Core IM | Internal Medicine Podcast

Latest Episodes:

#130 Cort (ACTH) Stim Test Jul 06, 2023

Show notes

BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?

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Behind The Scenes video on YouTube

Show notes & Transcript

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

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#129 Steroids: 5 Pearls Segment Jun 28, 2023

Show notes

How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?

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Show notes & Transcript

Time Stamps

02:59 Types of Corticosteroids
14:31 Side Effects of Steroids
21:15: Prophylaxis
27:32 Steroid Weaning
33:38 Steroid Weaning Limitations

Tags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndrome

#128 Cirrhosis Bleeding Risk, FFP and Indwelling Pleural Catheters: Gray Matters Segments Jun 14, 2023

Show notes

In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?

Show notes & Transcript

Time Stamps

02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis
05:35 Deep Dive 2: FFP effect on bleeding risk
15:43 Deep Dive 3: Risks of FFP
19:45 Deep Dive 4: Indwelling pleural catheters
30:31 Recap

Tags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonary

#127 Radiation Oncology Side Effects: 5 Pearls Segment May 31, 2023

Show notes

How long can fatigue last for after radiation? Are all patient post radiation immunocompromised? What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?

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Show notes & Transcript

Whiteboard Animation Video of Radiation Physiology

Time Stamps

02:37 Systemic Radiation Side Effects
14:29 Lung Radiation Side Effects
18:22 Breast Radiation Side Effects
21:45 Prostate Radiation Side Effects
24:54 Brain Radiation Side Effects

Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapy

#126 Radiation Oncology Part 1: 5 Pearls Segment May 24, 2023

Show notes

What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?

Show notes & Transcript

Whiteboard Animation Video of Radiation Physiology

Time Stamps

02:04 What is radiation?
03:17 How does radiation therapy work?
04:50 How is today’s radiation different from the past?
05:40 What role does radiation play in cancer treatment?
07:48 What are the different types of radiation?
15:34 How do you write a rad onc one-liner as an internist?
19:59 What is palliative radiation and how/when should we use it?

Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy

#125 Learning Habits, Time Management, and Leadership: Wisdom from Dr. Kelly Graham May 15, 2023

Show notes

What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?

Show notes & Transcript

Time Stamps

01:12 Learning Journey
05:58 Lifelong Learning
11:14 Time Management
16:38 Role Modeling
19:59 Re-Calibrating Failure

Tags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time management

#124 A1c & Glucose Measurements: Mind the Gap Segment Apr 26, 2023

Show notes

What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric?

Show notes, Transcript and References

Time stamps

00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test
03:03 Hemoglobin A1c
08:26 Fructosamine and Glycated Albumin
10:50 Continuous Glucose Monitoring
15:44 The Overlooked Issue of Insulin Resistance
19:11 Summary

Tags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complication

#123 Pacemakers & ICDs: 5 Pearls Segment Apr 12, 2023

Show notes

When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?

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Show notes, Transcript and References

Time stamps

02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?
21:28 How to determine which type of device your patient has?
25:10 What can a device interrogation tell you and doesn't tell you?
32:13 Do all patients with bacteremia need their implantable cardiac devices taken out?
38:44 End-of-life considerations with pacemakers vs. ICDs

Tags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacing

#122 Kidney Transplant Preparation: 5 Pearls Segment Mar 29, 2023

Show notes

How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?

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Show notes, Transcript and References

Time stamps

03:49 Episode start
07:13 Dialysis vs. kidney transplant morbidity and mortality
11:44 Eligibility for kidney transplant and when to refer
21:34 Pre-transplant evaluation process
25:38 How long are wait times on the transplant list?
36:21 What benefits of living donation? What are risks to the kidney donor?

Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidney

#121 Trach Care: 5 Pearls Segment Mar 08, 2023

Show notes

What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation?

Behind the Scenes YouTube Interview

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Show notes, Transcript and References:

https://www.coreimpodcast.com/2023/03/08/trac/

Time stamps

2:56 Trach Components

12:47 Trach Complication Management

27:48 Airway Clearance

34:53 Speaking Valve

38:54 Decannulation

Tags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacy