Louisville Lectures Internal Medicine Lecture Series Podcast

Dr. Rodrigo Cavallazzi discusses the bundles of care that have come out of the Surviving Sepsis guidelines as well as the recent evidence concerning "Early Goal Directed Therapy" pioneered by Dr. Rivers. He also discusses recent updates to the Surviving Sepsis guidelines and some nuances for patients not responding to initial therapies.   Some items in this lecture may have come from the lecturer’...

Dr. Rodrigo Cavallazzi discusses steps toward ventilator liberation including spontaneous breathing trial and other parameters to indicate readiness to wean. He then discusses strategies for weaning: optimizing fluid status, weaning protocols, sedation weaning, rehabilitation therapy. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or...

Dr. Karem El Kersh describes basics of anatomy, components and indications for tracheostomy. Then he spends time covering when and how to change a trach as well as suggestions for troubleshooting common problems involving tracheostomies.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more informati...

Dr. Chris Stewart reviews the basics of alcoholism including definitions, alcohol elimination rate, leading causes of death. He spends time on time and presentation of withdrawal as well as complications. Dr. Stewart finishes by outlining medication assisted and supportive detoxification.

Dr. Brian Beauerle covers the basics of cirrhosis including pathophysiology, symptoms and survival of patients with survival. He covers when and how to perform a paracentesis including interpretation of results. He discusses pharmacologic and dietary treatment of ascites and refractory ascites. He closes with complications of ascites including spontaneous bacterial peritonitis and hepatic hydrotho...

Dr. Eddie Apenbrinck dissects those ophthalmology notes that you can never decipher. He also covers retinal complications of diabetes including treatments including laser photocoagulopathy. Other systemic causes of retinal disease are covered including sickle cell anemia and hypertension. Among the other topics covered are thyroid eye disease, inflammatory ocular involvement of rheumatoid conditio...

Dr. Kris Krueger reviews the epidemiology and pathogenesis of C.difficile in the U.S. Then, she gives an update on current medical treatments including antibiotic, probiotic and surgical treatment before covering the evidence behind fecal microbial transplant. She also addresses prevention strategies and emerging C.difficile therapies such as immunotherapy and vaccines.

Dr. Mike Hughes discusses innovative medical care of chronic pancreatitis with ground-breaking work on auto-islet cell transplantation. He covers differences in auto vs. allo transplantation, indications of transplantation, evaluation of prospective transplant patients, peri-operative and outpatient management, and observed outcomes post-surgery. The lecture spends time reviewing several ongoing r...

Dr. Cindy Owen gives an overview of cutaneous drug reactions and an approach to diagnosis and treatment in this image-driven lecture. She spends time on urticaria, fixed drug eruption, serum-sickness reaction, hypersensitivity vasculitis, morbilliform rash, drug reaction with eosinophilia and systemic symptoms, erythema multiforme, toxic epidermal necrolysis and less familiar drug reactions (acute...

Dr. Rodrigo Cavallazzi covers the assessment of volume responsiveness including the static exam as well as dynamic markers to aid with treatment of shock without administration of excessive fluids. He spends some time on shock definition and physiologic compensation before discussing physical exam and laboratory findings consistent with tissue ischemia. Then, he delves into methods of determining...

Dr. Lorrel Brown returns to discuss tamponade cardiac physiology (including demystifying pulsus pardoxus). She continues to cover the differentiation of constrictive and restrictive cardiomyopathies. This action-packed lecture concludes with stress cardiomyopathy and HFpEF (heart failure with preserved ejection fraction).

Grand Rounds given by Internal Medicine Chairman, Dr. Jesse Roman. He covers the definition of interstitial lung disease as well as it's evaluation and management. He also spends time on idiopathic interstitial pneumonia and idiopathic pulmonary fibrosis.

Kristen takes a look at adverse drug reactions occurring secondary to identifiable genetic risk factors. She looks at the evidence supporting genetic testing, common mutations (Cyp phenotypes), and how to decide whom to test.

Dr. Sathya Krishnasamy presents cases to illuminate the physiology of thyroid disease including hypothyroidism, hyperthyroidism and thyroid nodules.

Dr. Lorrel Brown covers the common (and less common) results of MI  using cases. She includes papillary muscle rupture and mitral regurgitation, free wall rupture, ventricular septal defects, right ventricular infarct, pseudoaneurysm, aneurysm, pericarditis and bradyarrhythmias. Dr. Brown is an Assistant Professor at the University of Louisville and is the Associate Director of the Cardiovascular...

Dr. Gerald Lee discusses common primary immunodeficiencies using a case-based approach. He introduces the topic of immunodeficiencies by creating broad categories of clinical presentation to assist with pattern recognition. He spends more time on Selective IgA Deficiency and then covers Common Variable Immunodeficiency in depth.

Dr, Rodrigo Cavallazzi gives a comprehensive review of ARDS; he includes the definition, pathophysiology, risk factors, prognosis and differential. He spends time discussing the ARDS Network trial including fluid and  ventilation strategies as well as advanced treatments (prone positioning, ECMO, neurally adjusted ventilation. Some items in this lecture may have come from the lecturer’s personal a...

Dr. Charles Moore demystifies ANA testing and medications used for rheumatologic disorders including common side effects and screening for adverse effects. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2015 LouisvilleLectures.org

Dr. Lorrel Brown covers the basics of shock including how to recognize cardiac shock from history, physical exam and invasive monitoring. She discusses physiology and interpretation of pulmonary artery catheterization and then covers choice of vasopressors for therapy. Dr. Brown is an Assistant Professor at the University of Louisville and is the Associate Director of the Cardiovascular Medicine f...

For internists not inclined towards cardiology or critical care, an ultrasound might be merely a diagnostic test to be ordered. Research and expertise in this field are expanding rapidly, however, and an affordable handheld ultrasound that can easily be carried in a white coat is likely not many years away. In this lecture, Dr. Nunley discusses the basic principles, physics, and ideas behind ul...

Dr. Charles Moore covers more rheumatology topics including treatment of gout, psoriatic arthritis, and the clinical presentation of Sjögren's syndrome and sicca syndrome. Dr. Moore is an assistant professor of Medicine at University of Louisville in the department of Rheumatology. He trained in Internal Medicine and Pediatrics at University of Louisville then completed a fellowship in Rheumatolo...

Dr. Andrew Defilippis discusses his very practical research into the data behind cardiovascular risk scores. His findings on variations between different cohort studies have been published and debated the Annals of Internal Medicine this spring. As a set of tools we use daily in our outpatient primary care practice, a deeper dive into cardiovascular risk calculations fits our criteria for being b...

Dr. Tanya Wiese gives an overview of lung cancer screening then discusses solitary pulmonary nodules in detail; she covers their definition and workup in addition to the use of endobronchial ultrasound and navigational biopsy in diagnosis. Dr. Wiese is an Assistant Professor with the University of Louisville and is the Director of the Interventional Pulmonology program. In this lecture, Dr. Wiese...

Dr. George Bosse gives a thorough review of acetaminophen and salicylic acid pharmacokinetics followed by presenting symptoms, pathology and treatments for toxicity. Disclaimer: http://LouisvilleLectures.org/disclaimer ©2015 LouisvilleLectures.org

In this first of a two part series, Dr. Charles Moore discusses ankylosing spondylitis, polymyositis/dermatomyositis, inclusion body myositis, anti-synthetase syndrome and scleroderma including epidemiology, clinical manifestations, diagnostic criteria and treatments.