Core IM | Internal Medicine Podcast

By Core IM Team

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Core Internal Medicine via following segments: 5 Pearls || Clinically relevant pearls on IM topics! Mind the Gap || Why do we do what we do? Hoofbeats || Dissecting clinical reasoning!

Episode Date
#47 Stories of Women in Medicine
<p>We hope these stories can make us more introspective and open minded on how these concepts can affect each one of us differently.</p> <p>Let's continue the discussion on the <a href="" title="">Women in Medicine </a>Twitter chat on 8/25 at 9pm EST !</p> <p><a href="" title="">Full Transcript and Show Notes</a></p> Time Stamps <ul> <li>2:07 Introduction to one woman’s journey</li> <li>3:00  Stereotype Threat</li> <li>6:15 Not all Anger is Created Equal</li> <li>10:17 Asking and Writing Your Own Job Description</li> <li>13:08 Imposter Syndrome</li> <li>15:50 Breaking Points to Self Care</li> <li>18:50 Work Life Integration</li> <li>21:40 Support Networks</li> </ul>
Aug 21, 2019
#46 A 45F with Persistent Bleeding: Hoofbeats Segment
<p>20 Qs with Core IM Team vs. Expert Discussant !</p> <p><a title="" href="">Full Transcript and Show notes</a></p> <p>Get <a title="" href="">CME-MOC Credit </a>for listening to this episode (live at 09:00 am EST on 8/7)</p> <p>Time Stamps</p> <ul> <li>00:20 The game of medical Twenty Questions</li> <li>04:37 Case introduction</li> <li>05:50 The CoreIM team attempts to solve the case</li> <li>15:36 The discussant’s diagnostic schema for abnormal bleeding</li> <li>23:37 Primary versus secondary hemostasis</li> <li>30:33 The pathology report !</li> <li>37:38 Criteria for the final diagnosis</li> <li>38:46 Dissecting a diagnostic coup</li> <li>49:42 Conclusion</li> </ul> <p>Do you have a good case or an expert you would like to suggest for an episode? Send it our way at</p> <p>Tags: Coagulopathy, Bleeding Disorder, Diagnostic Schema, Von Willebrand's Disease, Clinical Reasoning</p>
Aug 07, 2019
#45 Statins: Prescribing Meds Day vs. Night Part 2 Mind the Gap Segment
<p>Night and Day… join us for part II of our exploration into why we prescribe medications in the morning vs. at night, featuring statins!</p> <p>03:28 How do statins and cholesterol synthesis work again, anyway?</p> <p>04:00 Power in numbers - what do the meta-analyses say about timing of statins?</p> <p>04:40 The long and short of it - how half-life may dictate when to take your statin.</p> <p>07:35 Effect magnitude - does medication timing actually really impact patient outcomes?</p> <p>10:30 Practical matters - so what should we tell patients?</p> <p>11:05 Review of teaching points</p> <p><a title="" href="">Show notes, transcripts and references</a></p>
Jul 24, 2019
#44 Coronary Calcium Score and CTAs: 5 Pearls Segment
<p>Solidify your knowledge on Coronary calcium scores and Coronary CTAs!</p> <p>ACP members can claim<b> <a title="" href="">CME-MOC Credit</a></b> !</p> <p><b>Quiz yourself </b>on the 5 pearls we will be covering below:</p> <ul> <li>3:10 What are the big picture differences of functional stress tests and anatomical cardiac tests?</li> <li> <p dir="ltr">7:48 What is the role of coronary artery calcium scores in managing coronary artery disease (CAD)?</p> </li> <li> <p dir="ltr">16:20 How do coronary CTAs compare to stress tests?</p> </li> <li> <p dir="ltr">24:28 When should we avoid CTA?</p> </li> <li> <p dir="ltr">29:33 How do we communicate coronary CTA results with patients?</p> </li> <li> <p dir="ltr">36:02 Recap</p> </li> </ul> <p> <a title="" href="">Full transcript, infographics and show notes</a> ! </p>
Jul 10, 2019
#43 "Difficult" Patients: At the Bedside Segment
In ‘At The Bedside’, our newest podcast segment, we tackle important topics that *aren’t* easily indexable in guidelines and UpToDate article –  topics that are better discussed…well…at the bedside. Our first episode examines the all-too-common trope of the ‘difficult’ patient. <ul> <li>01:13      Introduction</li> <li>05:27      Question 1: What makes a patient difficult for you?</li> <li>13:22      Question 2: What is a “good outcome” when working with difficult patients?</li> <li>23:05      Question 3: What have you learned from your difficult patients?</li> <li>31:56      Conclusion</li> </ul> <p><a title="" href="">Show notes, Transcript, Further Reading</a></p>
