The Curbsiders Internal Medicine Podcast

Latest Episodes:

#234 The Breast Lump, and Breast Cancer Screening with Nancy Keating MD, MPH Sep 28, 2020

Show notes

Master your breast cancer screening spiel, cultivate your approach to the breast mass, and empower your patients with empathetic shared decision-making (which we know you’re all already fabulous at)! On this fantastic episode, we are joined by Dr. Nancy Keating @NancyKeatingMD, policy wonk and primary care doc extraordinaire at Brigham and Women’s Hospital. This episode is rife with drama, as the ACS butts heads with the USPTF and the ACR, and you have to figure out what’s right for the patient by talking with them--almost as exciting as that moment on Grey’s when Izzie cuts the...anyway, I won’t ruin a key plot point in the most excellent medical show of all time, all in a day’s work, here at The Curbsiders. Enjoy!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Producer and Writer: Nora Taranto MD
Show Notes: Nora Taranto MD, Isabel Valdez PA
Infographic: Nora Taranto MD
Cover Art: Kate Grant, MD
Hosts: Stuart Brigham MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Reviewer: Arielle Medford MD
Guest: Nancy Keating MD, MPH

Sponsors Provider Solutions & Development

Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

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. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
Sponsor - VCU Health Continuing Education
00:30 Intro & Guest Bio
03:27 Guest one-liner
05:27 Best Advice for Women in Medicine
07:34 Picks of the Week
Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
10:00 Case 1: Brenda Cantwell and Breast Lump DDx
13:39 Clinical Breast Exam vs Self Breast Exam
17:26 Practical Tips for the Clinical Breast Exam
21:50 Imaging to Evaluate the Breast Lump
26:36 Demystifying BIRADS
28:36 Epidemiology Potpourri
33:02 Breast Pain without a Mass
34:30 Case 2: Mammie Gram and Breast Screening
46:03 Average Risk vs High Risk Screening
47:18 Breast Risk Prediction Tools
48:51 Breast Density
53:16 Imaging Modalities
61:28 Shared Decision Making in Screening
68:04 Case 3: Ms Britta Lumpworth and When to Stop Screening Mammograms
74:42 Take Home Points and Outro
Sponsor - VCU Health Continuing Education

Links*

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal

Listeners will learn how to evaluate a breast lump in the primary care clinic, what the guidelines recommend for asymptomatic breast cancer screening, and how to engage a patient in shared-decision making given the data available on mammograms.

Learning objectives

After listening to this episode listeners will…

Triage and evaluate the Breast Lump
Perform breast cancer risk assessment
Recall the Guideline Recommendations for Breast Cancer Screening and how they vary
Engage patients in conversation about b...

#233 Giving Effective Feedback with Drs. Abby Spencer and Alia Chisty Sep 21, 2020

Show notes

Listen to our medical education heroes, Dr. Abby Spencer, @abbyCCim (Cleveland Clinic), and Dr. Alia Chisty, @aliachisty (Penn State Health), school us on how to give effective and meaningful feedback! Topics include: the ADAPT framework, how to give difficult feedback, keywords and phrases when giving feedback, how to avoid gender and racial bias when giving feedback, giving feedback to your peers and how to solicit effective feedback as a team leader.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by Paul Williams MD, FACP
Cover Art: Paul Williams, MD, FACP
Infographic: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guests: Abby Spencer MD and Alia Chisty MD

Sponsors Provider Solutions & Development

VCU Health CE

Time Stamps

Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio, pun
04:00 Guest one-liners, Picks of the Week* (see links below)
10:25 Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
11:00 Case from Kashlak, Feedback definitions
15:00 Addressing perceived barriers to feedback
31:45 ADAPT model of feedback
38:10 Addressing potentially gendered feedback;
42:45 Giving feedback to those who lack insight
48:29 Feedback and racial bias
52:25 Giving peer feedback
58:10 Tips for soliciting feedback as a supervisor
69:05 Does giving difficult feedback mean people won’t like you?
75:10 Take home points and Outro
Sponsor - VCU Health Continuing Education

Links*

Goal

Listeners will demonstrate effective techniques to deliver and solicit meaningful feedback.

Learning objectives

After listening to this episode listeners will…

Discuss the definitions and terms used to discuss feedback.
Deliver effective feedback that is concordant with the learning goals of their trainees.
Address potential perceived barriers to feedback.
Utilize the ADAPT framework to partner with their learners and develop shared goals.
Develop strategies to mitigate against using gender- or racially-biased narrative language.
Deliver feedback to learners with limited insight by leveraging the impact of perception on achieving goals.
Solicit effective and meaningful feedback despite being in a position of authority

Disclosures

Drs. Spencer and Chisty report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Williams PN, Spencer A, Chisty A, Brigham SK, Jyang E, Watto MF. “#233 Giving effective feedback with Abby Spencer and Alia Chisty”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 21, 2020.

