The Curbsiders Internal Medicine Podcast

Latest Episodes:

#227 Baffled by NAFLD? Jul 27, 2020

Show notes

Swim through the sea of acronyms as Dr Scott Matherly (@liverprof) helps us become a little less baffled by the thought of NAFLD. We discuss the initial diagnosis of fatty liver disease, indications for additional evaluation with imaging and/or biopsy, and potential treatment options. With a quarter of the world affected, it’s crucial to understand the various forms of disease and how to counsel patients about this all-too-common condition!

Credits

Written and Produced by: Elena Gibson MD
Infographic and Cover Art: Elena Gibson MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Scott Matherly MD

Sponsor: Pediatrics On Call

Sponsor: VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

00:00 Intro
03:15 Guest one-liner; Picks of the Week* :
08:15 Sponsor
08:50 Case from Kashlak part 1; What is hepatic steatosis?
11:43 NAFLD acronyms and definitions
18:20 Alcohol and Fatty Liver
23:15 Initial Evaluation of NAFLD
35:12 Dr Matherly’s piel to patients with fatty
41:11 NASH/Fibrosis Risk Assessment
48:54 Outcomes in NASH with Fibrosis
51:20 Statins are safe in liver disease
56:15 Treatment Options (surgery, Vitamin E, Pioglitazone, SLGT2 inhibitors and GLP1 agonists; Coffee?!)
71:42 Take home points and Outro

#226 Kidney Boy on Acute Kidney Injury: Myths & Musings - Tips and Tricks from Joel Topf MD Jul 20, 2020

Show notes

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.

Credits

Written (including CME questions) and Produced by: Cyrus Askin, MD
Infographic by: Cyrus Askin, MD
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: Joel Topf, MD

Sponsor: Pediatrics On Call

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

00:00 Intro
03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame);
08:45 Sponsor
09:15 Definition of acute kidney injury (AKI) and fundamentals
11:00 Cardiorenal syndrome
12:24 Schema for AKI
17:30 Establish an etiology, determine urine output and address electrolyte abnormalities
21:22 AKI in the otherwise-healthy patient;
32:20 Rhabdomyolysis 38:21 Vancomycin
41:43 Acute interstitial nephritis (AIN)
44:52 Contrast induced nephropathy (CIN)
50:37 Gadolinium in AKI and/or CKD
52:53 Timing of dialysis
56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors;
62:01 Is Ultrasound necessary in AKI
64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology

#225 Women in Medicine: COVID Edition Jul 16, 2020

Show notes

Listen as our expert guests, Kelly Graham, MD, MPH (@KellyGrahamMD) and Lekshmi Santhosh, MD MAEd (@LekshmiMD), detail the professional and personal challenges faced by women in medicine during the COVID-19 pandemic.

Credits

Produced by: Leah Witt MD & Shreya Trivedi MD
Written by: Molly Heublein MD, Isabel Valdez PA-C, Leah Witt MD & Shreya Trivedi MD
Infographic & Cover Art: Edison Jyang
Hosts: Leah Witt MD & Shreya Trivedi MD, Justin Berk MD, MPH, MBA
Editor: Molly Heublein MD and Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guests: Kelly Graham, MD, MPH; Lekshmi Santhosh, MD MAEd

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Episode Breakdown

Intro, disclaimer
Introduction and bio for Kelly Graham, MD, MPH
Introduction and bio for Lekshmi Santhosh, MD MAEd
One-liner for Kelly Graham, MD, MPH
One-liner for Lekshmi Santhosh, MD MAEd
Gender Awakening Moments
Picks of the Week*
Case from Kashlak
Difficulty with lack of childcare while working
Hippocratic Oath paradox
Dr. Santhosh’s 3 Ps
Motherhood penalty-fatherhood bonus
Two Pandemics, One Response
Breadwinner-homemaker bias
Female physician burnout
Minority Tax
Silver Linings
Take home points and Outro

#224 Hospital Addiction Medicine with Dr Melissa Weimer Jul 13, 2020

Show notes

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter. In this episode we talk to addiction medicine expert, Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Topics include: the management of polysubstance withdrawal, approaching acute pain management for a person with opioid use disorder, and inpatient harm reduction strategies. After this episode listeners will gain new tools to help them best care for hospitalized patients with substance use disorders.

Credits

Writers and Producers: Carolyn Chan MD, Deb Gorth, and Nora Taranto MD
Cover Art and Infographics by: Carolyn Chan, MD
Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Carolyn Chan MD
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Melissa Weimer

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

Intro, disclaimer, guest bio : 00:00
Guest one-liner: 03:00
Picks of the Week*: 08:20
Case from Kashlak: 10:30
Urine Toxicology Screens 11:30
Discussing Urine Toxicology Screens with Patients 13:20
Management of Polysubstance Withdrawal 16:16
Tapering Benzodiazepines 19:56
Acute Pain Management and Opioid Use Disorder 30:35
Active Drug Use in the Hospital 38:52
Harm Reduction 40:00
Discharges - Planned 43:43
Perioperative Buprenorphine and Methadone: 46:50
QT Prolongation and Methadone - 52:53
Outro 56:21

Cystic Fibrosis Licked (Cribsiders #1) with Dr. Whittney Warren Jul 06, 2020

Show notes

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas. Show notes: https:/www.thecribsiders.com/.

