Core IM | Internal Medicine Podcast

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.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Amboss Article on Hyponatremia

Tags: urine studies, SIADH, Core IM, IMCore, antidiuretic hormone, hospital medicine, family medicine, nephrology

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 subscriptions

Discount code: "coreim"

Time stamps

• 02:50 Deep Dive #1
• 13:12 Deep Dive #2
• 26:39 Deep Dive Recap

Tags: IM Core, CoreIM, antibiotics, CMO, DNR/DNI, sepsis, reflection, grey matters

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/

Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E3

Timestamps:

• Pearl 1: 3:20
• Pearl 2: 8:20
• Pearl 3: 15:47
• Pearl 4: 26:55
• Pearl 5: 34:10

Tags: IMCore, CoreIM, Pulmonary, medication management, spirometry

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

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?

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/06/01/5-pearls-on-sickle-cell-anemia/

Sponsor: https://go.amboss.com/CoreIM-E2

Timestamps:

• 1:33 Pearl 1
• 4:48 Pearl 2
• 18:43 Pearl 3
• 29:45 Pearl 4
• 35:22 Pearl 5

Tags: IM Core, CoreIM, hematology oncology, health inequity, vaso-occlusive crisis

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, Transcript and References:  https://www.coreimpodcast.com/2022/05/11/5-pearls-on-guideline-directed-medical-therapy/

Sponsor: https://go.amboss.com/GDMT

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im 

Time stamps:

• 03:13 Pearl 1
• 12:14 Pearl 2
• 20:36 Pearl 3
• 26:42 Pearl 4
• 32:16 Pearl 5

Tags: IM Core, CoreIM, heart failure with reduced ejection fraction, GDMT, treatment, cardiology

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-pearls-segment/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im 

Time stamps:

• 02:14 Intro
• 04:26 Pearl 1
• 11:08 Pearl 2
• 20:43 Pearl 3
• 31:06 Pearl 4
• 35:06 Pearl 5

Tags: IM Core, CoreIM, fluids, hypertonic, volume, crystalloid, tonicity, blood, nephrology, hospital medicine

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 | Pearl 2
• 16:13 | Pearl 3
• 24:04 | Pearl 4
• 30:08 | Pearl 5

Tags: IM Core, CoreIM, PASP, Echo, hypoxia, PA pressure, vascular resistance

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 recommendations
• 14:53 Pre-set diets
• 20:47 Making sustainable changes

Tags: Core IM, IM Core, diet, salt intake, fiber, weight

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, assessment, functional status, tips

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/2022/02/23/24433/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time Stamps:

• 02:40 Deep Dive #1 Anticoagulation
• 08:50 Deep Dive #2 DOACs
• 14:08 Deep Dive #3 IVC Filter
• 17:49 Deep Dive #4 Biopsy
• 25:00 Recap

Tags: Core IM, IM Core, Anticoagulation, Bleeding, DOACs, IVC, reflections, clots

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 and References: https://www.coreimpodcast.com/2022/02/09/medical-educatio…ng-core-im-recap/

Time stamps

• 02:10 Make it Stick Virtually
• 08:35 Mentoring in the Modern Era: More than the Traditional Dyad
• 13:29 Clinical Update in Medical Education
• 20:58 Anti-Racism in Medical Education: Concrete Actions to Further Social Justice and Racial Equity

Tags: IM Core, CoreIM, virtual learning, note taking, feedback, mentorship, microaggressions, gender bias, sterotype threat

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 Case
• 10:42 Case analysis 
• 22:45 An unfamiliar domain
• 25:50 Lab review
• 40:04 Conclusions

Tags: IM Core, CoreIM, hyponatremia, preeclampsia, reasoning, adaptive expertise, situational awareness

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 
• 01:55 The math 
• 04:32 Functional hemoglobin
• 08:50 Donor and Patient 
• 11:18 Scenarios
• 12:58 Summary
• 14:34 Clarification 

Tags: IM Core, CoreIM, hemoglobin, intravascular volume, irradiation, donation

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 dignity, non-maleficence, ethics, medical humanities

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 Questions
• 22:46 Conclusion 

Tags: IM Core, CoreIM, autonomy, capacity, human dignity, non-maleficence, ethics, medical humanties

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 credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im 

Time stamps

• 01:01 Introductions
• 07:58 Nutrition
• 17:13 Medications
• 20:48 Outpatient medications
• 26:16 Recap

