IM & Hospital Medicine Recaps

In this episode, we walk through a practical, pattern-based approach to jaundice. We cover why fractionating bilirubin is the key first step, how to quickly distinguish unconjugated from conjugated hyperbilirubinemia, and the red flags for ascending cholangitis and acute liver failure. You’ll learn how to interpret AST/ALT vs alkaline phosphatase, when to reach for RUQ ultrasound, MRCP, or ERCP, a...

Explore the gray zone between celiac disease, wheat allergy, and IBS in this episode on Non-Celiac Gluten Sensitivity (NCGS). We break down how to rigorously rule out celiac and wheat allergy, why gluten and FODMAPs (especially fructans) are so hard to tease apart, and how brain–gut interactions and the nocebo effect shape symptoms. You’ll learn a practical approach to diagnosis, the role of elimi...

In this episode, we break down why lung cancer in people who have never smoked is a completely different disease biology than tobacco-related lung cancer. We walk through the dominance of adenocarcinoma in this population, the central role of single oncogenic drivers, and why EGFR, ALK, and other targetable alterations are so much more common in never-smokers. We cover how and why to send broad mo...

This episode walks through how syphilis evolves over time - from the painless primary chancre to systemic secondary disease, silent latent phases, and destructive tertiary complications. We break down how timing and symptoms define “early” vs “late” disease, how to use nontreponemal and treponemal tests (including the prozone phenomenon and early false negatives), and when to suspect or treat neur...

In this episode, we walk through the evolving concept of “stable ischemic heart disease” now reframed as Chronic Coronary Artery Disease (CCAD) - a long-term imbalance between myocardial oxygen supply and demand, usually from atherosclerotic coronary obstruction. We break down how to estimate pre-test probability, when to use CAC scoring, CCTA, or functional stress testing (including recognizing I...

Get a clear framework for approaching female hair loss in clinic. This episode walks through how to quickly flag scarring alopecia that needs urgent derm, distinguish female-pattern hair loss from chronic telogen effluvium and alopecia areata, choose and monitor treatments like topical and oral minoxidil (with when to add antiandrogens), and support patients through the psychological impact and wh...

Get a practical handle on when superficial fungal infections need pills, not creams. This episode covers why terbinafine is first-line for tinea capitis and onychomycosis, how long to treat based on site, when (and how) to confirm the diagnosis before committing to months of therapy, why topical steroids can create tinea incognito, and what to do when standard terbinafine fails. Source : Caplan AS...

Learn how to quickly sort benign drug rashes from true dermatologic emergencies at the bedside. This episode walks through morbilliform eruptions, leukocytoclastic vasculitis, AGEP, phototoxic reactions, erythema multiforme, erythroderma, DRESS, and SJS/TEN - highlighting classic morphology, timing, red-flag features, and what to do next when you’re the first clinician to see the rash. Subscribe t...

This episode reviews hyponatremia through a physiology-first lens, emphasizing that it is primarily a disorder of water balance rather than sodium itself. We discuss how urine sodium helps differentiate hypovolemic, hypervolemic, and euvolemic hyponatremia and why it often provides a more reliable assessment of effective volume status than the physical exam. The episode then focuses on SIADH, expl...

This episode breaks down what MGUS truly represents and why it’s so often misunderstood. It explains how a small, silent monoclonal protein fits into the spectrum of plasma cell disorders, why most people with MGUS feel completely well, and what actually drives the risk of progression to myeloma or related conditions. The discussion walks through the essential diagnostic labs, the Mayo Clinic risk...