#464 Recap Extravaganza: Dental Pain, Cardiac Amyloidosis, Diabetes & CGMs, Hyperparathyroidism, Neck Pain, Endometriosis, Rhinitis, and more!

23 december 2024 | 66 min

REBOOT #429 Anxiety 2.0: with Dr. Jessi Gold

16 december 2024 | 94 min

REBOOT #433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

9 december 2024 | 76 min

REBOOT #415 Bipolar Disorder With Dr. Kevin Johns

2 december 2024 | 80 min

#463 Tofurkey-cakes: A Hypertension Triple Pill, Arm Position & BP, early TAVR, Liberal vs Restrictive Transfusions, New Periop Guidelines

25 november 2024 | 50 min

#462 Male Hypogonadism Pearls with Dr. Bradley Anawalt: Insights on Testosterone Deficiency

18 november 2024 | 92 min

#461: Facial Nerve Follies: Understanding Bell's Palsy

11 november 2024 | 67 min

#460 HFpEF: Heart Failure with Preserved Ejection Fraction

4 november 2024 | 50 min

#459 DIGEST: Finerenone for Heart Failure, PCV21 and the latest Pneumonia Vaccine Recs, 24-hour vs 15-hour Oxygen Therapy, and PREVENT vs PCE for Cardiovascular Risk Estimation

28 oktober 2024 | 55 min

#458 HFrEF: Heart Failure with Reduced Ejection Fraction

21 oktober 2024 | 64 min

#457 Cold and Flu Season: Upper Respiratory Infections aka URIs

14 oktober 2024 | 66 min

#456 Outpatient Oxygen Therapy

7 oktober 2024 | 73 min

#455 Sports Injuries Part 2: Hip and Knee

30 september 2024 | 54 min

#454 Kidney Boy on Managing Diabetes and Hypertension in CKD

23 september 2024 | 66 min

#453 Sports Injuries Part 1: Concussion and Hip Pain

16 september 2024 | 58 min

#452 NAFLD/MASLD with Dr. Elliot Tapper

9 september 2024 | 75 min

#451 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 2

2 september 2024 | 64 min

#450 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 1

26 augusti 2024 | 63 min

REBOOT #326 NephMadness 2022: Cardiorenal Syndrome

19 augusti 2024 | 56 min

REBOOT #226 Kidney Boy on Acute Kidney Injury: Myths & Musings

12 augusti 2024 | 74 min

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.

AKI Tips and Tricks from Joel Topf MD, Kashlak’s Chief of Nephrology

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

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Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!

Credits

Written (including CME questions) and Produced by: Cyrus Askin, MD
Infographic by: Cyrus Askin, MD
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Joel Topf, MD

Time Stamps

00:00 Sponsors - VCU Health CE and Pediatrics On Call podcast by APP
00:30 Intro, disclaimer, guest bio
03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame);
08:45 Sponsor - Pediatrics On Call podcast by APP
09:15 Definition of acute kidney injury (AKI) and fundamentals
11:00 Cardiorenal syndrome
12:24 Schema for AKI
17:30 Establish an etiology, determine urine output and address electrolyte abnormalities
21:22 AKI in the otherwise-healthy patient;
32:20 Rhabdomyolysis 38:21 Vancomycin
41:43 Acute interstitial nephritis (AIN)
44:52 Contrast induced nephropathy (CIN)
50:37 Gadolinium in AKI and/or CKD
52:53 Timing of dialysis
56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors;
62:01 Is Ultrasound necessary in AKI
64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology
68:45 Outro and Sponsor - VCU Health CE

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REBOOT #316 Lower Extremity Edema with The Curbsiders

5 augusti 2024 | 65 min

REBOOT #387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules

29 juli 2024 | 65 min

Unlocked: Patreon #23 DGBI - IBS and Functional Dyspepsia

24 juli 2024 | 33 min

REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen

22 juli 2024 | 83 min

Addiction Medicine - #25 Methadone in the Clinic with Dr Ruth Potee and Dr David Frank

18 juli 2024 | 66 min

#449 Travel Medicine, Malaria, Traveler’s Diarrhea, Yellow Fever, and more! with Dr. Boghuma Titanji

15 juli 2024 | 103 min

#448 USPSTF Breast Cancer Screening - Updated recommendations and the reasoning behind them

10 juli 2024 | 31 min

#447 Rhinitis and Environmental Allergies with Dr. Olajumoke Fadugba

8 juli 2024 | 69 min

#446 Psychiatry Primer for the Hospitalist

1 juli 2024 | 65 min

#445 DIGEST-Hotcakes: Preventive PCI, Andexanet Alfa for ICH, Aspirin for Fatty Liver, Naltrexone in Cirrhosis, Pivmecillinam for UTI, Cefepime vs Pip-Tazo, MDRO Decolonization, Microplastics and MACE, Pax-NO-vid

24 juni 2024 | 70 min

#444 Macrocytosis, Hemolytic Anemia, Myelodysplastic Syndrome

17 juni 2024 | 56 min

Recorded LIVE! At Johns Hopkins Internal Medicine Grand Rounds

Step up your anemia game as we explore the causes and diagnostic approach for macrocytic anemia, what to do with a reticulocyte count, the differential diagnosis for hemolytic anemia, the significance of the direct antiglobulin test, and diagnosis and management pearls for autoimmune hemolytic anemia (AIHA) and myelodysplastic syndrome (MDS). Plus, common questions and concerns regarding folate supplementation and the use of bone marrow biopsies. We’re joined by hematologist and pun enthusiast Dr. Rakhi Naik MD, MHS, @redcell_doc @hopkinsheme.

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

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Show Segments

00:00 Intro and Guest intro
05:53 Case 1: Elise - Macrocytic Anemia
14:59 Case 2: Jane - Hemolytic Anemia
23:24 Testing for Underlying Causes of Autoimmune Hemolytic Anemia
24:40 Association of Autoimmune Hemolytic Anemia with Lymphomas
25:10 Autoimmune Hemolytic Anemia: Diagnosis and Treatment
26:06 Management Approach for Autoimmune Hemolytic Anemia
27:30 Considerations for Outpatient Treatment of Autoimmune Hemolytic Anemia
28:18 Clotting Risk in Autoimmune Hemolytic Anemia
29:20 Treatment Options for Autoimmune Hemolytic Anemia
30:42 Long-Term Prognosis and Recurrence of Autoimmune Hemolytic Anemia
33:32 Diagnostic Challenges in Myelodysplastic Syndrome
35:00 Considerations for Folate Supplementation
36:24 Factors to Consider in the Management of Myelodysplastic Syndrome
39:30 When to Perform a Bone Marrow Biopsy in Myelodysplastic Syndrome
41:25 Shared Decision-Making in the Treatment of Myelodysplastic Syndrome

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD, MSc
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Rakhi P. Naik MD, MHS

Sponsor: Beginly Health

Visit beginlyhealth.com/curbsiders job matching platform for every Physician and Advanced Practice Clinician, from training to practice.

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

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#443 Primary Hyperparathyroidism: Stones, bones, and almost certainly some groans

10 juni 2024 | 74 min

#442 Syncope: Live from SHM #Converge24 with Dr. Dan Dressler

3 juni 2024 | 73 min

#441 More Clinical Pearls (New antibiotics, syphilis, heart disease, cirrhosis, lots more!) from ACP #IM2024

27 maj 2024 | 68 min

More clinical pearls from ACP #IM2024, including emerging infectious diseases in the US (malaria, dengue, super gonorrhea, and a resurgence of syphilis), new C. diff treatments, coagulopathy and cirrhosis, fatty liver disease, HFpEF, peripheral arterial disease, Lp(a) and ApoB, CAR T-cells for autoimmune disease, SGLT2i for gout, and hematology updates. Paul and Watto are joined by Drs. Nora Taranto, Beth Garbitelli, and of course Chris “The Chiu Man” Chiu.

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

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Show Segments

00:00 Tropical Diseases: Resurgence of Malaria and Dengue Fever
03:44 Infectious Diseases: Syphilis Rates and New Treatments for C. diff
08:28 Coagulopathy and Cirrhosis: Managing Hemostasis and Portal Vein Thrombosis
11:34 Fatty Liver Disease: Risk Stratification and Treatment
14:59 Cardiology Updates: Cardiovascular Kidney Metabolic Syndrome
31:03 New Medications for Hypertension
32:54 Renal Denervation and Hypertension
33:51 Lp(a) Drugs and Their Potential
36:01 Peripheral Arterial Disease and Claudication
38:10 SGLT2 Inhibitors and Gout
41:50 APO-B and LDL Cholesterol
42:45 Secondary Hypogonadism and Head and Neck Radiation
45:30 VEXAS: A Genetic Autoimmune Condition
49:08 Obesity-Induced Leukocytosis
52:49 CAR T-Cell Therapy in Rheumatologic Diseases

Credits

Producers/Writers/Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD, Chris Chiu MD, Beth Garbitelli MD
CME, Cover Art: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Nora Taranto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

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Sponsor: Freed

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Sponsor: Beginly

Visit beginlyhealth.com/curbsiders for the job matching platform for every Physician and Advanced Practice Clinician, from training to practice

#440 Hepatitis B with Dr. Arthur Kim

20 maj 2024 | 78 min

#439 Shoulder Pain: Impingement, Bursitis, Tendonitis, Cuff Tears, and Arthritis with Dr. Ted Parks

13 maj 2024 | 68 min

#438 Recap from SHM #Converge24

6 maj 2024 | 79 min

#437 Clinical Pearls ACP #IM2024

29 april 2024 | 58 min

#436 Endometriosis for the Internist with Dr. Cope & Dr. Green

22 april 2024 | 84 min

#435 Neck Pain with Dr. Anthony Mikula

15 april 2024 | 75 min

#434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher

8 april 2024 | 63 min

#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

1 april 2024 | 74 min

Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!

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Show Segments

00:00 Introduction and Diabetes Puns
01:00 Introduction of Guest and Topic
09:12 Qualifications and Eligibility for CGMs
11:32 Types of CGMs and Sensor Placement
24:47 Interpreting CGM Data and Alarms
34:30 Troubleshooting Patterns and Adjustments
35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses
36:15 The Rule of 15 and Addressing Hypoglycemia
37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia
38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
39:51 Managing Exercise-Induced Hypoglycemia
41:43 Preventing Exercise-Induced Hypoglycemia with Snacks
43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas
45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia
51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin
56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin
57:44 Addressing Adherence and Medication Barriers
59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management
01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap
01:05:49 Considering Patient Adherence and Barriers to Treatment

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
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: Jeff Colburn MD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Panacea Financial

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#432 Hotcakes: E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, Lidocaine for neck pain, C diff risk by antibiotic type, and “dosing by clicks” for GLP1’s

25 mars 2024 | 56 min

#431 Myocarditis and Pericarditis

18 mars 2024 | 54 min

Show description:
Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter!

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Show Segments

Intro, disclaimer
A case of pericarditis
Diagnosing pericarditis
The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis
Etiologies of pericarditis and initial testing recommendations
Treatment of acute uncomplicated pericarditis
Using colchicine to prevent recurrent pericarditis
Patient counseling after diagnosing pericarditis
A case of myocarditis
Interpreting elevated troponin levels
Distinguishing between myocardial infarction and myocardial injury
Diagnostic testing for suspected myocarditis
When to pursue cardiac MRI and endomyocardial biopsy
The spectrum of myocarditis presentations
Fulminant myocarditis
Common etiologies of myocarditis
Immune checkpoint inhibitor myocarditis
Myocarditis from mRNA vaccines and from SARS-CoV-2 infection
Management of patients with myocarditis
Activity restrictions for patients with myocarditis
Outro

Credits

Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP
Guest: Vivek Kulkarni, MD, FACC
Producer, Script, and Show Notes: Adam Barelski, MD
Infographics and Cover Art: Edison Jyang
Reviewer: Leah Witt, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Panacea Financial

Download the full 2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.

Sponsor: Factor

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Unlocked Weight Management, Low Carb, Listener Q&A, Picks of the Weeks (Patreon #19)

13 mars 2024 | 37 min

#430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024!

11 mars 2024 | 53 min

#429 Anxiety 2.0: with Dr. Jessi Gold

4 mars 2024 | 93 min

#428 DIGEST: DVT prophylaxis in patients with cancer, anticoagulation in subclinical AFib, steroids in COPD exacerbations, breast cancer genetic testing guidelines, and at-home STI testing

26 februari 2024 | 56 min

#427 Kittleson Rules Cardiac Amyloidosis

19 februari 2024 | 68 min

The clinical picture of an underrecognized disease

Amyloidosis demystified. Learn the clinical clues that suggest possible amyloidosis and how to order the correct tests to diagnose this disease. We are joined by Dr. Michelle Kittleson who shows us the ropes of treating fibril accumulation, @MKittlesonMD (Cedars Sinai).

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

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Show Segments

Introduction
Case Presentation: Mr. Smith
Differential Diagnosis of Heart Failure with Preserved Ejection Fraction
Understanding Amyloidosis
Clinical Clues and Red Flags for Amyloidosis
Physical Examination Findings
Workup for Amyloidosis
Treatment Options
AL Amyloidosis and Hematologist's Role
ATTR Amyloidosis and Cardiologist's Role
Other Therapies for TTR Amyloidosis
Therapy on the Horizon
Cost and Access to Tafamidis
Alternative Therapies and Supplements
Monitoring and Side Effects of Tafamidis
Symptomatic Management and Anticoagulation
Take Home Points

Credits

Written and Produced by; Deborah Gorth, MD, PhD
Infographic and Cover Art: Meryl Gorth, RD, MPH and Deborah Gorth, MD, PhD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S. Achi MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Michelle Kittleson, MD, PhD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#426 Breast Cancer for the PCP With Dr Sandhya Pruthi

12 februari 2024 | 59 min

Join us as Sandhya Pruthi, MD talks us through basics of breast cancer, specifically how to share a new diagnosis with a patient, the spectrum of disease from favorable to more aggressive, and the basics of what to expect with initial treatment. Feel more confident sharing a new diagnosis of breast cancer and supporting your patients through this journey.

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Show Segments

00:00 Introduction
02:18 Getting to Know Dr Sandhya Pruthi
09:49 Picks of the Week
12:35 Case 1: Diagnosis and Treatment of ductal carcinoma in situ (DCIS)
21:24 Risk Stratification and Active Surveillance for DCIS
23:43 Genetic Testing Recommendations
28:08 Case 2: Evaluation and Diagnosis of a Breast Lump
39:14 Invasive Ductal Carcinoma
47:49 Initial Management of invasive ductal carcinoma (IDC)
48:19 Preoperative Discussion and MRI
49:19 Lumpectomy and Sentinel Lymph Node Biopsy
50:16 Radiation and Hormonal Adjuvant Therapy
51:46 Considerations for Chemotherapy
55:51 Signs of Late Recurrence or Metastasis
58:20 Screening Guidelines and Age
01:02:25 Importance of Breast Self-Awareness

Credits

Written and produced, Show Notes: Molly Heublein MD
Infographic and Cover Art: Edison Jyang
Hosts: Molly Heublein MD, Era Kryzhanovskaya MD
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Sandhya Pruthi MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#425 Perioperative Management of Antithrombotics with Dr. Poorvi Hardman

5 februari 2024 | 61 min

R.S.V. Immunization with The Cribsiders

31 januari 2024 | 50 min

#424 Hotcakes: Transfusion in Acute MI, COVID-19 Rebound after Paxlovid, Every-other-day Iron Revisited, Oral Phenylephrine Doesn’t Work, and Stop Correcting Serum Calcium

29 januari 2024 | 56 min

Join us as we review recent practice-changing articles on transfusion thresholds in acute MI, COVID-19 rebound after treatment with ritonavir-boosted nirmatrelvir (PaxlovidTM), the prevalence of iron deficiency, as well as the debut of our new “corrections and omissions” section, in which we cover important knowledge updates on oral iron dosing and correcting serum calcium. And, find out why oral phenylephrine does not work and what you should prescribe instead for upper respiratory symptoms. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

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Credits

Written, Produced, and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

00:00 Introduction and Calcium Puns
03:11 Iron Deficiency and Iron Supplementation
12:20 Corrected Calcium
18:09 Virologic Rebound after nirmatrelvir/ritonavir (Paxlovid™)
32:09 Phenylephrine and its Ineffectiveness
37:00 Restrictive vs. Liberal Transfusion Strategy in MI (MINT trial)
49:20 Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#423 Dental Pain, Caries, Gingivitis, and Oral Care Tips & Tactics for Primary Care With Dr Lisa Simon

22 januari 2024 | 75 min

Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice. Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction. Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.

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Show Segments

00:00 Introduction and Overview
09:13 Diagnosing Dental Pain and Examination Techniques
18:44 Treatment Options for Dental Pain
29:34 Complications and Emergencies in Dental Care
32:36 Post-operative Care and General Dental Advice
40:35 Dry Mouth and Treatment Options
44:05 Gingivitis
49:39 Temporomandibular Joint (TMJ) Dysfunction
55:43 Medications and Dental Side Effects
56:12 Anticoagulants and Dental Procedures
01:00:55 Endocarditis Prophylaxis
01:03:15 Joint Replacements and Antibiotic Prophylaxis
01:04:10 Oral Health in Patients with Opioid Use Disorder

Credits

Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Lisa Simon MD, DMD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#422 LIVE! Inpatient Management of Sickle Cell Crisis, Acute Pain, RBC Transfusions & Acute Chest Syndrome

15 januari 2024 | 57 min

Learn practical tips for the inpatient management of patients with sickle cell disease and vaso-occlusive crisis from guest, Dr. Yoo Mee Shin (Emory). We cover acute pain management including adjuvant therapies, IV fluids, oxygen therapy, the management of acute chest syndrome, and when to perform simple vs exchange transfusions. Key takeaways include the importance of early triage and analgesia, addressing misconceptions about opioid use disorder in patients with sickle cell disease, and recognizing complications of vaso-occlusive crises.

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Show Segments

00:00 Intro
01:27 Getting to know our guest
07:48 Case Presentation and Initial Management of Sickle Cell Disease (SCD)
13:46 Misconceptions about opioid use disorder and sickle cell
17:02 Management of Acute Pain in Sickle Cell Disease
25:46 Adjuvant therapy for pain
29:04 Transition to outpatient care
32:46 General admission orders for sickle cell
38:44 Management of Acute Chest Syndrome
42:01 Simple vs exchange transfusion
47:08 Transfusion in preoperative and pregnant patients
48:03 Transitions and follow-up care
49:35 Key takeaways and Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art & Infographic: Matthew Watto MD, FACP
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: Yoo Mee Shin MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#421 Antiphospholipid Syndrome with Dr. Arielle Langer

8 januari 2024 | 81 min

REBOOT: #334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI)

1 januari 2024 | 98 min

#420 Recap Extravaganza: 2023 Highlights and Top Stories

25 december 2023 | 77 min

Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders.

Our team needed a break so we did not make CME for this episode.

Show Segments

Time Stamps are for Patreon (Ad-Free) Version

00:00 Introduction and Overview
09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms
14:20 Understanding Hemochromatosis
19:24 Evaluation and Management of Hematuria
25:00 Updates in Diabetes Management
29:35 Xylazine Overdose and Withdrawal
35:35 Primary Aldosteronism
39:36 Resistant Hypertension
44:12 Delirium and its Implications
46:29 The Acorn trial and AKI risk
49:47 HIV trial: Reprieve
51:11 Updates in hospital medicine
56:00 Kratom and its implications
59:11 RSV vaccines and their effectiveness
01:05:38 Reflections and Gratitude

Credits

Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Matthew Watto MD, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

Sponsor - Glass Health

Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.

Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.

You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.

Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI.

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REBOOT #281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais

18 december 2023 | 86 min

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry. Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).

Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry. Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).

Show Segments

Intro, disclaimer, guest bio
Dr. Pallais One-Liner
Case from Kashlak
Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin
Causes of hypercalcemia
How Lithium works!
Testing for Hypercalcemia: Get that PTH, and that phos
Symptoms of Hypercalcemia, and Questions on History
Indications for Surgery for Parathyroidectomy
Management of Hypercalcemia and Hypercalcemic Emergency
Outro

Credits

Producer, Writer, Infographic, Cover Art: Nora Taranto MD
Hosts: Matthew Watto MD, FACP; Nora Taranto MD
Reviewer: Yan Emily Yuan MD, MSc
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Carl Pallais MD, MPH

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected]
Sponsor - Glass Health
Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.

Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context. You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.

Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI. You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS.

Glass, like a clinical reference text or podcast, should never replace clinician judgment.

Sponsor - PatternAt Pattern, we give you a quick, simple way to compare and buy disability insurance. Busy doctors shouldn't have to worry about whether or not they are getting the best rates and discounts. Trying to research all your options and make the right decision while in training can make the process even more overwhelming. That’s why thousands of doctors trust Pattern to help them compare and understand the disability insurance they are buying.

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REBOOT #250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf

11 december 2023 | 77 min

#419 Rapid Response Series: Sepsis with Dr. Mohleen Kang A shock to the system

4 december 2023 | 79 min

#418 DIGEST (Tofurkey Edition): Semaglutide for HFpEF, TCAs for IBS, Aspirin vs Clopidogrel after PCI, Pitavastatin for HIV, Starchy Vegetables & Weight Gain, Heavy Metals in Cannabis

27 november 2023 | 63 min

#417 USPSTF Update: PrEP for HIV Prevention with Dr. John Wong MD

22 november 2023 | 42 min

#416: Antifungals, Candida, Mucorales, Aspergillus, Pneumocystis: The Fungus Among Us with Dr. Ilan Schwartz MD

20 november 2023 | 73 min

#415 Bipolar Disorder With Dr. Kevin Johns

13 november 2023 | 78 min

REBOOT #300 Celiac Disease with Dr. Amy Oxentenko

6 november 2023 | 74 min

#414 Spooky Cakes: VKA vs DOACs in Frail Adults, RSV Vaccine, Cuff Size Matters, Bloating & Belching, AKI & Pip-Tazo

30 oktober 2023 | 58 min

#413: Common Ear Complaints, Ear Exam 101, Cerumen Remedies, and more! Get an EARful with Dr. Angela Peng!

23 oktober 2023 | 77 min

#24 Treating OUD in the Fentanyl Era: ASAM Treatment Week with Dr. Melissa Weimer

17 oktober 2023 | 55 min

#412 Low Carb, Keto, Fasting: Lifestyle Interventions for Weight Management

16 oktober 2023 | 79 min

#411 Adrenal Insufficiency with Dr. Atil Kargi

9 oktober 2023 | 89 min

#410 Diabetic Foot Infections

2 oktober 2023 | 82 min

#409 Hormonal and Nonhormonal Therapy for Vasomotor Symptoms of Menopause

25 september 2023 | 79 min

#408 COPD in Older Adults with Leah Witt, MD & Amber Lanae Martirosov, PharmD

18 september 2023 | 76 min

#407 DIGEST: Bempedoic acid and cardiac risk, Alpha-Gal Syndrome, Orforglipron, Zuranolone, DOACs for VTE of Malignancy, mAbs for Dementia, New Med for Smoking Cessation, Kiwis and Constipation

11 september 2023 | 66 min

REBOOT #293 The Best of Liver Tests with Dr. Elliot Tapper

4 september 2023 | 66 min

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!

