The Curbsiders Internal Medicine Podcast

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#444 Macrocytosis, Hemolytic Anemia, Myelodysplastic Syndrome Jun 17, 2024

Show notes

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.
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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

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#443 Primary Hyperparathyroidism: Stones, bones, and almost certainly some groans Jun 10, 2024

Show notes

Don’t just sit on that borderline calcium! Learn how to approach hypercalcemia and work up primary hyperparathyroidism. In this episode, we learn who goes to surgery, how to work them up, and some variants of typical primary hyperparathyroidism. We’re joined by Dr. Lindsay Kuo @lindsaykuo (Temple University Hospital)
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Show Segments

00:00 Intro
03:31 Understanding Primary Hyperparathyroidism
09:03 Handling Mistakes and Complications in Surgery
11:44 Case Discussion: Hypercalcemia and Elevated PTH Levels
22:41 Symptoms of Primary Hyperparathyroidism
25:06 The Role of Vitamin D in Primary Hyperparathyroidism
28:07 Testing Considerations for Parathyroid Hormone (PTH) Levels
46:02 Considerations for Parathyroid Carcinoma
49:19 Parathyroid Imaging in Primary Hyperparathyroidism
52:23 The Surgical Procedure for Primary Hyperparathyroidism
57:45 Intraoperative Parathyroid Hormone Monitoring
01:00:15 Post-Operative Monitoring for Hypocalcemia
01:04:38 Normocalcemic Primary Hypoparathyroidism and Normohormonal Primary Hyperparathyroidism

Credits

Written and produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Lindsay Kuo, MD

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#442 Syncope: Live from SHM #Converge24 with Dr. Dan Dressler Jun 03, 2024

Show notes

Don’t pass up on passing out!
Stand up to syncope as Dr. Dan Dressler (Emory University) guides us to confidently manage cases! We review a framework for understanding different types of syncope, and strategies for determining which low-risk patients can be safely discharged, and appropriate next steps to work up those high-risk and in-between cases.
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Show Segments

Intro
Picks of the Week
Case 1: Tamara
What is syncope?
Categorizing Syncope
Initial workup
Risk scores
Pulmonary embolism
Case 2: Travis
Cardiac evaluation
Take-home points
Outro

Credits

Producer, Script and Show Notes: Emi Okamoto MD
Infographic and Cover Art: Caroline Coleman MD
Hosts: Monee Amin MD and Meredith Trubitt MD
Reviewer: Rahul Ganatra MD, MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Daniel D. Dressler, MD, MSc, MHM, FACP

Sponsor: Freed

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Sponsor: Pathway

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#441 More Clinical Pearls (New antibiotics, syphilis, heart disease, cirrhosis, lots more!) from ACP #IM2024 May 27, 2024

Show notes

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.
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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: Beginly

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#440 Hepatitis B with Dr. Arthur Kim May 20, 2024

Show notes

Become a pro in Hepatitis B! Dr. Arthur Kim teaches us how to approach Hepatitis B screening and vaccination in primary care, provides pearls on counseling patients with chronic Hepatitis B infection, and summarizes considerations for Hepatitis B antiviral treatment and monitoring.
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Show Segments

Intro
Case from Kashlak
Hepatitis B screening - who should be screened?
Hepatitis B screening - interpreting test results
Hepatitis B vaccination
Stages of Chronic HBV infection
Counseling patients with chronic HBV about preventing transmission and protecting liver health
Treatment of chronic HBV infection
Screening for hepatocellular carcinoma
Outro

Credits

Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Arthur Kim MD

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#439 Shoulder Pain: Impingement, Bursitis, Tendonitis, Cuff Tears, and Arthritis with Dr. Ted Parks May 13, 2024

Show notes

Repair and replace your old approach to shoulder pain! We cover shoulder anatomy, explain the continuum of impingement syndrome (from bursitis to tendonitis to rotator cuff tears to cuff tear arthropathy), how to take a good shoulder history, perform a high-yield physical exam, when to refer, and when to get an MRI. Plus, how to differentiate glenohumeral joint arthritis from frozen shoulder, and how to diagnose AC joint pathology. We’re joined by everyone’s favorite orthopedic surgeon, inventor, and renaissance man, Dr. Ted Parks.
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Show Segments

00:00 Intro
05:38 Shoulder Anatomy
14:47 Continuum of Impingement Syndrome
33:41 When to order an MRI
36:28 Glenohumeral joint arthritis vs frozen shoulder
51:50 AC joint arthritis
62:25 Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Ted Parks 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: Pattern

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Sponsor: Panacea Financial

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#438 Recap from SHM #Converge24 May 06, 2024

