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.  

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 | Subscribe | 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. Note: A free VCU Health CloudCME account is required in order to seek credit. 

Time Stamps

• Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
• Sponsor - VCU Health Continuing Education
• 00:30 Intro, disclaimer, guest bio, pun
• 04:00 Guest one-liners, Picks of the Week* (see slinks 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
• Sponsor - VCU Health Continuing Education

Links*

1. Radical Candor (book)
2. Host (film)
3. Percy Jackson & The Olympians: The Lightning Thief movie 
4. Hamilton on Disney Plus
5. Her (film) 

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will demonstrate effective techniques to deliver and solicit meaningful feedback.

Learning objectives

After listening to this episode listeners will…  

1. Discuss the definitions and terms used to discuss feedback.
2. Deliver effective feedback that is concordant with the learning goals of their trainees.
3. Address potential perceived barriers to feedback.
4. Utilize the ADAPT framework to partner with their learners and develop shared goals.
5. Develop strategies to mitigate against using gender- or racially-biased narrative language.
6. Deliver feedback to learners with limited insight by leveraging the impact of perception on achieving goals.
7. Solicit effective and meaningful feedback despite being in a position of authority

Disclosures

Drs. Spencer and Chisty report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Williams PN, Spencer A, Chisty A, Brigham SK, Jyang E, Watto MF. “#233 Giving effective feedback with Abby Spencer and Alia Chisty”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 21, 2020.

References 

1. Ende J. Feedback in Clinical Medical Education.  JAMA.  1983. . [https://pubmed.ncbi.nlm.nih.gov/6876333/] 
2. Brown B.  2018.  Dare to Lead.  Random House.
3. Stone D and Heen S.  2014.  Thanks for the Feedback.  Penguin Books.
4. Scott K.  2019.  Radical Candor.  St. Martin’s Press.
5. Fainstad T et al.  Feedback can be less stressful: Medical trainee perceptions of using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) framework.  Cureus.  2018. [https://pubmed.ncbi.nlm.nih.gov/30906679/] 
6. Rojek AE et al.  Differences in narrative language in evaluations of medical students by gender and under-represented minority status.  J Gen Int Med.  2019.  [https://pubmed.ncbi.nlm.nih.gov/30993609/] 
7. Mueller AS et al.  Gender differences in attending physicians’ feedback to residents.  JGME.  2017.  [https://pubmed.ncbi.nlm.nih.gov/29075375/] 
8. Ross, DA et al.  Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations.  PLoS ONE.  2017.  [https://pubmed.ncbi.nlm.nih.gov/28792940/] 

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!

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). 

Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights. 

Show Notes | Subscribe | 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 and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

• Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
• Sponsor - VCU Health Continuing Education
• 00:30 Intro, disclaimer, guest bio
• 04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
• Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders
• 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 Case 3: 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 management &  treatment
• 59:10 Retinoid dermatitis
• 1:00:30 Maskne
• 1:02:29 Antibiotics for acne
• 1:03:38 Retinoids and pregnancy
• 1:04:09 Doxycycline for rosacea
• 1:06:15 Take home points
• Sponsor - VCU Health Continuing Education

Links*

1. Hamilton and Alexander Hamilton by Ron Chernow, 
2. Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance) 
3. The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt 
4. Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones) 
5. Brown Skin Matters on Twitter and Instagram
6. Skin of Color Society
7. American Academy of Dermatology
8. Society for Dermatology Hospitalists
9. Black Skin Directory Learning Journal
10. Mind the Gap (2020) by Malone Mukwende 
11. Ethnic Dermatology: Principles and Practice (2013)
12. Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012)
13. An Atlas of African Dermatology (2001)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic.

Learning objectives

After listening to this episode listeners will...

1. Recognize and treat common skin complaints of the scalp and face in primary care.
2. Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care.
3. Be able to differentiate non-scarring versus scarring hair loss on physical exam.
4. Comprehend nuances in total body presentations of psoriasis as a means to differentiate from seborrheic dermatitis. 
5. Review when referral to dermatology for hair loss or skin changes of the face/scalp  is necessary.
6. Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.

Disclosures

Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Pasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.

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.

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 | Subscribe | 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

Sponsors

POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates!  In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship.  Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team.  

Interview season is in full swing and they’re actively accepting applications.  Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information.  You can apply for fellowship using the eusfellowships.com portal.

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
• 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

Links*

1. Dr. Joel Topf’s Textbook
2. Dr. Joel Topf’s Blog
3. Dungeons and Dragons
4. Tartine (cookbook) by Elizabeth M. Prueitt
5. I Hate You, Don’t Leave Me by Hall Strauss
6. Intentional Parenting by Sissy Goff
7. Mindset by Carol Dweck
8. Nintendo Switch
9. 8.0 Bit Techno- The Curbsiders Theme Song by Stuart Kent Brigham
10. Ure-Na 
11. European Society of Endocrinology Clinical Practice Guidelines. 
12. Don’t miss Dr. Topf on twitter aka @kidney_boy.

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will recall the pathophysiology of hyponatremia and develop a systematized approach to identifying the type and cause of hyponatremia, as well as how to safely manage hyponatremia. 

Learning objectives

After listening to this episode listeners will…  

1. Differentiate true and false hyponatremia
2. Recall the pathophysiology of true and false hyponatremia 
3. Interpret blood and urine tests to identify the cause of hyponatremia
4. Recall the limitations of the volume status exam
5. List ADH dependent causes of hyponatremia
6. List ADH independent causes of hyponatremia 
7. Explain the pathophysiology of beer drinker’s potomania and “tea and toast” hyponatremia
8. Use uric acid to differentiate SIADH from other causes of hyponatremia
9. Basic therapy for SIADH
10. Recall safe rates of correction for hyponatremia

Disclosures

Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures. 

Citation

Topf J, Gorth DJ, Williams PN, Brigham SK, Heublein M, Jyang E, Watto MF. “REBOOT #48 Hyponatremia Deconstructed”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date: July 17, 2017; Updated September 7, 2020.

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! 

NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at 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

*Sponsors*

POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates!  In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship.  Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team.  

Interview season is in full swing and we’re actively accepting applications.  Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information.  You can apply for fellowship using the eusfellowships.com portal.

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

• 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

Goal

Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes.

Learning objectives

After listening to this episode listeners will…  

1. Identify the signs and symptoms of type 1 diabetes 
2. Practice appropriate work-up in the diagnosis of type 1 diabetes
3. Manage type 1 diabetes with evidence-based therapies
4. Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts
5. Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes)

Disclosures

Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures. 

Citation

Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (slink goes live on 9/2/2020)

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! 

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 | 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

• Sponsor - VCU Health Continuing Education
• 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
• Sponsor - VCU Health Continuing Education

Links*

1. Behave (book) by Robert Sapolsky
2. Boghuma’s blog theiddoc.net
3. Boghuma’s TED Talk 
4. Emory’s ID fellowship program

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will appropriately recognize, diagnose and treat the various presentations of urinary tract infection.

Learning objectives

After listening to this episode listeners will...

1. Define UTI and feel confident making the diagnosis of UTI based on lab tests, history and exam findings
2. Differentiate between complicated and uncomplicated UTI
3. Recognize how UTI may presents differently in differ groups (paraplegic, chronic foley catheter, men and women)
4. Choose the appropriate antibiotic and duration with an eye towards antibiotic stewardship
5. Determine an approach to the patient with recurrent UTIs, including who may benefit from long term antibiotic prophylaxis. 

