Core IM | Internal Medicine Podcast

Latest Episodes:

#140 Bonus Pacemaker & ICDs: 5 Pearls Segment Nov 29, 2023

Show notes

Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!

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Show Notes & Transcript

Timestamps:

01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?
06:31 Pearl 2: Considerations for patients with implantable devices before surgery.
12:26 Pearl 3: Considerations for patients with implantable devices before MRI.
14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures.
18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-ray

Tags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing

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#139 CKD Staging (Cr vs. Cystatin C, Albuminuria & more): Mind The Gap Segment Nov 08, 2023

Show notes

Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria?

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CME : http://bit.ly/CIMCME || Show Notes & Transcript

Timestamp:

00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage

04:20" What's wrong with how we estimate GFR?

06:50 Why is creatinine flawed as an estimator of GFR?

10:52 Enter new contender...Cystatin C!

16:16 Importance of the A Stage!

20:21 Which patients should you measure proteinuria in?

22:10 Treatments for albuminuria!

24:27 Summary and Closing

Tag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, nurse practitioner, physician assistant

#138 Incorporating Cancer Genetics into Your Practice: Lynch Syndrome and Beyond! Oct 25, 2023

Show notes

Check out the original interview on Youtube:

Essentials on Genetic Counselor | Lynch Syndrome

Who should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting!

Behind the Scenes YouTube Interview

Show Notes & Transcript

Timestamp

03:13 Part 1: Who should be referred to genetic counseling?
11:23 Part 2: How do we set up genetic counselors for success?
22:38 Part 3: Genetic counseling myth busting!

Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, nurse practitioner, physician assistant

#137 Hypokalemia & Potassium Repletion: 5 Pearls Segment Oct 18, 2023

Show notes

See some of the original interviews on Youtube!

What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?!

CME : http://bit.ly/CIMCME || Show Notes & Transcript

Behind the Scenes YouTube Interview

Whiteboard Animation video

Timestamp

01:45 Pearl 1: Evidence for potassium repletion
09:10 Pearl 2: Framework for hypokalemia
17:09 Pearl 3: Repletion goals
23:00 Pearl 4: Options for hypokalemia treatment
29:13 Pearl 5: Frequency of lab checks and repletion

Tags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional education

#136 How Did Diabetes Medications Become Obesity Meds? Beyond Journal Club on SURMOUNT-1 Trial Oct 04, 2023

Show notes

What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?

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Show Notes & Transcript

02:08 Framework for thinking about obesity
03:42 History of obesity treatment
06:29 Gila monsters and GLP and GIP mechanisms
08:29 Story of how medications for diabetes were found to have a weight loss benefit
12:50 SURMOUNT-1 trial

Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant

#135 Guideline Directed Medical Therapy Part II: 5 Pearls Segment Sep 20, 2023

Show notes

With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers?

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CME : http://bit.ly/CIMCME || Show Notes & Transcript

Timestamps

01:54 Pearl 1 – Recap of GDMT and CKD
09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate
20:59 Pearl 3 – Ivabradine
25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT
30:55 Pearl 5 – Ejection Fraction Recovery

Tags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiology

#134 Diagnostic Errors & Excellence Sep 06, 2023

Show notes

What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?

Timestamps

01:00 System 1 vs. System 2
07:46 Cognitive Biases
13:46 Case for Knowledge
18:29 Other Practices to Decrease Error
28:26 Conclusion

CME: http://bit.ly/CIMCME || Show Notes & Transcript

This episode is made in part of ACP’s Diagnostic Excellence curriculum

Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflection

#133 Post-Kidney Transplant: 5 Pearls Segment Aug 16, 2023

Show notes

What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection?

Behind The Scenes YouTube Interview

Timestamps

02:41 Types of Immunosuppression
14:31 Medication Reconciliation
22:36 AKI in the Transplant Patient
31:53 Infections in the Transplant Patient
40:00 Transplant rejection, cancer after transplant

CME: http://bit.ly/CIMCME || Show Notes & Transcript

Tags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressive

#132 Does PCI Save Lives in Heart Failure and CAD? Beyond Journal Club on the REVIVED Trial Aug 02, 2023

Show notes

In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.

How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.

Show notes & Transcript

Access to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.

Timestamps