#462 Male Hypogonadism Pearls with Dr. Bradley Anawalt: Insights on Testosterone Deficiency Nov 18, 2024

Risks/benefits in older males, when to test, fertility considerations, and more.
Master male hypogonadism diagnosis and management. Discover when and how to test, how to tackle confounding conditions, and why lifestyle changes may be more effective than testosterone therapy in certain patients. We are joined by Dr. Brad Anawalt, an expert in endocrine care, to guide us through the essentials.
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Show Segments

Intro
Case 1
History and Physical
Laboratory Testing
Effect of Lifestyle on Testosterone
Case 2
Prostate and Cardiovascular risk
Treatment Options and Considerations
Secondary Causes of Hypogonadism
Case 3
Testicular Size and Klinefelter Syndrome
hCG and Clomiphene
Monitoring and Follow-Up
Take-Home Points
Outro

Credits

Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD, MBA, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Bradley D. Anawalt MD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Pattern

With huge discounts for doctors in training, now is truly the best time to request your disability insurance quotes with Pattern at patternlife.com/curbsiders.
Sponsor: Litter Robot

As a special holiday offer, Whisker is offering up to $100 off Litter-Robot bundles. AND, as a special offer to listeners, you can get an additional $50 off when you go to stopscooping.com/CURB.

#461: Facial Nerve Follies: Understanding Bell's Palsy Nov 11, 2024

A Bell-Ringer of a Presentation
Is it a stroke or is it botox? No, it’s Bell’s palsy! Learn how to differentiate facial palsy from other sinister diagnoses. Join us as Dr. Jordan Amar (Assistant Professor of Clinical Neurology at USC Keck School of Medicine) gives us Bell’s palsy pointers (and a great mnemonic, if there is such a thing).
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Show Segments

Introduction
Rapid fire questions and Reflex Hammers
Case #1: Ms. Melanie
Framework for Bell's Palsy
Bell's Palsy vs Stroke: How to Differentiate
Approach to History and Physical Exam
Case #2: Mr. Lopez
Red Flags in Facial Palsy (GROWLS FACE)
Workup: From Imaging to Labs and What Not to Do
Treatment: The Role of Steroids and Antivirals
Supportive Care, Complications and Prognosis
Take-Home Points
Outro

Credits

Producer and Writer: Isabel Valdez, PA-C
Show Notes: Paul Wurtz MD, Ben Furman MPH MS3, Isabel Valdez, PA-C
Infographic and Cover Art: Zoya Surani, MS2
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jordan Amar, MD

Sponsor: Beginly Health

Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started

Sponsor: OpenEvidence

If you haven't tried it out yet check it out, it will save you time and help you make better decisions go to openevidence.com/curbsiders

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

#460 HFpEF: Heart Failure with Preserved Ejection Fraction Nov 04, 2024

00:00 Introduction and Advice for Physicians
02:24 Case Presentation
04:16 Understanding HFpEF
08:11 Differential Diagnosis of Dyspnea and Edema
11:30 Diagnosing HFPEF: H2F-PEF Score and Testing
17:07 Managing Comorbidities in HFpEF
20:54 Non-Pharmacological Interventions: Weight Loss and Exercise
23:16 Understanding the Challenges of HFpEF
25:08 Medications
30:13 Promising Results of GLP-1 Receptor Agonists
36:38 Managing Salt and Water Intake

Credits

Writer and Producer: Deborah Gorth MD, PhD
Infographic and Cover Art: Zoya Surani
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Michelle Kittleson MD, PhD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Bombas

Head over to Bombas.com/curb and use code curb for 20% off your first purchase.

Sponsor: Beginly Health

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#459 DIGEST: Finerenone for Heart Failure, PCV21 and the latest Pneumonia Vaccine Recs, 24-hour vs 15-hour Oxygen Therapy, and PREVENT vs PCE for Cardiovascular Risk Estimation Oct 28, 2024

Join us as we review recent articles and news featured in The DIGEST issues #56 and #57, including finerenone for heart failure, the skinny on pneumonia vaccines and the latest, PCV21, long-term oxygen therapy (the REDOX trial), and the PREVENT vs PCE cardiovascular risk equations. Fill your brain hole with a fully digestible meal! Featuring Alex Chaitoff (@alexchaitoff), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).
Note: **Update on Pneumonia Vaccine from ACIP: After we recorded and just before we published this episode, the CDC updated its vaccine guidance to include pneumonia vaccination for all adults aged 50 years and older to receive either PCV20, PCV21, or the combination of PCV15 followed by PPSV23 one year later (CDC site accessed 24 Oct 2024).**
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Credits

Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH, Alex Chaitoff MD, MPH, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD
Reviewer: Emi Okamoto MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP

Show Segments

Introduction + Pun
Exploring Finerenone in Heart Failure
Pneumonia Vaccines: The PCV21 Trial
Long-Term Oxygen Therapy: The REDOX Trial
Cardiovascular Risk Calculators: The PREVENT Equation

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Quince

Go to Quince.com/curb for free shipping on your order and 365-day returns.

Sponsor: Beginly Health

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#458 HFrEF: Heart Failure with Reduced Ejection Fraction Oct 21, 2024

Kittleson Rules Outpatient Heart Failure Volume 1
Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) breaks down the nuances of treating this common cardiac condition.
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Show Segments

00:00 Introduction
03:22 Case Presentation: Newly Diagnosed Heart Failure
07:26 Using Physical Exam Findings to Guide Diuresis
11:58 The Four Pillars of Guideline-Directed Medical Therapy for Heart Failure
15:07 Optimizing Therapy and Follow-Up in Heart Failure Patients
22:10 The Benefits of High-Intensity Initiation and Titration of Guideline-Directed Medical Therapy
28:02 Consideration of Other Medications
40:02 Referral to Advanced Heart Failure Specialist
49:11 Optimizing Therapy and Follow-Up
55:33 Conclusion and Book Recommendation

Credits

Writer and Producer: Deborah Gorth MD, PhD
Infographic and Cover Art: Zoya Surani
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Michelle Kittleson MD, PhD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Litter Robot

Right now, Whisker is offering $75 off Litter-Robot bundles. AND, as a special offer to listeners, you can get an additional $50 off when you go to stopscooping.com/CURB.

Sponsor: Beginly Health

Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started

#457 Cold and Flu Season: Upper Respiratory Infections aka URIs Oct 14, 2024

Treating colds, flu, and more with Dr Amber Bird!
Dive deep into upper respiratory viral infections with Dr Amber Bird, MD (Penn). Feel confident on when to order testing, recommend symptom relieving treatments, and avoid unnecessary antibiotics.
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Show Segments

00:00 Introduction and Setting the Agenda
03:07 Getting to Know the Guest and Rapid Fire Questions
05:51 Case from Kashlak: Mateo with Common Cold Symptoms
06:12 Defining and Diagnosing the Common Cold
09:08 Approach to History and Physical Exam
13:23 Viral Respiratory Testing and Its Indications
17:36 Symptomatic Treatment Options for the Common Cold
24:25 Managing Cough and Nasal Congestion
35:03 Home Remedies and natural products
42:16 Prescribing Antivirals for Influenza
46:33 Antibiotics and Counseling Patients
52:07 Contagiousness and Risk to Family Members
54:52 Recurring Colds and Risk Factors
59:38 Vaccination recommendations
01:01:23 Key Takeaways and Conclusion

Credits

Producer: Leah Witt, MD and Molly Heublein, MD
Show Notes/CME: Molly Heublein, MD
Cover Art and Infographic: Leah Witt, MD
Hosts, writers: Leah Witt and Molly Heublein, MD
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Amber Bird, MD

Sponsor: Babbel

Get up to 60% off at Babbel.com/CURB.

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code
CURB50 for $50 off their first month.
Sponsor: Panacea Legal
Let Panacea Legal help you today at Panacea.Legal

#456 Outpatient Oxygen Therapy Oct 07, 2024

Supplemental oxygen is ubiquitous and yet there is a tremendous amount of uncertainty related to prescription and management in the outpatient setting. Have no fear, we’ve got your back! On this episode of The Curbsiders we host special guest Susan Jacobs, RN, MS who is a bonafide, world-class expert in outpatient oxygen therapy. How to prescribe? What’s out there? What do you do when your patient travels? She joins us to tackle these questions and so much more so make sure to tune in and snag some knowledge food for that old brain hole!
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Getting to know our guest
Basics of oxygen prescribing and devices
Caveats for the patient who only has exertional hypoxemia
How to prepare for travel
Key points & take aways
Outro

Credits

Producer, Writer, Infographic and Cover Art Artist: Leah Witt, MD
Show Notes: Cyrus Askin, MD
Reviewer: Fatima Syed, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Susan Jacobs, RN, MS

Sponsor: UVA Health
To learn more about UVA Health, visit https://uvahealth.com/

Sponsor: Beginly Health

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Sponsor: Freed AI

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
View full show notes at thecurbsiders.com

