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    Health & Fitness

    Medgeeks with Andrew Reid

    Better health, with better science. Medgeeks teaches the mechanisms underlying chronic disease and the upstream drivers of health, translating the primary literature for clinicians and the curious.

    Subscribe for new podcasts covering nutrition, movement, sleep, mind-body health, metabolic medicine, and the systems approach to health optimization.

    Andrew Reid is the founder of Medgeeks, which has trained over 10,000 clinicians since 2013. This podcast is where his clinical work, primary literature deep dives, and self-experimentation become accessible to a broader audience.

    Andrew’s training:
    – Physician Assistant Program, University of California, Davis
    – MS in Physician Assistant Studies, AT Still University
    – MS in Personalized Nutrition, University of Connecticut
    – Graduate Certificate in Precision Nutrition, University of Connecticut
    – Didactics in Dietetics, California State University, Los Angeles

    Learn more about our resources at medgeeks.co

    Advertise
    • Apple Podcasts
    • Google Play
    • Spotify

    Latest Episodes:
    Thrombotic Thrombocytopenic Purpura (TTP). Jan 31, 2019
    Show notes

    Today, we have a 35 year old African American female with a past medical history of hypertension, who presents to the emergency department.

    He has a two week history of a viral upper respiratory symptoms, including a low grade fever, cough, nasal congestion, rhinorrhea, sore throat, decreased oral intake - followed by a persistent nose bleed.

    The nose bleed began over the last couple days and isn't stopping despite persistent pressure. And over the last 24 hours, she had a change in her mental status per her family.

    Her exam was unremarkable.

    Her vitals: 100.2 F, HR 90s, BP 145/82, and 98% O2 RA.

    Initial labs revealed:

    • WBC: 18,000
    • H/H: 9/27
    • Platelets: 7,000
    • Creatinine: 1.4
    • Total bilirubin: 3
    • LDH: 1,500
    • Normal fibrinogen, D-dimer, PT, INR
    • Peripheral smear: moderate schistocytes

    What's your diagnosis?

    Well, at this point, we are thinking Thrombotic thrombocytopenic purpura (TTP).

    Today, we are going to break this disease down for you.

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    ACE Inhibitors and Angioedema Jan 24, 2019
    Show notes

    Today, I want to talk about a specific topic, that I've seen about 5 times total in my career:

    Ace inhibitor induced angioedema

    The first question we should ask is, why do we care (aside from it being fatal)?

    Well, many patient's have hypertension, and many of them are placed on an ACE inhibitor. This makes ACE inhibitors the number one cause of drug induced angioedema in the United States.

    The most important thing to remember is the pathophysiology.

    Today, we'll do a quick review of...

    • The pathophysiology behind why this occurs
    • Why steroids and antihistamines will NOT help in this situation
    • How our patient will present
    • How long after an ACE is started will angioedema present?
    • Diagnosing ACE induced angioedema
    • Treating and managing your patient

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Acute Migraine Jan 17, 2019
    Show notes

    As you start your shift, your first patient comes in with a chief complaint of headache.

    A 38 year old female comes in with a two day history of headache. She describes 8/10 pain on the left side of her head and is pulsating in quality.

    She denies any radiation and states the pain started while she was at work and continued to worsen. She took Motrin with minimal improvement. As soon as she got off work, the patient went home, and locked herself in a dark room - which helped.

    She has had headaches in the past, but this was a lot worse, which prompted her visit today.

    What is your diagnosis?

    To me, this sounds very much like a migraine....

    In today's podcast, we'll touch on:

    Today, we'll touch on:

    • Common and Classic Migraines + the difference between the two
    • Signs and symptoms you don't want to miss aka red flags
    • Dangerous differentials
    • Who needs imaging?
    • Treating acute migraine in the ED setting

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Obstructive Sleep Apnea: A Rapid Fire Review Jan 12, 2019
    Show notes

    This week, I want to do a quick rapid review of OSA (obstructive sleep apnea). It's a topic on the blueprint and one you should know about, because it puts patient's at risk for many complications.

    OSA is one of the most common sleep disorders and occurs due to decreased airflow through the upper airway due to soft tissue collapse. This occurs during sleep and leads to derangement of the oxygen-carbon dioxide exchange.

    Today we'll touch on:

    • OSA Etiology and Risk factors
    • Signs and Symptoms
    • Diagnostic Testing
    • Management

    We'll cover it all in just 5 short minutes.

