Core IM | Internal Medicine Podcast

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**Core IM | Internal Medicine Podcast**

Core Internal Medicine via following series: 5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do? Gray Matters || Management Reasoning Hoofbeats || Dissecting clinical reasoning At the Bedside || Explore everyday challenges

Latest Episodes:

#38 A 66M w RUQ pain, a 41M in Afib w RVR and a 50M w Syncope: Hoofbeats Segment Apr 10, 2019

Show notes

Dissect 3 interesting cases and improve your clinical reasoning skills! Time Stamps:

New features in this episode [0:30]
Case one: 66M w RUQ pain [1:09]
Case two: 41M w Afib in RVR [9:26]
Case three: 50M w Syncope [14:33]
Reveal [19:57]
Retrieving illness scripts [22:29]
Typical versus Atypical presentation of diseases [26:12]

For full transcript and show notes: https://www.coreimpodcast.com/?p=21028

Tag: medical education, clinical cases, expert clinicians, internal medicine podcast

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#37 Unstable Angina: Mind the Gap Segment Mar 27, 2019

Show notes

Check out part 1: Acute Coronary Syndrome and TIMI Risk Score

Lets go deeper into

1) How the chest pain history correlates with pathophysiology? [2:40]

2) How has high-sensitivity troponin changed the way we think about unstable angina? [7:34]

For transcript, infographic and show notes: https://www.coreimpodcast.com/2019/03/27/unstable-angina/

#36 Pain Management: 5 Pearls Segment Mar 13, 2019

Show notes

Solidify your knowledge on inpatient pain management! Quiz yourself on the 5 pearls we will be covering:

How effective are non-opioids? ( 3:17)
Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51)
What are the best practices for patients who require opioid analgesia? (19:00)
When prescribing opioids at discharge what can we do to minimize harm? (25:02)
Throwback to mechanism of acetaminophen and NSAIDs (27:14)
How do we believe tylenol works and how does that compare to NSAIDS? (28:27)

For full transcript of the audio and show notes: https://www.coreimpodcast.com/2019/03/13/5-pearls-on-pain-management/

#35 Acute Coronary Syndrome and TIMI Risk Score: Mind the Gap Segment Feb 27, 2019

Show notes

Let's go deeper into the world of ACS and the origin of the TIMI score and major adverse cardiac events "MACE" outcomes!

The basics – what is acute coronary syndrome? (4:08)
Clinical context matters – angina pectoris, atypical chest pain, and troponins (5:22)
You can’t just “cath” everyone – risk stratification to identify patients with high mortality risk (9:42)
TIMI isn’t perfect – the issues with the score and MACE outcomes (14:00)
Review of teaching points (17:58)

For full transcript and show notes: https://www.coreimpodcast.com/2019/02/27/acute-coronary-syndrome-acs-and-the-timi-score/

#34 47M with chest pain : Hoofbeats segment Feb 13, 2019

Show notes

Dissect an interesting case and improve your clinical reasoning skills!

Time Stamps:

New features in this episode [00:25]
Data point 1: Early hypothesis generation? [03:20]
Data point 2: Pertinent negatives? [11:18]
Data point 3: Representativeness heuristic over-represented in medical education? [13:28]
Data point 4: Economical hypothesis generation by expert clinicians [19:20]
Data point 5: Diagnosing diagnostic error [22:10]
Data point 6: Moving toward a final diagnosis [27:11]
Case resolution [29:50]

For full transcript and show notes: https://www.coreimpodcast.com/2019/02/13/hoofbeats-47m-with-chest-pain/

#33 Barrett's Esophagus: 5 Pearls Jan 30, 2019

Show notes

Solidify your knowledge on Barrett's Esophagus and more! Quiz yourself on the 5 pearls we will be covering:

What is Barrett’s esophagus and why should we care? (4:12)
Who do we screen for Barrett’s, and why? (8:41)
How do we screen for Barrett’s and counsel? (13:50)
How do we treat and monitor Barrett’s esophagus? (18:21)
Take Aways (21:45)
Throwback to trending troponins (23:05)

For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2019/01/30/5-pearls-on-barretts-esophagus/

#32 A 34M with Fever, HA, Myalgias Jan 16, 2019

Show notes

Dissect an interesting case and improve your clinical reasoning skills!

Time stamps:

Player three has entered the game! [0:15]
Case presentation, part 1 [1:20]
First impressions [3:24]
Rethinking another provider’s diagnosis [4:36]
Interpreting the test of treatment [8:48]
Keeping your instincts on a leash? [10:58]
Case presentation, part 2 [12:33]
Diagnostic schemas [14:30]
Our discussant’s differential and the final diagnosis [17:46]
Shira’s cognitive autopsy [23:02]

For full transcript and show notes: https://www.coreimpodcast.com/2019/01/16/hoofbeats-34m-with-fever-headache-and-myalgias/

#31: Troponins: 5 Pearls Segment Jan 02, 2019

Show notes

Solidify your knowledge on troponins and more! Quiz yourself on the 5 pearls we will be covering:

What aspects of the history are concerning in a patient with a positive troponin? (4:00)
What is the difference between the TIMI, GRACE, and HEART scores, and how should we use them in the evaluation of a patient with an elevated serum troponin? (8:42)
How does the change in troponin over time help with diagnosis, and what should we consider in a patient with uptrending troponins but an unremarkable ECG? (14:48)
What can a “negative but detectable” troponin tell you about any patient, not just those with suspected ACS? (21:31)
Pearls Recap (25:26)
Throwback – what are the first-line medications for alcohol use disorder? (28:36)

For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2019/01/04/5-pearls-on-troponins/

Tags: chest pain, cardiology, myocardial infarction, acute coronary syndrome

#30 Acetaminophen/Fevers Pathophysiology and Patient Outcomes: Mind the Gap Segment Dec 19, 2018

Show notes

Let's dive deeper into the world of acetaminophen and fever and how it may work and patient outcomes

Time Stamps:

What data is there to support the use of acetaminophen as a fever reducer? (2:08)
Does acetaminophen improve patient outcomes? (4:30)
How does acetaminophen compare to other medications like NSAIDs? (9:56)
What is the mechanism of acetaminophen action? (10:50)
Review of teaching points (16:02)

For full show notes and transcript of audio: https://www.coreimpodcast.com/2018/12/19/mind-the-gap-on-acetaminophen-fevers-pathophysiology-and-patient-outcomes/