Free CME for this episode at curbsiders.vcuhealth.org

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Credits

Written and Produced by: Elena Gibson MD
Cover Art and Infographic: Kate Grant MD; Elena Gibson MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Elliot Tapper MD

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Sponsor: Birch
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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Definitions of liver enzymes, liver function tests
Patterns of acute liver injury
Drug-induced liver injury
Isolated alkaline phosphatase elevation
Isolated total bilirubin elevation
Livery Injury During Pregnancy
Acute liver failure
Outro

REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen

28 augusti 2023 | 80 min

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.

Free CME for this episode at curbsiders.vcuhealth.org

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Credits

Writer: Matthew Watto, MD, FACP
Producers: Matthew Watto, MD, FACP and Malini Gandhi
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Jordy Cohen MD

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak: New diagnosis of hypertension
How to make a diagnosis of hypertension
When to start anti-hypertensive medication
Initial blood pressure regimen
Case from Kashlak: White coat hypertension
Case from Kashlak: Hypertension in chronic kidney disease
ACEis and ARBs in chronic kidney disease
Diuretics in chronic kidney disease
Case from Kashlak: Refractory hypertension
History and initial workup for refractory hypertension
Treatment of primary hyperaldosteronism
Outro

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REBOOT #324: Obesity Medicine FAQ with Dr. Fatima Cody Stanford

21 augusti 2023 | 53 min

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Not only that, we’ve been thinking about obesity the wrong way for decades. Join us with Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital as we reframe our approach to this disease and learn tips on prescribing older, but still very effective, medications used to treat obesity.

Free CME for this episode at curbsiders.vcuhealth.org

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Credits

Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C
Show Notes, Infographics: Maddison McLellan
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Monee Amin, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Fatima Cody Stanford, MD

Sponsor: Locumstory

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CME Partner: VCU Health CEThe 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.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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner by Dr. Fatima Cody Stanford
Case from Kashlak
Guidelines for treatment
Getting the history and discussing weight goals
The Care Team: Dietician, Behavioral Specialist, Provider
Medications: Phentermine, Topiramate, Bupropion, Naltrexone
Obesity treatment in pregnancy
Referring to bariatric surgery
Take home points
Outro

REBOOT #316 Lower Extremity Edema with The Curbsiders

14 augusti 2023 | 62 min

REBOOT: #372 Endocrine Emergencies featuring Dr. Sara Markley Webster

7 augusti 2023 | 84 min

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm.

Free CME for this episode at curbsiders.vcuhealth.org

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!

Credits

● Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD
● Show Notes, Infographic and Cover Art: Caroline Coleman, MD
● Reviewer: Emi Okamoto, MD
● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Technical Production: PodPaste
● Guest: Sara Markley Webster, MD

Sponsor: Grammarly

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Sponsor: Locumstory

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Sponsor: Birch Living

Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you use code BIRCHPARTNER20!

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.

Show Segments

● Intro, disclaimer, guest bio
● Guest one-liner, Picks of the Week*
● Case 1 from Kashlak
● Adrenal crisis identification, workup and management
● Case 2 from Kashlak
● Myxedema identification, workup and management
● Case 3 from Kashlak
● Thyroid storm identification, workup and management
● Outro

Full transcript available HERE

#406 Kneedful Things: Knee Pain 201 with Dr. Ted Parks

31 juli 2023 | 67 min

#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips

24 juli 2023 | 58 min

#404 Hematuria with Dr. Derek Fine

17 juli 2023 | 53 min

#403 Hotcakes: Ketamine, Kratom, Nonhormone therapy for menopause, Metformin for long COVID, and New Breast Cancer Screening Recs

10 juli 2023 | 55 min

Addiction Medicine #12 - Listener Q & A on Substance Use Disorders

6 juli 2023 | 64 min

#402 Don’t Get Caught with a CAUTI

3 juli 2023 | 60 min

#401 Updates in Addiction Medicine - SGIM 2023

26 juni 2023 | 62 min

#400 Antiplatelets, Anticoagulation for Coronary Artery Disease and Afib

19 juni 2023 | 59 min

#399 Wisely Ordering Autoantibodies - ACP IM2023

12 juni 2023 | 57 min

# 398:Live! From SHM: Inpatient Cirrhosis Management

5 juni 2023 | 52 min

#397: Insulin, Type 2 Diabetes, Fanny Packs, and Hypoglycemia with Dr. Jeff Colburn

29 maj 2023 | 72 min

#396 Recap, Top Pearls from #SGIM23

22 maj 2023 | 78 min

#395 Dysphagia with Dr. Diana Snyder

15 maj 2023 | 55 min

#394 Recap, Top Pearls from ACP #IM2023

8 maj 2023 | 100 min

#393 Live from SHM: Clinical Updates in Hospital Medicine

1 maj 2023 | 56 min

#392 Live! Opioid and Xylazine Withdrawal in the Hospital

26 april 2023 | 45 min

#391 Hypercoagulable Work-Up with Dr. Jean Connors

24 april 2023 | 77 min

#390 Resistant Hypertension

17 april 2023 | 78 min

#389 Recap: SHM 2023 #Converge

10 april 2023 | 68 min

#388 HIV in Primary Care with Dr. Jonathan J. “JJ” Nunez MD

3 april 2023 | 55 min

#387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules

27 mars 2023 | 61 min

#386 Primary Aldosteronism, MRAs, and Renovascular Hypertension: NephMadness Pod Crawl 2023

20 mars 2023 | 71 min

#385 TIA/Stroke for the Hospitalist featuring Dr. Karima Benameur

13 mars 2023 | 66 min

#384 Updates in Chronic Kidney Disease with Dr. Joel Topf

6 mars 2023 | 75 min

#383 Hotcakes: Loop Diuretics for CHF, Time Restricted Eating, Breaks from Sitting, Early FMT for C. diff

27 februari 2023 | 40 min

#382 Abnormal Uterine Bleeding

20 februari 2023 | 57 min

#381 LIVE! Patient Centered Things We Do For No ReasonTM

13 februari 2023 | 36 min

#380 Hemochromatosis with Elliot Tapper

6 februari 2023 | 59 min

#379 Hearing Loss, Tinnitus, and Meniere's Disease

30 januari 2023 | 87 min

#378 Acute Exacerbations of COPD (AECOPD)

23 januari 2023 | 76 min

#377 Adrenal Incidentalomas, Primary Aldosteronism with Dr. William Young

16 januari 2023 | 61 min

#376 Hormone Therapy for Primary Prevention of Chronic Conditions in Postmenopausal Persons - a USPSTF update with Dr. Carol Mangione

11 januari 2023 | 27 min

#375 Delirium in the Hospital featuring Dr. Esther Oh

9 januari 2023 | 75 min

#374 ADHD with Dr. Kevin Simon

2 januari 2023 | 63 min

#373 Recap Extravaganza 2022

26 december 2022 | 64 min

#372 Endocrine Emergencies featuring Dr. Sara Markley Webster

19 december 2022 | 81 min

#371 Prostate Cancer: Screening, Advanced Testing, and Survivorship

12 december 2022 | 63 min

#370 Parkinson’s Disease for Primary Care with Dr. Albert Hung

5 december 2022 | 77 min

#369 Hand, Foot, Wrist and Ankle Pain, Myositis and Myopathy: A Rapid Review (TFTC)

30 november 2022 | 33 min

#368 Back Pain Update with Dr. Austin Baraki

28 november 2022 | 86 min

#367 Weekend Warriors, Fluids for Acute Pancreatitis, Colonoscopy Screening & Mortality, and SPRINT trial Revisited (Hotcakes)

21 november 2022 | 47 min

#366 Opioid Use Disorder and Acute Pain in the Hospitalized Patient

14 november 2022 | 63 min

#365: Perioperative Medicine with Anesthesiologist Dr. Angela Selzer

7 november 2022 | 63 min

#364 Screening for syphilis: A USPSTF Update with Dr. Katrina Donahue

2 november 2022 | 18 min

#363 Afib: Rhythm Control, Catheter Ablation, Afib in the hospital, and Left Atrial Appendage Closure

31 oktober 2022 | 53 min

#362 Migraine Headaches, Acute Hypoxemia: A rapid review (TFTC)

26 oktober 2022 | 40 min

#361 Advanced Lipidology

24 oktober 2022 | 78 min

#360 Disease-Modifying Nutrition with Dr. Michelle McMacken

17 oktober 2022 | 71 min

#359 Monkeypox with Dr. Boghuma Titanji

10 oktober 2022 | 80 min

#358 Oncologic Emergencies with Dr. Aditi Singh

3 oktober 2022 | 84 min

#357 Hotcakes: Ultra-short Antibiotics for Pneumonia, Acetazolamide for CHF, Psilocybin for AUD, and Asymptomatic Kidney Stone Removal

28 september 2022 | 41 min

#356 Chronic Obstructive Pulmonary Disease (COPD) Update with Dr. Antonio Anzueto

26 september 2022 | 79 min

#355 GI Bleed with Dr. Tanvi Dhere

19 september 2022 | 68 min

#354 Curbsiders Women in Medicine: Top 5 Challenges Faced by Women of Color in Academic Medicine

14 september 2022 | 72 min

#353 Colon Polyps

12 september 2022 | 56 min

REBOOT #49 Vertigo and Dizziness: How to Treat, Who to Send Home, and Who Might Have a Stroke

5 september 2022 | 76 min

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.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!

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

Sponsor: Better Help

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Sponsor: Panacea Financial

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Sponsor: Indeed

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#352 H. pylori and Obesity Medicine FAQ: A rapid review (TFTC)

31 augusti 2022 | 35 min

REBOOT #284 An Antibiotics Primer, with @IDdocAdi

28 augusti 2022 | 58 min

#351 Live! Foot and Ankle Pain with Dr. Joan Ritter

22 augusti 2022 | 67 min

#350 Rapid Response Series: Acute Hypoxemia

15 augusti 2022 | 74 min

#349 Hotcakes: Tirzepatide for weight loss, Personalized Antidepressants, Seasonal Edema, Nirmatrelvir for low-risk COVID-19

8 augusti 2022 | 50 min

#348 Myositis and Myopathy, LIVE!

1 augusti 2022 | 62 min

#347 USPSTF Update: Aspirin for Primary Prevention of CVD

27 juli 2022 | 34 min

#346 Meningitis

25 juli 2022 | 59 min

#345 Vitamin and Mineral supplementation: A USPSTF Update with Dr. Michael Barry

20 juli 2022 | 21 min

REBOOT #191 Lipids and Cardiovascular Risk Reduction with Erin Michos MD

18 juli 2022 | 75 min

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!

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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#344 Multiple Sclerosis with Dr. Annette Okai

11 juli 2022 | 84 min

Addiction Medicine Series #1 Methadone for OUD w/Dr. Ruth Potee

7 juli 2022 | 52 min

REBOOT #25 Master Hyperglycemia and DKA

4 juli 2022 | 50 min

#343 Hypertension FAQ and Cardiorenal: A rapid review (TFTC)

29 juni 2022 | 43 min

#342 Checkpoint Inhibitors: The power, and adverse effects, of immunotherapy (ACP 2022)

27 juni 2022 | 55 min

#341: Headache Update: Making Migraines Less Painful with Dr. Kevin Weber

20 juni 2022 | 75 min

#340 Gallbladder Disease

13 juni 2022 | 44 min

#339 Hand and Wrist Pain with Dr. Ted Parks

6 juni 2022 | 48 min

#338 LIVE! Medical Cannabis: Is it still dope?

30 maj 2022 | 53 min

#337 Palpitations, Erectile Dysfunction: A rapid review (TFTC)

25 maj 2022 | 29 min

#336 Updates in Addiction Medicine: Live from SGIM

23 maj 2022 | 48 min

#335 Generalized Anxiety Disorder

16 maj 2022 | 55 min

#334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI)

9 maj 2022 | 99 min

Learn diagnostic and therapeutic management strategies for IBS, functional dyspepsia, and cyclic vomiting (aka disorders of gut brain interaction (DGBI))! It's like three episodes in one as we run through how to individualize evaluation and management for patients with functional dyspepsia, IBS, and cyclic vomiting. Topics: scripts for counseling patients, the pathophysiology of DGBI, which diagnostic tests are necessary, pharmacologic and nonpharmacologic options, and even hypnotherapy?! We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic)

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

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions (6:20)
Definition of Disorders of the Gut-Brain Interaction (7:30-11:00)
Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments (24:30-36:00)
Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00)
Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11)
Take home points
Outro

Credits

Producer: Elena Gibson MD
Writer:Andréa Perdigão, Elena Gibson
Show Notes and Infographics: Andréa Perdigão
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Dr. Xiao Jing (Iris) Wang MD

Sponsor: Ten Thousand

Go to tenthousand.cc/curb to receive 10% off.

Sponsor: Pattern

Visit patternlife.com/curbsiders to request a disability insurance quote.

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.

#333 Prescribing pearls, Periop Medicine, PMR, Gout, OSA, Nocturia, Food as Medicine, a new Obesity paradigm, and rethinking Afib! ACP #IM2022 Highlights

6 maj 2022 | 62 min

#332 Inpatient Covid Management with Dr. Nathan Erdmann

2 maj 2022 | 62 min

#331 Inpatient Diabetes Part 2: DKA, insulin drips, insulin pumps, and CGMs

27 april 2022 | 61 min

#330 Inpatient Diabetes Part 1: Insulin regimens, oral hypoglycemics, corrections scales and more!

25 april 2022 | 80 min

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 (check out this Twitter thread on safe dosing), and how to reconcile diabetes meds at discharge!

Stay tuned for part 2 (drops Wed April 27th) covering 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.

Intro #1, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Inpatient diabetes - a bird’s eye view and the goal(s) of therapy
Management of outpatient diabetes medications
Inpatient insulin - options and dosing
Correctional insulin (“sliding scale”)
A word on the “Diabetic Diet”
Steroids and hyperglycemia
Discharge pearls for the patient with diabetes
Outro #1

Credits

Producer: Adam Barelski MD, Cyrus Askin MD
Writer: Adam Barelski MD
Show Notes: Cyrus Askin MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Adam Barelski MD
Technical Production: Pod Paste
Showrunner: Matthew Watto MD, FACP
Content Editor: Emi Okamoto MD
Guest & Content Reviewer: David Lieb MD, FACE, FACP

Sponsor: Bambee

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Sponsor: Grammarly

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CME Partner: VCU Health CE
The Curbsiders partner 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.

#329 Curing Hepatitis C: A Primary Care Primer

18 april 2022 | 77 min

#328 Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more! Highlights from #SGIM22

15 april 2022 | 80 min

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!

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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#SGIM22 Recap is on it's way! - Teaser Trailer

11 april 2022 | 1 min

#327 Acute Pancreatitis

4 april 2022 | 59 min

REBOOT #151 Anaphylaxis

30 mars 2022 | 41 min

REBOOT #145 Hepatorenal Syndrome

28 mars 2022 | 69 min

REBOOT #146 Pain Meds in CKD

21 mars 2022 | 67 min

#326 Cardiorenal Syndrome, Biomarkers, Diuretic Resistance (NephMadness 2022)

14 mars 2022 | 57 min

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.

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

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Sponsor: Masterworks

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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.

#325 Hotcakes: Fluid Wars revisited, Sleep & Weight Loss, Vitamin D, Pneumonia and HBV Vaccine Updates

7 mars 2022 | 46 min

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!

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

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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.

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

NephMadness 2022 Pod Crawl is coming!

5 mars 2022 | 2 min

#324 Obesity Medicine FAQ

28 februari 2022 | 55 min

Learn how to prescribe affordable, effective medications for obesity medicine! We discuss metformin, naltrexone, bupropion, phentermine, topiramate, GLP1 agonists, and how to counsel patients about the available weight loss modalities. Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital helps reframe our approach as she walks through these Obesity Medicine FAQs. Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long!

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

Credits

Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C
Show Notes, Infographics: Maddison McLellan
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Monee Amin, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Fatima Cody Stanford, MD

Sponsor: ACP

Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount: use code IM22CURB. Visit annualmeeting.acponline.org to learn more.

Sponsor: Grammarly

Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB

Sponsor: MedMastery

Listers are eligible for a lifetime 15% off discount on subscription if you go to https://www.medmastery.com/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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner by Dr. Fatima Cody Stanford
Case from Kashlak
Guidelines for treatment
Getting the history and discussing weight goals
The Care Team: Dietician, Behavioral Specialist, Provider
Medications: Phentermine, Topiramate, Bupropion, Naltrexone
Obesity treatment in pregnancy
Referring to bariatric surgery
Take home points
Outro

#323 Pelvic Pain, Constipation, Long COVID (TFTC)

23 februari 2022 | 39 min

#322 H. Pylori Infection

21 februari 2022 | 58 min

Say hi and bye to H. pylori infections! We review the basics of H. pylori screening, refresh your memory on testing basics, discuss treatment strategies, and talk through eradication testing with gastroenterologist Dr. George Saffouri (@gbsaff).

A special thanks to our listener Ana Maria Keilhauer Varona (@KeilhauerMa) of @UFMedu who pitched this episode. Her hard work formed the basis for our script!

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

Credits

Pitch Writer and Initial Script: Ana Maria Keilhauer Varona
Producer, Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli
Script Co-Writer: Elena Gibson, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: George Saffouri, MD

Sponsor: Panacea Financial

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Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

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: 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, disclaimer, pitch contest winner, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Conceptualizing gastritis vs. dyspepsia
When to screen for h.pylori
Gastric cancer and h.pylori infection
Cultural competency in screening
Other indications for h.pylori testing, ITP and h.pylori
How to test
Treatment modalities
Eradication testing, persistent infection

#321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen

14 februari 2022 | 83 min

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.

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

Credits

Writer: Matthew Watto, MD, FACP
Producers: Matthew Watto, MD, FACP and Malini Gandhi
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Jordy Cohen MD

Sponsor: Provider Solutions & Development

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Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Just go to Stamps.com, click the microphone at the top of the page, and enter code CURB.

Sponsor: SquareSpace

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Sponsor: Green Chef

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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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak: New diagnosis of hypertension
How to make a diagnosis of hypertension
When to start anti-hypertensive medication
Initial blood pressure regimen
Case from Kashlak: White coat hypertension
Case from Kashlak: Hypertension in chronic kidney disease
ACEis and ARBs in chronic kidney disease
Diuretics in chronic kidney disease
Case from Kashlak: Refractory hypertension
History and initial workup for refractory hypertension
Treatment of primary hyperaldosteronism
Outro

#320 Palpitations with Dr. Joshua Cooper

7 februari 2022 | 96 min

When should you fold or Holt onto your cards for palpitations? Learn about properly characterizing a patient’s palpitations, red flag symptoms, when to grab an echocardiogram and/or heart monitoring, and when certain “benign” ECG findings can be concerning. We’re joined by the director of cardiac electrophysiology at Temple University Hospital, Dr. Joshua Cooper (@narrowQRS) for this episode chock full of cardiac pearls to make your heart skip a beat.

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

Credits

Producer, Show Notes, Infographic, and Cover Art: Edison Jyang
Producer: Paul Williams MD, FACP
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: Joshua Cooper MD

Sponsor: BetterHelp

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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: Imperfect Foods

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Sponsor: Indeed

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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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Defining what the patient means by palpitations
Common causes and misdiagnoses
Red flag symptoms
Exposures and medications to consider
Sinus tachycardia
Workup for palpitations
Monitors
Script for a negative workup
Premature ventricular contractions
Outro

#319 Hotcakes: Afib, Chlorthalidone in CKD, Outpatient COVID Treatment Update

31 januari 2022 | 45 min

#318 LUTS, BPH, and Urinary Incontinence Triple Distilled

26 januari 2022 | 46 min

#317 Erectile Dysfunction for Primary Care

24 januari 2022 | 74 min

Listen as our expert guest Dr. Ashley Winter @AshleyGWinter (Northwest Kaiser Permanente, Portland, OR) helps us explore the spectrum of erectile dysfunction management for the internist and primary care clinician. This episode will empower you to provide evidence based, patient-centered care to erectile dysfunction while maintaining an astute and holistic diagnostic approach. We also explore treatment and patient counseling techniques.

Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/

Credits

Written and Produced by: Hannah R. Abrams, MD
Infographic and Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Show Notes: Hannah R. Abrams, MD; Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Hannah R. Abrams, MD
Reviewer: Molly Heublein, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Ashley Winter, MD

Sponsor: Masterworks

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a website or domain!

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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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Defining ED
Additional history, exam, and labs
How to talk about ED
Addressing ED for transgender and nonbinary patients
Treatment of ED
Advanced therapies and referral
Take Home Points; Outro; Bonus clip

#316 Lower Extremity Edema with The Curbsiders

17 januari 2022 | 67 min

We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.

Credits

Written and produced by: Paul Williams, MD, FACP
Infographic and Cover Art: Matthew Watto, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto, MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Stamps.com

Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts.

Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: Imperfect Foods

Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.

Sponsor: ACP

Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer
Picks of the Week*
The case of Lynn Fedema
Pathophysiology of edema
Differential diagnosis of chronic edema
Chronic edema work-up
Management of chronic edema
Calvin Fedema and acute edema
Evaluation of acute edema
Outro

#315 Long COVID

10 januari 2022 | 75 min

Explore the actively evolving clinical landscape of Long COVID as we discuss epidemiology, pathogenesis, manifestations, and patient-centered management options including the role of a dedicated Long COVID clinic.

Listen as our expert guest Dr. Monica Verduzco-Gutierrez @MVGutierrezMD (Long School of Medicine at UT Health, San Antonio) helps us navigate this rapidly emerging syndrome. This episode will empower you to provide evidence based, patient-centered care for this challenging facet of the ongoing COVID-19 pandemic. We explore the manifestations including fatigue, dyspnea, psychiatric symptoms, and other neurologic effects. We also examine the emergence of dedicated Long COVID clinics and the imperative of interdisciplinary care.

Update: The original version of this episode contained a brief, but incorrect characterization of mast cell disorders that was subsequently removed after feedback from our allergy/immunology colleagues. We apologize for this inconvenience and thank our colleagues for their peer review.

Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/

Credits

Written and Produced by: Avital O’Glasser MD, FACP, SFHM
Infographic: Edison Jyang
Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Show Notes: Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, SFHM
Reviewer: Hannah Abrams, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Monica Verduzco-Gutierrez, MD

Sponsor: Blueland

Right now, you can get 20% off your first order when you go to Blueland.com/CURB

Sponsor: ACP

Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case 1 from Kashlak
Definition of Long COVID or post-COVID symptoms
Pathogenesis of Long COVID
Illness script for mast cell activation
Epidemiology and risk factors for Long COVID
Interdisciplinary care for Long COVID
Illness script for POTS-like phenotype in Long COVID
Illness script for chronic fatigue syndrome/myalgic encephalomyelitis in Long COVID
Management of fatigue and post-exertional malaise (PEM)
Case 2 from Kashlak
Neuropsychiatric manifestations of Long COVID
Anosmia and smell training
Role of the patient voice and community in Long COVID
Disability assessments and management
Take Home Points; Outro; Bonus clip

#314 Constipation: When the Flow Won’t Go with Dr. Iris Wang

3 januari 2022 | 70 min

#313 Recap Extravaganza 2021

30 december 2021 | 58 min

#312 Infective Endocarditis

27 december 2021 | 82 min

Master endocarditis! Don’t feel thwarted by a positive set of blood cultures. We’re joined by Dr. David Serota (@serotavirus) for a comprehensive discussion of the pathophysiology of infective endocarditis, frameworks for work-up and diagnosis, the TTE vs. TEE debate, indications for valve surgery, antibiotic tips, harm reduction strategies, and more!

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

Credits

Writer and Producer: Adam Barelski MD
Show Notes: Beth Garbitelli; Adam Barelski MD
Infographic: Adam Barelski MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Adam Barelski MD
Reviewer: Meredith Trubitt, MD
Executive Producer, Cover Art: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: David Serota MD

Sponsor: Imperfect Foods

Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.

Sponsor: Southern California Permanente Medical Group

Want to make a difference in a community that appreciates your passion and expertise? Then join SCPMG as an Outpatient Internal Medicine Physician. Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684.

Sponsor: P3

P3 is a revenue cycle management provider that takes over your workload for claim submissions, and denial management. P3 is offering a 10% discount on all invoices for a limited time period. Visit www.p3care.com/curb and avail your offer today!

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, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
What to do with positive blood cultures
Initial workup for endocarditis
How to diagnose endocarditis
When to get a TTE and a TEE
Indications for valve surgery
Antibiotic tips
Oral vs IV antibiotics
Treatment considerations for patients who inject drugs
Take-home points
Outro

#311 Chronic Pelvic Pain

20 december 2021 | 65 min

Pelvic pain is not just a gyn issue! As a PCP, you can feel confident doing an initial workup and starting treatment for pelvic pain. Dr. Lamvu shares a great framework to narrow down your diagnosis and provides amazing resources for those who work in an under-resourced center. We’ll walk you through what to focus on in the history, a trauma-informed physical exam, and the first-line treatments. Feel confident with your ability to help your chronic pelvic pain patients.

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

Credits

Writers/Producer: Molly Heublein, MD
Infographic: Edison Jyang
Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Hosts: Beth Garbitelli, Molly Heublein, MD
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Georgine Lamvu, MD MPH

Sponsor: BetterHelp

Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: Locumstory

Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine. Locumstory is your source for all things locum tenens! Check out their website, locumstory.com, for resources, FAQs, and more!

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, disclaimer, guest bio
Guest introduction and recommendations
Picks of the Week
Case from Kashlak
Persistent Pelvic Pain Definitions
Differential diagnosis/organ system approach
History
Physical Exam
Trauma informed Care
First line Treatments
Resources for patient education and to build speciality team
Summary and take home points
Outro

Optimize your Feedback Conversations (TEACH ep. 1)

16 december 2021 | 86 min

#310 No Tension About Inpatient Hypertension

13 december 2021 | 62 min

Don’t sweat inpatient hypertension any longer. Who needs guidelines when Dr. Noble Maleque (@nobility75, Emory University, Division of Hospital Medicine) explains the spectrum of hypertensive disorders in the inpatient setting, and an approach for thinking about treatment.

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

Credits

Production, Script, Infographic, and Cover Art: Monee Amin, MD, Meredith Trubitt, MD MPH
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Monee Amin, MD, Meredith Trubitt, MD MPH
Reviewer: Adam Barelski MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Noble Maleque MD

Sponsor: Panacea Financial

Join the growing number of doctors nationwide that expect more from their bank and

have switched to Panacea Financial. Visit panaceafinancial.com today for information on

their student loan refinance loans and to learn about their “refer a friend” program.

Panacea Financial is a division of Primis, Member FDIC

Sponsor: Ten Thousand

Ten Thousand is offering our listeners 15% off your purchase! Go to tenthousand.cc and enter code CURB to receive 15% off your purchase!.

Sponsor: Locumstory

Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine. Locumstory is your source for all things locum tenens! Check out their website, locumstory.com, for resources, FAQs, and more!

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, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Definitions
Case from Kashlak
Elevated blood pressure / hypertensive urgency
Contributing factors to elevated blood pressure in the hospital
Hypertensive urgency—to treat or not to treat
Transitions of care and case against intensification of treatment
Case from Kashlak
Hypertensive emergency diagnosis and treatment
Secondary Hypertension
Outro

Curbsiders TEACH is Coming Soon!

7 december 2021 | 3 min

#309 Prediabetes & Type 2 Diabetes Screening: A USPSTF Quick Update

6 december 2021 | 42 min

#308 Metabolic Alkalosis and Hypokalemia: Kidney Boy Returns!

29 november 2021 | 69 min

@Kidney_Boy returns to school us on metabolic alkalosis and hypokalemia! What do diuretics, hyperaldosteronism, black licorice, and milk-alkali have in common? Our Chief of Nephrology, Dr. Joel Topf, talks through the pathophysiology of metabolic alkalosis, the utility of urine chloride and pH measurements, why normal saline is sometimes better than balanced solutions, when to reach for acetazolamide, and more! Urine for a good time ; )

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

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes, CME, Infographic and Cover Art by: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Joel Topf MD

Sponsor: ACP
Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

Sponsor: Grammarly

Take the stress out of getting the words right with Grammarly.

Our listeners get 20% off Grammarly Premium at grammarly.com/CURB

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, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Case of Al Kaline - metabolic alkalosis from vomiting
Pathophysiology of metabolic alkalosis
Case of Mike Arbonate - hypokalemic, metabolic alkalosis from aggressive IV diuresis and therapies to mitigate
Case of Fracture Franny - milk-alkali syndrome
Case of Hyper Al - metabolic alkalosis from excess mineralocorticoid receptor activation
Outro

#307 Spooky Tofurkey Cakes: SGLT2 for HFpEF, Diverticulitis, VTE update, Rotator Cuff Disease

24 november 2021 | 52 min

#306 Bronchiectasis and NTM: You can’t get enough sputum!

22 november 2021 | 79 min

Take a deep breath and inhale high-yield knowledge molecules about the perplexing conditions known as bronchiectasis and NTM (nontuberculous mycobacteria)! Learn the pitfalls and pearls of diagnosis and management from one of the world’s experts, the great Dr. PJ McShane from UT Health - East Texas!

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

Credits

Writers/Producers: Cyrus Askin MD; Leah Witt MD
Infographic & Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
Reviewer: PJ McShane MD
Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com
Guest: PJ McShane MD

Sponsor: Ten Thousand.
Ten Thousand is offering our listeners 15% off your next purchase! Go to https://www.tenthousand.cc and enter code: CURB to receive 15% off your purchase at checkout!

Sponsor: The American College of Physicians

Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

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, disclaimer, guest bio
Guest introduction and recommendations
Case from Kashlak - Part I: The Basics
- What is bronchiectasis, how do we define it?
- Symptoms and history
- Why does it matter?
- What should you ask, how do you work this up?
- A brief discussion on antibiotics
Case from Kashlak - Part II: Getting into the Management
- Airway Clearance
Case from Kashlak - Part III: The Sputum (Plot) Thickens
- What is a bronchiectasis exacerbation?
- Pitfall and pearls regarding exacerbation management
Case from Kashlak - Part IV: The Sputum (Plot) Thickens Even Further!
- Non-tuberculous Mycobacterial Infections - the basics
- Triple Drug Therapy for MAC
- The new kid on the block: Liposomal Inhaled Amikacin for refractory MAC
Summary and take home points from Dr. McShane
Outro

#305 OB for the Internist: What to Expect

15 november 2021 | 62 min

#304 COVID Updates: The Outpatient Edition

8 november 2021 | 49 min

#303 Women in Medicine: Wellness & Workarounds

1 november 2021 | 50 min

Explore burnout and gender-based differences in well-being with our esteemed guests Drs. Clif Knight, Tammy Lin, and Kim Templeton. We discuss workarounds for leading our way to wellness.

Dr. Clif Knight is a family physician and Senior Vice President for Education at the American Academy of Family Physicians (AAFP) with extensive leadership and expertise in well-being.

Dr. Tammy Lin is an internal medicine specialist and a Voluntary Assistant Clinical Professor at the University of California, San Diego Health Sciences. We originally met her as a member of the Wellness through Equity and Leadership (WEL) Program and she started a podcast called "The DEI Shift" (pronounced The "Day" Shift), which focuses on diversity, equity, and inclusion within the medical field. Dr. Knight and Dr. Lin participated in the 2019-2020 WEL program-- six different specialty organizations came together to think about the core tenets of equity, well-being and leadership and how you really can’t have one without the other.

Dr. Kim Templeton is Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City. Her research focuses on women physicians and the inclusion of sex and gender medicine in medical education.

No CME for this episode, but claim CME for past episodes at curbsiders.vcuhealth.org!

Credits

Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD
Infographic: Leah Witt, MD
Cover Art: Kate Grant MBChB MRCGP DipGUMed
Hosts: Matthew Watto MD, FACP; Leah Witt, MD, Shreya Trivedi, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Clif Knight, MD, Tammy Lin, MD, Kim Templeton, MD

Sponsor: Grammarly

Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB

Sponsor: The American College of Physicians

Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

Sponsor: Panacea Financial

Learn about their $1,000 giveaway at panaceafinancial.com/curb. Panacea Financial is a division of Primis member FDIC.

Sponsor: Provider Solutions & Development

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bios
Burnout & Wellness
The Case: Dr. Elizabeth Blackwell & her friend in primary care
The Part-Time Discussion
Outro

#302 LFTs Triple Distilled

27 oktober 2021 | 36 min

#301 LIVE! Top Pearls 2021: A Rapid Fire Review of Systems

25 oktober 2021 | 75 min

#300 Celiac Disease with Dr. Amy Oxentenko

18 oktober 2021 | 72 min

#299 Acute Pain Management for the Hospitalist

11 oktober 2021 | 68 min

#298 Urinary Stone Disease Will Rock Your World

4 oktober 2021 | 68 min

#297 CRC Screening, Common Skin Complaints, and Antibiotic Pearls (TFTC #8)

29 september 2021 | 38 min

#296 Diabetes FAQ with Dr. Jeff Colburn

27 september 2021 | 66 min

#295 Advance Your Care Planning with Dr. Rebecca Sudore

20 september 2021 | 61 min

#294 Pulmonary Hypertension Update

13 september 2021 | 59 min

#293 The Best of Liver Tests with Dr. Elliot Tapper

6 september 2021 | 65 min

#292 Acute Heart Failure, CHF Triple Distilled

1 september 2021 | 31 min

REBOOT #230 Kittleson Rules Heart Failure

30 augusti 2021 | 75 min

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea? Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement. Enjoy this Curbsiders classic and stay tuned this Wednesday, September 1, 2021 for a brand new CHF Triple Distilled episode.

Credits

Written and Produced by: Deborah Gorth ScM
Cover Art and Infographic by: Edison Jyang
Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Michelle Kittleson MD, PhD

Sponsor: Ten Thousand tenthousand.cc

Head to tenthousand.cc and enter our code CURB at checkout to save 15%.

Sponsor: BetterHelp betterhelp.com/curb

Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb

Time Stamps*

Time Stamps refer to ad-free version

00:00 Intro, disclaimer, guest bio
02:40 Guest one-liner; Picks of the Week
08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic)
13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction?
20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?!
28:36 Labs to trend during an ADHF admission
33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes
45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2?
49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB)
56:05 Who needs a right heart cath?
59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care
64:04 SGLT2i in heart failure 
68:15 Take home points and outro

#291 CBC Abnormalities Triple Distilled

25 augusti 2021 | 30 min

Reboot #167 LIVE! CBC Abnormalities

23 augusti 2021 | 53 min

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 25, 2021 for a brand new CBC Abnormalities Triple Distilled episode.

Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia.

Credits

Written, Produced and Edited by: Matthew Watto MD, FACP
Cover Art and Infographic by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Guest: Mary Kwok MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB.

Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: Birch by Helix birchliving.com/curb

Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

Time Stamps*

Time Stamps refer to ad-free version

00:00 Intro; Paul shame’s the audience; Guest bio
03:17 Guest one-liner, book recommendation* –Emperor of All Maladies (book) by Siddhartha Mukherjee, When Breath Becomes Air (book) by Paul Kalanithi; Career advice -set goals for whatever you’re learning.
08:43 Picks of the week: John Wick 3 (film); The Movies That Made Me (podcast) by Joe Dante; The Tim Ferriss Podcast with Julie Rice of Soul Cycle; Infinity Chamber (film) by Travis Milloy
11:50 A case of asymptomatic leukocytosis; Red flags; Repeat the CBC until it’s normal
17:30 The peripheral smear; Leukemoid reaction
20:00 The physical exam; When to send flow cytometry?
22:18 A case of lymphopenia; benign ethnic neutropenia; What to look for in the history
27:10 A case of erythrocytosis; Checking EPO levels; JAK2 mutation; Differential Diagnosis; Therapeutic Phlebotomy; Physical findings of Polycythemia Vera
36:53 A case of thrombocytopenia; Lab workup; Differential diagnosis; Pathophysiology; Culprit meds
45:35 Advice for internists
46:36 Take Home Points
47:46 Dr. Kwok’s disclaimer
48:10 Outro and post credit scene

#290 Stroke and TIA Triple Distilled

18 augusti 2021 | 24 min

Reboot #164 Stroke and TIA Deconstructed

16 augusti 2021 | 78 min

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 18, 2021 for a brand new Stroke and TIA Triple Distilled episode.

Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences. Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders

Credits

Producers: Molly Heublein MD; Matthew Watto MD, FACP
Writer (including CME questions): Molly Heublein MD
Cover Art: Bryan Brown MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto, MD; Matthew Watto MD, FACP
Guest: Chris Favilla, MD

Sponsor: Indeed indeed.com/internalmedicine

Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.

Sponsor: Qalo qalo.com/curb

Head to qalo.com/curb to get 20% off your purchase today.

Time Stamps*

Time Stamps refer to ad-free version

00:00 Intro, disclaimer, guest bio, and a bad pun
04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch,
07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter
08:40 A case of TIA; definition of TIA
12:14 Stroke territories
14:24 New definition of TIA
16:00 Differentiation from complex migraine
19:17 Risk stratifying TIA and ABCD2 score
22:00 A bit on tPA
24:01 Workup for TIA; workup for amaurosis fugax
25:36 CNS imaging studies after stroke or TIA; Choice of imaging study
33:15 HINTS exam for posterior circulation stroke
34:48 Is an echo necessary? Bubble study for PFO?
38:32 Duration of afib monitoring
40:24 Echo reports: what to look for in patient with stroke or TIA; “soft markers”
41:55 Blood testing after Stroke and TIA (lipid panel, HbA1C; +/- RPR, coags, CBC)
43:50 Folic acid; Sparkle trial: high dose atorvastatin versus placebo for secondary prevention
47:00 Incidental finding: multiple patchy infiltrates in a patient without stroke or TIA; Is it significant?
48:50 Aspirin therapy after TIA; Dosage adjustment based on weight?
51:10 A case of stroke; TOAST trial and classification of acute stroke; ESUS; aortic arch atheromas
55:58 Large artery strokes (hypoperfusion, acute thrombosis, artery to artery embolization)
57:15 Antiplatelets after stroke and TIA; DAPT and duration of therapy
62:57 Antidiabetic drugs and stroke
63:40 Lightning round: CHA2DS2VASc score and women; how much afib is significant?; 66:32 Are all DOACs created equal?; 68:20 Regaining function after a stroke; 69:47 Silent infarcts on imaging
71:54 Resources for stroke: Decision making in neurology textbook
73:28 Outro

#289 Afib Triple Distilled

11 augusti 2021 | 27 min

Reboot #159 Atrial Fibrillation

9 augusti 2021 | 83 min

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 11, 2021 for a brand new Afib Triple Distilled version.

Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up – This episode is going to send your heart racing! You might even skip a beat!

Credits

Writer and Producer: Cyrus Askin MD
Infographic: Cyrus Askin MD
Cover Art: Cyrus Askin MD
Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD
Editors: Matthew Watto MD
Guest: James Furgerson MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 100 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: Panacea Financial panaceafinancial.com

Visit panaceafinancial.com today to open your account and join a bank built with you in mind.

Time Stamps*
*Note: Time stamps refer to ad-free version

00:00 Intro, disclaimer and guest bio
03:45 Guest one liner, a bit on physician well-being and some other randomness
08:15 A case of palpitations; risk factors for atrial fibrillation
12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters?
15:08 Case summary and next steps in initial work up
18:48 Counseling patient about atrial fibrillation and its consequences
21:40 Ischemic heart disease and atrial fibrillation
24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation
25:25 Rate versus rhythm control; AFFIRM trial
30:50 Strict versus lenient rate control; RACE trial
33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy
36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials
40:40 When to refer to cardiology and electrophysiology
42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation
45:22 DOACs in CKD and some other nuances in choice of agent
52:27 Bleeding and anticoagulation
58:38 Cardioversion for atrial fibrillation (initial versus delayed)
63:32 Anticoagulation before and after cardioversion
67:48 Lifestyles measures for atrial fibrillation
70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism
74:12 Aspirin monotherapy is not appropriate for atrial fibrillation
76:42 Take home points
78:50 Outro

#288 LIVE! Neutropenic Fever featuring Dr. Susan Seo

2 augusti 2021 | 64 min

We’ve got a neutropenic fever and the only cure is...more cowbell? LIVE! It’s neutropenic fever (aka febrile neutropenia) deconstructed with infectious diseases expert, Dr. Susan Seo (Memorial Sloan Kettering Cancer Center). Topics: identifying low vs high risk patients, initial labs & imaging, empiric antibiotic therapy, when to add antifungals, de-escalation, and the G-CSF controversy.

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

Credits

Writer and Producer: Matthew Watto MD, FACP
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Matthew Watto MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Susan Seo MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: BetterHelp betterhelp.com/curb

Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb

Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Initial workup for neutropenic fever
Low risk neutropenic fever
High risk neutropenic fever
When to add antifungal coverage, G-CSF
Audience questions
Outro

#287 Angina, Stable CAD, HMB, Hypercalcemia (TFTC #7)

28 juli 2021 | 33 min

#286 Mingle with Shingles featuring Dr. Boghuma Titanji

26 juli 2021 | 70 min

Shaken by a shortage of shingles savvy? Vexed by varicella-zoster imposters? Perplexed by post-herpetic neuralgia? Get ready to sharpen your expertise in varicella vaccines, learn how to tell a zoster from a zebra, and administer infection interventions with an eye towards prevention. We are joined today by special guest and returning Curbsiders expert, Dr. Boghuma Kabisen Titanji MD, M.Sc., DTM&H, PhD. (@Boghuma on Twitter!).

Unfortunately, CE credit is NOT YET available for this episode : (

Credits

Written and Produced by: Sarah Phoebe Roberts, MPH
Show Notes by: Sarah Phoebe Roberts MPH, Kate GrantMBChB MRCGP DipGUMed
Cover Art: Kate Grant MBChB MRCGP DipGUMed
Infographic: Sarah Phoebe Roberts
Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH
Reviewer: Paul Williams MD, FACP
Editor: Kate Grant MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Boghuma Titanji, MD, M.Sc., DTM&H, PhD

Sponsor: BetterHelp betterhelp.com/curb

Special offer for listeners: get 10% off your first month at betterhelp.com/curb

Sponsor: Grammarly grammarly.com/curb

Get 20% off Grammarly Premium by signing up at Grammarly.com/curb

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 .

Show Segments

Intro, disclaimer
Guest bio and one-liner
First Kashlak case: Diagnosis of varicella-zoster virus (VZV, aka shingles)
Mimics and atypical presentations
Treatment for uncomplicated shingles cases
Second Kashlak case: Post-herpetic neuralgia (PHN)
PHN treatment options
Management of complicated shingles cases
VZV prophylaxis and infection control
Third Kashlak case: Immunization guidelines for older adults
VZV vaccine efficacy, live attenuated vs. recombinant vaccine
Varicella (chickenpox) vaccine guidelines
Final pearls and Outro

#285 Common Skin Complaints in Primary Care (Dermsiders)

19 juli 2021 | 76 min

#284 An Antibiotics Primer with @IDdocAdi

12 juli 2021 | 59 min

#283 CRC Screening: USPSTF Update with Dr. Michael Barry

5 juli 2021 | 45 min

#282 Bariatric Surgery, Osteoporosis, 2021 Conference Highlights! (TFTC #6)

30 juni 2021 | 47 min

#281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais

28 juni 2021 | 87 min

#280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients

21 juni 2021 | 62 min

Explore the intersection of hematology and women’s health as we discuss heavy menstrual bleeding (HMB), gynecologic risks of therapeutic anticoagulation, and prescribing contraception in the setting of venous thromboembolic disease.

Wondering how to expand your women’s health knowledge as an internist? Listen as our insightful guest Dr. Bethany Samuelson Bannow @bsamuelson_md (Oregon Health & Science University) helps us navigate the intersections between non-malignant hematology and menstrual health. This episode will empower you to tackle the stigma and overcome knowledge gaps with regard to abnormal menstrual bleeding, as well as learn treatment, and management pearls. We also explore the intersection between therapeutic anticoagulation, heavy menstrual bleeding, and thromboembolic disease of different contraceptive options. Finally, we face the themes of overcoming sexism, and even misogyny, in women’s health head-on throughout this episode. After all, half the population has a uterus.

Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/

Credits

Written and Produced by: Avital O’Glasser MD, FACP, FHM
Infographic: Avital O’Glasser MD, FACP, FHM
Cover Art : Kate Grant MBChB MRCGP DipGUMed
Show Notes: Kate Grant MBChB MRCGP DipGUMed, Maddie Morgan, and Avital O’Glasser MD, FACP, FHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM
Reviewer: Carolyn Chan, MD
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Bethany Samuelson Bannow, MD

Sponsor: Birch by Helix birchliving.com/curb

Sponsor: Green Chef GreenChef.com/curb100

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case 1 from Kashlak
Definitions related to menstrual health
Quantifying/defining heavy menstrual bleeding
Overcoming stigma of asking about menstrual history/health
Clinical evaluation/management of the patient with heavy menstrual bleeding
Case 2 from Kashlak
Risk of heavy menstrual bleeding (HMB) in the setting of therapeutic anticoagulation
Hormonal and nonhormonal therapy options for HMB while anticoagulated
Contraception options for someone who develops VTE
Case 3 from Kashlak
Counseling about VTE risk of different contraception options
Take Home Points; Outro; Bonus clip

#279 Dominate Stable Angina with the CardioNerds

14 juni 2021 | 83 min

Learn how to dominate stable angina. Coronary artery disease with stable angina is a different beast than acute coronary syndrome. We deconstruct it’s pathophysiology, diagnosis, and management with Drs. Dan Ambinder and Rick Ferraro. Topics: When to order coronary CT vs Stress testing; An approach to non-obstructive coronary disease; What treatments are life prolonging; Medical therapy vs Stenting; An approach to antianginal therapy; and how to partner with each patient. Listen as we dive deep into the recent literature and recommendations to dominate stable angina.

