr. Kate Grant MBChB DipGUMed
  • CME/MOC: Cyrus Askin, MD
  • Hosts: Cyrus Askin MD; Leah Witt, Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editors: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest: Denitza Blagev, MD

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps

Mar 02, 2020
#196 LIVE! Refugee Health with Tanuja Devaraj MD
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Develop your approach to refugee health in the primary care setting.  We discuss important considerations for primary care of the refugee patient with Dr. Tanuja Devaraj (Penn State), an internist with expertise in migration health.  We review barriers to primary care, how to take a migration history, and common health concerns that occur in this patient population.  We also discuss strategies for screening for trauma and mental health issues, which are common among patients who have gone through migration.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Producer: Paul Williams MD, FACP
  • Writer: Tanuja Devaraj MD and Paul Williams MD, FACP
  • Infographic: Emi Okamoto MD
  • Cover Art: Paul Williams MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written)
  • Guest: Tanuja Devaraj MD

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps

#195 TWDFNR 3: Potassium, Oxygen, and antipsychotics
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Discover common practices that persist in the hospital wards despite no proven benefit! We review how potassium replacement goals should not drive you bananas, extra oxygen should not give you comfort, and how you should maybe calm down with antipsychotics for delirium. Join returning guests: high-value care specialist Dr. Lenny Feldman (@DocLennyF, Johns Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 3 of “Things We Do for No ReasonTM.

SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Burton H. Shen MD, Justin Berk, MD MPH MBA
  • Infographic:
  • Cover Art:
  • Hosts: Justin Berk MD MPH MBA; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FaCP
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest: Lenny Feldman MD, Tony Breu MD

Sponsors

The Society of Hospital Medicine

Hospital Medicine 2020 (HM20) is the Society of Hospital Medicine’s Annual Conference April 15th through the 18th in sunny San Diego. Don’t miss the largest hospital medicine meeting. Register now at https://shmannualconference.org/ and use the code CURBSIDERS to receive a $50 discount.

Primary Care Internal Medicine of Ithaca

Feb 17, 2020

#194 Treatment of Alcohol Use Disorder with Dr. Marlene Martin MD
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Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder.  Your patients need you!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Carolyn Chan, MD
  • Cover Art and Infographic: Carolyn Chan, MD
  • Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest: Marlene Martin, MD

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps

  • 00:00 Sponsor -ACP’s MKSAP 18
Feb 10, 2020
#193 LIVE! The Struggling learner with Dr. Melissa McNeil
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Join us as we discuss how to approach “The Struggling Learner” with Dr. Melissa McNeil (@missydoc0128), Professor Medicine and Associate Chief of General Internal Medicine at the University of Pittsburgh Medical Center (UPMC), recorded LIVE in Pittsburgh, PA!  In this episode, we discuss how to approach the struggling learner, highlighting the 5-Step process discussed in a recent article co-written by Dr. McNeil (Merriam 2019).  This episode is not intended to give educators a roadmap for how to develop and implement a corrective action plan, but was put together to provide a common toolset on how to approach a struggling learner.  As such, the topics discussed can be applied to all kinds of learners that struggle, not just in medicine. However, the techniques discussed involve a common framework routinely taught in medical education (assessment, diagnosis, and referral) and, therefore, is communicated using this shared language.

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Stuart Brigham MD
  • Infographic: Matthew Watto MD, FACP
  • Cover Art: Stuart Brigham MD
  • Hosts:  Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham, MD
  • Editor: Stuart Brigham MD (written materials); Clair Morgan at Nodderly.com
  • Guest: Melissa McNeil MD, MACP
  • Special thanks to Dr. William Kelly, FACP, FCCP

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Feb 03, 2020
#192 Dialysis for the Internist with Joel Topf MD
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Kidney Boy Returns! Compare the types of dialysis, learn how nephrologists approach medication management in ESRD, and avoid the most common mistakes non-nephrologists make in patients on dialysis! Kashlak Chief of Nephrology Dr. Joel Topf, @kidney_boy, walks us through what you need to know to take care of a patient on dialysis and gives us an idea of how nephrologists think through mineral bone disease (calcium, phosphorus and vitamin D), anemia, iron repletion, and hypertension. We answer all your questions about co-managing patients on dialysis!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Producer: Hannah R. Abrams
  • Written and produced by: Hannah R. Abrams
  • Cover Art and Infographic by: Hannah R. Abrams
  • Hosts: Hannah R. Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD, FACP (written materials), Clair Morgan of Nodderly.com (audio)
  • Guest: Joel Topf MD

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps

Jan 27, 2020
Season 9 Trailer and KIDNEYcon 2020 Announcement!
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Trailer for season 9 of The Curbsiders! Plus, our friends from NephJC and the Freely Filtered Podcast will be at KIDNEYcon 2020! It features 6 amazing hands on workshops and lots of celebrities from #NephTwitter. The deadline for travel grants is approaching (See below).

What: KIDNEYcon 2020 (www.kidneycon.org)

When: April 16-19, 2020

Where:
Little Rock, Arkansas

Who Should Attend: Internal Medicine Residents, Pediatric Residents, Adult and Pediatric Nephrology Fellows, Attending Nephrologists

Travel Grants: Available for Adult and Pediatric Residents and Nephrology Fellows (Deadline to apply: February 1st )

Click HERE to Register in January 2020

Jan 24, 2020
#191 Lipids Update with Erin Michos MD
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Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! 

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

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Credits

  • Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli 
  • Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA
  • Infographic: Beth “Garbs” Garbitelli
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP   
  • Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest: Erin Michos MD MHS

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps

  • 00:00:00 Intro
  • 00:01:52 Getting to know Dr. Erin Michos
  • 00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and Jan 20, 2020
REBOOT #137 Hyperkalemia Master Class with Joel Topf MD
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A Curbsiders classic with a fresh intro by Hannah Abrams @hannahRabrams (soon to be MD)! Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis. Get deeper into potassium physiology with a FREE pdf copy of Joel’s book The Fluid Electrolyte and Acid Base Companion here.

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits

  • Written, edited and produced by: Matthew Watto MD, FACP
  • Intro: Hannah R Abrams
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
  • Infographic and Cover Art: Matthew Watto MD, FACP
  • Guest: Joel Topf MD

Time Stamps

REBOOT #129 Depression and Physician Suicide with Elisabeth Poorman MD
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Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic!

Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that. 

The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line. 

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at doctorpoorman@gmail.com, or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need.

New episodes return January 20, 2020!

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits

  • Written and produced by: Nora Taranto MD, Shreya Trivedi MD
  • Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD
  • Edited by: Matthew Watto MD 
  • Guest: Elisabeth Po
Jan 06, 2020
#190 Recap Extravaganza 2019
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Recap extravaganza 2019 featuring top pearls from our staff’s favorite episodes of 2019 and voicemails from Kashlak faculty, Dr. Avital O’Glasser (@aoglasser), Dr. Kimberly Manning (@gradydoctor), Dr. Renee Dversdal (@DrSonosRD) and The Curbsiders team. Topics include: HFpEF, the PARAGON-HF trial, Buprenorphine, Opioid Use Disorder, Cirrhosis, Coagulopathy, SBP, Hyperkalemia treatment, Multimorbidity, and how to think about NNT. Plus, the team shares a bunch of other favorite moments and random pearls!

Upcoming shows: The next two weeks will feature REBOOT episodes with fresh intros from The Curbsiders team. Season 9 starts January 20, 2020 with a Lipid Update from Cardiologist Dr. Erin Michos (@ErinMichos)

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Produced by: Sarah Phoebe Roberts MPH and Chris Chiu MD, FACP, FAAP 
  • Writer: Sarah Phoebe Roberts MPH
  • Infographic: Sarah Phoebe Roberts MPH
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Chris Chiu MD, FACP, FAAP; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Chris Chiu MD, FACP, FAAP (audio), Matthew Watto MD, FACP (show notes)

Time Stamps

#189 Medical Overuse: Common Cases of Overtesting, Overdiagnosis, Overtreatment
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Team up with the authors of the JAMA Medicine series on Medical Overuse, Dr. Dan Morgan @dr_dmorgan (University of Maryland) and Dr. Deborah Korenstein @DKorenstein (Memorial Sloan Kettering). We discuss procalcitonin (again!), the dangers of incidentalomas, risks of chest CT for lung cancer screening, the easiest place to get antibiotics for a viral infection, and why not to treat subclinical hypothyroidism despite guidelines. Trying to find ways to shed the fat off of some common medical practices? Look no further. 

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Justin Berk, MD MPH MBA
  • Infographic: Justin Berk, MD MPH MBA
  • Cover Art: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Molly Heublein MD, Matthew Watto MD, FACP, Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
  • Guest:  Daniel Morgan MD, Deborah Korenstein MD, FACP

Time Stamps

  • 00:00 Intro, disclaimer, guest bios
  • 04:45 Guest one-liners
  • Picks of the Week*: The Fifth Season is part of
Dec 23, 2019
#188 GERD and Dyspepsia with Dr. Amy Oxentenko MD
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Delve into the diagnosis and management of GERD and dyspepsia with Dr. Amy Oxentenko (@AmyOxentenkoMD), Gastroenterologist and the Internal Medicine Residency Program Director, Associate Chair for the Department of Internal Medicine, and Professor of Medicine at Mayo Clinic in Rochester, MN. Our discussion features a review of the standard presentations of GERD and dyspepsia, alarm symptoms and who needs referral for endoscopy or other specialized testing (pH, impedance testing, screening for Barrett’s esophagus). Additionally, we comprehensively cover proton pump inhibitor (PPI) therapy including: choice of agent, dose, frequency, how taper, how to counsel patients about risk, what labs should be monitored and the use of adjuvant therapies like H2 blockers, antacids and even carafate. After this episode, you will be flexing on reflux!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli
  • CME Questions: Beth Garbitelli, Matthew Watto MD, FACP
  • Infographic: Beth Garbitelli 
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts:  Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD, FACP (written materials); Clair Morgan at Nodderly.com
  • Guest: Amy Oxentenko MD

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:47 Guest one-liner, Picks of the Week*: Reality TV Shows: Survivor  and
Dec 16, 2019
#187 Buprenorphine Master Class: Managing Opioid Use Disorder for the Generalist
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How to initiate buprenorphine like a pro. Treating people with Opioid Use Disorder can be the most rewarding part of your practice!  Get comfortable with counseling and pharmacotherapy for OUD with tips from Dr. Michael Fingerhood, Associate Professor of Medicine at Public Health at Johns Hopkins.  We review building a therapeutic relationship with people with substance use disorders, the differences between the three FDA-approved medications for opioid use disorder (buprenorphine, methadone and extended-release naltrexone), and the nitty-gritty of prescribing buprenorphine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Justin Berk, MD MPH MBA, Joseph “Seffy” Muller MD
  • Infographic: Hannah R Abrams and Justin Berk MD, MPH, MBA
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Justin Berk, MD MPH MBA
  • Editor: Matt Watto MD, FACP (written materials), Clair Morgan at Nodderly.com (audio)
  • Guest: Michael Fingerhood MD

Time Stamps

  • 00:00: Introduction
  • 04:40: Guest introduction & questions (great stories about addiction)
  • Picks of the Week*: Papillon (film) and Papillon (book) per Dr. Fingerhood; Dec 09, 2019
#186 Sarcopenia: Raising the Bar in Primary Care
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Make some gains with Drs. Feigenbaum (@Jordan_theCoach) & Baraki (@AustinBaraki) of Barbell Medicine as we delve into the topic of sarcopenia! Together we’ll learn what exactly is sarcopenia, how it is diagnosed, and explore approaches to both management and counseling including: exercise prescriptions,  recommendations for protein intake, and even how to treat patients with multiple comorbidities.

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by:  Cyrus Askin MD
  • Infographic: Cyrus Askin MD, Hannah Abrams
  • Cover Art: Dr. Kate Grant MBChB DipGUMed
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editors: Matthew Watto MD, FACP; Clair Morgan of Nodderly.com
  • Guests: Jordan Feigenbaum MD; Austin Baraki MD

Check Out our friends at Barbell Medicine!

Learn more about Barbell Medicine through their website at www.barbellmedicine.com or their YouTube channel - Barbell Medicine. They also have their own Podcast, The Barbell Medicine Podcast and can be found on Instagram: @barbell_medicine, Twitter via @BarbellMedicine.

Drs. Feigenbaum and Baraki can

Dec 02, 2019
#185 Hotcakes: Updates on CAP, Asthma & Red Meat!
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“Guidelines” galore! From Community-Acquired Pneumonia to asthma to...red meat? While you may be listening to this around Thanksgiving, we actually recorded on October 30th‒the best and spookiest time of the year. To really set the mood I wanted to include some terrible skeleton puns, but the ones I found weren’t humerus. What we do have for you are some tasty knowledge treats, courtesy of our ghosts‒oops, I mean our HOSTS‒Chris, Matt, Stuart and Paul. Join us as we review the most terrifyingly relevant research findings and creepiest clinical pearls!

Today also marks the debut of our newest Hotcakes team member, the frighteningly talented Dr. Rahul Ganatra. Rahul will now be our resident statistician/study design expert, and will use his research skulls‒no wait, SKILLS‒to provide even more insight into the practice-changing findings we love to highlight for you.  

ACP members can claim CME-MOC at CME credit https://www.acponline.org/curbsiders. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits 
  • Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
  • Statistics Expert: Rahul Ganatra MD
  • Editors: Christopher Chiu MD (audio/text), Emi Okamoto MD (text)
  • Cover-Art: Sarah Phoebe Roberts MPH
  • Music: Stuart Brigham MD

Time stamps

  • 00:00 Introduction/Disclaimer
  • 03:18 Getting to know Dr. Rahul Gantra
  • 05:35 Community-Acquired Pneumonia Guidelines
  • 15:13 Sarah explains Hotcakes ratings
  • 16:45 A new Asthma Strategy
  • 17:26 Chris forgets what LABA stands for
  • 27:37 Stuart makes a joke
  • 29:00 A lot of meat talk
  • 37:22 Rahul’s Napkin Calculations
  • 51:40 Honorable Mentions
  • 52:42 Take-away Points & Outtro

Meet Rahul:

Rahul Ganatra is a Medical Attending and Director of Continuing Medical Education for the Medical Service at the VA Boston Healthcare System.  He fell in love with clinical epidemiology and public health while taking night classes for his MPH during medical school. and we

Nov 27, 2019
#184 Update in Sleep Medicine: LIVE from CHEST 2019!
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Score some great insights and clinical pearls from Dr. Christine Won on the incredibly important topic of sleep medicine during this live recording at CHEST! On this episode we’ll tackle why we sleep, how to treat insomnia, the “Z-drugs” and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Cyrus Askin MD, Matthew Watto MD, FACP 
  • Infographic: Matthew Watto MD, FACP
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Matthew Watto MD, FACP; Emi Okamoto MD
  • Guest: Christine Won, MD MSc

Sponsor

The American College of Chest Physicians

Time Stamps

#183 Longevity, Healthspan and Lifespan with Peter Attia MD
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We want to live longer… and healthier too! Dr Peter Attia, a physician focusing on the applied science of longevity, walks us through lifespan and healthspan, exploring tactics aimed at extending both. Listeners will challenge the conventional approach to primary care and explore tactics to optimize exercise, nutrition, and health, including counseling on different dietary patterns, fasting, exercise, emotional well-being and how to prepare for the Centenarian Olympics!

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

  • Written and Produced by: Matthew Watto MD, FACP and Elena Gibson MD 
  • Cover Art and Infographic: Elena Gibson MD
  • Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Editor: Emi Okamoto MD
  • Audio Editor: Clair Morgan of Nodderly
  • Guest: Peter Attia MD 

 

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 04:22 Guest one-liner, Career Advice, Picks of the Week*
  • 14:30 Case: A couple seeking maximize longevity; Defining longevity, healthspan, lifespan and the 4 types of death
  • 19:30 Lifespan, the longevity curve and the long tail
  • 23:50 Peter’s approach to shepherding patients toward longevity; Exploring motivations
  • 32:06 Back to our couple: What exercises should they perform
  • 42:09 Peter’s advice on nutrition; the standard American diet; Intermittent fasting; Dietary Restriction
  • 51:20 Periodic fasting and water only fasting
  • 54:33 Genetics and longevity
  • 56:40 Metformin;
Nov 18, 2019
#182 Becoming a PGY3: Not Just a Repeat of PGY2
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This podcast covers several concrete steps that residents can do or program directors can suggest to help residents transition to assuming the role of PGY3. A year is a long time, but requires a strategic approach to ensure that residents get the most out of it. It’s our latest offering from ACP’s IMpower series for residents featuring our friends from Walter Reed IM Residency: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray).

 

If you are a PGY3 you should: LEAD like someone’s life depends on it!

Credits

  • Written and Produced by: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD
  • Infographics: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD
  • Cover Art: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP
  • Guests:  Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray)

 

Sponsor - ACP IMpower: Catalyzing your professional future

Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.

Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

Time Stamps

  • 00:00 Sponsor, disclaimers, intro, guest bios
  • 05:10 Guest one-liners
  • 07:43 Precocious Passion for teaching
  • 09:30 Picks of the Week*: High Life (film);
Nov 11, 2019
#181 The Multimorbidity Games
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Learn how to approach the geriatric patient with multimorbidity and how to parse through and prioritize a mile-long problem list with Dr Josh Uy, master geriatrician at the University of Pennsylvania. We review different approaches to a clinic visit with a patient who takes fifteen daily medications with just as many chief complaints, all in a thirty minute (or less!) appointment time. We discuss what the term “multimorbidity” even means, how to ask about patient preferences and use them to inform the treatment plan, and what the evidence has to say about adjusting treatment goals of common conditions for individual patients. (Spoiler alert: It all depends on the patient, comorbid conditions and goals!) 

Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Producer: Nora Taranto MD 
  • Writer:  Nora Taranto MD, Leah Witt MD 
  • Infographic:  Leah Witt MD 
  • Cover Art: Nora Taranto MD 
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Leah Witt MD, Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP; Clair Morgan
  • Guest: Josh Uy MD

Time Stamps

#180 CHEST 2019 Recap Part 2
3411

CHEST 2019 Recap Part 2 featuring random pearls and highlights from #CHEST2019 in New Orleans including: tips for addressing futile end-of-life care, bleeding in the ICU, DOAC reversal agents, use of procalcitonin and monocyte distribution width to identify sepsis, vitamin C for sepsis treatment, small particles and lung cancer risk, augmented reality/virtual learning, and tech as a teaching tool. Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality. 

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written, produced, and co-hosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP
  • Edited by: Matthew Watto MD, FACP
  • Special Guests: Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Chidinma Chima-Melton MD, FCCP (@LABritishLady), Kim Fabyan MD (@kfabsMD)

Time Stamps

  • 00:00 Pun, Disclaimer, Intro
  • 03:58 Dr Erin Narewski on end of life conversations
  • 13:30 Bleeding in the ICU
  • 15:40 DOACs and reversal agents
  • 18:40 Dr Chidinma Chima-Melton on ICU visiting hours
  • 22:50 Vitamin C use in the ICU, Stuart’s Vitamin C rant
  • 29:22 Monocyte distribution width for identifying patients with sepsis
  • 30:55 Sarah Phoebe Roberts on Procalcitonin and CRP for sepsis
  • 39:36 Dr Nina on technolo
Oct 30, 2019
#179 CHEST 2019 Recap Part 1
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Recap of random pearls and highlights from #CHEST2019 including: A pop quiz on inhaler use, interstitial lung disease, pulmonary fibrosis (IPF), limitations of supplemental oxygen, lung cancer screening, imposter syndrome, and is it safe to use beta blockers in COPD. 

Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality. 