Disclosures

Dr Titanji reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Titanji BK, Williams PN, Watto MF. “#231 U Talkin’ UTIs Re: Me”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 24, 2020.

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. 

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 | 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

• 00:00 Sponsor - VCU Health CE; Intro, disclaimer, guest bio
• 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

• Sponsor - VCU Health CE

Links*

1. Dr. Kittleson’s go-to brownie recipe
2. My Own Country: A Doctor’s Story by Abraham Verghese
3. The new Run the Jewels album RTJ4
4. #KittlesonRules 
5. Practice Tests for Jeopardy 
6. Core IM podcast about Salt Restriction in Heart Failure 

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will learn how to manage acute decompensated heart failure. 

Learning objectives

After listening to this episode listeners will…

1. Learn the basic pathophysiology of acute decompensated heart failure (ADHF)
2. Develop a framework for the approach to diuretic therapy 
3. Gain the tools to effectively monitor the progress of diuresis
4. Develop strategies to approach diuretic resistance 
5. Establish criteria for discharge and strategies to reduce readmission
6. Know which drugs reduce mortality for heart failure with reduced ejection fraction (HFrEF)

Disclosures

Dr Kittleson reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Kittleson MM, Gorth DJ, Williams PN, Watto MF. “#230 Kittleson Rules Heart Failure”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 17, 2020.

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! 

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 | 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. 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
• 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” 

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will hone their skills in critical appraisal as they appraise the design, methodology and primary findings of breaking research. 

Learning objectives

After listening to this episode listeners will…  

1. Describe the results of a study comparing treatment with dexamethasone to usual care for COVID-19 
2. Recognize the utility of statins for adults aged 75+  
3. Compare dual antiplatelet therapy to monotherapy with ticagrelor for the prevention of major adverse cardiac events among patients with ACS 

Disclosures

Dr. Rahul Ganatra would like to acknowledge that he works with many of the authors on the statins paper. He, and the rest of The Curbsiders, report no relevant financial disclosures. 

Citation

Ganatra RB, Roberts SP, Williams PN, Watto MF. “#229 Hotcakes: COVID on steroids, statins over 75, and shortened duration DAPT”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. August 10, 2020.

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!

Listeners can claim Free CE credit through VCU Health at curbsiders.vcuhealth.org (CME goes live at 0900 ET on the episode’s release date). 

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

Credits

• Written and Produced by: Tima Karginov and Matthew Watto MD, FACP
• 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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

• 00:00 Sponsors - VCU Health Continuing Education and the AAP’s Pediatrics On Call podcast

• 00:30 Intro, disclaimer, guest bio
• 03:15 Guest one-liner, favorite failure, Picks of the Week*: After the Fall (How Humpty Dumpty Got Back Up Again) (children’s book), Circe (book), IMPACT https://www.impact4hc.com/ (Non-profit)
• 08:50 Sponsor - the AAP’s Pediatrics On Call podcast

• 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
• Sponsor - VCU Health Continuing Education

Links*

1. After the Fall (How Humpty Dumpty Got Back Up Again (Children’s book)
2. Circe (book)
3. Impact4hc.com Dr Bloomgarden and friends started this non-profit to address the infodemic during COVID19 

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will develop an approach to the diagnosis and management of hyperthyroidism and thyrotoxicosis.

Learning objectives

After listening to this episode listeners will…  

1. Recognize the signs and symptoms of thyrotoxicosis
2. Perform the appropriate diagnostic evaluation to differentiate between the various causes of thyrotoxicosis
3. Counsel and treat patients with thyrotoxicosis
4. Develop an approach to subclinical hyperthyroidism

Disclosures

Dr Bloomgarden reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Bloomgarden E, Karginov T, Williams PN, Watto MF. “#228 Thyroid on Fire: Hyperthyroidism with Dr Eve Bloomgarden”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 3, 2020.

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. The Cribsiders 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 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

We are excited to announce that the Curbsiders are now partnering with 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

Resources

• AAP COVID-19 Planning Considerations: Guidance for School Re-entry
• Johns Hopkins school reopening tracker

Goal

Listeners will explain the risks and benefits to school reopening during the COVID-19 pandemic. In addition, they will understand the most important steps to reopening being safe and what physicians can do to aid in school reopening. 

Learning objectives

After listening to this episode listeners will…  

1. Recall the benefits of reopening schools.
2. Be familiar with the risks of reopening and how to mitigate them.
3. Recognize what students may be at increased risk of suffering if schools do not reopen and how to advocate for them in the future.
4. Identify how pediatricians can help school systems remain functional during the COVID-19 pandemic.

Disclosures

Dr Sharfstein reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures.

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!

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 | 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

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

We are excited to announce that the Curbsiders are now partnering with 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 Sponsors - VCU Health Continuing Education and the AAP’s Pediatrics On Call podcast

• 00:30 Intro, disclaimer, guest bio

• 03:15 Guest one-liner; Picks of the Week*
: 
• 08:15 Sponsor - the AAP’s Pediatrics On Call podcast

• 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

Links*

1. Episode 100: Cirrhosis Initial Evaluation and Management 
2. Episode 101: Cirrhosis Medications, Decompensation, Complications 
3. The Last of Us Part II
4. Not a Diet Book by James Smith
5. Fooled by Randomness by Nassim Nicholas Taleb
6. Beirut Band - Gallipoli and The Flying Club Cup
7. Beat Saber

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will develop an approach to the basic evaluation and initial management of NAFLD. 

Learning objectives

After listening to this episode listeners will…  

1. Recognize the different etiologies of hepatic steatosis 
2. Define terms:  non-alcoholic fatty liver disease (NAFLD), non-alcoholic fatty liver (NAFL) non-alcoholic steatohepatitis (NASH), alcoholic steatosis, cryptogenic cirrhosis  
3. Define the risk factors associated with NAFLD 
4. Develop an approach to the initial evaluation and management of NAFLD and NASH 
5. Recognize the value of weight loss in the management of NAFLD
6. Determine when and how to monitor patients for progression of NAFLD 
7. Identify pharmacologic treatment options for patients with NASH and recognize when and how to use them. 
8. Describe the outcomes of concern associated with NAFLD and NASH. 

Disclosures

Dr Matherly reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Matherly S, Gibson EG, Williams PN, Okamoto E, Watto MF. “#227 Baffled by NAFLD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list . Original air date July 27, 2020.

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.

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 | Subscribe | 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

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

We are excited to announce that the Curbsiders are now partnering with 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 Sponsors - VCU Health CE and Pediatrics On Call podcast by APP
• 00:30 Intro, disclaimer, guest bio
• 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 - Pediatrics On Call podcast by APP
• 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
• 68:45 Outro and Sponsor - VCU Health CE

Links*

1. Dr. Topf: Nephrology & Social Media - May 2020, Vol 50, Issue 3, p 247-328 of Seminars in Nephrology
2. Dr. Topf: Zoe Keating - cellist & composer
3. Dr. Topf: Mrs. America a miniseries which dramatizes the women’s movement and fight for and against the Equal Rights Amendment in the 1970s
4. Dr. Williams: Last of Us 2

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will develop a rational approach to the diagnosis and management of the patient with acute kidney injury (AKI).

