The Curbsiders Internal Medicine Podcast

Latest Episodes:

#140 Psychopharmacology 2.0 - Antidepressant Master Class Feb 18, 2019

Show notes

Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).
Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits
Written and produced by: Molly Heublein, MD
CME questions by: Molly Heublein, MD
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein, MD
Edited by: Matthew Watto MD
Guest Presenter: Patrick Finley, PharmD BCPP
Sponsor
Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

#139 Genetic Testing in Primary Care Feb 11, 2019

Show notes

Join us at the forefront as we talk genetic testing in primary care with Dr Dallas Read, esteemed gynecologist and **the only** medical geneticist at Tufts Medical Center. Topics include: what internists should be comfortable testing for in the office, how and when to refer for screening, what tests to order, how to interpret test results, how to handle direct-to-consumer results or requests, and so much more! For years, the medical community has been talking about the immense potential for genetic testing to guide diagnosis and treatment. But has it realized its full potential? The answer to that seems to be a resounding no at the moment--but the days of ubiquitous genetic testing to identify disease and disease risk may not be so far off after all. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).
Coming to you from the Curbsiders, we hope you’ll enjoy this latest episode about the genes you wear, whether you want to put them on or not. Genes, Genes, they’re (maybe) good for your heart. But do patients want to know if they are, or if they aren’t?

Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits

Written and produced by: Nora Taranto MS4
CME questions by: Nora Taranto MS4
Hosts: Stuart Brigham MD, Matthew Watto MD, Nora Taranto MS4
Images and infographics: Beth Garbitelli MS1
Edited by: Matthew Watto MD, Chris Chiu MD
Guest: Dr. Dallas Reed MD

Sponsor
Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

#138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis Feb 04, 2019

Show notes

Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich, Assistant Professor of Medicine and co-director of the Inflammatory Bowel Disease Program at Temple University Hospital. In this episode, we learn about the initial work-up, general principles of management, and important primary care considerations for Crohn’s disease and ulcerative colitis (ie endoscopic surveillance, immunizations, bone health/osteoporosis, and more!).
Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits

Written and produced by: Paul Williams MD
Edited by: Matthew Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Adam Ehrlich MD

Sponsor
Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

#137 Hyperkalemia Master Class with Joel Topf MD Jan 28, 2019

Show notes

Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis.
Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Sponsor

Join us at ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there!
Credits

Written and produced by: Matthew Watto, MD
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Infographic: Matthew Watto MD
Edited by: Matthew Watto MD
Guest: Dr Joel Topf MD

#136 Sickle Cell Disease, Management & Complications Jan 21, 2019

Show notes

Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sickle Cell Center for Adults at Johns Hopkins joins!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Sponsor

ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA. We'll see you there!

Credits

Written (including CME questions) and produced by: Justin Berk MD, Martha Brucato MD PhD, Beth Garbitelli MS1

Hosts: Paul Williams MD, Justin Berk MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Sophie Lanzkron MD MHS

Time Stamps

00:00 Announcements, intro
02:30 A quick refresher on hemoglobinopathy
03:45 Guest bio
05:03 Guest one-liner, movie recommendation, career advice, picks of the week
10:53 ACP Internal Medicine Meeting 2019 (ad read)
12:33 Clinical case; defining sickle cell; pathophysiology
16:23 Different types of hemoglobinopathy genotypes and phenotypes
20:20 Preventive care for sickle cell disease
22:56 Taking a history at the initial visit in patient with sickle disease
26:40 Life expectancy in SCD
28:30 Hydroxyurea
30:40 Chronic red blood cell transfusion therapy; complications; monitoring
37:07 Silent cerebral infarcts and mild cognitive impairment in SCD
40:10 Chronic pain management; opioid use disorder in sickle cell disease
46:00 Acute pain crisis management; PCAs vs bolus therapy
54:08 Reticulocyte count in sickle cell disease
55:40 Itching, opioids and naloxone?
58:10 Red blood cell transfusion threshold in sickle cell disease (anemia)
60:03 Acute fever in SCD
61:48 Acute chest syndrome
66:45 Transition from pediatrics to adult medicine in sickle cell
68:00 Incentive spirometry to prevent acute chest syndrome
68:45 Take home points
70:00 Outro

#135 Perioperative Medicine with Dr Avital O'Glasser Jan 14, 2019

Show notes

Optimize perioperative risk and dominate perioperative medicine. Topics include surgical risk calculators, preoperative labs, stress testing, use of BNP and troponins, postoperative MI, cardiac and pulmonary risk stratification, and more! We’re joined by perioperative medicine expert, Avital O’Glasser MD, Associate Professor of Medicine at Oregon Health & Science University and Assistant Program Director for Scholarship and Social Media. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Credits

Written and produced by: Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Matthew Watto MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Avital O’Glasser MD

Time Stamps

00:00 Disclaimer, intro and guest bio
04:20 Guest one-liner, book and movie recommendations, career advice
11:20 ACP Internal Medicine Meeting 2019 details
14:02 Patient with coronary artery calcifications going for elective hip surgery and wants "clearance"
20:50 Functional capacity
25:00 Preoperative stress testing and coronary revascularization
31:55 Canadian guidelines, BNP and troponin testing
36:30 The METS trial and predicting perioperative cardiac events and mortality
40:44 Preoperative testing (labs, imaging, urine studies)
50:24 Choosing your perioperative cardiac and surgical risk calculator (RCRI, MICA, ACS-NSQIP)
59:50 Communicating risk to patient and their surgeon
61:30 Pulmonary risk assessment and complications
70:35 Perioperative use of opioids
75:30 Who needs an echocardiogram prior to surgery?
79:00 Canceling a patient's surgery
82:55 Take home points
83:45 Outro

