The Curbsiders Internal Medicine Podcast

Latest Episodes:

#332 Inpatient Covid Management with Dr. Nathan Erdmann May 02, 2022

Show notes

Join Dr. Nathan Erdmann (@NerdmannID, University of Alabama Birmingham) as he walks us through inpatient covid management from antivirals, immune modulators and anticoagulation.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Outpatient vs ER therapeutic options
Considerations for labs to risk stratify
Antivirals
Immunomodulators
Anticoagulation
Empiric Antibiotics
Transitions of Care
Take Home Points
Outro

Credits

Producer: Monee Amin, MD
Writers: Monee Amin, MD and Meredith Trubitt, MD
Show Notes: Meredith Trubitt, MD
Infographic and Cover Art: Monee Amin, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Rahul Ganatra, MD
Showrunner: Matthew Watto MD, FACP
Production Team: PodPaste
Guest: Nathan Erdmann, MD

Sponsor: Panacea Financial Visit panaceafinancial.com today to learn how a bank for doctors, by doctors can help you.
Sponsor: BetterHelp
Visit betterhelp.com/curb for 10% of your first month.

CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

#331 Inpatient Diabetes Part 2: DKA, insulin drips, insulin pumps, and CGMs Apr 27, 2022

Show notes

More inpatient diabetes! In this part 2 of 2, we cover diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.
Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments

Intro
DKA and HHS - introduction and therapy overview
Insulin drips, closing the gap and transitioning to a subcutaneous regimen
Euglycemic DKA
Pumps and glucose monitors
Final take home points
Outro

Credits

Producer: Adam Barelski MD, Cyrus Askin MD
Writer: Adam Barelski MD
Show Notes: Cyrus Askin MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Adam Barelski MD
Technical Production: Pod Paste
Showrunner: Matthew Watto MD, FACP
Content Editor: Emi Okamoto MD
Guest & Content Reviewer: David Lieb MD, FACE, FACP

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Sponsor: Bambee

Visit bambee.com/curb for a free HR audit of your business.
Sponsor: Grammarly

Visit grammarly.com/curb for 20% off when you sign up

#330 Inpatient Diabetes Part 1: Insulin regimens, oral hypoglycemics, corrections scales and more! Apr 25, 2022

Show notes

Dominate inpatient diabetes! In this part 1 of 2, we discuss how to handle oral hypoglycemics, how to choose an initial insulin regimen, the use of correction scale insulin monotherapy, how to titrate insulin, how to use NPH for steroid-induced hyperglycemia (check out this Twitter thread on safe dosing), and how to reconcile diabetes meds at discharge!
Stay tuned for part 2 (drops Wed April 27th) covering diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip!
Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro #1, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Inpatient diabetes - a bird’s eye view and the goal(s) of therapy
Management of outpatient diabetes medications
Inpatient insulin - options and dosing
Correctional insulin (“sliding scale”)
A word on the “Diabetic Diet”
Steroids and hyperglycemia
Discharge pearls for the patient with diabetes
Outro #1

Credits

Producer: Adam Barelski MD, Cyrus Askin MD
Writer: Adam Barelski MD
Show Notes: Cyrus Askin MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Adam Barelski MD
Technical Production: Pod Paste
Showrunner: Matthew Watto MD, FACP
Content Editor: Emi Okamoto MD
Guest & Content Reviewer: David Lieb MD, FACE, FACP

Sponsor: Bambee Visit bambee.com/curb for a free HR audit of your business.
Sponsor: Grammarly Visit grammarly.com/curb for 20% off when you sign up
CME Partner: VCU Health CE
The Curbsiders partner with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

#329 Curing Hepatitis C: A Primary Care Primer Apr 18, 2022

Show notes

DeLiver on the promise of elimination with Dr. Christian Ramers
Let’s deLiver on the promise of hepatitis C elimination! Dr. Christian Ramers @cramersmd brings hepatitis C diagnosis, care, and cure into the primary care clinic with a simplified algorithm for workup and treatment.
Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Who should we screen?
Patient Workup
Preparing for treatment
Treating hepatitis C
Opportunities for integration of care
Outro

Credits

Producer, writer, co-host: Emi Okamoto MD, FACP
Show Notes, infographic, cover art: Lyan Chang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Christian Ramers MD, MPH, FIDSA

Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month.
Sponsor: MedMastery Visit www.medmastery.com/curbsiders for a 15% lifetime discount!
Sponsor: Birch Matresses
Visit birchliving.com/curb to claim your $200 off any Birch Mattress plus two free pillows
Sponsor: Indeed
Visit Indeed.com/internalmedicine and get a $75 credit to sponsor your first job
CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Update Description

#328 Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more! Highlights from #SGIM22 Apr 15, 2022

