In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Show Notes & Transcript 01:50 Pathophysiology of Steroids and...

Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray! Sponsor: Post Investment: Real Estate Syndications  Show Notes & Transcript Timestamps: 01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?06:31 Pearl 2: Considerations for patients with implantable devices before surgery.12:26 Pearl 3: Considerations for...

Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria? Sponsor: Panacea Financial Student Loan Consultation CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamp: 00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage 04:20" What's wrong with how we estimate GFR? 06:50 Why is creatinine flawed as an estimator of GFR? 10:52 Enter new contender...Cystatin...

Who should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting! Sponsor: Hellofresh (50% off + free shopping with code: 50COREIM) Show Notes & Transcript Timestamp 03:13 Part 1: Who should be referred to genetic counseling?11:23 Part 2: How do we set up genetic counselors for success?22:38 Part 3: Genetic counseling myth busting! Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc,...

What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?! Sponsor: Hellofresh (50% off + free shopping with code: 50COREIM) CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamp 01:45 Pearl 1: Evidence for potassium repletion 09:10 Pearl 2: Framework for hypokalemia17:09 Pearl 3:...

What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss? Sponsors: Post Investment: Real Estate Syndications || Hellofresh   Show Notes & Transcript 02:08 Framework for thinking about obesity03:42 History of obesity treatment06:29 Gila monsters and GLP and GIP mechanisms08:29 Story of how medications for diabetes were found to have a weight loss benefit12:50 SURMOUNT-1...

With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers?  Sponsors: Hellofresh | Pranay's Effective Living Formula Course Pranay's Free Masterclass (Sept 20 and 27th at 5pm PST) CME : http://bit.ly/CIMCME || Show Notes &...

What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence? Timestamps 01:00 System 1 vs. System 207:46 Cognitive Biases13:46 Case for Knowledge18:29 Other Practices to Decrease Error28:26 Conclusion CME: http://bit.ly/CIMCME || Show Notes & Transcript This episode is made in part of ACP’s Diagnostic Excellence curriculum Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and...

What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection? Timestamps 02:41 Types of Immunosuppression14:31 Medication Reconciliation22:36 AKI in the Transplant Patient31:53 Infections in the Transplant Patient40:00 Transplant rejection, cancer after...

In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery. How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group. Show notes &...

Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories ! Listen to the original July Stories: https://bit.ly/3Y4n8jG Subscribe to our new Youtube Channel ! Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedback Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out HelloFresh! Use code 50COREIM for a...

BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim  Show notes & Transcript Subscribe to our new Youtube Channel ! Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue Find the best disability insurance for you:...

How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim  Subscribe to our new Youtube Channel ! Use this link for CME-MOC credit with...

In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection? Show notes & Transcript Time Stamps02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis05:35 Deep Dive 2: FFP effect on bleeding risk15:43 Deep Dive 3: Risks of...

How long can fatigue last for after radiation? Are all patient post radiation immunocompromised?  What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim  Use this link for CME-MOC credit with ACP Show notes & Transcript Whiteboard Animation Video of Radiation Physiology Time Stamps02:37 Systemic Radiation Side Effects14:29 Lung Radiation Side...

What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation? Show notes & Transcript Whiteboard Animation Video of Radiation Physiology Time Stamps02:04 What is radiation?03:17 How does radiation therapy work?04:50 How is today’s radiation different from the past?05:40 What role does radiation play in cancer treatment?07:48 What are the...

What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members? Show notes & Transcript Time Stamps01:12 Learning Journey05:58 Lifelong Learning11:14 Time Management16:38 Role Modeling19:59 Re-Calibrating Failure Tags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome,...

What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric? Show notes, Transcript and References Time stamps 00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test03:03 Hemoglobin A1c08:26 Fructosamine and Glycated Albumin10:50 Continuous Glucose...

When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD? Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”Use this link for CME-MOC credit with ACPShow notes, Transcript and References Time stamps 02:51 What are the different types of pacemakers and...

How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes, Transcript and References Time stamps 03:49...

What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation? Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im  Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E10 Show notes, Transcript and...

Why are safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care? Show notes, Transcript and References: https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/ Timestamps: 0:00 Hahnemann University Hospital 4:36 What is a Safety Net Hospital? 11:11 The Origins and Paradox of the Safety Net Hospital Links to other episodes: A Complex Patchwork of...

How does your problem representation change as we get more history in this episode? How can we use Oxaam's razor & Hickman's dictum as powerful diagnostic tools IF used properly?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/15/25438/Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim (https://glass.health/coreim) Time stamps* 01:51 Intro* 07:57 Case * 13:09 Differential* 16:15 Diagnosis* 22:20 Problem...

How do you approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/ (https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/)Time stamps* 04:45 What do we mean by “futility”?* 11:20 Definitions* 20:23 Ethical Analysis*...