References

Ende J. Feedback in Clinical Medical Education. JAMA. 1983. . [https://pubmed.ncbi.nlm.nih.gov/6876333/]
Brown B. 2018. Dare to Lead. Random House.
Stone D and Heen S. 2014. Thanks for the Feedback. Penguin Books.
Scott K. 2019. Radical Candor. St. Martin’s Press.
Fainstad T et al. Feedback can be less stressful: Medical trainee perceptions of using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) framework. Cureus. 2018. [https://pubmed.ncbi.nlm.nih.gov/30906679/]
Rojek AE et al. Differences in narrative language in evaluations of medical students by gender and under-represented minority status. J Gen Int Med. 2019. [https://pubmed.ncbi.nlm.nih.gov/30993609/]
Mueller AS et al. Gender differences in attending physicians’ feedback to residents. JGME. 2017. [https://pubmed.ncbi.nlm.nih.gov/29075375/]
Ross, DA et al. Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations. PLoS ONE. 2017. [https://pubmed.ncbi.nlm.nih.gov/28792940/]

#232 Skinternship: Scalp & Face with Helena Pasieka MD Sep 14, 2020

Show notes

Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights.

Credits

Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP,
Cover Art and Infographic by: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Helena Pasieka MD, MS

Sponsors Provider Solutions & Development

VCU Health CE

Time Stamps

Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders
08:30 Case 1: Alopecia
12:05 Assessing scalp for inflammatory changes and follicular drop-out
13:10 Central Centrifugal Cicatricial Alopecia (CCCA)
14:00 Alopecia/hair loss non-scarring subtypes
25:00 Alopecia Treatments
28:55 Case 2: Psoriasis vs. Seborrheic Dermatitis
31:45 Looking for psoriatic plaques
32:11 Seborrheic dermatitis hallmarks
35:19 Treatment for Seborrheic Dermatitis
42:10 Case 3: Rosacea vs. Acne
50:40 Differentiating rosacea rash from SLE
52:40 Rosacea management & treatment
55:00 Identifying rosacea in Black skin
56:50 Acne management & treatment
59:10 Retinoid dermatitis
1:00:30 Maskne
1:02:29 Antibiotics for acne
1:03:38 Retinoids and pregnancy
1:04:09 Doxycycline for rosacea
1:06:15 Take home points
Sponsor - VCU Health Continuing Education

Links*

Hamilton and Alexander Hamilton by Ron Chernow,
Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance)
The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones)
Brown Skin Matters on Twitter and Instagram
Skin of Color Society
American Academy of Dermatology
Society for Dermatology Hospitalists
Black Skin Directory Learning Journal
Mind the Gap (2020) by Malone Mukwende
Ethnic Dermatology: Principles and Practice (2013)
Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012)
An Atlas of African Dermatology (2001)

Goals

Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic.

Learning objectives

After listening to this episode listeners will...

Recognize and treat common skin complaints of the scalp and face in primary care.
Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care.
Be able to differentiate non-scarring versus scarring hair loss on physical exam.
Comprehend nuances in total body presentations of psoriasis as a means to differentiate from seborrheic dermatitis.
Review when referral to dermatology for hair loss or skin changes of the face/scalp is necessary.
Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.

Disclosures

Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Pasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.

REBOOT #48 Hyponatremia Deconstructed Sep 07, 2020

Show notes

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Original episode written and produced by: Matthew Watto MD, FACP
Show Notes and CME questions by: Deb Gorth ScM
Cover Art and Infographic by: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein (written materials); Matthew Watto MD (audio)
Guest: Joel Topf MD

Sponsors POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team.

Interview season is in full swing and they’re actively accepting applications. Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information. You can apply for fellowship using the eusfellowships.com portal.

VCU Health CE

Time Stamps

00:00 Intro
03:30 Guest interview
07:15 Pick of the week w/Dr. Topf
16:20 Clinical case of hyponatremia
17:48 False hyponatremia normal osmolality
19:34 False hyponatremia high osmolality
20:36 Understanding why osmolality matters
23:28 Workup false hyponatremia
24:45 Recap of discussion so far
25:40 ADH dependent vs independent hyponatremia
27:00 Psychogenic polydipsia
289:15 Renal failure and hyponatremia
30:03 Tea and toast, and Beer Drinker’s potomania
35:22 ADH dependent hyponatremia
38:15 Volume versus osmolality
40:00 Volume status exam
45:14 Additional testing with urine lytes and uric acid
47:30 Treatment for SIADH
52:42 Discussion of the vaptans
58:21 Additional testing in SIADH
62:50 When to admit patient for hyponatremia
63:59 Clinical case of hyponatremia complications
68:56 Fluids and rate of correction
73:36 DDAVP clamp
76:30 Moderate hyponatremia
78:35 Diuretic dosing DOES matter!
81:59 Loop diuretics for SIADH
84:25 Take home points
87:25 Outro

Links*

Goal

Listeners will recall the pathophysiology of hyponatremia and develop a systematized approach to identifying the type and cause of hyponatremia, as well as how to safely manage hyponatremia.

Learning objectives

After listening to this episode listeners will…

Differentiate true and false hyponatremia
Recall the pathophysiology of true and false hyponatremia
Interpret blood and urine tests to identify the cause of hyponatremia
Recall the limitations of the volume status exam
List ADH dependent causes of hyponatremia
List ADH independent causes of hyponatremia
Explain the pathophysiology of beer drinker’s potomania and “tea and toast” hyponatremia
Use uric acid to differentiate SIADH from other causes of hyponatremia
Basic therapy for SIADH
Recall safe rates of correction for hyponatremia

Disclosures

Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures.

Citation

Topf J, Gorth DJ, Williams PN, Brigham SK, Heublein M, Jyang E, Watto MF. “REBOOT #48 Hyponatremia Deconstructed”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date: July 17, 2017; Updated September 7, 2020.

Become #1 in T1DM (Cribsiders #6) Aug 31, 2020

Show notes

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot!

NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively.

Credits

Written and Produced by: Shannon Snellgrove
Infographic: Shannon Snellgrove
Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders)
Hosts: Justin Berk MD and Christopher Chiu MD
Editor:Justin Berk MD; Clair Morgan of nodderly.com
Guest(s): Hussein Abdullatif MD

*Sponsors* POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team.

Interview season is in full swing and we’re actively accepting applications. Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information. You can apply for fellowship using the eusfellowships.com portal.

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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Diagnosis of T1DM 6:50
Presentation of T1DM 10:10
Explaining T1DM to a parent 12:00
Genetic Predisposition to Diabetes 15:20
T1DM Antibodies 17:10
Initial work-up for concomitant autoimmune disease 21:10
Atypical Presentation of T1DM 22:44
Treatment of T1DM 29:10
Dietary Modifications in T1DM 33:10
Checking blood sugars 39:50
Honeymoon Period 42:25
Hypoglycemia 44:00
Sports, Sickness, Alcohol and Glucose levels 48:25
Periop glucose management 51:10
Long-term complications of T1DM 53:50
Closed Loop System and Future Treatments 56:10

Goal

Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes.

Learning objectives

After listening to this episode listeners will…

Identify the signs and symptoms of type 1 diabetes
Practice appropriate work-up in the diagnosis of type 1 diabetes
Manage type 1 diabetes with evidence-based therapies
Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts
Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes)

Disclosures

Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures.

Citation Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (link goes live on 9/2/2020)

#231 U Talkin’ UTIs Re: Me? Aug 24, 2020

Show notes

Are U Talkin’ UTIs Re: Me? Infectious Diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED) schools us on the diagnosis and management of urinary tract infections: updated definitions of complicated and uncomplicated UTI, pitfalls of the urinalysis, first line antibiotics, duration of therapy and which agents to use for complicated UTI. This episode is liquid gold!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art and Infographic by: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
Guest: Boghuma Kabisen Titanji MD, PhD

Sponsor - 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
02:50 Guest one-liner, Picks of the Week*: Urban gardening, Behave (book) by Robert Sapolsky
08:54 Defining UTI; Framework for UTI
16:35 Case 1 - Cath Foley; Acute uncomplicated cystitis; Interpreting the Urinalysis
28:00 Women with recurrent UTIs
38:55 Case 2 - UTI in a man
47:15 Treatment of complicated infections; Duration of therapy
52:27 Case 3 - Catheter associated UTI; MRSA UTI
61:25 Duration of therapy for bacteremia from UTI
64:40 Take home points, plugs and outro
Sponsor - VCU Health Continuing Education

Links*

Goals

Listeners will appropriately recognize, diagnose and treat the various presentations of urinary tract infection.

