- #150 Rhythm Control in Afib: 5 Pearls Segment
What are the benefits of early rhythm control versus rate control alone? When is electrical cardioversion used and what information can it tell us? What side effects for amiodarone, dofetilide, and sotalol, propafenone and flecainide? When should catheter ablation be considered in patients with atrial fibrillation?
Time stamps:
- 02:05 Pearl 1 - Rhythm control
- 11:23 Pearl 2 - Electrical cardioversion
- 17:53 Pearl 3 - Class III antiarrhythmics and side effects
- 26:31 Pearl 4 - Class Ic antiarrhythmics and side effects
- 31:55 Pearl 5 - Catheter ablation
Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillation
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Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care.
Time Stamps
- 01:47 Evolving story of asthma management
- 03:26 Pathophysiology of asthma management
- 06:01 Key players & terms
- 08:56 Story of asthma through the decades
- 17:55 MANDALA Trial
Tags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalers
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How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula? What is a Fishbane reaction? And how is it different from anaphylaxis?
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Time stamps:
02:09: Spaced repetition from the last Gray Matters Episode
05:29: Choosing between oral and IV iron
11:17: Considerations with oral iron repletion
24:02: Considerations with IV iron repletion
32:36: Complications and side effects of IV iron
Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy39m - Mar 27, 2024 - #147 Iron Deficiency: Grey Matters Segment
What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history?
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Expert Interviews on Youtube
Time stamps:
- 03:43 Iron deficiency labs and interpretation in inflammation
- 16:08 Heavy menstrual bleeding evaluation
- 27:04 When should a premenopausal woman with iron deficiency have endoscopy?
- 35:15 Recap
Tags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosis
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Privacy & Opt-Out: https://redcircle.com/privacy39m - Mar 13, 2024 - #146 Tube Feeds: 5 Pearls Segment
Uncover many blind spots on tube feeds!
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Youtube Interviews:
What is venting aka decompression?
Timestamp
- 02:21 Indications for tube feeds
- 09:36 Routes of enteral access
- 19:20 Components of tube feeds
- 7:03 Tube feeds complications
- 34:50 Counseling patients before discharge and medication interactions
Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feeds
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Privacy & Opt-Out: https://redcircle.com/privacy42m - Feb 28, 2024 - #145 Heart Failure in Older Adults & Guardianship: Gray Matter Segment
How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship?
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Youtube Interviews:
Limitation and value of individualism
Timestamp
- 04:03 Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult?
- 11:55 Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship?
- 28:30 Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred?
- 33:27 Reflections
- 37:06 Recap
Tags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case management
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How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
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Time Stamps
- 02:30 Epidemiology of RSV
- 03:46 Development of RSV vaccine
- 05:55 Vaccine trial design
- 12:22 ARESVI and RENOIR Trials
- 18:18 Who should we recommend the RSV vaccine to?
- 19:50 What don’t we know?
Tags: IMCore, CoreIM, primary care, infectious disease, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy23m - Jan 31, 2024 - #143 Hypomagnesemia and Hypophosphatemia: 5 Pearls Segment
When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement?
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Youtube interview on key points on magnesium
Youtube interview on key points on phosphate
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp
- 01:37 Pearl 1: Magnesium
- 09:39 Pearl 2: Framework for hypomagnesemia
- 16:53 Pearl 3: Magnesium repletion
- 22:39 Pearl 4: Phosphorous
- 28:36 Pearl 5: Phosphorous repletion
Tags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renal
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Sharpen your de-escalation skills!
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Timestamps:
- 02:26 Difficult Patients
- 10:25 Mediation Toolkit
- 17:20 Maxims of Mediation
- 26:46 When the Conversation Still Breaks Down
- 35:11 Conclusion
Tags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnout
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Privacy & Opt-Out: https://redcircle.com/privacy38m - Dec 27, 2023 - #141 Do Steroids Have a Role in Community-Acquired Pneumonia? Beyond Journal Club on the CAPE COD Trial
In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
- 01:50 Pathophysiology of Steroids and Infection
- 03:50 Steroids in PNA Studies
- 08:56 CAPE COD Trial
- 14:13 Discussion of CAPE COD Trial
- 18:36 Takeaways/Discussion
Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy22m - Dec 6, 2023 - #140 Bonus Pacemaker & ICDs: 5 Pearls Segment
Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!