Learning objectives

After listening to this episode listeners will…  

1. … be facile with the definition of AKI
2. … have a framework for approaching AKI including an understanding of what features in a patient’s history may shed light on the diagnosis
3. … appreciate prerenal azotemia and the relationship with ATN
4. … develop an approach to rhabdomyolysis and AKI
5. … be able to discuss the various types of AKI likely to be seen in the critically ill patient
6. ... recognize the paradigm shift related to the safety when using iodinated contrast and gadolinium with regards to renal function
7. … know common medications implicated in AKI
8. … appreciate common AKI-related issues in the outpatient setting and have a head-start on how best to deal with them

Disclosures

Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures. 

Citation

Topf J, Askin CA, Williams PN,  Watto MF. “#226 Kidney Boy on Acute Kidney Injury: Myths & Musings”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. Original Air Date: July 20th, 2020.

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.

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 | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with 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

• 0:00 Intro, disclaimer
• 2:04 Introduction and bio for Kelly Graham, MD, MPH
• 2:30 Introduction and bio for Lekshmi Santhosh, MD MAEd
• 3:54 One-liner for Kelly Graham, MD, MPH
• 4:41 One-liner for Lekshmi Santhosh, MD MAEd
• 5:12 Gender Awakening Moments
• 10:08 Advice to their younger selves
• 13:15 Picks of the Week*
• 18:02 Case from Kashlak: Dr. Blackwell
• 20:10 Difficulty with lack of childcare while working
• 22:52 Hippocratic Oath paradox
• 26:02 Physician, educator, researcher, household manager & zoom homeschool teacher
• 27:14 Dr. Santhosh’s 3 Ps
• 28:08 Motherhood penalty-fatherhood bonus
• 32:00 Emotional Labor
• 35:10 Two Pandemics, One Response 
• 36:25 Breadwinner-homemaker bias
• 39:34 Impact of pandemic on women physician productivity
• 39:58 Female physician burnout
• 41:38 Minority Tax
• 48:03 Silver Linings
• 55:35 Suggestions for addressing pandemic-related inequity
• 67:10 COVID contributions on CV
• 68:50 Take home points and Outro

Links*

1. Dr. Santhosh’s recently published McSweeney’s piece: ““THANKS FOR ASSUMING I’M NOT THE FACULTY AND THAT MY FACULTY IS MALE”: TEXTS FROM FOUR WOMEN ICU PHYSICIANS ACROSS THE COUNTRY CARING FOR COVID PATIENTS”
2. Leah’s pick of the week: Paint by Sticker book 
3. Shreya’s pick of the week: Dr Giselle Corbie-Smith A Different Kind of Leader 
4. Justin’s pick of the week: 13th movie
5. Kelly’s pick of the week: Piece by Dr Kimberly Manning, When Grief and Crises Intersect: Perspectives of a Black Physician in the Time of Two Pandemics.  Conan O’Brien Needs a Friend podcast.
6. Lekshmi’s pick of the week: The Nocturnists podcast and Smitten ice cream delivery

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Discuss how the new challenges of COVID and working from home mean that women are often doing extra double duty         

Learning objectives

After listening to this episode listeners will...

1. Discuss the impact of COVID on the workload and productivity of women in medicine
2. Anticipate the long-term implications that this pandemic will have on gender inequity
3. Recognize areas where medicine may improve to promote gender equity when the second wave hits 

Disclosures

Kelly Graham, MD, MPH and Lekshmi Santhosh, MD MAEd report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Graham K, Santhosh L, Trivedi S, Berk J, Witt L, Valdez I, Heublein M, Watto MF. “#225 Women in Medicine: COVID Edition”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. Original air date: July 16, 2020.

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter.  In this episode we talk to Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Dr. Weimer is board certified in Internal Medicine and Addiction Medicine. She is the Medical Director of the Yale Addiction Medicine Consult Service and is a passionate clinician educator. We discuss a wide range of topics this episode including 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.

Listeners can claim Free CE credit through VCU Health at curbsiders.vcuhealth.org (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with 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

• 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

Goal

Listeners will discuss management of common inpatient addiction medicine scenarios. 

Learning objectives

After listening to this episode listeners will…  

1. Describe clinical indications for inpatient urine drug testing. 
2. Describe treatment management of polysubstance withdrawal. 
3. Discuss taper strategies for patients with benzodiazepine use disorders.
4. Discuss an approach to pain management in hospitalized patients with opioid use disorder. 
5. Integrate harm reduction principles into individual patient care plans. 
6. Manage treatment methadone in patients with prolonged QT in the hospital setting.

Disclosures

Dr Melissa Weimer reports working with Path, an addiction medicine treatment company. No trade names were used and that a balance range of therapeutic options were included in the discussion. The Curbsiders report no relevant financial disclosures. 

Citation

Weimer MB, Chan CA, Taranto NT, Gorth DJ, Williams PN, Brigham SK, Okamoto E, Watto MF. “#224 Hospital Addiction Medicine”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date July 6, 2020.

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. Recognize common extrapulmonary complications of cystic fibrosis in children and adults.
5. Describe available disease-modifying agents in cystic fibrosis care.

Disclosures

Dr. Warren reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures. 

Citation

Warren W, Mao C, Watto MF, Chiu C, Berk J. “Cystic Fibrosis Licked-ty Split with Dr. Whittney Warren”. The Cribsiders Pediatric Podcast. https:/www.thecribsiders.com/ Original Air Date: July 6, 2020.

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. 

Listeners can claim Free CE credit through VCU Health at curbsiders.vcuhealth.org (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with 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, 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

Goal

Listeners will learn about the role of race in COVID-19 outcomes, possible hormonal adjunctive therapies for depression, and when to recommend probiotics. 

Learning objectives

After listening to this episode listeners will…  

1. Learn the effect of race on COVID-19 outcomes.
2. Know the indications for adjunctive hormonal treatment for depression.
3. Discuss the role of probiotics for the treatment of common gastrointestinal illness. 

Disclosures

Dr. Utibe Essien reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Essien UR, Ganatra RB, Okamoto E, Roberts SP, Gorth DJ, Watto MF. “#223 Hot COVID Cakes: COVID19 Disparities, Steroids, Hormones for Depression, Probiotics”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. Original air date July 2, 2020.

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. 

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 | 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

We are excited to announce that the Curbsiders are now partnering with 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, 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

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will understand the way that structural racism pervades medicine and develop approaches for addressing the effects of racism within their clinics and communities.

Learning objectives

After listening to this episode listeners will…  

1. Define common terms: race, structural racism, white supremacy, health disparities 
2. Develop an approach to talking to patients about the effects of structural racism on health
3. Develop an approach for advocating to colleagues and within institutions on the effects of structural racism
4. Identify situations in which historical myths and structural racism in medicine may alter clinician judgment: race-based formulas, disparities in pain management, and disparities in screening and treatment of common conditions.

Disclosures

Dr. Essien and Ceasar report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Essien UR, Ceasar JN, Abrams HR, Williams PN, Watto MF. “#222 Addressing Anti-Black Racism in Medicine”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 26, 2020.

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. 

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). 

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

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

Sponsors

Join the ACP Community!

Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.  

VCU Health CE

We are excited to announce that the Curbsiders are now partnering with 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

• 0:00  Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT
• 00:30 Intro, disclaimer, guest bio
• 03:14 Guest one-liner, career advice, favorite failure, Picks of the Week*: The Strain, FX Horror TV Show; One Hundred Years of Solitude (book) by Gabriel Garcia Marquez; Hypoallergenic pillows; Peanut butter whiskey 
• 10:02 Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT
• 11:00 Case from Kashlak, Definitions
• 16:40 Buckets of ILD
• 32:06 Discussion of testing ILD: Labs and Imaging
• 44:20 Imaging findings in ILD
• 49:44 Basic Management of ILD
• 61:00 Take home points and Outro

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will feel comfortable with the basic pathophysiology, diagnosis, and management of interstitial lung disease. 