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written, produced, and cohosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP
  • Edited by: Matthew Watto MD, FACP
  • Special Guests: Leah Witt MD (@leahJwitt); Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Hassan Bencheqroun MD, FCCP (@drBcalifornia); Chidinma Chima-Melton MD, FCCP (@LABritishLady)

Time Stamps

  • 00:00 Intro, disclaimer
  • 05:20 Dr Leah Witt @leahwitt (UCSF) quizzes us on inhalers.
  • 09:55 Dr Leah Witt on ILD in geriatric patients
  • 13:09 Dr Erin Narewski @erinnarewski (Temple) on supplement oxygen. 
  • 15:07 Dr Erin Narewski discusses the brand new BLOCK trial.
  • 18:11 Dr Chidinma Chima-Melton
Oct 28, 2019
#178 Tuberculosis Updates with Laila Woc-Colburn MD
4419

Catch up on the latest guidelines and insights on tuberculosis with help from Dr. Laila Woc-Colburn, @docwoc71 (Baylor)! We cover new recommendations for screening health care workers, treatment of both latent and active TB, and best practices for counseling patients throughout the process. Listen to find out more… And say goodbye to the annual PPD?

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Full notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced by: Hannah R. Abrams
  • Cover Art and Infographic by: Hannah R. Abrams
  • Hosts: Hannah R. Abrams; Matthew Watto MD, FACP
  • Editors: Matthew Watto MD, FACP; Emi Okamoto MD
  • Guest: Laila Woc-Colburn, MD, FACP

Partners

 

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

  1. What makes you proud to practice internal medicine or one of the I.M. subspecialties? 
  2. What recent patient experience made you proud to be an internist or subspecialist?
  3. How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two rec

Oct 21, 2019
#177 Osteoarthritis Master Class with Tuhina Neogi MD, PhD
4511

ACR osteoarthritis guidelines author, Dr. Tuhina Neogi (Boston University; @tuhinaneogi) schools us on all things OA, including new understandings of pathophysiology, diagnosis, when to order imaging and labs, and an overview of pharmacologic and nonpharmacologic therapies. Plus, get answers to your questions from Twitter on CBD, turmeric, glucosamine, chondroitin, NSAIDS, intra-articular steroid and hyaluronic acid injections, tai chi, and more!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written (including CME questions) and Produced by: Beth Garbitelli and Matthew Watto MD, FACP
  • Cover Art and Infographic by: Beth Garbitelli
  • Hosts: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP
  • Guest: Tuhina Neogi MD, PhD

Partners

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

  1. What makes you proud to practice internal medicine or one of the I.M. subspecialties? 
  2. What recent patient experience made you proud to be an internist or subspecialist?
  3. How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

Oct 14, 2019
In-Flight Emergencies REBOOT
2428

Dominate the most common in-flight emergencies with tools and tips from this classic Curbsiders episode. Our guest, Angelica Zen MD, (formerly an IM Chief Resident at UCLA), recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane. Original air date November 21, 2016.

Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written, produced and edited by: Matthew Watto MD, FACP
  • Cover Art by: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Matthew Watto MD, FACP
  • Guest: Angelica Zen MD

Partners

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

  • Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!
  1. What makes you proud to practice internal medicine or one of the I.M. subspecialties? 
  2. What recent patient experience made you proud to be an internist or subspecialist?
  3. How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

  • We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Time Stamps

  • 0
Oct 07, 2019
#176 Survive Intern Year: Becoming a PGY1
3557

Tools, tips and tactics to survive intern year from Alex Glaser MD (PENN) and Saumil Chudgar MD @saumilchudgar (Duke). It’s our latest offering from ACP’s IMpower series for residents

The transition from medical student to intern is one of the world’s most notorious times in a career, and tales of woe from intern year have even permeated into TV shows and movies.  Ultimately, while the transition seems daunting with multiple challenges, it should not be feared. Many physicians look back fondly on this early time in their training, and life-long friendships often develop among an intern class.  This is a time of major growth, and unease about intern year should be met with excitement for the career that is yet to come!

For meeting notes, a discussion guide and facilitators guide visit https://www.acponline.org/impower. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

 

Credits

  • Written and Produced by: Alex Glaser MD 
  • Cover Art: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Emi Okamoto MD; Matthew Watto MD, FACP
  • Guests: Alex Glaser MD, Saumil Chudgar MD

 

Sponsor - ACP IMpower: Catalyzing your professional future

Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.

Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

Time Stamps

  • 00:00 Pun, disclaimer
  • 00:58 Sponsor: ACP’s IMpower ser
Oct 02, 2019
#175 Cervical Cancer Screening and HPV
3684

We dive deep into the relationship between HPV and cervical cancer and identify when and how to screen women with tips from Dr. Karen Smith-McCune (UCSF), Professor in the Department of Obstetrics and Gynecology! We review common cytology findings, screening guidelines, and basic indications for HPV vaccination. 

Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Producer: Molly Heublein MD
  • Writer: Elena Gibson MD and Molly Heublein MD
  • Infographic: Beth Garbitelli MS2
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Molly Heublein MD; Matthew Watto MD, FACP
  • Editor: Emi Okamoto MD; Matthew Watto MD, FACP
  • Guest: Karen K. Smith-McCune MD, PhD

 

Sponsors

Win a prize! Help ACP Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

  • What makes you proud to practice internal medicine or one of the I.M. subspecialties? 
  • What recent patient experience made you proud to be an internist or subspecialist?
  • How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Time Stamps

  • 00:00
Sep 30, 2019
#174 Dominate Perioperative Medication Management
5488

Dominate perioperative medication management with tips from Kashlak’s newly minted Chief of Perioperative Medicine, @aoglasser, Avital O’Glasser MD, FACP, FHM (OHSU). We cover perioperative anticoagulation, why “bridging is dead”, aspirin, dual antiplatelet therapy, DMARDS, diabetic medications, buprenorphine, and much more! Be sure to check out Dr. O’Glasser’s previous episode #135 Perioperative Medicine: Assess and Optimize Risk to get a full overview of perioperative medicine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced by: Avital O’Glasser MD, FACP, FHM and Matthew Watto MD, FACP 
  • CME Questions: Matthew Watto MD, FACP
  • Infographic: Matthew Watto MD, FACP
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP 
  • Editor: Matthew Watto MD, FACP
  • Guest: Avital O’Glasser MD, FACP, FHM

Time Stamps

#173 Hotcakes: Imposter syndrome, Vacations, Pneumonia vaccine, More!
3641

Dr Kimberly Manning joins to discuss imposter syndrome, how vacations affect health, and an update on the pneumonia vaccine, PCV13. Plus, hot takes on the dangers of vaping, and using procalcitonin and CRP to determine need for antibiotics. 

Howdy, gentle listeners! It’s that special time of year when the school doors reopen, classrooms are awash in ‘new pencil’ smell, and FOAMed fans grab their trays and head to the cafeteria for some tasty knowledge food. Rest assured your Curbsiders friends have saved you a seat at the lunch table for this very special September 2019 episode! 

Today we are joined by Dr. Kimberly Manning MD, FACP, FAAP, who is an Associate Professor of Medicine at Emory University School of Medicine. Dr. Manning authors a blog (“Reflections of a Grady Doctor”) that was named in 2010 by ‘O’ The Oprah Magazine as one of “four top medical blogs you should read.” She can also be found on Twitter, @gradydoctor. Thanks for listening!

Full show notes at https://thecurbsiders.com/episode-list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits 
  • Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD, FACP, FAAP
  • Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH, Paul Williams MD, FACP; and Christopher Chiu MD, FACP, FAAP
  • Editor: Christopher Chiu MD, FACP, FAAP; Emi Okamoto MD
  • Cover-Art: Christopher Chiu MD, FACP, FAAP
  • Guest: Kimberly Manning MD, FACP, FAAP
Time stamps
Sep 16, 2019
#172 Cost-of-Care Conversations
3274

 

Recognize the importance of cost-of-care conversations and identify resources to facilitate these discussions with help from Gwen Darien, executive vice president at the National Patient Advocate Foundation, and Dr. Jessica Dine, Associate Professor and Chief of the division of Pulmonology and Critical Care at Perelman School of Medicine.  We review barriers to cost-of-care conversations and identify tools to help make these conversations a part of routine care discussions. 

Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced by: Elena Gibson, MD
  • Infographic and Cover Art: Elena Gibson, MD
  • Hosts: Elena Gibson MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  
  • Editor: Matthew Watto MD, FACP; Emi Okamoto MD 
  • Guest: Gwen Darien and Jessica Dine MD

Partners and Grant Support

The American College of Physicians. Check out this supplement to the Annals of Internal Medicine from May 2019 on Fostering Productive Health Care Cost Conversations https://annals.org/aim/issue/937992

The Robert Wood Johnson Foundation https://www.rwjf.org provided grant support for this episode.

Time Stamps

#171 Lupus in Primary Care with Beth Jonas MD
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Diagnose and treat lupus in primary care with tips from rheumatologist, Beth Jonas MD, FACR (UNC). We discuss the history and exam findings in lupus, initial lab workup, the dreaded ANA, who needs expanded lab testing, lifestyle factors in lupus, vaccinations, the basics of treatment...and Jethro Tull?! 

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced: Kate Grant MBChB DipGUMed; Matthew Watto MD, FACP
  • Infographic: Matthew Watto MD, FACP
  • Cover Art: Kate Grant MBChB DipGUMed
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP
  • Guest: Beth Jonas MD, FACR

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 03:03 Guest one-liner; Book recommendation*: How Doctors Think (book) by Jerome Groupman; Career advice
  • 10:50 A case of hematuria and rash, Ms Luna Wolferton
  • 12:00 Differential diagnosis for a patient with symptoms suggestive of lupus
  • 13:50 Clues for lupus on history and exam
  • 15:42 Classification criteria versus making a clinical diagnosis of lupus (Dorner 2019)
  • 18:17 ANA, what is it good for?
  • 21:33 Basic lab workup (CBC, urinalysis and TSH)
  • 25:10 Labs to send once lupus is suspected
  • 28:15 Does Ms Wolferton have lupus? 
Sep 09, 2019
#170 Hypernatremia is Easy with Joel Topf MD
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Solve hypernatremia with tips and tactics from Dr. Joel Topf, MD (@kidney_boy), our Kashlak Chief of Nephrology. We review the diagnostic workup for hypernatremia, polydipsia and polyuria, review the pathophysiology of diabetes insipidus, and how to differentiate between nephrogenic and central DI. Plus, we walk through how to treat hypernatremia in the acute setting and Dr. Topf shares clinical pearls on why hypernatremia is the opposite of hyponatremia… It’s easy!

Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written by Hannah R. Abrams and Joel Topf MD
  • Producer: Hannah R. Abrams
  • Cover Art and infographic by: Hannah R. Abrams
  • Hosts: Hannah R. Abrams; Stuart Brigham MD; Matthew Watto MD, FACP
  • Editors: Matthew Watto MD, FACP; Emi Okamoto MD 
  • Guest: Joel Topf MD

Check out Dr. Topf’s podcast!

The NephJC podcast, Freely Filtered, discusses the latest NephJC topic every two weeks. Subscribe here or on iTunes

Time Stamps

#169 PGY3 and Beyond with Alia Chisty MD
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Search and secure your first job after residency. Dr. Alia Chisty (Penn State) returns to school us on surviving the PGY3 and beyond, part of ACP’s IMpower series. Topics: finding mentors, how to plan ahead as an intern and PGY2, master the interview day, avoid common pitfalls and confidently enter your early career. We’re joined by Curbsider and recent graduate Justin Berk MD, MPH, MBA who shares his experiences from the job trail.

Flip the classroom!

For meeting notes, a discussion guide and facilitators guide visit visit IMpower: Catalyzing your professional future

Credits

  • Written and Produced by: Paul Williams MD, FACP and Alia Chisty MD, MS 
  • Cover Art: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP
  • Guests: Alia Chisty MD, MS; Justin Berk MD, MPH, MBA

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Sponsor

Join The American College of Physicians today! Resident members get exclusive access to IMpower: Catalyzing your professional future. 

Time Stamps

#168 Diabetes Update with Jeff Colburn MD
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Step up your diabetes game! We answer your questions from #MedTwitter with help from returning guest, Jeff Colburn MD, FACP, FACE (USU) Topics include: the pitfalls of A1C testing, the A1C target controversy, lifestyle interventions, continuous glucose monitoring, pathophysiology of T2DM, use of SGLT2 inhibitors, GLP1 agonists, and how to initiate and titrate insulin therapy. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Writer (including CME Questions) and Producer: Matthew Watto MD, FACP
  • Cover Art and Infographic: Bryan Brown MD
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP; Emi Okamoto MD
  • Guest: Jeff Colburn MD, FACP, FACE

Time Stamps

Aug 26, 2019
#167 LIVE! Common CBC Abnormalities with Mary Kwok MD
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Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia. 

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written, Produced and Edited by: Matthew Watto MD, FACP
  • Cover Art and Infographic by: Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Guest: Mary Kwok MD

 

Sign Up for a course w/our Chief of POCUS, Dr. Renee Dversdal!

ACPacponline.org/pocus

AIUM - Check out https://aium.org for upcoming events. 

TRUST (Train the Ultrasound Trainers) https://www.ultrasoundtraining.com.au/courses/category/train-the-ultrasound-trainer-trust

Time Stamps

#166 Advocacy and Hot Topics in Healthcare Policy with Robert McLean MD, FACP
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Join us for this roundtable discussion of advocacy in healthcare and a rundown of hot topics: coding and billing, the Affordable Care Act, universal healthcare, gender equity, women’s health, gun violence and more! Returning guest, Dr. Robert McLean (@rmmclean84), current president of the American College of Physicians, helps us answer questions like, What is advocacy in healthcare? What are the issues that are impacting your profession? What can your medical home do for you? He’s been heavily involved in advocacy throughout his career including testifying before Congress. Guest hosts Drs. Fatima Syed MD, MSc and Deep Shah MD, MSc join! 

Full show notes available at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced by: Fatima Syed, MD, MSc; Matthew Watto MD, FACP
  • Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Fatima Syed, MD, MSc; Deep Shah, MD, MSc
  • Editor: Matthew Watto MD, FACP
  • Guest: Robert McLean MD, FACP

 

Time Stamps

  • 00:00 Intro, disclaimer, and guest bios
  • 03:22 How can new docs in practice get involved in advocacy and shaping healthcare policy
  • 11:30 Medicare’s proposed changes to billing and documentation
  • 13:40 Who’s involved in changing Medicare policies?
  • 16:09 What’s the purpose of policy papers? How are they written?
  • 19:12 Getting involved in local and national councils as a student or resident
  • 25:22 The Affordable Care Act and Universal coverage
  • 29:25 What’s the risk of non-ACA approved insurance plans?
  • 31:40 Why do people oppose the ACA?
  • 34:40 Universal healthcare defined
  • 40:23 The gender pay gap; Shout out to ACP’s CEO Darilyn Moyer MD, FACP
  • 45:10 Women’s health policy paper
  • 47:40 Gun violence and how advocacy issues take off
  • Aug 14, 2019
#165 Things We Do For No Reason™ Part 2
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Discover more common practices that persist in the hospital wards despite no proven benefit! We review how hospitals prescribe a “crapload” of docusate which only clogs up the medication list, how unnecessary echocardiograms are ordered enough times to make your head spin, and how basal insulin needs to slide back into your inpatient diabetes management instead of correctional insulin monotherapy. Join high-value care specialist Dr. Lenny Feldman (@DocLennyF, Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 2 of “Things We Do For No Reason™.” 

SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced by: Justin Berk, MD MPH MBA, Matthew Watto MD
  • Infographic: Justin Berk MD MPH MBA
  • Cover Art: Matthew Watto MD
  • Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD  
  • Editor: Matthew Watto MD, Emi Okamoto MD
  • Guest: Lenny Feldman MD, Tony Breu MD

 

Sponsor

The Society of Hospital Medicine / Journal of Hospital Medicine - Things We Do For No Reason™series. Check out all the Things We Do For No ReasonTM articles here: Master Index of TWDFNR articles .

Time Stamps

Aug 12, 2019
Reboot #108 POCUS: Point-of-care Ultrasound for the Internist
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Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at www.acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written by: Christopher Chiu MD, FACP and Renee Dversdal MD, FACP 
  • Produced and CME questions by: Christopher Chiu MD, FACP
  • Edited by: Matthew Watto MD, FACP 
  • Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Christopher Chiu MD, FACP 
  • Guest Expert: Renee Dversdal MD, FACP 

Special thanks to our POCUS friends!

ACP

We can speak first hand that the following courses are amazing POCUS learning experiences! Sign up today

Point-of-Care Ultrasound: Foundational Skills for Internists

  • November 7-8, 2019 and November 9-10, 2019 (same 2-day course repeated back to back)
  • Crowne Plaza O’Hare Hotel and Conference Center, Rosemont, IL
  • Registration is now open at acponline.org/pocus

Point-of-Care Ultrasound: Foundational Skills for Internists

  • April 21-22, 2020 (during Internal Medicine Meeting 2020)
  • Los Angeles Convention Center
  • Registration will open at the end of September 

Point-of-Care Ultrasound: Advanced Skills for Outpatient Practice

  • April 22, 2020 (during Internal
Aug 07, 2019
#164 Stroke and TIA Deconstructed
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Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences.  Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Producers: Molly Heublein MD; Matthew Watto MD, FACP
  • Writer (including CME questions): Molly Heublein MD
  • Cover Art: Bryan Brown MD
  • Hosts: Stuart Bringham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Emi Okamoto, MD; Matthew Watto MD, FACP
  • Guest: Chris Favilla, MD

Time Stamps

  • 00:00 Intro, disclaimer, guest bio, and a bad pun
  • 04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch, 
  • 07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter
  • 08:40 A case of TIA; definition of TIA
  • 12:14 Stroke territories
  • 14:24 New definition of TIA
  • 16:00 Differentiation from complex migraine
  • 19:17 Risk stratifying TIA and ABCD2 score
  • 22:00 A bit on tPA
  • 24:01 Workup for TIA; workup for amaurosis fugax
Aug 05, 2019
#163 Hotcakes: Burnout, iron for heart failure, aspirin & VTE prevention
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Summary

The sun is shining, the cakes are hot, and the takes are even hotter. Welcome to our July 2019 Hotcakes episode! Join us as our beloved hosts Chris, Matt, Stuart and Paul share some of the latest practice-changing knowledge, news and research in medical science. Today’s discussion covers studies on the use of IV iron supplementation for heart failure, aspirin as VTE prophylaxis after arthroplasty, and the relationship between physician burnout and ability to address patients’ social determinants of health. Honorable mentions include a throwback to the life-changing magic of Pokémon GO.   

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits 
  • Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
  • Editor: Christopher Chiu MD, Emi Okamoto MD
  • Cover-Art: Matthew Watto MD
Time stamps
  • 00:20 Disclaimer, intro
  • 02:30 Clinic capacity, provider burnout, and social determinants of health
  • 15:00 Iron deficiency and heart failure meta-analysis (Zhou et al., 2019)
  • 17:15 Iron deficiency and stable heart failure RCT (Ponikowski et al., 2015)
  • 19:00 Iron deficiency and decompensated heart failure RCT (Yeo et al., 2018)
  • 26:00 Aspirin as VTE prophylaxis after arthroplasty
  • 38:00 Honorable mention (Pokémon Go!)
  • 39:00 Wrap-up and outro
Jul 29, 2019
#162 Gender & Sexual Harassment in Medicine, #MeToo
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Dr. Reshma Jagsi (TIME’S UP Healthcare; UMichigan) schools us on sexual harassment and describes the systemic and cultural changes that need to happen to effect real change. She unpacks the definition of sexual harassment, describes the state of the #MeToo and TIME’s UP movements across the science and medicine fields and highlights how we all can recognize/respond to harassment.

