Core IM | Internal Medicine Podcast

Solidify your knowledge on Coronary calcium scores and Coronary CTAs! ACP members can claim CME-MOC Credit ! Quiz yourself on the 5 pearls we will be covering below: 3:10 What are the big picture differences of functional stress tests and anatomical cardiac tests? 7:48 What is the role of coronary artery calcium scores in managing coronary artery disease (CAD)? 16:20 How do coronary CTAs compare t...

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. 01:13   Introduction 05:27   Question 1: What makes a patient difficult for you? 13:22   Question 2: What is a “good outco...

Transitions can be hard. Laugh, commiserate and be inspired by these July stories in medicine! Very big thank you to everyone who told their stories ! 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 hello@coreimpodcast.com . Lets contin...

Dissect clinical reasoning and dive deeper into an interesting case! 02:04   Initial Presentation 03:03   The Core IM team tackles the case 09:30   Social History 16:05   Physical Exam 22:47   An exercise in Bayesian inference 36:35   Pre-mortem 43:37   Revealing the diagnosis 48:57   How do we define diagnostic success? Full transcript with references and show notes Find the best disability insur...

Dive deeper into why we prescribe medications in the morning vs. at night ! Why do we dose warfarin at night? (2:45) Back to the basics - what are the pharmacodynamics of warfarin and how does vitamin K intake matter? (4:28) Practical matters - so what should we tell patients (6:14) Dippers and non-dippers - what happens to blood pressure (BP) at night? (9:32) The surprising link between dipping a...

Solidify your knowledge on stress tests! Quiz yourself on the 5 pearls we will be covering: What are the indications for a stress test? (2:18) How to choose stress protocol in a stress test? (8:29) How to choose diagnostic modality in a stress test? (14:46) How do we interpret results from stress tests, and how should this be communicated to patients? (24:08) Pearl Recap (31:13) Risk of contrast i...

Dissect 3 interesting cases and improve your clinical reasoning skills! Time Stamps: New features in this episode [0:30] Case one: 66M w RUQ pain [1:09] Case two: 41M w Afib in RVR [9:26] Case three: 50M w Syncope [14:33] Reveal [19:57] Retrieving illness scripts [22:29] Typical versus Atypical presentation of diseases [26:12] For full transcript and show notes:  https://www.coreimpodcast.com/?p=2...

Check out part 1: Acute Coronary Syndrome and TIMI Risk Score Lets go deeper into 1) How the chest pain history correlates with pathophysiology? [2:40] 2) How has high-sensitivity troponin changed the way we think about unstable angina? [7:34] For transcript, infographic and show notes:  https://www.coreimpodcast.com/2019/03/27/unstable-angina/ Find the best disability insurance for you: https://w...

Solidify your knowledge on inpatient pain management! Quiz yourself on the 5 pearls we will be covering: How effective are non-opioids? ( 3:17) Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51) What are the best practices for patients who require opioid analgesia? (19:00) When prescribing opioids at discharge what can we do to m...

Let's go deeper into the world of ACS and the origin of the TIMI score and major adverse cardiac events "MACE" outcomes! The basics – what is acute coronary syndrome? (4:08) Clinical context matters – angina pectoris, atypical chest pain, and troponins (5:22) You can’t just “cath” everyone – risk stratification to identify patients with high mortality risk (9:42) TIMI isn’t perfect – t...

Dissect an interesting case and improve your clinical reasoning skills! Time Stamps: New features in this episode [00:25] Data point 1: Early hypothesis generation? [03:20] Data point 2: Pertinent negatives? [11:18] Data point 3: Representativeness heuristic over-represented in medical education? [13:28] Data point 4: Economical hypothesis generation by expert clinicians [19:20] Data point 5: Diag...

Solidify your knowledge on Barrett's Esophagus and more! Quiz yourself on the 5 pearls we will be covering: What is Barrett’s esophagus and why should we care? (4:12) Who do we screen for Barrett’s, and why? (8:41) How do we screen for Barrett’s and counsel? (13:50) How do we treat and monitor Barrett’s esophagus? (18:21) Take Aways (21:45) Throwback to trending troponins (23:05) For full tran...