Show notes

Fill up with delicious practice-changing knowledge food from #SGIM22 as The Curbsiders team discusses breast cancer survivorship, sexual dysfunction, How climate change will affect health, Are PT consults necessary in the hospital?, Do we need antibiotics for aspiration events?, bias in note writing, Are plant-based meats a healthy?, complications after breast implantation, how to get breast reduction approved, doxycycline for chlamydia, the metronidazole and alcohol myth, pearls for clinician-educators, telehealth, TEACHIM.org, CGMs help lower a1c, PT for rotator cuff disease, Is it safe to taper antidepressants? and how to treat methamphetamine use disorder!
Note: There is no CME for this episode, but claim CME for prior episodes at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Hosted by: Nora Taranto MD, Beth Garbitelli (about to be an MD!), Era Kryzhanovskaya MD, Justin Berk MD, MPH, MBA, Shreya Trivedi MD, Chris Chiu MD, Paul Williams MD, Matthew Watto MD
Show Notes and Cover Art: Matthew Watto MD, FACP
Showrunner: Matthew Watto MD, FACP
Technical Production: Pod Paste

Show Segments

Intro
A few ambulatory teaching models include the One Minute Preceptor, SNAPS (summarize, narrow, analyze, probe, plan, and select), PIPP (precepting in the presence of the patient) [see Community Preceptor Toolbox]
Ikigai is a Japanese term indicating a motivational force or reason for living. It is associated with decreased mortality [Tanno, 2009]. Explore your ikigai here (PositivePsychology.com).
Listening to podcasts while driving does not affect knowledge retention (Gottleib et al. 2021)
Treatment of Hot flashes: Avoid paroxetine, fluoxetine, and sertraline in breast cancers survivors taking tamoxifen. Instead use venlafaxine (or another SNRI), citalopram, or escitalopram. Gabapentin given at bedtime is also an option. (Clinical Update 2019: Tamoxifen and Antidepressants)
Distress in patients with cancer can be measured using the NCCN screening tool [NCCN Distress Thermometer]
Don’t forget to ask for a Cancer Survivorship Plan from oncology [CDC Cancer Survivorship Care Plans]
Ask about sexual dysfunction in cancer survivors.
How will climate change impact our patient’s health? NIH framework; CH2OPD2 environmental screening tool [CH2OPD2 ]; and the 15 steps of climate communication.
Use the AM-PAC score cutoff of >18 to avoid a PT consult in hospitalized patients (Martinez 2021).
Early antibiotics after an aspiration event do not improve outcomes (Aga 2021).
Biased language is more common in notes about Black patients (Beach 2021). Be thoughtful about what you write and role model good behavior.
While plant-based meats are more eco-friendly than animal-sourced meats, they are heavily processed foods (van Vliet 2021) and may have high sodium.
Silicone breast implant rupture can be insidious. Guidelines recommend screening with MRI after 6 years, then every 2-3 years (FDA 2020, More FDA info) (Note: FDA’s most recent guidance also recommends ultrasound as an alternative screening method, so always check with the patient's insurance about which modality will be covered)
Document a trial of NSAIDs, physical therapy, attempted weight loss, and supportive bra usage before breast reduction surgery for macromastia.
Doxycycline is now first line for chlamydia rather than azithromycin [STI Treatment Guidelines Update], BUT the most effective treatment is the one your patient will take!
Metronidazole does not cause a disulfiram-like reaction and is no longer recommended by the guidelines [STI Treatment Guidelines Update]
More clinician-educator pearls from Era: Don’t be afraid to brand yourself! Network with like-minded individuals (e.g. interest groups).
BST mode: bite-sized teaching pearls can help reduce extrinsic load and improve retention [Manning, 2021]
A guided discussion based on Scrubs episodes can improve resident wellness [Holtzclaw 2021]
Chris recaps some posters (click links to see them on Twitter!): Telehealth disparities and tech equity (poster 1, poster 2); TeachIM.org (poster)
Continuous glucose monitors can help lower a1c in patients on basal insulin [Martens 2021]
A single session of PT improved shoulder pain. The benefits of steroid injections were limited to 8 weeks in the GRASP trial [Hopewell 2021]
There is a high risk of recurrence after tapering antidepressants [Lewis 2021]
Methamphetamine use disorder can be treated with IM naltrexone every 3 weeks, plus oral bupropion 450 mg daily [Trivedi 2021]. Limitations include cost and co-use of opioids.
Outro

Sponsor: Masterworks
Get started at masterworks.art/curbsiders. Sponsor: Ten Thousand
Get 15% off at tenthousand.cc/curb Sponsor: Green Chef
Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: BluelandGet 20% off your first order at blueland.com/curb

#SGIM22 Recap is on it's way! - Teaser Trailer Apr 11, 2022

Show notes

We need a few days to process the highlights from #SGIM22 in Orlando, FL. We'll be dropping a DELUXE recap and highlights episode this Friday April 15, 2022 covering Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more!