This is the third episode of our Women in Medicine series. Last August, you heard us talk to Dr. Vinny Arora about the paucity of women in leadership positions, finding sponsors for career advancement, and being bold about career decisions. In December, we spoke to Dr. Susan Hingle about work-life integration. Her advice? Stop worrying about what other people think, acknowledge that being a doctor is hard, especially for women due to disproportionate out-of-work responsibilities, and define a beautiful life that is individualized to you. 

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits  

  • Written and produced by: Leah Witt MD, Shreya Trivedi MD, Nora Taranto MD, Sarah P. Roberts MPH.
  • Editor: Matthew Watto MD
  • Hosts: Shreya Trivedi MD, Chris Chiu MD, Leah Witt MD
  • Guest: Reshma Jagsi MD, DPhil
  • Special thanks to: Hannah Abrams MS4, Beth Garbitelli MS2, and Molly Heublein MD 

Time Stamps 

  • 00:00 Intro, disclaimer and guest bio
  • 03:10 Guest one-liner, WIM moment of awakening, Dr. Jagsi’s advice to her younger self
  • 10:40 TIME’S UP Healthcare, how to get involved
  • 13:10 Picks of the week: This American Life (podcast); The Bon Appétit (YouTube), The Nocturnists (podcast); Twitter
  • 17:05 Defining sexual harassment
  • 21:05 A case of sexual harassment; P
Jul 22, 2019
#161 A Rash Approach to Rashes with Helena Pasieka MD
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Tackle rashes with wisdom from Kashlak’s resident Skinternist (or Internist-Externist) Dr. Helena Pasieka (MedStar, Georgetown), board certified in both Internal Medicine and Dermatology.  She offers “a rash approach to rashes” including: initial triage, ‘inside job’ vs ‘outside job’, differential diagnosis, a review of common culprits, basic management techniques, and how to determine if the reaction is life-threatening. Plus, Dr Pasieka teaches us how to handle family and friends asking, “Can you take a look at this rash?”. 

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced: Beth Garbitelli MS2
  • Infographic and Cover Art: Beth Garbitelli MS2
  • Hosts: Stuart Bringham MD, Matthew Watto MD, Paul Williams MD  
  • Editor: Matthew Watto MD
  • Guest: Helena Pasieka MD 

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 04:10 Guest one-liner, book recommendations 
  • 09:56 Case of a rash; initial thought process (sick versus not sick); review of systems
  • 18:05 Grouping rashes: inside job versus outside job
  • 22:07 Terminology: Many people dont speak derm
  • 26:03 Skin itching versus Skin pain; Morbilliform drug eruption
  • 30:08 Urticaria (hives) vs morbilliform rash; Cotton tipped applicators and dermatographism
  • 35:42 Itching is not all about histamine; Treatment of hives
  • 38:26 Treatment of morbilliform rash
  • 40:00 Case summary and review of concepts learned thus far
  • 41:00 AGEP
  • 45:14 SJS/TEN; Nikolsky’s sign
  • 53:20 Complications of TEN - Ocular surface disease; Vulvar disease
  • Jul 15, 2019
#160 Hotcakes: E-cigarettes, UTIs, Heart Failure
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Confession: we have been holding out on you. Specifically, we’ve been sitting on a special episode of Hotcakes and Hot Takes that we recorded this March, with featured guest Armand Gottlieb, MD of the online publication The Scope. But here it is! We hope you’ll enjoy our discussion of topics like the ever-controversial e-cigarettes for smoking cessation question, outcomes related to antibiotic treatment of UTIs among elderly adults, and the role of sacubitril-valsartan for acute decompensated heart failure in inpatient settings (the PIONEER-HF study).  Special guest is Dr. Armand Gottlieb @ArmandGottlieb, who was a third year internal medicine resident at Columbia University Medical Center in New York City at the time of recording. He is a co-Editor of the The Scope, a free and brief weekly roundup of the most recent and relevant medical literature.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits 

  • Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
  • Guest Presenter and Content Planning: Armand Gottlieb, MD
  • Editor: Christopher Chiu MD
  • Cover-Art: Christopher Chiu MD

 

Pick of the Week

The SCOPE. The week’s best in evidence-based medicine, written in plain language and delivered to your inbox. Sign-up for weekly emails or download the app

Time stamps

  • 01:00 Disclaimer, intro, guest bio
  • 06:30 E-cigarettes vs. nicotine replacement therapy (NRT)
  • 15:50 Antibiotic treatment of urinary tract infections (UTIs)
  • 27:45 Sacubitril-valsartan for acute decompensated heart failure (PIONEER-HF study)
  • 42:30 Wrap-up and outro
Jul 10, 2019
#159 Atrial Fibrillation Review and Update with James Furgerson MD
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Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD  is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up - This episode is going to send your heart racing! You might even skip a beat! Full notes at https://thecurbsiders.com.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Writer and Producer: Cyrus Askin MD
  • Infographic: Cyrus Askin MD
  • Cover Art: Cyrus Askin MD
  • Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD
  • Editors: Matthew Watto MD
  • Guest: James Furgerson MD

 

Time Stamps

  • 00:00 Intro, disclaimer and guest bio
  • 03:45 Guest one liner, a bit on physician well-being and some other randomness
  • 08:15 A case of palpitations; risk factors for atrial fibrillation
  • 12:17 Subclinical atrial fibrillation, overdiagnosis of afib; How much afib burden matters? 
  • 15:08 Case summary and next steps in initial work up
  • 18:48 Counseling patient about afib and its consequences
  • 21:40 Ischemic heart disease and atrial fibrillation
  • 24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation
  • 25:25 Rate versus rhythm control; AFFIRM trial
  • 30:50 Strict versus lenient rate control;  RACE trial
  • 33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy
Jul 08, 2019
#158 Medicine and Incarceration
3539

Expand your knowledge about how--and how well--we manage the health of incarcerated patients in the United States, with the expert knowledge of correctional health experts Drs. Aaron Fox @adfoxmd, Jon Giftos @JonGiftosMD, and Emily Wang @ewang422. Correctional medicine is a black box for many providers who do not work in prison and jail settings. But it’s ever more relevant to primary care physicians everywhere, with increasing rates of incarceration the last decade.  In this episode, recorded live at SGIM 2019 #SGIM19, Dr. Fox, Dr. Giftos, and Dr. Wang talk us through the variability of the correctional healthcare systems throughout the country, the challenges to health for patients both while incarcerated and in the transition after release, and some essential nuts and bolts for providers about how to provide better care to this vulnerable population.  

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Justin Berk MD MPH MBA, Nora Taranto MD
  • Cover Image: Beth Garbitelli MS2
  • Infographic: Beth Garbitelli MS2
  • Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MPH MBA
  • Edited by: Matthew Watto MD
  • Guests: Aaron Fox MD, Jon Giftos MD, Emily Wang MD MAS

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Time Stamps

  • 00:00 Intro, disclaimer and guest bios
  • 05:10 One liners, book recommendations, career advice
  • 13:00 Why does incarceration matter for healthcare?; Defining terms: jail, prison, probation
  • 18:47 What is healthcare like during incarceration? What services are available? Who provides the care? How does it breed “passive patients”?
  • Jul 01, 2019
#157 Teaching in the Hospital: The 4Ds of Rounding
5504

Bring back Bedside Rounds with tips from a master clinician educator, Jeff Wiese MD MACP (Tulane). How to accomplish teaching in the hospital is not on the curriculum for most folks in medical school or residency. This can feel especially daunting as you move from resident to attending. We address strategies to assess, monitor, teach, and coach the medical learners under your leadership with teaching wizard and coach extraordinaire, Dr. Jeff Wiese, recipient of over 50 teaching awards! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the release date).

Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and Produced by:  Matthew Watto MD FACP and Beth Garbitelli MS1 (almost MS2!)
  • CME questions by: Matthew Watto MD FACP
  • Hosts: Stuart Brigham MD, Paul Williams MD FACP, Matthew Watto MD FACP
  • Images and infographics: Beth Garbitelli MS1
  • Edited by: Matthew Watto MD FACP, Emi Okamoto MD
  • Guest: Jeff Wiese MD MACP

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 03:28 Guest one-liner, love of Aaron Sorkin, book recommendations
  • 10:52 Setting goals and expectations on day one
  • 23:52 Preparing the resident for autonomy and assessing their place on the scale of supervision to autonomy
  • 28:18 How to prepare for rounds as an attending to set yourself up for efficiency and success; The cardinal rule for being an attending
  • 33:50 How long does it take determine a resident’s readiness for autonomy; Give your colleagues an “educational signout”
  • 38:31 How to handle a request for card flipping; Prodiving a rationale for bedside rounds
  • 43:54 The three Ds of Rounding; Should there be a fourth D
  • 4
Jun 26, 2019
#156 Chronic Pain, Opioids, Tapers
3930

Rethink how you’re diagnosing and managing chronic pain with high-yield tips from pain experts and primary care doctors Soraya Azari MD @azarimugs (UCSF), and Phoebe Cushman MD, MS (UMass Memorial). Because let’s face it, managing chronic pain can be very difficult. Expand your toolbox for management-- including the importance of activity, empowering your patient, risk stratification for patients prior to opioid initiation, how to identify opioid use disorder, and how to taper opioids. Plus, updates on recent practice changing articles in chronic pain.

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Nora Taranto MD
  • Hosts: Nora Taranto MD, Paul Williams MD, Matthew Watto MD
  • Edited by: Emi Okamoto MD, Matthew Watto MD
  • Guests: Soraya Azari MD; Phoebe Cushman MD, MS

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Time Stamps

  • 00:00 Intro, disclaimer, guest bios
  • 04:50 Guest one-liners, book recommendations, picks of the week, career advice
  • 14:50 A case of chronic pain; Group pain into 1 of 3 buckets
  • 18:48 Use of pain scales; and taking a pain history; affirming positive behaviors surrounding pain
  • 23:13 Nonpharmacologic measures for chronic pain
  • 26:30 Cognitive behavior therapy (CBT) for chronic pain; remote CBT vs traditional CBT
  • 30:32 Apps for Meditation, Affirmations
  • 31:53 Back to the case: Should we trial opioids for our patient’s chronic pain? Our guests give their recommendations and how they counsel patients about opioids
  • 34:55 Counseling about risk of opioids
  • 37:42 Jun 24, 2019
#155 LGBT Health in Primary Care
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Build your knowledge base to improve primary care for LGBT patients! This episode is chock full of clinical pearls and updates for LGBT health from SGIM presenters, Dr. Jenny Siegel (Boston University) and Dr. Megan McNamara (Louis Stokes Cleveland VAMC). They define common gender identity terms and provide tips on how to take a sexual history. You’ll develop an approach to the unique clinical concerns of LGBT patients and learn how to phrase medical information in a gender neutral framework. This is a must listen episode for all health care providers!

Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

 

Written and Produced by: Carolyn Chan MD

Graphics: Hannah Abrams

Hosts: Carolyn Chan MD, Paul Williams MD, Matthew Watto MD

Guest: Megan McNamara MD, Jenny Siegel MD

 

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Time Stamps

  • 00:00 Intro, disclaimer, guest bios
  • 02:45 Guest one-liners, movie recommendations; favorite failures; Paul’s pick of the week
  • 10:52 Defining terms of gender identity
  • 14:20 What to do when you misgender someone or use the wrong term
  • 17:10 Is it a mistake to think of the entire LGBT group as the same?
  • 19:19 How to take a sexual history, the 5Ps
  • 22:00 Unique clinical concerns of LGBT patients; what screening should be performed
  • 24:20 Avoid focusing too much on sexuality and gender identity. Don’t forget to address their medical concerns
  • 24:42 Screening for mental health disorders and asking about suicide
  • 27:16 Cancer screening in transgender patients; a bit on
Jun 17, 2019
#154 DVT and PE Master Class with Michael Streiff MD
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What do Judas Priest, surfing, and clots have in common? They are the passionate interests of expert Dr. Michael Streiff who guides us through the diagnosis and management of DVT and PE aka venous thromboembolism (VTE). By the end of the episode you will know how to catch a clot very Wells! We dive deep into the treatment options, literature, and some unique cases. ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by (including CME questions): Justin Berk MD, MPH, MBA
  • Cover art by: Kate Grant MBChB DipGUMed
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
  • Edited by: Matthew Watto, MD, FACP
  • Guest:  Michael Streiff MD

Time Stamps

  • 00:00 Intro, disclaimer and guest bio
  • 04:40 Guest one-liner, book and music recommendations, advice about rejection, how to think about studies
  • 11:15 A case of DVT and some basic terminology
  • 15:37 Which DVT risk factors are most important?
  • 18:40 Use of the Wells score and D-dimer testing; should we use an age adjusted D-dimer; What about the YEARS criteria
  • 22:55 Classifying DVT; determining need and duration of anticoagulation [distal (calf vein) DVT, proximal DVT]; brief discussion of IVC filters & catheter directed therapies
  • 27:56 IVC filters for trauma
  • 29:30 Upper extremity DVT
  • 33:12 Proximal vs whole leg ultrasound for diagnosis of DVT
  • 36:25 A case of pulmonary embolism; how to diagnose pulmonary embolism and a bit on V/Q scans
  • 40:35 PESI score and HESTIA criteria<
Jun 10, 2019
#153 Heart Disease in Women with Dr Bairey Merz
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Expand your idea of ischemic heart disease to include non-obstructive patterns, which as our guest, Dr Noel Bairey Merz, a clinical investigative cardiologist whose multiple roles include Director of the Barbra Streisand Women’s Heart Center and the Preventive Cardiac Center at the Smidt Cedars-Sinai Heart Institute, shares with us, is incredibly common, especially in women.  Learn to recognize these women and treat according to guidelines, preventing unnecessary IHD mortality in our female (and some male) patients. We review a variety of non-obstructive pathologies and the best techniques to evaluate them.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Shreya Trivedi MD, Molly Heublein MD
  • Hosts: Paul Williams MD, FACP; Shreya Trivedi MD; Molly Heublein MD
  • Edited by: Matthew Watto MD, FACP; Emi Okamoto MD
  • Graphics by: Hannah Abrams
  • Guest: Dr. C Noel Bairey Merz MD, FACC, FAHA

Curbsiders' Schwag!

We’ve got the perfect father’s day gift for every internal medicine nerd. The Curbsiders have opened our own online shop. Get your Curbsiders t-shirts, hoodies, stickers, and coffee mugs. Help support the show and gain instant bragging rights. Note: All purchases come with admitting privileges at Kashlak Memorial Hospital!

Time Stamps

  • 00:00 Intro, disclaimer and guest bio
  • 04:36 Guest one-liner; Advice for success in research and clinical practice
  • 07:07 A case of shortness of breath and chest tightness; Why the paradigm of obstructive coronary artery disease is flawed.
  • 12:04 Why is there a sex difference in ischemic heart disease?
  • 14:52 How to recognize ischemic heart disease in women; Are certain symptoms more likely in women; Categorizing angina
  • 20:13 Who needs stress testing?; Screening for ischemic heart disease in women
  • 24:52 How guidelines make good doctors great doctors
  • 27:00 Diagnosis of NSTEMI in a
Jun 03, 2019
#152 Dare to Lead: Becoming a PGY2
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Dare to lead. Master the transition to PGY2 with tips from expert educator Abby Spencer MD, MS, FACP, IM Residency Program Director and Vice Chair for Education for the Medicine Institute at Cleveland Clinic and Shreya Trivedi MD, GIM Fellow at NYU School of Medicine. Topics include: how to run work rounds, preparing your team for attendings rounds, how to teach on the fly, finding your leadership style, and what to read during residency. This is the first of three episodes that we’re co-developing with the American College of Physicians for their Resident Transitions Series.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Shreya Trivedi MD
  • Graphics and Show Notes by: Hannah R Abrams
  • Hosts: Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP; Shreya Trivedi MD
  • Guest: Abby Spencer MD, MS, FACP

Sponsor

The Resident Transitions Series is brought to you by The American College of Physicians with support from its Council of Resident/Fellow Members. Visit acponline.org/resident to learn more about the benefits of Resident/Fellow Membership and join our proud internal medicine community today!

Time Stamps

  • 00:00 ACP’s Resident Transitions Series - Sponsor
  • 01:50 Disclaimer, intro and guest bio
  • 06:05 Guest one liner, book recommendations, favorite failure, advice for learners
  • 14:10 Stuart’s tale of struggle from residency
  • 18:05 New PGY2 resident thinks she has nothing to teach her learners
  • 20:20 How to run work rounds and set expectations
  • 31:55 How, when and where to teach as a resident
  • 46:09 Leadership skills, understanding your learners, and giving difficult feedback
  • 60:08 What to read during residency, how to find time, and some strategies to achieve your learning goals
  • 71:30 Take home points
  • 75:28
May 29, 2019
#151 Anaphylaxis with Dr Olajumoke Fadugba MD
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Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic...even when you inject your own thumb?! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes available at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Writer (interview, show notes & CME questions) and cover art: Emi Okamoto MD
  • Infographic by: Emi Okamoto MD
  • Hosts: Matthew Watto MD, FACP; Stuart Brigham MD
  • Editors: Matthew Watto MD, FACP
  • Guest: Olajumoke Fadugba MD
  • Special thanks to Sarah Phoebe Roberts MPH for booking!

Time Stamps

  • 00:00 Intro and disclaimer
  • 03:00 Guest one-liner, book recommendation, advice to fellows and trainees
  • 07:15 Case of anaphylaxis with mucocutaneous and GI symptoms
  • 09:05 Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin)
  • 12:34 Vancomycin and non-IgE mediated reactions
  • 14:40 Common presentations of anaphylaxis and the three diagnostic criteria
  • 22:09 Biphasic reactions and predicting severity
  • 26:42 Counseling patients on the use of epinephrine
  • 28:35 Stuart’s thumb question
  • 30:00 Adjuvant medications: antihistamines and corticosteroid
May 27, 2019
#150 HFpEF with Dr Clyde Yancy MD
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HFpEF (heart failure with preserved ejection fraction) with master cardiologist, Dr Clyde Yancy MD, Chief of Cardiology and Professor of Medicine (Cardiology) and Medical Social Sciences, Northwestern, Feinberg School of Medicine. Topics include: pathophysiology, HFpEF phenotypes, how to interpret a borderline ejection fraction, evidence based therapies, diuretics, and future directions (pulmonary artery monitors, intra-atrial shunts, ARNI compounds), and more!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Paul Williams MD, FACP; Sarah Phoebe Roberts MPH
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
  • Show Notes: Justin Berk MD, MPH, MBA; and Beth Garbitelli MS1
  • Infographics: Beth Garbitelli MS1
  • Editor: Matthew Watto MD, FACP
  • Guest: Clyde Yancy MD, MSc, MACC, FAHA, MACP, FHFSA

Time Stamps

  • 00:00 Thanks to our producers Sarah Phoebe Roberts, Beth Garbitelli and Justin Berk
  • 00:50 Intro and guest bio
  • 04:00 Guest one liner, career advice
  • 08:20 Ms Diana Stolic has HFpEF. What’s the difference in HFpEF and diastolic dysfunction?  
  • 11:33 How should we think about borderline ejection fraction?
  • 15:24 Pathophysiology and Phenotypes of HFpEF
  • 18:57 More on the pathophysiology of HFpEF (nitric oxide, fibrosis, inflammatory signaling)
  • 21:00 Are there morbidity and mortality differences for HFpEF versus HFrEF?
  • 24:45 What historical factors are most important in HFpEF?
  • 27:50 Pulmonary artery monitors for HFpEF
  • 29:00 Does Diuretic therapy differ in HFpEF and HFrEF?
  • 33:44 Ischemic workup for new HFpEF
  • 35:33 Right heart cath for HFpEF
May 20, 2019
Recap SGIM19 Day 2
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Recap of random pearls and highlights from SGIM19 Day 2 including: methadone and buprenorphine, perioperative buprenorphine, medical cannabis, HPV vaccination, young adult medicine, academic promotions, long term sequelae of childhood kidney disease, stage 1 hypertension, some great free resources in addiction medicine, and more! Special thanks to the Society for General Internal Medicine for their hospitality.

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Nora Taranto MS4 (soon to be MD!)
  • Edited by: Matthew Watto MD

Time Stamps and Links are included below

  • 00:00 Intro and Disclaimer
  • 02:30 Generalists receive the same number of grants, but publish fewer publications and are less likely to achieve professorship versus medical or surgical subspecialists (JGIM 2017)
  • 05:30 GIM division directors differ in their emphasis on peer-reviewed publications for academic promotion (Acad Med 2015)
  • 07:30 Only about 30% of patients are started on MAT after an overdose despite a known mortality benefit and a known mortality rate of 5% twelve month mortality in this population (Larochelle Annals Int Med 2018)
  • 08:48 A representative in NYC has proposed a bill to get rid of the buprenorphine waiver program.
  • 11:00 Stimulant use is not a contraindication to continuing buprenorphine (expert opinion from SGIM session on Addiction Medicine).
  • 11:45 Perioperative buprenorphine: 1) Consider switching to full agonist therapy or 2) Dose buprenorphine 3-4 times daily and continue use during the perioperative period (Expert opinion from SGIM session titled “Buprenorphine 2
May 17, 2019
Recap SGIM19 Day 1
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Recap of random pearls and highlights from SGIM19 Day 1 including: Kidney stone treatment (roller coasters, sex and tamsulosin), aspirin, SGLT2 inhibitors to reduce kidney events, oral antibiotics for endocarditis, preferred physician attire, sexual harassment, writing letters of recommendation, triple therapy for COPD, DAPT for stroke, and more! Special thanks to the Society for General Internal Medicine for their hospitality.

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Abby Spencer MD, MS, Nora Taranto MS4 (soon to be MD!)
  • Edited by: Matthew Watto MD
  • Special Guest: Abby Spencer MD, MS 

Time Stamps and Links are included below

  • 00:00 Intro and Disclaimer
  • 02:33 Abby explains what it means to attend SGIM
  • 04:35 Tips for writing letters of recommendation
  • 08:54 How to handle lapses of professionalism in a trainee
  • 10:30 How to address sexual harassment
  • 12:42 Oral antibiotics after 10 days of IV antibiotics are noninferior for left sided endocarditis in non-IVDU (NEJM 2019)
  • 14:22 Patients prefer physicians to dress in more formal attire. (BMJ Open 2018)
  • 16:29 Kidney stone passage occurs more frequently when sitting in the back car of a roller coaster (J Am Osteopath Assoc 2018)
  • 18:00 Sexual intercourse three times weekly improves rate of kidney stone passage (Urology 2015)
  • 18:58 Vancomycin coverage for hospital acquired pneumonia can safely be stopped after four days if cultures remain negative for MRSA (May 13, 2019
#149 Hip Pain for Primary Care
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Identify and treat the most common causes of hip pain in the outpatient setting with returning guest, Dr Ted Parks. A large majority of hip pain in the office setting will be due to one of three conditions (hip osteoarthritis, greater trochanteric pain syndrome, and lumbo-sacral back pain). Learn to easily identify these conditions, how to initiate conservative treatment, and more about hip replacements. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Molly Heublein MD, Nora Taranto MS4

CME questions by:  Molly Heublein MD, Nora Taranto MS4

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein MD

Edited by: Matthew Watto MD, Emi Okamoto MD

Guest Presenter: Ted Parks MD

Time Stamps

  • 00:00 CME announcement, disclaimer, intro and guest bio
  • 04:05 Guest one-liner; advice for teachers and learners
  • 08:30 Case of hip pain, review of hip anatomy, and the three buckets of hip pain
  • 15:35 Greater trochanteric pain syndrome
  • 16:20 The zebras of hip pain
  • 18:12 Physical exam for hip pain
  • 21:33 Hip osteoarthritis: imaging and initial therapy
  • 24:18 Hip injections: Do steroids work? What about hyaluronic acid?
  • 29:00 Who needs hip replacement surgery? How long will it last?
  • 32:30 Greater trochanteric pain syndrome
  • 35:58 Lumbar spine versus hip pain from OA
  • 38:58 Hip replacement technology: materials; etiology of component loosening and need for re-operation
  • 42:03 Take home points and outro
May 06, 2019
Telehealth with Ana María López MD
3315

Electric cars, virtual reality, nanotechnology, and now… telemedicine? We chat with Dr. Ana María López MD, FACP about the future of telehealth, how to implement it in your practice, and the challenges you might face in doing so. Dr. López is immediate past president of the American College of Physicians (ACP) as well as Vice Chair of Medical Oncology and Chief of New Jersey Division Sidney Kimmel Cancer Center of Thomas Jefferson University. Her main areas of professional interest and expertise include cancer prevention and equity, integrative oncology, implementation of innovations in health care including telemedicine, and women’s health. We learned immensely from our talk with her and we hope you will, too! ACP members can claim free CME & MOC credit at https://acponline.org/curbsiders. Download Dr Brigham’s telehealth cheat sheet as a PDF at http://thecurbsiders.com/podcast.

Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Hannah Abrams, Stuart Brigham MD

Cohosts: Matt Watto MD, Stuart Brigham MD, Paul Williams MD, Hannah Abrams

Guest: Ana María López MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 04:20 Guest one line, poetry recommendations, favorite failure
  • 12:00 Defining telemedicine
  • 14:12 What kind of services exist in telemedicine? How can the technology make your practice easier?
  • 20:18 Is there good evidence for telehealth and telemedicine?
  • 24:20 Concerns about telehealth and the loss of touch as part of the doctor-patient relationship; haptics and the remote physical exam
  • 30:17 Providing telehealth across state lines
  • 34:35 Consultation codes for telehealth and ECHO (remote consultations)
  • 40:20 Basic steps and best practices to start implementing telehealth
  • 44:30 Stuart’s shares some preliminary data on use of telehealth and workforce satisfaction
  • 49:12 Adding access by using telehealth in primary care
  • 51:40 Take home points
  • 54:42 Stuart shares a pun

 

May 02, 2019
#148 Benign Prostatic Hyperplasia for the Internist
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This week we narrow in on the enlarging prostate and decipher the common issue of benign prostatic hyperplasia with Adam C. Reese MD, Associate Professor of Urology at the Lewis Katz School of Medicine at Temple University and Chief of Urologic Oncology at Temple University Hospital. Learn how to interpret the symptom profile for patients presenting with common urinary issues, what to feel for in the digital rectal exam, how to treat BPH, and when to refer.

ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

See you at SGIM 2019!

Find us in our red Curbsider’s t-shirts handing out Curbsiders and Kashlak stickers/patches at SGIM 2019 in Washington DC! We’ll be recording full length shows and daily recaps!

Credits

Written and produced by: Paul Williams MD

Hosts: Paul Williams MD, Matthew Watto MD

Images and infographics: Elena Gibson, Beth Garbitelli

Show Notes: Elena Gibson, Beth Garbitelli

Edited by: Matthew Watto MD, Chris Chiu MD

Guest: Adam Reese MD

Time Stamps

00:00 SGIM announcement

00:30 Disclaimer, intro and guest bio

03:20 Guest one liner, book recommendation, favorite failure and surgical M&M

10:56 Case of benign prostatic hyperplasia, defining terms and obstructive/voiding versus storage/irritative symptoms

16:11 IPSS score and evaluating symptoms

22:10 Digital rectal exam. Will this give any useful information?

26:55 Taking a history about BPH and some lifestyle modifications

29:20 Lab studies for urinary tract symptoms and interpreting PSA and free PSA

36:20 Initial therapy for BPH and managing patient expectations, alpha blocker side effects

39:25 Choice of agent and monitoring symptoms on therapy

42:25 Nonpharmacologic management of bladder complaints

45:10 Who and when to refer to urology

47:33 Counseling about use of 5 alpha reductase inhibitors, their side effects and is there a risk for high grade cancer?

52:35 Phosphodiesterase inhibitors for BPH symptoms

53:50 Urethral milking. NOT prostate milking

54:55 Desmopressin for nocturia

56:20 Take home points

59:03 Prostate volume and PSA

61:10 Outro

Full show notes available at http://thecurbsiders.com/episode-list. Join our

Apr 29, 2019
Random Pearls #IM2019 Day 3
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Random pearls from ACP #IM2019 Day 3. The Curbsiders crew is joined by Dr Alan Dow of VCU to discuss highlights from ACP’s Internal Medicine Meeting in Philadelphia including: sleep deprivation, the glymphatics system, inflammatory back pain, heart failure, dermatology pearls, a new definition for pulmonary hypertension and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

#IM2019 Curbsiders Crew

  • Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
  • Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
  • Director of operations: Chris Chiu MD
  • Twitter: Cyrus Askin MD, Hannah Abrams MS3
  • Instagram: Beth Garbitelli MS1
  • Facebook: Chris Chiu MD
  • Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4
  • Marketing: Jen Watto
Apr 22, 2019
Random Pearls #IM2019 Day 2
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Random pearls from ACP #IM2019 Day 2. The Curbsiders crew is joined by Dr Alia Chisty (future PD at Penn State Hershey) at ACP’s Internal Medicine Meeting in Philadelphia to discuss highlights including: baloxavir a new drug for flu, stress testing and coronary CT angiography pearls, celiac disease, H. pylori pearls, and a bunch of random pearls from infectious diseases, palliative care and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

#IM2019 Curbsiders Crew

  • Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
  • Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
  • Director of operations: Chris Chiu MD
  • Twitter: Cyrus Askin MD, Hannah Abrams MS3
  • Instagram: Beth Garbitelli MS1
  • Facebook: Chris Chiu MD
  • Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4
  • Marketing: Jen Watto

 

Apr 19, 2019
Random Pearls #IM2019 Day 1
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Random pearls from #IM2019 Day 1. The Curbsiders crew is joined by Kashlak’s POCUS Chief, Renee Dversdal MD at ACP’s Internal Medicine Meeting in Philadelphia to discuss day 1 highlights inlcuding: POCUS, lyme rash, back pain, syphilis, women’s health, patient handoffs, the flip-flop fungal sign a ton of cardiology pearls (ie diuretics, paracentesis for CHF, beta blockers, LBBB, when is it safe to have intercourse after an MI?) and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

#IM2019 Curbsiders Crew

  • Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
  • Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
  • Director of operations: Chris Chiu MD
  • Twitter: Cyrus Askin MD, Hannah Abrams MS3
  • Instagram: Beth Garbitelli MS1
  • Facebook: Chris Chiu MD
  • Off-air producer: Sarah Phoebe Roberts MPH
  • Marketing: Jen Watto
Apr 15, 2019
#147 Rheumatoid Arthritis for the Internist
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Join(t) us in learning about rheumatoid arthritis care for the internist with Robert McLean MD, rheumatologist, Associate Clinical Professor at Yale, and President Elect of the ACP! We discuss the complexity of rheumatoid arthritis, how to differentiate from other arthritic conditions, and how to have a patient-centered framework for the evaluation and treatment of affected patients. ACP members can claim CME-MOC credit at on ACP's site..

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Writer (Interview & CME questions): Cyrus Askin MD

Show Notes and Infographic by: Elena Gibson MS4

Hosts: Matthew Watto MD, Stuart Brigham MD

Editors: Matthew Watto MD, Emi Okamoto MD

Guest: Robert McLean MD

Time Stamps

  • 00:35 Disclaimer, intro and guest bio
  • 03:38 Guest onliner; Nudge (book) on behavioral economics
  • 08:30 Favorite failure; Stuart’s pick of the week
  • 12:24 Key historical features of RA
  • 15:30 Differential diagnosis
  • 19:20 Physical findings in RA
  • 20:58 Initial labs orders for suspected inflammatory arthritis; CRP vs high sensitivity (cardio) CRP assays
  • 27:45 Epidemiology of RA; Is there a utility for scoring systems?; A bit more on inflammatory markers
  • 32:30 Recap and test interpretation
  • 36:22 High yield physical exam in RA
  • 40:56 Initial counseling after RA diagnosis
  • 46:00 Therapeutic trial with NSAIDS or steroids for inflammatory arthritis
  • 50:29 When to reach for the DMARDS
  • 52:40 Are steroids considered DMARDS?
  • 54:50 Primary care considerations for patients starting steroids or DMARDS (TB, vaccinations)
  • Apr 08, 2019
#146 NephMadness: Pain Meds in Chronic Kidney Disease
5045

Pain management in patients with chronic kidney disease (CKD) often goes something like this: NSAIDs are evil, acetaminophen hardly works, opioids are dangerous, and all the rest (tramadol, gabapentinoids, antidepressants) are messy. But, we tackle the complexities of pain management in patients with chronic kidney disease in this special @NephMadness 2019 episode that, on a scale of 1-10, will leave you feeling very relieved in addressing pain.

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Earn CME and read about each region in NephMadness 2019 at AJKD blog.

Credits

  • Written and produced by: Justin Berk MD, Samantha Gelfand MD
  • NephMadness Pun Contest produced by: Hannah R Abrams MS3
  • Cover art by: Kate Grant MBChB, Dip GUMed
  • Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
  • Edited by: Matthew Watto MD, Emi Okamoto MD
  • Guests:  Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD 

Time Stamps

  • 00:00 Kidney Pun
  • 01:19 Disclaimer, intro and guest bios
  • 06:30 Guest one-liners
  • 10:42 Books recommendations, staff picks and a patient complaint
  • 15:25 Clinical Case and Pain Management Disclaimer
  • 16:33 Modalities in pain medicine
  • 18:20 Opioids for pain and their metabolites
  • 20:44 Dave Juurlink reframes the question, “what is our real goal with pain management?”
  • 24:42 Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD
  • 27:44 Communicating meds that are contraindicated or relatively contraindicated in CKD
  • 30:40 Buprenorphine
  • 32:40 What about the WHO Pain Ladder for CKD?; 33:32 Should we use more cannabinoids? Ketamine?
Apr 01, 2019
#145 NephMadness: Hepatorenal Syndrome vs AKI
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Does your sympathetic nervous system get activated when you notice acute kidney injury in patients with cirrhosis? Ever wonder how to really diagnose hepatorenal syndrome (HRS)? Think you have the bile-acid-stones to start diuretics on a patient requiring pressor support for kidney failure? You have come to the right place! Listen to @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) tackle the complex pathophysiology and treatment of hepatorenal syndrome in this NephMadness 2019 special episode!

Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Earn CME and read about each region at AJKD blog.

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Justin Berk MD, Nora Taranto MS4

Infographic by: Alex M @nephroguy

Hosts: Matthew Watto MD

Edited by: Matthew Watto MD, Emi Okamoto MD

Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Time Stamps

  • 00:00 NephMadness Kidney Pun Contest
  • 01:04 Disclaimer
  • 01:38 Sponsor - Become an ACP member today!
  • 02:12 Intro, guest bio
  • 04:38 Guest one-liners, some career advice and Joel’s pick of the week
  • 13:14 Sponsor - Become an ACP member today!
Mar 25, 2019
HCP: Primary Care Workforce with Fatima and Deep
3692

Some precocious policy wonks take a deep dive into the evolving trends and future directions for our primary care workforce. Experts, Dr. Fatima Syed and Dr. Deep Shah return to school us on Physician Supply and Demand, the Access Gap, role of NPs and PAs, Retail Clinics, and Managed Care Clinics. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Catch up on our previous discussions with Dr. Syed and Dr. Shah: Episode #62: Pod Save Health Care: The Curbsiders Foray into health policy and Episode #120 Health Policy, Patients, Payments, Paperwork for more context. We also did an overview of health care policy essentials with Dr. Sue Bornstein in Episode #64: Stuff You Should Know About Health Policy

Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Fatima Syed MD, MSc; Deep Shah MD, MSc

CME questions by: Chris Chiu MD, Beth Garbitelli MS1,

Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD,

Images and infographics: Beth Garbitelli MS1

Edited by: Matthew Watto MD, Chris Chiu MD

Guest: Fatima Syed MD, MSc, Deep Shah MD, MSc

 

Time Stamps

  • 00:00 Disclaimer, intro, guest bios
  • 04:40 Picks of the week
  • 11:40 Defining physician supply and demand
  • 21:30 Why are physicians less productive?
  • 28:23 What does the supply demand mismatch mean for patients?
  • 30:19 Discussion of various care delivery models (retails health clinics, minutes clinics, urgent care centers)
  • 42:15 Physician compensation
  • 53:50 Take home points from Fatima and Deep
  • 59:39 Outro
Mar 20, 2019
#144 NephMadness: Inpatient Hypertension
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Inpatient hypertension is tricky. What’s the best way to answer those overnight nursing phone calls for elevated blood pressures? What’s the role of treating hypertensive urgency in the hospital? Plus, Our nephrology experts put a new issue on the generalist’s radar: are ACE-inhibitors dangerous to give (or hold) during an operation? This NephMadness 2019 episode, features special guests Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) to better understand the role of anti-hypertensives in the inpatient setting and keep your blood pressure down on those overnight calls.

Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders!

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Justin Berk MD, MPH, MBA; Pascale Khairallah MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto, MD

Guest:  Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Time Stamps

  • 00:00 Kidney Pun Contest with Hannah Abrams
  • 01:16 Disclaimer
  • 01:45 Sponsor - Become an ACP Member today!
  • 02:14 Intro and guest bios
  • 03:50 Picks of the weeks
  • 06:00 Sponsor - Become an ACP Member today!
  • 07:20 Case of acute severe hypertension; Does hypertensive urgency exist? Should we treat it?
  • 26:40 Case of perioperative medicine. Should we hold the ace inhi
Mar 18, 2019
#143 NephMadness: Fluid Wars
3117

The battle over the superiority of resuscitation fluids is coming to a boil. Enter the Fluid Wars. Are Lactated Ringers superior to normal saline? Will LR increase a patient’s lactate? What about albumin? The Curbsiders quench the thirst for knowledge by turning to masters Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) for guidance in this special @NephMadness episode that will get your feet wet with the complicated world of fluid resuscitation.

Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders!

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday.

Credits

Written and produced by: Justin Berk MD, Pascale Khairallah MD

NephMadness Pun Contest produced by: Hannah R Abrams MS3

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest:  Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD

Time Stamps

  • 00:00 Nephmadness pun contest
  • 02:18 Disclaimer
  • 02:52 Intro to the show and NephMadness, guest bios
  • 08:04 Guest one-liners,
  • 10:58 Joel explains NephMadness
  • 12:58  Guest book recommendations and career advice
  • 17:30 Clinical case; goals of fluid resuscitation; choice of initial IV fluid
  • Corporate (TV series) Comedy Central
  • 19:41 Complications of normal saline
  • 21:29 Colloids versus crystalloids
  • LR versus normal saline is not an innocuous decision
  • 26:32 Saline versus balance fluids. What’s the makeup?
  • 28:19 Does lactated ringers elevate lactate?
  • 31:03 Is hyperkalemia a contraindication for LR?
Mar 15, 2019
#142 Cirrhosis TIPS: Acute Complications
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Cirrhosis TIPS for the decompensated cirrhotic & acute on chronic liver failure from expert hepatologist and keto-practitioner Scott Matherly MD, @liverprof and chief hepatologist at @KashlakHospital. We walk through acute management of variceal bleeds, when to suspect SBP in decompensated cirrhosis (all the time, it turns out), how much fluid to remove in paracentesis, and some definitions about what decompensated cirrhosis and acute on chronic liver failure really mean.

Take our pretest on cirrhosis!

Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4, Matthew Watto MD

Pretest by: Cyrus Askin MD

Hosts: Matthew Watto MD, Paul Williams MD,

Images and infographics: Hannah Abrams MS3

Edited by: Matthew Watto MD

Guest: Scott Matherly MD

Sponsor 

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Time Stamps

  • 00:00 NephMadness teaser
  • 00:50 Sponsor - Become an ACP Member today!
  • 01:25 Intro, guest bio
  • 03:45 Guest one-liner, keto diet
  • 07:40 Picks of the week from Paul, Matt and Scott
  • 11:50 Sponsor - Become an ACP Member today!
  • 13:26 Clinical case of bleeding and altered mental status in cirrhosis
  • 16:10 Interpretation of our patient’s labs and physical exam
  • 18:53 Defining terminology in cirrhosis (decompensated vs compensated vs acute on chronic liver failure)
  • 24:48 Initial workup, resuscitation and stabilization in variceal bleeding
  • 26:10 Why occult blood and ammonia levels are unhelpful in cirrhosis
  • 29:00 Fluid choice for the cirrhotic patient with hypotension; o
Mar 11, 2019
Reboot - Diuretics, leg cramps, and resistant hypertension
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Listen to our first ever discussion with @kidney_boy, Joel Topf MD. It’s a classic episode with a fresh intro as we prepare for @NephMadness 2019 with our friends from Twitter and @AJKDonline

Dominate leg cramps, diuretic therapy, and resistant hypertension with tips from @kidney_boy, Joel Topf MD @kidney_boy, Chief of Nephrology Kashlak Memorial Hospital, co-creator @NephMadness. We start with basic renal physiology and build up to the treatment of resistant hypertension.

Corrections: Dr Topf posted the following corrections on his blog PBfluids.com 3/22/2017

“I enjoyed the experience immensely, but in an hour of talking off the cuff I made some embarrassing mistakes:

In describing water reabsorption I said it occured in the cortical collecting duct rather than the medullary collecting duct.

In describing my cure for cramps I tell the story of Gitelman’s and say it is like congenital loop diuretics rather than congenital thiazide diuretics

I mucked up the story about the MRFIT story and how it allowed a head to head comparison of HCTZ and chlorthalidone. I really oversold what happened.”

 

Full show notes at https://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written by: Matthew Watto MD

Produced by: Stuart Brigham MD and Matthew Watto MD

Cohosts: Stuart Brigham MD and Matthew Watto MD

Guest: Joel Topf MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 201

Mar 04, 2019
#141 Wound Care Pearls
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Demystify chronic wound care management with high yield pearls from wound care expert Dr. Elizabeth (Foy) White-Chu. She takes us through a simple yet thorough approach to manage complex chronic wounds. We discuss everything from selecting a dressing, to pain management, and what kind of water should you really use when cleansing a wound. Answers to all of these burning questions and more await you, so don’t waste anymore time! Press play and let Dr. White-Chu take you on a journey through evidence based practices for the management of chronic wounds. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written by: Carolyn Chan MD

CME questions by: Justin Berk MD

Produced by: Matthew Watto MD

Hosts: Matthew Watto MD, Paul Williams MD, Carolyn Chan MD

Guest: Dr. Elizabeth (Foy) White-Chu

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Time Stamps

  • 00:00 Sponsor - ACPs MKSAP 18
  • 00:25 Disclaimer, intro, guest bio
  • 03:58 Guest one-liner, movie recommendation, favorite failure, career advice
  • 11:40 Picks of the week
  • 15:58 Sponsor - ACPs Medical Knowledge Self Assessment 18
  • 17:50 Clinical case of lower extremity ulcer; describing a wound
  • 21:04 Taking a wound focused history
  • 26:28 Differentiating wound types
  • 29:04 Edema and compression therapy; Should diuretics be used?
  • 36:43 Description of the multi-component wrap
  • 38:10 Counseling a patient about wound care and setting expectations for healing
  • 41:29 High value option
Feb 25, 2019
#140 Psychopharmacology 2.0 - Antidepressant Master Class
3692

Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Molly Heublein, MD

CME questions by: Molly Heublein, MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein, MD

Edited by: Matthew Watto MD

Guest Presenter: Patrick Finley, PharmD BCPP

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Time Stamps

  • 00:00 Sponsor ACP’s MKSAP 18
  • 00:25 Disclaimer, intro and guest bio
  • 04:33 Guest one-liner, book recommendation, and first patient complaint
  • 08:04 Picks of the week
  • 12:10 Sponsor ACP’s MKSAP 18
  • 14:03 Clinical case of depression; assessing target symtpoms to characterize depression; choice of initial SSRI
  • 17:49 Discussion of iron, ferritin, folate and L methylfolate as they relate to treatment refractory depression
  • 20:12 Postpartum depression, iron, genetics and environmental factors
  • 22:35 How to switch from one SSRI to another; Cross-titration from SNRI to SSRI or from SSRI to SNRI
  • 26:05 Withdrawal symptoms from SSRIs or SNRIs and a bit more on switching and cross titration
  • 31:33 Is paroxetine ever a good idea?
  • 33:03 Ultra-rapid metabolizers of SSRIs and pharmacogenomics
Feb 18, 2019
#139 Genetic Testing in Primary Care
5079

Join us at the forefront as we talk genetic testing in primary care with Dr Dallas Read, esteemed gynecologist and **the only** medical geneticist at Tufts Medical Center. Topics include: what internists should be comfortable testing for in the office, how and when to refer for screening, what tests to order, how to interpret test results, how to handle direct-to-consumer results or requests, and so much more! For years, the medical community has been talking about the immense potential for genetic testing to guide diagnosis and treatment. But has it realized its full potential? The answer to that seems to be a resounding no at the moment--but the days of ubiquitous genetic testing to identify disease and disease risk may not be so far off after all. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Coming to you from the Curbsiders, we hope you’ll enjoy this latest episode about the genes you wear, whether you want to put them on or not. Genes, Genes, they’re (maybe) good for your heart. But do patients want to know if they are, or if they aren’t?

Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Nora Taranto MS4
  • CME questions by: Nora Taranto MS4
  • Hosts: Stuart Brigham MD, Matthew Watto MD, Nora Taranto MS4
  • Images and infographics: Beth Garbitelli MS1
  • Edited by: Matthew Watto MD, Chris Chiu MD
  • Guest: Dr. Dallas Reed MD

Sponsor 

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Time Stamps

  • 00:00 Announcement
  • 00:37 Sponsor: ACP’s MKSAP 18
  • 01:04 Disclaimer, intro, guest bio
  • 06:31 Guest one liner, book recommendations, career advice
  • 12:23 Cohost picks of the week
  • 16:22 Sponsor: ACP’s MKSAP 18
  • 18:12 Dr Reed walks us through the genetic machinery from the top down (genome, chromosomes, exons, genes, SNPs, and epigenetics)
  • Feb 11, 2019
#138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis
5303

Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich, Assistant Professor of Medicine and co-director of the Inflammatory Bowel Disease Program at Temple University Hospital.  In this episode, we learn about the initial work-up, general principles of management, and important primary care considerations for Crohn’s disease and ulcerative colitis (ie endoscopic surveillance, immunizations, bone health/osteoporosis, and more!).

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by: Paul Williams MD
  • Edited by: Matthew Watto MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Adam Ehrlich MD

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

 

Time Stamps

  • 00:00 Sponsor: MKSAP 18
  • 00:32 Disclaimer, Intro, guest bio
  • 04:05 Guest one-liner, Adam’s movie rec - RBG (documentary), career advice, Paul’s movie rec - Edge of Tomorrow
  • 09:25 Sponsor: ACP’s MKSAP 18
  • 11:25 Definitions and pathophysiology of inflammatory bowel disease (IBD)

Ulcerative Colitis

  • 13:40 A case of ulcerative colitis; Classic symptoms; Initial approach and basic differential diagnosis
  • 19:10 Smoking and ulcerative colitis
  • 21:17 Initial workup for suspected IBD; Fecal calprotectin
  • 25:50 A bit more on CRP and IBD
  • 26:55 When to refer for colonoscopy
  • 27:58 Back to the case; a typical colonoscopy reports in ulcerative colitis (UC)
  • 30:33 Extraintestinal manifestations of UC
  • 34:50 Initial counseling for newly diagnosed IBD; natural history of IBD, prognosis
  • 39:50 Treatment of ulcerative colitis
  • 43:02 Some specifics on steroids, plus topical therapies

Crohn’s disease

  • 47:05 A case of Crohn’s disease; initial approach and differential diagnosis
  • 50:25 Initial diagnostic tes
Feb 04, 2019
#137 Hyperkalemia Master Class with Joel Topf MD
4899

Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Sponsor

Join us at ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there!

Credits

Written and produced by: Matthew Watto, MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Infographic: Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Dr Joel Topf MD

 

Time Stamps

  • 00:00 Ad disclaimer, intro and guest bio
  • 05:11 Guest one-liner and picks of the week —Peloton indoor cycle, “your local library”, The Nice Guys (film) by Shane Black, and Forgotten Hand (PS4 game)
  • 11:17 ACP Internal Medicine Meeting 2019 details
  • 12:55 Clinical case of hyperkalemia; discussion of pseudohyperkalemia
  • 19:55 Hyperkalemia and the EKG
  • 23:38 Threshold for treatment of hyperkalemia
  • 27:20 Use of telemetry and the U-shaped curve for potassium and mortality
  • 30:11 Choice of therapy for acute hyperkalemia
  • 33:13 Albuterol for hyperkalemia
  • 34:24 First rule out urinary obstruction and hyperglycemia; Use of IV insulin and dextrose and frequency of monitoring
  • 39:44 Loop diuretics plus fluid; Distal sodium delivery and potassium handling in the nephron
  • 43:10 Fludrocortisone for hyperkalemia
  • 45:05 Calcium for elev
Jan 28, 2019
#136 Sickle Cell Disease, Management & Complications
4296

Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sickle Cell Center for Adults at Johns Hopkins joins!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Sponsor

ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA. We'll see you there!

Credits

Written (including CME questions) and produced by: Justin Berk MD, Martha Brucato MD PhD, Beth Garbitelli MS1

Hosts: Paul Williams MD, Justin Berk MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Sophie Lanzkron MD MHS

Time Stamps

  • 00:00 Announcements, intro
  • 02:30 A quick refresher on hemoglobinopathy
  • 03:45 Guest bio
  • 05:03 Guest one-liner, movie recommendation, career advice, picks of the week
  • 10:53 ACP Internal Medicine Meeting 2019 (ad read)
  • 12:33 Clinical case; defining sickle cell; pathophysiology
  • 16:23 Different types of hemoglobinopathy genotypes and phenotypes
  • 20:20 Preventive care for sickle cell disease
  • 22:56 Taking a history at the initial visit in patient with sickle disease
  • 26:40 Life expectancy in SCD
  • 28:30 Hydroxyurea
  • 30:40 Chronic red blood cell transfusion therapy; complications; monitoring
  • 37:07 Silent cerebral infarcts and mild cognitive impairment in SCD 
  • 40:10 Chronic pain management; opioid use disorder in sickle cell disease
  • 46:00 Acute pain crisis management; PCAs vs bolus therapy
  • 54:08 Reticulocyte count in sickle cell disease
  • 55:40 Itching, opioids and naloxone?
  • 58:10 Red blood cell transfusion threshold in sickle cell disease (anemia)
  • 60:03 Acute fever in SCD
  • 61:48 Acute chest syndrome
  • 66:45 Transition from pediatrics to adult medicine in sickle cell
  • 68:00 Incentive spirometry to prevent acute chest syndrome
  • 68:45 Take home points
  • 70:00 Outro
Jan 21, 2019
#135 Perioperative Medicine
5114

Optimize perioperative risk and dominate perioperative medicine. Topics include surgical risk calculators, preoperative labs, stress testing, use of BNP and troponins, postoperative MI, cardiac and pulmonary risk stratification, and more! We’re joined by perioperative medicine expert, Avital O’Glasser MD, Associate Professor of Medicine at Oregon Health & Science University and Assistant Program Director for Scholarship and Social Media. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Matthew Watto MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Avital O’Glasser MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 04:20 Guest one-liner, book and movie recommendations, career advice
  • 11:20 ACP Internal Medicine Meeting 2019 details
  • 14:02 Patient with coronary artery calcifications going for elective hip surgery and wants "clearance"
  • 20:50 Functional capacity
  • 25:00 Preoperative stress testing and coronary revascularization
  • 31:55 Canadian guidelines, BNP and troponin testing
  • 36:30 The METS trial and predicting perioperative cardiac events and mortality
  • 40:44 Preoperative testing (labs, imaging, urine studies)
  • 50:24 Choosing your perioperative cardiac and surgical risk calculator (RCRI, MICA, ACS-NSQIP)
  • 59:50 Communicating risk to patient and their surgeon
  • 61:30 Pulmonary risk assessment and complications
  • 70:35 Perioperative use of opioids
  • 75:30 Who needs an echocardiogram prior to surgery?
  • 79:00 Canceling a patient's surgery
  • 82:55 Take home points
  • 83:45 Outro
Jan 14, 2019
#134 Urinary Tract Infections Delirium and Voltaire
3288

“Urinary tract infections” (UTIs) are overdiagnosed. Antibiotics are overprescribed. UTIs are inappropriately blamed for geriatric syndromes (eg delirium) despite little supporting evidence. Our guest, Tom Finucane MD, Emeritus Professor of Medicine at Johns Hopkins makes us question everything. Topics: How can we diagnose “UTI”? Who needs treatment? Do urinary tract symptoms matter? Does malodorous urine correlate with infection? Who’s at risk for pyelonephritis and sepsis? Don’t miss this paradigm changing episode. And stop using the term “urinary tract infection” unless it’s prefaced by air quotes!

Sponsor: Join ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Matthew Watto MD

Hosts: Matthew Watto MD, Paul Williams MD

Edited by: Matthew Watto MD

Guest: Tom Finucane MD, MACP

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 04:00 Guest one liner, book recommendation, career advice
  • 08:22 The “medical ignorome”
  • 13:40 ACP Internal Medicine Meeting 2019 details
  • 16:20 Case of malodorous urine; Urine is NOT sterile; Defining terms
  • 25:14 Stop saying UTI unless using air quotes
  • 28:34 What symptoms or history matters in evaluation for “UTI”? And can we predict who will become systemically ill?
  • 34:47 Voltaire and when treatment is warranted for “urinary tract infections”
  • 37:15 Delirium in an older adult with possible UTI, how to work it up, and who warrants antibiotics
  • 51:55 Take home points
  • 53:38 Outro
Jan 07, 2019
2018 Recap Extravaganza
3126

Take a trip down memory lane with top clinical pearls and favorite moments from The Curbsiders in 2018.

Welcome to our 2018 Recap Extravaganza! Since last year, the Curbsiders team has grown substantially and the podcast has undergone several exciting developments. These include our collaboration with ACP that allows us to provide CME and MOC credit for select episodes, our new partnership with Human Dx as featured in our Kashlak Morning Reports, and the launch of our Women in Medicine series. For our 2017 year-end show, we had listeners vote for their favorite episodes from the past year. This year, we're changing it up a bit and have invited our Curbsider colleagues to share their picks for pearliest pearls and most illuminating episodes of 2018. We hope you’ll enjoy hearing the team’s highlights, and we’ll be back in 2019 with fresh content. Note: No CME-MOC credit for this episode, but stay tuned in 2019 for eligible episodes.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Chris Chiu MD and Sarah Phoebe Roberts, MPH

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Chris Chiu MD

Edited by: Chris Chiu MD

Time Stamps

  • 00:00 Disclaimer, Intro
  • 06:39 Clinical Reasoning Pearls
  • 12:35 Pulmonary Hypertension Pearls
  • 15:52 Women In Medicine Pearls
  • 20:40 Iron Deficiency Pearls
  • 24:52 Tick-Borne Illness Pearls
  • 28:00 STI Pearls
  • 31:00 Physical Exam Pearls
  • 32:51 “Things we do for no reason” Pearls
  • 36:16 Host Picks
  • 42:38 Paul Wraps-up the Year
  • 43:38 Outro and Curbsider Team sign-offs
Dec 31, 2018
#133 Herpes for Everyone
3500

Master the diagnosis and management of Genital Herpes with tips from expert, Robert Bettiker MD . Topics include: the natural history, diagnosis & screening guidelines for genital herpes; cold sores; options for primary and recurrent episodes including prophylaxis; and consideration of specific populations including symptomatic and asymptomatic patients, pregnancy and MSM (men who have sex with men). We also discuss partner notification and treatment.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Kate Grant MBChB DipGUMed, Matthew Watto MD

Images by: Kate Grant MBChB DipGUMed

Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD

Guest: Robert Bettiker MD

Time Stamps

  • 00:00 Disclaimer, guest bio, intro
  • 01:50 Guest one liner, memorable teaching moment and a few failures
  • 10:50 Intro to herpes
  • 12:25 Case 1: Genital herpes in a married man
  • 15:42 Overview of testing options
  • 18:50 Marital counseling in Herpes
  • 22:18 Prophylaxis in serodiscordant partners and asymptomatic shedding
  • 25:08 Case 2: Severe outbreak of genital herpes in a young woman
  • 31:50 Case 3: Young male with recent exposure to herpes
  • 38:45 Herpes 1 (HSV1) versus Herpes 2 (HSV2)
  • 44:12 Case 4: Herpes in pregnancy
  • 50:45 Do topical agents work for herpes
  • 55:05 Take home points
  • 56:10 Outro
  • 57:52 Stuart shares a PUN!
Dec 24, 2018
#132 A Case of Abdominal Pain
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Sharpen your diagnostic schema for abdominal pain and eosinophilia with this mystery case http://hdx.org/Rxg (click link to follow along). Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx attempts to solve this challenging case with the help of The Curbsiders.

Use this link http://hdx.org/Rxg to follow along with the case on the Human Dx app and check out more Global Morning Report cases.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Hannah R Abrams

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes.

Time Stamps

  • 00:00 Announcement, disclaimer, intro, guest bio
  • 01:20 Picks of the week
  • 05:42 How Reza fell in love with clinical reasoning
  • 08:58 Case of 50 yo male with abdominal pain
  • 21:14 Some unexpected findings
  • 43:00 Case conclusion/answer, cognitive autopsy and Reza’s take home points
  • 48:35 Outro
Dec 19, 2018
#131 A Case of Cough and Dyspnea
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Hone your diagnostic skills with this mystery case of cough and dyspnea http://hdx.org/pdp (click link to follow along). The Curbsiders deconstruct the case and discuss their diagnostic schemas for these common problems with the help of returning guest, Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx.

Use this link http://hdx.org/pdp to follow along with the case on the Human Dx app or website and check out more Global Morning Report cases.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Hannah R Abrams

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes.

Time Stamps

  • 00:00 Announcement, disclaimer, intro, guest bio
  • 03:13 When and how to practice clinical reasoning
  • 05:53 Creating diagnostic schemas and Clinical Problem Solvers Podcast
  • 09:40 A bit on Human Dx and the show format
  • 12:00 Case of a 40 yo male with a cough
  • 23:22 Some insights from Reza on “signal versus noise”
  • 37:10 Case conclusion/answer, cognitive autopsy and Reza’s take home points
  • 45:36 Outro
Dec 17, 2018
#130 Work-Life Fit: Women In Medicine
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Create a successful partnership and career withs tips from Wonder Woman, Sue Hingle MD of ACP. 

Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro tip: stop worrying about what others think!). Dr. Hingle is Professor in the Department of Internal Medicine and Vice Chair of Education and Faculty Development and Associate Internal Medicine Residency Program Director at Southern Illinois University. She is also the Immediate Past Chair of the Board of Regents of the American College of Physicians (ACP). She has served at the ACP in a variety of ways, including as a member of the ACP Women’s Task Force. Her clinical expertise is in women’s health, health promotion, and disease prevention. Enjoy the episode!

ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4, Shreya Trivedi MD, Leah Witt MD, Sarah P. Roberts MPH.

CME Questions by: Shreya Trivedi MD

Editors: Matthew Watto MD and Chris Chiu MD

Hosts: Shreya Trivedi MD, Paul Williams MD, Leah Witt MD

Guest: Susan Hingle MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 02:52 Guest one liner, WIM Moment of awakening, advice for her younger self
  • 07:45 Picks of the week
  • 10:30 Physician with family and caregiver responsibility; How to plan for personal and professional goals
  • 18:20 What to look for in a partner, how to work with them to achieve work life fit, and non-traditional roles
  • 28:35 Advice on family planning
  • 31:40 Residency programs and life events
  • 32:55 Should you go part-time?
  • 39:43 Work life balance? Or work life fit? And some examples/tips for success
  • 49:54 Take home points
  • 50:45 Outro
Dec 13, 2018
#129 Depression and Suicide: Occupational Hazards of Practicing Medicine
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Dr Elisabeth Poorman MD joins us to discuss the natural history of physician depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line. The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat).

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available either via email, private msg on FB or twitter (@DrPoorman), or any of us on twitter. We are happy to talk and see that you get support you need.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4, Shreya Trivedi MD

Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Elisabeth Poorman, MD

Time Stamps

  • 00:00 Disclaimer, Intro, Guest Bio
  • 3:25 Wellness Recommendations: Find a Therapist
  • 6:12 How to find a therapist in training
  • 6:39 Licensing and Mental Health
  • 12:14 Disclaimer and Trigger Warning: Stories are Sensitive. National suicide hotline info
  • Next, Dr Poorman and each of The Curbsiders share their personal experiences with mental health (see below).
  • 12:05 Shreya story
  • 21:40 Stuart’s story
  • 31:19 Elisabeth’s story
  • 36:17 Watto’s story
  • 37:41 Passive suicidal ideaiton, a definition  
  • Dec 10, 2018
#128 Aspirin Overhyped and Overused
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Aspirin’ to figure out if ASA can help prevent a heart attack? Interpreting all the new trials doesn’t have to cause chest pain! Join Dr. Ambarish Pandey from UT Southwestern as he helps The Curbsiders ASCEND the mountains of the latest studies to ARRIVE at some well-informed conclusions on the role of aspirin in primary prevention for cardiac events. The team also discusses secondary prevention, aspirin and dual (or triple) antiplatelet therapy, and whether it’s okay to stop giving aspirin to older adults without known CAD (Spoiler alert: it’s okay). ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Justin Berk MD, Matthew Watto MD

CME questions by: Justin Berk MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD and Chris Chiu MD

Guest: Dr. Ambarish Pandey MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 04:15 Guest one liner, book recommendation, career and research advice
  • 11:07 Case of aspirin for primary prevention, aspirin’s public persona, and nocebo effects of statins
  • 21:40 ARRIVE and ASCEND trials
  • 28:14 Aspree trial
  • 32:38 Coronary artery calcium; aspirin use for secondary prevention
  • 37:42 Dual antiplatelet therapy and the DAPT score
  • 41:25 Should we continue aspirin when a patient also needs a DOAC?
  • 46:14 Should we continue DAPT in a patient who needs a DOAC (or warfarin)?
  • 49:40 Deprescribing aspirin for primary prevention in older adults?
  • 50:51 Closing remarks
  • 52:33 Outro
Dec 03, 2018
Hotcakes: Exercise, Aspirin, Fish Oil and Hypertension
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Tony Breu MD joins us for some hotcakes, and “cold cakes” including: how aspirin and zodiac sign affect the treatment of acute MI, a recent study on how exercise is probably still good for you, the recently announced REDUCE-IT trial, and the evidence (or lack thereof) for the treatment of hypertensive urgency. Welcome to another edition of Hotcakes and Hot Takes, where we discuss the most interesting articles and news that we have been reading. Special guest is the prolific Dr. Tony Breu (@tony_breu) who is an Assistant Professor of Medicine at Harvard Medical School and a Hospitalist and Director of Internal Medicine Resident Education at the VA Boston Healthcare System. He is known for his series on "Things We Do For No Reason” as well as his thought-provoking “Tweetorials” online. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST on day of release).

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD

CME Questions: Christopher Chiu MD

Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD

Guest Presenter and Content Planning: Anthony Breu MD

Editor: Christopher Chiu MD

Cover-Art: Christopher Chiu MD

Time stamps
  • 00:00 Disclaimer, intro, guest bio
  • 05:53 Discussion on Tweetorials
  • 08:00 Cold Cake: ISIS-2 and the treatment of acute MI with aspirin
  • 14:04 ISIS-2 and zodiac subgroup analysis
  • 16:19 What is the relationship between cardiorespiratory fitness on mortality?
  • 24:40 Discussion of the REDUCE-IT study
  • 33:00 Cold Cake: VA Cooperative study and the evidence for treating essential hypertension
  • 36:42 TWDFNR and the treatment of hypertensive urgency
  • 46:36 Wrap-up and outro
Nov 29, 2018
#127 STIs: Syphilis, Gonorrhea and Chlamydia
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Master the diagnosis and management of common STIs (sexually transmitted infections) with tips from expert, Dana Dunne MD, Associate Professor of Medicine in Infectious Diseases at Yale. Topics include: the stages and many presentations of syphilis, syphilis treatment and counseling, the natural history, diagnosis, and screening guidelines for gonorrhea and chlamydia, treatment options in the age of growing resistance, and a discussion of partner notification and treatment.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Bryan Brown MD

Hosts: Bryan Brown MD, Paul Williams MD, Matthew Watto MD

Guest: Dana Dunne MD

Special thanks to Kate Grant MBChB, Dip GUMed for her contribution of knowledge and artwork.

Time Stamps

  • 00:00 Announcement, disclaimer, intro and guest bio
  • 04:29 Guest onliner, book recommendation, advice for learners/teacher, and picks of the week
  • 11:00 A case of syphilis, clinical manifestations and discussion of the stages
  • 26:05 Testing for syphilis
  • 39:05 Mandatory reporting and partner tracing
  • 42:40 Counseling patients with syphilis
  • 44:44 A case of gonorrhea and chlamydia, clinical manifestations, screening guidelines
  • 52:30 How to counsel patients to obtain samples from urethra, rectum, vagina, oropharynx; Mycoplasma genitalium
  • 59:40 CDC treatment guidelines, Super gonorrhea, test of cure, and treatment of partners
  • 72:35 Take home points
  • 74:30 Outro
Nov 26, 2018
#126 Kashlak Morning Report with Human Dx
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Practice solving diagnostic puzzles with The Curbsiders and Internist / Diagnostician, Reza Manesh MD, Assistant Program Director for Clinical Reasoning of the Osler Medical Training Program at Johns Hopkins! Solve along with us at these links: Case 1 http://hdx.org/I2B and Case 2 http://hdx.org/uM2. Topics include: clinical reasoning terminology, how to use cases to practice diagnostic reasoning, how to build a diagnostic schema, and how to conduct your own cognitive autopsy.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Hannah Abrams

Hosts: Hannah Abrams, Paul Williams MD, Stuart Brigham MD, Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Doctors Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing cases

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 04:02 Guest one liner, book recommendation, favorite failure, advice for learners
  • 11:27 Human Dx Project and Global Morning Report
  • 15:35 Diagnostic terminology
  • 21:25 Case #1, Reza solves
  • 33:40 Diagnostic autopsy and teaching points for case #1
  • 38:00 Case #2, The Curbsiders solve
  • 57:30 Diagnostic autopsy and teaching points for case #2
  • 61:33 Take home points and a plug
  • 64:30 Outro
Nov 19, 2018
#125 Hidden Curriculum
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Check out this audio treasure map to find the hidden curriculum and learn how it can change your practice. Learn how positive teaching spans not just the classroom or bedside but, how we simply talk about patients. Sanjay Desai MD, coauthor of ACP’s Position Paper on Hidden Curriculum and Internal Medicine program director at Johns Hopkins guides us through several cases that illustrate how our institutional norms can shape the practice of medicine...for better or worse. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Sanjay Desai MD; Justin Berk MD, MPH, MBA; Matthew Watto MD

CME questions by: Justin Berk MD

Editors: Chris Chiu MD & Matthew Watto MD

Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD

Guest: Sanjay Desai MD

Time Stamps

  • 00:00 Disclaimer, Intro and guest bio
  • 04:00 Guest one liner, book recommendations, career advice
  • 10:50 Intro to the hidden curriculum and ACP’s three recommendations
  • 22:00 Case #1: A patient with schizophrenia
  • 32:10 Case #2: The iPatient
  • 38:07 Case #3: Attending forgets to wash their hands
  • 41:10 Case #4: A dying patient’s primary care doctor saves the day
  • 46:26 Case #5: A case of violating duty hours
  • 60:10 Take home points
  • 62:00 Outro
Nov 15, 2018
#124 The Shoulder - Simplify Your Approach
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Shoulder pain made simple. Develop your confidence and skills with tips from sports medicine specialist Dr. Carlin Senter MD. We discuss her simplified approach to the basic shoulder exam, including when and how to do special tests, high yield exam maneuvers, when to refer shoulder pain patients to orthopedic surgery, and who can be managed conservatively.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Molly Heublein MD and Nora Taranto MS4

Editor: Matthew Watto MD

Hosts: Molly Heublein, MD, Paul Williams MD, Matthew Watto MD

Guest: Carlin Senter, MD

Time Stamps

  • 00:00 Disclaimer, intro, and guest bio
  • 03:15 Guest one liner, book recommendation, career advice, and some picks of the week
  • 13:20 Clinical case of shoulder pain; helpful historical features
  • 18:54 Differentiating referred pain from c-spine pathology from shoulder pathology
  • 21:00 A framework for shoulder pain, HIP-ROT, and using ROM to generate a differential
  • 27:40 Frozen shoulder aka adhesive capsulitis
  • 31:57 Glenohumeral joint arthritis
  • 33:52 Rotator cuff disease
  • 40:53 Specific testing for rotator cuff tears
  • 51:45 Impingement syndrome versus bursitis
  • 56:25 Counseling patient with shoulder pain or injury
  • 59:03 Steroid injections, topical therapy, and AC joint arthritis
  • 65:18 When to refer to surgery and some take home points
Nov 12, 2018
#123 Sleep Apnea Pearls and Pitfalls
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The sleep apnea episode that won’t put you to sleep. Become a sleep apnea guru with incredible insights from Barbara Phillips MD, MSPH, FCCP an expert in pulmonary medicine, critical care and sleep medicine who is also a past president of CHEST! We discuss high-yield topics in the world of obstructive sleep apnea including: home sleep studies vs in-lab polysomnography, the importance of oxygen saturation (the T90 and ODI) when interpreting sleep study results, tricks to improve CPAP adherence, and alternatives therapies for obstructive sleep apnea. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Cyrus Askin MD

CME questions by: Cyrus Askin MD

Editor: Chris Chiu MD & Matthew Watto MD

Hosts: Cyrus Askin MD & Matthew Watto MD

Guest: Barbara Phillips, MD

Cover-Art & Infographic - Beth Garbitelli, MS1

Time Stamps

  • 00:00 Disclaimer, intro, guest bio
  • 03:00 Guest one liner, book recommendation, advice for trainees
  • 08:10 Clinical case of sleep apnea, some basic stats, and key predictors of sleep apnea
  • 12:38 Barriers to diagnosis and treatment of OSA
  • 15:23 Discussion of T90, hypoxemia and sleep fragmentation
  • 17:05 How to read a sleep study report
  • 21:55 Home sleep apnea testing
  • 24:15 What are the consequences of sleep apnea
  • 28:30 What is the efficacy of cpap for lowering blood pressure and mortality
  • 31:45 Counseling a patient who is new to cpap
  • 33:45 Choice of mask
  • 40:10 Do alternatives to cpap work? e.g. surgery, mandibular advancement devices
  • 44:17 Modafinil and z-drugs
  • 47:15 Driver’s license issues in sleep apnea
  • 48:35 Future of sleep medicine and take home points
Nov 05, 2018
#122 Headaches Advanced Class
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We delve into advanced management of headaches, including novel therapies, migraines with aura, migraines in complicated patients, and headaches of short duration with Dr. Rebecca Burch, a headache medicine specialist at the John R. Graham Headache Center at Brigham and Women’s Hospital.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Paul Williams MD

Edited by: Matthew Watto MD

Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD

Guest: Rebecca Burch MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 03:28 Guest one-liner, movie and podcast recommendations, favorite failure and picks of the week from The Curbsiders
  • 10:38 Clinical case of migraines; diagnosis and classification
  • 14:12 Does medication overuse headache exist?
  • 16:16 Chronic daily headache; Conversion from episodic to chronic and vice versa
  • 21:43 Approaches to medication overuse headache
  • 25:54 Case 2: migraine with aura and other types of migraine (retinal, hemiplegic, etc.)
  • 32:09 Pathophysiology of migraine; how triptans work; How should aura effect management?
  • 38:44 Migraine cocktails
  • 41:15 Comorbid mood disorders; Use of psych meds and triptans
  • 45:08 Migraines and oral contraceptives
  • 48:42 Botulinum toxin and new CGRP therapies
  • 53:36 What does success look like in migraine therapy?
  • 55:32 Nonpharmacologic management
  • 60:45 Case 3: headaches of short duration
  • 66:36 Headache red flags; Imaging for headaches; pathophysiology of high and low pressure headaches
  • 72:00 Idiopathic intracranial hypertension
  • 75:25 Take home points
  • 77:00 Outro

 

Oct 29, 2018
#121 HIV Care for the Internist
3630

HIV care for the internist with author and HIV expert, Michael Saag MD, Professor of Infectious Diseases at University of Alabama and founder of the 1917 Clinic. We discuss the specifics of screening & diagnostic testing in HIV, monitoring CD4 counts and viral loads, first line antiretroviral therapy, harm reduction, and how to provide excellent HIV care in your primary care clinic.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written & Produced by: Elena Gibson MS4, Justin Berk MD MBA MPH

Artwork by: Elena Gibson MS4

Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MBA MPH

Editor: Matthew Watto MD

Guest: Michael Saag MD

Time Stamps

  • 00:00 Disclaimer, intro, and guest bio
  • 04:35 Getting to know our guest, a movie recommendation, and words of wisdom
  • 08:48 Clinical case, HIV screening, in-depth discussion of HIV testing & diagnosis
  • 15:56 New diagnosis of HIV, counseling after diagnosis, confirmation, follow-up testing, the second visit
  • 24:20 Treatment - what to start and when; some basic comments on therapy
  • 30:05 Primary care after diagnosis, vaccines, cancer screening, cardiovascular disease prevention
  • 34:35 Monitoring CD4 counts and viral load; interpreting CD4 count; time course of response for CD4 and viral load
  • 42:02 Harm reduction counseling; addressing medication non-adherence
  • 47:40 PCP prophylaxis
  • 49:43 The 1917 Clinic, Ryan White Clinics, and linking patients to care
  • 53:10 Take home points
  • 55:40 Plugs
  • 57:45 Will a cure or vaccine for HIV emerge?
  • 59:16 Outro
Oct 22, 2018
#120 Policy, Patients, Payments, Paperwork
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Join us in this roundtable discussion of patients before paperwork, administrative burden, the new CMS payment model proposal, and a bit on health insurance with cohost, Fatima Syed MD MSc and guest, Deep Shah MD MSc. Doctors Syed and Shah are both early career physicians with masters degrees in comparative social policy from Oxford University and are active members of the American College of Physicians. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Fatima Syed MD MSc and Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Fatima Syed MD MSc, Matthew Watto MD

Guest: Deep Shah MD MSc

Time Stamps

  • 00:00 Disclaimer, intro, and guest bios
  • 02:18 Guest one liners, book recommendations, picks of the week
  • 11:00 Administrative burden
  • 16:00 Will the documentation problem get better? Suggestions for improvement
  • 25:11 Why do CMS rules spread to the private insurance sector?
  • 29:30 What innovations might reduce administrative burden?
  • 32:40 The Affordable Care Act, health insurance, price transparency
  • 40:20 Take home points
  • 43:20 Outro
Oct 19, 2018
#119 Nutrition Pearls, Heart Health and Bacon
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Nutrition pearls from integrative cardiologist, Steven Devries MD, Associate Professor of Medicine, Northwestern Feinberg School of Medicine, Executive Director of The Gaples Institute. Clinicians receive little formal nutritional training in medical school and residency. It’s time to fill that gap! We discuss the strength of the literature supporting dietary interventions for cardiovascular health and review practical tips to help patients achieve healthy eating patterns. Patients need to hear from us that nutrition matters!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written & Produced by: Molly Heublein MD

Hosts: Matthew Watto MD, Paul Williams MD, Molly Heublein MD

Guest: Stephen Devries MD

Editor: Matthew Watto MD

Special thanks to Elena Gibson MS4 for writing our show notes

Time Stamps

  • 00:00 Disclaimer
  • 00:35 Intro and guest bio
  • 02:40 Guest one-liner, book recommendation, favorite failure, nontraditional career path
  • 10:10 Nutrition and medical education
  • 12:45 Evidence for how nutrition can improve health outcomes
  • 15:33 How to describe a heart healthy or Mediterranean diet to patients
  • 25:16 Discussion of fats and oils
  • 31:44 Food deserts, healthy snacking options
  • 37:15 Calorie counting and use of healthy eating apps
  • 40:55 How to frame the discussion about a healthful eating pattern with patients
  • 47:18 Macronutrient content. Does it matter?
  • 52:50 Intermittent fasting
  • 54:24 A free resource for patients to learn about nutrition

 

Oct 15, 2018
#118 Female Sexual Problems with Stacy Lindau MD
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Houston, we have a female sexual dysfunction problem. Female sexual problems, which can affect women of all ages, are underdiagnosed and undertreated--in part because clinicians are not the best at asking about sex in primary care visits. In the course of this episode, learn about how to have that sex talk you’ve (maybe) been avoiding, what to ask when working up sexual problems in women, and find the words to talk to patients about sex. Today, we’re lucky to have the female sexual health expert of experts, Dr. Stacy Lindau, MD, MA, Professor of Obstetrics and Gynecology and Medicine-Geriatrics at the University of Chicago Medicine, on the show to teach us the best “sex talk” language, the differential for female sexual problems, and explore therapies. Sadly, there’s no sildenafil-like magic bullet, but a multidisciplinary team can make real impact on female sexual problems. Don’t forget to check out http://womanlab.org

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4

Hosts: Leah Witt MD and Matthew Watto MD

Infographic: Leah Witt MD

Editor: Matthew Watto MD

Guest: Stacy Lindau MD

Time Stamps

  • 00:00 Disclaimer
  • 00:35 Intro and guest bio
  • 03:30 Guest one liner, book recommendations, favorite failure, career advice and picks of the week
  • 12:57 Clinical Case of female sexual dysfunction and some definitions
  • 15:08 Are sexual problems a normal part of aging?; How to take a sexual history; Etiology of sexual dysfunction; “Diagnostic sex”; Red flags
  • 27:54 Medications that contribute to sexual dysfunction
  • 31:00 Labs
  • 34:45 Treatment: pelvic PT, medications, counseling, flibanserin, herbal supplements
  • 49:05 Screening for female sexual problems
  • 51:58 Take home points; WomanLab.org
  • 55:19 Outro