Credits

Producer: Molly Heublein, MD
Writer: Molly Heublein, MD, Michael Sternberg MD
Show Notes: Molly Heublein, MD, Beth Garbitelli
Infographic, Cover Art: Beth Garbitelli
Hosts: Molly Heublein, MD; Paul Williams MD, FACP
Editor: (written materials); Cyrus Askin MD, Clair Morgan of nodderly.com
Guest: Daniel Ambinder, MD; Rick Ferraro, MD

Sponsor: Panacea Financial panaceafinancial.com

Panacea Financial a nationwide digital bank built for doctors by doctors. Panacea offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com.

Panacea Financial is a division of Primis, member FDIC

Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders.

Sponsor: Audible Audible.com/curb

New members can always try Audible Plus free for 30 days. Visit Audible.com/curb or text curb to 500-500.

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, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Case from Kashlak
Definitions of stable angina, unstable angina
INOCA
Assessing risk
Treatment - life prolonging vs symptom relief
Diagnosis- stress testing vs anatomical studies
Angioplasty/stenting- ISCHEMIA trial
Take home points
Outro

#278 Neuro Mystery Case with The CPSolvers

7 juni 2021 | 50 min

#277 Bone Up on Osteoporosis in Primary Care with Dr. Carolyn Crandall

31 maj 2021 | 62 min

#276 Chronic Diarrhea, Dementia, OHS, MSK Pearls (TFTC #5)

26 maj 2021 | 45 min

#275 Bariatric Surgery for the Internist with Dr. Vivian Sanchez

24 maj 2021 | 74 min

#274 MSK Triple Distilled: Shoulder, Elbow, Hip, Knee

17 maj 2021 | 58 min

#273 ACP 2021: The Highlight Reel Part 2

10 maj 2021 | 66 min

#272 ACP 2021: The Highlight Reel Part 1

3 maj 2021 | 62 min

#271 PAD, Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea (TFTC #4)

28 april 2021 | 34 min

#270 SGIM 2021: The Highlight Reel

26 april 2021 | 75 min

It’s SGIM 2021, #SGIM21! LGBTQ health, updates in primary care for patients of all ages, caring for the Muslim patient, periop pearls, MRSA in your nose, and more!

It’s the most wonderful time of the year for internists: SGIM and ACP, all in one month! We’re here to help you make the most out of these action-packed virtual events, starting with our SGIM 2021 conference highlights. We hope you enjoy this grab-bag of clinical pearls, from LGBTQ healthcare to periop medicine to primary care, reproductive health, and beyond. Stay tuned for our upcoming ACP IMM2021 recaps for even more knowledge food!

Credits

Written, Produced, and Hosted by: Sarah Phoebe Roberts MPH; Becca Raymond-Kolker, Paul Williams MD, FACP; Chris Chiu MD, FACP, FAAP; Matthew Watto MD FACP
Show Notes by: Sarah Phoebe Roberts MPH
Cover Art and Infographic: Sarah Phoebe Roberts MPH
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: The American College of Physicians

Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov

Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process.

Sponsor: Audible Audible.com/curb

New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500.

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.

Show Segments
Top Pearls on:

LGBTQ health
Gynecological health
Reproductive medicine
Primary Care
Hospital Medicine
Perioperative Medicine
Caring for the Muslim patient
Young adult medicine pearls (including COVID19; and Down Syndrome)
Reflections on SGIM 2021 and Outro

#269 Obesity Hypoventilation Syndrome (OHS) and the Didgeridoo with Dr Aneesa Das

19 april 2021 | 67 min

Does obesity hypoventilation syndrome (OHS) give you respiratory distress? Are you baffled by bilevel? The wait is over! Learn all the ins and outs about OHS from Dr. Aneesa Das, @AneesaDas, a sleep specialist and pulmonologist at The Ohio State University! You’ll learn tips and tricks regarding the diagnosis and management of OHS, the important role PCPs can play, and why on earth we’re discussing the didgeridoo!

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

Credits

Written and Produced by: Cyrus Askin, MD
Infographic: Cyrus Askin, MD
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Cyrus Askin, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Reviewer: Leah Witt, MD
Editor: Matthew Watto, MD (written materials); Clair Morgan of nodderly.com
Guest: Aneesa Das, MD

Sponsor: The American College of Physicians

Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: Birch by Helix birchliving.com/curb

Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov

Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process.

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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week
Case from Kashlak
Basic risk factors for OHS and red flags
That pathophysiologic trifecta
Physical Exam & History - OHS
Surveys and specific testing
Labs and other tests (PFTs, Echo, and more)
OSA, OHS, and Central Sleep Apnea
Treating OSA: CPAP vs Bilevel
The importance of weight loss
Keys for inpatient management
Perioperative considerations
Take-home points
Outro

#268 Dementia Made Simple with Dr. Josh Uy

12 april 2021 | 62 min

#267 Diarrhea Disemboweled Part 2: Chronic Diarrhea with Dr. Iris Wang

7 april 2021 | 57 min

#266 Diarrhea Disemboweled Part 1: Acute Diarrhea with Dr. Iris Wang

5 april 2021 | 55 min

#265 Hypertension Update, Sarcoidosis, Seizures (TFTC #3)

31 mars 2021 | 27 min

#264 Hotcakes: Semaglutide for Weight Loss, Abx for Diverticulitis, Periop COVID19

29 mars 2021 | 44 min

#263 Iron Deficiency and Anemia of CKD (NephMadness 2021)

22 mars 2021 | 71 min

#262 Subacute and Chronic Abdominal Pain: Physical Exam Series

17 mars 2021 | 38 min

#261 Acute Abdominal Pain: Physical Exam Series

15 mars 2021 | 45 min

#260 Peripheral Artery Disease with Dr. Vlad Lakhter

8 mars 2021 | 72 min

#259 Addiction Medicine Triple Distilled

1 mars 2021 | 49 min

Let's recap our favorite addiction medicine pearls! We cover the treatment of alcohol use disorder, opioid use disorder and discuss strategies surrounding the management of long-term opioid therapy. Please share your favorite addiction medicine pearls with us that we may have forgotten in the comments or by tagging us on Twitter @thecurbsiders.

Credits

Producers: Carolyn Chan MD; Nora Taranto MD
Infographics: Hannah R Abrams; Justin Berk MD, MPH, MBA; Carolyn Chan MD; Nora Taranto MD
Writer and Cover Art: Carolyn Chan, MD
Hosts: Carolyn Chan MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Justin Berk MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial
This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial, you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea is also excited to announce their “Match Day Giveaway.” $500 will be awarded to five medical students entering the match in 2021. Entry is free, and students can enter the giveaway on their website until March 31, 2021. Winners will be selected randomly on April 1st,

2021. No purchase necessary for entry. Go to panaceafinancial.com/matchday today to learn more.

Panacea Financial, a Division of Sonabank, Member FDIC

Partner: The Cribsiders Pediatric Medicine Podcast

A Pediatric Podcast here to feed pediatric knowledge food to your adult-sized brain hole & provide weight-based dosings of fun. New episodes drop every other Wednesday! https://thecribsiders.com/

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

Time Stamps

Intro, disclaimer 00:00
Alcohol Use disorder (inpatient and outpatient management) 03:50
Sponsor -Panacea Finanicial 24:00
Partner -The Cribsiders Pediatric Medicine Podcast
Chronic Pain and Opioid Therapy (prescribing buprenorphine; microdosing) 25:30
Benzo Tapers 46:11
Outro

#258 Nephrotic Syndrome, Smoking Cessation, Prev Med Update (TFTC #2)

24 februari 2021 | 34 min

#257 Carpe Diem: Seizure Basics for Primary Care

22 februari 2021 | 72 min

#256 Sarcoidosis

15 februari 2021 | 64 min

This grand overview of granulomas will leave you comfortable tackling an often breathtaking disease, sarcoidosis. Listen as our esteemed guests Dr. Mary Beth Scholand (University of Utah) and Dr. Jonathan Boltax (University of Utah) rheum-inate on sarcoidosis. We discuss the pathophysiology, diagnosis, and treatment of this disease, role of the primary care clinician and why sarcoidosis in the chart reminds Paul of Shakespeare.

Credits

Producer: Cyrus Askin MD and Deborah Gorth
Writer: Deborah Gorth
Infographic and Cover art: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Drs. Mary Beth Scholand & Jonathan Boltax

Sponsor: ACP’s MKSAP

MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout.

Sponsor: birch by Helix
Visit birchliving.com/curb

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.

Time Stamps

00:00 Intro, disclaimer, guest bio, Awful(ly good?) Pun
03:42 Guest one-liners
06:28 Sponsor - ACP’s MKSAP19
07:40 Case from Kashlak
08:40 Explaining sarcoidosis
12:19 Possible drivers of sarcoidosis
13:30 Taking a sarcoidosis history
17:26 Suggestions for catching sarcoidosis
21:44 Sponsor - birchliving.com/curb
23:52 Sarcoidosis physical exam, Diagnosis
33:00 Lofgren’s and Heerfordt’s syndromes; Imaging for sarcoidosis
40:44 Initiating therapy for sarcoidosis; Prognosis; the Treatment team
51:23 Primary care considerations for sarcoidosis
54:55 Diagnosing and treating a sarcoidosis exacerbation
61:20 Take home points and outro

#255 Hotcakes: Colchicine for CAD, and Gout flares, PT versus Steroids for Knee OA

8 februari 2021 | 48 min

#254 Hypertension Update with Dr. Wanpen Vongpatanasin

1 februari 2021 | 57 min

Listen as our esteemed guest Dr. Wanpen Vongpatanasin, @DrWanpen (UT Southwestern) discusses the nitty-gritty of blood pressure monitoring and hypertension treatment. We review the thresholds for HTN diagnosis and how to accurately measure blood pressure levels at home and in the office. Dr Vongpatanasin shares the latest guideline recommendations for first line pharmaceutical therapies as well as her pearls about how to treat special populations.

Produced by: Deborah Gorth and Isabel Valdez, PA
Written by: Deborah Gorth
Infographic and Cover Art: Edison Jyang
Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; Paul Williams, MD, FACP
Editor: Molly Heublein, MD (written materials); Clair Morgan of nodderly.com
Guest: Wanpen Vongpatanasin, MD

Sponsor: ACP’s MKSAP18
MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021.

Sponsor: Provider Solutions and Development
Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/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.

Time Stamps

00:00 Sponsors, Intro, disclaimer, guest bio

03:20 Guest one-liner

05:50 Sponsor - ACP’s MKSAP 18

07:05 Case from Kashlak; Defining hypertension and treatment thresholds

10:43 Measuring blood pressure (at home, in the office, validatebp.org)

16:46 Wrist BP cuff

19:50 Home monitoring and ambulatory BP monitoring; What time to take BP medication

31:23 Sponsor - Provider Solutions and Development

32:10 Approach to treatment; Combo pills; How to titrate meds

42:20 Treating resistant hypertension; hyperaldosteronism; Isolated systolic hypertension

52:04 Take home points and Outro

#253 COVID-19 Vaccines with Dr Monica Gandhi

27 januari 2021 | 65 min

Answer all your burning questions (and your patients’ burning questions) about the different COVID-19 vaccines currently authorized in the US. Infectious diseases / HIV expert, Dr Monica Gandhi @MonicaGandhi9 (UCSF) joins us to cover: the Pfizer-BioNTech and Moderna novel mRNA vaccine mechanisms, trial data, and practicalities of who should receive them. We discuss data around the Oxford-AstraZeneca adenovirus vaccine, which is authorized in the UK and India, and may be available in the US later this year. Feel confident recommending COVID-19 vaccines to your patients!

Credits

Written and Produced by: Molly Heublein, MD
Cover Art: Chris Chiu, MD, FACP, FAAP
Infographic: Tima Karginov
Hosts: Chris Chiu, MD, FACP, FAAP; Molly Heublein, MD; Paul Williams, MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Monica Gandhi, MD, MPH

Sponsor: Panacea Financial
This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: 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.

Time Stamps

Intro, disclaimer, guest bio - 00:00
Guest one-liner, book recommendation - 3:40
Authorized vaccines in the US - 8:30
AstraZeneca vaccine mechanism- 9:26
mRNA vaccine mechanism - 10:30
Vaccine distribution issues (cold chain) - 16:05
mRNA safety - 18:24
mRNA vaccine efficacy/data from phase 3 trials - 19:40
How did we get this so quickly - 23:40
Vaccine impact on asymptomatic infection - 26:18
AstraZeneca trials - 28:20
Pregnancy - 35:10
Anaphylaxis - 37:10
Prior COVID-19 infection - 39:07
Side effects - 42:05
Pediatric patients - 45:12
Phases of role outs in the US -46:50
Herd immunity - 48:16
Thoughts of how to make this happen - 52:45
Preexisting conditions - 53:40
How long will immunity last - 57:15
Mutant strains - 58:25
Future of mRNA vaccines - 1:00:30
Take home points and Outro - 1:02:12

#252 Smoking Cessation Unfiltered

25 januari 2021 | 67 min

Get all the details on varenicline, nicotine replacement therapy, and integrating psychosocial interventions into a comprehensive smoking cessation treatment plan! Smoking cigarettes is the leading cause of preventable death worldwide. Listen as our esteemed guest Dr. Steve Baldassarri (Yale) provides us expert pearls to help our patients quit smoking.

Credits

Written and produced by: Carolyn Chan, MD
Infographic: Edison Jyang
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin, MD (written materials); Clair Morgan of nodderly.com
Guest: Steve Baldassarri MD MHS

Sponsor: The American College of Physicians
Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.

“Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org. (Prices shown online at registration pages reflect Discounted Rates.)

Register now—Early Bird savings end January 31st!

Sponsor: 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.

Time Stamps*

*Note: Time Stamps refer to ad free version.

03:02 Intro, disclaimer, guest bio
04:35 Guest one-liner
09:50 Tobacco Use Disorder - Chronic Disease
11:08 Case from Kashlak
11:56 Obtaining a history
13:39 Motivations for Smoking Cessation
15:29 Factors associated with challenges in smoking cessation:
21:40 Gradual Tapers vs Cold Turkey
25:18 Nicotine Replacement 32:40
28:57 Pharmacotherapy - “Controller” Medications
31:05 Pharmacotherapy - Short Acting Medications
33:20 Dosing Medications
38:35 Varenicline
39:00 Nicotine gum dosing
44:40 Duration of therapy
48:08 Bupropion
49:05 Behavioral Interventions
55:24 Vaping and electronic cigarettes
57:03 Vaping for smoking cessation
01:02:35 EVALI
01:05:49 Outro

#251 What the USPSTF? Preventive Medicine Updates with Dr. Amber-Nicole Bird

18 januari 2021 | 65 min

#250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf

11 januari 2021 | 76 min

#249 Cellulitis, Bites, Vulvovaginitis, MGUS, SPEP (TFTC #1)

4 januari 2021 | 18 min

#248 Top Pearls of 2020: Curbsiders' Recap Extravaganza

28 december 2020 | 64 min

#247 SPEP It Up: MGUS, Myeloma, and Immunology, Oh My!

21 december 2020 | 65 min

#246 Take a Bite out of Cellulitis with Dr Boghuma Titanji

14 december 2020 | 72 min

ADHD: All that Fidgets is Not... (Cribsiders #13)

9 december 2020 | 47 min

#245 COVID Cakes: Masks, Home Testing, Anticoagulation, Vaccines

7 december 2020 | 43 min

#244 Vulvovaginitis for All Ages with Dr. Monica Christmas

30 november 2020 | 57 min

#243 Diabetes Triple Distilled

23 november 2020 | 47 min

Listen in as we recap four of our favorite diabetes episodes to bring you the pearls you need to stay up to date on type 2 diabetes management in the clinic. We cover pitfalls of A1c testing, guidelines for A1C targets, when and how to use the newer medications SGLT-2 inhibitors and GLP-1 agonists. We wrap up with a discussion of managing DM2 in patients with kidney disease and in which patients to consider de-intensifying treatment. Feel confident managing diabetes with the latest data in 2020!

Listeners can claim 4 HOURS of Free CE credit for this episode through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Molly Heublein, MD
Infographic and Cover Art: Isabel Valdez, PA
Show Notes: Isabel Valdez, PA; Molly Heublein, MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein, MD
Editors: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com

Sponsors:

ACP’s I Raise the Rates

Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

0:00 Intro,

2:45 Pitfalls of A1c testing,

7:00 Diabetes goals/A1c guidelines; Macrovascular vs Microvascular benefits,

16:20 Choosing between SGLT2 inhibitors vs GLP1 agonists,

19:10 Stuart rants on insulin for symptomatic hyperglycemia,

22:32 Start your patient on an SGLT2i and counsel them about potential adverse events,

30:30 GLP-1 agonists,

36:50 Deintensification; Diabetes Treatment in CKD,

Tags

Diabetes, hypoglycemia, SGLT2 inhibitors, GLP-1 agonist, metformin, CKD, primary care, assistant, doctor, education, family, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, physician, resident, student

#242 Wilderness Medicine: Prepare for Disaster

16 november 2020 | 80 min

Explore the essentials of Wilderness Medicine and prepare yourself for austere environments as we discuss Altitude Sickness, Frostbite, Animal Bites, Thermoregulation, Wound Care and the proper way to apply a tourniquet.

Thinking about outdoor escapes and vacations now more than ever? Listen as our esteemed guest Dr. Thomas DeLoughery @Bloodman (Oregon Health & Science University) takes us through the fascinating, and at times chilling, world of Wilderness Medicine. This episode will empower you to explore the great outdoors as safely as possible. We discuss the breadth of wilderness medicine, multiple unique clinical entities encountered in austere environments, and practical ways to protect yourself and others on your adventures. This episode is truly wild!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written, Produced, and Infographic by: Avital O’Glasser MD, FACP, FHM
Show Notes: Deborah Gorth ScM and Avital O’Glasser MD, FACP, FHM
Cover Art: Kate Grant, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Thomas DeLoughery MD, MACP, FAWM

Sponsors:

Provider Solutions and Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
Sponsor - VCU Health CE curbsiders.vcuhealth.org
00:00 Intro, disclaimer, guest bio
03:45 Guest one-liner, advice and Picks of the Week*
08:10 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
09:00 Case of mountaineering; What is Wilderness Medicine? 
12:05 What’s in your first aid kit? 
21:36 Altitude sickness: acute mountain sickness, high altitude cerebral edema and High altitude pulmonary edema 
31:25 Hypothermia
39:36 Frostbite  
47:25 Hyperthermia: Heat exhaustion and Heat stroke; How much water should you drink? 
51:55 Bat bites and rabies 
58:20 Snake bites 
66:03 Wound care and tourniquets 
75:40 Take Home Points; Outro; Bonus clip
Sponsor - VCU Health CE curbsiders.vcuhealth.org

Links*

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will learn the basics of wilderness medicine and how to approach a few common conditions.

Learning objectives

After listening to this episode listeners will…

Appreciate Wilderness Medicine as a medicine subspeciality and understand why or how someone might pursue this clinical focus area
Recognize signs and symptoms of high altitude sickness
Develop an approach to treating animal bites and injuries
Learn high yield tips for administering first aid in the wilderness including field hemostasis

Disclosures

Dr DeLoughery reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

O’Glasser AY, Gorth D, Deloughery T, Williams PN, Watto MF. “#242 Wilderness Medicine: Prfor Disaster”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date November 16, 2020.

Tags

Wilderness Medicine, Travel medicine, first aid, first aid kit, altitude sickness, acute mountain sickness, high altitude cerebral edema, high altitude pulmonary edema, acetazolamide, dexamethasone, hypothermia, frostbite, frostnip, heat exposure, heat exhaustion, heat syncope, hyperthermia, hyponatremia, animal bites, bats, rabies, snakes, antivenom, wound care, tourniquet, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#241 Chronic Cough

9 november 2020 | 58 min

Rejoice! as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward. Listeners can claim free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). We hope you enjoy learning from this episode as much as we enjoyed producing it!

Credits

Written (including CME questions) and Produced by: Cyrus Askin MD
Infographic by: Cyrus Askin MD
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Brad Hayward MD

Sponsors:

Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - Panacea Financial panaceafinancial.comSponsor - VCU Health CE curbsiders.vcuhealth.org
00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week*
06:23 Sponsor - Panacea Financial panaceafinancial.com
07:30 Case of Post Infectious Cough; Basic definitions for cough
Important aspects of the history
Empiric therapies for post-viral cough
22:50 Case of idiopathic chronic cough; Physical exam
29:20 Basic testing and empiric therapy for the common causes of chronic cough
41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds
54:28 Take home message; Outro
Sponsor - VCU Health CE curbsiders.vcuhealth.org

Links*

90 Day Fiancé (show)
Below Deck Mediterranean (show)
Mastering Communication with Seriously Ill Patients by Anthony Back, Robert Arnold & James Tulsky (book)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will develop a pragmatic approach to evaluating subacute and chronic cough in adult patients.

Learning objectives

After listening to this episode listeners will be able to…

... define sub-acute vs chronic cough
... build a repertoire of history questions geared towards identifying the etiology of cough in a patient
... build a toolbox of diagnostic studies / tests that can be used in the evaluation of cough
... marry history, physical and diagnostic studies into a coherent approach to diagnosing subacute and chronic cough through a tiered/logical approach
... understand empiric therapies for cough that may have an advantageous risk-reward profile, even in the absence of diagnosis
... educate patients on common causes for subacute cough and chronic cough, as well as how to appropriately set expectations regarding symptoms severity and duration

Disclosures

Dr. Hayward reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Askin CA, Hayward B, Williams PN, Brigham SK, Okamoto E, Watto MF. “241: Chronic Cough”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date: November 9, 2020.

