The Curbsiders Internal Medicine Podcast

We’ve Come a Long Way From Ether

Learn how an anesthesiologist approaches perioperative medicine from how to choose the right type of anesthesia (general anesthesia vs regional anesthesia vs MAC), to preoperative risk assessment, and how to avoid anesthesia related complications. Our guest, anesthesiologist, Dr. Angela Selzer (Denver, CO) helps us explore high yield pearls regarding the practice of anesthesiology to empower the internal medicine clinician to deliver team-based, perioperative care.

Claim Free CE credit for this episode through VCU Health CE at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner
• Introduction to anesthesiology 
• Introduction to regional anesthesiology  
• Walk through what an anesthesiologist does in the operating room
• Ambulatory surgery center exclusions 
• Approach to preop assessments
• “Will it change management?” applied to anesthesiologists
• ASA Classes 
• Anesthesia complications
• Take Home Points; Outro; Bonus clip

Credits

• Written and Produced by: Edison Jyang; Avital O’Glasser MD, FACP, SFHM
• Cover Art: Sarah Phoebe Roberts, MPH
• Infographic:  Avital O’Glasser MD, FACP, SFHM; Edison Jyang
• Show Notes: Avital O’Glasser MD, FACP, SFHM
• Hosts: Matthew Watto MD, FACP; Avital O’Glasser MD, FACP, SFHM
• Technical Production: Pod Paste 
• Reviewer: Sai S Achi, MD MBA
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Angela Selzer, MD

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Full transcript HERE

We ran the numbers, and it’s still important!

Should patients be screened for syphilis? If so, which ones? Dr. Katrina Donahue (USPSTF) talks us through this re-affirmation of the USPSTF syphilis screening guideline, including who might be high risk and how to screen them.

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Credits

• Producers: Elena Gibson, MD and Paul Williams MD, FACP
• Writer: Elena Gibson, MD
• Show notes: Paul Williams MD, FACP
• Infographic and Cover Art: Elena Gibson, MD
• Hosts: Paul Williams MD, FACP and Elena Gibson MD 
• Production team: Podpaste
• Guest: Katrina Donahue MD

Full Transcript HERE

Optimize and update your approach to atrial fibrillation (afib) as we discuss early rhythm control, antiarrhythmic drugs, TTE/cardioversion, afib ablation, new onset afib in the hospitalized patient, and left atrial appendage closure. Plus, we try to answer, Does afib burden matter? Our guest is cardiologist-electrophysiologist, Hugh Calkins MD, @hughcalkinsMD, Professor of Cardiology at Johns Hopkins, @hopkinsheart. 

Sorry, but we won’t be offering CME for this episode. You can claim CME for past episodes at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner
• Case from Kashlak; Definitions
• An approach to new-onset afib in the office
• Rhythm control
• Lifestyle modification is a pillar of afib treatment
• Indications for hospitalization in afib
• More on rhythm control and when to pursue afib ablation
• Rhythm control in heart failure
• New onset afib in the hospitalized patient
• Does afib burden matter?
• Left atrial appendage closure 
• Watto and Paul recap what we’ve learned
• Outro

Credits

• Written and Produced by: Matthew Watto MD, FACP
• Show Notes: Matthew Watto MD, FACP
• Cover art and Infographic by:
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Emi Okamoto MD
• Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Technical Production: PodPaste
• Guest: Hugh Calkins MD

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Full transcript HERE

Recap and review the top pearls from recent episodes #341 Migraine Headaches Update and #350 Acute Hypoxemia with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #341 and #350!

Show Segments

• Intro, disclaimer, guest bio
• Migraine Headaches Update
• An approach to Hypoxemia
• Outro

Credits

• Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP  
• Show Notes: Matthew Watto MD, FACP
• TFTC Cover Art design: Edison Jyang
• Technical Production: Pod Paste

Full transcript HERE

Lipids Update 2022: Cardiovascular Risk Reduction and New Medications on the Horizon with Erin Michos, MD

Show description: 
Ready to take the next step in management of your patient with hyperlipidemia? Dr. Erin Michos (@erinmichos) returns to give us a lesson in Advanced Lipidology. She updates us on what new medications we can use for those difficult to treat lipids and what medications are on the horizon.

Unfortunately, this episode will not be available for CME. You can claim free CME for other episodes at curbsiders.vcuhealth.org!

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Show Segments

• Intro, Getting to know Dr. Erin Michos, Pick of the Week
• Patient Case, Digging into ASCVD Risk 
• Coronary artery calcium scoring - why it’s important
• What are “Risk Enhancing Factors”?
• Biomarker testing, what is the significance of Lip a and how can we use it to drive management?
• Introduction to PCSK9 inhibitors
• More than just statins - other LDL-lowering medications
• siRNAs, ASOs - Pelacarsen and more
• Apollo Trial regarding Pelacarsen
• Importance of Family History
• What to do if maxed out on a statin or statin intolerance - Ezetimibe, PCSK9 inhibitors, MAB therapies, and more
• Bempedoic Acid discussion
• Medication side effects
• Homozygous FH - approach to treatment, ANGPTL3 inhibitors
• Triglycerides discussion, icosapent ethyl, the REDUCE-IT trial
• Wrap-up and Take home points, Outtro

Credits

• Producer and written by: Christopher Chiu MD, FACP, FAAP
• Show Notes: James Antaki MD
• Infographic: Edison Jyang
• Cover Art: Kate Grant MBChB, DipGUMed
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Associate Editor: Leah Witt MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Erin Michos MD, MHS

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Full transcript HERE

The treatment your patients need but may not be getting!

Take a bite out of our latest episode featuring guest expert Dr. Michelle McMacken (@DrMcMacken) and learn how you can help your patients effectively and sustainably reap the health benefits of improved nutrition. Discover the enormous evidence base for nutritional recommendations, develop scripts to engage patients, and update your CVD, T2DM, and hyperlipidemia treatment plans to meaningfully incorporate nutrition. Get your truffle-hunting outfit on, it’s time to go foraging for some tasty knowledge food! 

Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, favorite advice
• Case from Kashlak; definitions
• “Evidence-based nutrition” vs plant-based diet
• Unifying the guidelines for patient care
• Treating the skeptical patient
• Tailoring recommendations to patients’ needs 
• Treating the motivated patient
• Host questions
• Outro

Credits

• Written and Produced by: Deep Shah MD
• Show Notes:  Sarah Phoebe Roberts, Deep Shah MD
• Infographic and Cover Art: Lyan Chang
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deep Shah MD
• Reviewers:  Emi Okamoto MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Michelle McMacken MD, FACP, DipABLM
  
  

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Super foods handout 

Full transcript HERE

Master the latest knowledge on the ongoing monkeypox outbreak with Dr. Boghuma Titanji (@Boghuma)! Learn how to recognize monkeypox in the clinic, how to test for monkeypox, how to approach management (including options for antiviral agents), and more.

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week
• Case from Kashlak
• History of monkeypox - past and current outbreaks
• Transmission of monkeypox
• Risk factors for monkeypox
• Clinical presentation of monkeypox
• Testing for monkeypox
• Management of monkeypox: supportive care and antivirals
• Monkeypox in patients with HIV
• Monkeypox in pregnancy
• Monkeypox vaccines
• Outro

Credits

• Producer and Writer: Paul Williams MD, FACP
• Show Notes: Malini Gandhi 
• Infographic: Sarah Phoebe Roberts
• Cover Art: Kate Grant MD
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Emi Okamoto MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Boghuma Titanji MD

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Full Transcript HERE

From Cord Compression to Tumor Lysis Syndrome

Do you freak out over oncologic emergencies like cord compression or tumor lysis syndrome? Join Dr. Aditi Singh (University of Pennsylvania, Abramson Cancer Center, @AditiSinghMD) for this comprehensive conversation on six commonly encountered oncologic emergencies we see in the hospital!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week*
• Cord Compression
• SVC Syndrome
• Malignant Obstruction
• Tumor Lysis Syndrome
• Blast Crisis
• Outro

Credits

• Producer, Writer, Hosts: Meredith Trubitt, MD MPH; Monee Amin, MD
• Infographic and Cover Art: Caroline Coleman
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Associate Editor: Leah Witt, MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Aditi Singh, MD

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Find out if ultra-short course (two days) antibiotics work for pneumonia, if acetazolamide improves diuretic efficiency in acute decompensated heart failure, should we prescribe psilocybin (magic mushrooms) to treat alcohol use disorder, and if removal of asymptomatic kidney stones decreases the incidence of future events! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto) catch up on recent practice-changing articles and guidelines! 

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer
• Ultra-short Antibiotics for Pneumonia, 
• Acetazolamide for acute heart failure exacerbations, 
• Psilocybin for AUD,
• Asymptomatic Kidney Stone Removal
• Outro

Credits

• Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
• Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
• Cover Art: Matthew Watto MD, FACP
• Reviewer: Rahul Ganatral MD, MPH
• Technical Production: Pod Paste
  
  Full transcript HERE

Brush up on your COPD skills and learn some new tips for diagnosis and management of this common respiratory condition from our expert Dr. Antonio Anzueto (University of Texas San Antonio). 

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner
• Case from Kashlak
• Epidemiology
• Diagnosis
• Workup
• Characterization of disease
• Treatment
• Outro

Credits

• Writer and Producer: Cyrus Askin, MD
• Show Notes: Deborah Gorth MD, PhD
• Infographic: Kate Grant MD
• Cover Art: Kate Grant MD
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Associate Editor: Leah Witt, MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Antonio Anzueto, MD

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Full Transcript HERE

Upper and Lower GI Bleed Diagnosis and Management

Handle the gush of upper and lower GI bleeds with ease thanks to Dr. Tanvi Dhere (@DhereMdEmory)! Learn diagnosis, initial management as well as post-procedure management including when to resume anticoagulation and antithrombotic therapy.

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week*
• Case from Kashlak;
• Upper GI bleed
• Labs, Stool Studies
• Initial Management of GI bleed
• Endoscopy
• Post-procedure management
• Lower GI bleed
• Colonoscopy
• Imaging/Interventional Radiology
• Outro

Credits

• Producers and Writers: Meredith Trubitt MD, MPH; Monee Amin MD
• Show Notes:  Monee Amin, MD
• Infographics and Cover Art: Caroline Coleman, MD
• Hosts: Meredith Trubitt MD, MPH; Monee Amin MD  
• Reviewer: Emi Okamoto MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Tanvi Dhere, MD
  
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Full Transcript HERE

We’re back with another women in medicine episode– this time Shreya and Leah interview their she-ro Dr. Kemi Doll, career coach extraordinaire to women of color in academic medicine. She is breaking down the biggest challenges she’s seen her clients face and how to tackle them! 

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week
• Dr. Doll’s journey into coaching women of color in academic medicine
• Top 5 challenges faced by women of color in academic medicine
• Solutions to the challenges
• Outro

Credits

• Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD
• Infographic and Cover Art: Shreya Trivedi, MD
• Show Notes: Leah Witt, MD
• Hosts: Leah Witt, MD, Shreya Trivedi, MD and Matthew Watto MD, FACP
• Associate Editor: Emi Okamoto, MD
• Showrunners: Leah Witt, MD and Shreya Trivedi, MD
• Technical Production: PodPaste
• Guest: Kemi Doll, MD

Full transcript HERE

Polyps, polypectomy & surveillance with Dr. Jennifer Maranki

Learn how to recommend a good bowel prep, read colonoscopy reports, and review recommended polyp surveillance with Dr. Jennifer Maranki, @jenmarankimd (Penn State Health)

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week
• Case from Kashlak; definitions
• Polyp definitions and categories 
• Bowel prep & colonoscopy quality
• Colorectal polyp surveillance 
• Potential complications 
• When to consider polyposis syndromes 
• Outro

Credits

• Producer & Writer: Elena Gibson MD
• Show Notes: Elena Gibson MD
• Infographic & Cover Art: Kate Grant MBChB DipGUMed 
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Emi Okamoto MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Jennifer Maranki MD

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Full Transcript HERE

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here.

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Show Segments

• Intro, Getting to know our guest
• Clinical Case
• Why can’t patients describe their dizziness?
• Classifying dizziness
• The 3 vestibular syndrome buckets defined
• Episodic vestibular syndrome differential diagnosis
• Acute vestibular syndrome differential diagnosis
• Chronic vestibular syndrome differential diagnosis
• Challenges of medical history taking
• Approach to the acute vestibular syndrome/HINTS
• How to evaluate nystagmus
• How to perform the head impulse test (aka head thrust)
• How to perform “test of skew” (alternate cover testing)
• Recap of HINTS exam and discussion of MRI
• Signs and symptoms of cerebellar stroke
• Use of Dix-Hallpike for episodic vertigo
• What happens when you choose the wrong test
• Continuous versus triggered dizziness, or vertigo
• Meclizine use in BPPV
• How to cure horizontal canal BPPV
• Treatment for vestibular neuritis
• Treatment for Meniere’s disease
• Who benefits from vestibular rehab/exercises
• Dizziness and giddiness
• Take home points
• Outro

Credits

• Produced and Written by: Cyrus Askin MD
• Show Notes: Matthew Watto MD
• Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP
• Editor: Matthew Watto MD, FACP
• Guest: David Newman-Toker MD, PhD

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Recap and review the top pearls from recent episodes #322 H. Pylori and #324 Obesity Medicine FAQ with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #322 and #324!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!


Show Segments

• Intro, disclaimer, guest bio
• H. pylori
• Obesity Medicine FAQ
• Outro

Credits

• Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP  
• Show Notes: Matthew Watto MD, FACP
• TFTC Cover Art design: Edison Jyang
• Technical Production: Pod Paste

Full transcript HERE

On this Curbsiders classic, we discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)! This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! Original show notes here.

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner
• Picks of the Week*
• How to approach antibiotics
• Choosing antibiotics / Framework
• Dr. Shah’s favorite antibiotics
• Pneumonia
• Diabetic Foot Infections
• Take-home points
• Outro

Credits

• Produced and Written by: Nora Taranto MD
• Infographic, Cover Art, Show Notes: Beth Garbitelli
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com
• Reviewer: Victor Kovac MD
• Guest: Adi Shah MBBS

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The Thrill of Victory and the Agony of the Feet

Don’t fear foot pain!  Learn how to evaluate the painful foot and ankle, what needs imaging, and who needs rehab.  We are joined by Dr. Joan Ritter (Walter Reed National Military Medical Center) for a special live Curbsiders episode!  

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week*
• Case from Kashlak
• Relevant anatomy
• Ankle sprains
• Achilles tendon rupture and tendonitis
• Plantar fasciitis
• Posterior tibial tendon dysfunction
• Midfoot pain
• Morton’s neuroma
• Audience questions
• Outro

Credits

• Writer and Producer: Paul Williams MD, FACP
• Show Notes and Infographic: Paul WIlliamsMD, FACP
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Associate Editor: Leah Witt MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Joan Ritter MD

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Fully Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Diagnosing & Managing Acute Hypoxemia with Nick Mark MD

Quick! Your patient is desaturating! Have no fear, for in this installment of our Rapid Response series we have recruited pulmonologist/intensivist extraordinaire, the great Dr. Nick Mark of ICU One Pager, to share with us all the pitfalls and pearls we need to have under our collective belt when it comes to understanding, managing, and considering the etiologies of acute hypoxemia! 