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Timestamps:
- 01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?
- 06:31 Pearl 2: Considerations for patients with implantable devices before surgery.
- 12:26 Pearl 3: Considerations for patients with implantable devices before MRI.
- 14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures.
- 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-ray
Tags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing
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Privacy & Opt-Out: https://redcircle.com/privacy24m - Nov 29, 2023 - #139 CKD Staging (Cr vs. Cystatin C, Albuminuria & more): Mind The Gap Segment
Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria?
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CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp:
00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage
04:20" What's wrong with how we estimate GFR?
06:50 Why is creatinine flawed as an estimator of GFR?
10:52 Enter new contender...Cystatin C!
16:16 Importance of the A Stage!
20:21 Which patients should you measure proteinuria in?
22:10 Treatments for albuminuria!
24:27 Summary and Closing
Tag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy26m - Nov 8, 2023 - #138 Incorporating Cancer Genetics into Your Practice: Lynch Syndrome and Beyond!
Check out the original interview on Youtube:
Essentials on Genetic Counselor | Lynch Syndrome
Who should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting!
Timestamp
- 03:13 Part 1: Who should be referred to genetic counseling?
- 11:23 Part 2: How do we set up genetic counselors for success?
- 22:38 Part 3: Genetic counseling myth busting!
Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy32m - Oct 25, 2023 - #137 Hypokalemia & Potassium Repletion: 5 Pearls Segment
See some of the original interviews on Youtube!
What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?!
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp
- 01:45 Pearl 1: Evidence for potassium repletion
- 09:10 Pearl 2: Framework for hypokalemia
- 17:09 Pearl 3: Repletion goals
- 23:00 Pearl 4: Options for hypokalemia treatment
- 29:13 Pearl 5: Frequency of lab checks and repletion
Tags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional education
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Privacy & Opt-Out: https://redcircle.com/privacy34m - Oct 18, 2023 - #136 How Did Diabetes Medications Become Obesity Meds? Beyond Journal Club on SURMOUNT-1 Trial
What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?
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- 02:08 Framework for thinking about obesity
- 03:42 History of obesity treatment
- 06:29 Gila monsters and GLP and GIP mechanisms
- 08:29 Story of how medications for diabetes were found to have a weight loss benefit
- 12:50 SURMOUNT-1 trial
Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant
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With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers?
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CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamps
- 01:54 Pearl 1 – Recap of GDMT and CKD
- 09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate
- 20:59 Pearl 3 – Ivabradine
- 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT
- 30:55 Pearl 5 – Ejection Fraction Recovery
Tags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiology
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Privacy & Opt-Out: https://redcircle.com/privacy36m - Sep 20, 2023 - #134 Diagnostic Errors & Excellence
What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?
Timestamps
- 01:00 System 1 vs. System 2
- 07:46 Cognitive Biases
- 13:46 Case for Knowledge
- 18:29 Other Practices to Decrease Error
- 28:26 Conclusion
CME: http://bit.ly/CIMCME || Show Notes & Transcript
This episode is made in part of ACP’s Diagnostic Excellence curriculum
Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflection
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What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection?
Timestamps
- 02:41 Types of Immunosuppression
- 14:31 Medication Reconciliation
- 22:36 AKI in the Transplant Patient
- 31:53 Infections in the Transplant Patient
- 40:00 Transplant rejection, cancer after transplant
CME: http://bit.ly/CIMCME || Show Notes & Transcript
Tags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressive
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In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.
How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.
Access to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.
Timestamps
- 00:50 Question REVIVED addressed
- 01:44 Revascularication in HFrEF
- 06:32 Revascularization in stable CAD
- 10:02 REVIVED trial
- 12:20 Summary and takeaways
Tags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicine
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Privacy & Opt-Out: https://redcircle.com/privacy17m - Aug 2, 2023 - #131 July Stories 2.0
Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories !
Listen to the original July Stories: https://bit.ly/3Y4n8jG
Subscribe to our new Youtube Channel !
Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedback
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Privacy & Opt-Out: https://redcircle.com/privacy22m - Jul 19, 2023