Tags

Cough, dyspnea, asthma, COPD, eosinophil, IL-5, allergy, ENT, allergist, pulmonary, pulmonologist, PFT, spirometry, post-nasal drip, GERD, reflux, eczema, rash, atopy, mucus, bronchiectasis, lung, antihistamine, CT, X-Ray, smoking, vaping, birds, dust, cockroaches, steroids, ICS, inhaled, gabapentin, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#240 Elbow Pain: Straighten it out

2 november 2020 | 66 min

Returning guest expert Dr Ted Parks helps us get the elbow straight with a simple approach to common causes of elbow pain for primary care. Listen as he guides Stuart through physical exam techniques (or watch them on YouTube) for epicondylitis and learn what the bursa is there for anyways. Find out what fracture you can treat in your office, why you shouldn’t stab straight into the olecranon bursa and when elbow pain should be referred. Feel confident when your patient comes in with elbow pain!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Molly Heublein, MD
Cover Art and Infographic: Edison Jyang
Hosts: Stuart Brigham MD, Matthew Watto MD, FACP; Molly Heublein, MD
Editor: Emi Okamoto, MD (written materials); Clair Morgan of Nodderly.com (audio/video)
Guest: Ted Parks, MD

Sponsors

Provider Solutions and Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
Sponsor - VCU Health CE curbsiders.vcuhealth.org
00:00 Intro, disclaimer, guest bio
04:00 Picks of the Week*
Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
09:50 Medial and lateral epicondylitis case, Elbow anatomy
13:00 Pathophysiology of epicondylitis, Epicondylitis exam, Epicondylitis treatment
34:11 Olecranon bursitis, Bursitis diagnosis and aspiration
46:12 Radial head fracture diagnosis, Radial head fracture treatment
55:30 Cubital tunnel nerve entrapment
57:45 Platelet rich plasma
60:39 Take home points, Plug and Outro
64:00 Bonus Pick of the Week
Sponsor - VCU Health CE curbsiders.vcuhealth.org

Goals

Listeners will have a working differential of elbow complaints that commonly present in primary care, and understand how to diagnose these and initiate treatment.

Learning objectives

After listening to this episode listeners will...

Perform an exam for medial and lateral epicondylitis.
Describe treatment options for medial and lateral epicondylitis
Identify when further evaluation for clinical olecranon bursitis beyond clinical exam is needed
Explain how radial head fractures differ from most other fractures, and why casting or surgery is generally not needed.

Links*

Molly’s Pick: The Warmth of Other Suns (book) by Isabel Wilkerson
Stuart’s Pick: The Fringe (TV show), JJ Abrams
Practical Office Orthopedics (textbook) by Ted Parks, MD

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

References

Johnson GW, Cadwallader K, Scheffel SB, Epperly TD. Treatment of lateral epicondylitis. Am Fam Physician. 2007 Sep 15;76(6):843-8. PMID: 17910298.
Simental-Mendía M, et al. Clinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials. Clin Rheumatol. 2020 Aug;39(8):2255-2265. doi: 10.1007/s10067-020-05000-y. Epub 2020 Feb 26. PMID: 32103373.
Parks, Ted. Practical Office Orthopedics. McGraw-Hill Education / Medical; 1st Edition (December 29, 2017).
Khodaee M. Common Superficial Bursitis. Am Fam Physician. 2017 Feb 15;95(4):224-231. PMID: 28290630.
Liow RY, Cregan A, Nanda R, Montgomery RJ. Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols. Injury. 2002 Nov;33(9):801-6. doi: 10.1016/s0020-1383(02)00164-x. PMID: 12379391.
Boone S, Gelberman RH, Calfee RP. The Management of Cubital Tunnel Syndrome. J Hand Surg Am. 2015 Sep;40(9):1897-904; quiz 1904. doi: 10.1016/j.jhsa.2015.03.011. Epub 2015 Aug 1. PMID: 26243318.

Tags

Elbow, orthopedics, olecranon bursitis, bursa, aspiration, septic joint, medial epicondylitis, lateral epicondylitis, radial head fracture, PRP, platelet rich plasma, humerus, olecranon, radius, tendonitis, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Disclosures

Dr Parks reports is the author of Practical Office Orthopedics (McGraw-Hill 2017) . The Curbsiders report no relevant financial disclosures.

Citation

Heublein M, Parks T, Jyang E, Brigham SK, Okamoto E, Watto MF. “#240 Elbow Pain: Straighten it out. A dabble into elbow care with Dr Ted Parks”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list November 02, 2020.

#239 Sinusitis: It’s Not That Tricky

23 oktober 2020 | 75 min

A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL).

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli
Cover Art: Kate Grant MBChb, MRCGP
Infographic by: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio)
Guest: Dink Jardine, MD

Sponsors: National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor – National Internal Medicine Day, The American College of Physicians
Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
03:00 Guest one-liner, Favorite failure, Pick of the Week*: Still Life by Louise Penny
Sponsor – National Internal Medicine Day, The American College of Physicians
09:30 Case 1 - Acute Viral Rhinosinusitis
10:40 Rhinosinusitis vs. Sinusitis
14:20 Physical exam in rhinosinusitis
20:40 Counseling patients about viral vs. bacterial infection
22:56 Sinus regimen/nasal irrigation - “Is there a sinus toilet”
27:10 Intranasal fluticasone and other intranasal medications
29:40 Rhinitis medicamentosa
30:40 Nasal spray positioning
33:50 Case 1 - Double Sickening
37:40 Worst case scenarios from rhinosinusitis
40:40 Antibiotic treatment for bacterial rhinosinusitis
43:20 Failed improvement on antibiotics? Second-line options
49:30 Case 2 - Chronic rhinosinusitis
52:28 Etiology of chronic rhinosinusitis
53:33 Making a diagnosis of chronic rhinosinusitis
55:25 Treating chronic rhinosinusitis
58:40 Vasomotor rhinitis
60:40 Sinus irrigation counseling and tips (YouTube)
65:30 Case 3 - Allergic Rhinitis
70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis
73:51 Take-home points

Links*

Still Life: A Chief Inspector Gamache Novel by Louise Penny, Chief Inspector Gamache series
“Dr. Adappa and Dr. Palmer teach you How to do Nasal Irrigation” https://www.youtube.com/watch?v=Br928VfiC1M

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will develop an approach to the diagnosis and management of rhinosinusitis.

Learning objectives

After listening to this episode listeners will...

Classify rhinosinusitis, including acute, chronic, bacterial, and viral.
Discuss the microbiology and pathophysiology underpinning rhinitis and sinusitis.
Differentiate the presentation and management of acute bacterial and acute viral rhinosinusitis.
Develop an approach to the diagnosis and management of allergic rhinosinusitis.
Recognize and manage patients with non-allergic rhinitis.
Discuss the role of antibiotic therapy and surgery in the management of rhinosinusitis.

Disclosures

Dr. Jardine reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Williams PN, Garbitelli B, Jardine D, Heublein M, Watto MF.. “#239 Sinusitis: It’s not that tricky.” The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 26, 2020.

Tags

sinus, sinusitis, rhinitis, acute bacterial, rhinosinusitis, bacterial, viral, virus, nose, chronic sinusitis, ENT, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#238 DVT / PE Triple Distilled

22 oktober 2020 | 30 min

DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates.

Listeners can claim 2 hours of Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: 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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

00:00 Intro, disclaimer
01:40 Making the diagnosis of VTE
09:07 Triage and risk stratify Pulmonary Embolism
14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE
21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight, advanced CKD and in antiphospholipid syndrome
28:22 IVC filters
30:20 Outro

Links

Check out the full show notes from previous Curbsiders’ shows covering VTE.

Dr Oren Friedman #92 Pulmonary Embolism for the Internist
Dr Michael Streiff #154 DVT and PE Master Class

Goals

Listeners will feel confident in the diagnosis and management of VTE

Learning objectives

After listening to this episode listeners will...

Diagnose (VTE) DVT and PE using imaging, risk scores and clinical gestalt

Risk stratify patients with pulmonary embolism

Choose the appropriate initial anticoagulant for VTE

Decide duration of anticoagulation for VTE

Recall real risks and questionable benefits of IVC filters in DVT / PE

Determine need for cancer or thrombophilia workup in unprovoked DVT / PE

Disclosures

The Curbsiders report no relevant financial disclosures.

Citation

Watto MF, Williams PN, Brigham SK, Watto MF. “#238 DVT / PE Triple Distilled”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 22, 2020.

Tags

Pulmonary embolism, vte, dvt, pe, heparin, anticoagulation, right ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC filter, TPA, echocardiogram, CT scan, bleed, clot, deep, vein, thrombosis, DOAC, NOAC, anticoagulation, d-dimer, Wells, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#237 Ophthalmology for Primary Care

19 oktober 2020 | 62 min

Fun, fluorescein, and fundoscopy unite as our esteemed guest, Dr. Nisha Chadha @iEducatorMD (Mount Sinai School of Medicine) brings us ophthalmology for primary care! Dr. Chadha is a medical educator and the content creator of the med-ed simulation website 20/20 Sim. She teaches us the 3-vital signs of ophthalmology, how to recognize common diabetic eye diseases, how to explain diabetic retinopathy to our patients, how to optimize a patient for cataract surgery and so much more. This episode is truly vision-ary!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written, Produced, and Infographic by: Carolyn Chan, MD
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Nisha Chadha

Sponsors:

National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor – National Internal Medicine Day, The American College of Physicians
Sponsor – VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
03:21 Guest one-liner, Carolyn’s Pick of the Week
09:05 Picks of the Week*
10:13 Case from Kashlak, 3 - Vital Signs of Ophthalmology
17:09 Ocular complications of diabetes
20:22 Screening for diabetic retinopathy; Reports and Abbreviations
26:07 Counseling Patients: The eye is a camera; Clinical symptoms of ocular complications
32:07 Fluorescein Stain; Treatment Options for Diabetic Eye Disease: NPDR, PDR, VH, and RD
41:16 Eye Vitamins for Macular Edema
43:35 Cataracts
47:22 Missing Glaucoma Drops
50:50 Periop Optimization for Cataract Surgery, Anticoagulation and Other Medical Management
58:14 Take Home Points, Plug: 20/20 Sim; Outro
Sponsor – VCU Health Continuing Education

Links*

Mindset: The New Psychology of Success by Carol S. Dwek
Crackdown Podcast
20/20 Sim Site

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will discuss screening, counseling, and management of common ocular diseases seen within primary care.

Learning objectives

After listening to this episode listeners will…

Define and assess the three vital signs of ophthalmology.
List ocular complications of diabetes.
Counsel a patient on a new diagnosis of diabetic retinopathy.
Describe treatments for diabetic retinopathy.
Define proliferative retinopathy, non-proliferative retinopathy, and macular edema.
Compose a perioperative medication management plan for cataract surgery

Disclosures

Dr. Chadha reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Chan C., Chadha N., Okamoto E., Watto MF. “#237 Ophthalmology for Primary Care”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date October 19, 2020.

Tags

Eye, ophthalmology, ophtho, optometry, glaucoma, diabetes, diabetic retinopathy, macular edema, cataracts, cataract surgery, perioperative management, physical exam, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#236 Approach to Shortness of Breath: Physical Exam Series

12 oktober 2020 | 41 min

Learn which exam maneuvers are worthwhile and which ones are worthless in your approach to shortness of breath. In our evidence based series on the physical exam, we discuss the approach to the dyspneic patient with Dr. Brian Garibaldi (Hopkins, SBM), associate professor of pulmonary and critical care medicine at Johns Hopkins, and co-president of the Society of Bedside Medicine. We discuss the physical exam’s effect on our differential diagnosis, maneuvers that are commonly taught, and some simple tests with great data that may go overlooked. Be prepared, this episode may take your breath away!

Credits

Written and Produced by: Justin Berk, MD, MPH, MBA and Sam Masur, MD
Infographic: Sam Masur, MD, Beth Garbitelli
Cover Art: Beth Garbitelli
Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; and Paul Williams, MD, FACP
Editor:Justin Berk MD; Clair Morgan of nodderly.com
Guest(s): Brian Garibaldi, MD

Sponsors:

National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor – National Internal Medicine Day, The American College of Physicians
Sponsor – VCU Health Continuing Education
00:00 Intro, disclaimer, guest bio
Sponsor – National Internal Medicine Day, The American College of Physicians
03:47 Introduction to evidence-based exam, pre-test probability, and likelihood ratios
05:29 Case from Kashlak Memorial
06:51 Dr. Garibaldi’s initial maneuvers for the dyspneic patient
11:33 Recapping the exam maneuvers
14:05 Likelihood ratios for common maneuvers
18:25 Over 6/Under 6 maneuvers
25:30 Recap of Dr. Garibaldi’s go-to maneuvers
28:19 Role of labs and diagnostic imaging
31:03 Role of point-of-care ultrasound (POCUS)
34:10 Friday at 5pm
36:31 Take home points
39:25 Outro
Sponsor – VCU Health Continuing Education

Links*

Goal

Listeners will feel confident how to optimally use the physical exam to guide clinical decision-making in patients presenting with dyspnea.

Learning objectives

After listening to this episode listeners will…

Describe the effectiveness of the exam when it comes to aiding diagnosis in a patient with dyspnea
Identify specific exam maneuvers that can aid clinical decision-making
Identify exam maneuvers that may not offer more information compared to imaging such as POCUS

Disclosures

This episode was made with assistance from the Society of Bedside Medicine and funding from the New York Academy Medicine. Dr Garibaldi reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Masur S, Garibaldi BT, Watto M, Williams P, Brigham S, Berk J. #236 Physical Exam Series: Approach to Shortness of Breath. The Curbsiders Internal Medicine Podcast. https:/www.thecurbsiders.com/episode-list. Original Air Date October 12, 2020.

References

Mochizuki K et al. Importance of respiratory rate for the prediction of clinical deterioration after emergency department discharge: a single-center, case-control study. Acute Med Surg. Nov 2016. doi:10.1002/ams2.252
Sarkar M et al. Physical signs in patients with chronic obstructive pulmonary disease. Lung India. 2019. doi:10.4103/lungindia.lungindia_145_18
Fagan TJ. Letter: Nomogram for Bayes theorem. N Engl J Med. 1975;293(5):257. doi:10.1056/NEJM197507312930513
Simel, David, et al. Rational Clinical Examination, McGraw-Hill Professional Publishing, 2009. ProQuest Ebook Central
McGee, Steven. Evidence-based physical diagnosis [4th edition] Elsevier, 2018. Clinical Key
Benbassat, J., Baumal, R. Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?. J GEN INTERN MED 25, 865–872 (2010). https://doi.org/10.1007/s11606-010-1327-8
Al Deeb M et al. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-852. doi:10.1111/acem.12435
Yousefifard et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emerg (Tehran). 2016;4(1):1-10.
Martindale et al. Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016;23(3):223-242. doi:10.1111/acem.12878
Caldentey et al. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure). JACC Heart Fail 2014.. doi:10.1016/j.jchf.2013.10.004

Tags

Physical exam, dyspnea, shortness of breath, auscultation, PMI, percussion, heart failure, wheeze, POCUS, COPD, JVD, hepatojugular reflux, observation, asymmetry, Brian Garibaldi, practice, pallor, lung, heart, hands.

#235 Spooky Cakes: Dapa-CKD, Turmeric for Knee Pain, Honey for URTI

5 oktober 2020 | 50 min

Time for spooky cakes with a side of candy corn. We discuss Dapagliflozin (SGLT2i) for CKD, Turmeric for knee pain and Honey for URTI (cough) on this halloween themed hotcakes with Rahul Ganatra MD, MPH @rbganatra

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (Note: CME for this episode won’t be available until 10/12/20. We apologize for the inconvenience).

Credits

Producer: Sarah Phoebe Roberts
Written by: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH
Cover Art: Matthew Watto MD, FACP
Hosts: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

00:00 Sponsor – National Internal Medicine Day, The American College of Physicians
00:25 Sponsor – VCU Health Continuing Education
00:40 Intro, disclaimer, Picks of the Week
07:38 Sponsor – National Internal Medicine Day, The American College of Physicians
08:40 Dapa-CKD
20:00 Turmeric for Knee Osteoarthritis
32:10 Honey for URTI and Cough
46:32 Shout out to @votehealth2020 and PatientVoting.com
48:25 Outro
Sponsor – VCU Health Continuing Education

Links*

Candy Corn (autumn mix) and (classic)
Paul’s Halloween movie marathon: Cabin in the Woods, The Descent, The Witch, Ghostbusters

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will review and perform critical appraisal of recent articles with the potential to change internal medicine practice

Learning objectives

After listening to this episode listeners will…

Review the potential benefits of dapagliflozin for prevent of CKD progression and death
Evaluate the utility of turmeric for osteoarthritis with inflammatory synovitis
Discuss the efficacy of honey for the treatment of acute upper respiratory tract infection and persistent post-infectious cough

Disclosures

The Curbsiders report no relevant financial disclosures.

Citation

Watto M, Ganatra R, Williams PN, Brigham SK, Roberts SP. “235 Spooky Cakes”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 5, 2020.

Tags

Dapagliflozin, slgt2i, sglt2 inhibitors, ckd, turmeric, curcumin, knee osteoarthritis, knee pain, synovitis, honey, urti, respiratory tract infection, cough, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#234 The Breast Lump, and Breast Cancer Screening with Nancy Keating MD, MPH

28 september 2020 | 77 min

#233 Giving Effective Feedback with Drs. Abby Spencer and Alia Chisty

21 september 2020 | 80 min

Listen to our medical education heroes, Dr. Abby Spencer, @abbyCCim (Cleveland Clinic), and Dr. Alia Chisty, @aliachisty (Penn State Health), school us on how to give effective and meaningful feedback! Topics include: the ADAPT framework, how to give difficult feedback, keywords and phrases when giving feedback, how to avoid gender and racial bias when giving feedback, giving feedback to your peers and how to solicit effective feedback as a team leader.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by Paul Williams MD, FACP
Cover Art: Paul Williams, MD, FACP
Infographic: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guests: Abby Spencer MD and Alia Chisty MD

Sponsors

Provider Solutions & Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio, pun
04:00 Guest one-liners, Picks of the Week* (see links below)
10:25 Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
11:00 Case from Kashlak, Feedback definitions
15:00 Addressing perceived barriers to feedback
31:45 ADAPT model of feedback
38:10 Addressing potentially gendered feedback;
42:45 Giving feedback to those who lack insight
48:29 Feedback and racial bias
52:25 Giving peer feedback
58:10 Tips for soliciting feedback as a supervisor
69:05 Does giving difficult feedback mean people won’t like you?
75:10 Take home points and Outro
Sponsor - VCU Health Continuing Education

Links*

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will demonstrate effective techniques to deliver and solicit meaningful feedback.

Learning objectives

After listening to this episode listeners will…

Discuss the definitions and terms used to discuss feedback.
Deliver effective feedback that is concordant with the learning goals of their trainees.
Address potential perceived barriers to feedback.
Utilize the ADAPT framework to partner with their learners and develop shared goals.
Develop strategies to mitigate against using gender- or racially-biased narrative language.
Deliver feedback to learners with limited insight by leveraging the impact of perception on achieving goals.
Solicit effective and meaningful feedback despite being in a position of authority

Disclosures

Drs. Spencer and Chisty report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Williams PN, Spencer A, Chisty A, Brigham SK, Jyang E, Watto MF. “#233 Giving effective feedback with Abby Spencer and Alia Chisty”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 21, 2020.

References

Ende J. Feedback in Clinical Medical Education. JAMA. 1983. . [https://pubmed.ncbi.nlm.nih.gov/6876333/]
Brown B. 2018. Dare to Lead. Random House.
Stone D and Heen S. 2014. Thanks for the Feedback. Penguin Books.
Scott K. 2019. Radical Candor. St. Martin’s Press.
Fainstad T et al. Feedback can be less stressful: Medical trainee perceptions of using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) framework. Cureus. 2018. [https://pubmed.ncbi.nlm.nih.gov/30906679/]
Rojek AE et al. Differences in narrative language in evaluations of medical students by gender and under-represented minority status. J Gen Int Med. 2019. [https://pubmed.ncbi.nlm.nih.gov/30993609/]
Mueller AS et al. Gender differences in attending physicians’ feedback to residents. JGME. 2017. [https://pubmed.ncbi.nlm.nih.gov/29075375/]
Ross, DA et al. Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations. PLoS ONE. 2017. [https://pubmed.ncbi.nlm.nih.gov/28792940/]

#232 Skinternship: Scalp & Face with Helena Pasieka MD

14 september 2020 | 73 min

Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights.

Credits

Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP,
Cover Art and Infographic by: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Helena Pasieka MD, MS

Sponsors

Provider Solutions & Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders
08:30 Case 1: Alopecia
12:05 Assessing scalp for inflammatory changes and follicular drop-out
13:10 Central Centrifugal Cicatricial Alopecia (CCCA)
14:00 Alopecia/hair loss non-scarring subtypes
25:00 Alopecia Treatments
28:55 Case 2: Psoriasis vs. Seborrheic Dermatitis
31:45 Looking for psoriatic plaques
32:11 Seborrheic dermatitis hallmarks
35:19 Treatment for Seborrheic Dermatitis
42:10 Case 3: Rosacea vs. Acne
50:40 Differentiating rosacea rash from SLE
52:40 Rosacea management & treatment
55:00 Identifying rosacea in Black skin
56:50 Acne management & treatment
59:10 Retinoid dermatitis
1:00:30 Maskne
1:02:29 Antibiotics for acne
1:03:38 Retinoids and pregnancy
1:04:09 Doxycycline for rosacea
1:06:15 Take home points
Sponsor - VCU Health Continuing Education

Links*

Hamilton and Alexander Hamilton by Ron Chernow,
Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance)
The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones)
Brown Skin Matters on Twitter and Instagram
Skin of Color Society
American Academy of Dermatology
Society for Dermatology Hospitalists
Black Skin Directory Learning Journal
Mind the Gap (2020) by Malone Mukwende
Ethnic Dermatology: Principles and Practice (2013)
Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012)
An Atlas of African Dermatology (2001)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic.

Learning objectives

After listening to this episode listeners will...

Recognize and treat common skin complaints of the scalp and face in primary care.
Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care.
Be able to differentiate non-scarring versus scarring hair loss on physical exam.
Comprehend nuances in total body presentations of psoriasis as a means to differentiate from seborrheic dermatitis.
Review when referral to dermatology for hair loss or skin changes of the face/scalp is necessary.
Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.

Disclosures

Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Pasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.

REBOOT #48 Hyponatremia Deconstructed

7 september 2020 | 89 min

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Original episode written and produced by: Matthew Watto MD, FACP
Show Notes and CME questions by: Deb Gorth ScM
Cover Art and Infographic by: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein (written materials); Matthew Watto MD (audio)
Guest: Joel Topf MD

Sponsors

POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team.

Interview season is in full swing and they’re actively accepting applications. Please go to pennultrasound.org or contact [email protected] for information. You can apply for fellowship using the eusfellowships.com portal.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

00:00 Intro
03:30 Guest interview
07:15 Pick of the week w/Dr. Topf
16:20 Clinical case of hyponatremia
17:48 False hyponatremia normal osmolality
19:34 False hyponatremia high osmolality
20:36 Understanding why osmolality matters
23:28 Workup false hyponatremia
24:45 Recap of discussion so far
25:40 ADH dependent vs independent hyponatremia
27:00 Psychogenic polydipsia
289:15 Renal failure and hyponatremia
30:03 Tea and toast, and Beer Drinker’s potomania
35:22 ADH dependent hyponatremia
38:15 Volume versus osmolality
40:00 Volume status exam
45:14 Additional testing with urine lytes and uric acid
47:30 Treatment for SIADH
52:42 Discussion of the vaptans
58:21 Additional testing in SIADH
62:50 When to admit patient for hyponatremia
63:59 Clinical case of hyponatremia complications
68:56 Fluids and rate of correction
73:36 DDAVP clamp
76:30 Moderate hyponatremia
78:35 Diuretic dosing DOES matter!
81:59 Loop diuretics for SIADH
84:25 Take home points
87:25 Outro

Links*

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will recall the pathophysiology of hyponatremia and develop a systematized approach to identifying the type and cause of hyponatremia, as well as how to safely manage hyponatremia.

Learning objectives

After listening to this episode listeners will…

Differentiate true and false hyponatremia
Recall the pathophysiology of true and false hyponatremia
Interpret blood and urine tests to identify the cause of hyponatremia
Recall the limitations of the volume status exam
List ADH dependent causes of hyponatremia
List ADH independent causes of hyponatremia
Explain the pathophysiology of beer drinker’s potomania and “tea and toast” hyponatremia
Use uric acid to differentiate SIADH from other causes of hyponatremia
Basic therapy for SIADH
Recall safe rates of correction for hyponatremia

Disclosures

Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures.

Citation

Topf J, Gorth DJ, Williams PN, Brigham SK, Heublein M, Jyang E, Watto MF. “REBOOT #48 Hyponatremia Deconstructed”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date: July 17, 2017; Updated September 7, 2020.

Become #1 in T1DM (Cribsiders #6)

31 augusti 2020 | 62 min

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot!

NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively.

Credits

Written and Produced by: Shannon Snellgrove
Infographic: Shannon Snellgrove
Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders)
Hosts: Justin Berk MD and Christopher Chiu MD
Editor:Justin Berk MD; Clair Morgan of nodderly.com
Guest(s): Hussein Abdullatif MD

*Sponsors*

POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team.

Interview season is in full swing and we’re actively accepting applications. Please go to pennultrasound.org or contact [email protected] for information. You can apply for fellowship using the eusfellowships.com portal.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Diagnosis of T1DM 6:50
Presentation of T1DM 10:10
Explaining T1DM to a parent 12:00
Genetic Predisposition to Diabetes 15:20
T1DM Antibodies 17:10
Initial work-up for concomitant autoimmune disease 21:10
Atypical Presentation of T1DM 22:44
Treatment of T1DM 29:10
Dietary Modifications in T1DM 33:10
Checking blood sugars 39:50
Honeymoon Period 42:25
Hypoglycemia 44:00
Sports, Sickness, Alcohol and Glucose levels 48:25
Periop glucose management 51:10
Long-term complications of T1DM 53:50
Closed Loop System and Future Treatments 56:10

Goal

Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes.

Learning objectives

After listening to this episode listeners will…

Identify the signs and symptoms of type 1 diabetes
Practice appropriate work-up in the diagnosis of type 1 diabetes
Manage type 1 diabetes with evidence-based therapies
Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts
Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes)

Disclosures

Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures.

Citation Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (link goes live on 9/2/2020)

#231 U Talkin’ UTIs Re: Me?

24 augusti 2020 | 68 min

Are U Talkin’ UTIs Re: Me? Infectious Diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED) schools us on the diagnosis and management of urinary tract infections: updated definitions of complicated and uncomplicated UTI, pitfalls of the urinalysis, first line antibiotics, duration of therapy and which agents to use for complicated UTI. This episode is liquid gold!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art and Infographic by: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
Guest: Boghuma Kabisen Titanji MD, PhD

Sponsor - 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
02:50 Guest one-liner, Picks of the Week*: Urban gardening, Behave (book) by Robert Sapolsky
08:54 Defining UTI; Framework for UTI
16:35 Case 1 - Cath Foley; Acute uncomplicated cystitis; Interpreting the Urinalysis
28:00 Women with recurrent UTIs
38:55 Case 2 - UTI in a man
47:15 Treatment of complicated infections; Duration of therapy
52:27 Case 3 - Catheter associated UTI; MRSA UTI
61:25 Duration of therapy for bacteremia from UTI
64:40 Take home points, plugs and outro
Sponsor - VCU Health Continuing Education

Links*

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals

Listeners will appropriately recognize, diagnose and treat the various presentations of urinary tract infection.

Learning objectives

After listening to this episode listeners will...

Define UTI and feel confident making the diagnosis of UTI based on lab tests, history and exam findings
Differentiate between complicated and uncomplicated UTI
Recognize how UTI may presents differently in differ groups (paraplegic, chronic foley catheter, men and women)
Choose the appropriate antibiotic and duration with an eye towards antibiotic stewardship
Determine an approach to the patient with recurrent UTIs, including who may benefit from long term antibiotic prophylaxis.

Disclosures

Dr Titanji reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Titanji BK, Williams PN, Watto MF. “#231 U Talkin’ UTIs Re: Me”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 24, 2020.

#230 Kittleson Rules Acute Heart Failure

17 augusti 2020 | 72 min

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea? Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement.

Credits

Written and Produced by: Deborah Gorth ScM
Cover Art and Infographic by: Edison Jyang
Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Michelle Kittleson MD, PhD

Sponsor - 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.

Time Stamps

00:00 Intro
02:40 Guest one-liner; Picks of the Week
08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic)
13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction?
20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?!
28:36 Labs to trend during an ADHF admission
33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes
45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2?
49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB)
56:05 Who needs a right heart cath?
59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care
64:04 SGLT2i in heart failure
68:15 Take home points and outro

#229 Hotcakes: COVID on steroids, statins over 75, short duration DAPT

10 augusti 2020 | 43 min

#228 Thyroid on Fire! Hyperthyroidism with Dr. Eve Bloomgarden

3 augusti 2020 | 71 min

Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire!

Credits

Written and Produced by: Tima Karginov and Matthew Watto MD, FACP
Infographic by: Tima Karginov
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Eve Bloomgarden MD

Sponsors: Pediatrics On Call podcast by the American Academy of Pediatrics

If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here.

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.

Time Stamps

00:00 Intro
03:15 Guest one-liner, favorite failure, Picks of the Week*
08:50 Sponsor
10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs
14:20 Case from Kashlak, Symptoms of Hyperthyroidism
25:00 Grave’s eye disease: exam, therapy and counseling
32:35 Thyroid exam and ultrasound
38:55 Thyroid Stimulating Immunoglobulin
41:00 Biotin
44:30 Thyroid Scintigraphy
49:00 Causes of Thyrotoxicosis
52:00 Treatment & Adherence to antithyroid medication (methimazole)
56:20 Beta Blockers in thyrotoxicosis
64:50 Subclinical Hyperthyroidism
67:00 Take Home Points, Outro

Back to School Special - COVID Edition (Cribsiders #3)

29 juli 2020 | 59 min

#227 Baffled by NAFLD?

27 juli 2020 | 75 min

#226 Kidney Boy on Acute Kidney Injury: Myths & Musings - Tips and Tricks from Joel Topf MD

20 juli 2020 | 69 min

#225 Women in Medicine: COVID Edition

16 juli 2020 | 74 min

#224 Hospital Addiction Medicine with Dr Melissa Weimer

13 juli 2020 | 60 min

Cystic Fibrosis Licked (Cribsiders #1) with Dr. Whittney Warren

6 juli 2020 | 60 min

#223 Hot COVID Cakes: COVID19 Disparities, Steroids, Hormones for Depression, Probiotics

2 juli 2020 | 47 min

#222 Addressing Anti-Black Racism in Medicine Utibe Essien MD, MPH

25 juni 2020 | 54 min

#221 Interstitial Lung Disease with Erin Narewski DO - Breathtaking knowledge and other words of inspiration

22 juni 2020 | 64 min

#220 Social Determinants of Health with Karen DeSalvo MD

18 juni 2020 | 40 min

#219 Post-Op Fever and Complications with Avital O’Glasser MD

15 juni 2020 | 58 min

#218 Trauma-Informed Care with Megan Gerber MD

8 juni 2020 | 66 min

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment, modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255.

Credits

Producer/Writer/Graphics: Beth Garbitelli
Co-Producer: Paul Williams MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
Guest: Megan Gerber MD, MPH, FACP

Sponsor: ACP - Visit acponline.org/member

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

Intro, disclaimer, guest bio (0:00 - 3:15)
Guest one-liner (3:30)
Kashlak Cases (13:45)
Epidemiology of trauma (15:18)
Trauma and #MeToo (18:10)
Defining Trauma-Informed Care (TIC) (19:00)
Integrating TIC into primary care (22:48)
Screening in TIC (25:00)
Containment and retraumatization (29:00)
Inquiring about trauma (30:45)
Recap and Office Visit Mechanics (35:30)
Building the Relationship (38:00)
Common Inquiry Mishaps (38:52)
TIC Physical Exam (40:20)
Resources for Patients (44:30)
Office Environment (48:00)
Provider Burnout (50:00)
TIC in Covid-19 (52:30)
Take-home Points (56:20)

Curious Clinicians Episode 1 - Clubbing

3 juni 2020 | 22 min

#217 COVID Cakes the Fourth: ACTT-1, Triple Therapy, PCR, Serology

1 juni 2020 | 52 min

#216 Homeless Healthcare with Stefan Kertesz MD

28 maj 2020 | 66 min

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!). Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is.

Credits

Written and Produced by Nora Taranto MD
Infographics by Nora Taranto MD
Cover Art by Kate Grant MBChB, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD
Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com
Guest: Stefan Kertesz MD

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
3:17 Guest one-liner
8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/
10:07 Case from Kashlak
10:56 Language: How to ask where a patient lives?
13:25 Terminology: Persons Experiencing Homelessness:
14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors
20:44 How to start the visit, and how to establish trust early on?
27:40 Why is the mortality rate higher?
35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C
54:15 COVID and homeless healthcare
57:00 Care Models
62:30 Take Home Points and Outro

#215 Medical Myths: Challenge Dogma with Dr. Douglas Paauw

25 maj 2020 | 51 min

#214 COVID Cakes 3: Llamas, Remdesivir, Strokes, Predicting the Future, and More!

18 maj 2020 | 52 min

#213 Fatigue for Primary Care with Nina Mingioni MD - A Common Sense Framework

11 maj 2020 | 58 min

#212 Inpatient Alcohol Withdrawal: Sober Talk with Joji Suzuki, MD

7 maj 2020 | 58 min

#211 COVID Cakes: Remdesivir, Anticoagulation, and Transmission

1 maj 2020 | 50 min

#210 Kidney Transplant for the Internist with Freely Filtered (NephMadness)

27 april 2020 | 74 min

#209 LIVE! Twitter, Social Media and Digital Scholarship

23 april 2020 | 52 min

#208 Hypothyroidism Master Class with Susan Mandel MD - How to dominate the diagnosis and management

20 april 2020 | 69 min

#207 How to create a medical podcast: Tales from The Curbside

16 april 2020 | 43 min

#206 Airway Management for the Non-Intensivist

13 april 2020 | 71 min

#205 COVID Cakes and Hot Takes with Rahul Ganatra MD

10 april 2020 | 45 min

#204 NephMadness 2020: SGLT2 Inhibitors

6 april 2020 | 50 min

#203 How to Create an Online Curriculum for Medical Education

2 april 2020 | 55 min

#202 LIVE! Lymphadenopathy: Taking Your Lumps - with Carrie Thompson MD

30 mars 2020 | 44 min

#201 COVID Narratives: Stories from Physicians at the Front Lines

26 mars 2020 | 65 min

#200 COVID-19 with Paul Sax MD - Transmission, quarantine, PPE, diagnosis and management

22 mars 2020 | 54 min

Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral! Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected]

Credits

Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP
Cover Art and Infographic by: Beth Garbitelli
Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Paul Sax MD

Sponsor: Cayuga

Time Stamps

00:00 Intro
04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza
07:00 Rahul highlights areas of caution interpreting COVID cases studies
12:35 Sponsor
13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms
18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity
21:15 Who merits testing for COVID-19
23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine
25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital
30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible?
32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine
36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces?
40:20 Do exposed HCWs without symptoms require quarantine?
41:30 Personal Protective equipment (PPE)
45:00 COVID-19 in pregnancy
47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.)
50:45 Where should you get your COVID-19 information?
52:30 Closing remarks and outro

#199 NephMadness: Hyperkalemia, Diet, Potassium Binders, Exercise

16 mars 2020 | 56 min

#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD

9 mars 2020 | 66 min

#197 Pulmonary Nodules and Lung Cancer Screening with Denitza Blagev MD

2 mars 2020 | 54 min

#196 LIVE! Refugee Health with Tanuja Devaraj MD

24 februari 2020 | 48 min

#195 TWDFNR 3: Potassium, Oxygen, and antipsychotics

17 februari 2020 | 60 min

#194 Treatment of Alcohol Use Disorder with Dr. Marlene Martin MD

10 februari 2020 | 54 min

#193 LIVE! The Struggling learner with Dr. Melissa McNeil

3 februari 2020 | 57 min

#192 Dialysis for the Internist with Joel Topf MD

27 januari 2020 | 72 min

#191 Lipids Update with Erin Michos MD

20 januari 2020 | 72 min

REBOOT #137 Hyperkalemia Master Class with Joel Topf MD

13 januari 2020 | 77 min

REBOOT #129 Depression and Physician Suicide with Elisabeth Poorman MD

6 januari 2020 | 77 min

Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic!

Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that.

The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line.

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at [email protected], or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need.

New episodes return January 20, 2020!

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits

Written and produced by: Nora Taranto MD, Shreya Trivedi MD
Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD
Edited by: Matthew Watto MD
Guest: Elisabeth Po

#190 Recap Extravaganza 2019

30 december 2019 | 65 min

#189 Medical Overuse: Common Cases of Overtesting, Overdiagnosis, Overtreatment

23 december 2019 | 64 min

#188 GERD and Dyspepsia with Dr. Amy Oxentenko MD

16 december 2019 | 82 min

#187 Buprenorphine Master Class: Managing Opioid Use Disorder for the Generalist

9 december 2019 | 64 min

#186 Sarcopenia: Raising the Bar in Primary Care

2 december 2019 | 71 min

#185 Hotcakes: Updates on CAP, Asthma & Red Meat!

27 november 2019 | 55 min

“Guidelines” galore! From Community-Acquired Pneumonia to asthma to...red meat? While you may be listening to this around Thanksgiving, we actually recorded on October 30th‒the best and spookiest time of the year. To really set the mood I wanted to include some terrible skeleton puns, but the ones I found weren’t humerus. What we do have for you are some tasty knowledge treats, courtesy of our ghosts‒oops, I mean our HOSTS‒Chris, Matt, Stuart and Paul. Join us as we review the most terrifyingly relevant research findings and creepiest clinical pearls!

Today also marks the debut of our newest Hotcakes team member, the frighteningly talented Dr. Rahul Ganatra. Rahul will now be our resident statistician/study design expert, and will use his research skulls‒no wait, SKILLS‒to provide even more insight into the practice-changing findings we love to highlight for you.

ACP members can claim CME-MOC at CME credit https://www.acponline.org/curbsiders. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Statistics Expert: Rahul Ganatra MD
Editors: Christopher Chiu MD (audio/text), Emi Okamoto MD (text)
Cover-Art: Sarah Phoebe Roberts MPH
Music: Stuart Brigham MD

Time stamps

00:00 Introduction/Disclaimer
03:18 Getting to know Dr. Rahul Gantra
05:35 Community-Acquired Pneumonia Guidelines
15:13 Sarah explains Hotcakes ratings
16:45 A new Asthma Strategy
17:26 Chris forgets what LABA stands for
27:37 Stuart makes a joke
29:00 A lot of meat talk
37:22 Rahul’s Napkin Calculations
51:40 Honorable Mentions
52:42 Take-away Points & Outtro

Meet Rahul:

Rahul Ganatra is a Medical Attending and Director of Continuing Medical Education for the Medical Service at the VA Boston Healthcare System. He fell in love with clinical epidemiology and public health while taking night classes for his MPH during medical school. and we

#184 Update in Sleep Medicine: LIVE from CHEST 2019!

25 november 2019 | 58 min

#183 Longevity, Healthspan and Lifespan with Peter Attia MD

18 november 2019 | 69 min

#182 Becoming a PGY3: Not Just a Repeat of PGY2

11 november 2019 | 61 min

#181 The Multimorbidity Games

4 november 2019 | 60 min

#180 CHEST 2019 Recap Part 2

30 oktober 2019 | 57 min

#179 CHEST 2019 Recap Part 1

28 oktober 2019 | 47 min

#178 Tuberculosis Updates with Laila Woc-Colburn MD

21 oktober 2019 | 72 min

#177 Osteoarthritis Master Class with Tuhina Neogi MD, PhD

14 oktober 2019 | 73 min

In-Flight Emergencies REBOOT

7 oktober 2019 | 39 min

Dominate the most common in-flight emergencies with tools and tips from this classic Curbsiders episode. Our guest, Angelica Zen MD, (formerly an IM Chief Resident at UCLA), recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane. Original air date November 21, 2016.

Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits

Written, produced and edited by: Matthew Watto MD, FACP
Cover Art by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Matthew Watto MD, FACP
Guest: Angelica Zen MD

Partners

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Time Stamps

0

#176 Survive Intern Year: Becoming a PGY1

2 oktober 2019 | 59 min

#175 Cervical Cancer Screening and HPV

30 september 2019 | 59 min

We dive deep into the relationship between HPV and cervical cancer and identify when and how to screen women with tips from Dr. Karen Smith-McCune (UCSF), Professor in the Department of Obstetrics and Gynecology! We review common cytology findings, screening guidelines, and basic indications for HPV vaccination.

Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits

Producer: Molly Heublein MD
Writer: Elena Gibson MD and Molly Heublein MD
Infographic: Beth Garbitelli MS2
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Molly Heublein MD; Matthew Watto MD, FACP
Editor: Emi Okamoto MD; Matthew Watto MD, FACP
Guest: Karen K. Smith-McCune MD, PhD

Sponsors

Win a prize! Help ACP Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

#174 Dominate Perioperative Medication Management

23 september 2019 | 91 min

#173 Hotcakes: Imposter syndrome, Vacations, Pneumonia vaccine, More!

16 september 2019 | 61 min

#172 Cost-of-Care Conversations

11 september 2019 | 55 min

#171 Lupus in Primary Care with Beth Jonas MD

9 september 2019 | 55 min

#170 Hypernatremia is Easy with Joel Topf MD

2 september 2019 | 73 min

#169 PGY3 and Beyond with Alia Chisty MD

28 augusti 2019 | 75 min

#168 Diabetes Update with Jeff Colburn MD

26 augusti 2019 | 71 min

#167 LIVE! Common CBC Abnormalities with Mary Kwok MD

19 augusti 2019 | 50 min

#166 Advocacy and Hot Topics in Healthcare Policy with Robert McLean MD, FACP

14 augusti 2019 | 62 min

#165 Things We Do For No Reason™ Part 2

12 augusti 2019 | 74 min

Reboot #108 POCUS: Point-of-care Ultrasound for the Internist

7 augusti 2019 | 60 min

#164 Stroke and TIA Deconstructed

5 augusti 2019 | 75 min

#163 Hotcakes: Burnout, iron for heart failure, aspirin & VTE prevention

29 juli 2019 | 42 min

#162 Gender & Sexual Harassment in Medicine, #MeToo

22 juli 2019 | 62 min

#161 A Rash Approach to Rashes with Helena Pasieka MD

15 juli 2019 | 79 min

#160 Hotcakes: E-cigarettes, UTIs, Heart Failure

10 juli 2019 | 45 min

#159 Atrial Fibrillation Review and Update with James Furgerson MD

8 juli 2019 | 80 min

#158 Medicine and Incarceration

1 juli 2019 | 59 min

#156 Chronic Pain, Opioids, Tapers

24 juni 2019 | 66 min

#155 LGBT Health in Primary Care

17 juni 2019 | 53 min

#154 DVT and PE Master Class with Michael Streiff MD

10 juni 2019 | 69 min

#153 Heart Disease in Women with Dr Bairey Merz

3 juni 2019 | 54 min

#152 Dare to Lead: Becoming a PGY2

29 maj 2019 | 78 min

#151 Anaphylaxis with Dr Olajumoke Fadugba MD

27 maj 2019 | 39 min

#150 HFpEF with Dr Clyde Yancy MD

20 maj 2019 | 48 min

Recap SGIM19 Day 2

17 maj 2019 | 41 min

Recap SGIM19 Day 1

13 maj 2019 | 40 min

#149 Hip Pain for Primary Care

6 maj 2019 | 44 min

Telehealth with Ana María López MD

2 maj 2019 | 55 min

#148 Benign Prostatic Hyperplasia for the Internist

29 april 2019 | 62 min

This week we narrow in on the enlarging prostate and decipher the common issue of benign prostatic hyperplasia with Adam C. Reese MD, Associate Professor of Urology at the Lewis Katz School of Medicine at Temple University and Chief of Urologic Oncology at Temple University Hospital. Learn how to interpret the symptom profile for patients presenting with common urinary issues, what to feel for in the digital rectal exam, how to treat BPH, and when to refer.

ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

See you at SGIM 2019!

Find us in our red Curbsider’s t-shirts handing out Curbsiders and Kashlak stickers/patches at SGIM 2019 in Washington DC! We’ll be recording full length shows and daily recaps!

Credits

Written and produced by: Paul Williams MD

Hosts: Paul Williams MD, Matthew Watto MD

Images and infographics: Elena Gibson, Beth Garbitelli

Show Notes: Elena Gibson, Beth Garbitelli

Edited by: Matthew Watto MD, Chris Chiu MD

Guest: Adam Reese MD

Time Stamps

00:00 SGIM announcement

00:30 Disclaimer, intro and guest bio

03:20 Guest one liner, book recommendation, favorite failure and surgical M&M

10:56 Case of benign prostatic hyperplasia, defining terms and obstructive/voiding versus storage/irritative symptoms

16:11 IPSS score and evaluating symptoms

22:10 Digital rectal exam. Will this give any useful information?

26:55 Taking a history about BPH and some lifestyle modifications

29:20 Lab studies for urinary tract symptoms and interpreting PSA and free PSA

36:20 Initial therapy for BPH and managing patient expectations, alpha blocker side effects

39:25 Choice of agent and monitoring symptoms on therapy

42:25 Nonpharmacologic management of bladder complaints

45:10 Who and when to refer to urology

47:33 Counseling about use of 5 alpha reductase inhibitors, their side effects and is there a risk for high grade cancer?

52:35 Phosphodiesterase inhibitors for BPH symptoms

53:50 Urethral milking. NOT prostate milking

54:55 Desmopressin for nocturia

56:20 Take home points

59:03 Prostate volume and PSA

61:10 Outro

Full show notes available at http://thecurbsiders.com/episode-list.

