The Curbsiders Internal Medicine Podcast

Latest Episodes:

#434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher Apr 08, 2024

Show notes

It’s NOT Always a UTI!
Sounds like another UTI but it could be more than that! Time to explore the entire pelvic floor and see what more you can treat. School’s in session with the Bladder Teacher, Kellen Choi, DO from the University of Louisville @KellenChoi
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

Intro
Rapid fire questions/Picks of the Week
Case #1 and Definitions
Bowel habits
Water intake
Case #2
Vaginal Estrogen
Non-antibiotic prophylaxis
Antibiotic in prophylaxis
Pelvic Floor Physical Therapy
Take-home points
Outro

Credits

Producer, Writer & Show Notes: Isabel Valdez, PA
Infographic & Covert Art: Edison Jyang
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: Kellen Choi DO, FAOCS

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: Locumstory

Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.

#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns Apr 01, 2024

Show notes

Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

00:00 Introduction and Diabetes Puns
01:00 Introduction of Guest and Topic
09:12 Qualifications and Eligibility for CGMs
11:32 Types of CGMs and Sensor Placement
24:47 Interpreting CGM Data and Alarms
34:30 Troubleshooting Patterns and Adjustments
35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses
36:15 The Rule of 15 and Addressing Hypoglycemia
37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia
38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
39:51 Managing Exercise-Induced Hypoglycemia
41:43 Preventing Exercise-Induced Hypoglycemia with Snacks
43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas
45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia
51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin
56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin
57:44 Addressing Adherence and Medication Barriers
59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management
01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap
01:05:49 Considering Patient Adherence and Barriers to Treatment

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: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jeff Colburn 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: Panacea Financial

Download the 2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.

#432 Hotcakes: E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, Lidocaine for neck pain, C diff risk by antibiotic type, and “dosing by clicks” for GLP1’s Mar 25, 2024

Show notes

Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
Claim CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME!

Credits

Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

Introduction and disclaimer
E-cigarettes for smoking cessation
Gabapentinoids and COPD exacerbations
Topical lidocaine for neck pain
Association between specific antibiotics and C. diff infection
Shortage of GLP-1 agonists and “dosing by clicks”

#431 Myocarditis and Pericarditis Mar 18, 2024

Show notes

Show description:
Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter!
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

Intro, disclaimer
A case of pericarditis
Diagnosing pericarditis
The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis
Etiologies of pericarditis and initial testing recommendations
Treatment of acute uncomplicated pericarditis
Using colchicine to prevent recurrent pericarditis
Patient counseling after diagnosing pericarditis
A case of myocarditis
Interpreting elevated troponin levels
Distinguishing between myocardial infarction and myocardial injury
Diagnostic testing for suspected myocarditis
When to pursue cardiac MRI and endomyocardial biopsy
The spectrum of myocarditis presentations
Fulminant myocarditis
Common etiologies of myocarditis
Immune checkpoint inhibitor myocarditis
Myocarditis from mRNA vaccines and from SARS-CoV-2 infection
Management of patients with myocarditis
Activity restrictions for patients with myocarditis
Outro

Credits

Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP
Guest: Vivek Kulkarni, MD, FACC
Producer, Script, and Show Notes: Adam Barelski, MD
Infographics and Cover Art: Edison Jyang
Reviewer: Leah Witt, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

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: Panacea Financial

Download the full 2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.
Sponsor: Factor

Head to factormeals.com/curb50 and use code curb50 to get 50% off.