Learning objectives

After listening to this episode listeners will…  

1. Be able to define the lung interstitium. 
2. Develop a mental framework for the basic subtypes of interstitial lung disease. 
3. Learn with the types of questions necessary to elucidate the pathophysiology of their patient’s ILD. 
4. Know the steps to initiate a workup for ILD.
5. Become familiar with the treatment strategy for ILD. 

Disclosures

Dr Narewski reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Narewski E, Gorth DJ, Kus N, Madnick D, Wikoff P, Williams PN, Jyang E, Brigham SK, Watto MF. “#221 Interstitial Lung Disease with Erin Narewski DO”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list . June 22, 2020.

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 | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. 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  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 the SDOH are, and who they affect 34:00
• Start paying attention to SDOH 37:00
• Outro 38:49

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will recognize the ubiquity of SDOH and their effects on individual well-being and disease.

Learning objectives

After listening to this episode listeners will…  

1. Recognize social determinants of health and the impact on health
2. Give a framework for how to improve patient care by focusing on social determinants
3. Recognize how to leverage care teams and technology in innovative ways to improve health of individuals

Disclosures

Dr DeSalvo was a former board member of Humana. The Curbsiders report no relevant financial disclosures. 

Citation

DeSalvo KB, Okamoto EE, Williams PN, Watto MF. “#217 Social Determinants of Health with Karen DeSalvo MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 18, 2020.

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.

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 | Subscribe | 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

Sponsors

Join the ACP Community!

Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.  

VCU Health CE

We are excited to announce that the Curbsiders are now partnering with 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 Sponsors
• 00:30 Intro, disclaimer, guest bio
• 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 -Visit acponline.org/member
  
• 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 Comanaging Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis

• 57:55 Outro

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will effectively comanage perioperative patients with surgical colleagues.

Learning objectives

After listening to this episode listeners will…  

1. Identify effective strategies to improve safety at the time of transfer acceptance.
2. Develop an approach for asking appropriate perioperative questions to the surgical team.
3. Recognize common mistakes that hospitalists make when accepting a transfer.
4. Become familiar with evidence based post-operative care to prevent and treat common post-op complications
5. Develop a differential diagnosis and management approach for post-op fever
6. Develop a differential diagnosis and management approach for delirium

Disclosures

Dr O’Glasser reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

O’Glasser AY, Abrams HR, Williams PN, Watto MF. “#219 Post-Op Care and Complications with Avital O’Glasser MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 15, 2020.

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber. Dr. Gerber is an Associate Professor of Medicine at Boston University School of Medicine and serves as Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship. Dr. Gerber edited the textbook, “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 bring up upsetting thoughts or memories for some of our listeners. We will provide some self-care and trauma-informed resources in our show notes. The practice of medicine, especially during times of national crisis, can increase our exposure to traumatic events and reactivate difficult memories, predisoposing folks to depression and suicide risk. We just want to reiterate that you are not alone. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255. 

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 | Subscribe | 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

Sponsors

Join the ACP Community!

Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.  

VCU Health CE

We are excited to announce that the Curbsiders are now partnering with 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

• Intro, disclaimer, guest bio (0:00 - 4:09)
• Guest one-liner (4:24)
• Picks of the Week*: Keep Going: 10 Ways to Stay Creative in Good Times and Bad by Austin Kleon; Pilgrim at Tinker Creek by Annie Dillard; Molly’s Challah on King Arthur Flour website from cook/food writer Molly Yeh; OXO Good Grips Stainless Steel Food Scale with Pull-Out Display; Buffy the Vampire Slayer on Hulu, Amazon Prime; Devs on Hulu, Amazon Prime; Terry Pratchett’s Discworld series (Book 1 of 40: The Color of Magic, Night Watch) and The Wee Free Men; On Becoming a Healer by Saul J. Weiner MD (10:16) 
• Kashlak Cases (14:39)
• Epidemiology of trauma (16:11)
• Trauma and #MeToo (19:04)
• Defining Trauma-Informed Care (TIC) (19:56)
• Integrating TIC into primary care (23:42)
• Screening in TIC (25:56)
• Containment and retraumatization (29:56)
• Inquiring about trauma (31:39)
• Recap and Office Visit Mechanics (36:24)
• Building the Relationship (38:56)
• Common Inquiry Mishaps (39:46)
• TIC Physical Exam (41:14)
• Resources for Patients (45:24)
• Office Environment (48:56)
• Provider Burnout (50:56)
• TIC in Covid-19 (53:24)
• Take-home Points (57:14)
• Outro (65:44)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by slinking to Amazon. Simply put, if you click on our Amazon.com slinks and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will gain fluency in trauma-informed care practices, methods, and perspectives in order to deliver compassionate care to patients who have experienced trauma and reduce the impacts of trauma in the healthcare setting. 

Learning objectives

After listening to this episode listeners will…  

1. Define trauma-informed care and discuss the various forms of trauma. 
2. Develop increased awareness of prevalence of adverse childhood experience, post-traumatic stress disorders, sexual violence, and intimate partner violence.
3. Foster a safe, calm, welcoming clinical environment for patients who have experienced trauma. 
4. Manage trauma disclosures and assess appropriate next steps for care and referrals.
5. Cultivate advanced communication skills and strategies on the topics of sexual violence, intimate partner violence, and other trauma-related experiences. 
6. Be able to engage in harm reduction strategies when caring for patients with trauma history. 

Disclosures

Dr. Gerber reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Garbitelli EC, Gerber MR, Williams PN, Heublein M, Watto MF. “#218 Trauma-Informed Care with Megan Gerber MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 8, 2020.

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.

Stay current with the emerging COVID-19 research including: ACCT-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 | Subscribe | 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

Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.  

VCU Health CE

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.

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

Goal

Listeners will practice their critical appraisal skills as they update themselves on the latest COVID-19 research.

Learning objectives

After listening to this episode listeners will...

1. Describe the quality of evidence put forth by and the implications of the recent Lancet paper on triple therapy for COVID-19
2. Be familiar with the results of the ACCT-1 trial or remdesivir for COVID-19
3. Appreciate the complexities of PCR in testing for SARS-CoV2
4. Gain insight into the role of serological testing for SARS-CoV2

Disclosures

The Curbsiders report no relevant financial disclosures. 

Citation 

Gorth DJ, Ganatra RB, Okamoto E, Roberts SP, Watto MF. “#217 COVID Cakes 4 the Fourth”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. June 1, 2020.

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction medicine physician, Stefan Kertesz MD, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!).  To teach us the tricks of the trade, Dr. Kertesz draws on his many years of treating the underserved and researching homelessness, housing, and addiction in Birmingham, Alabama, where he currently serves as professor at UAB and Birmingham VA Medical Center.  In the course of this episode, we discuss the challenge of creating a welcoming and useful space for individuals experiencing homelessness (this is the preferred term, per Dr. Kertesz), 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 why the foot exam is of paramount importance. 

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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for and create your FREE account!

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

Goal

Listeners will learn the unique health challenges posed to individuals who are experiencing homelessness, and the best practices for addressing these challenges. 