Random Pearls #IM2019 Day 3

22 april 2019 | 36 min

Random Pearls #IM2019 Day 2

19 april 2019 | 45 min

Random Pearls #IM2019 Day 1

15 april 2019 | 48 min

#147 Rheumatoid Arthritis for the Internist

8 april 2019 | 78 min

#146 NephMadness: Pain Meds in Chronic Kidney Disease

1 april 2019 | 84 min

#145 NephMadness: Hepatorenal Syndrome vs AKI

25 mars 2019 | 79 min

HCP: Primary Care Workforce with Fatima and Deep

20 mars 2019 | 62 min

#144 NephMadness: Inpatient Hypertension

18 mars 2019 | 44 min

#143 NephMadness: Fluid Wars

15 mars 2019 | 52 min

#142 Cirrhosis TIPS for Acute Complications

11 mars 2019 | 91 min

Reboot - Diuretics, leg cramps, and resistant hypertension

4 mars 2019 | 65 min

#141 Wound Care Pearls

25 februari 2019 | 71 min

#140 Psychopharmacology 2.0 - Antidepressant Master Class

18 februari 2019 | 59 min

#139 Genetic Testing in Primary Care

11 februari 2019 | 83 min

#138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis

4 februari 2019 | 86 min

#137 Hyperkalemia Master Class with Joel Topf MD

28 januari 2019 | 81 min

#136 Sickle Cell Disease, Management & Complications

21 januari 2019 | 69 min

Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sickle Cell Center for Adults at Johns Hopkins joins!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Sponsor

ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA. We'll see you there!

Credits

Written (including CME questions) and produced by: Justin Berk MD, Martha Brucato MD PhD, Beth Garbitelli MS1

Hosts: Paul Williams MD, Justin Berk MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Sophie Lanzkron MD MHS

Time Stamps

00:00 Announcements, intro
02:30 A quick refresher on hemoglobinopathy
03:45 Guest bio
05:03 Guest one-liner, movie recommendation, career advice, picks of the week
10:53 ACP Internal Medicine Meeting 2019 (ad read)
12:33 Clinical case; defining sickle cell; pathophysiology
16:23 Different types of hemoglobinopathy genotypes and phenotypes
20:20 Preventive care for sickle cell disease
22:56 Taking a history at the initial visit in patient with sickle disease
26:40 Life expectancy in SCD
28:30 Hydroxyurea
30:40 Chronic red blood cell transfusion therapy; complications; monitoring
37:07 Silent cerebral infarcts and mild cognitive impairment in SCD
40:10 Chronic pain management; opioid use disorder in sickle cell disease
46:00 Acute pain crisis management; PCAs vs bolus therapy
54:08 Reticulocyte count in sickle cell disease
55:40 Itching, opioids and naloxone?
58:10 Red blood cell transfusion threshold in sickle cell disease (anemia)
60:03 Acute fever in SCD
61:48 Acute chest syndrome
66:45 Transition from pediatrics to adult medicine in sickle cell
68:00 Incentive spirometry to prevent acute chest syndrome
68:45 Take home points
70:00 Outro

#135 Perioperative Medicine with Dr Avital O'Glasser

14 januari 2019 | 85 min

#134 Urinary Tract Infections Delirium and Voltaire

7 januari 2019 | 54 min

2018 Recap Extravaganza

31 december 2018 | 51 min

#133 Herpes for Everyone

24 december 2018 | 58 min

#132 A Case of Abdominal Pain

19 december 2018 | 50 min

#131 A Case of Cough and Dyspnea

17 december 2018 | 48 min

#130 Work-Life Fit: Women In Medicine

13 december 2018 | 53 min

Create a successful partnership and career withs tips from Wonder Woman, Sue Hingle MD of ACP.

Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro tip: stop worrying about what others think!). Dr. Hingle is Professor in the Department of Internal Medicine and Vice Chair of Education and Faculty Development and Associate Internal Medicine Residency Program Director at Southern Illinois University. She is also the Immediate Past Chair of the Board of Regents of the American College of Physicians (ACP). She has served at the ACP in a variety of ways, including as a member of the ACP Women’s Task Force. Her clinical expertise is in women’s health, health promotion, and disease prevention. Enjoy the episode!

ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits

Written and produced by: Nora Taranto MS4, Shreya Trivedi MD, Leah Witt MD, Sarah P. Roberts MPH.

CME Questions by: Shreya Trivedi MD

Editors: Matthew Watto MD and Chris Chiu MD

Hosts: Shreya Trivedi MD, Paul Williams MD, Leah Witt MD

Guest: Susan Hingle MD

Time Stamps

00:00 Disclaimer, intro and guest bio
02:52 Guest one liner, WIM Moment of awakening, advice for her younger self
07:45 Picks of the week
10:30 Physician with family and caregiver responsibility; How to plan for personal and professional goals
18:20 What to look for in a partner, how to work with them to achieve work life fit, and non-traditional roles
28:35 Advice on family planning
31:40 Residency programs and life events
32:55 Should you go part-time?
39:43 Work life balance? Or work life fit? And some examples/tips for success
49:54 Take home points
50:45 Outro

#129 Depression and Suicide: Occupational Hazards of Practicing Medicine

10 december 2018 | 69 min

#128 Aspirin Overhyped and Overused

3 december 2018 | 53 min

Hotcakes: Exercise, Aspirin, Fish Oil and Hypertension

29 november 2018 | 49 min

#127 STIs: Syphilis, Gonorrhea and Chlamydia

26 november 2018 | 76 min

#126 Kashlak Morning Report with Human Dx

19 november 2018 | 66 min

#125 Hidden Curriculum

15 november 2018 | 63 min

#124 The Shoulder - Simplify Your Approach

12 november 2018 | 72 min

#123 Sleep Apnea Pearls and Pitfalls

5 november 2018 | 52 min

#122 Headaches Advanced Class

29 oktober 2018 | 78 min

#121 HIV Care for the Internist

22 oktober 2018 | 61 min

#120 Policy, Patients, Payments, Paperwork

19 oktober 2018 | 44 min

#119 Nutrition Pearls, Heart Health and Bacon

15 oktober 2018 | 58 min

#118 Female Sexual Problems with Stacy Lindau MD

8 oktober 2018 | 57 min

#117 Clostridium Difficile: IDSA Guidelines, Bad Puns, and Random Pearls

1 oktober 2018 | 64 min

#116 Geriatric Psychiatry: Sleep, Dementia, and Behavioral Disturbances

27 september 2018 | 30 min

#115 Geriatric Depression

24 september 2018 | 46 min

Summary

Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and titrate medications, and how long to continue therapy. Stay tuned for part two of our discussion with Dr Popeo on managing sleep and behavioral problems in older adult patients with dementia.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits

Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

00:00 A question for you, the listeners
01:12 Disclaimer, intro and guest bio
05:00 Getting to know our guest, recommendations for reading, and career advice
14:13 Case of geriatric depression; effective history taking; recognizing associated symptoms; depression scales
19:03 Suicide in older adults; firearm safety
24:26 Choice of therapy; Pharmacologic agents; Counseling patients and managing expectations; Dose titration and tracking symptoms
34:41 Augmenting therapy versus cross-titration to another agent; When is it okay to stop an antidepressant
40:50 Take home points
44:40 Outro

Tags: psychiatry, psych, geri, geriatrics, depression, mdd, sleep, insomnia, appetite, agitation, suicide, SSRIs, side, effects, therapy, diagnosis, serotonin, mirtazapine, bupropion, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#114 High Value Care: Assess Quality, Mitigate Diagnostic Uncertainty, Overcome Barriers

17 september 2018 | 58 min

#113 Gout: Uric acid targets, urate lowering therapy, and random questions from social media

10 september 2018 | 38 min

#112 Gout Flares: Bathtubs and Firefighting

3 september 2018 | 48 min

#111: Hotcakes - Complementary Medicine in Cancer, Dosing Aspirin by Body Weight, Marijuana & Respiratory Symptoms, Penicillin Allergies and More!

31 augusti 2018 | 42 min

#110: Driver’s safety for Older Adults: When is it Time to Give Up the Keys?

27 augusti 2018 | 73 min

Get schooled on driver’s safety for older adults by expert, Alice Pomidor MD, Professor of Geriatrics at Florida State University. Whether or not older adults can continue to drive is a huge problem faced by for primary care clinicians, and will remain one until driverless cars become ubiquitous. Topics covered include: how to take a driving history, red flags, physical exam, cognitive exam, and vision assessment for driver’s safety, resources, when to refer, alternate means of transportation, and the legal repercussions of reporting...or not reporting.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits:

Written and produced by: Matthew Watto MD and Elizabeth Garbitelli MD Candidate 2022
Editor: Matthew Watto MD
Cover Image by: Kate Grant MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Alice Pomidor MD

Time Stamps

00:00 Disclaimer
00:35 Intro and guest bio
03:10 Guest onliner, book recommendations, and career advice
10:43 Clinical case, and the 5 Rs of clinicians responsibility
19:15 Taking a history from older adult drivers
26:28 The clinical exam for driver’s safety (cognition, vision, and MSK tests)
37:24 How can we avoid patient anger towards clinician and family members?
41:10 When and where to refer for driving evaluation
47:00 Alternative transportation
52:00 What to do if someone refuses or forgets to stop driving
59:45 Reporting requirements and legal ramifications
69:15 Take home points
72:00 Outro

Tags: driving, elderly, geriatrics, dementia, treatment, prevention, cognition, seniors, drivers, safety, crash, motor, vehicle, car, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#109: Things We Do For No Reason: A High Value Episode

20 augusti 2018 | 67 min

#108: Point-of-care Ultrasound for the Internist

13 augusti 2018 | 60 min

#107: Women in Medicine, Be Bold

6 augusti 2018 | 59 min

“Women in medicine, be bold.” Medical World, powerful women are here to stay. Dr. Vineet (Vinny) Arora, Professor of Medicine at University of Chicago, an exemplary Woman in Medicine and Leadership, shares snippets of her own story, valuable career advice to folks at all levels of training, and fascinating data about the gender disparities that exist in training, promotion, and pay. We hope you’ll learn from this episode, whether you have faced or anticipate facing these struggles as a Woman in Medicine or as a member of another marginalized group, or whether you’re an ally and want to learn more about the issue.

Women are entering medical school now more than ever, and are learning to provide the best possible care to patients (didn’t you see that patients of female physicians have significantly lower mortality rates than patients of male physicians? (Tsugawa et al., 2016)). The modern medical woman wants to teach, mentor, and lead--and be fairly evaluated, and promoted. That’s where We In Medicine (both women and men) have some work to do. Because gender disparities (and other disparities hinging on identity) do exist.

N.b. This episode is our inaugural in what we hope will be a Women in Medicine series for the Curbsiders. We have many more topics with which we’d like to engage, from career trajectory to imposter syndrome to sexual harassment to balancing career and personal lives (as inequity is not only at work (Khullar. Being a Doctor is Hard. It’s Harder for Women. NYT 2017)), to conversations about race, gender, and LGBTQ identity in medicine. We’re passionate, at The Curbsiders, about all these topics, and we want to dive deep into how to make Medicine a more welcoming and ceiling-less place for all. We can’t wait to bring this series to you, not to mention to bring some more fabulous female experts on air.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits:

Written and produced by: Leah Witt MD, Shreya P. Trivedi MD, Nora Taranto AB, Sarah Phoebe Roberts MPH, Molly Heublein MD, Beth Garbitelli, Hannah R Abrams,
Images by: Beth Garbitelli and Hannah Abrams
Editor: Matthew Watto MD
Hosts: Leah Witt MD, Shreya P. Trivedi MD, Matthew Watto MD
Guest: Vineet Arora MD

#106: Hotcakes: Cardiac risk, diabetes, pulmonary embolism, opioid use disorder, neck ties and nose picking?

30 juli 2018 | 56 min

#105: Lyme Disease and Tick-Borne Illness with ID Expert Paul Sax

23 juli 2018 | 59 min

#104: Renal tubular acidosis with Kidney Boy, Joel Topf MD

16 juli 2018 | 76 min

#103: Train Your Brain: Mapping out your road to expertise

9 juli 2018 | 59 min

#102: Hotcakes: Asthma, Smoking Cessation, PCP Prophylaxis, Procalcitonin

2 juli 2018 | 75 min

Curbsiders’ Journal Club features rapid summary and critical appraisal of recent articles and news stories in internal medicine by The Curbsiders. This month’s topics include: asthma, maintenance versus as needed inhaler use, procalcitonin, Pneumocystis pneumonia prophylaxis, colon cancer screening, smoking cessation, cannabis and cognitive impairment, LDL cholesterol and mortality, plus some medical podcast recommendations.

Over the last month, we have developed a list of more than 40 interesting articles and news stories that we have been feeding our own brain holes. From this list we have plucked a select few that we really wanted to highlight and share with you.

Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
Editor: Matthew Watto MD

Time Stamps:

00:00 Announcements
00:20 Disclaimer
01:00 Intro to Curbsiders Journal Club
03:07 Mild asthma and as needed versus maintenance inhaler use
09:50 Smoking cessation, e-cigarettes, and financial incentives
17:23 Pneumocystis pneumonia prophylaxis
22:18 Cannabis and cognitive impairment
26:15 Colorectal cancer screening update by American Cancer Society
30:37 Procalcitonin for lower respiratory tract infections in the ED
37:29 Cholesterol, baseline LDL-C, mortality and cardiovascular events
41:01 Incorrect symbology and some podcast recommendations
46:22 Outro

Tags: asthma, maintenance, inhaler, procalcitonin, Pneumocystis, pcp, pneumonia, prophylaxis, colon, cancer, screening, crc, smoking, cessation, marijuana, cannabis, cognitive impairment, LDL, cholesterol, mortality, cardiovascular, podcast, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed

#101: Cirrhosis: Medications, decompensation, complications

25 juni 2018 | 40 min

Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits:

Written by: Cyrus Askin MD
Infographics: Beth Garbitelli
Produced by: Cyrus Askin MD and Matthew Watto MD
Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Scott Matherly MD

Time Stamps

00:00 Announcements
00:54 Disclaimer
01:30 Guest bio
02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis
06:56 Clinical case of decompensated cirrhosis
09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics
18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin
25:10 Timing of medical therapy
26:39 MAP of 82 mmHg, beta blockers and variceal bleeding
31:04 Use of midodrine for hypotension
33:45 Prophylaxis of SBP
36:05 Take home points
38:04 Outro

Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

#100: Cirrhosis: Initial Evaluation and Management

18 juni 2018 | 48 min

#99 Cancer Survivorship: What to do when the treatment is done

11 juni 2018 | 52 min

#98 Knee Pain: History, exam, bracing, x-rays, and injectables

4 juni 2018 | 65 min

#97 Hotcakes: Hypertension, Prostate Cancer Screening, Lifestyle & Mortality

28 maj 2018 | 39 min

#96 Diabetes: A1C targets & ACP guidelines controversy

21 maj 2018 | 50 min

#95 Food allergy, food intolerance and celiac disease

14 maj 2018 | 58 min

#94: Random Pearls: Microbiome, POTS, Gabapentin, and Leonardo Da Vinci

7 maj 2018 | 29 min

#93 Clinical Pearls ACP 2018 with Nina Mingioni MD

30 april 2018 | 32 min

#92: Pulmonary Embolism for the Internist

23 april 2018 | 57 min

Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz

Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Time Stamps

5:10 - Start of Interview / Introduction
10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology
16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”)
23:30 - Other ways to risk-stratify (Other CT findings, clot burden)
28:45 - What does a low-risk patient look like?
30:35 - When to consider treatment modalities other than general anticoagulation
35:12 - Anticoagulation treatment options
36:38 - Next step intensive interventions after anticoagulation
42:00 - Evidence behind catheter-directed lysis
44:05 - IVC Filter discussion
47:22 - Discharge criteria for PE
50:00 - Incidental PEs
52:40 - Interdisciplinary PERT Team

Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

Random Clinical Pearls ACP 2018 Day 2

21 april 2018 | 23 min

Random Clinical Pearls ACP 2018 Day 1

20 april 2018 | 18 min

#91 Hotcakes: Fluid Wars, Barbershops, HTN, Aromatherapy, Coffee

16 april 2018 | 34 min

#90 Clinical Reasoning: Become an expert diagnostician

9 april 2018 | 64 min

#89 Conjunctivitis: Red Eye in Pr-eye-mary Care with Dr Glaucomflecken

2 april 2018 | 58 min

#88 Acid base, boy bands, and grandfather clocks with Joel Topf MD

26 mars 2018 | 93 min

#87 Toxicology 101: Talking Tox with The Dantastic Mr. Tox & Howard

19 mars 2018 | 80 min

#86 COPD: Diagnosis, treatment, PFTs, and nihilism

12 mars 2018 | 81 min

#85: Contraceptives: Pills, mini pills, and tiny pills

5 mars 2018 | 66 min

#84: Anemia, Iron Deficiency, IV iron, and Tony Stark

26 februari 2018 | 62 min

#83 Valvular heart disease, anticoagulation, TAVR, and primary care

19 februari 2018 | 68 min

#82 Dementia Dos and Don’ts: The GeriSiders

12 februari 2018 | 81 min

Challenge your beliefs on the efficacy of pervasive treatments used in dementia with expert Eric Widera, MD, Professor and clinician-educator in the Division of Geriatrics at the University of California-San Francisco. We explore the use of cholinesterase inhibitors, antipsychotics for behavior disturbances, feeding tubes, medications and supplements used for weight gain (inspired by Choosing Wisely and the American Geriatric Society’s “Ten Things Clinicians and Patients Should Question”). Plus, we introduce our new correspondent, Dr. Leah Witt, Geriatrics Fellow at UCSF.

Written and produced by: Jordana Kozupsky, NP, Nora Taranto, MS3, Leah Witt, MD; Edited by: Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Self Assessment Questions Take the quiz now!

Time Stamps

00:00 Disclaimer
00:37 Guys set up the show
02:00 Dr Widera’s bio
03:15 Getting to know our guests
13:10 Picks of the week
16:40 Clinical case: new diagnosis of dementia
17:40 Discussing dementia with patients and caregivers
23:42 Cholinesterase inhibitors
27:35 Stopping cholinesterase inhibitors
33:35 Follow up to therapy
36:05 Dealing with behavior disturbances
39:15 DICE approach
44:17 Risks of antipsychotic medications
48:00 Use of benzos or sedative hypnotics
49:45 Melatonin for delirium or sleep
52:00 Mirtazapine
53:54 Clinical case: patient with dementia not eating
54:40 Feeding tubes
59:40 Dysphagia and NPO orders
62:04 Misinformation on malnutrition and girth creep
65:10 Thickened liquid challenge
70:25 Appetite stimulants
72:38 Megestrol
73:54 Take home points from Dr Widera
79:17 Outro

Tags: dementia, donepezil, cholinesterase, inhibitor, antipsychotic, behavior, disturbance, agitation, benzodiazepine, supplement, feeding, tube, restraints, thickened, liquids, geriatric, choosing, wisely, american, society, ags, assistant, care, doct

#81: Placebos, nocebos, and the doctor as a placebo

5 februari 2018 | 53 min

#80 Pulmonary hypertension, freeways, and cows in heart failure

29 januari 2018 | 63 min

#79 Dermatitis: Atopic to Remember w/The DermSiders

22 januari 2018 | 73 min

#78 ID Pearls with Paul Sax MD

15 januari 2018 | 66 min

It's a potpourri of Infectious Diseases with tips from expert, Dr Paul Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women's Hospital, and Professor of Medicine at Harvard Medical School. We discuss the man flu, the flu vaccine, travel medicine, malaria, lyme disease, post lyme syndrome, chronic lyme, shingles, cellulitis, abscesses, antibiotics, c diff, antibiotic associated diarrhea, the dangers of fluoroquinolones, why doxycycline is awesome, and more! Told you it was a potpourri. Dr Shreya Trivedi joins Matt and Paul as guest host.

Show Notes, MCQ by Shreya Trivedi, MD
Edited by Matthew Watto, MD
Infographics and cover image by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Time Stamps:

00:00 Announcement
01:38 Intro
03:46 Picks of the Week
06:47 Guest bio
08:47 Getting to know our guest
15:40 Flu vaccination
19:54 Barriers to the flu vaccine
23:34 Can you give the flu vaccine to an ill patient
24:14 Man flu
26:27 Travel Medicine
30:35 Tick bites
33:49 Lyme serologies
35:38 Lyme prophylaxis
37:37 Chronic lyme disease and post lyme syndrome
38:55 Penicillin and antibiotic allergies
41:48 Fluoroquinolones and adverse reactions
45:24 Should antibiotics be given after an I&D of an abscess
49:34 Antibiotic associated diarrhea, C diff
52:10 Probiotics, stool transplantation, and C diff
54:50 Shingles, recurrent zoster, complications, and the new subunit vaccine
61:45 Using salad tongs at a buffet
63:04 Take home points
64:26 Outro

Tags:

ID, infectious, diseases, disease, flu, influenza, lyme, doxycycline, cdiff, antibiotics, infection, cellulitis, abscess, vaccine, zoster, shingles, malaria, travel, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#77 Hypertension Guidelines Showdown

8 januari 2018 | 75 min

Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes.

Time Stamps

00:00 The setup
02:15 Disclaimer
03:32 Picks of the Week
08:13 Getting to know Dr Forciea
13:35 Broad overview and a clinical case of geriatric hypertension
14:45 Brief history on BP targets
18:05 How do you measure a blood pressure? What type of monitors are available?
22:13 How to standardize BP in the office?
23:55 Ambulatory BP monitoring
24:55 Home blood pressure monitoring
26:11 Standing blood pressure readings and orthostatic hypotension
27:53 How guidelines are written
30:51 Evaluating evidence quality and strength of recommendation
32:35 Timeline and process for guideline generation
34:27 How to read guidelines with a “critical eye”
36:15 Return to our case of uncontrolled hypertension
38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults
40:33 Counsel patients on BP targets
42:25 Low diastolic blood pressure
45:35 SPRINT and the ACP BP guidelines
48:58 Take home points from Dr Forciea
50:07 HTN targets and pay for performance in clinical practice
51:45 Curbsiders recap the ACP guidelines
53:45 Matt and Paul recap the AHA guidelines
54:47 AHA definitions of hypertension
56:15 Diagnosing hypertension and how to measure a blood pressure
60:35 Choosing a blood pressure monitor and HBPM
62:29 Blood pressure goals in ACC guidelines
66:08 Non-pharmacologic measures
69:15 Will we follow these new strict targets?
72:45 Outro

Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resid

#76 Pneumonia Pearls with Dr Robert Centor

1 januari 2018 | 67 min

#75 Recap, highlights, and clinical pearls extravaganza for The Curbsiders 2017

25 december 2017 | 69 min

#74 Opioid use disorder, pain, detox, tapers, health policy, and more!

