EPISODES
  • #146 Tube Feeds: 5 Pearls Segment

    Uncover many blind spots on tube feeds!

    Sponsor: At Panacea Financial, every single customer gets their OWN 24/7 primary care banker who actually knows you!

    Youtube Interviews: 

    Short-term enteral access

    Durable enteral access

    What is venting aka decompression?

    Show Notes & Transcript

    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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    42m | 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?

    Sponsor: Echonous, the maker of Kosmos, is redefining point-of-care ultrasound at half the price (or less) of comparable carts. Mention Core IM at the Demo to get a free A.I application of choice!

    Youtube Interviews: 

    When to consider a guardian?

    Guardianship Process

    Limitation and value of individualism

    Show Notes & Transcript

    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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    38m | Feb 14, 2024
  • #144 RSV & What Makes Vaccine Trials Different: Beyond Journal Club on the RENOIR and AReSVi Trials

    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.

    Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more

    Show Notes & Transcript

    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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    23m | 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?

    Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more

    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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    37m | Jan 17, 2024
  • #142 Managing Conflict: At the Bedside Segment

    Sharpen your de-escalation skills!

    Sponsor: GlassHealth | Get unlimited A.I queries for 1 month with promo code: COREIM !

    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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    38m | 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.

    Show Notes & Transcript

    • 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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    22m | 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!

    Sponsor: Post Investment: Real Estate Syndications 

    Show Notes & Transcript

    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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    24m | 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?

    Sponsor: Panacea Financial Student Loan Consultation

    CMEhttp://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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    26m | 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!

    Show Notes & Transcript

    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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    32m | 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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    34m | 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?

    Sponsors: Post Investment: Real Estate Syndications || Hellofresh  

    Show Notes & Transcript

    • 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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    21m | 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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    36m | 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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    30m | 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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    44m | 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.

    Show notes & Transcript

    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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    17m | 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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    22m | 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 

    Show notes & Transcript

    Subscribe to our new Youtube Channel !

    Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue



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    14m | 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?

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    Show notes & Transcript

    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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    41m | 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?

    Show notes & Transcript

    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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    31m | 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 

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    Show notes & Transcript

    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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    28m | May 31, 2023
Core IM | Internal Medicine Podcast
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