Jun 26, 2019
#42 July Stories
<p>Transitions can be hard. Laugh, commiserate and be inspired by these July stories in medicine!</p> <p>Very big thank you to <a href="" title="">everyone who told their stories</a> !</p> <p>Let's help each other feel a little less alone in the struggle, be more understanding and compassionate or laugh at ourselves. Please share this episode with colleagues.  Do you have a July story? Email us at <a href=""></a>.</p> <p>Lets continue conversation over social media. Which stories moved you? Which July stories can you relate to?<a href=""> Tweet us</a>, find us on <a href="">instagram</a> at coreimpodcast or <a href=";eid=ARADFLD0RWKMem224lXxNguMrGvkUhP_ayvJG8kpusNN-FMg5ytfF-xpHcPVj2NcpHGbaJQ5P5kKtqIg&amp;hc_ref=ARQVlNLcCGuZSu7Xshjkp88FcogWfiDpYiASwcigKABJ21hq-PtISbcyGLtKiq9Rkrs&amp;fref=nf&amp;__xts__[0]=68.ARDR43ZkTOAGKtkLHSLOaEbobF9z8Ng6-NwQS-mlw1qtV8MaYqL5QYA3LKFk82R9YeLw6NNOehqX5bgZvN0bKQtr4OKW9TRSrJCo0gCWVr8wnVCfFhNHv_UNd5il_6SVrF6Ficg8yfP50KNFbcPyj6dhjrLea8sqCWqhkhU0A6j64GrqfFbLZPm8ZSdoVqdSRh-EqX9t4SCKxjZrcUR75SN3o4atrKOPnkTMeD9I7FtNcNBkirof6oGo9eIdefSmeKmFbiWVLwIEfNgm-FuWM6v0GdbKs4WZFL4-q0nAmteHklWGM4_xjRBfvgsyZ3MVIMxJqUBVBd-4n7r55a95Y_Y">Facebook</a>. Good luck this coming July !</p>
Jun 12, 2019
#41 A 23M with AMS and Fever: Hoofbeats Segment
<p>Dissect clinical reasoning and dive deeper into an interesting case!</p> <ul> <li>02:04     Initial Presentation </li> <li>03:03     The Core IM team tackles the case </li> <li>09:30     Social History </li> <li>16:05     Physical Exam </li> <li>22:47     An exercise in Bayesian inference </li> <li>36:35     Pre-mortem</li> <li>43:37     Revealing the diagnosis</li> <li>48:57     How do we define diagnostic success? </li> </ul> <p><a href="" title="">Full transcript with references and show notes </a></p>
May 22, 2019
#40 Prescribing Meds Day vs. Night Part 1: Mind the Gap Segment
Dive deeper into why we prescribe medications in the morning vs. at night ! <ul> <li>Why do we dose warfarin at night? (2:45)</li> <li>Back to the basics - what are the pharmacodynamics of warfarin and how does vitamin K intake matter? (4:28)</li> <li>Practical matters - so what should we tell patients (6:14)</li> <li>Dippers and non-dippers - what happens to blood pressure (BP) at night? (9:32)</li> <li>The surprising link between dipping and cardiovascular outcomes (11:15)</li> <li>Timing is everything… or is it? The evidence behind taking BP meds at night (11:58)</li> <li>Review of teaching points (15:58)</li> </ul> <p>What is your prescribing practice with blood pressure medications? Leave a<a title="" href=""> comment</a>, <a title="" href="">tweet</a> us or share with us on <a title="" href="">instagram</a> or <a title="" href="">facebook</a> on how you dose BP meds?</p> <p><a title="" href="">Transcript with references and show notes</a></p>
May 08, 2019
#39 Stress Testing: 5 Pearls Segment
<p>Solidify your knowledge on stress tests! Quiz yourself on the 5 pearls we will be covering:</p> <ul> <li>What are the indications for a stress test? (2:18)</li> <li>How to choose  stress protocol in a stress test? (8:29)</li> <li>How to choose diagnostic modality in a stress test? (14:46)</li> <li>How do we interpret results from stress tests, and how should this be communicated to patients? (24:08)</li> <li>Pearl Recap (31:13)</li> <li>Risk of contrast induced nephropathy between arterial and venous contrast load (36:02)</li> </ul> <p>For full transcript, infographic and show notes: <a href=";preview=true" target="wp-preview-21061"></a></p> <p> </p> <p>Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology</p>
Apr 24, 2019
#38 A 66M w RUQ pain, a 41M in Afib w RVR and a 50M w Syncope: Hoofbeats Segment
Dissect 3 interesting cases and improve your clinical reasoning skills! Time Stamps: <ul> <li>New features in this episode [0:30]</li> <li>Case one: 66M w RUQ pain [1:09]</li> <li>Case two: 41M w Afib in RVR [9:26]</li> <li>Case three: 50M w Syncope [14:33]</li> <li>Reveal [19:57]</li> <li>Retrieving illness scripts [22:29]</li> <li>Typical versus Atypical presentation of diseases [26:12]</li> </ul> <p>For full transcript and show notes: <a title="" href=""></a></p> <p>Tag: medical education, clinical cases, expert clinicians, internal medicine podcast</p>