#455 Sports Injuries Part 2: Hip and Knee Sep 30, 2024

De-stress your approach to stress fractures (and trochanteric pain syndromes and meniscus tears)!
Follow along as the great Dr. Senter guides us through the diagnosis, workup, and treatment of an all-star lineup of sport injuries. Part 2 covers stress fractures, relative energy deficiency in sports, trochanteric pain, meniscus tears, and the ongoing quest to diagnose Paul’s mysterious hip injury.
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Show Segments

Case 1 - Hip stress fracture
Approach to hip injuries in runners
Relative Energy Deficiency in Sports (RED-S)
Imaging consideration for bone stress injuries
Surgical and treatment consideration for hip stress fractures
Osteoporosis evaluation
Case 2 - Greater trochanteric pain syndrome
Hip and trochanter anatomy
Treatment and imaging of trochanteric tendinopathies
Case 3 - Meniscus tear
Knee evaluation and physical exam
Bucket handle tears and surgical considerations
Special physical exam maneuvers
Imaging and further surgical considerations
Outro & Take Home Points

Credits

Producer and Show Notes: Peter Wikoff MD
Writer, Infographic and Cover art: Edison Jyang MD
Reviewer: Sai S Achi MD MBA FACP
Hosts and Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Carlin Senter MD

Sponsor: ClinicalKey AI

To learn more about ClinicalKey AI, visit Elsevier.health/AI

Sponsor: Beginly Health

Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started.
Sponsor: Freed AI

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

#454 Kidney Boy on Managing Diabetes and Hypertension in CKD Sep 23, 2024

Written and Produced by: Fatima Syed, MD, MSc
Infographic and Cover Art: Zoya Surani, MD
Show Notes: Fatima Syed, MD, MSc
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi, MD, MBA, FACP
Showrunners: Matthew Watto MD, FACP and Paul Williams MD, FACP
Technical Production: Pod Paste
Guest: Joel Topf, MD

Sponsor: Mint Mobile

To get this new customer offer and your new 3-month premium wireless plan for just 15 bucks a month, go to mintmobile.com/CURB.

Sponsor: ClinicalKey AI

ClinicalKey AI is an award-winning solution that combines trusted, evidence-based clinical content with conversational search powered by generative AI. To unlock the power of AI in clinical decision-making with ClinicalKey AI, visit Elsevier.health/AI”

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

#453 Sports Injuries Part 1: Concussion and Hip Pain Sep 16, 2024

Follow along as the great Dr. Senter guides us through the diagnosis, workup, and treatment of an all-star lineup of sport injuries. Part 1 covers concussions, femoroacetabular impingement (FAI), and the ongoing quest to diagnose Paul’s mysterious hip injury.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

00:00 Introduction
08:43 Case 1 - Concussion
9:39 Approach and Workup of Concussions
18:08 Treatment of Concussions (Return to Activity)
24:10 Consideration of Head Imaging
33:20 Case 2 - Hip Pain (FAI)
34:15 Hip Anatomy and Differential Diagnosis
38:41 Hip Physical Exam
45:41 Hip Imaging
47:28 Treatment of FAI
Outro & Take Home Points

Credits

Producer and Show Notes: Peter Wikoff MD
Writer, Infographic and Cover art: Edison Jyang MD
Reviewer: Sai S Achi MD MBA FACP
Hosts and Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Carlin Senter MD

Sponsor: ClinicalKey AI

ClinicalKey AI is an award-winning solution that combines trusted, evidence-based clinical content with conversational search powered by generative AI. To unlock the power of AI in clinical decision-making with ClinicalKey AI, visit Elsevier.health/AI

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: Babbel

Get up to 60% off your Babbel subscription - but only for our listeners at Babbel.com/CURB.

#452 NAFLD/MASLD with Dr. Elliot Tapper Sep 09, 2024

Intro
Rapid Fire Segment
Case 1 Part 1
NAFLD/MASLD terminology and differential diagnoses
PEth testing
Diagnostic tools for NAFLD/MASLD: Fib4 Score
Imaging
When to Refer to a Hepatologist?
Treatment options
Lifestyle modifications
Role of GLP-1 agonists
Role of new FDA approved medications
Outro

Credits

Producer: Sai S Achi, MD, MBA, FACP; Matthew Watto MD, FACP
Writer, Show Notes, Cover Art, and Infographics: Sai S Achi, MD MBA, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Elliot Tapper MD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: The University of Virginia

Visit uvahealth.com website to explore this exceptional opportunity and submit your application today.