Free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week
• Case from Kashlak; Definitions
• How does a pulse oximeter work?
• Clinical approach to hypoxemia
• The SIX causes of hypoxemia
• Delivering supplemental oxygen 

Credits

• Written and Produced by: Cyrus Askin MD & Edison Jyang MS4
• Infographic and Cover Art: Edison Jyang MS4
• Show Notes: Cyrus Askin, MD
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
• Reviewer: Emi Okamoto MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste 

Guest: Nick Mark MD


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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Find out how tirzepatide might revolutionize weight loss, pharmacogenomics might improve antidepressant prescribing, seasonal edema affects Google searches, and whether nirmatrelvir/ritonavir helps standard-risk patients with COVID-19, and patient-centered recommendations for inpatient care from SHM/Choosing Wisely! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, Picks of the Week
• Case from Kashlak; Definitions
• Tirzepatide for weight loss
• Pharmacogenomics for personalized antidepressants
• Seasonal Edema
• Nirmatrelvir/ritonavir for standard-risk COVID-19
• Hospital Medicine Choosing Wisely recommendations
• Outro

Credits

• Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
• Cover Art: Matthew Watto MD, FACP
• Reviewer: Rahul Ganatral MD, MPH
• Technical Production: Pod Paste

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Learn to recognize myositis and myopathy (aka the idiopathic inflammatory myopathies), perform the appropriate initial testing, whether or not statins and exercise are safe to continue, and how to partner with our subspecialist colleagues to treat these patients in primary care.  Recorded LIVE at Johns Hopkins, we’re joined by Dr. Lisa Christopher-Stine, @DrLisaCS of @HopkinsMedicine, a rheumatologist and leading expert on myositis and myopathy! 

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week*
• Case from Kashlak
• History and Exam
• Workup for suspected myositis
• Cancer screening
• Safety of statin use and exercise
• Our role in primary care
• Audience Questions
• Outro

Credits

• Written and Produced by: Matthew Watto MD, FACP
• Show Notes: Matthew Watto MD, FACP
• Cover Art and Infographic: Andréa Perdigão
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Molly Heublein MD
• Technical Production: Pod Paste
• Guest: Lisa Christopher-Stine MD, MPH
  
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  Full Transcript HERE
  
  The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 
  
  

USPSTF Update with Dr. John Wong

Review the updated 2022 United States Preventive Task Force (USPSTF) guidelines on aspirin use to prevent cardiovascular disease (CVD) with Dr. John Wong.

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Credits

• Producer & Writer: Elena Gibson MD
• Show Notes: Elena Gibson MD 
• Cover Art & Infographic: Elena Gibson MD 
• Hosts: Paul Williams MD, FACP; Elena Gibson MD  
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: John Wong, MD 

Sponsor: Medmastery

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Full Transcript HERE

There’s nothing that gets a hospitalist more anxious and excited at the same time than a case of suspected meningitis. In this episode, we learn that if the thought crosses our mind, a lumbar puncture is almost certainly indicated. Our guest, Dr. Payal Patel, helps us with the balancing act that is diagnosing and managing meningitis!
Free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week*
• Case from Kashlak; history and physical
• Initial workup for meningitis
• Treatment choices and duration
• Transitions of Care

Credits

• Written and Produced by: Monee Amin MD, Meredith Trubitt MD, MPH
• Infographic and Cover Art: Caroline Coleman, MD
• Show Notes: Monee Amin, MD
• Hosts: Matthew Watto MD, FACP; Monee amin,, MD
• Reviewer: Rahul Ganatra, MD MPH
• Executive Producer: Karly Loy
• Showrunner: Matthew Watto MD, FACP
• Editor: podpaste
• Guest: Payal Patel, MD

Sponsor: Indeed 

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Can vitamins prevent CVD and cancer? We kind of don’t have the answer!

Is vitamin and mineral supplementation safe? Effective? Listen as our esteemed guest Dr. Michael Barry talks to us about the new United States Preventive Services Task Force recommendation regarding the role of vitamin and mineral supplementation in preventing cardiovascular disease and cancer.
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Credits

• Producers: Paul Williams MD, FACP and Elena Gibson, MD
• Writer: Paul Williams MD, FACP
• Show notes: Paul Williams MD, FACP
• Infographic and Cover Art: Elena Gibson, MD
• Hosts: Paul Williams MD, FACP and Elena Gibson MD 
• Production team: Podpaste
• Guest: Michael Barry MD
  
  Full Transcript HERE

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow-up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! Get the original show notes here!
Prior lipid episodes: #37 Lipids, PCSK9, and ezetimibe: Lower is better.#10 Cholesterol, lipids, statins, fish oil. Become a Master Lipidologist.
Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org!
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Show Segments

• Intro
• Getting to know Dr. Erin Michos
• Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel
• Digging into ASCVD Risk Calculator
• Who should get 10 year ASCVD Risk assessment and what are the categories?
• How Dr. Michos discusses healthy lifestyle and “Primordial Prevention”
• What are “Risk Enhancing Factors”?
• Who should get biomarker testing vs CAC scoring?
• How Dr. Michos discusses statin therapy with her patients
• How to address risks of side effects
• Primary vs Secondary Prevention
• “What should my cholesterol be?”
• How often to follow-up labs?
• Differences between stain intensity
• How to manage side effects
• PCSK9 inhibitor discussion
• Aspirin, Fibrates and Icosapent Ethyl
• High Risk vs Stable ASCVD
• Take home points and the future
• Outro
  
  

Credits

• Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli MD
• Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA
• Infographic: Beth “Garbs” Garbitelli MD
• Cover Art: Kate Grant MBChB DipGUMed
• Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP   
• Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
• Guest: Erin Michos MD MHS
  
  

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Recognize multiple sclerosis in the clinic, learn how to diagnose it, and partner with your neurology colleagues to help care for these patients. Dr. Annette Okai expertly walks us through multiple sclerosis (North Texas Institute of Neurology & Headache). 
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Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner
• Case from Kashlak
• Patient presentation
• Physical exam
• Labs and imaging
• Pathophysiology
• Treatment
• Recognizing and treating relapses
• Outro