Apr 10, 2019
#37 Unstable Angina: Mind the Gap Segment
<p>Check out part 1: <a title="" href="">Acute Coronary Syndrome and TIMI Risk Score</a></p> <p>Lets go deeper into</p> <p>1) How the chest pain history correlates with pathophysiology? [2:40]</p> <p>2) How has high-sensitivity troponin changed the way we think about unstable angina? [7:34]</p> <p>For transcript, infographic and show notes: <a title="" href=""></a></p>
Mar 27, 2019
#36 Pain Management: 5 Pearls Segment
Solidify your knowledge on inpatient pain management! Quiz yourself on the 5 pearls we will be covering: <ul> <li>How effective are non-opioids? (<b><i></i></b> 3:17)</li> <li>Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51)</li> <li>What are the best practices for patients who require opioid analgesia? (19:00)</li> <li>When prescribing opioids at discharge what can we do to minimize harm? (25:02)</li> <li>Throwback to mechanism of acetaminophen and NSAIDs (27:14)</li> <li>How do we believe tylenol works and how does that compare to NSAIDS? (28:27)</li> </ul> <p>For full transcript of the audio and show notes: <a target="wp-preview-20964" href=";preview=true"></a></p>
Mar 13, 2019
#35 Acute Coronary Syndrome and TIMI Risk Score: Mind the Gap Segment
Let's go deeper into the world of ACS and the origin of the TIMI score and major adverse cardiac events "MACE" outcomes! <ul> <li>The basics – what is acute coronary syndrome? (4:08)</li> <li>Clinical context matters – angina pectoris, atypical chest pain, and troponins (5:22)</li> <li>You can’t just “cath” everyone – risk stratification to identify patients with high mortality risk (9:42)</li> <li>TIMI isn’t perfect – the issues with the score and MACE outcomes (14:00)</li> <li>Review of teaching points (17:58)</li> </ul> <p>For full transcript and show notes: <a title="" href=""></a></p>
Feb 27, 2019
#34 47M with chest pain : Hoofbeats segment
<p>Dissect an interesting case and improve your clinical reasoning skills!</p> <p>Time Stamps:</p> <ul> <li>New features in this episode [00:25]</li> <li>Data point 1: Early hypothesis generation? [03:20]</li> <li>Data point 2: Pertinent negatives? [11:18]</li> <li>Data point 3: Representativeness heuristic over-represented in medical education? [13:28]</li> <li>Data point 4: Economical hypothesis generation by expert clinicians [19:20]</li> <li>Data point 5: Diagnosing diagnostic error [22:10]</li> <li>Data point 6: Moving toward a final diagnosis [27:11]</li> <li>Case resolution [29:50]</li> </ul> For full transcript and show notes: <a href=";preview=true" target="wp-preview-20903"></a>
Feb 13, 2019
#33 Barrett's Esophagus: 5 Pearls
<p>Solidify your knowledge on Barrett's Esophagus and more! Quiz yourself on the 5 pearls we will be covering:</p> <ol> <li>What is Barrett’s esophagus and why should we care? (4:12)</li> <li>Who do we screen for Barrett’s, and why? (8:41)</li> <li>How do we screen for Barrett’s and counsel? (13:50)</li> <li>How do we treat and monitor Barrett’s esophagus? (18:21)</li> <li>Take Aways (21:45)</li> <li>Throwback to trending troponins (23:05)</li> </ol> <p>For full transcript of the podcast, show notes and references: <a title="" href=""></a></p>
Jan 30, 2019
#32 A 34M with Fever, HA, Myalgias
<p>Dissect an interesting case and improve your clinical reasoning skills!</p> <p>Time stamps:</p> <ul> <li>Player three has entered the game! [0:15]</li> <li>Case presentation, part 1 [1:20]</li> <li>First impressions [3:24]</li> <li>Rethinking another provider’s diagnosis [4:36]</li> <li>Interpreting the test of treatment [8:48]</li> <li>Keeping your instincts on a leash? [10:58]</li> <li>Case presentation, part 2 [12:33]</li> <li>Diagnostic schemas [14:30]</li> <li>Our discussant’s differential and the final diagnosis [17:46]</li> <li>Shira’s cognitive autopsy [23:02]</li> </ul> <p>For full transcript and show notes: <a title="" href=""></a></p>
Jan 16, 2019