Sponsor: Beginly Health

Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started.

#451 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 2 Sep 02, 2024

Quit playing games with my heart
Yet another beat no to skip here with part 2 of our conversation with cardiologist Dr. Sanjeev Francis (@, Maine Medical Center)for acute coronary syndrome. Learn about the warranty on stress tests, initial management of ACS and how to deal with those pesky elevated troponins from patients with sepsis.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Start Part 1
Intro
Rapid fire questions/Picks of the Week
Case 1
History and Physical
ECGs
Definitions
Risk Stratification Tools
Non-invasive Testing Options
End Part 1
Start Part 2
Case 2
Warranty on Non-invasive Testing
Invasive Management of non ST elevation ACS
Medical Management of non ST elevation ACS
Case 3
Myocardial Injury Definitions
Diagnostics to Consider for Myocardial Injury
Transitions of Care
Outro
End Part 2

Credits

Producer, Writer, Show Notes, Hosts: Meredith Trubitt, MD, MPH, Monee Amin MD
Infographic, Cover Art: Caroline Coleman, MD
Reviewer: Rahul Ganatra, MD, MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Sanjeev Francis, MD

Sponsor: Babbel

Get up to 60% off your Babbel subscription - but only for our listeners at Babbel.com/CURB.

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Panacea Financial

If you’re ready to join the thousands of doctors who have declared independence from traditional banks, visit panaceafinancial.com today.

#450 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 1 Aug 26, 2024

Quit playing games with my heart
Don’t skip a beat and join us in part 1 of our conversation with cardiologist Dr. Sanjeev Francis (@, Maine Medical Center)for acute coronary syndrome. First up, the basics on physical exam, how to interpret high-sensitivity troponin and how to think through the spectrum of acute coronary syndrome.
Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Start Part 1
Intro
Rapid fire questions/Picks of the Week
Case 1
History and Physical
ECGs
Definitions
Risk Stratification Tools
Non-invasive Testing Options
End Part 1
Start Part 2
Case 2
Warranty on Non-invasive Testing
Invasive Management of non ST elevation ACS
Medical Management of non ST elevation ACS
Case 3
Myocardial Injury Definitions
Diagnostics to Consider for Myocardial Injury
Transitions of Care
Outro
End Part 2

Credits

Producer, Writer, Show Notes, Hosts: Meredith Trubitt, MD, MPH, Monee Amin MD
Infographic, Cover Art: Caroline Coleman, MD
Reviewer: Rahul Ganatra, MD, MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Sanjeev Francis, MD

Sponsor: Mint Mobile

To get your new 3-month premium wireless plan for just 15 bucks a month, go to mintmobile.com/CURB.

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off your first month.

Sponsor: American College of Physicians

Preorder ACP MKSAP to receive discounted pricing plus free MKSAP 19 premium content you can use now at acponline.org/acpmksap

REBOOT #326 NephMadness 2022: Cardiorenal Syndrome Aug 19, 2024

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.
Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more.
Claim 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 bios
Guest one-liners, Introduction to Nephmadness 2022
Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine
Definition and pathophysiology of cardiorenal syndrome
Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome
Case #2 from Kashlak: the creatinine bump with diuresis
Approach to the creatinine bump with diuresis
Tips for the volume exam
Interpreting cardiac biomarkers in patients with chronic kidney disease
Case #3 from Kashlak: diuretic resistance
Maximizing loop diuretic efficacy
Sequential nephron blockade
Use of hypertonic saline
Outro

Credits

Producer, Writer, Show Notes, Infographics: Malini Gandhi
Cover Art: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD

Sponsor: Beginly Health
Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started.
Sponsor: Locumstory
Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

REBOOT #226 Kidney Boy on Acute Kidney Injury: Myths & Musings Aug 12, 2024

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.
AKI Tips and Tricks from Joel Topf MD, Kashlak’s Chief of Nephrology
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.
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).
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Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

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

Time Stamps

00:00 Sponsors - VCU Health CE and Pediatrics On Call podcast by APP
00:30 Intro, disclaimer, guest bio
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 - Pediatrics On Call podcast by APP
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
68:45 Outro and Sponsor - VCU Health CE

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Panacea Financial

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Sponsor: Locumstory

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REBOOT #316 Lower Extremity Edema with The Curbsiders Aug 05, 2024