Learning objectives

After listening to this episode listeners will…

1. Screen for and identify patients experiencing homelessness
2. Identify the unique challenges facing this population 
3. Identify best practices in caring for this population
4. Differentiate between different structures of healthcare delivery, and their advantages and disadvantages for the homeless population.  

Disclosures

Dr Kertesz reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Kertesz S, Taranto NT, Williams PN, Brigham SK, Chan, Caroyn, Watto MF. “#216: Homeless Healthcare with Stefan Kertesz MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. May 28,2020.

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. 

Listeners can claim Free CME credit through VCU Health at curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org/ for more information.

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

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will challenge the dogma of specific medical practices that have been spread without evidence basis.

Learning objectives

After listening to this episode listeners will...

1. Counsel patients taking metronidazole on alcohol use
2. Describe the risks associated with taking expired medications
3. Diagnose and treat commonly defined “sinus headaches”
4. Describe the risks associated with epinephrine injections in the extremities 

Disclosures

Dr Paauw reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Pauuw D, Berk J, Williams PN, Watto MF. “#215 Medical Myths: Challenge Dogma with Dr. Douglas Paauw”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list May 25, 2020.

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 | Subscribe | 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: Sarah P. Roberts MPH, Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD   
• Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.

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 effected 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 less 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

Goal

Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19

Learning objectives

After listening to this episode listeners will...

1. Critically appraise recent research on remdesivir as a treatment for COVID-19
2. Recognize the consequences of COVID-19 on strokes
3. Discuss the potential benefits of proning for COVID-19 patients
4. Describe different scenarios likely for the pandemic’s future

Disclosures

The Curbsiders report no relevant financial disclosures. 

Citation

Ganatra R, Okamoto E, Williams P, Roberts SP, Watto MF. “#214 COVID Cakes 3: Llamas, Remdesivir, Strokes, Predicting the Future, and More!”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list May 18, 2020.

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

Listeners can claim Free CME credit through VCU Health at curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | 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

Announcement

Join in! We’re hosting a LIVE! COVID Cakes discussion of Remdesivir and other hot COVID-19 stories this coming Tuesday May 12, 2020 at 8:30 pm ET @thecurbsiders on Twitter and Periscope!

Sponsor

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org/ for more information.

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

Goal

Listeners will develop an approach to caring for patients with fatigue symptoms.

Learning objectives

After listening to this episode listeners will…  

1. Identify top causes of fatigue
2. Develop an evidence-based approach to assessing a patient with fatigue
3. Describe evidence-based screening tools for fatigue

Disclosures

Dr. Mingioni reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Mingioni N, Abrams HR, Williams PN, Watto MF. “#213 Fatigue for Primary Care with Nina Mingioni MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. Air date May 11, 2020.

Summary

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 | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.

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

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will be able to screen patients for risk of alcohol withdrawal and decide on management strategies that are individualized to the patient. 

Learning objectives

After listening to this episode listeners will…

1. Screen and identify for patients at high risk of withdrawal 
2. Identify who would benefit from inpatient withdrawal, and ICU vs floor level care  
3. Identify the best withdrawal management protocol 
4. List indications and contraindications of first line therapy for alcohol use disorder.

Disclosures

Dr Suzuki reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Suzuki J, Taranto NT, Williams PN, Askin C, Watto MF. “#212 Sober Talk: Managing Alcohol Withdrawal with Joji Suzuki, MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list May 7, 2020.

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! 

Listeners can claim Free CME credit through VCU Health at curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | 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

Apollo

If you’re a healthcare worker looking for an opportunity to volunteer with the COVID relief efforts or you’ve been furloughed and are in need of work, please check out apollohct.com to see jobs and volunteer opportunities in your area and across the states. All you have to do is make a profile, input your preferences, and Apollo will do the searching for you.

VCU Health Continuing Education

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.

Time Stamps

• 00:00 Sponsors, 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

Picks of the Week / Links

1. You Bet Your Garden podcast with Mike McGrath
2. Ologies podcast with Alie Ward
3. Frosted Mini Wheats

Goal

Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19

Learning objectives

After listening to this episode listeners will...

1. Critically appraise recent research on remdesivir as a treatment for COVID-19
2. Review emerging literature and guidelines on thrombotic complications of COVID-19 
3. Interpret new data on asymptomatic transmission of COVID-19 

Disclosures

The Curbsiders report no relevant financial disclosures. 

Citation

Ganatra R, Chiu CJ, Okamoto E, Roberts SP, Watto MF. “COVID Cakes: Remdesivir, anticoagulation, and presymptomatic transmission”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 29, 2020.

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 freely Filtered in this NephMadness episode exploring topics in kidney transplant! On this show, the gang turns to Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist, to take the reins during this guided tour of concepts in transplant medicine that internists should be familiar with. During this episode, you’ll learn about indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! And of course, we will talk a little NephMadness as we wrap things up. So maybe you need to learn about kidney transplant or perhaps you’re still mourning the loss of March Madness 2020 - either way, we encourage you to take a listen and hope you’ll enjoy!

Listeners can claim free CE credit for this episode at curbsiders.vcuhealth.org (goes live at 1200 ET on the episode’s release date). 

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

It's time for NephMadness 2020! Fill out your bracket before the April 30, 2020 deadline and be sure to list The Curbsiders as your team. 

1. Read this year’s region posts here.
2. Submit an individual or team bracket here.
3. Discuss your picks with #NephTwitter!

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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.

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

Goal

Listeners will learn valuable skills to assist in the management and counseling of pre- and post- kidney transplant patients.

Learning objectives

After listening to this episode listeners will…  

1. Recognize the criteria for kidney transplant referral and evaluation, as well as the importance of referring a patient as soon as they are eligible. 
2. Be able to counsel a patient regarding what to expect before, during and after the transplant process.
3. Know the main classes of medication used after patients have received transplants, to include their side effects and any relevant monitoring. 
4. Be familiar with the different types of rejection, the clinical signs/symptoms of rejection and the utility / limitations of kidney biopsy.
5. Be able to discuss the post-transplant complications of kidney transplantation (cardiovascular, malignancy, etc.) as well as what type of prophylactic medications should be considered in these patients.

Disclosures

Drs. Cyrus Askin MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD report no relevant financial disclosures. Dr. Topf has received honoraria from Astra Zeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures. 

Citation

Cyrus A, Topf J, Farouk S, Swapnil H, Lin J, Sparks M, Watto MF. “#210 NephMadness: Kidney Transplant for the Internist”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. April 27, 2020

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.  

Check out this recent paper on Twitter in #Meded by Dr. Brooks and friends [Drs. Rebecca Jaffe, Tony Breu, Charlie Wray, Margaret Chapman and Avital O’Glasser (Kashlak Chief of Periop Medicine)]!

Show Notes | Subscribe | 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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out https://curbsiders.vcuhealth.org/ for more information.

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 

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will develop a framework on how Twitter can be used for scholarship and medical education.

Learning objectives

After listening to this episode listeners will...

• Define the landscape of digital media platforms available to the modern medical educator

• Discuss how digital platforms can be used to promote career development through digital scholarship
• Explain how Twitter is being used to disseminate medical education, future directions and concerns that have been raised. 

Disclosures

Dr Brooks reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Brooks M, Williams PN, Brigham SK, Watto MF. “#209 LIVE! Twitter, Social Media and Digital Scholarship”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date April 23, 2020.

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!

Listeners can claim Free CME credit through VCU Health at https://curbsiders.vcuhealth.org/ (CME goes live at 1200 PM ET on the episode’s release date). 

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

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out https://curbsiders.vcuhealth.org/ for more information.

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


Goal

Listeners will develop an approach to the diagnosis and management of patients with hypothyroidism.

Learning objectives

After listening to this episode listeners will…  

1. Recognize the different etiologies of hypothyroidism.
2. Identify signs and symptoms of hypothyroidism.
3. Develop an approach to diagnosing and treating hypothyroidism.
4. Define subclinical hypothyroidism and when to treat it. 
5. Recognize how pregnancy influences hypothyroidism management.
6. Be able to counsel patients on treatment for hypothyroidism.

Disclosures

Dr. Mandel reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Mandel S, Gibson EG, Grant K, Williams PN, Brigham SK, Okamoto E, Watto MF. “Hypothyroidism”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 20, 2020.

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.

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

Disclosures

The Curbsiders report no relevant financial disclosures. 

Goals

Listeners will develop a framework for how to create a medical podcast from the original idea to software, equipment, recording and a bit about editing.

Learning objectives

After listening to this episode listeners will...

•  Define your podcast’s content, and who it's for

1. Conceptualize the logistics of recording a podcast
2. Recall the necessary equipment and software for a medical podcast
3. BRIEFLY discuss podcast editing
4. Talk about how to disseminate a medical podcast (website, media host)
5. Review the potential pitfalls and nuances, like intellectual property considerations, SEO, branding, etc.

Citation

Watto MF, Williams PN. "#207 How to create a medical podcast: Tales from The Curbside". The Curbsiders Internal Medicine Podcast https://thecurbsiders.com/episode-list. Air date April 16, 2020.

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 | Subscribe | 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

Sponsor

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 Sponsor - AccessMedicine by McGraw Hill http://bit.ly/MHCurbsiders 
• 00:15 Disclaimer, intro, guest bio
• 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice
• 07:40 Sponsor - AccessMedicine by McGraw Hill http://bit.ly/MHCurbsiders 
• 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

Links

1. Internet Book of Critical Care (IBCC) Podcast by Dr. Josh Farkas - COVID-19
2. Dr. Jessica Bunin’s Video Lecture on Vent Basics for Non-Intensivists
3. COVID-19 Toolbox
4. One-Stop for some COVID-19 video content, also on the COVID-19 Toolbox Site

Goal

Listeners will be equipped with the basics to provide ventilatory support, to include the use of mechanical ventilation, for critically ill patients in the COVID-19 era.

Learning objectives

After listening to this episode listeners will…  

1. Appreciate the unique challenges faced by the medical community as pertaining to the current COVID-19 pandemic.
2. Be familiar with fundamentals of critical care as pertaining to airway management.
3. Define the diagnostic criteria of ARDS and appreciate early clinical signs that may indicate a patient is developing ARDS.
4. Review the various non-invasive methods of assisting with oxygenating & ventilating a patient (NC, NRB, HFNC, NIPPV, etc.) and any key contraindications.
5. Recognize signs suggestive of impending respiratory failure requiring invasive mechanical ventilation (i.e. indications for intubation).
6. Be familiar with basic ventilator parameters, basic terminology / modes.
7. Know initial vent settings for a patient with resp failure / ARDS based on ARDSnet data.
8. Have an approach to titrating vent settings based on physiologic parameters & the blood gas.
9. Know special considerations for management of ARDS in a patient with COVID-19.
10. Be familiar with advanced management strategies for patients with ARDS such as proning and paralysis

Disclosures

Dr. Chung reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Chung, K, Askin C, Rose M, Hiltz K, Gibson E, Williams PN, Watto MF. “206 Airway Management for the Non-Intensivist”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list 04/13/2020.\

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) who provides critical appraisal of the article that inspired Trump’s infamous hydroxychloroquine and azithromycin comment. 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 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
• Hosts: Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Editor: Matthew Watto MD 
• Guest: Rahul Ganatra MD

Time Stamps

• 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week: Kimberly Manning thread Frontline-ish; Steak Umm thread; Some Good News YouTube Channel by John Krazinski
• 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site
• 11:50 Telehealth best practices: Postpone routine therapy, Choose therapy that doesn’t require monitoring Treat empirically, Only order tests that will change management, Keep people out of the ED (see attached); Doximity dialer for video calls is in Beta testing
• 16:42 Convalescent plasma and Serology (Chenguang JAMA “Trial” of Convalescent Plasma; Nat’l Academy Sciences 10 pt study; COVID-19 Insights Blog by Bill Rodriguez; FDA Press Release re: SARS-CoV-2 Serologic Testing; FDA Emergency Auth for Rapid IgG/IgM 
• 21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report)
• 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality
• 25:30 Hydroxychloroquine background; Rahul provides critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial 
• 49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)
• 43:05 Outro

Goals

Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19

Learning objectives

After listening to this episode listeners will...

1. Discuss the limitations in the evidence for hydroxychloroquine and azithromycin as treatment for COVID-19
2. Discuss some challenges of telehealth during the COVID-19 pandemic
3. Be aware of racial disparities during the COVID-19 pandemic
4. Explain the rationale for serologic testing and the use of convalescent plasma in COVID-19 disease

Disclosures

Dr Ganatra reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Ganatra R, Williams PN, Chiu CJ, Watto MF. “#205 COVID Cakes and Hotakes with Rahul Ganatra MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 10, 2020.

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 | Subscribe | 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

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.

Join The Curbsiders! 

Pre-med and medical students, we need your help with production of the show! You’ll learn all aspects of podcasting, get to network with national thought leaders and join an amazing global team of Curbsiders. We are especially in need of folks with experience creating video content, developing websites and using social media tools. Application deadline is Friday April 10, 2020. Send an email to thecurbsiders@gmail.com and include the following:

[  ] A half page on why you’d make a great Curbsider

[  ] A copy of your CV

[  ] Your social media handles on Instagram, Twitter, etc. 

[  ] Samples of prior work (e.g. videos, websites, etc.)

Time Stamps

• 00:00 Sponsor
• 00:26 Intro, disclaimer, guest bio
• 02:57 Guest one-liner and Pick 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

#NephMadness 2020: SGLT2i Region – AJKD Blog

Goal

Listeners will recognize the different potential mechanisms for SGLT2i mechanisms and the different populations which may derive benefit from treatment. 

Learning objectives

After listening to this episode listeners will…  

1. Identify the theorized mechanism by which SGLT2i improve outcomes through their effect on tubuloglomerular feedback and other theorized mechanisms for SGLT2i effects
2. Develop a pathophysiological understanding of SGLT2i adverse effects, including acute decrease in GFR and genital infections
3. Recognize the potential benefit of using SGLT2i in non-diabetic patients, including for kidney disease, heart failure, and kidney transplant

Disclosures

The Curbsiders report no relevant financial disclosures. Drs. Seethapathy and Sparks report no relevant financial disclosures. Joel Topf lists the following on his blog “I have an ownership stake in a few Davita run dialysis clinics and a vascular access center. Takeda Oncology made a donation to MM4MM the program that is taking me to Mount Everest in 2018.”

Citation

Seethapathy H, Abrams HR, Okamoto E, Sparks M, Topf J, Watto MF. “#204 NephMadness 2020: SGLT2 Inhibitors”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 6, 2020.

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. You should also check out this guide to building your online curriculum at https://www.brosencephalon.com/onlinecurriculum. 

Show Notes | Subscribe | 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

Join The Curbsiders! 

Pre-med and medical students, we need your help with production of the show! You’ll learn all aspects of podcasting, get to network with national thought leaders and join an amazing global team of Curbsiders. We are especially in need of folks with experience creating video content, developing websites and using social media tools. Application deadline is Friday April 10, 2020. Send an email to thecurbsiders@gmail.com and include the following:

[  ] A half page on why you’d make a great Curbsider

[  ] A copy of your CV

[  ] Your social media handles on Instagram, Twitter, etc. 

[  ] Samples of prior work (e.g. videos, websites, etc.)

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*: Gumption (book) by Nick Offerman; Man Search for Meaning (book) by Viktor Frankl; Death Stranding (videogame); Alita: Battle Angel (film)
• 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

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will learn the basic tools needed to develop their own online curriculum and educational model.

Learning objectives

After listening to this episode listeners will...

1. Outline the benefits of creating an online curriculum.
2. Identify the necessary tools to create an online curriculum.
3. Recognize the potential benefits and pitfalls of asynchronous education.
4. Discuss the learning theory that supports asynchronous learning.
5. Explain how an existing curriculum can be quickly modified to adapt to evolving learner needs.

Disclosures

Drs. Sidhu and Zechar report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Sidhu A, Zechar K, Williams PN, Watto MF. “#203 How to Create an Online Curriculum for Medical Education”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. April 2, 2020.

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!

Special Thanks!

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 | Subscribe | 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

Join The Curbsiders! 

Medical students, we need your help with production of the show! You’ll learn all aspects of podcasting, get to network with national thought leaders and join an amazing global team of Curbsiders. We are especially in need of folks with experience creating video content, developing websites and using social media tools. Application deadline is Friday April 10, 2020. Send an email to thecurbsiders@gmail.com and include the following:

[  ] A half page on why you’d make a great Curbsider

[  ] A copy of your CV

[  ] Your social media handles on Instagram, Twitter, etc. 

[  ] Samples of prior work (e.g. videos, websites, etc.)

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

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will develop a framework and systematic approach to evaluating the patient with lymphadenopathy. 

Learning objectives

After listening to this episode listeners will...

1. Describe differential diagnosis of enlarged lymph nodes.
2. Summarize the evaluation of lymphadenopathy.
3. Identify the most appropriate type and timing of lymph node biopsy.

Disclosures

Dr Thompson reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Thompson C, Williams PN, Brigham SK, Watto MF. “#202 LIVE! Lymphadenopathy: Taking Your Lumps”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 30, 2020.

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 | Subscribe | 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

Sponsor

Primary Care Internal Medicine of Ithaca

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 Sponsor - https://www.primarycareinternalmedicineofithaca.com/.
• 00:20 Intro, disclaimer, guest bios and a bad pun
• 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 - https://www.primarycareinternalmedicineofithaca.com/.
• 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 Plugs64:20 Outro

Links*

1. The Seattle Flu Study research team helped identify first patterns of COVID in the US
2. A New York Times article highlighted the story of the Seattle Flu Study  was one of the first 
3. A published case series of the first 12 US COVID patients (Dr. Alvarez is a co-author)
4. The CDC offers a very comprehensive video for donning and doffing
5. A previous “Things We Do For No ReasonTM” article suggests MDIs are non-inferior to nebulizer treatments
6. COVID Communications Guide
7. CardioNerds: Episode #20: COVID-19 in the ICU
8. UW COVID Resource Site
9. OnePagerICU.com

Goal

Listeners will recall the perspectives of the first providers taking care of COVID patients and will be able to apply some of their insights to when the epidemic hits their region.

Learning objectives

After listening to this episode listeners will…  

1. Be familiar with the ICU and hospitalist challenges in taking care of COVID patients.
2. Describe how to learn new information and connect with others in the COVID community.
3. Recognize the social challenges associated with the epidemic for patients and providers.

Disclosures

Drs. Maciag, Mark, Alvarez, and Furfaro report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Alvarez, F, Maciag K, Furfaro D, Mark N, Berk, JB, Williams PN, Watto MF. “#201: COVID Narratives: Stories from Physicians at the Front Lines”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 26, 2020.

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 | Subscribe | 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

Primary Care Internal Medicine of Ithaca

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 Sponsor- Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/
• 00:20 Intro, guest bio, guest one-liner
• 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- Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/
• 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

Goals

Listeners will review the current research on COVID-19 including transmission, protection strategies, testing, symptoms, and basics of management.

Learning objectives

After listening to this episode listeners will know…

1. The basics of COVID-19 including epidemiology, prevention, transmission, and treatment
2. Where to find reliable data sources and how to interpret new studies with caution 
3. The importance of PPE and limiting disease exposure 
4. What drug regimens are recommended and what experimental treatments are available
5. The role of virtual visits, telemedicine and other non-traditional methods to reduce patient contact
6. Impact of COVID-19 on at-risk populations 

Disclosures

Paul E. Sax, MD, has disclosed the following relevant financial relationships:  Served as a director, officer, partner, employee, advisor, consultant, or trustee for: Bristol-Myers Squibb Company; Gilead Sciences, Inc.; GlaxoSmithKline; Janssen; Merck. Received research grant from: Bristol-Myers Squibb Company; Gilead Sciences, Inc.; GlaxoSmithKline; Merck.

The Curbsiders report no relevant financial disclosures. 

Citation

Sax P, Roberts SP, Chiu CJ, Garbitelli B, Abrams H, Williams PN, Watto MF. “#200 COVID-19 with Paul Sax MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 22, 2020.

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 Sponsor - AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders
• 00:20 Intro, disclaimer, guest bio
• 02:55 Guest one-liners; Intro to NephMadness 2020
• 07:28 Sponsor - AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders
• 08:15 Hyperkalemia in CKD; Case of hyperkalemia; Meds, supplements and a bit on diet
• 17:07 Patiromer, Sodium zirconium, SPS
• 31:08 Diet and potassium
• 46:00 Exercise and hyperkalemia. Is it safe in CKD?
• 51:51 Take home points and Outro

Learning objectives

After listening to this episode listeners will…  

1. Recognize when and how to manage hyperkalemia in CKD 
2. Identify when to use potassium binders in CKD 
3. Define the pharmacology, adverse effects and evidence behind different potassium binders 
4. Develop an approach to using renin-angiotensin-aldosterone system inhibitor (RAASi) medications in patients with hyperkalemia
5. Define the potential benefits of high-potassium diets and the potential harms of low-potassium diets 
6. Recognize how exercise influences potassium

Disclosures

The Curbsiders report no relevant financial disclosures. Joel Topf lists the following on his blog “I have an ownership stake in a few Davita run dialysis clinics and a vascular access center. Takeda Oncology made a donation to MM4MM the program that is taking me to Mount Everest in 2018.”

Citation

Sohaney R, Gibson E, Clegg D, Topf J, Williams PW, Brigham SK, Watto MF. “#199 NephMadness: Hyperkalemia, Diet, Potassium Binders, Exercise”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 16, 2020.