#31: Troponins: 5 Pearls Segment
<p>Solidify your knowledge on troponins and more! Quiz yourself on the 5 pearls we will be covering:</p> <ol> <li>What aspects of the history are concerning in a patient with a positive troponin? (4:00)</li> <li>What is the difference between the TIMI, GRACE, and HEART scores, and how should we use them in the evaluation of a patient with an elevated serum troponin? (8:42)</li> <li> How does the change in troponin over time help with diagnosis, and what should we consider in a patient with uptrending troponins but an unremarkable ECG? (14:48)</li> <li> What can a “negative but detectable” troponin tell you about any patient, not just those with suspected ACS? (21:31)</li> <li>Pearls Recap (25:26)</li> <li>Throwback – what are the first-line medications for alcohol use disorder? (28:36)</li> </ol> <p>For full transcript of the podcast, show notes and references: <a title="" href=""></a></p> <p>Tags: chest pain, cardiology, myocardial infarction, acute coronary syndrome</p>
Jan 02, 2019
#30 Acetaminophen/Fevers Pathophysiology and Patient Outcomes: Mind the Gap Segment
<p>Let's dive deeper into the world of acetaminophen and fever and how it may work and patient outcomes</p> <p dir="ltr">Time Stamps:</p> <p></p> <ol> <li dir="ltr"> <p dir="ltr">What data is there to support the use of acetaminophen as a fever reducer? (2:08)</p> </li> <li dir="ltr"> <p dir="ltr">Does acetaminophen improve patient outcomes? (4:30)</p> </li> <li dir="ltr"> <p dir="ltr">How does acetaminophen compare to other medications like NSAIDs? (9:56)</p> </li> <li dir="ltr"> <p dir="ltr">What is the mechanism of acetaminophen action? (10:50)</p> </li> <li dir="ltr"> <p dir="ltr">Review of teaching points (16:02)</p> </li> </ol> <p>For full show notes and transcript of audio: <a title="" href=""></a></p>
Dec 19, 2018
#29 A 43M with Diarrhea: Hoofbeats Segment
<p>Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here:</p> <p>Time stamps:</p> <ol> <li>Case [1:19]</li> <li>Diagnostic weight [8:42]</li> <li>Hypothesis driven reasoning [12:26]</li> <li>Anomalous clinical data [19:30]</li> <li>Final diagnosis [22:20]</li> <li>Take away points [31:21]</li> </ol> <p>Human Dx  Case link: <a href="" title=""></a></p> <p>For show notes: <a title="" href=""></a></p>
Dec 05, 2018
#28 What Would You Tell Your Younger Self?
<p>Women in medicine inspire us with what they would tell their younger selves. Some of the speakers with Shreya Trivedi MD @ShreyaTrivediMD at the Women in Medicine GirlMedLive Conference:</p> <p>Qaali Hussein MD @QaaliHussein1 Clinical Pearl @ClinicalPearl Marguerite Duane MD @mduanemd Kate Prior MBBS @doctorwibble C. Nicole Swiner MD @docswiner Carmen Landrau MD @DrLandrau Jessica Willett MD @jkwillettmd Ilene Brenner MD @irb123 Joannie Yeh MD @BetaMomma Karen Davidson, Esq Suzanne Feigofsky MD @DrSuzyFeigofsky GirlMedLive: <a href="" title=""></a></p> <p>Episode page: <a title="" href=""></a></p> <p>Tags: career development, professional development, lifelong learning, burnout, imposter syndrome, mentorship, worklife balance</p>
Nov 21, 2018
#27 Treatment of Alcohol Use Disorder: 5 Pearls Segment
Solidify your knowledge on Alcohol Use Disorder (AUD) treatment and more! Quiz yourself on the 5 pearls we will be covering: <ol> <li>Throwback: At what levels of drinking does unhealthy alcohol use start, and how do you screen for unhealthy alcohol use? (1:47)</li> <li>What does the brief intervention and counseling part of SBIRT entail? (4:43)</li> <li>What are the first line medications for AUD and contraindications to them? (11:11)</li> <li>What are the  second-line medications for AUD and their limitations? (18:14)</li> <li>What new therapies are being studied for for alcohol use disorder? (22:09)</li> <li>Pearls Recap (25:06)</li> </ol> <p>For full transcript of the podcast, show notes and references: <a title="" href=""></a></p> <p>tag: naltrexone, acamprosate, gabapentin, topiramate, SBIRT, neuromodulation, nalmafene, psychaedelics, audit-c</p>
Nov 07, 2018
#26 A 85F with AMS Part 2: Hoofbeats Segment