#134 Urinary Tract Infections Delirium and Voltaire Jan 07, 2019

Show notes

“Urinary tract infections” (UTIs) are overdiagnosed. Antibiotics are overprescribed. UTIs are inappropriately blamed for geriatric syndromes (eg delirium) despite little supporting evidence. Our guest, Tom Finucane MD, Emeritus Professor of Medicine at Johns Hopkins makes us question everything. Topics: How can we diagnose “UTI”? Who needs treatment? Do urinary tract symptoms matter? Does malodorous urine correlate with infection? Who’s at risk for pyelonephritis and sepsis? Don’t miss this paradigm changing episode. And stop using the term “urinary tract infection” unless it’s prefaced by air quotes!

Sponsor: Join ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there!

Credits

Written and produced by: Matthew Watto MD

Hosts: Matthew Watto MD, Paul Williams MD

Edited by: Matthew Watto MD

Guest: Tom Finucane MD, MACP

Time Stamps

00:00 Disclaimer, intro and guest bio
04:00 Guest one liner, book recommendation, career advice
08:22 The “medical ignorome”
13:40 ACP Internal Medicine Meeting 2019 details
16:20 Case of malodorous urine; Urine is NOT sterile; Defining terms
25:14 Stop saying UTI unless using air quotes
28:34 What symptoms or history matters in evaluation for “UTI”? And can we predict who will become systemically ill?
34:47 Voltaire and when treatment is warranted for “urinary tract infections”
37:15 Delirium in an older adult with possible UTI, how to work it up, and who warrants antibiotics
51:55 Take home points
53:38 Outro

2018 Recap Extravaganza Dec 31, 2018

Show notes

Take a trip down memory lane with top clinical pearls and favorite moments from The Curbsiders in 2018.

Welcome to our 2018 Recap Extravaganza! Since last year, the Curbsiders team has grown substantially and the podcast has undergone several exciting developments. These include our collaboration with ACP that allows us to provide CME and MOC credit for select episodes, our new partnership with Human Dx as featured in our Kashlak Morning Reports, and the launch of our Women in Medicine series. For our 2017 year-end show, we had listeners vote for their favorite episodes from the past year. This year, we're changing it up a bit and have invited our Curbsider colleagues to share their picks for pearliest pearls and most illuminating episodes of 2018. We hope you’ll enjoy hearing the team’s highlights, and we’ll be back in 2019 with fresh content. Note: No CME-MOC credit for this episode, but stay tuned in 2019 for eligible episodes.

Credits

Written and produced by: Chris Chiu MD and Sarah Phoebe Roberts, MPH

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Chris Chiu MD

Edited by: Chris Chiu MD

Time Stamps

00:00 Disclaimer, Intro
06:39 Clinical Reasoning Pearls
12:35 Pulmonary Hypertension Pearls
15:52 Women In Medicine Pearls
20:40 Iron Deficiency Pearls
24:52 Tick-Borne Illness Pearls
28:00 STI Pearls
31:00 Physical Exam Pearls
32:51 “Things we do for no reason” Pearls
36:16 Host Picks
42:38 Paul Wraps-up the Year
43:38 Outro and Curbsider Team sign-offs

#133 Herpes for Everyone Dec 24, 2018

Show notes

Master the diagnosis and management of Genital Herpes with tips from expert, Robert Bettiker MD . Topics include: the natural history, diagnosis & screening guidelines for genital herpes; cold sores; options for primary and recurrent episodes including prophylaxis; and consideration of specific populations including symptomatic and asymptomatic patients, pregnancy and MSM (men who have sex with men). We also discuss partner notification and treatment.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Kate Grant MBChB DipGUMed, Matthew Watto MD

Images by: Kate Grant MBChB DipGUMed

Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD

Guest: Robert Bettiker MD

Time Stamps

00:00 Disclaimer, guest bio, intro
01:50 Guest one liner, memorable teaching moment and a few failures
10:50 Intro to herpes
12:25 Case 1: Genital herpes in a married man
15:42 Overview of testing options
18:50 Marital counseling in Herpes
22:18 Prophylaxis in serodiscordant partners and asymptomatic shedding
25:08 Case 2: Severe outbreak of genital herpes in a young woman
31:50 Case 3: Young male with recent exposure to herpes
38:45 Herpes 1 (HSV1) versus Herpes 2 (HSV2)
44:12 Case 4: Herpes in pregnancy
50:45 Do topical agents work for herpes
55:05 Take home points
56:10 Outro
57:52 Stuart shares a PUN!

#132 A Case of Abdominal Pain Dec 19, 2018

Show notes

Sharpen your diagnostic schema for abdominal pain and eosinophilia with this mystery case http://hdx.org/Rxg (click link to follow along). Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx attempts to solve this challenging case with the help of The Curbsiders.

Use this link http://hdx.org/Rxg to follow along with the case on the Human Dx app and check out more Global Morning Report cases.

Credits

Written and produced by: Hannah R Abrams

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes.