The Curbsiders Internal Medicine Podcast

Latest Episodes:

Reboot #167 LIVE! CBC Abnormalities Aug 23, 2021

Show notes

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 25, 2021 for a brand new CBC Abnormalities Triple Distilled episode.
Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
Credits

Written, Produced and Edited by: Matthew Watto MD, FACP
Cover Art and Infographic by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Guest: Mary Kwok MD

00:00 Intro; Paul shame’s the audience; Guest bio
03:17 Guest one-liner, book recommendation* –Emperor of All Maladies (book) by Siddhartha Mukherjee, When Breath Becomes Air (book) by Paul Kalanithi; Career advice -set goals for whatever you’re learning.
08:43 Picks of the week: John Wick 3 (film); The Movies That Made Me (podcast) by Joe Dante; The Tim Ferriss Podcast with Julie Rice of Soul Cycle; Infinity Chamber (film) by Travis Milloy
11:50 A case of asymptomatic leukocytosis; Red flags; Repeat the CBC until it’s normal
17:30 The peripheral smear; Leukemoid reaction
20:00 The physical exam; When to send flow cytometry?
22:18 A case of lymphopenia; benign ethnic neutropenia; What to look for in the history
27:10 A case of erythrocytosis; Checking EPO levels; JAK2 mutation; Differential Diagnosis; Therapeutic Phlebotomy; Physical findings of Polycythemia Vera
36:53 A case of thrombocytopenia; Lab workup; Differential diagnosis; Pathophysiology; Culprit meds
45:35 Advice for internists
46:36 Take Home Points
47:46 Dr. Kwok’s disclaimer
48:10 Outro and post credit scene

#290 Stroke and TIA Triple Distilled Aug 18, 2021

Show notes

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #164 with Neurologist Dr. Chris Favilla!
This mini episode is not available for CME, but episode #164 on Stroke and TIA is available for CME credit through the ACP!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Ten Thousand tenthousand.cc Head to tenthousand.cc and enter our code CURB at checkout to save 15%.

Show Segments

Intro, disclaimer, guest bio
Afib prevention
Workup for afib
Treatment of afib
Updates on ablation, Left atrial appendage occlusion
Outro

Reboot #164 Stroke and TIA Deconstructed Aug 16, 2021

Show notes

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 18, 2021 for a brand new Stroke and TIA Triple Distilled episode.
Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences. Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders

Credits

Producers: Molly Heublein MD; Matthew Watto MD, FACP
Writer (including CME questions): Molly Heublein MD
Cover Art: Bryan Brown MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto, MD; Matthew Watto MD, FACP
Guest: Chris Favilla, MD

Sponsor: Indeed indeed.com/internalmedicine Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.
Sponsor: Qalo qalo.com/curb Head to qalo.com/curbto get 20% off your purchase today.

Time Stamps* Time Stamps refer to ad-free version

00:00 Intro, disclaimer, guest bio, and a bad pun
04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch,
07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter
08:40 A case of TIA; definition of TIA
12:14 Stroke territories
14:24 New definition of TIA
16:00 Differentiation from complex migraine
19:17 Risk stratifying TIA and ABCD2 score
22:00 A bit on tPA
24:01 Workup for TIA; workup for amaurosis fugax
25:36 CNS imaging studies after stroke or TIA; Choice of imaging study
33:15 HINTS exam for posterior circulation stroke
34:48 Is an echo necessary? Bubble study for PFO?
38:32 Duration of afib monitoring
40:24 Echo reports: what to look for in patient with stroke or TIA; “soft markers”
41:55 Blood testing after Stroke and TIA (lipid panel, HbA1C; +/- RPR, coags, CBC)
43:50 Folic acid; Sparkle trial: high dose atorvastatin versus placebo for secondary prevention
47:00 Incidental finding: multiple patchy infiltrates in a patient without stroke or TIA; Is it significant?
48:50 Aspirin therapy after TIA; Dosage adjustment based on weight?
51:10 A case of stroke; TOAST trial and classification of acute stroke; ESUS; aortic arch atheromas
55:58 Large artery strokes (hypoperfusion, acute thrombosis, artery to artery embolization)
57:15 Antiplatelets after stroke and TIA; DAPT and duration of therapy
62:57 Antidiabetic drugs and stroke
63:40 Lightning round: CHA2DS2VASc score and women; how much afib is significant?; 66:32 Are all DOACs created equal?; 68:20 Regaining function after a stroke; 69:47 Silent infarcts on imaging
71:54 Resources for stroke: Decision making in neurology textbook
73:28 Outro

#289 Afib Triple Distilled Aug 11, 2021

Show notes

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #159 with Cardiologist Dr. James Furgerson; Plus, updates on ablation and left atrial appendage occlusion!
This episode is not available for CME, but episode #159 on Atrial Fibrillation is available for CME credit through the ACP!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: FIGS wearfigs.com Head to wearfigs.com and enter our code CURB at checkout to save 15%.
ASN Loan Mitigation Pilot Program: asn-online.org/lmpp The American Society of Nephrology’s Loan Mitigation Pilot Program (LMPP) aims to decrease the loan burden of those entering the field of nephrology, while also increasing interest in the specialty. Year 1 of the program will center on individuals historically underrepresented in medicine. Visit ASN-online.org/lmpp or email grants@asn-online.org

Show Segments

Intro, disclaimer, guest bio
Afib prevention
Workup for afib
Treatment of afib
Updates on ablation, Left atrial appendage occlusion
Outro

Reboot #159 Atrial Fibrillation Aug 09, 2021

Show notes

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 11, 2021 for a brand new Afib Triple Distilled version.
Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up – This episode is going to send your heart racing! You might even skip a beat!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
Credits

Writer and Producer: Cyrus Askin MD
Infographic: Cyrus Askin MD
Cover Art: Cyrus Askin MD
Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD
Editors: Matthew Watto MD
Guest: James Furgerson MD

Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 100 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: Panacea Financial panaceafinancial.com Visit panaceafinancial.com today to open your account and join a bank built with you in mind.
Time Stamps*
*Note: Time stamps refer to ad-free version

00:00 Intro, disclaimer and guest bio
03:45 Guest one liner, a bit on physician well-being and some other randomness
08:15 A case of palpitations; risk factors for atrial fibrillation
12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters?
15:08 Case summary and next steps in initial work up
18:48 Counseling patient about atrial fibrillation and its consequences
21:40 Ischemic heart disease and atrial fibrillation
24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation
25:25 Rate versus rhythm control; AFFIRM trial
30:50 Strict versus lenient rate control; RACE trial
33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy
36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials
40:40 When to refer to cardiology and electrophysiology
42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation
45:22 DOACs in CKD and some other nuances in choice of agent
52:27 Bleeding and anticoagulation
58:38 Cardioversion for atrial fibrillation (initial versus delayed)
63:32 Anticoagulation before and after cardioversion
67:48 Lifestyles measures for atrial fibrillation
70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism
74:12 Aspirin monotherapy is not appropriate for atrial fibrillation
76:42 Take home points
78:50 Outro

#288 LIVE! Neutropenic Fever featuring Dr. Susan Seo Aug 02, 2021

Show notes

We’ve got a neutropenic fever and the only cure is...more cowbell? LIVE! It’s neutropenic fever (aka febrile neutropenia) deconstructed with infectious diseases expert, Dr. Susan Seo (Memorial Sloan Kettering Cancer Center). Topics: identifying low vs high risk patients, initial labs & imaging, empiric antibiotic therapy, when to add antifungals, de-escalation, and the G-CSF controversy.
Free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Writer and Producer: Matthew Watto MD, FACP
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Matthew Watto MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Susan Seo MD

Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: BetterHelp betterhelp.com/curb Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb

Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Initial workup for neutropenic fever
Low risk neutropenic fever
High risk neutropenic fever
When to add antifungal coverage, G-CSF
Audience questions
Outro

#287 Angina, Stable CAD, HMB, Hypercalcemia (TFTC #7) Jul 28, 2021

Show notes

We recap the top pearls on angina, Stable CAD, Heavy Menstrual Bleeding, and Hypercalcemia. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.
Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #279, #280, and #281.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Beth Garbitelli, Avital O’Glasser, and Nora Taranto
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Amercian College of Physicians acponline.org/100curb ACP’s all-new CME 100 video package is now available at acponline.org/100CURB Use code 100CURB.

Sponsor: The Jordan Harbinger Show jordanharbinger.com/subscribe

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.

Show Segments

Intro, disclaimer
Angina and Stable CAD
Heavy Menstrual Bleeding and Anticoagulation in Menstruating patients
Hypercalcemia and primary hyperparathyroidism
Outro

#286 Mingle with Shingles featuring Dr. Boghuma Titanji Jul 26, 2021

Show notes

Shaken by a shortage of shingles savvy? Vexed by varicella-zoster imposters? Perplexed by post-herpetic neuralgia? Get ready to sharpen your expertise in varicella vaccines, learn how to tell a zoster from a zebra, and administer infection interventions with an eye towards prevention. We are joined today by special guest and returning Curbsiders expert, Dr. Boghuma Kabisen Titanji MD, M.Sc., DTM&H, PhD. (@Boghuma on Twitter!).
Unfortunately, CE credit is NOT YET available for this episode : (
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Sarah Phoebe Roberts, MPH
Show Notes by: Sarah Phoebe Roberts MPH, Kate GrantMBChB MRCGP DipGUMed
Cover Art: Kate Grant MBChB MRCGP DipGUMed
Infographic: Sarah Phoebe Roberts
Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH
Reviewer: Paul Williams MD, FACP
Editor: Kate Grant MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Boghuma Titanji, MD, M.Sc., DTM&H, PhD

Sponsor: BetterHelp betterhelp.com/curb Special offer for listeners: get 10% off your first month at betterhelp.com/curb

Sponsor: Grammarly grammarly.com/curb Get 20% off Grammarly Premium by signing up at Grammarly.com/curb

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 .

Show Segments

Intro, disclaimer
Guest bio and one-liner
First Kashlak case: Diagnosis of varicella-zoster virus (VZV, aka shingles)
Mimics and atypical presentations
Treatment for uncomplicated shingles cases
Second Kashlak case: Post-herpetic neuralgia (PHN)
PHN treatment options
Management of complicated shingles cases
VZV prophylaxis and infection control
Third Kashlak case: Immunization guidelines for older adults
VZV vaccine efficacy, live attenuated vs. recombinant vaccine
Varicella (chickenpox) vaccine guidelines
Final pearls and Outro

#285 Common Skin Complaints in Primary Care (Dermsiders) Jul 19, 2021

Show notes

Walk with us through common skin complaints in primary care, focusing on the trunk and extremities. Our favorite skinternist, Dr. Helena Pasieka (Chief of Dermatology at Kashlak) schools us on tinea versicolor, the fluff test, treatment of skin tags, how to work up and manage generalized pruritus, venous insufficiency, and how to get ready for sandal season in the face of onychomycosis. #dermismedicine!
Free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers: Maddie “Mad Dog” Morgan, Edison Jyang
Infographic and Cover Art: Edison Jyang
Writer: Beth Garbs Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD, FACP
Editor: Emi Okamoto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Dr. Helena Pasieka

Sponsor: Qalo qalo.com/curb Listeners get 20% off at qalo.com/curb (Promo code: CURB20)

Sponsor: Green Chef GreenChef.com/curb100 Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!

Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders
Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

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 to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Tinea (pityriasis) versicolor and the fluff test, bumps, and lesions
Generalized Pruritus: clinical features, work-up and supportive care
Lower Extremity Venous Insufficiency and Lipodermatosclerosis
Onychomycosis
Take-Home Points
Outro

#284 An Antibiotics Primer with @IDdocAdi Jul 12, 2021

Show notes

This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! We discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and so much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, Script and Show Notes: Nora Taranto MD
Infographic, Cover Art, Show Notes: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com
Reviewer: Victor Kovac MD
Guest: Adi Shah MBBS

Sponsor: Panacea Financial panaceafinancial.com Panacea Financial is a division of Primis, member FDIC
Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders

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 to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
How to approach antibiotics
Choosing antibiotics / Framework
Dr. Shah’s favorite antibiotics
Pneumonia
Diabetic Foot Infections
Take-home points
Outro

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