<p>Dissect a working diagnosis through a process of validation!</p> <p>Time Stamps:</p> <ol> <li>Your collective differential [0:40]</li> <li>The test results (that you asked for) are in... [2:13]</li> <li>The hospital course, and the diagnosis (or is it?) [7:10]</li> <li>Validating a diagnosis: Base rate, adequacy, and coherence [8:30]</li> <li>Revisiting the differential [14:44]</li> <li>What to do when there <i>is </i>no final diagnosis? [17:39]</li> </ol> <p>For full show notes: <a title="" href=""></a></p> <p>Tags: Clinical reasoning, Diagnostic Uncertainty</p>
Oct 24, 2018
#25 A 85F with AMS Part 1: Hoofbeats segment
<p>Submit your diagnosis or differential for this episode's case at (free registration required): <a title="" href=""></a> ! Part 2 (releasing 10/24) will have the final diagnosis!</p> <p><b>Time stamps:</b></p> <ol> <li> A new challenge and the rules of the game (1:13)</li> <li> Introduction to Human Dx (3:06)</li> <li> The case: An 85 year-old woman with paranoid delusions (5:28)</li> <li> What exactly is problem representation? (15:15)</li> <li> Building the differential (19:53)</li> </ol> For full show notes: <a title="" href=""></a> <ol> </ol> <p> </p>
Oct 10, 2018
#24 Meet the Producers
<p>Join us in this episode with Doctors Who Create where we explore how Core IM was started and some things that happen behind the scenes!</p> <p>Episode page: <a title="" href=""></a></p>
Sep 27, 2018
#23 UTIs and Delirium: MInd the Gap Segment
<p> </p> <p class="MsoNormal">Let's go deeper into the world of UTIs and delirium!</p> <ol type="1" start="1"> <li class="MsoNormal">The basics – what are the official (IDSA) definitions for bacteriuria, pyuria, and UTI? (02:07)</li> <li class="MsoNormal">The lay of the land – how common are bacteriuria and delirium? (07:09)</li> <li class="MsoNormal">The big money question – do UTIs really cause delirium and what does the evidence tell us? (10:50)</li> <li class="MsoNormal">Review of teaching points (15:59)</li> </ol> <p class="MsoNormal">Full show notes: <a title="" href=""></a></p> <p> </p>
Sep 11, 2018
#22 Proton-Pump Inhibitors: 5 Pearls segment
<p>Solidify your knowledge on Proton-Pump Inhibitors (PPIs) and more! Quiz yourself on the 5 pearls we will be covering:</p> <ol> <li>What are associated adverse effects for patients are on long-term PPIs? (2:02)</li> <li>What are strategies to get your patient off PPIs?  (10:57)</li> <li>How do histamine-2 (H2) receptor antagonists blockers work and how can it explain why H2 blockers might not be as effective as PPIs? (13:30)</li> <li>How should you educate patients to take PPIs to get the maximize benefit? (16:48)</li> <li>How do you manage ongoing symptoms in patients on PPIs? (21:41)</li> </ol> <p>For full transcript of the podcast and references: <a title="" href=""></a><a href="" title=""></a></p>
Aug 29, 2018
#21 57F with confusion: Hoofbeats segment
<p>Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here:</p> <ol> <li>Case history and exam 00:40</li> <li>Causal models 11:24</li> <li>Facets versus diagnoses 13:25</li> <li>Problem representation 16:37</li> <li>Part two of the case 17:10</li> <li>Occam’s razor, Hickam’s dictum, and Crabtree’s bludgeon 23:00</li> <li>Diagnostic uncertainty 27:10</li> <li>Learning points 34:24</li> </ol> <p>For show notes: <a title="" href=""></a></p>
Aug 15, 2018
#20 Vancomycin: Mind the Gap Segment
<p>Lets go deeper into the misunderstood side of Vancomycin!</p> <ol> <li> Where did vancomycin come from, and why is it so controversial? (0:28)</li> <li> What is vancomycin-induced nephrotoxicity and how common is it? (4:37)</li> <li> Vancomycin trough monitoring – what is it good for?  (7:28)</li> <li> AUC to MIC ratio – the real math behind vancomycin dosing (7:53)</li> <li> Review of teaching points (10:27)</li> </ol> <p>Full show notes: <a href="" title=""></a></p>
Aug 01, 2018
#19 Unhealthy Alcohol Use: 5 Pearls segment
<p>Solidy your understanding of unhealthy alcohol use! Quiz yourself of the 5 Pearls we will be covering:</p> <ol> <li>What is alcohol use disorder (AUD), and how is it different from unhealthy alcohol use? </li> <li>Who should we screen for unhealthy alcohol use, and which screening tools are preferred?</li> <li>What are the consequences of unhealthy alcohol use? </li> <li>Can moderate alcohol be good for patients, and if so, how much is “moderate”? </li> <li>Who, how and how often should patients with chronic hepatitis B infection be screened for hepatocellular carcinoma?</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
Jul 11, 2018
#18: A 54M with diarrhea: Hoofbeats segment
<p>Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here:</p> <ol> <li>Part one of case (0:56)</li> <li>Cognitive ease and strain (03:51)</li> <li>Metacognition and routine diagnostic timeout (08:15)</li> <li>Think outside the box of organ systems (11:19)</li> <li>Illness behavior (12:30)</li> <li>Part two of case (14:06)</li> <li>Algorithms (17:57) </li> <li>Fast thinking &amp; pattern recognition (19:30)</li> <li>Slow thinking &amp; analytical reasoning (21:31)</li> <li>Diagnosis (25:15)</li> <li>Takeaways (26:52)</li> </ol> For full show notes: <a title="" href=""></a> <ol> </ol>
Jun 27, 2018
#17: Celebrating #ProudtobeGIM
<p>Be inspired by why so many are proud to be in General Internal Medicine (GIM)!</p> <p>Episode page: <a title="" href=""></a></p>
Jun 20, 2018
#16 Steroids in COPD: Mind the Gap Segment
<p>Let’s take your breath away… with a review on steroids in treating COPD exacerbations!</p> <p>Time Stamps</p> <ol> <li>How does GOLD (Global Initiative for Chronic Obstructive Lung Disease) define a COPD exacerbation? (2:44)</li> <li>What outcomes do steroids actually improve in treating a COPD exacerbation? (5:08)</li> <li>What is the evidence behind a 5 day steroid “burst”? (7:20)</li> <li>Are IV steroids more powerful than PO? (9:00)</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
May 30, 2018
#15 Contrast-Induced Nephropathy: 5 Pearls segment
<p>Solidify your understanding of contrast-induced nephropathy (CIN)! Quiz yourself on the 5 pearls we will be covering:</p> <ol> <li>Are there diagnostic criteria for CIN? (2:11)</li> <li> Is there a difference between exposure to intra-arterial vs. intra-venous contrast in terms of risk of CIN? (6:28)</li> <li> What are the biggest risk factors for CIN? (14:48)</li> <li> What preventive measures have been shown to best reduce the risk of CIN? (19:41)</li> <li> Can ESRD patients on hemodialysis still suffer from CIN? (23:32)</li> <li> Recap (25:49)</li> </ol> <p>For full show notes: <a title="" href=""></a><a href="" title=""></a></p>
May 16, 2018
#14 A 36F with weakness: Hoofbeats segment
<p>Dissect an interesting case and think about the way clinicians think! So many clinical reasoning pearls here:</p> <p></p> <ol> <li>Part 1 Case (2:05)</li> <li>Framing bias (7:07)</li> <li>Data-driving reasoning  (11:48)</li> <li>Hypothesis-driven approach (12:38)</li> <li>Periodic paralysis syndromes (16:08)</li> <li>Representativeness heuristic (17:26)</li> <li>Part 2 Case (20:51)</li> <li>Pivot Points (31:36)</li> <li>Diagnosis (35:55)</li> <li>Take aways (37:20)</li> </ol> Check out the key teaching points: <a title="" href=""></a>
May 02, 2018
#13 Chronic Adrenal Insufficiency: 5 Pearls segment
<p>Solidify your knowledge on adrenal insufficiency! Quiz yourself on the 5 pearls we will be covering:</p> <ol> <li>What are signs and symptoms of chronic adrenal insufficiency (AI)? What is the most sensitive? (2:02)</li> <li>How do we diagnose and differentiate types of adrenal insufficiency? (6:05)</li> <li>How sensitive and specific are the diagnostic tests for AI &amp; at what cutoffs? (12:06)</li> <li>Can we both test and treat adrenal insufficiency <i>at the same time</i>? (16:40)</li> <li>Throwback: How do hypokalemia and hepatic encephalopathy connected? (24:55)</li> <li>Dr. Nidhi Agrawal Recap (19:20)</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
Apr 18, 2018
#12 Latent TB: 5 Pearls segment
Solidify your knowledge on latent TB! Quiz yourself on the 5 pearls we will be covering: <ol> <li>Who should be screened for latent tuberculosis infection (LTBI)? (1:45)</li> <li>What screening tests are available and how do they differ? (6:30)</li> <li>What are the LTBI treatment options available? (10:24)</li> <li>What are the major adverse drug effects to consider? (13:28)</li> <li>How frequently should you check liver function tests in a patient being treated for LTBI? What do you do with the results? 17:43</li> <li>Dr. Caplan-Shaw Recap (21:29)</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