Credits

Writer, Producer, Infographic, CME Questions: Clara Mao
Cover Art: Christopher Chiu MD
Hosts: Justin Berk MD, Christopher Chiu MD, and Matthew Watto MD
Editor: Justin Berk MD; Clair Morgan of nodderly.com
Guest: Whittney Warren DO

Time Stamps

Intro / Disclaimer 0:00
Guest bio 2:25
Guest one-liner, picks of the week 3:15
Explaining CF to patients, life expectancy 7:00
Types of CF mutations and phenotypes 11:50
Presentation of CF in older patients 15:20
Screening and diagnosis 16:40
PFTs and airway clearance 25:20
Nutrition and the “CF diet” 29:10
CF exacerbations and antibiotic selection 32:25
Extrapulmonary manifestations 39:35
Transition of care for CF adolescents (alcohol, exercise, sex) 43:50
CFTR modulator therapy 51:35
Lung transplantation 54:45

Goal

Listeners will develop a systematic approach towards long-term management and acute exacerbations of cystic fibrosis.

Learning objectives

After listening to this episode listeners will…

Explain the pathophysiology underlying cystic fibrosis.
Identify maintenance therapies that optimize pulmonary function and nutritional status in patients with cystic fibrosis.
Choose evidence-based practices in the management of cystic fibrosis-associated pulmonary exacerbations.

#223 Hot COVID Cakes: COVID19 Disparities, Steroids, Hormones for Depression, Probiotics Jul 02, 2020

Show notes

This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening. Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial.

Credits

Written and Produced by: Rahul Ganatra MD, MPHl Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD
Show Notes and CME questions by: Deborah J. Gorth ScM
Cover Art: Deborah J. Gorth ScM
Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Utibe Essien MD, MPH

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

00:00 Intro, disclaimer, guest bio
02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Netflix; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page!
07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19
26:10 Dexamethasone for COVID-19
28:55 Hormonal therapy for depression
38:16 Probiotics
45:00 Outro

#222 Addressing Anti-Black Racism in Medicine Utibe Essien MD, MPH Jun 25, 2020

Show notes

Listen as our esteemed guest Dr. Utibe Essien @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings.

Credits

Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD
Cover Art: Hannah Abrams MD
Infographic: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD
Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com
Guest: Utibe Essien MD

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

00:00 Intro, disclaimer, guest bio
02:40 Guest one-liner, Picks of the Week*: Just Mercy
09:20 Statement from the show; Importance of discussing racism in medicine
14:11 Definitions
18:06 Identifying how racism manifests in the clinical setting
37:46 Ideas for advocacy
49:50 Take points and Outro

#221 Interstitial Lung Disease with Erin Narewski DO - Breathtaking knowledge and other words of inspiration Jun 22, 2020

Show notes

Throw out your down pillows and join The Curbsiders for this lively discussion on interstitial lung disease. While the hundreds of interstitial lung disease types make this topic a bit overwhelming, breathe easy knowing that pulmonologist, Dr. Erin Narewski @erinnarewski (Temple), can boil things down to an easy to approach framework in less time than it takes to complete a few 6-minute walk tests. In this episode, we walk through the classification, relevant patient history, workup, and management of interstitial lung disease.

Credits

Written and Produced by: Paul Williams, MD, FACP; Nicole Kus, David Madnick, and Peter Wikoff
Infographic and Cover Art: Edison Jyang
Show Notes: Deborah Gorth
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Paul Williams MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Erin Narewski DO, FCCP

Sponsor: ACP membership acponline.org/member

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

0:00 Intro
03:14 Guest one-liner, career advice, favorite failure, Picks of the Week*: The Strain, FX Horror TV Show; One Hundred Years of Solitude (book) by Gabriel Garcia Marquez; Hypoallergenic pillows; Peanut butter whiskey
10:02 Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT
11:00 Case from Kashlak, Definitions
16:40 Buckets of ILD
32:06 Discussion of testing ILD: Labs and Imaging
44:20 Imaging findings in ILD
49:44 Basic Management of ILD
61:00 Take home points and Outro

#220 Social Determinants of Health with Karen DeSalvo MD Jun 18, 2020

Show notes

We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing.

Credits

Written and Produced by: Emi Okamoto MD
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Karen DeSalvo MD, MPH, MSc

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account!

Time Stamps

Intro, disclaimer, guest bio 0:44
Dr Desalvo’s one-liner 3:34
Picks of the Week*- The Great Influenza book by John M Barry 5:01
Dr Desalvo’s advice and past experience 6:10
Case from Kashlak 10:30
What about the evidence for social determinants? 13:40
What to do about this in the clinic, and is it worth screening? 16:06
Approaching as a team and with the community 19:40
How do we affect the upstream, before the downstream consequences? 22:40
NAM recommendations and framework 26:00
The role of technology 30:00
What are Social Determinants of Health (SDOH), and who they affect 34:00
Start paying attention to SDOH 37:00
Outro 38:49

#219 Post-Op Fever and Complications with Avital O’Glasser MD Jun 15, 2020

Show notes

Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever.

Credits

Written: Hannah Abrams MD, Avital O’Glasser MD
Produced by, Infographic and Cover Art by: Hannah Abrams MD
Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com
Guest: Avital O’Glasser MD

Sponsor: ACP - acponline.org/member

Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps

00:00 Intro
02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students
09:28 Sponsor
10:17 Kashlak case; How to collaborate with our surgical colleagues
13:45 Questions to ask at the time of transfer
23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea
44:25 Co-managing Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis
57:55 Outro

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Sponsor: Pediatrics On Call

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Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

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Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

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Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

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Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account!

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Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account!

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