Show notes

We went to it so you don’t have to
We recap the top pearls for the hospitalist from #SHM #Converge24 covering discussions on heart failure, gastrointestinal bleeds, sepsis, updates in critical care, updates in hospital medicine, oncologic emergencies, pneumonia, COPD, transitions of care, vulnerable populations, AI, and more!
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Show Segments

Intro
Picks of the Week
Heart Failure
Patients with Disabilities
POCUS on Inpatient Service
GI Updates
High Value Delivery of Medical Education
Molecular Testing for Infectious Diseases
Interhospital Transfers
Artificial intelligence in Inpatient Care
Care of the Incarcerated Patient
Periop Updates
Oncologic Emergencies--Neutropenic Fever
Oral vs IV Antibiotics
Updates in Hospital Medicine
Updates in Critical Care & Guidelines in Hospital Medicine
Post Acute Care
Things We Do For No Reason ™
Iron Deficiency Anemia
Updates in Community Acquired Pneumonia
Updates in Palliative Care
Outro

Credits

Written, produced and show notes by: Monee Amin MD, Caroline Coleman MD, Meredith Trubitt MD
Cover Art: Caroline Coleman MD
Hosts: Monee Amin MD, Meredith Trubitt MD
Reviewer: Rahul Ganatra, MD, MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guests: Harika Gorti MD, Sneha Neurgaonkar MD

#437 Clinical Pearls ACP #IM2024 Apr 29, 2024

Show notes

We cover angina, COPD-asthma overlap, home oxygen, colon cancer screening, cancer survivorship, tobacco cessation, e-cigarettes, step counts for health, new drugs, the RSV vaccine, addiction medicine, interstitial lung disease, APOL1-mediated kidney disease, testosterone therapy, antimicrobial resistance, office-based allergy testing and more! The Curbsiders review highlights, clinical pearls, and practice-changing updates from the American College of Physician Internal Medicine Meeting #IM2024!
No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro
ACP Pearls
Outro

Credits

Producers: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD
Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer:Matthew Watto MD FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

Sponsor: Beginly Health

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

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#436 Endometriosis for the Internist with Dr. Cope & Dr. Green Apr 22, 2024

Show notes

Energize your education on endometriosis! Learn common clinical presentations, optimal diagnostic imaging tests, and how to counsel patient on treatment options. We are joined by Dr. Adela Cope (Mayo Clinic) and Dr. Isabel Green @isabelgreenMD (Mayo Clinic).
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Show Segments

00:00 Intro
03:00 Guest Introduction
06:45 Topic
07:30 Endo Definition & Symptoms
14:40 Endo phenotypes
21:30 Differential Diagnoses to Consider
25:47 Making a Diagnosis
31:00 Imaging to consider
37:40 Endo Hormonal Treatment Optiosn
48:30 Monitoring Treatment
52:20 When to Refer
57:30 Surgical Treatment
1:09:20 Pain Management
1:13:30 Take Homes
1:19:00 Outro

Credits

Producer, Show notes, Infographics: Carolyn Chan, MD, MHS
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: Dr. Adela Cope and Dr. Isabel Green

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#435 Neck Pain with Dr. Anthony Mikula Apr 15, 2024

Show notes

A real pain in the neck (Get it?! We have fun.)
Protect your neck! Learn how to evaluate a patient with neck pain, and differentiate between mechanical neck pain, radiculopathy, and myelopathy. You’ll learn who should be reassured, who should see a surgeon, and what nonoperative options are available. We’re joined by Dr. Anthony Mikula @anthony_mikula from Mayo Clinic.
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Show Segments

00:00 Introduction
06:14 Anatomy and Pain Generators
09:58 Approach to Neck Pain
22:57 Differentiating Radiculopathy from Non-Specific Neck Pain
24:05 Management of Mechanical Neck Pain
27:36 Indications for Imaging
29:21 Terminology and Explanation of Spondylosis, Spondylolisthesis, and Spondylolysis
30:48 Diffuse Idiopathic Skeletal Hyperostosis (DISH)
32:23 Imaging Terminology and Plain Films
36:19 Pathophysiology of Cervical Radiculopathy
38:34 Physical Examination for Cervical Radiculopathy
44:54 Diagnostic Work-up for Radiculopathy
51:53 Interventions for Cervical Radiculopathy
53:53 Considerations for Surgery
57:49 Recognizing Cervical Myelopathy
01:00:17 Natural History of Myelopathy
01:02:25 Referral and Treatment for Myelopathy
01:09:28 Summary and Takeaways

Credits

Written and Produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Anthony Mikula, 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.

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