- #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!
Sponsor: Post Investment: Real Estate Syndications
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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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?
Sponsor: Panacea Financial Student Loan Consultation
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!
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!
Sponsor: Hellofresh (50% off + free shopping with code: 50COREIM)
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
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?!
Sponsor: Hellofresh (50% off + free shopping with code: 50COREIM)
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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Privacy & Opt-Out: https://redcircle.com/privacy21m | Oct 4, 2023 - #135 Guideline Directed Medical Therapy Part II: 5 Pearls Segment
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?
Sponsors: Hellofresh | Pranay's Effective Living Formula Course
Pranay's Free Masterclass (Sept 20 and 27th at 5pm PST)
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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Privacy & Opt-Out: https://redcircle.com/privacy30m | Sep 6, 2023 - #133 Post-Kidney Transplant: 5 Pearls Segment
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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Privacy & Opt-Out: https://redcircle.com/privacy44m | Aug 16, 2023 - #132 Does PCI Save Lives in Heart Failure and CAD? Beyond Journal Club on the REVIVED Trial
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 - #130 Cort (ACTH) Stim Test
BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?
Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
Subscribe to our new Youtube Channel !
Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue
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Privacy & Opt-Out: https://redcircle.com/privacy14m | Jul 6, 2023 - #129 Steroids: 5 Pearls Segment
How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?
Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
Subscribe to our new Youtube Channel !
Use this link for CME-MOC credit with ACP
Time Stamps
- 02:59 Types of Corticosteroids
- 14:31 Side Effects of Steroids
- 21:15: Prophylaxis
- 27:32 Steroid Weaning
- 33:38 Steroid Weaning Limitations
Tags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndrome
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Privacy & Opt-Out: https://redcircle.com/privacy41m | Jun 28, 2023 - #128 Cirrhosis Bleeding Risk, FFP and Indwelling Pleural Catheters: Gray Matters Segments
In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?
Time Stamps
- 02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis
- 05:35 Deep Dive 2: FFP effect on bleeding risk
- 15:43 Deep Dive 3: Risks of FFP
- 19:45 Deep Dive 4: Indwelling pleural catheters
- 30:31 Recap
Tags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonary
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Privacy & Opt-Out: https://redcircle.com/privacy31m | Jun 14, 2023 - #127 Radiation Oncology Side Effects: 5 Pearls Segment
How long can fatigue last for after radiation? Are all patient post radiation immunocompromised? What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?
Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
Use this link for CME-MOC credit with ACP
Whiteboard Animation Video of Radiation Physiology
Time Stamps
- 02:37 Systemic Radiation Side Effects
- 14:29 Lung Radiation Side Effects
- 18:22 Breast Radiation Side Effects
- 21:45 Prostate Radiation Side Effects
- 24:54 Brain Radiation Side Effects
Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapy
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Privacy & Opt-Out: https://redcircle.com/privacy28m | May 31, 2023 - #126 Radiation Oncology Part 1: 5 Pearls Segment
What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?
Whiteboard Animation Video of Radiation Physiology
Time Stamps
- 02:04 What is radiation?
- 03:17 How does radiation therapy work?
- 04:50 How is today’s radiation different from the past?
- 05:40 What role does radiation play in cancer treatment?
- 07:48 What are the different types of radiation?
- 15:34 How do you write a rad onc one-liner as an internist?
- 19:59 What is palliative radiation and how/when should we use it?
Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy
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Privacy & Opt-Out: https://redcircle.com/privacy26m | May 24, 2023 - #125 Learning Habits, Time Management, and Leadership: Wisdom from Dr. Kelly Graham
What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?
Time Stamps
- 01:12 Learning Journey
- 05:58 Lifelong Learning
- 11:14 Time Management
- 16:38 Role Modeling
- 19:59 Re-Calibrating Failure
Tags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time management
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Privacy & Opt-Out: https://redcircle.com/privacy23m | May 15, 2023 - #124 A1c & Glucose Measurements: Mind the Gap Segment
What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric?
Show notes, Transcript and References
Time stamps
- 00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test
- 03:03 Hemoglobin A1c
- 08:26 Fructosamine and Glycated Albumin
- 10:50 Continuous Glucose Monitoring
- 15:44 The Overlooked Issue of Insulin Resistance
- 19:11 Summary
Tags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complication
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Privacy & Opt-Out: https://redcircle.com/privacy21m | Apr 26, 2023 - #123 Pacemakers & ICDs: 5 Pearls Segment
When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?
- Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”
- Use this link for CME-MOC credit with ACP
- Show notes, Transcript and References
Time stamps
- 02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?
- 21:28 How to determine which type of device your patient has?
- 25:10 What can a device interrogation tell you and doesn't tell you?
- 32:13 Do all patients with bacteremia need their implantable cardiac devices taken out?
- 38:44 End-of-life considerations with pacemakers vs. ICDs
Tags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacing
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Privacy & Opt-Out: https://redcircle.com/privacy47m | Apr 12, 2023 - #122 Kidney Transplant Preparation: 5 Pearls Segment
How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?
- Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim
- Use this link for CME-MOC credit with ACP
- Show notes, Transcript and References
Time stamps
- 03:49 Episode start
- 07:13 Dialysis vs. kidney transplant morbidity and mortality
- 11:44 Eligibility for kidney transplant and when to refer
- 21:34 Pre-transplant evaluation process
- 25:38 How long are wait times on the transplant list?
- 36:21 What benefits of living donation? What are risks to the kidney donor?
Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidney
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Privacy & Opt-Out: https://redcircle.com/privacy46m | Mar 29, 2023 - #121 Trach Care: 5 Pearls Segment
What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation?
Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im
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Show notes, Transcript and References:
https://www.coreimpodcast.com/2023/03/08/trac/
Time stamps
2:56 Trach Components
12:47 Trach Complication Management
27:48 Airway Clearance
34:53 Speaking Valve
38:54 Decannulation
Tags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacy
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Privacy & Opt-Out: https://redcircle.com/privacy42m | Mar 8, 2023