22 december 2017 | 76 min

#73: Opioid Addiction, Chronic Pain, and Abstinence

18 december 2017 | 55 min

Take the pain out of pain management with clinical pearls from addiction medicine specialists Dr. Stefan Kertesz at the University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton, Virginia. They walk us through an approach to pain management in persons with a history of opioid use disorder (OUD), discuss treatment options for OUD, plus hot tips on how to interpret guidelines surrounding opioids, and more! What are you waiting for? Hit the play button! Special thanks to Elena Gibson, MD and Carolyn Chan, MD

Credits

Producer: Elena Gibson and Carolyn Chan
Writer: Carolyn Chan
Infographic: Elena Gibson
Cover Art: Elena Gibson
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Stefan Kertez and Dr. Ajay Manhapra

Time Stamps

00:00 Intro
01:58 Host picks of the week
04:10: Intro to the episode
04:35: Guest Bios
12:32: Case from Kashlak Memorial
13:40 Define substance dependence, substance use, unhealthy use
17:42 Where to go next conversation about pain control
17:54: Assessing risk of relapse
19:35 Screening Tools
20:10 Risk factors for developing OUD when initiating opioids.
25:10: CDC Guidelines length of prescription and risk of substance use disorder (7)
27:00: Defining optimal length of opioid after common surgical procedures (6)
30:30: Long term use of opioids
33:50: OUD treatment options
37:30: Duration of buprenorphine/naloxone treatment, tapering risks (8)
38:50: POATs: Prescription opioids (9)
40:05 Social support and mental health services for SUD treatment
41:10 Risk of abstinence and adverse outcomes
42:35 Protracted withdrawal
43:35: Editorial BMJ Golden Month of Opioid use disorder (10)
44:00 Overdose risk in patients on long term opioids
44:40 Op-Ed on the Hill (11)
45:40 Example of protracted withdrawal syndrome
47:40 Reducing Harms: Naloxone, who to prescribe to?
50:30 Take home points
53:40 Outro

#72 Transgender Care in Primary Care

11 december 2017 | 62 min

#71 Asthma Made Simple

4 december 2017 | 62 min

#70 KevinMD: Kevin Explains Everything

1 december 2017 | 58 min

#69 CKD: Prescribing Do’s and Dont’s with @kidney_boy, Joel Topf

27 november 2017 | 41 min

#68 Tremors: One degree of Kevin Bacon?

20 november 2017 | 64 min

#67 Chronic Kidney Disease Pearls with @kidney_boy, Joel Topf

13 november 2017 | 44 min

#66 Hepatitis C: Workup and Treatment in Primary Care

6 november 2017 | 54 min

#65 Scott Weingart of EMCrit on Emergency versus Internal Medicine: The Devil of the Gaps

30 oktober 2017 | 52 min

#64 Stuff You Should Know About Health Policy

27 oktober 2017 | 50 min

#63 Medical Marijuana: Is it really dope?

23 oktober 2017 | 51 min

Expand your consciousness around medical cannabis (aka marijuana) with expert Dr Donald Abrams, Chief of the Hematology-Oncology Division at San Francisco General Hospital and a Professor of Clinical Medicine at the University of California San Francisco. We explain the cannabinoid system, THC, CBD aka cannabidiol, limitations surrounding cannabis research, current and future medical uses for medical cannabis (marijuana), and potential conditions it may benefit. We take a deep dive on the potential harms of medical cannabis and how to counsel patients on safe use. Plus, the return past guest and new correspondent, Dr Molly Heublein, Assistant Professor of Medicine from UCSF.

Thanks to Dr Molly Heublein for writing and producing this episode and it’s show notes!

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Clinical case from Kashlak Memorial: MM is a 62 yo woman with a history of osteoarthritis and breast cancer, now on an aromatase inhibitor. She struggles with aching and stiffness in her hands, shoulders, knees, and hips. A friend suggested she try medical marijuana. She wants her provider’s opinion on if this is safe and effective.

Time Stamps

00:00 Intro

01:30 Picks of the week

03:40 Guest bio

05:11 Getting to know our guest

11:03 Clinical case

11:40 Limitations for cannabis research

12:59 Discussion of THC and cannabidiol

14:50 Smoking versus ingesting cannabis products

16:40 Recap of cannabinoid mechanism of action

18:30 Cannabis and cannabinoid products available

20:20 Synthetic THC (dronabinol)

21:46 How “recommending” cannabis and dispensaries work

25:46 Conditions that respond to medical cannabis

29:15 Potential harms of medical cannabis

34:51 Future directions of cannabinoid medicine research

37:24 Cannabis induced hyperemesis syndrome

39:00 Possible lung cancer risk

40:12 Take home points

42:54 The Curbsiders recap and share their views on the medical cannabis controversy

49:40 Outro

#62 Pod Save Health Care: The Curbsiders Foray into health policy

16 oktober 2017 | 37 min

#61 Vasculitis and Giant-Cell Arteritis: ‘Rheum’ for improvement

9 oktober 2017 | 55 min

Keep your cool in the face of inflammation, and make the path to vasculitis diagnosis less tortuous with Dr. Rebecca Sharim, Rheumatologist and Assistant Professor of Medicine at Temple University. In this episode, we go with the flow from large vessel to small vessel vasculitides, and then learn how to make the diagnosis and management of Giant Cell Arteritis (GCA) and polymyalgia rheumatica (PMR) less of a headache. Correspondent, Dr. Bryan Brown cohosts!

Special thanks to Dr. Bryan Brown for writing our show notes, and creating figures for our handouts.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Case from Kashlak Memorial: A 75 year-old woman with a PMHx of hypertension presents to the ED with three days of worsening left sided headache, now with left sided vision loss during a Norwegian folk festival. On review of systems, she also endorses a week of soreness of her shoulders and hips. This has never happened to her before.

Time Stamps

00:00 Intro

03:07 Picks of the week

09:13 Getting to know our guest

15:00 Clinical case of vasculitis

15:59 Defining and classifying vasculitis

20:55 Workup for suspected vasculitis

23:17 How to explain GCA to a patient

25:08 Typical symptoms of vasculitis

28:00 Chewing gum test

29:34 Interpreting ESR

32:54 Basic exam and lab workup for vasculitis

35:23 Headache and suspicion for GCA/temporal arteritis

38:10 Is a temporal artery biopsy still mandatory?

39:20 Polymyalgia rheumatica

40:59 Steps to take when GCA/temporal arteritis suspected in clinic

43:55 PCP prophylaxis with high dose steroids

46:30 DMARDs and steroid sparing agents

48:12 Imaging studies to aid in diagnosis of GCA

50:50 Complications of long term steroid therapy

52:31 Take home points

53:26 Outro

Tags: giant, cell, arteritis, gca, vasculitis, steroids, temporal, biopsy, artery, esr, pmr, polymyalgia, rheumatica, vessel, headache, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

#60: Masters of MKSAP on Medical Education

2 oktober 2017 | 55 min

#59: Back pain and Sciatica: Straighten out your practice

25 september 2017 | 70 min

Solidify your approach to back pain and sciatica with Dr. Chris Miles, Assistant Professor, Family & Community Medicine and Associate Director, Sports Medicine program, Wake Forest Baptist Medical Center. He schools us on red/yellow flags, physical exam maneuvers, when to order imaging, and practical tools and tips for evidence-based management! Correspondent Dr. Shreya Trivedi cohosts!

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Case from Kashlak Memorial: 53 yo M construction worker with a BMI of 29 and PMhx of DM2, HTN, depression presenting with right low back pain. He can't remember any trauma or injury. Denies radiation, no bowel or bladder dysfunction, saddle anesthesia, weakness

Case from Kashlak Memorial: 48 yo F nurse who has had intermittent back pain for years presented with acute flare after helping lift a patient. The pain similar to previous episodes but more severe and also radiates to her left foot. She has tried naproxen and exercises/mindful stress reduction for months without improvement. It is unbearable for her to work.

Time Stamps

00:00 Intro

02:14 Listener feedback

03:44 Announcements

05:14 Picks of the week

08:20 Millenial learners

10:40 Topic intro and guest bio

12:06 Getting to know our guest

17:30 Clinical case of back pain

20:18 How to hand sensory deficits

21:51 Red and yellow flag symptoms

25:44 How to approach patient with yellow flag symptoms

28:00 Physical exam for back pain

30:00 Special testing: Trendelenburg, Slump test, and Straight leg raise

35:48 Classifying types of back pain and a quick recap of teaching points so far

39:28 How to manage patient expectations

40:42 Treatment of non-radicular back pain

46:33 Home exercises and YouTube training

49:31 When to follow up after initial treatment trial

51:35 The patient with severe acute pain

53:33 Some pearls on muscle relaxants

55:22 Clinical case and how to treat radicular pain

59:40 Invasive treatment of back pain

65:04 Back pain treatments that don’t work

#58: Concussion, traumatic brain injury, and post-concussive syndrome

18 september 2017 | 73 min

Summary:

Get a-HEAD of concussions (aka traumatic brain injuries) with tools, tips, and tricks from The Concussion Guy, Dr. Evan Ratner, Medical Director of Gridiron Heroes. Learn to recognize concussions/traumatic brain injury, what questions to ask, physical exam maneuvers, and how to counsel patients and families on safe return-to-learn/play.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Case from Kashlak Memorial: 29F with no significant PMH presents to primary care office less than 24 hours after she accidentally struck her head on the metal of her car door. She experienced temporary altered consciousness lasting about one hour along with a headache. No nausea, vomiting, speech, or vision changes. She rested at home last night, but didn’t feel up to reading, or watching TV. She drove herself to your office today.

Time Stamps

00:00 Intro

02:33 Listener feedback

05:35 Picks of the week

12:15 Getting to know our guest

19:41 Defining and classifying concussion

23:00 What questions to ask your patient

26:34 Physical exam for patient with concussion

28:50 Use of neurocognitive testing in concussion

30:45 Specifics of testing eye movements and balance

35:00 Who needs imaging?

41:51 Recap of what we’ve learned so far

43:40 Can you let someone with a concussion go to sleep?

47:08 Return-to-learn protocol

50:30 Return-to-play protocol

52:30 Post-concussive syndrome

53:55 Medications for post-concussive symptoms

58:58 Second impact syndrome

64:40 Counseling the patient with multiple concussions

67:08 Take home points

69:09 The Curbsiders recap their favorite teaching points

71:30 Outro

Tags: concussion, post, concussive, syndrome, tbi, traumatic, brain, injury, return, play, school, cognitive, rest, treatment, diagnosis, assistant, care, education, doctor, family, foam,

#57: Polypharmacy and deprescribing Part 2: More thinking and thoughts

15 september 2017 | 24 min

#56: Polypharmacy and deprescribing Part 1: Living better through chemicals

11 september 2017 | 52 min

#55: Eating disorders: Specified and Not Otherwise Specified

4 september 2017 | 76 min

Enhance your skills in the identification and management of eating disorders with clinical pearls from Dr. Rosalind Kaplan, Clinical Associate Professor of Medicine at Thomas Jefferson University and a Primary Care Physician in Jefferson Women's Primary Care. We learn who to screen for eating disorders, what questions to ask, criteria for diagnosis, common complications, and how to manage them. This is a must listen if you’re like us and don’t know much about eating disorders specified and not otherwise specified.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Case from Kashlak Memorial Hospital: 24yo F medical student with history of anxiety, weight loss, and restricting food senior year of high school. She regained weight with psychotherapy. Now she is a medical student who is over exercising, and abusing laxatives. She passes out one day after class and is referred to you at Kashlak.

Time Stamps:

00:00 Intro

01:19 Listener feedback

02:43 Picks of the week

06:50 Topic intro and guest bio

09:10 Getting to know our guest

15:18 Clinical case

20:15 Broad overview of eating disorders

26:40 Eating disorder not otherwise specified

29:19 Underreporting and under diagnosis in men

30:25 Who to screen and how to do it

34:33 Questionnaires: SCOFF, ESP, and Binge Eating Disorder Inventory

38:42 Initial lab workup for eating disorders

42:38 Bone density screening, treatment

45:41 Back to the case: Initial patient counseling

49:22 Medical therapy

52:20 Can we use bupropion?

54:02 What’s the role for primary care?

58:14 Hyponatremia in eating disorders

60:34 Complications of purging

66:25 How to be an ally for your patient

69:12 Treatment for binge eating

72:51 Take home points

74:30 Outro

Tags: anorexia, nervosa, bulimia, eating, disorder, weight, loss, binge, binging, purge, electrolytes, not, otherwise, specified, ideal, body, image, treatment, screening, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#54: Upper Respiratory Infections: Coughs, colds, gargling, and antibiotic underuse?!

28 augusti 2017 | 69 min

#53: Urinary Incontinence: Tips and strategies to stay dry.

21 augusti 2017 | 59 min

Get control of urinary incontinence with tips from Internist and Women’s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you’re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else.

Time Stamps

00:00 Intro

01:06 Listener feedback

02:43 Announcements

03:43 Picks of the week

09:07 Getting to know our guest

14:27 Case of urinary incontinence (UI)

15:30 Epidemiology of UI

16:34 Screening for UI

17:30 The 3IQ Questionnaire

18:44 Additional testing in UI

21:23 Classifying UI

24:00 Nonpharmacologic therapy for UI

32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy

34:50 Case continued. Changing medications

37:42 Mirabegron as an alternative to anticholinergics

40:18 More options for stress UI management

41:40 Next line therapies for urge UI, overactive bladder

44:38 Surgery for stress urinary incontinence

45:50 Botox therapy for urge UI, overactive bladder

48:30 Do we need any more fancy diagnostic tests?

50:30 Take home points

55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds

56:40 Outro

Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, educ

#52: Anemia: Tips, and tools for diagnosis and treatment

14 augusti 2017 | 66 min

#51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction

7 augusti 2017 | 47 min

#50: How to read the medical literature like a journal editor

31 juli 2017 | 56 min

#49: Vertigo and Dizziness: How to Treat, Who to Send Home and Who Might Have a Stroke

24 juli 2017 | 83 min

#48: Hyponatremia Deconstructed

17 juli 2017 | 88 min

#47: Osteoporosis Part 2: bone markers, fracture risk, and more on calcium and Vitamin D

10 juli 2017 | 62 min

#46: Chest pain, coronary CT angiography, and coronary artery disease

3 juli 2017 | 69 min

#45: Heart failure: update and guidelines review

26 juni 2017 | 63 min

#44: Obesity Medication Overview from AACE 2017

19 juni 2017 | 54 min

#43 Random Clinical Pearls: ACP Highlights and Recap Part 2

12 juni 2017 | 65 min

#42: The Diabetic Foot: Diagnose, prevent, and treat ulcers and infections

5 juni 2017 | 45 min

#41: HIV, PrEP, and STI screening

29 maj 2017 | 46 min

#40: Pseudo endocrine disorders, fatigue, and the Schmerbsiders?

22 maj 2017 | 54 min

#39: Secondary hypertension, hyperaldosteronism, Cushing’s, and pheochromocytoma

15 maj 2017 | 41 min

#38: Hospice and palliative care: How to manage end of life symptoms

8 maj 2017 | 64 min

#37: Lipids, PCSK9, and ezetimibe: Lower is better.

1 maj 2017 | 69 min

#36: Random Clinical Pearls: ACP Highlights and Recap Part 1

24 april 2017 | 33 min

#35: Depression: MDD with DJ MMC

17 april 2017 | 65 min

#34: Super Utilizers, hot spotting, and difficult patients

10 april 2017 | 38 min

#33: The Dementia Episode You Won’t Forget

3 april 2017 | 60 min

#32: Syncope Deconstructed

27 mars 2017 | 63 min

#31: Diuretics, leg cramps, and resistant hypertension with The Salt Whisperer

20 mars 2017 | 61 min

#30: Mastering Menopause

13 mars 2017 | 60 min

#29: Neuropathy Deconstructed

6 mars 2017 | 50 min

#28: Coronary artery calcium scoring: The ultimate cardiovascular risk assessment

27 februari 2017 | 41 min

#27: Conquer Irritable Bowel Syndrome

20 februari 2017 | 46 min

#26: What’s the deal with Radiation Oncology?

13 februari 2017 | 32 min

#25: Master hyperglycemia and DKA

6 februari 2017 | 47 min

The Curbsiders Internal Medicine Podcast

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice-changi...

Om podden

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#464 Recap Extravaganza: Dental Pain, Cardiac Amyloidosis, Diabetes & CGMs, Hyperparathyroidism, Neck Pain, Endometriosis, Rhinitis, and more!

REBOOT #429 Anxiety 2.0: with Dr. Jessi Gold

REBOOT #433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

REBOOT #415 Bipolar Disorder With Dr. Kevin Johns

#463 Tofurkey-cakes: A Hypertension Triple Pill, Arm Position & BP, early TAVR, Liberal vs Restrictive Transfusions, New Periop Guidelines

#462 Male Hypogonadism Pearls with Dr. Bradley Anawalt: Insights on Testosterone Deficiency

#461: Facial Nerve Follies: Understanding Bell's Palsy

#460 HFpEF: Heart Failure with Preserved Ejection Fraction

#459 DIGEST: Finerenone for Heart Failure, PCV21 and the latest Pneumonia Vaccine Recs, 24-hour vs 15-hour Oxygen Therapy, and PREVENT vs PCE for Cardiovascular Risk Estimation

#458 HFrEF: Heart Failure with Reduced Ejection Fraction

#457 Cold and Flu Season: Upper Respiratory Infections aka URIs

#456 Outpatient Oxygen Therapy

#455 Sports Injuries Part 2: Hip and Knee

#454 Kidney Boy on Managing Diabetes and Hypertension in CKD

#453 Sports Injuries Part 1: Concussion and Hip Pain

#452 NAFLD/MASLD with Dr. Elliot Tapper

#451 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 2

#450 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 1

REBOOT #326 NephMadness 2022: Cardiorenal Syndrome

REBOOT #226 Kidney Boy on Acute Kidney Injury: Myths & Musings

REBOOT #316 Lower Extremity Edema with The Curbsiders

REBOOT #387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules

Unlocked: Patreon #23 DGBI - IBS and Functional Dyspepsia

REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen

Addiction Medicine - #25 Methadone in the Clinic with Dr Ruth Potee and Dr David Frank

#449 Travel Medicine, Malaria, Traveler’s Diarrhea, Yellow Fever, and more! with Dr. Boghuma Titanji

#448 USPSTF Breast Cancer Screening - Updated recommendations and the reasoning behind them

#447 Rhinitis and Environmental Allergies with Dr. Olajumoke Fadugba

#446 Psychiatry Primer for the Hospitalist

#445 DIGEST-Hotcakes: Preventive PCI, Andexanet Alfa for ICH, Aspirin for Fatty Liver, Naltrexone in Cirrhosis, Pivmecillinam for UTI, Cefepime vs Pip-Tazo, MDRO Decolonization, Microplastics and MACE, Pax-NO-vid

#444 Macrocytosis, Hemolytic Anemia, Myelodysplastic Syndrome

#443 Primary Hyperparathyroidism: Stones, bones, and almost certainly some groans

#442 Syncope: Live from SHM #Converge24 with Dr. Dan Dressler

#441 More Clinical Pearls (New antibiotics, syphilis, heart disease, cirrhosis, lots more!) from ACP #IM2024

#440 Hepatitis B with Dr. Arthur Kim

#439 Shoulder Pain: Impingement, Bursitis, Tendonitis, Cuff Tears, and Arthritis with Dr. Ted Parks

#438 Recap from SHM #Converge24

#437 Clinical Pearls ACP #IM2024

#436 Endometriosis for the Internist with Dr. Cope & Dr. Green

#435 Neck Pain with Dr. Anthony Mikula

#434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher

#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

#432 Hotcakes: E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, Lidocaine for neck pain, C diff risk by antibiotic type, and “dosing by clicks” for GLP1’s

#431 Myocarditis and Pericarditis

Unlocked Weight Management, Low Carb, Listener Q&A, Picks of the Weeks (Patreon #19)

#430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024!

#429 Anxiety 2.0: with Dr. Jessi Gold

#428 DIGEST: DVT prophylaxis in patients with cancer, anticoagulation in subclinical AFib, steroids in COPD exacerbations, breast cancer genetic testing guidelines, and at-home STI testing

#427 Kittleson Rules Cardiac Amyloidosis

#426 Breast Cancer for the PCP With Dr Sandhya Pruthi

#425 Perioperative Management of Antithrombotics with Dr. Poorvi Hardman

R.S.V. Immunization with The Cribsiders

#424 Hotcakes: Transfusion in Acute MI, COVID-19 Rebound after Paxlovid, Every-other-day Iron Revisited, Oral Phenylephrine Doesn’t Work, and Stop Correcting Serum Calcium

#423 Dental Pain, Caries, Gingivitis, and Oral Care Tips & Tactics for Primary Care With Dr Lisa Simon

#422 LIVE! Inpatient Management of Sickle Cell Crisis, Acute Pain, RBC Transfusions & Acute Chest Syndrome

#421 Antiphospholipid Syndrome with Dr. Arielle Langer

REBOOT: #334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI)

#420 Recap Extravaganza: 2023 Highlights and Top Stories

REBOOT #281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais

REBOOT #250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf

Sponsor - Pattern Life

#419 Rapid Response Series: Sepsis with Dr. Mohleen Kang A shock to the system

#418 DIGEST (Tofurkey Edition): Semaglutide for HFpEF, TCAs for IBS, Aspirin vs Clopidogrel after PCI, Pitavastatin for HIV, Starchy Vegetables & Weight Gain, Heavy Metals in Cannabis

#417 USPSTF Update: PrEP for HIV Prevention with Dr. John Wong MD

#416: Antifungals, Candida, Mucorales, Aspergillus, Pneumocystis: The Fungus Among Us with Dr. Ilan Schwartz MD

#415 Bipolar Disorder With Dr. Kevin Johns

REBOOT #300 Celiac Disease with Dr. Amy Oxentenko

#414 Spooky Cakes: VKA vs DOACs in Frail Adults, RSV Vaccine, Cuff Size Matters, Bloating & Belching, AKI & Pip-Tazo

#413: Common Ear Complaints, Ear Exam 101, Cerumen Remedies, and more! Get an EARful with Dr. Angela Peng!

#24 Treating OUD in the Fentanyl Era: ASAM Treatment Week with Dr. Melissa Weimer

#412 Low Carb, Keto, Fasting: Lifestyle Interventions for Weight Management

#411 Adrenal Insufficiency with Dr. Atil Kargi

#410 Diabetic Foot Infections

#409 Hormonal and Nonhormonal Therapy for Vasomotor Symptoms of Menopause

#408 COPD in Older Adults with Leah Witt, MD & Amber Lanae Martirosov, PharmD

#407 DIGEST: Bempedoic acid and cardiac risk, Alpha-Gal Syndrome, Orforglipron, Zuranolone, DOACs for VTE of Malignancy, mAbs for Dementia, New Med for Smoking Cessation, Kiwis and Constipation