<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="https://www.clinicalcorrelations.org/?p=18393" title="https://www.clinicalcorrelations.org/?p=18393">https://www.clinicalcorrelations.org/?p=18393</a></p>

<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="https://www.clinicalcorrelations.org/?p=18183" href="https://www.clinicalcorrelations.org/?p=18183">https://www.clinicalcorrelations.org/?p=18183</a></p>

<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>

<p>Be inspired by why so many are proud to be in General Internal Medicine (GIM)!</p>

<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 href="https://www.clinicalcorrelations.org/?p=17823" title="https://www.clinicalcorrelations.org/?p=17823">https://www.clinicalcorrelations.org/?p=17823</a></p>

<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="https://www.clinicalcorrelations.org/?p=17613" href="https://www.clinicalcorrelations.org/?p=17613">https://www.clinicalcorrelations.org/?p=17613</a></p> <p> </p>

<p>Dissect an interesting case and think about the way clinicians think! So many clinical reasoning pearls here:</p> <p><span id="docs-internal-guid-9ec685fb-1f07-1ac7-2029-95582701dd6f"></span></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> <div>Check out the key teaching points: <a title="https://www.clinicalcorrelations.org/?p=17333" href="https://www.clinicalcorrelations.org/?p=17333">https://www.clinicalcorrelations.org/?p=17333</a></div>

<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="https://www.clinicalcorrelations.org/?p=16993" href="https://www.clinicalcorrelations.org/?p=16993">https://www.clinicalcorrelations.org/?p=16993</a></p>

<div> <div>Solidify your knowledge on latent TB! Quiz yourself on the 5 pearls we will be covering:</div> <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></div> <p>For full show notes: <a title="https://www.clinicalcorrelations.org/?p=16783" href="https://www.clinicalcorrelations.org/?p=16783">https://www.clinicalcorrelations.org/?p=16783</a></p>

<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 href="https://www.clinicalcorrelations.org/?p=16133" title="https://www.clinicalcorrelations.org/?p=16133">https://www.clinicalcorrelations.org/?p=16133</a></p>

<p><span id="docs-internal-guid-f5c9ef99-9212-9b44-fabb-51967ca17581"><span>Let’s go deeper into to why we think about diseases the way we do: COPD Classifications through the years!</span></span></p> <div><span>Time Stamps</span><span>:<br /><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></span></div> <p><span id="docs-internal-guid-f5c9ef99-9215-7c1b-b22b-7f340516562d"></span></p> <p>For full show notes: <a title="https://www.clinicalcorrelations.org/?p=15683" href="https://www.clinicalcorrelations.org/?p=15683">https://www.clinicalcorrelations.org/?p=15683</a></p>

<p><em>Quiz yourself </em><em>on the following 5 Pearls on Chronic Hepatitis B (HBV) Management!</em></p> <ol> <li>What is the <strong>focused history, physical and lab</strong> workup in a patient with chronic HBV? (1:40)</li> <li>What is the best <strong>imaging</strong> 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 <strong>treatment</strong>? (7:41)</li> <li>What <strong>drugs</strong> are available for HBV treatment and how do you choose? (11:18)</li> <li>Which chronic HBV patient should be <strong>screened for HCC</strong>, and how often? (14:45)</li> </ol> <p>For full show notes: <a title="https://www.clinicalcorrelations.org/?p=15273" href="https://www.clinicalcorrelations.org/?p=15273">https://www.clinicalcorrelations.org/?p=15273</a></p>

<p dir="ltr"><span>Solidify your knowledge on Chronic Hepatitis B (HBV) screening and vaccinations! Quiz yourself on the 5 Pearls we will be covering:</span></p> <div><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></div> <p>For full show notes: <a title="https://www.clinicalcorrelations.org/?p=14603" href="https://www.clinicalcorrelations.org/?p=14603">https://www.clinicalcorrelations.org/?p=14603</a></p>

<div>Let's go deeper as to why we do what we do: albumin in spontaneous bacterial peritonitis (SBP) !</div> <div></div> <div><span>Time Stamps:<br /></span><span>1. How much albumin is recommended in SBP? (1:45)<br /></span><span>2. What antibiotics are used for the treatment of SBP? (2:30)<br /></span><span>3. Why do we give albumin in SBP? (4:15)<br /></span><span> - How does albumin compare to crystalloid? (7:15)<br /></span><span> - Do we always have to give to albumin? (9:00)</span></div> <div></div> <div>For full shownotes: <a title="https://www.clinicalcorrelations.org/?p=14273 " href="https://www.clinicalcorrelations.org/?p=14273">https://www.clinicalcorrelations.org/?p=14273</a></div> <p><span id="docs-internal-guid-cb165dc5-b4ea-3360-718c-61406996c551"></span></p>

<div><span id="docs-internal-guid-3ad8e469-48b7-7452-0b3b-b88a70088d32">Cement your knowledge on Hepatic Encephalopathy (HE)! <i>Quiz yourself </i><i>on the following 5 Pearls we’ll be covering on HE</i>: <br /></span><span><b></b></span></div> <div></div> <div><b>Time Stamps</b></div> <div><span><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></span></div> <p>For full shownotes: <a title="https://www.clinicalcorrelations.org/?p=13953" href="https://www.clinicalcorrelations.org/?p=13953">https://www.clinicalcorrelations.org/?p=13953 </a></p> <p><span id="docs-internal-guid-3ad8e469-48b8-084e-0fcb-98f35c8f84ee"></span></p>

<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 href="https://www.clinicalcorrelations.org/?p=13503" title="https://www.clinicalcorrelations.org/?p=13503">https://www.clinicalcorrelations.org/?p=13503</a></p>

<div> <div>Solidify your knowledge on iron deficiency anemia! Quiz yourself on the 5 Pearls we will be covering:</div> <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></div> <div>For full shownotes: <a href="https://www.clinicalcorrelations.org/?p=13083" title="https://www.clinicalcorrelations.org/?p=13083" target="_blank">https://www.clinicalcorrelations.org/?p=13083</a></div>

<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 <strong>clinical judgement to rule out SBP</strong>? Is <strong>faculty</strong> judgement any better? And if you’re going to do a paracentesis on admission, do you<strong> need to do it right away</strong>? Go deeper with Dr. Steve Liu and Dr. Janine Knudsen!</p> <p>Click the link for the full show notes: <a title="Show Notes" href="https://www.clinicalcorrelations.org/?p=12323">https://www.clinicalcorrelations.org/?p=12323</a></p> <p><strong>Time Stamps</strong></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>

<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="https://www.clinicalcorrelations.org/?p=11493" href="https://www.clinicalcorrelations.org/?p=11493">https://www.clinicalcorrelations.org/?p=11493</a></p> <p><strong>Time Stamps</strong></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>

<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 href="https://www.clinicalcorrelations.org/?p=11623" title="https://www.clinicalcorrelations.org/?p=11623">https://www.clinicalcorrelations.org/?p=11623</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> <div></div>