Tags

sexual dysfunction, female, gynecologist, ob-gyn, female sexual disorder, libido, sex, hormones, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Oct 08, 2018
#117 Clostridium Difficile: IDSA Guidelines, Bad Puns, and Random Pearls
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Summary

Conquer Clostridium difficile (Clostridioides difficile) with this “spore-tacular” episode featuring infectious diseases expert, Dr. Curtis Donskey, Professor at Case Western Reserve University and clinician at the Louis Stokes VA Hospital. We discuss the updates in the 2017 IDSA C. difficile guidelines plus a bunch of random pearls. If you have ever laid awake at night wondering how many pills are needed for a fecal transplant, then this is the episode for you!  We discuss why metronidazole was dropped as the first line therapy for Clostridium difficile infection (CDI) along with other hot topics such as two-step testing, loperamide use, which antibiotics are the least likely to cause CDI, and more. Do not miss this episode!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written by: Carolyn Chan MD

Produced by: Matthew Watto MD

Hosts: Carolyn Chan MD, Matthew Watto MD, Paul Williams MD

Editor: Matthew Watto MD

Guest: Curtis Donskey, MD

Time Stamps

  • 00:00 Intro, disclaimer, guest bio
  • 02:19 Getting to know our guest, recommendations for reading, career advice
  • 06:40 Clinical case and CDI testing
  • 09:30 Testing for CDI: PCR and Two step testing
  • 16:30 Testing after treatment
  • 20:00 Treatment of initial CDI episodes, metronidazole pharmacokinetics
  • 24:15 Classification of CDI severity
  • 29:30 Fidaxomicin pearls: when to use, cost, and tapers
  • 34:10 Vancomycin tapers
  • 36:05 Fecal transplant pearls: freeze dried capsules, c-scopes, treating fulminant CDI
  • 44:44 Infection control: counseling homegoing patients, hand washing, and baths
  • 47:50 Social media questions: immodium and toxic megacolon, antibiotics less likely to promote CDI, probioti
Oct 01, 2018
#116 Geriatric Psychiatry: Sleep, Dementia, and Behavioral Disturbances
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Geriatric psychiatry returns. We tackle sleep problems and behavioral disturbances in patients with dementia with returning guest, and Geriatric Psychiatrist Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: pharmacologic and nonpharmacologic management of insomnia; treating agitation and irritability; medical management of psychotic symptoms and paranoia; ethical concerns about the treatment of challenging behaviors in dementia; and the shortage of geriatricians and geriatric psychiatrists.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

  • 00:00 Intro and guest bio
  • 01:55 Case of sleep disturbance in a patient with dementia; medications for sleep disturbances; nonpharmacologic strategies for sleep
  • 11:32 Irritability and agitation versus paranoia, or psychotic symptoms; benzodiazepines in older adults
  • 15:40 Antipsychotic medications, the black box warning and ethical concerns
  • 23:50 Geriatricians, geriatric psychiatrists in short supply; Behavioral interventions
  • 28:16 Outro

Tags

psychiatry, psych, geri, geriatrics, dementia, paranoia, psychosis, sleep, insomnia, agitation, antipsychotics, atypical, black, box, warning, adverse, zolpidem, benzodiazepine, side, effects, therapy, mirtazapine, gabapentin, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Sep 27, 2018
#115 Geriatric Depression
2746

Summary

Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and titrate medications, and how long to continue therapy. Stay tuned for part two of our discussion with Dr Popeo on managing sleep and behavioral problems in older adult patients with dementia.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

  • 00:00 A question for you, the listeners
  • 01:12 Disclaimer, intro and guest bio
  • 05:00 Getting to know our guest, recommendations for reading, and career advice
  • 14:13 Case of geriatric depression; effective history taking; recognizing associated symptoms; depression scales
  • 19:03 Suicide in older adults; firearm safety
  • 24:26 Choice of therapy; Pharmacologic agents; Counseling patients and managing expectations; Dose titration and tracking symptoms
  • 34:41 Augmenting therapy versus cross-titration to another agent; When is it okay to stop an antidepressant
  • 40:50 Take home points
  • 44:40 Outro

Tags: psychiatry, psych, geri, geriatrics, depression, mdd, sleep, insomnia, appetite, agitation, suicide, SSRIs, side, effects, therapy, diagnosis, serotonin, mirtazapine, bupropion, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Sep 24, 2018
#114 High Value Care: Assess Quality, Mitigate Diagnostic Uncertainty, Overcome Barriers
3507

Kick up the quality of your care with tips and tactics from Caitlin Clancy MD, coauthor of ACP’s High Value Care Curriculum. We learn to define quality and value in healthcare; the most common barriers to high value care; use of probability and likelihood ratios to boost clinical reasoning and combat diagnostic uncertainty; some useful tools to estimate cost; sources of healthcare waste; and some general pearls on how the healthcare system works...or doesn’t. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written & Produced by: Matthew Watto MD
  • Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
  • Guest: Caitlin Clancy MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 03:50 Guest one-liner, some discussion on non traditional paths, and picks of the week
  • 12:10 Case 1: Defining value, cost, quality; sources of healthcare waste; and how to avoid the waste of daily labs
  • 23:00 Case 2: An uninsured patient who needs major surgery; costs for uninsured versus insured patients
  • 28:35 Do insured patients have better outcomes?
  • 31:15 How to determine cost and “fair market price”
  • 36:29 Case 3: Clinical case of suspected heart failure
  • 45:45 Case 4: Clinical case of patient requesting antibiotics; barriers to high value care and how to overcome them
  • 57:05 Outro

Tags: high, value, care, quality, cost, diagnostic, uncertainty, likelihood, ratio, testing, treatment, consumer, acp, college, american, insured, uninsured, bill, charge, reimbursement, Sep 17, 2018

#113 Gout: Uric acid targets, urate lowering therapy, and random questions from social media
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Master the management of gout with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. Topics include: how to initiate and titrate urate lowering therapy, guidelines controversy over uric acid targets, colchicine & NSAIDS for anti-inflammatory prophylaxis, uricosuric agents, febuxostat, HLA B5801, use of uric acid levels in the acute setting and more random gout facts.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written and produced by: Matthew Watto MD
  • Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
  • Guest: Tuhina Neogi MD, PhD

Time Stamps

  • 00:00 Intro and guest bio
  • 01:30 Allopurinol initiation and titration
  • 07:10 Uricosuric therapy
  • 09:10 Controversy over uric acid targets for gout
  • 17:40 Parachutes and randomized controlled trials
  • 19:15 Colchicine or NSAIDS for prophylaxis
  • 23:20 Who needs febuxostat?
  • 26:20 When to refer for gout, HLA B5801, and checking uric acid levels in the acute setting  
  • 33:29 Take home points
  • 36:15 Outro

Tags: allopurinol, uric, urate, acid, level, therapy, management, gout, flare, crystal, arthritis, titration, probenecid, febuxostat, target, acr, acp, guidelines, nsaids, colchicine, hla b5801, septic, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Sep 10, 2018
#112 Gout Flares: Bathtubs and Firefighting
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Crystalize your knowledge of gout and stop flares in their tracks with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. On this first of two gout episodes we learn to diagnose gout with or without arthrocentesis, how to treat flares, and how to counsel patients about gout, which apparently involves fire fighting and bathtubs. Don’t miss next week’s episode on urate lowering therapy, gout guidelines controversy, and answers to your gout questions from social media.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written and produced by: Matthew Watto MD
  • Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
  • Guest: Tuhina Neogi MD, PhD

Time Stamps

  • 00:00 Disclaimer, intro
  • 01:40 Guest bio
  • 03:20 Guest one liner, music recommendations, advice for researchers, and some comments on failure
  • 09:15 Clinical diagnosis of gout
  • 12:15 Is taking a diet history useful?
  • 14:30 Classification criteria for gout
  • 17:35 MSK ultrasound and Physical exam findings in gout
  • 21:06 Arthrocentesis and MSU crystals
  • 24:45 A recap of how to make the diagnosis of gout
  • 26:50 The bathtub analogy and how to counsel a patient with a new diagnosis of gout
  • 30:55 Pathophysiology of gout
  • 34:55 Treatment for acute gout flares (steroids, colchicine, NSAIDS. And topical NSAIDS?) 
  • 45:30 Outro

Tags: gout, crystal, colchicine, steroids, nsaids, joint, flare, acute, chronic, urate, uric, acid, arthritis, acr, exam, diagnosis, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Sep 03, 2018
#111: Hotcakes - Complementary Medicine in Cancer, Dosing Aspirin by Body Weight, Marijuana & Respiratory Symptoms, Penicillin Allergies and More!
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Dr. Neda Frayha (@nedafrayha) of Primary Care RAP (Hippo Education) joins us this month for our thoughts and analysis of some recent (and not so recent) journal articles that interested us this month. Our articles spanned topics that include at cancer survival among patients pursuing treatment with complementary medicine, the effect of body weight on effectiveness of preventive aspirin dosing, strategies to promote physician leadership, respiratory symptoms in those with marijuana use and MRSA risk among patients with penicillin allergies. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

Full show notes available at http://thecurbsiders.com/podcastJoin our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you!

Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.  

Credits:

  • Written by: Sarah Phoebe Roberts MPH, Neda Frayha MD, Christopher Chiu MD
  • Producers: Sarah Phoebe Roberts MPH, Christopher Chiu MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
  • Editor: Matthew Watto MD 

Time stamps:

  • 00:00 Disclaimer, intro, guest bio
  • 05:05 Do patients using complementary medicine for cancer therapy have worse outcomes?
  • 13:11 Does low dose aspirin work for primary prevention of major adverse cardiac events?
  • 19:16 Do physicians make better leaders?
  • 24:55 Does marijuana cause respiratory symptoms?
  • 30:40 Does penicillin allergy confer increased risk for C Diff and MRSA infection?
  • 38:40 Wrap-up and outro

Tags:​ aspirin, cardiac risk, mortality, cancer, complementary, alternative, conventional, therapy, marijuana, cannabis, respiratory, symptoms, leader,

Aug 31, 2018
#110: Driver’s safety for Older Adults: When is it Time to Give Up the Keys?
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Get schooled on driver’s safety for older adults by expert, Alice Pomidor MD, Professor of Geriatrics at Florida State University. Whether or not older adults can continue to drive is a huge problem faced by for primary care clinicians, and will remain one until driverless cars become ubiquitous. Topics covered include: how to take a driving history, red flags, physical exam, cognitive exam, and vision assessment for driver’s safety, resources, when to refer, alternate means of transportation, and the legal repercussions of reporting...or not reporting.

Full show notes available at http://thecurbsiders.com/podcastJoin our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written and produced by: Matthew Watto MD and Elizabeth Garbitelli MD Candidate 2022
  • Editor: Matthew Watto MD
  • Cover Image by: Kate Grant MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Alice Pomidor MD 

Time Stamps

  • 00:00 Disclaimer
  • 00:35 Intro and guest bio
  • 03:10 Guest onliner, book recommendations, and career advice
  • 10:43 Clinical case, and the 5 Rs of clinicians responsibility
  • 19:15 Taking a history from older adult drivers
  • 26:28 The clinical exam for driver’s safety (cognition, vision, and MSK tests)
  • 37:24 How can we avoid patient anger towards clinician and family members?
  • 41:10 When and where to refer for driving evaluation
  • 47:00 Alternative transportation
  • 52:00 What to do if someone refuses or forgets to stop driving
  • 59:45 Reporting requirements and legal ramifications
  • 69:15 Take home points
  • 72:00 Outro 

Tags: driving, elderly, geriatrics, dementia, treatment, prevention, cognition, seniors, drivers, safety, crash, motor, vehicle, car, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

 

Aug 27, 2018
#109: Things We Do For No Reason: A High Value Episode
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Things We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound and urine electrolytes in acute kidney injury (AKI), folate deficiency and anemia work-up, prealbumin and malnutrition, blood transfusions, shellfish and contrast allergies, monitoring after switch from IV or oral antibiotics, and “against medical advice” discharges.

Don't forget to check out Clinicwiki.org a free, online resource for teaching ambulatory medicine.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Credits:

  • Written and produced by: Justin Berk MD, MPH, MBA
  • Editor: Matthew Watto, MD
  • Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD, FACP
  • Guest: Lenny Feldman MD, FACP

Goal: Listeners will recognize things we do for now reason aka low value practices with an unfavorable ratio of benefits to cost and/or harm.

Learning objectives:

After listening to this episode listeners will…

  1. Determine if renal ultrasound is indicated in acute kidney injury
  2. Recognize the limitations of urine electrolytes in AKI.
  3. Identify the shortcomings of folate testing.
  4. Explain the significance of low albumin and prealbumin.
  5. Identify patients at risk for serious allergic reactions from IV contrast administration
  6. Explain the futility in discharge Against Medical Advice (AMA) paperwork
  7. Counsel patients on harm reduction in “AMA” discharges
  8. Rationalize discharging patients immediately after switching from IV to  oral (PO) antibiotics.

Time Stamps

  • 00:00 Announcements
  • 00:38 Disclaimer, intro, and guest bio
  • 03:53 Guest one liner, some recommendations, and advice
Aug 20, 2018
#108: Point-of-care Ultrasound for the Internist
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Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine.

Full show notes available at http://thecurbsiders.com/podcastJoin our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Christopher Chiu MD and Renee Dversdal MD
  • Produced and CME questions by: Christopher Chiu MD
  • Edited by: Matthew “Mike” Watto MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Christopher Chiu MD
  • Guest Expert: Renee Dversdal MD

Tags: point-of-care, acp, impocus, ultrasound, bedside, POCUS, CLUE, exam, training, lifestyle, management, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Aug 13, 2018
#107: Women in Medicine, Be Bold
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“Women in medicine, be bold.” Medical World, powerful women are here to stay. Dr. Vineet (Vinny) Arora, Professor of Medicine at University of Chicago, an exemplary Woman in Medicine and Leadership, shares snippets of her own story, valuable career advice to folks at all levels of training, and fascinating data about the gender disparities that exist in training, promotion, and pay.  We hope you’ll learn from this episode, whether you have faced or anticipate facing these struggles as a Woman in Medicine or as a member of another marginalized group, or whether you’re an ally and want to learn more about the issue.

Women are entering medical school now more than ever, and are learning to provide the best possible care to patients (didn’t you see that patients of female physicians have significantly lower mortality rates than patients of male physicians? (Tsugawa et al., 2016)).  The modern medical woman wants to teach, mentor, and lead--and be fairly evaluated, and promoted. That’s where We In Medicine (both women and men) have some work to do.  Because gender disparities (and other disparities hinging on identity) do exist.

N.b. This episode is our inaugural in what we hope will be a Women in Medicine series for the Curbsiders.  We have many more topics with which we’d like to engage, from career trajectory to imposter syndrome to sexual harassment to balancing career and personal lives (as inequity is not only at work (Khullar. Being a Doctor is Hard. It’s Harder for Women. NYT 2017)), to conversations about race, gender, and LGBTQ identity in medicine.  We’re passionate, at The Curbsiders, about all these topics, and we want to dive deep into how to make Medicine a more welcoming and ceiling-less place for all.  We can’t wait to bring this series to you, not to mention to bring some more fabulous female experts on air.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written and produced by: Leah Witt MD, Shreya P. Trivedi MD, Nora Taranto AB, Sarah Phoebe Roberts MPH, Molly Heublein MD, Beth Garbitelli, Hannah R Abrams,
  • Images by: Beth Garbitelli and Hannah Abrams
  • Editor: Matthew Watto MD
  • Hosts: Leah Witt MD, Shreya P. Trivedi MD, Matthew Watto MD
  • Guest: Vineet Arora MD

Time Stamps

  • 00:00 Disclaimer and intro
  • 03:15 Guest bio, and one liner
Aug 06, 2018
#106: Hotcakes: Cardiac risk, diabetes, pulmonary embolism, opioid use disorder, neck ties and nose picking?
3336

Short on time but hungry for knowledge? Curbsiders’ Journal Club gives you the speedy article analysis you crave. We provide brief summaries of recent research and news items in the field of internal medicine, so you can save time and stay on top of the literature. On this episode, we were joined by Kashlak Memorial’s very own Chair of Medicine, Dr. Robert Centor AKA @medrants on Twitter or “Uncle Bob” to the Curbsider Crew. This month’s topics include: estimating atherosclerotic cardiovascular disease risk, whether CT pulmonary angiography (CTPA) effectively rules out pulmonary embolism, discharging low risk patients with pulmonary embolism from the ED, metformin and risk of acidosis in patients with CKD, treating opioid use disorder after a nonfatal overdose, Canagliflozin and renal protection in type 2 diabetes, screening for diabetes among patients below age 40, and the association between nose-picking and staphylococcus. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you!

Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.  

Credits:

  • Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
  • Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
  • Editor: Matthew Watto MD
  • Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
  • Guest: Robert Centor MD

Time stamps:

  • 00:00 Disclaimer and Intro to Curbsiders Journal Club
  • 04:00 Dr. Centor's Pick of the Week
  • 06:10 Clinical Implications of the Revised Pooled Cohort Equations
  • 12:10 Negative Predictive Value in CTPA for VTE
  • 18:34 Can low risk patients with PE be discharged from the ED?
Jul 30, 2018
#105: Lyme Disease and Tick-Borne Illness with ID Expert Paul Sax: Why you should never go outside or to Boston in the summer
3521

Lyme disease and tick-borne illness deconstructed by Infectious Diseases expert, Paul E. Sax MD, of episode 78 fame. Oh, Summer Nights. The time for romance between Danny Zuko and good girl Sandy, the time to sit in the backyard around the bonfire, the time for sunset hikes in the woods and mountains…..and don’t forget, it’s also the time for those pesky woodland ticks who’ll go for a ride on you and maybe suck your blood (gross!). Dr. Sax takes us through the essentials of tick-borne illness, with a focus on Lyme Disease: diagnosing it, treating it, identifying possible co-infections, and managing Post-Lyme residual symptoms.  

Our (And Dr. Sax’s) Disclaimer about this episode, and the shownotes: Tick-borne illness is a very serious problem in public health in the US, but management is quite a controversial issue. We’ve done our best with this episode to stay as evidence-based as possible. Moreover, given the limited time we have on air, we have tried to focus on what we think is most clinically relevant.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Shreya P. Trivedi MD, Nora Taranto AB
  • Produced by: Shreya P. Trivedi MD, Nora Taranto AB
  • Editor: Matthew Watto MD
  • Images by:  Hannah R. Abrams
  • Hosts: Shreya P. Trivedi MD, Matthew Watto MD, Paul Williams MD
  • Guest: Paul E. Sax MD

Time Stamps

  • 00:00 Intro
  • 02:17 Disclaimer
  • 03:19 Guest bio
  • 05:17 Getting to know Guest
  • 08:33 Favorite hiking experiences
  • 12:20 Disclaimer of Tick-borne illness
  • 12:28 Clinical case of recent hiking in endemic area with a rash
  • 20:59 Lyme testing limitations
  • 27:38 Patient education to doxycycline
  • 30:16 Case of elderly outdoorsy healthy male with flu-like symptoms in the summer
  • 32:39 Differentiating anaplasmosis and babesiosis
  • 33:17 W
Jul 23, 2018
#104: Renal tubular acidosis with Kidney Boy, Joel Topf MD
4554

Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at http://thecurbsiders.com/podcast .