Learning objectives

After listening to this episode listeners will...

Define UTI and feel confident making the diagnosis of UTI based on lab tests, history and exam findings
Differentiate between complicated and uncomplicated UTI
Recognize how UTI may presents differently in differ groups (paraplegic, chronic foley catheter, men and women)
Choose the appropriate antibiotic and duration with an eye towards antibiotic stewardship
Determine an approach to the patient with recurrent UTIs, including who may benefit from long term antibiotic prophylaxis.

Disclosures

Dr Titanji reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Titanji BK, Williams PN, Watto MF. “#231 U Talkin’ UTIs Re: Me”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 24, 2020.

#230 Kittleson Rules Acute Heart Failure Aug 17, 2020

Show notes

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea? Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement.

Credits

Written and Produced by: Deborah Gorth ScM
Cover Art and Infographic by: Edison Jyang
Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Michelle Kittleson MD, PhD

Sponsor - VCU Health CE

Time Stamps

00:00 Intro
02:40 Guest one-liner; Picks of the Week
08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic)
13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction?
20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?!
28:36 Labs to trend during an ADHF admission
33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes
45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2?
49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB)
56:05 Who needs a right heart cath?
59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care
64:04 SGLT2i in heart failure
68:15 Take home points and outro

#229 Hotcakes: COVID on steroids, statins over 75, short duration DAPT Aug 10, 2020

Show notes

Join us for an extra-hot summer episode featuring our critical appraisal expert, Rahul Ganatra MD, MPH @rbganatra. Prepare to marvel as he breaks down his recent tweetorial on the RECOVERY trial of dexamethasone for COVID-19; to gasp as Paul Williams updates us on statins and ASCVD prevention and to be enthralled by the dulcet tones of Matt Watto explaining the latest research on DAPT vs. monotherapy with ticagrelor. Bonus: a new hotcakes rating scale has arrived!

Credits

Producer: Sarah Phoebe Roberts
Show Notes by: Sarah Phoebe Roberts
Writer: Rahul Ganatra MD, Sarah Phoebe Roberts, Matthew Watto MD, Paul Williams MD
Cover Art: Matthew Watto MD
Hosts: Rahul Ganatra MD, Matthew Watto MD, Paul Williams MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE

Time Stamps

00:00 Intro
02:15 Picks of the Week
06:15 New Hotcakes rating scale
09:20 RECOVERY trial
17:30 Rapid home-testing for COVID
20:15 Statins and ASCVD prevention
32:30 Ticagrelor monotherapy after ACS
41:30 Outro

Picks of the week

Paul: U Talkin' Talking Heads 2 My Talking Head podcast
Sarah: New hotcakes scale!
Rahul: Chromeo’s new Quarantine Casanova album
Watto: 30 Rock season 1, episode 3 “Blind Date”

#228 Thyroid on Fire! Hyperthyroidism with Dr. Eve Bloomgarden Aug 03, 2020

Show notes

Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire!

Credits

Written and Produced by: Tima Karginov and Matthew Watto MD, FACP
Infographic by: Tima Karginov
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Eve Bloomgarden MD

Sponsors: Pediatrics On Call podcast by the American Academy of Pediatrics

If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here.

VCU Health CE

Time Stamps

00:00 Intro
03:15 Guest one-liner, favorite failure, Picks of the Week*
08:50 Sponsor
10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs
14:20 Case from Kashlak, Symptoms of Hyperthyroidism
25:00 Grave’s eye disease: exam, therapy and counseling
32:35 Thyroid exam and ultrasound
38:55 Thyroid Stimulating Immunoglobulin
41:00 Biotin
44:30 Thyroid Scintigraphy
49:00 Causes of Thyrotoxicosis
52:00 Treatment & Adherence to antithyroid medication (methimazole)
56:20 Beta Blockers in thyrotoxicosis
64:50 Subclinical Hyperthyroidism
67:00 Take Home Points, Outro

Back to School Special - COVID Edition (Cribsiders #3) Jul 29, 2020

Show notes

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year!

Credits

Producers & Writers: Edward Corty, Nicholas Lee MD
Infographic: Nicholas Lee MD
Cover Art: Chris Chiu MD
Hosts: Justin Berk MD, Chris Chiu MD, Edward Corty
Editor:Justin Berk MD; Chris Chiu MD
Guest(s): Joshua Sharfstein MD

Sponsors: Pediatrics On Call

Sponsor: VCU Health Continuing Education - to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org or cribsiders.vcuhealth.org