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) http://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/
• 00:35 Intro, disclaimer, guest bio
• 03:00 Guest one-liner, book recommendation; Picks of the Week*: The Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death, by Dr BJ Miller and Shoshana Berger; Overdrive App to download audio books and other media from libraries
• 07:58 AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/
• 09:30 Case of PCOS; Definition; Common presenting complaints
• 14:40 Hirsutism and terminal hair growth
• 17:05 Alopecia
• 20:25 Acne; Hidradenitis suppurativa
• 23:05 Irregular menses; Lab workup; Non-classic congenital adrenal hyperplasia
• 28:38 Hyperandrogenism lab workup (Testosterone, DHEA-S, Anti-Mullerian Hormone, utility of LH and FSH); Quick word on US
• 37:15 Recap of how to diagnose PCOS
• 38:15 Insulin resistance, body habitus in PCOS
• 40:04 Pathophysiology in PCOS (two schools of thought: Hypothalamus vs Insulin)
• 43:27 Dr. Sherif’s spiel to patients newly diagnosed with PCOS
• 46:40 Long term risks in PCOS
• 50:35 Approach to treatment of PCOS (OCPs, metformin, spironolactone, hair removal)
• 60:35 Treatment of alopecia; Lifestyle factors
• 63:55 Take home points and Outro

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will explain the basic pathophysiology, diagnosis, and management of PCOS.

Learning objectives

After listening to this episode listeners will…  

1. List the criteria for diagnosis of PCOS.
2. Explain the relationship between PCOS and metabolic risks.
3. Determine first line treatments for PCOS symptoms including oligomenorrhea, hirsutism, acne and alopecia.
4.  Counsel patients on long term risks associated with PCOS and how to mitigate these.

Disclosures

Dr Sherif reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Sherif K, Heublein M, Grant K, Okamoto E, Watto MF.  “#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 9, 2020.

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

• 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders
• 00:15 Intro, disclaimer, guest bio
• 02:15 Guest one-liner; Picks of the Week*: Educated (book) by Tara Westover; Cheer, Netflix series; The Witcher, Netflix series; Uptime /  Downtime -album by The
• 06:24 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders
• 07:25 Case: Incidental pulmonary nodules; Defining terms: mass vs nodule
• 15:20 Spiel/Counseling a patient with an  incidental lung nodule; Analogy about skin findings and lung nodules
• 20:50 Types of nodules, duration of monitoring; Tracking nodules; Recap on incidental pulmonary nodules
• 27:54 Case: Lung cancer screening (USPSTF, NLST criteria and CMS guidelines); Shared decision making
• 41:56 Lung-RADS and lung cancer screening; Types of CT scan; When to refer
• 48:22 Take home points on Lung Cancer screening
• 52:35 Outro

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will develop an approach to incidentally found pulmonary nodules, lung cancer screening and what to do with the suspicious lung nodule or mass.

Learning objectives

After listening to this episode listeners will...

• ...be familiar with the differences between nodules & masses and some of the common etiologies for these findings.

• ... appreciate the difference between the incidental pulmonary nodule and those found during lung cancer screening and thus the different systems (Fleischner vs. Lung-Rads) used to assess nodules.

• ... have a framework for how to approach incidental pulmonary nodules, particularly with respect to the 2017 Fleischner Society Guidelines .

• ... be able to educate peers & patients regarding who qualifies for lung cancer screening and who does not.

• ... understand what makes a patient “high risk” vs. “standard risk” with respect to incidentally found pulmonary nodules.

• ... appreciate the background and reasoning behind the current recommendation for lung cancer screening

• ... discover how to determine follow up of a lung nodule found as part of a lung cancer screening CT using Lung-Rads.

• ... learn strategies regarding how to discuss incidental nodules and nodules found on screening CTs with patients, as well as how to approach the discussion of whether or not to screen with the use of various readily available resources .

Disclosures

Dr. Blagev has received research grants from Astra Zeneca, Zebra Medical and GSK through grants to Intermountain Healthcare and joint publications. We did not discuss any of these products or services during this recording. The Curbsiders have no relevant financial disclosures.

Citation

Askin C, Witt L, Blagev D, Williams PN, Watto MF. “#197 Pulmonary Nodules and Lung Cancer Screening with Denitza Blagev MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 2, 2020.

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

• 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 
• 00:15 Intro, disclaimer, guest bio
• 02:08 Guest one-liner, book recommendations, career advice
• 07:12 Picks of the Week*: Full Catastrophe Living - Jon Kabat-Zinn (book); Exit West: A novel - Mohsin Hamid; Ad Astra (film); Snuff - Terry Pratchett (book)
• 09:36 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 
• 10:30 Defining terms refugee, asylee, migrant
• 12:08 Bhutan and The Buthanese refugee population
• 15:08 The overseas medical examination (prior to arrival in the US)
• 17:28 The initial domestic medical examination, primary care visit; Vaccinations; Initial lab testing
• 21:54 Barriers to refugee health
• 26:12 Taking a migration history
• 29:25 Who’s paying for refugee care?
• 31:08 Mental health and the refugee population
• 34:20 Screening and addressing past trauma, torture
• 40:14 Recap; Quick discussion of parasitic infections
• 45:08 Audience questions: Visits with multiple family members; Additional resources available for refugee health
• 47:50 Outro

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will develop an approach for the management of the refugee patient in the primary care setting.

Learning objectives

After listening to this episode listeners will…  

1. Describe the differences between refugees, asylees, and migrants.
2. Recognize the exposure to healthcare and health screenings that have occurred prior to the initial primary care visit.
3. Be able to obtain a thorough and relevant migration history.
4. Navigate the potential barriers that can arise during the refugee primary care visit.
5. Demonstrate the ability to screen for trauma and common mental health concerns in the refugee population.

Disclosures

Dr. Devaraj reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Devaraj T, Williams PN, Brigham SK, Okamoto E, Watto MF. “#196 LIVE! Refugee Health with Tanuja Devaraj MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list February 24, 2020.

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 Reason^TM.

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

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 -SHM’s Annual Conference, HM20 (use code CURBSIDERS) and Primary Care Internal Medicine of Ithaca (email: arcostello@gmail.com)
• 00:38 Intro, disclaimer, guest bio
• 02:10 Guest one-liners
• 03:35 Picks of the Week*: Knives Out (film), Priced Out by Uwe E. Reinhardt; Crisis in the Red Zone by Richard Preston; CardioNerds podcast; Outbreak (film); Teaching Physiology on the Fly (faculty development course)
• 07:55 Sponsors -SHM’s Annual Conference, HM20 (use code CURBSIDERS) and Primary Care Internal Medicine of Ithaca (email: arcostello@gmail.com)
• 09:30 Case of Eric Lokay; Repleting potassium. Is it necessary to “buff the lytes”
• 20:30 Pathophysiology of hypokalemia; Final recommendations on potassium repletion
• 24:30 Supplemental oxygen; pO2 vs total oxygen content; Oxygen, vasoconstriction and potential harms
• 30:33 Evidence of harm from supplemental O2
• 35:00 Tony’s recommendations for use of supplemental O2
• 41:55 Case of delirium; Definition and diagnosis
• 46:20 Can we prevent delirium? Melatonin and ramelteon
• 50:33 Should we use antipsychotics? Benzodiazepines?; What should we do instead?
• 58:25 Take home points, Outro and a terrible pun

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Disclosures

Dr. Feldman and Dr. Breu report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Feldman L, Breu T, Shen BH, Berk JL, Williams PN, Brigham SK, Watto MF. “#195 TWDFNRTM 3: Potassium, Oxygen, and antipsychotics”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. February 17, 2020.

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