Credits

• Written and Produced by: Deborah Gorth MD, PhD
• Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth
• Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP   
• Reviewer: Emi Okamoto MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Annette Okai MD

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Supercharge your knowledge on using methadone for the treatment of opioid use disorder! We discuss treatment goals, and how to start or continue methadone in the hospital.  We’re joined by guest Dr Ruth Potee, addiction medicine physician, full-scope family medicine doc, feminist, and expert composter.  She inspires us to be strong advocates for our patients. 
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

• Intro, disclaimer, guest bio 0:46
• Guest one-liner 3:23
• Case from Kashlak 5:00
• Methadone for OUD 5:47
• Methadone Dosing 16:35
• 72 hour Rule 25:35
• What is a methadone clinic  31:00
• Methadone Checklist 35:44
• QTc Prolongation and Methadone 39:15
• Confirming Methadone Dose 43:17
• Managing Missed Methadone doses: 45:20
• Outro 50:40

Credits

• Producer, Writer: Kenneth Morford, MD
• Show Notes, Infographic, Cover Art: Zina Huxley-Reicher, MD
• Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD; Kenneth Morford, MD 
• Reviewer: Shawn Cohen MD
• Showrunner: Carolyn Chan, MD
• Technical Production: Castos
• Guest: Dr. Ruth Potee

The Curbsiders Addiction Medicine are proud to partner with  The American College of Addiction Medicine (ACAAM) to bring you this mini-series.  ACAAM is the proud home for academic addiction medicine faculty and trainees and is dedicated to training and supporting the next generation of academic addiction medicine leaders. Visit their website at acaam.org to learn more about their organization.
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn. Get the original show notes here!
Prior diabetes episodes: #330 & #331 Inpatient Diabetes with Dr. Dave Lieb#309 USPSTF Quick Update: Prediabetes & Type 2 Diabetes Screening#296 Diabetes FAQ with Dr. Jeff Colburn#243 Diabetes Triple Distilled#168 Diabetes Update with Jeff Colburn MD#96: Diabetes: A1C targets & ACP guidelines controversy#51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction
Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org!
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Show Segments

• Intro
• Rapid fire questions
• Definitions and classification of diabetes
• DKA in type 2 diabetes?
• Pathophysiology of DKA
• Severe hyperglycemia mislabeled as DKA
• Which type 2 diabetics get DKA?
• The cardinal issue is dehydration
• Starvation ketosis vs DKA vs other
• How to handle severe hyperglycemia in outpatients
• Sick day management in type 1 diabetes
• Initial testing for diagnosis of DKA
• Subcutaneous or IV insulin for DKA
• Initial evaluation and management in ER
• Fluids and electrolyte management
• SGLT2 inhibitors and euglycemic DKA

Credits

• Writer, Producer: Matthew Watto MD, FACP
• Show Notes: Matthew Watto MD, FACP
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Stuart Brigham MD
• Showrunner: Matthew Watto MD, FACP
• Technical Production: PodPaste
• Guest: Jeffrey Colburn MD, FACP, FACE

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Recap and review the top pearls from recent episodes #321 Hypertension FAQ and #326 Cardiorenal Syndrome (NephMadness 2022) with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.
Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #321, and #326!
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Show Segments

• Intro, disclaimer, guest bio
• Hypertension FAQ
• Cardiorenal syndrome
• Outro

Credits

• Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP  
• Show Notes: Matthew Watto MD, FACP
• TFTC Cover Art design: Edison Jyang
• Technical Production: Pod Paste

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

With great power comes great immunogenicity.  Learn about the ins and outs of immunotherapy–its indications, its power, and its adverse effects–in this episode with Dr. Christian Cable, hematologist/oncologist and medical educator extraordinaire.  We learn a riveting history of immunotherapy and about how checkpoint inhibitors work, as well as the best practices for identifying downstream effects of checkpoint inhibitors and their immune system activation (it’s all about the -Itis!).

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Show Segments

• Intro
• What is Immunotherapy?
• A History Lesson
• Immune Checkpoint Inhibitors (ICIs) 
• Immune Related Adverse Events (irAEs) 
• Endocrine complications of checkpoint inhibitors
• Rheumatologic complications of checkpoint inhibitors 
• Considerations before starting checkpoint inhibitors (and what labs to check) 
• Diagnosing and Managing irAEs 
• Common post-irAE questions 
• New Kids on the Block: CAR-T 
• Take Home Points 

Credits

• Written and Produced by: Nora Taranto MD
• Hosted by: Molly Heublein MD; Nora Taranto MD; Paul Williams MD, FACP  
• Guests: Christian Cable MD 
• Show Notes: Nora Taranto MD 
• Cover Art: Andrea Perdigão
• Infographics: Andrea Perdigão
• Reviewer: Emi Okamoto MD, FACP 
• Production team: Pod Paste

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Full transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit

Dr. Kevin Weber @KwebMD (Ohio State University Wexner Medical School) takes the pain out of headache management! Have the confidence to prescribe new CGRP-antagonists and ditans for migraine prevention and acute relief. We also dive deep into when to order imaging and alternatives like infusions and devices.

