Core IM | Internal Medicine Podcast

How do you decide which lung nodules should be worked up inpatient or outpatient? How common are incidental lung nodules? What considerations are there for patients that could potentially get lost to follow up? What risk adopted approach can be implement in our practice? Do you know what fast forward rounds are? Sponsor: Use the code “ COREIM-AMBOSS ” to get a free month of access on https://go.am...

Can you identify where along the clinical reasoning pathway the learner is struggling? What coaching exercises can be helpful? What feedback do you fall back on when working with learners? What are common challenges? Show notes, Transcript and References:  https://www.coreimpodcast.com/2020/12/09/hoofbeats-strugg…inical-reasoning/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-po...

Hear personal stories about racial trauma or stereotype threat. How can we respond and how do we differentiate an up stander from a bystander? What barriers exist when we try to respond? Show notes, Transcript and References:    https://www.coreimpodcast.com/2022/08/24/upstander/   Time stamps 04:51Overview of Microaggressions 08:11 Prevalence 11:43 How to respond 21:03 Barriers to appropriate res...

What are the 3 types of solutes you can use in hyponatremia? What are each of their drawbacks? How do loop diuretics work help in hyponatremia? What can you use to tell you on day 1 that fluid restriction alone will not work? Show notes, Transcript and References:   https://www.coreimpodcast.com/2022/08/03/hyponatremia-man…5-pearls-segment/ Sponsor: https://go.amboss.com/CoreIM-E4 Get CME-MOC cred...

What does each diagnostic test tell you? How do you interpret urine osmolality, urine sodium, or urine urea? What studies can be used to better assess response to treatment? How can uric acid be utilized as a diagnostic tool? What is the interplay between ADH and UOsm? Show notes and Transcript:  https://www.coreimpodcast.com/2021/02/10/5-pearls-on-hyponatremia-episode-1/ ACP CME:  https://www.acp...

Other than infection, what do you think about as other causes of fever? How can you distinguish sepsis from drug fever from antibiotics? What medications are most likely to cause neurotoxicity? What are some risk factors? How do you think about goals of care with patients?  Show notes & Transcript:   https://bit.ly/3P8wqG6 Sponsor: Visit  www.medmastery.com/coreim  for 15% off on all subscript...

What are the 3 different types of inhaler devices and what should you educate patients about each? When do you stop the inhaled steroid in COPD? And when do you think of increasing the dose? What is important to communicate at the time of diagnosis, and during goals of care discussions? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/06/22/5-pearls-on-copd-management/ Spo...

How do you ask about spiritual health? How is spirituality different from religion? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/06/15/spirituality/ Time stamps 00:01 What is spirituality? 7:12 Why does spirituality matter? 12:09 How do we screen for it? 18:50 Chaplains 27:49 Conclusion   Tags: IM Core, CoreIM, ethics, medical humanities Find the best disability insura...

What are the indications for a simple transfusion? And what the indications for an exchange transfusion? What is your approach to pain management in patients with sickle cell? What are the treatment options for sickle cell and which ones actually decrease sickle crisis and improve mortality? What are some of the major sickle cell complications to watch out for and how can we prevent some of them?...

How do you counsel patients on beta blockers? Is one beta-blocker better than the other? What is preferred: ACEi, ARBs or ARNIs? What are the pros and cons of each? How does spironolactone compare to eplerenone? When do you stop mineralocorticoid receptor antagonist? What are risks with SGLT2 inhibitors? How do you initiate GDMT? Which meds do you start first and in what order? Show notes, Transcr...

How much of D5W vs. isotonic saline contributes to intravascular volume? How do you distinguish between oncotic pressure and tonicity? What balanced solutions do you reach for? What is the data behind using colloids like albumin as an intravascular expander? How much do pRBCs stay in the plasma?  Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/04/27/fluids-colloids-5-pea...

What do you include in your initial basic work-up for suspected pulmonary hypertension? Do you know how to calculate the PASP on the ECHO? What physiological insults that can cause high pulmonary pressures? How can we interpret the E/e’ ratio? Whiteboard animation video on YouTube Show notes, Transcript and References Get CME-MOC credit with ACP Time stamps: 02:18 | Intro 05:27 | Pearl 1  12:17 |...

How can we use food as medicine? How can we best counsel our patients on their diets? Which pre-set diets can we recommend for or against? How can we make the changes sustainable?  Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/03/23/obesity-and-nutr…-2021-sgim-recap/ Time stamps: 03:10 Trends in weight and dieting 06:01 Counseling patients on diet 09:35 Food group reco...

What are some tricks to help you perform a virtual physical exam? What role do these visits play in our overall care for the patient? What tools do we have at our disposal for a more thorough evaluation? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/03/09/telemedicine-and…-2021-sgim-recap/ Tags: IM Core, CoreIM, tele visit, gizmos, history taking, virtual, physical exam...

How long should you anticoagulant for a PE? When can you safely stop anticoagulation for thrombogenic patients who need an urgent biopsy? Should an IVC filter be placed to prefer further embolization of a DVT? What percentage of patients with cancer associated blood clots will have progression while on anticoagulation? Show Notes, Transcript, and References: https://www.coreimpodcast.com/2022/02/2...

How can you implement effective note taking for virtual learning? Do you use interleaving during rounds? What is the 5/10/30 rule and how does it apply to mentorship? Does implicit bias affect gender performance scores in clinical rotations? How common are biased patient behaviours? How can you foster a safer learning environment for trainees? How can you promote antiracism? Show notes, Transcript...

What’s your comfort level with managing hyponatremia and how does it change in unfamiliar environment? How can you vary your practice to build up adaptive exerptise?  Show notes, Transcript & References:   https://www.coreimpodcast.com/2022/01/26/hoofbeats-consult-case/   Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps 01:36 Cas...

Have you ever thought about where the 1g/dL hemoglobin appropriate bump after 1 unit of pRBC transfusion? How does the patient's intravascular volume affect this? What rise in hemoglobin should you expect? What factors can impact this? Show notes, Transcript and References:   https://www.coreimpodcast.com/2022/01/05/1-to-1-prbc-bump…-the-gap-segment/ Time stamps 01:22 Unpacking the question  0...

Let’s apply to cases! We use the 7 questions framework to 3 practical cases Show notes, Transcript and References: https://www.coreimpodcast.com/2021/12/22/treatment-over-objection-part-2/ Time stamps 2:19 Case 1: Review of Framework 7:59 Case 2 9:04 Consent vs. Assent  11:11 Role of Consult Services 13:16 Role of Surrogates 15:29 Conclusion   Tags: IM Core, CoreIM, autonomy, capacity, human digni...

Get a very useful framework to help you weigh the risks and benefits of treatment over objection! Show notes, Transcript and References:  https://www.coreimpodcast.com/2021/12/08/treatment-over-objection/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im  Time stamps 03:02 Ethical and emotional challenges 10:08 Case 1 18:55 Study of the 7 Questio...

What degree of hyperkalemia makes you worried enough to send your patient to the ED? Are ECG changes sensitive in detecting hyperkalemia? Do you know how to advise your patient on dietary changes? What medications can you effectively use in the outpatient setting? Show notes, Transcript and References:  https://www.coreimpodcast.com/2021/11/17/hyperkalemia-mind-the-gap-segment/   Get CME-MOC credi...

What are pearls and pitfalls when assessing an older patient for the first time? Time Stamps: 02:25 Initial Office Visit 08:08 Mobility Assessment  13:25 Cognitive Evaluation  19:27 Medications  26:29 Throwback Pearl Show notes, Transcript and References: https://www.coreimpodcast.com/2021/10/31/5-pearls-on-geriatric-care/ Tags: Core IM, IM Core, delirium, goals of care, dementia, mini cog, MOCA,...

Should we use oral diabetes agents in our hospitalized patients? Do you hold metformin for fear of lactic acidosis? Do you typically order an insulin sliding scale? When can you comfortably restart PTA meds? Time Stamps: 02:25 Can we give metformin in the hospital? 10:50 Incretin-based therapies 14:49 Sodium Glucose Cotransporter-2 Inhibitors 16:27 Sulfonylurea & Thiazolidinediones 18:00 Basal...

What are practical phrases can you incorporate to help patients who use drugs? What changes can you make to ensure person-first language? What safe drug practices can you advise? What is MOUD? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/09/29/5-pearls-on-stig…oid-use-disorder/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamp...

A very practical episode around nuanced code status conversations with many examples! Time Stamps: 00:08 Introduction 04:01 Information Gathering 20:41 Informed Consent 29:47 Giving Recommendations 36:47 Mistakes 48:22 Wrap Up Show notes, Transcript and References: https://www.coreimpodcast.com/2021/09/12/code-status Tags: Core IM, IM Core, DNR/DNI, CPR, intubation, goals of care, shared decision...