Unlocked Weight Management, Low Carb, Listener Q&A, Picks of the Weeks (Patreon #19) Mar 13, 2024

Show notes

This episode has been Unlocked from patreon.com/curbsiders!
Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM #SGIM23 in Denver, Colorado This audio episode is only available on Patreon!
Below are links to the original interview & show notes.
#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips
Picks of the week:

Paul recommends: Blue Eye Samurai (Netflix)
Matt recommends: Live, Die, Repeat aka Edge of Tomorrow (film)

Show Segments
00:00 Introduction and Happy New Year
02:22 Overview of Obesity Medicine
04:13 Challenges in Weight Maintenance
06:07 Prevention of Obesity
08:04 Barriers to Obesity Care
09:29 Setting Realistic Weight Loss Goals
10:24 Counseling Patients on Weight Loss
11:45 Measuring Waist Circumference
12:44 Telemedicine and Tracking Apps
13:41 Psychological Considerations in Obesity Medicine
15:05 Low-Carb Diets
21:04 Managing Side Effects of GLP-1 Agonists
23:54 New Medication for Obesity
24:52 Prolia and Forteo for Osteoporosis
26:18 Statins and Lab Testing
29:30 Annual Labs and Urine Testing
32:37 Picks of the Week
35:02 Outro
Join our Patreon today and save 16% on an annual membership at patreon.com/curbsiders. Kashlak Admitting Privileges comes with ad-free episodes, access to the Kashlak Vault, which contains PDF files and graphics from over 400 Curbsiders shows, access to our private Discord group, plus twice monthly bonus episodes like this one!

#430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024! Mar 11, 2024

Show notes

Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It’s NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl!
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

Time stamps refer to the ad-free version

00:00 Introduction and Guest Bio
07:46 Case Presentation
08:42 Initial Approach to CKD Management
09:10 Metabolic Acidosis in CKD
13:30 Consequences of Metabolic Acidosis
22:28 Administration of Bicarbonate
23:54 Alternative Options for Bicarbonate Repletion
24:47 Citrate and Bicarbonate
26:02 Sodium Bicarbonate for CKD
30:19 Dietary Modifications
33:35 Renal Diet
38:20 Counseling CKD Patients
41:39 Veverimer and Other Treatments
44:36 Mistakes and Pitfalls
46:55 Conclusion

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: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Timothy Yau MD

Sponsor: Rocket Money

Cancel your unwanted subscriptions by going to RocketMoney.com/CURB

Sponsor: Freed

You can try Freed for free right now by going to freed.ai And listeners of Curbsiders can use code CURB 50 for $50 off their first month.

#429 Anxiety 2.0: with Dr. Jessi Gold Mar 04, 2024

Show notes

Elevate your primary care management of anxiety. Become confident in counseling patients about a new anxiety diagnosis, 2nd and 3rd line medications, augmentation for anxiety treatment, and options for non-pharmacological anxiety treatment. We are joined by psychiatrist and mental health expert Dr. Jessi Gold, @drjessigold (University of Tennessee System; drjessigold.com).
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

Intro
Case from Kashlak
Diagnosing anxiety
Explaining anxiety to patients
Non-pharmacological management of anxiety
Pharmacological management of anxiety
2nd and 3rd line treatments
Cannabis and anxiety
Outro

Credits

Writer, Producer, Show Notes, Infographic, Cover Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai Achi MD, MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jessi Gold MD

Sponsor: Locumstory

Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.
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: Allbirds

Visit Allbirds.com and use code CURB for a free pair of socks with a purchase of $48 or more.

#428 DIGEST: DVT prophylaxis in patients with cancer, anticoagulation in subclinical AFib, steroids in COPD exacerbations, breast cancer genetic testing guidelines, and at-home STI testing Feb 26, 2024

Show notes

Join us as we review recent articles and news featured in The DIGEST #48, #49, and #50 including thromboprophylaxis for patients receiving chemotherapy, eosinophil count to guide steroids in COPD exacerbations, anticoagulation in subclinical atrial fibrillation, the new genetic testing recommendations for patients with breast cancer, and at-home STI testing–not to mention trial names galore. Fill your brain hole with a fully digestible meal! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).
Claim CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME!

Credits

Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Nora Taranto MD
Reviewer: Emi Okamoto MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

00:00 Introduction + Pun
06:06 Target TP Trial: Thromboprophylaxis in Cancer Patients
13:07 Steroids for COPD Exacerbations
25:25 Anticoagulation in Subclinical Atrial Fibrillation
34:01 Genetic Testing in Breast Cancer
43:38 Home STI Testing

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
Sponsor: Factor

Head to FactorMeals.com/curb50 and use code curb50 to get 50% off.
Sponsor: NetSuite

Download NetSuite’s popular KPI Checklist, designed to give you
consistently excellent performance - absolutely free, at NetSuite.com/CURBSIDERS.

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.

#427 Kittleson Rules Cardiac Amyloidosis Feb 19, 2024

Show notes

The clinical picture of an underrecognized disease
Amyloidosis demystified. Learn the clinical clues that suggest possible amyloidosis and how to order the correct tests to diagnose this disease. We are joined by Dr. Michelle Kittleson who shows us the ropes of treating fibril accumulation, @MKittlesonMD (Cedars Sinai).
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

Introduction
Case Presentation: Mr. Smith
Differential Diagnosis of Heart Failure with Preserved Ejection Fraction
Understanding Amyloidosis
Clinical Clues and Red Flags for Amyloidosis
Physical Examination Findings
Workup for Amyloidosis
Treatment Options
AL Amyloidosis and Hematologist's Role
ATTR Amyloidosis and Cardiologist's Role
Other Therapies for TTR Amyloidosis
Therapy on the Horizon
Cost and Access to Tafamidis
Alternative Therapies and Supplements
Monitoring and Side Effects of Tafamidis
Symptomatic Management and Anticoagulation
Take Home Points

Credits

Written and Produced by; Deborah Gorth, MD, PhD
Infographic and Cover Art: Meryl Gorth, RD, MPH and Deborah Gorth, MD, PhD
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: Michelle Kittleson, MD, PhD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

Sponsor: Panacea

Visit panaceafinancial.com today to open your free account.

Sponsor: Grammarly

Make a bigger impact at work with Grammarly. Sign up and download for FREE at grammarly.com/PODCAST

Sponsor: Rocket Money

Stop wasting money on things you don’t use. Cancel your unwanted subscriptions by going to RocketMoney.com/CURB.

#426 Breast Cancer for the PCP With Dr Sandhya Pruthi Feb 12, 2024

Show notes

Join us as Sandhya Pruthi, MD talks us through basics of breast cancer, specifically how to share a new diagnosis with a patient, the spectrum of disease from favorable to more aggressive, and the basics of what to expect with initial treatment. Feel more confident sharing a new diagnosis of breast cancer and supporting your patients through this journey.
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

00:00 Introduction
02:18 Getting to Know Dr Sandhya Pruthi
09:49 Picks of the Week
12:35 Case 1: Diagnosis and Treatment of ductal carcinoma in situ (DCIS)
21:24 Risk Stratification and Active Surveillance for DCIS
23:43 Genetic Testing Recommendations
28:08 Case 2: Evaluation and Diagnosis of a Breast Lump
39:14 Invasive Ductal Carcinoma
47:49 Initial Management of invasive ductal carcinoma (IDC)
48:19 Preoperative Discussion and MRI
49:19 Lumpectomy and Sentinel Lymph Node Biopsy
50:16 Radiation and Hormonal Adjuvant Therapy
51:46 Considerations for Chemotherapy
55:51 Signs of Late Recurrence or Metastasis
58:20 Screening Guidelines and Age
01:02:25 Importance of Breast Self-Awareness

Credits

Written and produced, Show Notes: Molly Heublein MD
Infographic and Cover Art: Edison Jyang
Hosts: Molly Heublein MD, Era Kryzhanovskaya MD
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Sandhya Pruthi MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
Sponsor: Freed

You can try Freed for free right now by going to freed.ai Listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Babbel

Get 50% off at Babbel.com/CURB

Sponsor: NetSuite

Get your own KPI Checklist at NetSuite.com/CURBSIDERS

Our TOPPODCAST Picks

Follow Us

Stay Connected

The Curbsiders Internal Medicine Podcast

Related Podcasts

Links

Stay Connected