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Matthew Watto MD and Joel Topf MD
  • Produced by: Matthew Watto MD
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Joel Topf MD

Time Stamps

  • 00:00 Announcements
  • 01:02 Disclaimer
  • 01:40 Intro and guest bio
  • 04:00 Joel’s one liner
  • 06:05 Joel’s “favorite failure”
  • 11:45 Paul shares a failure
  • 13:20 Tweetorials
  • 16:39 Clinical case of non gap metabolic acidosis
  • 18:06 Three buckets of NAGMA and GI losses
  • 21:02 Chloride intoxication and normal saline
  • 25:14 Renal tubular acidosis and normal role of kidney in acid base
  • 35:03 Proximal (type 2) RTA
  • 40:33 Cases of proximal RTA
  • 43:38 Distal (type 1) RTA
  • 53:15 Bicarbonate dosing and titration
  • 55:28 Type 4 RTA (hypoaldosteronism)
  • 62:09 Urinary anion gap and ammonium
  • 67:26 Replacing GI losses of bicarbonate
  • 70:25 Joel reviews quick cases of RTA and NAGMA
  • 74:49 Outro 

Tags: renal, tubular, acidosis, non, gap, rta, nagma, metabolic, kidney, diarrhea, sodium, normal, saline, ringer's, lactate, tubule, bicarbonate, physiology, acid, base, ammonia, ammonium, nephrolithiasis, assist

Jul 16, 2018
#103: Train Your Brain: Mapping out your road to expertise
3514

Expert diagnostician, Dr. Gurpreet Dhaliwal, again joins The Curbsiders to dive deeper into the topic of clinical expertise.  Topics include, and are mainly focused on, Dr. Dhaliwal’s “training regimen:” feedback, simulation, quizzing, learning from consultants, and how to read the medical literature as a clinician.  While we found this episode to be incredibly useful (and entertaining to record), don’t let our bias sway your opinion! In fact, just listen to the episode and listen for practical advise on how to improve your own clinical acumen.  

Dr Brigham’s comment:  Be forewarned, much of what we talk about is seemingly common sense, but, upon listening to the episode many times, I realize that we have, over time, overly complicated the fundamentals of expertise.  I’m just as guilty as the next physician.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

  • Written and produced by:  Stuart Brigham MD
  • Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD
  • Guest: Gurpreet Dhaliwal MD
  • Images by: Beth Garbitelli
  • Edited by:  Matthew Watto MD

Time Stamps

  • 00:00 Disclaimer, Intro
  • 02:25 Guest Bio
  • 03:57 Pun
  • 04:25 Dr. Dhaliwal
  • 05:57 Pick of the Week - Move, “Jiro Dreams of Sushi”
  • 08:00 Pick of the Week - Podcast, “Unspooled”
  • 09:06 Pick of the Week - Water Putty, “Durham’s Rock Hard Water Putty”
  • 10:20 “Clinical Case” Introduction
  • 12:00 Developing expertise, introduction
  • 15:50 Developing a patient log
  • 21:30 Asking the wrong question leads to the wrong answer
  • 23:35 Telling a colleague they were wrong
  • 26:00 Five to one ratio
  • 28:58 Understanding the why
  • 33:57 Simulation in practice
  • 37:35 Quote on learning… Just listen.
  • 41:00 Quizzing and consolidating memory
  • 44:24 Reading the literature as a clinician
  • Jul 09, 2018
#102: Curbsiders Journal Club Hotcakes and Hot Takes June 2018
2945

Curbsiders’ Journal Club features rapid summary and critical appraisal of recent articles and news stories in internal medicine by The Curbsiders. This month’s topics include: asthma, maintenance versus as needed inhaler use, procalcitonin, Pneumocystis pneumonia prophylaxis, colon cancer screening, smoking cessation, cannabis and cognitive impairment, LDL cholesterol and mortality, plus some medical podcast recommendations.

Over the last month, we have developed a list of more than 40 interesting articles and news stories that we have been feeding our own brain holes. From this list we have plucked a select few that we really wanted to highlight and share with you.

Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

  • Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
  • Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
  • Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
  • Editor: Matthew Watto MD

Time Stamps:

  • 00:00 Announcements
  • 00:20 Disclaimer
  • 01:00 Intro to Curbsiders Journal Club
  • 03:07 Mild asthma and as needed versus maintenance inhaler use
  • 09:50 Smoking cessation, e-cigarettes, and financial incentives
  • 17:23 Pneumocystis pneumonia prophylaxis
  • 22:18 Cannabis and cognitive impairment
  • 26:15 Colorectal cancer screening update by American Cancer Society
  • 30:37 Procalcitonin for lower respiratory tract infections in the ED
  • 37:29 Cholesterol, baseline LDL-C, mortality and cardiovascular events
  • 41:01 Incorrect symbology and some podcast recommendations
  • 46:22 Outro

Tags: asthma, maintenance, inhaler, procalcitonin, Pneumocystis, pcp, pneumonia, prophylaxis, colon, cancer, screening, crc, smoking, cessation, marijuana, cannabis, cognitive impairment, LDL, cholesterol, mortality, cardiovascular, podcast, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed

Jul 02, 2018
#101: Cirrhosis: Medications, decompensation, complications
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Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology!

Full show notes available at http://thecurbsiders.com/podcastJoin our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Cyrus Askin MD
  • Infographics: Beth Garbitelli
  • Produced by: Cyrus Askin MD and Matthew Watto MD
  • Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Scott Matherly MD

Time Stamps

  • 00:00 Announcements
  • 00:54 Disclaimer
  • 01:30 Guest bio
  • 02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis
  • 06:56 Clinical case of decompensated cirrhosis
  • 09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics
  • 18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin
  • 25:10 Timing of medical therapy
  • 26:39 MAP of 82 mmHg, beta blockers and variceal bleeding
  • 31:04 Use of midodrine for hypotension
  • 33:45 Prophylaxis of SBP
  • 36:05 Take home points
  • 38:04 Outro

Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

Jun 25, 2018
#100: Cirrhosis: Initial Evaluation and Management
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Cirrhosis. Finally. Take your liver game to the next level with tips from @liverprof, Scott Matherly MD, Assistant Professor of Medicine at Virginia Commonwealth University. Topics include: exam findings in cirrhosis, interpreting liver function tests, incidental cirrhosis on imaging, fatty liver disease, steatohepatitis, hep c, shear wave elastography, screening for varices and hepatocellular carcinoma, pathophysiology, and lifestyle measures for initial management. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date).

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Cyrus Askin MD
  • CME questions by: Cyrus Askin MD
  • Produced by: Cyrus Askin MD and Matthew Watto MD
  • Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Scott Matherly MD

Time Stamps

  • 00:00 Announcements
  • 00:45 Disclaimer
  • 01:19 Intro to the show and our guest
  • 04:15 Guest one liner, books recommendations, and career advice
  • 09:04 Cyrus’ pick of the week
  • 10:14 Clinical case of abnormal liver functions tests
  • 11:12 Seven hand findings of cirrhosis
  • 13:28 Should we screen for NASH?
  • 15:28 Incidental finding of cirrhosis on imaging
  • 17:47 Next steps after diagnosis of cirrhosis
  • 20:36 Non-invasive scoring systems to predict cirrhosis
  • 23:55 Liver biopsy
  • 25:33 Shear wave elastography
  • 29:10 Recap of what we learned so far
  • 31:58 Three ways cirrhosis can kill you
  • 33:56 Counseling patients about cirrhosis
  • Jun 18, 2018
#99 Cancer Survivorship: What to do when the treatment is done
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Step up your primary care of cancer survivors with tips from Dr Regina Jacob, Assistant Professor of Medicine at Temple University. Care of the cancer patient does not end when their cancer treatment is over, and there is more to a past diagnosis of cancer than surveillance. We discuss cancer survivorship care with Dr. Regina Jacob, including the changing demographics of survivorship, the importance of survivorship care plans, and how survivorship is largely just good primary care.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Paul Williams MD
  • Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD
  • Produced by: Paul Williams MD
  • Edited by: Matthew Watto MD
  • Guest: Regina Jacob MD 

Time Stamps

  • 00:00 Disclaimer
  • 00:35 Intro to the topic and guest bio
  • 02:15 Guest one liner, book and app recommendations
  • 06:58 Paul’s pick of the week.
  • 07:40 Clinical case, definitions, and phases survivorship
  • 12:36 Survivorship statistics
  • 15:04 Co-survivorship
  • 17:41 Care models for survivorship
  • 20:56 Assigning roles in care of cancer survivors
  • 22:59 Sample survivorship care plan
  • 27:39 Childhood, adolescent and young adult cancer survivorship
  • 34:18 Sexual dysfunction in cancer survivorship
  • Turn down Watto and Regina tracks
  • 35:56 Stressors in young adult cancer survivors
  • 37:33 Fatigue
  • 43:28 Guidelines on survivorship
  • 45:06 Late cardiac toxicity
  • 46:23 Support groups and resources
  • 49:04 Take home points
  • 50:29 Outro 
Jun 11, 2018
#98: Knee Pain: History, exam, bracing, x-rays, and injectables
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Knee pain is easy with practical tips from Orthopedist, medical educator, car-builder, and inventor extraordinaire Dr. Ted Parks. He teaches us the four buckets of knee pain, how to perform a 30-second knee exam, choose a knee brace, order x-rays, and the red flags to look for in a history and physical that should have you shouting for your closest neighborhood orthopedic surgeon. This episode is brought to you in partnership with the American College of Physicians. ACP members can claim free CME-MOC credit at acponline.org/curbsidersCheck out our video of the Parks-Approved 30-second knee exam!

Credits:

  • Written by: Nora Taranto BA, Matthew Watto MD
  • Produced by: Chris Chiu MD and Nora Taranto BA
  • Edited by: Matthew Watto MD.
  • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD.
  • Guest: Ted Parks MD.  

Full show notes available at http://thecurbsiders.com/podcastJoin our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Time Stamps

  • 00:00 Announcement
  • 01:00 Disclaimer
  • 01:35 Intro and guest bio
  • 04:08 Dr Parks’ one-liner, book recommendation, inventions, and career advice
  • 10:52 A case of knee pain, and recognizing emergencies
  • 14:17 Four buckets of knee pain
  • 17:40 Initial approach to treatment of knee pain
  • 20:19 Corticosteroid injection controversy
  • 22:47 Hyaluronic acid injections
  • 24:50 Topical agents
  • 27:03 Taking a history about knee pain
  • 29:39 Knee locking or giving out
  • Practical Office Orthopedics by Ted Parks
  • 31:44 How to order knee X-rays
  • 36:45 Knee braces
  • 41:0
Jun 04, 2018
#97 Hotcakes: Hypertension, Prostate Cancer Screening, Lifestyle & Mortality
2365

Keep current with this monthly journal club covering landmark articles through May 2018, plus rapid fire hot takes from the medical literature and health news. We rate each article according to a highly scientific ‘Hotcakes’ scale to highlight what practice-changing knowledge we’ll take to work this month. Topics: Hypertension, blood pressure monitoring, prostate cancer screening, Intimate Partner Violence screening, alcohol is killing you, new diabetes drugs and mortality, DPP-4 inhibitors and IBD risk, NT-proBNP-guided therapy vs usual care, effect of teaching status on mortality, and more! If you’re a listener and have something interesting for us to discuss, please send it our way.

Join our mailing list to receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

  • Written and produced by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
  • Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
  • Editor: Matthew Watto MD

Time Stamps: 

  • 00:00 The Curbsiders need a web master
  • 00:50 Disclaimer
  • 01:25 Intro to the format
  • 03:25 Ambulatory BP monitoring and mortality
  • 09:08 Blood pressure treatment strategies: CVD risk score vs systolic BP targets
  • 14:14 Repeated BP measurements important at office visits and future directions of BP management
  • 21:25 Hot takes in order of appearance: Prostate cancer screening, intimate partner violence, alcohol, DPP4 inhibitors mortality and IBD, teaching status and mortality in US hospitals, 5 lifestyle factors that may add to life expectancy, NT pro-BNP, BNP and mortality
  • 38:12 Outro
May 28, 2018
#96: Diabetes: A1C targets & ACP guidelines controversy
3028

Get schooled on hemoglobin a1c targets in type 2 diabetes mellitus by American College of Physicians guidelines coauthor, Devan Kansagara MD MCR, Associate Professor of Medicine, Oregon Health Sciences University. We summarize outcomes from the landmark diabetes trials (ACCORD, ADVANCE, VADT, UKPDS 33 & 34), how a1c targets effect microvascular and macrovascular events, estimating life expectancy, and how to personalize diabetes control for your patients. We’re proud to announce our new partnership with the ACP to provide free CME credit and MOC points on select episodes of The Curbsiders. ACP members can visit acponline.org to redeem free CME/MOC credit.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list to receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written, produced, and edited by: Matthew Watto MD.
  • Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD.
  • Guest: Devan Kansagara MD, MCR

Time Stamps

  • 00:00 Announcement
  • 00:48 Disclaimer and intro
  • 03:11 Getting to know our guest: one liner, book recommendation, mentorship
  • 06:50 How and why did ACP write their guidance statement on diabetes, A1C targets
  • 09:18 Landmark trials in type 2 diabetes
  • 11:36 Does tight control prevent micro or macrovascular complications
  • 13:20 Trials of newer agents like SGLT2i, GLP-1 and DPP4i
  • 14:33 How do ACP’s guidelines differ from other published guidelines
  • 17:20 Quick recap of landmark trial findings
  • 22:24 Personalizing glycemic control
  • 24:30 Controversy over an A1C goal of 7-8%
  • 28:05 Clinical inertia
  • 30:26 Legacy effect and metabolic memory
  • 34:00 Deintensifying therapy
  • 38:29 Life expectancy and comorbid conditions
  • 43:15 Performance measures in diabetes
  • 44:42 Take-home points
  • 46:30 The Curbsiders recap and give some closing remarks
  • 49:13 Outro 

Tags: diabetes, a1c, target, dm, hypoglycemia, glycemic, intensive, tight, glucose, control, cardiovascu

May 21, 2018
#95: Food allergy, food intolerance and celiac disease
3457

Separate the wheat from the chaff when it comes to food allergy, food intolerance, and celiac disease. Featuring renowned gastroenterologist and current president of the American Gastroenterological Association, Dr. Sheila Crowe MD FRCPC FACP FACG AGAF, we discuss how to differentiate a food allergy from an intolerance, what diagnostic testing is appropriate, and why fructans might be the real culprit in patients with ‘gluten sensitivity’.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

  • Written by: Sarah P. Roberts, MPH
  • Guest: Sheila Crowe, MD
  • Hosts: Matthew Watto, MD; Stuart Brigham, MD; Paul Williams, MD
  • Producers: Sarah P. Roberts, MPH and Chris Chiu, MD
  • Editor: Matthew Watto, MD

Time Stamps:

  • 00:00 Disclaimer
  • 03:35 Getting to know our guest, book recs, and career advice
  • 10:35 Clinical case
  • 11:40 Defining allergy, intolerance
  • 14:05 Food intolerance and FODMAP
  • 18:02 Taking a history in patient with potential food allergy vs intolerance
  • 21:34 Dermatitis herpetiformis, gluten ataxia, and extraintestinal manifestations of celiac
  • 26:12 Diagnosing celiac disease
  • 30:53 Next steps if celiac testing is negative; lactose, fructose intolerance, IBS
  • 33:48 Non-celiac gluten sensitivity (NCGS)
  • 37:48 Study of NCGS
  • 40:41 Olmesartan and drug-induced enteropathy
  • 43:38 Dieticians, dietary recs, elimination diets
  • 48:10 “Voodoo” testing
  • 52:36 Counseling patients on diet
  • 54:35 Take home points
  • 55:50 Outro

Tags: food, allergy, intolerance, sensitiv

May 14, 2018
#94: Random Pearls: Microbiome, POTS, Gabapentin, and Leonardo Da Vinci
1735

A random serving of knowledge food for your brain hole with returning guest, Dr. Alan Dow, Professor of Internal Medicine at Virginia Commonwealth University School of Medicine. Our final live recap show from ACP 2018 covering: human microbiome, copper deficiency, POTS syndrome, substances of abuse, drugs for delirium and how to be more like Leonardo Da Vinci. Please let us know what you liked, didn’t like and how we can make the show better.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Time stamps:

  • 00:00 Disclaimer
  • 01:30 Guest bio
  • 03:19 Getting to know our guest, podcast, and book recommendations
  • 08:55 Human microbiome
  • 11:05 A case of anemia and neuropathy
  • 13:30 Physiology and treatment of POTS syndrome
  • 17:00 Novel substances of abuse
  • 20:17 Benzodiazepines for delirium
  • 24:00 Leonardo Da Vinci versus the modern physician
  • 27:18 Outro

Tags: microbiome, transplant, bupropion, gabapentin, pregabalin, copper, POTS, substance, use, disorder, leonardo, da, vinci, acp, journal, article, literature, news, media, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

May 07, 2018
#93: Clinical Pearls ACP 2018 with Nina Mingioni MD
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A fast moving recap of hot topics and clinical pearls live from Internal Medicine’s largest national conference, ACP 2018 in New Orleans! Dr. Nina Mingioni, Clinical Associate Professor and director of Undergraduate Medical Education in Internal Medicine at Thomas Jefferson University Hospital serves up some knowledge food for our brain holes. Topics: the athlete as a patient, sports physicals, food as medicine, medical marijuana (cannabis), and more! Listeners, please let us know what you liked, didn’t like and how we could make this better. YouTube video of this episode available here: ACP 2018 Recap with Nina Mingioni

You can join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders. 

 

Time stamps:

  • 00:00 Music and disclaimer
  • 02:48 Getting to know our guest
  • 06:07 The athlete as a patient
  • 10:20 Relative energy deficiency in sports
  • 12:00 Drug interactions
  • 15:51 Food as medicine
  • 21:56 Marijuana
  • 30:24 Outro

Credits: 

Written by: Nina Mingioni MD, Hannah Abrams. Producer/videographer: Chris Chiu MD. Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD. Editor: Matthew Watto MD

Tags: food, microbiome, marijuana, athlete, ekg, ecg, physical, sports, training, energy, relative, deficiency, cannabinoid, entourage, effect, cannabidiol, thc, cannabis, acp, 2018, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Apr 30, 2018
#92: Pulmonary Embolism for the Internist
3441

Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz

Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Time Stamps

  • 5:10 - Start of Interview / Introduction
  • 10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology
  • 16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”)
  • 23:30 - Other ways to risk-stratify (Other CT findings, clot burden)
  • 28:45 - What does a low-risk patient look like?
  • 30:35 - When to consider treatment modalities other than general anticoagulation
  • 35:12 - Anticoagulation treatment options
  • 36:38 - Next step intensive interventions after anticoagulation
  • 42:00 - Evidence behind catheter-directed lysis
  • 44:05 - IVC Filter discussion
  • 47:22 - Discharge criteria for PE
  • 50:00 - Incidental PEs
  • 52:40 - Interdisciplinary PERT Team

Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

Apr 23, 2018
Random Clinical Pearls ACP 2018 Day 2
1374

Random clinical pearls from day 2 of ACP 2018 live in New Orleans. Topics include: Perioperative medicine, DOACs, anticoagulation, reversal agents, ACP statements on hidden curriculum, physician well being and burnout, modeling behavior, dermatology pearls, rashes, venous stasis ulcers, pentoxifylline, biotin and Grave's disease, dermatology pearls, Stuart's tips on sports doping, and how chocolate milk improves recovery time. Doctors Chris Chiu and Chris Thrash join us to discuss their favorite teaching points from today's sessions.

Cochrane Review on Venous Ulcers https://bit.ly/2JdQAMu

Joinour mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Apr 21, 2018
Random Clinical Pearls ACP 2018 Day 1
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