Tags: IM Core, CoreIM, outpatient, blood work, diet, electrolytes, ECG, nephrology, chronic kidney disease, nutrition

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, deprescribing

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 Insulin inpatient

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/10/13/oral-diabetes-medications-in-hospitalization-mind-the-gap-segment/

ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Tags: Core IM, IM Core, glucose, insulin, hospitalized patients, oral medications, sliding scale, DPP-4, GLP-1

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 Stamps:

04:24 Starting the Conversation 

10:43 The Shared Agenda

14:46 Exploring patient goals

18:54 Reducing drug use

24:09 Reducing harm in opioid use

29:06 Recap

Tags: Core IM, IM Core, MOUD, buprenorphine, patient centeredness, motivational interviewing, safe practices

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 making, documentation, conversations, recommendations

What are the differences in resources, nursing and clinician oversight and who pays for what?!

Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/

ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time stamps:

• 04:07 SAR vs SNF
• 13:35 Long term Nursing Home Care
• 18:30 Assisted Living Facility
• 24:40 Acute rehab
• 26:11 LTACH
• 27:49 Home

Tags: Subacute rehab, skilled nursing facility, long-term acute care hospital, CoreIM, Core_IM, hospital medicine, family medicine, emergency medicine, physician assistant, nurse practitioner, interprofessional education

What are the indications for a stress test?  How to choose stress protocol in a stress test?  How to choose diagnostic imaging in a stress test?  How do we interpret results from stress tests, and how should this be communicated to patients?

For full transcript, infographic and show notes: https://www.coreimpodcast.com/2019/04/24/stress-testing/

Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology, angina, ischemia

What goes into a capacity assessments? Is it just reciting risks, benefits and alternatives? Explore this and more on this At the Bedside Episode!

Show notes, Transcript and References: https://www.coreimpodcast.com/?p=22310

Tags: CoreIM, AMA Discharges, Psych, Competency, medical ethics, medical humanties

20 Qs game with Core IM Team vs. Expert Discussant !

Full Transcript and Show notes

Get CME-MOC Credit for listening to this episode

Time Stamps

• 00:20 The game of medical Twenty Questions
• 04:37 Case introduction
• 05:50 The CoreIM team attempts to solve the case
• 15:36 The discussant’s diagnostic schema for abnormal bleeding
• 23:37 Primary versus secondary hemostasis
• 30:33 The pathology report !
• 37:38 Criteria for the final diagnosis
• 38:46 Dissecting a diagnostic coup
• 49:42 Conclusion

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.

Tags: Narrative Medicine, CoreIM, IMcore, imposter syndrome

How can we help colleagues that we think are struggling with substance use disorder? What options are available for physicians? Are these different state to state? What deterrents do physicians face when seeking help?

Time Stamps:

• 00:21 Introduction
• 02:59 Scope/Definitions
• 08:05 Systems for Physician Impairment
• 13:50 Barriers to Care
• 24:48 Helping an Impaired Physician
• 28:44 Systems Level Change

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/06/09/physician-clinician-impairment/

Tags: Core IM, IM Core, impairment, substance use disorder, mental health, stigma, treatment, cost

Debunk common myths of penicillin allergies! What's the best way to ask about allergies? How can you challenge patients to determine if they have a true allergy? Organic chemistry buffs, what mediates cross-reactivity? What medications can you safely give your patients?

Show note, Transcript and References: https://www.coreimpodcast.com/2021/06/02/5-pearls-on-penicillin-allergy/

Time Stamps:

• 02:49 Penicillin Myths
• 07:20 Penicillin Allergy
• 11:21 Allergic Reactions
• 19:01 Managing allergic reactions
• 26:53 Alternative medications
• 33:28 Recap

Tags: CORE IM, IM Core, history taking, rash, skin testing, hypersensitivity, medications, over labeling, antibiotics, management

What are good habits in QI? What are the areas of expertise needed to have a successful career in QI? How can you get involved in quality improvement? What projects can you get involved with, and how do you work outside of your own interests? How can you partner with your healthcare system to make changes?

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/05/08/quality-improvement-careers-series/

Time Stamps:

• 01:36 Getting started
• 05:01 Formal training
• 08:27 What are areas of expertise to get good at?
• 16:27 Typical Day
• 19:27 Challenges
• 23:56 Metrics

Tags: CORE IM, IM Core, fellowships, jobs, leadership, metrics, training, patient safety

How does cost, potency, and bleeding risk affect which antiplatelet you choose P2Y12 inhibitors? How long after starting, do you feel comfortable stopping DAPT on a patient? How do you manage DAPT in patients who need anticoagulation?

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/04/07/5-pearls-on-dual…platelet-therapy/

Join Our Team

Time stamps

• 02:35 Indications
• 08:52 Medications
• 17:37 Duration
• 28:23 De-escalation
• 30:55 Anticoagulation

Tags: IM Core, CoreIM, anticoagulation, DAPT, acute coronary syndrome, stents, thrombosis, bleeding risk, cardiology, hospitalist, primary care

Hear perspectives that don't get as much spotlight! What is it like to be a surrogate? How can we be better listeners for our patients and for their surrogates?

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/03/17/supporting-surrogates/

Time Stamps:

• 01:09 Background Information
• 03:54 Surrogate Challenges
• 16:04 Clinician Challenges
• 36:10 Conclusion

Tags: CORE IM, IM Core, decisions, prognosis, goals of care, clinicians, patients, family medicine, palliative care, end-of-life

How can we better serve the public's health? What does the landscape of public health look like? What opportunities are available to better hone your skills? What are common challenges professionals face?

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/02/24/public-health-ca…rs-in-gim-series/

Time Stamps:

• 01:00 Introduction
• 05:07 Defining Public Health
• 11:17 Pursuing a Public Health Career
• 20:12 Politicization of Health

Tags: CORE IM, IM Core, fellowships, advocacy, healthcare, jobs, leadership, population health

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?

Time Stamps:

• 04:50 General Diagnostic Approach
• 12:26 Serum Osmolality
• 19:34 Urine Osmolality
• 32:09 Urine Sodium
• 45:23 Uric Acid

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/02/10/5-pearls-on-hyponatremia-episode-1/

ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Tags: urine studies, SIADH, Core IM, IMCore, antidiuretic hormone, hospital medicine, family medicine, nephrology

How can I best answer my families medical questions? How can I give my loved ones the best care without providing it directly for them? What boundaries should I have in place?

Show notes, Transcript and References:  https://www.coreimpodcast.com/2021/01/13/treating-friends-family/

Time Stamps:

• 02:45 The tension, the push and pull
• 05:45 Prevalence
• 06:32 Stances of societies/professional organizations
• 08:18 Concerns
• 10:35 How to respond
• 17:52 Favors for physician/trainee colleagues, self-doctoring
• 22:26 Formal vs informal, documentation
• 23:55 Long-term care

Tags: patient care, advocate, advice, healthcare, Core IM, IM Core, medical ethics, medical humanities

How do you form an educational mission statement? What role do coaches and mentors play? Do you need formal training for a MedEd career? What are the challenges with careers in medical education?

Show notes, Transcript and References: https://www.coreimpodcast.com/2020/12/27/medical-educatio…s-careers-series/

Time Stamps:

• 00:00 Introductions
• 05:44 General Tips
• 18:00 Challenges in Med Ed
• 24:54 Conclusion
• 
  

Tags: CoreIM, IM Core, mission statement, clinician educator, mentors, coaching, training, feedback

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-podcasts/core-im

Time Stamps:

• 00:00 Introduction
• 03:33 Mental Health & Wellbeing
• 06:43 Case 1
• 11:48 Exercise 1
• 12:53 Exercise 2
• 14:35 Case 2
• 19:15 Exercise 3
• 21:22 Exercise 4
• 23:24 Case 3
• 27:29 Exercise 5
• 28:07 Exercise 6
• 29:24 Conclusion

Tags: CoreIM, IM Core, problem representation, coaching exercises, data gathering, hypothesis generation, clinical reasoning, faculty development

What is the difference between mnemonics and schemata? What does the mnemonic NAACP bring to mind? How do repeat interviews bring you closer to or further away from the diagnosis? Show notes, transcript and references: https://www.coreimpodcast.com/2020/11/25/a-29m-with-cough…oofbeats-segment/ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time Stamps:

• 00:43 Case presentation Part 1
• 04:55 Case presentation Part 2
• 06:50 Expert discussant
• 28:52 Framing bias
• 33:38 Concluding thoughts

Tags: IM Core, CoreIM, schemata, mnemonics, eosinophilia, framing bias

What leads patients to search for alternative treatments than those offered in Western Medicine? How can we provide patients with safer complimentary interventions? How do we prioritize what is important in our patients health?

Show notes, Transcript and References: https://www.coreimpodcast.com/2020/10/15/approach-to-patients-with-cam-beliefs/

Time stamps:

• 01:49 Intro
• 04:54 What is CAM
• 06:29 Prevalence of CAM
• 08:01 Holistic approach to patient care
• 11:09 Patient empowerment
• 14:38 Integrating CAM
• 18:34 Risks and Benefits
• 19:50 Caution patients
• 22:29 Indirect Risk
• 23:45 Big Picture
• 26:04 Therapeutic Alliance
• 27:27 Conclusion

Tags: IM Core, CoreIM, supplements, homeopathic, naturopathic, Ayurvedic medicine, mind-body interventions, massage, acupuncture, and chiropractic manipulation, qi gong and Reiki

How can we feel more comfortable in treating these patients? What treatment options do we now have in our toolbox to fight COVID-19? How has the landscape changed in what we can offer patients?

Show notes, Transcript and References: https://www.coreimpodcast.com/2020/09/30/covid-management/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time stamps

• 04:16 Supportive Care
• 07:48 Step-up approach to oxygenation
• 13:44 Data Points
• 15:30 Clots
• 19:13 Steroid use

Tags: IM Core, CoreIM, oxygenation, proning, anticoagulation

How do we respond to challenging times? Are you a driver of change? How can we forge ahead during times of adversity? What lessons can we learn from the stories of our peers and colleagues?

Show notes, Transcript and References: https://www.coreimpodcast.com/2020/09/16/transitions-episode/

Time Stamps:

• 02:48 Minneapolis 2020 with Dr. Uloko
• 06:44 Early HIV/AIDS with Dr. Kalet
• 12:07 Hurricane Sandy with Dr. Hwang
• 17:20 Aftermath of the Syrian Civil War
• 20:23 Transitions with Dr. Arora

Tags: Core IM, IM Core, change, inspiration, narrative medicine

What are common mistakes with protein on the UA? What questions should you ask while obtaining a history that could clue you into nephrotic syndrome? Are kidney biopsies risky business? Is there an associated clot risk in patients with nephrotic syndrome?

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Show note, Transcript and References: https://www.coreimpodcast.com/2020/09/02/5-pearls-on-nephrotic-syndrome/

Amboss Article on Nephrotic Syndrome: https://www.amboss.com/us/knowledge/Nephrotic_syndrome?utm_source=affiliate&utm_medium=link&utm_campaign=coreim-01

Time Stamps:

• 03:22 Evaluating Proteinuria
• 09:37 Nephrotic Syndrome specifics
• 22:31 Who to biopsy
• 31:39 Diuretics
• 37:16 Thrombosis Risk

Tags - CoreIM, IM Core, edema, proteinuria, kidneys, thrombosis, urinalysis, diuresis 

How tough is it to forge your career in clinical research? What struggles do physicians face in finding protected time? Are there setbacks and frequent rejections? How can you follow your passion and find success?

Show note, Transcript and References: https://www.coreimpodcast.com/2020/08/19/research-careers…rs-in-gim-series/

Time Stamps:

1:28 Origins

6:57 Mentorship

14:30 Reality, Roadbumps, and Failures

18:17 The path of many fellowships

Tags - CoreIM, IM Core, clinical investigator, general internal medicine

Are fall prevention programs helping our patients? Should patients receive outpatient PT based on clinical diagnosis? How has the landscape changed because of insurance reimbursement?

Show note, Transcript and References: https://www.coreimpodcast.com/2020/08/05/physical-therapi…education-series/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-imTime Stamps:

• 01:47 Functional Assessment
• 07:47 Documentation
• 14:35 Outpatient PT
• 18:14 Durable Medical Equipment
• 22:55 Reimbursement

Tags: Core IM, IM Core, physical therapy, durable medical equipment, IPE, multidisciplinary team, interdisciplinary

What goes into decision making? What are the invisible tugs that may keep patients from acting in line with their values? Why isn't it part of the formal capacity assessment?

Show notes, Transcript and References: https://www.coreimpodcast.com/2020/07/22/capacity-2-0-and-voluntarism/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time Stamps:

• 2:57 Defining voluntarism
• 5:36 Four elements that influence voluntarism
• 10:26 How do you incorporate voluntarism into the capacity assessment?
• 16:11 Discussions with uncooperative patients
• 19:14 Protecting unrepresented patients
• 21:30 Clinician perspective
• 25:06 Moral distress

Tags: medical humanities, ethics, psychiatry, IM Core, CoreIM

Unpack a famous historical legend's medical dilemma on a special "Historical CPC" episode!

Show notes, transcript and references: https://www.coreimpodcast.com/2020/07/08/22729/

Time Stamps:

• 02:55 HPI
• 07:33 Past Medical History
• 04:25 Physician Exam findings
• 24:22 Historical Figure Revealed
• 26:30 Reflections on top 3 diagnosis

Tags: cognitive and neuropsychiatric disturbances, rabies, mercury poisoning, cholera, delirium, COREIM, IMCORE, clinical reasoning case

Packed with so many clinically relevant points taking care of a patient with decompensated heart failure on general medicine floors!

Time Stamps:

• 03:17 What are the key initial clinical variables in evaluating heart failure admissions?
• 10:09 What are key lab findings for patients with heart failure exacerbation?
• 17:14 Which guideline-directed medical therapy, and in what circumstances?
• 22:12 What are diuretics dosing strategies and monitoring tips to help guide initial volume removal?
• 28:43 What role do thiazides and ultrafiltration play in diuresis, why does diuretic-induced metabolic alkalosis happen and what should you do about it?
• 38:09 Expert Recap

Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/24/5-pearls-on-inpatient-heart-failure/

ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Tag: Cardiology, BNP, cardiorenal syndrome, beta-blockers, CoreIM, IMCore

SNF vs. NH? SAR vs. SNF? What are the differences in resources, nursing and clinician oversight and who pays for what?!

Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/

ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time stamps:

• 04:07 SAR vs SNF
• 13:35 Long term Nursing Home Care
• 18:30 Assisted Living Facility
• 24:40 Acute rehab
• 26:11 LTACH
• 27:49 Home

Tags: Subacute rehab, skilled nursing facility, long-term acute care hospital, CoreIM, Core_IM, hospital medicine, family medicine, emergency medicine, physician assistant, nurse practitioner, interprofessional education

Let's dive deeper into the dogma of salt restriction in heart failure! Show notes, transcript and references: https://www.coreimpodcast.com/2020/05/20/salt-restriction-in-heart-failure-mind-the-gap-segment/ Get CME-MOC credit with ACP! Time Stamp

• 01:37 Sodium restriction guidelines
• 07:13 Current data in outpatient data
• 11:32 Do inpatient studies show signal?
• 13:44 Physiology behind sodium balance
• 16:27 Take away and clinical applicability

How do you navigate new challenges with goals of care with your patients in clinics?

Show Notes, Transcript, References: https://www.coreimpodcast.com/2020/05/06/outpatient-advanced-care-planning-during-covid-19/

Time Stamps

• 01:32 COVID Crisis as an Outpatient and Advance Care Planning (ACP)
• 08:06 The virtual visit
• 12:44 Vital Talk Mnemonic: “CALMER”
• 22:03 Challenges to Outpatient COVID Care
• 26:03 Parting Thoughts

Episode Outline

1. Disconnection/connection: Patients
2. Disconnection/connection: Family/friends
3. Disconnection: Security, Certainty
4. Connection: Other clinicians

• Sharing fears, supporting each other)
• Shared ethos in healthcare (one workforce, no division of specialty or hierarchy)

1. Conclusion: Post-traumatic growth / Peri-Traumatic Growth

Thank you to everyone we interviewed, particularly to the voices you heard:

Dr. Kimberly Manning (@gradydoctor)

Dr. John Hwang (Hoofbeats segment)

Dr. Steve Liu (Mind the Gap segment)

Dr Katherine Arthur

Dr. Maria Garcia-Jimenez

Dr. Kelsey Luoma

Hosts:

Dr. Margot Hedlin (@MargotHedlin) - Introduction and Ending

Dr. Tamar Schiff

Dr. Michael Shen (also audio editing)

Dr. Jafar Al-Mondhiry (@mondhiry)

tags: COVID19, COVID-19, CoreIM, coronavirus, narrative medicine