#327 Acute Pancreatitis Apr 04, 2022

Show notes

Learn what you really need to diagnose pancreatitis, when to use imaging sources and what is most important in management! Rapidly treating Acute Pancreatitis might change its course! We’re joined by Dr. Kaveh Sharzehi @sharzehi of Oregon Health & Science University (@OHSUNews).
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Risk factors for severe course
Use of Scoring Systems
Requirements to make the diagnosis
Rational use of imaging
Initial management: fluids, analgesia, and nutrition
When to use antibiotics
When to perform cholecystectomy
Most common complications and interventions
How to follow up in the outpatient setting

Credits

Producer & Scriptwriters: Monee Amin MD and Meredith Trubitt MD
Show Notes & Infographics: Andréa Perdigão
Cover Art: Monee Amin MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Kaveh Sharzehi MD, MS

Sponsor: BetterHelpVisit betterhelp.com/curb for 10% of your first month.
Sponsor: MedMasteryVisit www.medmastery.com/curbsiders for a 15% lifetime discount!
CME Partner: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

REBOOT #151 Anaphylaxis Mar 30, 2022

Show notes

Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic…even when you inject your own thumb?! Original show notes here.
Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Producer, infographic, and cover art: Emi Okamoto MD
Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, Emi Okamoto MD
Editor: Matthew Watto MD, FACP
Guest: Olajumoke Fadugba MD
Special thanks to Sarah Phoebe Roberts MPH for booking!

Show Segments

Intro and disclaimer
Guest one-liner, book recommendation, advice to fellows and trainees
Case of anaphylaxis with mucocutaneous and GI symptoms
Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin)
Vancomycin and non-IgE mediated reactions
Common presentations of anaphylaxis and the three diagnostic criteria
Biphasic reactions and predicting severity
Counseling patients on the use of epinephrine
Stuart’s thumb question
Adjuvant medications: antihistamines and corticosteroids
Are there any contraindications to epinephrine use?
Use of tryptase levels when the diagnosis of anaphylaxis is uncertain
Outro

Sponsor

Medmastery - Visit www.medmastery.com/curbsiders for a 15% lifetime discount!

REBOOT #145 Hepatorenal Syndrome Mar 28, 2022

Show notes

Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here.
Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and produced by: Justin Berk MD, Nora Taranto MD
Infographic by: Alex M @nephroguy
Host: Matthew Watto MD
Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials)
Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD

Show Segments

NephMadness Kidney Pun Contest
Disclaimer
Intro, guest one-liners
Case of acute kidney injury in a patient with cirrhosis
Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium)
History and physical in cirrhosis and AKI
Fluid choice
Diuretic therapy in cirrhosis and volume overload
Is a Renal Ultrasound useful in AKI?
Recap: the initial approach to AKI in cirrhosis
Therapeutic trials when volume status is uncertain
Hepatorenal physiology revisited
Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine
Type 1 versus type 2 hepatorenal syndrome
Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?!
Diagnostic criteria or HRS
NephMadness matchups including bile cast nephropathy
Outro

Sponsors

Grammarly. Visit grammarly.com/curb for 20% off.
Panacea Financial. Visit panaceafinancial.com a bank for doctors, by doctors.

REBOOT #146 Pain Meds in CKD Mar 21, 2022

Show notes

We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and produced by: Justin Berk MD
NephMadness Pain Region: Samantha Gelfand MD
NephMadness Pun Contest produced by: Hannah R Abrams
Cover art by: Kate Grant MBChB, Dip GUMed
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes)
Guests: Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

Show Segments

Kidney Pun
Disclaimer, intro and guest bios
Guest one-liners
Clinical Case and Pain Management Disclaimer
Modalities for pain meds in ckd
Opioids for pain and their metabolites
Dave Juurlink reframes the question, “what is our real goal with pain management?”
Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD
Communicating meds that are contraindicated or relatively contraindicated in CKD
Buprenorphine
What about the WHO Pain Ladder for CKD?
Should we use more cannabinoids? Ketamine?
Dave Juurlink rants on Tramadol
NSAIDS and CKD
Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?!
Estimating eGFR in CKD and AKI. Which equation is best?
How would each of our experts treat this patient with CKD and knee pain
Outro

Sponsors:

Birch by Helix birchliving.com/curb for $200 off all mattresses and 2 free eco-rest pillows
BetterHelp betterhelp.com/curb for 10% of your first month
Indeed indeed.com/internalmedicine for a $75 sponsored job credit
Squarespace squarespace.com/curb offer code: CURB to save 10%

Our TOPPODCAST Picks

Follow Us

Stay Connected

The Curbsiders Internal Medicine Podcast

Related Podcasts

Links

Stay Connected