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Sepsis Updated Guidelines Jan 04, 2019
    Show notes

    Sepsis is an ever changing syndrome that has evolving definitions, scoring systems, and management.

    You might have heard about the surviving sepsis campaign. It's a joint collaboration between the Society of Critical Care Medicine and the European Society of Critical Care Medicine, which offers evidence based guidelines aimed at reducing sepsis related mortality and morbidity.

    Guidelines have been published 4 times now, with the 5th being in progress as we speak. Each edition has evolved, with the most recent being published in 2016.

    Today, I want to go over:

    • Defining sepsis
    • Finding the source
    • Labs and imaging
    • Management (antibiotics, fluids, etc)

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Pulmonary Hypertension Dec 28, 2018
    Show notes

    Today, I'd like to talk about pulmonary hypertension.

    Most find this quite dull and boring. But, I find this topic interesting, and actually wrote a PA school paper on the topic.

    Before you skip this podcast, reconsider...

    ...I mean this topic is on the boards. Can you really say you know all the groups of pulmonary hypertension without looking them up?

    If not, then let's dive right in!

    We'll cover everything you need to know in 10 minutes.

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Rhabdomyolysis Dec 20, 2018
    Show notes

    The next patient on your list is a 35 year old male with a past medical history of IV drug and alcohol abuse. He's been sober for the last 7 years.

    He presents to the ER after a mechanical fall at home. The nursing triage notes states the patient was in his normal state of health, until about two days prior.

    He may have hit his head, but is unsure. The patient had a loss of consciousness. No neurological deficits. The day after his fall, he's experienced decreased urine output, despite increasing his water intake.

    The urine that was seen was noted to be brown.

    Labs were notable for

    • BUN of 63 mg/dL
    • Creatinine of 8 mg/dl. His last creatinine from a wellness visit was .8 mg/dl.
    • Potassium 6.8 mEq/L. EKG is normal sinus rhythm.
    • CK: 40,000
    • AST: 1066
    • ALT: 450
    • Urine analysis was positive for blood, but negative for RBCs.

    What would you do next?

    We'll walk you every step of the way!

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    COPD exacerbation Dec 13, 2018
    Show notes

    Today, I want to review the evaluation and management of an acute COPD exacerbation.

    We have a 65 year old obese male who's a former smoker of 30 years (1 pack/day), but quit 5 years ago.

    He has a past medical history of COPD on 3L nasal canula, coronary artery disease, GERD, and type 2 DM.

    He's presenting with a 3 day history of subjective fever, increasing cough, increasing sputum production, and shortness of breath.

    On exam, he has bilateral wheezing.

    First let's treat the vitals:

    • fever = tylenol
    • tachycardia = EKG and former EKG
    • hypoxia = high flow oxygen first line

    Now, that we've got the base down, we can start to manage the underlying cause: COPD exacerbation.

    I'll walk you through every step of the way in today's podcast.

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Anticoagulation reversal agents Dec 07, 2018
    Show notes

    Last week, we reviewed the different types of anticoagulation medications.

    Today, I want to review what to do when things go bad aka what are the reversal agents.

    There are 4 basic questions you should consider when thinking about anticoagulation reversal:

    1. Is the patient actively bleeding aka do I have to take action immediately?
    2. What anticoagulant is the patient on?
    3. When was their last dose?
    4. What doest the patient need the reversal for? i.e. life threatening bleed, emergent surgical procedure, etc.

    Let's dive right in!

    -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


    Anticoagulation Nov 29, 2018
    Show notes

    Today, we're going to change gears.

    No case today and no systematic review.

    Instead, I want to review anticoagulation pharmacology...any medication that inhibits one or more steps of that coagulation cascade.

    We're going to review the new and old agents, including:

    • Mechanism of action
    • Indications
    • Precautions
    • Adverse effects
    • Monitoring
    • Dosing

    We'll also quickly review and simplify the intrinsic and extrinsic pathways.

    Next week, we'll touch on what to do when things get ugly and need to reverse these medications.

    -

    Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks -

    Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.

    This looks different to everyone, which is why we take such a personalized approach.

    Whether you want to ...

    • Stop taking your work home
    • Have the skillset to work autonomously
    • Improve your work life balance
    ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us

    - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:

    https://www.facebook.com/groups/medgeeks

    - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.


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