Help your patients navigate gallbladder disease, including asymptomatic stones, incidental polyps, and uncomplicated cholecystitis. Dr. Rahul Pannala (@RahulPannala) talks us through how to diagnose biliary colic, what imaging to order, and what to anticipate for potential post-cholecystectomy complications (eg persistent pain or diarrhea). Feel confident in sending the right patients for cholecystectomy!

Join us as Curbsiders favorite Dr. Ted Parks gives us a hand with the diagnosis and management of common causes of hand and wrist pain.
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Show Segments 

• Intro, disclaimer, guest bio
• Guest one-liner
• Anatomy review: the thumb is the short one
• Pathophysiology of De Quervain’s tenosynovitis
• Physical examination for thumb pain
• Management of DeQuervain’s and CMC arthritis
• Pathophysiology of trigger finger
• Management of trigger finger
• Pathophysiology of carpal tunnel syndrome
• Physical examination for carpal tunnel syndrome
• Carpal tunnel syndrome management
• Outro
  
  

Credits

• Writer and Producer: Paul Williams, MD
• Infographic and Cover Art: Paul Williams, MD
• Hosts: Paul Williams MD and Molly Heublein, MD
• Editor: Emi Okamoto, MD (written materials)
• Guest: Ted Parks, MD

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The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Master the ins-and-outs of medical cannabis! Dr. Julia Arnsten (@DrArnsten) will lead us through the initial evaluation of a patient interested in medical cannabis, summarize the state of evidence for the benefits and harms, lay out a schema for dosing and formulations, provide pearls on how to counsel patients, and more!

Recap and review the top pearls from recent episodes #320 Palpitations and #317 Erectile Dysfunction with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Learn from an expert panel in addiction medicine about a potpourri of fascinating topics, with updated data to guide clinical decision-making. We picked the brains of physicians Stefan Kertesz, Ximena Levander, Kenny Morford, and Katherine Mullins to learn about the latest updates in opioid tapering (don’t do it if there isn’t a good reason!), how to define recovery in alcohol use disorder, different options to treat methamphetamine use disorder, and Hepatitis C treatment in patients with active IV drug use. And there’s so much more, that we’re following this with a whole series in Addiction Medicine, set to come out in early July 2022!

Join us as we de-mystify the diagnosis, talk treatment strategies, parse through pharmaceutical options, and figure out follow-up in Generalized Anxiety Disorder with Dr. Dheepa Sekar (@DheepaSekarMD)! Anxiety disorders are one of the most common mental health concerns in our country and this episode will give you the tools to address it in clinic!

Discover DGBI! Learn its pathophysiology, evaluation and individualized treatments so you can leave the fear of managing DGBI behind. We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic)

We recap the top pearls from ACP #IM2022 including important drug interactions/intolerance (acetaminophen, tramadol, ticagrelor, nirmatrelvir-ritonavir), perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS), recognizing PMR, when to initiate urate-lowering therapy in gout, glucocorticoid-induced osteoporosis, food as medicine, dietary potassium, OSA, nocturia, telemedicine and health equity, a new obesity medicine paradigm, advances in HIV/PrEP, and rethinking atrial fibrillation!

Join Dr. Nathan Erdmann (@NerdmannID, University of Alabama Birmingham) as he walks us through inpatient covid management from antivirals, immune modulators and anticoagulation.

More inpatient diabetes! In this part 2 of 2, we cover diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.

Dominate inpatient diabetes! In this part 1 of 2, we discuss how to handle oral hypoglycemics, how to choose an initial insulin regimen, the use of correction scale insulin monotherapy, how to titrate insulin, how to use NPH for steroid-induced hyperglycemia, and how to reconcile diabetes meds at discharge with Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.

DeLiver on the promise of elimination with Dr. Christian Ramers

Let’s deLiver on the promise of hepatitis C elimination! Dr. Christian Ramers @cramersmd brings hepatitis C diagnosis, care, and cure into the primary care clinic with a simplified algorithm for workup and treatment.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner, Picks of the Week*
• Case from Kashlak; Definitions
• Who should we screen?
• Patient Workup 
• Preparing for treatment
• Treating hepatitis C
• Opportunities for integration of care
• Outro

Credits

• Producer, writer, co-host: Emi Okamoto MD, FACP
• Show Notes, infographic, cover art: Lyan Chang
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Leah Witt, MD
• Executive Producer: Beth Garbitelli
• Showrunner: Matthew Watto MD, FACP
• Editor: Clair Morgan of nodderly.com
• Guest: Christian Ramers MD, MPH, FIDSA

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CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Update Description

Fill up with delicious practice-changing knowledge food from #SGIM22 as The Curbsiders team discusses breast cancer survivorship, sexual dysfunction, How climate change will affect health, Are PT consults necessary in the hospital?, Do we need antibiotics for aspiration events?, bias in note writing, Are plant-based meats a healthy?, complications after breast implantation, how to get breast reduction approved, doxycycline for chlamydia, the metronidazole and alcohol myth, pearls for clinician-educators, telehealth, TEACHIM.org, CGMs help lower a1c, PT for rotator cuff disease, Is it safe to taper antidepressants? and how to treat methamphetamine use disorder! 
Note: There is no CME for this episode, but claim CME for prior episodes at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

• Written and Hosted by: Nora Taranto MD, Beth Garbitelli (about to be an MD!), Era Kryzhanovskaya MD, Justin Berk MD, MPH, MBA, Shreya Trivedi MD, Chris Chiu MD, Paul Williams MD, Matthew Watto MD
• Show Notes and Cover Art: Matthew Watto MD, FACP
• Showrunner: Matthew Watto MD, FACP
• Technical Production: Pod Paste

Show Segments

• Intro
• A few ambulatory teaching models include the One Minute Preceptor, SNAPS (summarize, narrow, analyze, probe, plan, and select), PIPP (precepting in the presence of the patient) [see Community Preceptor Toolbox]
• Ikigai is a Japanese term indicating a motivational force or reason for living. It is associated with decreased mortality [Tanno, 2009]. Explore your ikigai here (PositivePsychology.com).
• Listening to podcasts while driving does not affect knowledge retention (Gottleib et al. 2021)
• Treatment of Hot flashes: Avoid paroxetine, fluoxetine, and sertraline in breast cancers survivors taking tamoxifen. Instead use venlafaxine (or another SNRI), citalopram, or escitalopram. Gabapentin given at bedtime is also an option.  (Clinical Update 2019: Tamoxifen and Antidepressants)
• Distress in patients with cancer can be measured using the NCCN screening tool [NCCN Distress Thermometer]
• Don’t forget to ask for a Cancer Survivorship Plan from oncology [CDC Cancer Survivorship Care Plans]
• Ask about sexual dysfunction in cancer survivors.
• How will climate change impact our patient’s health? NIH framework; CH2OPD2 environmental screening tool [CH2OPD2 ]; and the 15 steps of climate communication.
• Use the AM-PAC score cutoff of >18 to avoid a PT consult in hospitalized patients (Martinez 2021). 
• Early antibiotics after an aspiration event do not improve outcomes (Aga 2021). 
• Biased language is more common in notes about Black patients (Beach 2021). Be thoughtful about what you write and role model good behavior.
• While plant-based meats are more eco-friendly than animal-sourced meats, they are heavily processed foods (van Vliet 2021) and may have high sodium.
• Silicone breast implant rupture can be insidious. Guidelines recommend screening with MRI after 6 years, then every 2-3 years (FDA 2020, More FDA info) (Note: FDA’s most recent guidance also recommends ultrasound as an alternative screening method, so always check with the patient's insurance about which modality will be covered)
• Document a trial of NSAIDs, physical therapy, attempted weight loss, and supportive bra usage before breast reduction surgery for macromastia. 
• Doxycycline is now first line for chlamydia rather than azithromycin [STI Treatment Guidelines Update], BUT the most effective treatment is the one your patient will take!
• Metronidazole does not cause a disulfiram-like reaction and is no longer recommended by the guidelines [STI Treatment Guidelines Update]
• More clinician-educator pearls from Era: Don’t be afraid to brand yourself! Network with like-minded individuals (e.g. interest groups). 
• BST mode: bite-sized teaching pearls can help reduce extrinsic load and improve retention [Manning, 2021]
• A guided discussion based on Scrubs episodes can improve resident wellness [Holtzclaw 2021]
• Chris recaps some posters (click links to see them on Twitter!): Telehealth disparities and tech equity (poster 1, poster 2); TeachIM.org (poster)
• Continuous glucose monitors can help lower a1c in patients on basal insulin [Martens 2021]
• A single session of PT improved shoulder pain. The benefits of steroid injections were limited to 8 weeks in the GRASP trial [Hopewell 2021]
• There is a high risk of recurrence after tapering antidepressants [Lewis 2021]
• Methamphetamine use disorder can be treated with IM naltrexone every 3 weeks, plus oral bupropion 450 mg daily [Trivedi 2021]. Limitations include cost and co-use of opioids. 
• Outro

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We need a few days to process the highlights from #SGIM22 in Orlando, FL. We'll be dropping a DELUXE recap and highlights episode this Friday April 15, 2022 covering Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more!

Learn what you really need to diagnose pancreatitis, when to use imaging sources and what is most important in management! Rapidly treating Acute Pancreatitis might change its course! We’re joined by Dr. Kaveh Sharzehi @sharzehi of Oregon Health & Science University (@OHSUNews).
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner
• Case from Kashlak
• Risk factors for severe course
• Use of Scoring Systems 
• Requirements to make the diagnosis 
• Rational use of imaging 
• Initial management: fluids, analgesia, and nutrition
• When to use antibiotics 
• When to perform cholecystectomy 
• Most common complications and interventions 
• How to follow up in the outpatient setting 

Credits

• Producer & Scriptwriters: Monee Amin MD and Meredith Trubitt MD
• Show Notes & Infographics: Andréa Perdigão 
• Cover Art: Monee Amin MD
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Molly Heublein MD
• Executive Producer: Beth Garbitelli
• Showrunner: Matthew Watto MD, FACP
• Editor: Clair Morgan of nodderly.com
• Guest: Kaveh Sharzehi MD, MS

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CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic…even when you inject your own thumb?! Original show notes here.
Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

• Producer, infographic, and cover art: Emi Okamoto MD
• Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, Emi Okamoto MD
• Editor: Matthew Watto MD, FACP
• Guest: Olajumoke Fadugba MD
• Special thanks to Sarah Phoebe Roberts MPH for booking!

Show Segments

• Intro and disclaimer
• Guest one-liner, book recommendation, advice to fellows and trainees
• Case of anaphylaxis with mucocutaneous and GI symptoms
• Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin)
• Vancomycin and non-IgE mediated reactions
• Common presentations of anaphylaxis and the three diagnostic criteria
• Biphasic reactions and predicting severity
• Counseling patients on the use of epinephrine
• Stuart’s thumb question
• Adjuvant medications: antihistamines and corticosteroids
• Are there any contraindications to epinephrine use?
• Use of tryptase levels when the diagnosis of anaphylaxis is uncertain
• Outro

Sponsor

• Medmastery - Visit www.medmastery.com/curbsiders for a 15% lifetime discount! 

Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here.
Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

• Written and produced by: Justin Berk MD, Nora Taranto MD
• Infographic by: Alex M @nephroguy
• Host: Matthew Watto MD
• Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials)
• Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD
  
  

Show Segments

• NephMadness Kidney Pun Contest
• Disclaimer
• Intro, guest one-liners
• Case of acute kidney injury in a patient with cirrhosis
• Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium)
• History and physical in cirrhosis and AKI
• Fluid choice
• Diuretic therapy in cirrhosis and volume overload
• Is a Renal Ultrasound useful in AKI?
• Recap: the initial approach to AKI in cirrhosis
• Therapeutic trials when volume status is uncertain
• Hepatorenal physiology revisited
• Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine
• Type 1 versus type 2 hepatorenal syndrome
• Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?!
• Diagnostic criteria or HRS
• NephMadness matchups including bile cast nephropathy
• Outro

Sponsors 

• Grammarly. Visit grammarly.com/curb for 20% off.
• Panacea Financial. Visit panaceafinancial.com a bank for doctors, by doctors.

We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

• Written and produced by: Justin Berk MD
• NephMadness Pain Region: Samantha Gelfand MD
• NephMadness Pun Contest produced by: Hannah R Abrams
• Cover art by: Kate Grant MBChB, Dip GUMed
• Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
• Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes)
• Guests:  Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

Show Segments

• Kidney Pun
• Disclaimer, intro and guest bios
• Guest one-liners
• Clinical Case and Pain Management Disclaimer
• Modalities for pain meds in ckd
• Opioids for pain and their metabolites
• Dave Juurlink reframes the question, “what is our real goal with pain management?”
• Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD
• Communicating meds that are contraindicated or relatively contraindicated in CKD
• Buprenorphine
• What about the WHO Pain Ladder for CKD?
• Should we use more cannabinoids? Ketamine?
• Dave Juurlink rants on Tramadol
• NSAIDS and CKD
• Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?!
• Estimating eGFR in CKD and AKI. Which equation is best?
• How would each of our experts treat this patient with CKD and knee pain
• Outro

Sponsors: 

• Birch by Helix birchliving.com/curb for $200 off all mattresses and 2 free eco-rest pillows
• BetterHelp betterhelp.com/curb for 10% of your first month
• Indeed indeed.com/internalmedicine for a $75 sponsored job credit 
• Squarespace squarespace.com/curb offer code: CURB to save 10%

Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more. This episode is part of our first ever NephMadness Pod Crawl, so check out the other podcasts, and fill out your NephMadness 2022 brackets!
Credits

• Producer, Writer, Show Notes, Infographics: Malini Gandhi
• Cover Art:  Beth Garbitelli
• Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Reviewer: Emi Okamoto MD, FACP
• Executive Producer: Beth Garbitelli
• Showrunner: Matthew Watto MD, FACP
• Editor: Clair Morgan of nodderly.com
• Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD

*Claim free CME for this episode at curbsiders.vcuhealth.org! *Available within 24 hours of release.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments

• Intro, disclaimer, guest bios
• Guest one-liners, Introduction to Nephmadness 2022
• Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine
• Definition and pathophysiology of cardiorenal syndrome
• Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome
• Case #2 from Kashlak: the creatinine bump with diuresis
• Approach to the creatinine bump with diuresis
• Tips for the volume exam
• Interpreting cardiac biomarkers in patients with chronic kidney disease
• Case #3 from Kashlak: diuretic resistance
• Maximizing loop diuretic efficacy
• Sequential nephron blockade
• Use of hypertonic saline
• Outro

NephMadness 2022 Pod Crawl

• Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast 
• Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders
• Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com
• Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/
• Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered 
• Twitter: @thecurbsiders @TheCribsiders @NephJC_Podcast @drs_washington @upmynursinggame @medmyths

Sponsor: ACP’s Internal Medicine Board Review

• The Greater Chicago course, beginning on May 23rd  through May 27th     or
• Washington, D.C., on July 11th through July 15th

New registrants will receive 6 months of access to the course recordings. Visit acponline.org/imbr2022 to register or learn more.
Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain.
Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!
Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders 
CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Find out whether balanced solutions beat saline in the ICU (fluid wars revisited), how sleep affects weight loss and calorie intake, whether or not Vitamin D can prevent autoimmune disease, new guidelines for pneumonia and hepatitis B (HBV) vaccination, and the utility of ultrasound to measure JVP! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines! 
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

• Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
• Reviewer: Matthew Watto, MD, FACP
• Executive Producer: Beth Garbitelli
• Showrunner: Matthew Watto MD, FACP
• Editor: Clair Morgan of nodderly.com

Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!
Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb
Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.
Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.
CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 
Show Segments

• Intro, picks of the week
• Fluid wars: balance solution vs saline
• Sleep and energy intake, weight loss
• Vitamin D to prevent autoimmune disease
• New ACIP guidelines for Pneumonia and Hepatitis B (HBV) vaccines
• Ultrasound for JVP
• Outro