Dissect an interesting case and improve your clinical reasoning skills! Time stamps: Player three has entered the game! [0:15] Case presentation, part 1 [1:20] First impressions [3:24] Rethinking another provider’s diagnosis [4:36] Interpreting the test of treatment [8:48] Keeping your instincts on a leash? [10:58] Case presentation, part 2 [12:33] Diagnostic schemas [14:30] Our discussant’s diffe...

Solidify your knowledge on troponins and more! Quiz yourself on the 5 pearls we will be covering: What aspects of the history are concerning in a patient with a positive troponin? (4:00) 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) How does the change in troponin over time help wi...

Let's dive deeper into the world of acetaminophen and fever and how it may work and patient outcomes Time Stamps: What data is there to support the use of acetaminophen as a fever reducer? (2:08) Does acetaminophen improve patient outcomes? (4:30) How does acetaminophen compare to other medications like NSAIDs? (9:56) What is the mechanism of acetaminophen action? (10:50) Review of teaching po...

Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here: Time stamps: Case [1:19] Diagnostic weight [8:42] Hypothesis driven reasoning [12:26] Anomalous clinical data [19:30] Final diagnosis [22:20] Take away points [31:21] Human Dx Case link: https://www.humandx.org/o/co7yrer3dim2y59t5c0sbd370?s=FEED For show notes: https://www.coreimpodcast.com/2...

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: 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...

Solidify your knowledge on Alcohol Use Disorder (AUD) treatment and more! Quiz yourself on the 5 pearls we will be covering: Throwback: At what levels of drinking does unhealthy alcohol use start, and how do you screen for unhealthy alcohol use? (1:47) What does the brief intervention and counseling part of SBIRT entail? (4:43) What are the first line medications for AUD and contraindications to t...

Dissect a working diagnosis through a process of validation! Time Stamps: Your collective differential [0:40] The test results (that you asked for) are in... [2:13] The hospital course, and the diagnosis (or is it?) [7:10] Validating a diagnosis: Base rate, adequacy, and coherence [8:30] Revisiting the differential [14:44] What to do when there is no final diagnosis? [17:39] For full show notes: h...

Submit your diagnosis or differential for this episode's case at HumanDx.org (free registration required): http://hdx.org/2VP ! Part 2 (releasing 10/24) will have the final diagnosis! Time stamps: A new challenge and the rules of the game (1:13) Introduction to Human Dx (3:06) The case: An 85 year-old woman with paranoid delusions (5:28) What exactly is problem representation? (15:15) Building...

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! Episode page: https://www.coreimpodcast.com/2018/09/27/meet-the-producers/ Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out CovePure and use my code CovePure.com/coreim for a great...

  Let's go deeper into the world of UTIs and delirium! The basics – what are the official (IDSA) definitions for bacteriuria, pyuria, and UTI? (02:07) The lay of the land – how common are bacteriuria and delirium? (07:09) The big money question – do UTIs really cause delirium and what does the evidence tell us? (10:50) Review of teaching points (15:59) Full show notes: https://www.coreimpodcas...

Solidify your knowledge on Proton-Pump Inhibitors (PPIs) and more! Quiz yourself on the 5 pearls we will be covering: What are associated adverse effects for patients are on long-term PPIs? (2:02) What are strategies to get your patient off PPIs? (10:57) 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) How...

Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here: Case history and exam 00:40 Causal models 11:24 Facets versus diagnoses 13:25 Problem representation 16:37 Part two of the case 17:10 Occam’s razor, Hickam’s dictum, and Crabtree’s bludgeon 23:00 Diagnostic uncertainty 27:10 Learning points 34:24 For show notes: https://www.coreimpodcast.com/...

Lets go deeper into the misunderstood side of Vancomycin! Where did vancomycin come from, and why is it so controversial? (0:28) What is vancomycin-induced nephrotoxicity and how common is it? (4:37) Vancomycin trough monitoring – what is it good for? (7:28) AUC to MIC ratio – the real math behind vancomycin dosing (7:53) Review of teaching points (10:27) Full show notes: https://www.coreimpodcast...