Core IM | Internal Medicine Podcast

MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we finally entering an era where we can meaningfully treat MASH? In this Beyond Journal Club episode, we unp...

What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability , antihypertensive selection, and strategies to prevent intradialytic complications while optimizing long-term outcomes.  🔹 Sponsor:  ...

Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis , why ESKD patients have unique physiology , and how volume overload, not just hypertension, drives many complications. Learn practical pearls on dry weight, sodium restriction, diuretics, and the strategies that can reduce hospitalizations and improve patient outcomes.  🔹 Spon...

Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between alg...

We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but h...

Can you distinguish benign eosinophilia from a sign of serious disease, and know exactly when to act at the bedside? In this high-yield episode, test your clinical reasoning as we tackle: When eosinophilia becomes dangerous and why it matters How to distinguish if its from atopy vs. systemic disease Which medications to stop (and which to watch) How travel, diet, and exposure history shape your wo...

Is coffee helping or harming our patients’ hearts? In this Beyond Journal Club, we unpack the  CRAVE trial  and use it as a lens to answer a bigger question: How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust? Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle. 🔹 Sponsor: Oakst...

Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach. .🔹Sponsor:  DoxGPT  by Doximity  - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, char...

A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded? A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI? A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter? And the classic inpatient dilemma: your heart...

Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help . In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them. • Do cholinesterase inhibitors really work? • What should clinicians know about lecanemab and donanemab before referring patients? • How much benefit should we expect and for how...

Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI? 🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, sec...

From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden. 🔹  Sponsor : Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group:  https://cme-info.nejm.org/core-im/ 🔹 Transcr...

Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside , learn how clinicians should act when ethics, law, and trust collide. 🔹 Sponso...

Baby alligators   - those betrayals of purpose  , or, death by a thousand paper cuts  ! Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with: Regulated curiosity Strategic empathy Small, well-chosen moves... ...and change that is  big enough to matter, and small enough to win! 🔹 Sponsor: Caraway’s cookware set is a favorite for a reason. For 1...

Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots? When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely. 🔹 Sponsor : Pain Management and Opioids Adaptive Learni...

We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both. 🔹  Sponsor: Oakstone CME Use the code "CORE30" for 30% off:  https://www.coreimpodcast.com/MKSAP   🔹  Transcript and Shownotes (1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life (10:2...

Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t? 🔹  Sponsor: Oakstone CME Use the code "CORE30" for 30% off:  https://www.coreimpodcast.com/MKSAP  ...

How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when? 🔹 Transcript and Shownotes (03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast (05:27) | Triglycerides as a Cardiovascular Risk Marker (0...

Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score? 🔹 Sponsor: Oakstone CME Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP  ...

SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use? 🔹 Sponsor: Use the code "CORE30" for 30% off:  https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show Notes Timestamp...

What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care? 🔹  Sponsor : Oakstone CME Use the code "CORE25" for 25% off:  https://www.coreimpodcast.com/MKSAP 🔹  Transcript &am...

HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right? 🔹  Sponsor : Oakstone CME Use the code "CORE25" for 25% off:  https://www.coreimpodcast.com/MKSAP 🔹  Transcript & Show Notes Timestamps:  (00:57) | Understanding the Pathophysiology of HRS  (03:42) |...

Who’s really at risk for fractures, and how should we be treating them?  Most fragility fractures occur in patients without osteoporosis. Should we rethink who gets treated? And could just one or two IV infusions (spread years apart) of zoledronate prevent fractures for years? Have the concerns about bisphosphonates been overblown? Find out all the nuances on this episode of Beyond Journal Club, a...

Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic hypotension? 🔹  Sponsor : Oakstone CME’ Use the code "CORE25" for 25% off:  https://www.coreimpodcast.com/MKSAP 🔹...

Learn specific, practical ways to counsel patients on non-pharmacologic interventions. What is our goal with OH treatment? Is it the blood pressure number that matters? How do we avoid missing neurogenic causes of orthostatic hypotension (OH)?  🔹  Sponsor : Oakstone CME’ Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26:  https://www.coreimpodcast.com/MKSAP 🔹  Transcrip...