Mar 28, 2018
#10 Albuminuria: 5 Pearls segment
<p>Solidify your knowledge on albuminuria! Quiz yourself on the 5 Pearls we will be covering:</p> <ol> <li>How good is a dipstick, urinalysis and UACR in detecting albuminuria? (1:42)</li> <li> What conditions that lead to transient proteinuria? What is the appropriate interval to recheck and how should be it be repeated? (5:14)</li> <li>Who should be screened for albuminuria and can it prognosticate risk for cardiovascular mortality? (7:47)</li> <li> Does increasing RAAS inhibition improve renal outcomes? (10:57)</li> <li> Throwback Question: How do you prescribe oral iron and what tips do you tell your patients? (13:11)</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
Feb 28, 2018
#9 COPD Classifications: Mind the Gap segment
<p>Let’s go deeper into to why we think about diseases the way we do: COPD Classifications through the years!</p> Time Stamps:<ol> <li>How did prior understanding of COPD pathophysiology lead to COPD classifications in the past? (3:25)</li> <li>How is COPD diagnosed? (6:13)</li> <li>How has COPD been classified and why? (6:42)</li> </ol> <p></p> <p>For full show notes: <a title="" href=""></a></p>
Feb 14, 2018
#8 Chronic Hepatitis B (Part 2) Management: 5 Pearls segment
<p><i>Quiz yourself </i><i>on the following 5 Pearls on Chronic Hepatitis B (HBV) Management!</i></p> <ol> <li>What is the <b>focused history, physical and lab</b> workup in a patient with chronic HBV? (1:40)</li> <li>What is the best <b>imaging</b> to evaluate for intermediate stages of liver fibrosis? (4:06) <ul> <li>What scoring tools can you use to estimate fibrosis and what are their limitations?</li> </ul> </li> <li>What factors do you use to assess which patients get <b>treatment</b>? (7:41)</li> <li>What <b>drugs</b> are available for HBV treatment and how do you choose? (11:18)</li> <li>Which chronic HBV patient should be <b>screened for HCC</b>, and how often? (14:45)</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
Jan 31, 2018
#7: Chronic Hepatitis B Part 1: 5 Pearls segment
<p dir="ltr">Solidify your knowledge on Chronic Hepatitis B (HBV) screening and vaccinations! Quiz yourself on the 5 Pearls we will be covering:</p> <ol> <li>Who do you screen for HBV? (3:37) <ul> <li>How is HBV transmitted and who is at risk for HBV reactivation?</li> </ul> </li> <li>What tests do you order when screening for HBV?   (10:48) <ul> <li>In which populations is HBV vaccination recommended?</li> </ul> </li> <li>What are the four possible meanings of an isolated positive total anti-HBc? (13:55)</li> <li>In an asymptomatic adult, is it necessary to send an anti-HBc IgM to distinguish acute from chronic HBV infection? (15:01)</li> <li>What are the implications of seroconversion of HBeAg from positive to negative? (16:19)</li> </ol> <p>For full show notes: <a title="" href=""></a></p>
Jan 17, 2018
#6 The Wonderful World of Albumin: Mind the Gap segment
Let's go deeper as to why we do what we do: albumin in spontaneous bacterial peritonitis (SBP) ! Time Stamps:1. How much albumin is recommended in SBP? (1:45)2. What antibiotics are used for the treatment of SBP? (2:30)3. Why do we give albumin in SBP? (4:15) - How does albumin compare to crystalloid? (7:15) - Do we always have to give to albumin? (9:00) For full shownotes: <a title="" href=""></a> <p></p>
Jan 03, 2018
Hepatic Encephalopathy: 5 Pearls Edition Ep3
Cement your knowledge on Hepatic Encephalopathy (HE)! <i>Quiz yourself </i><i>on the following 5 Pearls we’ll be covering on HE</i>: <b></b> <b>Time Stamps</b> <ol> <li>What are other causes of altered mental status in cirrhotics? (1:45) <ul> <li>What are common precipitants for an acute episode of HE? </li> </ul> </li> <li>What is asterixis? (6:10) <ul> <li>What is the diagnostic utility of a cirrhotic with asterixis? </li> </ul> </li> <li>How do lactulose &amp; rifaximin reduce symptoms of HE? (11:00) <ul> <li>What are their indications? </li> </ul> </li> <li>What is the connection between hypokalemia and HE? (14:10)</li> <li>What is the discriminatory power of an ammonia level in HE? (16:40) <ul> <li>In what situation does the NH3 has stronger predictive value? </li> </ul> </li> </ol> <p>For full shownotes: <a title="" href=""></a></p> <p></p>
Dec 13, 2017
Mind The Gap Ep2: Part 2 of Paracentesis
<p>Part 2 on Abdominal Paracentesis ! Let's go deeper</p> <p>Time Stamps</p> <p>Should a cirrhotic’s INR and platelets deter you from doing a paracentesis? (3:15)</p> <p>Do generalist have worse procedure complications than specialists?  (5:40)</p> <p>Do you need to send ascites fluid in blood culture bottles? (6:10)</p> <p>For full shownotes: <a title="" href=""></a></p>
Nov 29, 2017
5 Pearls Ep2: Iron Deficiency Anemia
Solidify your knowledge on iron deficiency anemia! Quiz yourself on the 5 Pearls we will be covering: <ol> <li>Should patients be screened for iron deficiency? If so, who and how often? (1:40)</li> <li>What are the indications for diagnostic endoscopy in iron deficient patients? (3:23)</li> <li>How should you advice patients to take oral iron? (5:53) <ul> <li>What is optimal dosing for oral iron? </li> </ul> </li> <li>In which patients would you consider IV iron? What are the risks? (11:41)</li> <li>Throwback Question: What is a medication-overuse HA? (14:44)</li> </ol> For full shownotes: <a title="" href=""></a>
Nov 15, 2017
CORE IM podcast: Mind The Gap on Admission Paracentesis
<p>You have always been told to do a diagnostic paracentesis on admission in cirrhotics with ascites, but why? Can you just get away with <b>clinical judgement to rule out SBP</b>? Is <b>faculty</b> judgement any better? And if you’re going to do a paracentesis on admission, do you<b> need to do it right away</b>? Go deeper with Dr. Steve Liu and Dr. Janine Knudsen!</p> <p>Click the link for the full show notes: <a title="" href=""></a></p> <p><b>Time Stamps</b></p> <ol> <li> What do guidelines say about diagnostic paracentesis in cirrhotics with ascites? (1:51)</li> <li>Can we just use clinical judgement to decide if paracentesis is warranted? (3:13) <ul> <li>Do attendings have better clinical judgement than residents to rule out SBP?</li> </ul> </li> <li> Does timing of paracentesis on admission matter for mortality? (6:33)</li> </ol>
Nov 01, 2017
Core IM Podcast: 5 pearls on Headaches - Core IM | Internal Medicine | Medical Education | FOAMed | Family Medicine | Physician Assistant | Resident | Nurse Practitioner | Medical Student | Hospitalist | Primary Care
<p>Cement your knowledge on headaches with 5 Pearls on when imaging is indicated, approach to abortive medications, medication overuse headaches, when to use migraine prophylaxis and effective non-pharmacological treatment for migraines!</p> <p>For full shownotes: <a title="" href=""></a></p> <p><b>Time Stamps</b></p> <ol> <li>What are the indications for imaging for HA? (1:36)</li> <li>What is your approach to abortive therapy for migraines? (4:45)</li> <li>How do you diagnose medication overuse HA? (6:41)</li> <li>What is your approach to migraine prophylaxis? (8:29)</li> <li>What are some evidence based nonpharmacological therapies for migraines?  (10:42)</li> </ol>
Oct 18, 2017
Introducing the CORE IM Podcasts: 5 Pearls & Mind the Gap - Core IM | Internal Medicine | Medical Education | FOAMed | Family Medicine | Physician Assistant | Resident | Nurse Practitioner | Medical Student | Hospitalist | Primary Care
<p>CORE IM is an independent consortium of educators aligned to create internal medicine-specific portable learning tools in the form of podcasts, corresponding show notes and illustrations. Segments include 5 Pearls and Mind The Gap.</p> <p>For more information: <a title="" href=""></a></p> <p>Sincerely,</p> <p>CORE IM team:</p> <p>Executive Producer: Shreya P. Trivedi, MD (@ShreyaTrivediMD)</p> <p>Five Pearls Producer: Marty Fried, MD (@Marty_Fried)</p> <p>Mind the Gap Producer: Steve Liu, MD</p> <p>Advisors: Neil Shapiro MD, John Hwang MD, Vincent Santillo MD</p> <p>Podcast editing and technical set-up: Harit Shah and Steven Liu MD</p> <p>Director of Sound Design, Theme song: Shaun Finnegan</p> <p>Artistic director: Dr. Mike Natter (@mike_natter)</p>
Oct 13, 2017