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.
Your swell guide to the swollen leg
We're taking a short summer break, but we'll be back at the end of August with brand new episodes.
We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer
Picks of the Week*
The case of Lynn Fedema
Pathophysiology of edema
Differential diagnosis of chronic edema
Chronic edema work-up
Management of chronic edema
Calvin Fedema and acute edema
Evaluation of acute edema
Outro

Credits

Written and produced by: Paul Williams, MD, FACP
Infographic and Cover Art: Matthew Watto, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto, MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Rocket Money

Cancel your unwanted subscriptions by going to RocketMoney.com/CURB.
Sponsor: Grammarly
Get AI writing support that works where you work. Sign up and download for FREE at grammarly.com/PODCAST

REBOOT #387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules Jul 29, 2024

Producer: Matthew Watto, MD and Isabel Valdez, PA
Writer: Matthew Watto, MD
Show Notes, Cover Art and Infographics: Isabel Valdez, PA
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Marie E. McDonnell, MD

Show Segments

Puns and Intro.
Disclaimer and Guest bio
Case from Kashlak
Labs to distinguish type 1 from type 2 diabetes
Selecting initial therapy: Focus on weight loss and glucose control
HbA1c goals
Yeast infections and SGLT2-i
Using sulfonylureas and extended release metformin
Pancreatitis and GLP-1 RA
Cancer and GLP-1 RA
Semaglutide tips
Tirzepatide, how it works and benefits
Take home points
Outro

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Sponsor: ACP MKSAP

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Sponsor: Pathway

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Unlocked: Patreon #23 DGBI - IBS and Functional Dyspepsia Jul 24, 2024

This is an unlocked episode from our Curbsiders Patreon. You can sign up at Patreon.com/curbsiders.

REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen Jul 22, 2024

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.
Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.
Claim CME for this episode at curbsiders.vcuhealth.org!
Credits
● Writer: Matthew Watto, MD, FACP
● Producers: Matthew Watto, MD, FACP and Malini Gandhi
● Show Notes, Infographic, and Cover Art: Malini Gandhi
● Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Reviewer: Emi Okamoto MD
● Executive Producer: Beth Garbitelli
● Showrunner: Matthew Watto MD, FACP
● Editor: Clair Morgan of nodderly.com
● Guest: Jordy Cohen MD
Show Segments
● Intro, disclaimer, guest bio
● Guest one-liner, Picks of the Week*
● Case from Kashlak: New diagnosis of hypertension
● How to make a diagnosis of hypertension
● When to start anti-hypertensive medication
● Initial blood pressure regimen
● Case from Kashlak: White coat hypertension
● Case from Kashlak: Hypertension in chronic kidney disease
● ACEis and ARBs in chronic kidney disease
● Diuretics in chronic kidney disease
● Case from Kashlak: Refractory hypertension
● History and initial workup for refractory hypertension
● Treatment of primary hyperaldosteronism
● Outro
Sponsor: Freed

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Sponsor: Pathway

Download the Pathway app by visiting pathway.md
Sponsor: Mint Mobile
Go to mintmobile.com/CURB to get a 3-month premium wireless plan for just $15 a month.

Addiction Medicine - #25 Methadone in the Clinic with Dr Ruth Potee and Dr David Frank Jul 18, 2024

OTP yea you know me
Make methadone a part of your practice. Learn how the methadone system in the US works and how you can play an active role in improving care for people with opioid use disorder treated with methadone. We’re joined by Dr. Ruth Potee @DrRuthPotee (website) and Dr. David Frank @highway_dave
Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.
Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
5:00 Guest one-liner
10:25 Case from Kashlak; Definitions
11:19 Methadone pharmacology and evidence
17:08 What an OTP feels like
20:25 OTP intake
24:45 Talking through methadone with a patient
28:15 Personal impact of methadone
30:20 Requirements at an OTP
33:43 What your patient needs to access an OTP
37:25 The line
39:06 Dosing/Take homes
44:48 Loss of take homes
48:39 How to interact with an OTP as a PCP
52:50 Methadone at STRs
57:03 How to clinicians use their voice to improve things
1:00:45 Take home points
1:03:00 Plugs
1:04:24 Outro

Credits

Producer, Writer, Show Notes, Infographic, Cover Art: Shawn Cohen MD
Hosts: Carolyn Chan, MD. MHS and Shawn Cohen MD
Reviewer: Payel Jhoom Roy MD, MSc
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Ruth Potee MD, David Frank PhD

#449 Travel Medicine, Malaria, Traveler’s Diarrhea, Yellow Fever, and more! with Dr. Boghuma Titanji Jul 15, 2024

Get your patients ready to globetrot with our fantastic review of Travel Medicine with the esteemed Dr. Boghuma Titanji (@Boghuma)! We cover malaria, anti-malarial chemoprophylaxis, basics of treatment and management of traveler’s diarrhea, yellow fever, and vaccination guidance!
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Case 1 - Defining travel medicine
How to approach a travel clinic visit
Malaria basics, transmission and burden
Chemoprophylaxis for malaria
Basic guidance for mosquito avoidance and travel
Harm reduction, pregnancy and STI prevention, PrEP and doxyPEP
Case 2 - Traveler’s diarrhea
Food safety
When to treat traveler’s diarrhea
Case 3 - Yellow fever vaccine
General vaccination guidance
Take home points
Outro

Credits

Producer, Writer, Show Notes & Graphics: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD
Reviewer:Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Boghuma Titanji MD, MSc., DTM&H, PhD

Sponsor: Babbel

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Sponsor: Freed

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Sponsor: Rocket Money

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#448 USPSTF Breast Cancer Screening - Updated recommendations and the reasoning behind them Jul 10, 2024

In this episode of The Curbsiders Podcast, the team delves into the recently updated breast cancer screening recommendations from the U.S. Preventive Services Task Force (USPSTF) with Dr. Wanda Nicholson (@wnicholsonobgyn), an expert in preventive medicine, diversity, equity and inclusion, and women's health and the Chair of the Task Force. Join us as we review the newest screening mammography recommendations, evidence for earlier screening for all women, the challenge of dense breast findings, and more. Importantly, we discuss disparities in breast cancer outcomes and the need to better understand and address them.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro and Guest Background
Case
Updated Breast Cancer Screening Recommendations
Rationale for screening age
Considerations for findings of dense breasts
Balancing benefits and harms
Racial disparities
Research Gaps
Outro

Credits

Producer, writer, show notes, infographic, and cover art: Fatima Syed MD
Hosts: Paul Williams MD, FACP and Fatima Syed MD
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Wanda Nicholson MD, MBA, MPH

#447 Rhinitis and Environmental Allergies with Dr. Olajumoke Fadugba Jul 08, 2024

Elevate your rhinitis management!
Learn from expert allergist Dr. Olajumoke Fadugba about rhinitis and environmental allergies. You’ll review how to distinguish between allergic and non-allergic rhinitis, and how to decode the drugstore allergy aisle for your patients!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Rapid Fire Questions
Case Part 1
Allergic vs Non-Allergic Rhinitis
The Rhinitis History and Physical
Allergy skin testing
The Pathophysiology of Allergies
Oral, intranasal and ocular treatments
Case Part 2
Allergy immunotherapy
Chronic sinusitis
Sinus rinses
Climate Change and Allergies
Outro

Credits

Producer: Leah Witt, MD & Matthew Watto MD
Writer, Show Notes, Infographic, and Cover Art: Leah Witt, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi, MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Olajumoke Fadugba MD

Sponsor: Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: Litter Robot

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#446 Psychiatry Primer for the Hospitalist Jul 01, 2024

Intro
Rapid fire questions/picks of the week
Case
Pertinent history
Physical Exam including Mental Status Exam
Role of the multidisciplinary team
Work-up for reversible causes
Agitation management
Framework for capacity and challenging ethical scenarios
Mortality gap
Transitions of Care
Outro

Credits

Producer, Writer, Show Notes, Hosts: Meredith Trubitt MD MPH, Monee Amin MD
Infographic and Cover Art: Caroline Coleman, MD
Reviewer: Rahul Ganatra, MD MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Aaron Gluth

Sponsor: Dementia Care Aware

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CURB50 for $50 off their first month.

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#445 DIGEST-Hotcakes: Preventive PCI, Andexanet Alfa for ICH, Aspirin for Fatty Liver, Naltrexone in Cirrhosis, Pivmecillinam for UTI, Cefepime vs Pip-Tazo, MDRO Decolonization, Microplastics and MACE, Pax-NO-vid Jun 24, 2024

Join us as we review recent practice-changing articles on preventive PCI, andexanet alfa for ICH, aspirin for fatty liver, naltrexone in cirrhosis, pivmecillinam for UTI, cefepime vs pip-tazo, MDRO decolonization, microplastics and MACE, and more! Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).
Claim CME for this episode at curbsiders.vcuhealth.org!
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Credits

Written and Hosted by: Rahul Ganatra MD, MPH; Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH; Emi Okamoto MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

Intro, disclaimer
Preventive PCI
Andexanet alfa for ICH
Aspirin for MASLD
Naltrexone for AUD in cirrhosis
Pivmecillinam for UTI
MDRO decolonization
Cefepime vs pip/tazo
Microplastics
Pax-NO-vid
Outro

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code
CURB50 for $50 off their first month.

Sponsor: ACP MKSAP

Learn more about ACP MKSAP at acponline.org/acpmksap

Sponsor: Litter Robot

Whisker is currently offering $50 off Litter-Robot bundles. As a special offer to listeners of the show, go tostopscooping.com/CURB and use promo code CURB to save an additional $50 on any Litter-Robot bundle.

#444 Macrocytosis, Hemolytic Anemia, Myelodysplastic Syndrome Jun 17, 2024

Recorded LIVE! At Johns Hopkins Internal Medicine Grand Rounds
Step up your anemia game as we explore the causes and diagnostic approach for macrocytic anemia, what to do with a reticulocyte count, the differential diagnosis for hemolytic anemia, the significance of the direct antiglobulin test, and diagnosis and management pearls for autoimmune hemolytic anemia (AIHA) and myelodysplastic syndrome (MDS). Plus, common questions and concerns regarding folate supplementation and the use of bone marrow biopsies. We’re joined by hematologist and pun enthusiast Dr. Rakhi Naik MD, MHS, @redcell_doc @hopkinsheme.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

00:00 Intro and Guest intro
05:53 Case 1: Elise - Macrocytic Anemia
14:59 Case 2: Jane - Hemolytic Anemia
23:24 Testing for Underlying Causes of Autoimmune Hemolytic Anemia
24:40 Association of Autoimmune Hemolytic Anemia with Lymphomas
25:10 Autoimmune Hemolytic Anemia: Diagnosis and Treatment
26:06 Management Approach for Autoimmune Hemolytic Anemia
27:30 Considerations for Outpatient Treatment of Autoimmune Hemolytic Anemia
28:18 Clotting Risk in Autoimmune Hemolytic Anemia
29:20 Treatment Options for Autoimmune Hemolytic Anemia
30:42 Long-Term Prognosis and Recurrence of Autoimmune Hemolytic Anemia
33:32 Diagnostic Challenges in Myelodysplastic Syndrome
35:00 Considerations for Folate Supplementation
36:24 Factors to Consider in the Management of Myelodysplastic Syndrome
39:30 When to Perform a Bone Marrow Biopsy in Myelodysplastic Syndrome
41:25 Shared Decision-Making in the Treatment of Myelodysplastic Syndrome

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD, MSc
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Rakhi P. Naik MD, MHS

Sponsor: Beginly Health

Visit beginlyhealth.com/curbsiders job matching platform for every Physician and Advanced Practice Clinician, from training to practice.

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Babbel

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#443 Primary Hyperparathyroidism: Stones, bones, and almost certainly some groans Jun 10, 2024

Don’t just sit on that borderline calcium! Learn how to approach hypercalcemia and work up primary hyperparathyroidism. In this episode, we learn who goes to surgery, how to work them up, and some variants of typical primary hyperparathyroidism. We’re joined by Dr. Lindsay Kuo @lindsaykuo (Temple University Hospital)
Claim CME for this episode at curbsiders.vcu health.org!
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Show Segments

00:00 Intro
03:31 Understanding Primary Hyperparathyroidism
09:03 Handling Mistakes and Complications in Surgery
11:44 Case Discussion: Hypercalcemia and Elevated PTH Levels
22:41 Symptoms of Primary Hyperparathyroidism
25:06 The Role of Vitamin D in Primary Hyperparathyroidism
28:07 Testing Considerations for Parathyroid Hormone (PTH) Levels
46:02 Considerations for Parathyroid Carcinoma
49:19 Parathyroid Imaging in Primary Hyperparathyroidism
52:23 The Surgical Procedure for Primary Hyperparathyroidism
57:45 Intraoperative Parathyroid Hormone Monitoring
01:00:15 Post-Operative Monitoring for Hypocalcemia
01:04:38 Normocalcemic Primary Hypoparathyroidism and Normohormonal Primary Hyperparathyroidism

Credits

Written and produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Lindsay Kuo, MD

Sponsor: Freed

You can try Freed for free by going to freed.ai. Use code CURB50 for $50 off your first month.

Sponsor: Panacea Financial

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Sponsor: Grammarly

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#442 Syncope: Live from SHM #Converge24 with Dr. Dan Dressler Jun 03, 2024

Don’t pass up on passing out!
Stand up to syncope as Dr. Dan Dressler (Emory University) guides us to confidently manage cases! We review a framework for understanding different types of syncope, and strategies for determining which low-risk patients can be safely discharged, and appropriate next steps to work up those high-risk and in-between cases.
Claim CME for this episode at curbsiders.vcu health.org!
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Show Segments

Intro
Picks of the Week
Case 1: Tamara
What is syncope?
Categorizing Syncope
Initial workup
Risk scores
Pulmonary embolism
Case 2: Travis
Cardiac evaluation
Take-home points
Outro

Credits

Producer, Script and Show Notes: Emi Okamoto MD
Infographic and Cover Art: Caroline Coleman MD
Hosts: Monee Amin MD and Meredith Trubitt MD
Reviewer: Rahul Ganatra MD, MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Daniel D. Dressler, MD, MSc, MHM, FACP

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Pattern

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Sponsor: Pathway

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#441 More Clinical Pearls (New antibiotics, syphilis, heart disease, cirrhosis, lots more!) from ACP #IM2024 May 27, 2024

More clinical pearls from ACP #IM2024, including emerging infectious diseases in the US (malaria, dengue, super gonorrhea, and a resurgence of syphilis), new C. diff treatments, coagulopathy and cirrhosis, fatty liver disease, HFpEF, peripheral arterial disease, Lp(a) and ApoB, CAR T-cells for autoimmune disease, SGLT2i for gout, and hematology updates. Paul and Watto are joined by Drs. Nora Taranto, Beth Garbitelli, and of course Chris “The Chiu Man” Chiu.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

00:00 Tropical Diseases: Resurgence of Malaria and Dengue Fever
03:44 Infectious Diseases: Syphilis Rates and New Treatments for C. diff
08:28 Coagulopathy and Cirrhosis: Managing Hemostasis and Portal Vein Thrombosis
11:34 Fatty Liver Disease: Risk Stratification and Treatment
14:59 Cardiology Updates: Cardiovascular Kidney Metabolic Syndrome
31:03 New Medications for Hypertension
32:54 Renal Denervation and Hypertension
33:51 Lp(a) Drugs and Their Potential
36:01 Peripheral Arterial Disease and Claudication
38:10 SGLT2 Inhibitors and Gout
41:50 APO-B and LDL Cholesterol
42:45 Secondary Hypogonadism and Head and Neck Radiation
45:30 VEXAS: A Genetic Autoimmune Condition
49:08 Obesity-Induced Leukocytosis
52:49 CAR T-Cell Therapy in Rheumatologic Diseases

Credits

Producers/Writers/Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD, Chris Chiu MD, Beth Garbitelli MD
CME, Cover Art: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Nora Taranto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

Sponsor: Litter Robot

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Sponsor: Freed

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Sponsor: Beginly

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#440 Hepatitis B with Dr. Arthur Kim May 20, 2024

Become a pro in Hepatitis B! Dr. Arthur Kim teaches us how to approach Hepatitis B screening and vaccination in primary care, provides pearls on counseling patients with chronic Hepatitis B infection, and summarizes considerations for Hepatitis B antiviral treatment and monitoring.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Case from Kashlak
Hepatitis B screening - who should be screened?
Hepatitis B screening - interpreting test results
Hepatitis B vaccination
Stages of Chronic HBV infection
Counseling patients with chronic HBV about preventing transmission and protecting liver health
Treatment of chronic HBV infection
Screening for hepatocellular carcinoma
Outro

Credits

Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Arthur Kim MD

Sponsor: Babbel
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Sponsor: Freed

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Sponsor: Pattern

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#439 Shoulder Pain: Impingement, Bursitis, Tendonitis, Cuff Tears, and Arthritis with Dr. Ted Parks May 13, 2024

Repair and replace your old approach to shoulder pain! We cover shoulder anatomy, explain the continuum of impingement syndrome (from bursitis to tendonitis to rotator cuff tears to cuff tear arthropathy), how to take a good shoulder history, perform a high-yield physical exam, when to refer, and when to get an MRI. Plus, how to differentiate glenohumeral joint arthritis from frozen shoulder, and how to diagnose AC joint pathology. We’re joined by everyone’s favorite orthopedic surgeon, inventor, and renaissance man, Dr. Ted Parks.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

00:00 Intro
05:38 Shoulder Anatomy
14:47 Continuum of Impingement Syndrome
33:41 When to order an MRI
36:28 Glenohumeral joint arthritis vs frozen shoulder
51:50 AC joint arthritis
62:25 Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Ted Parks MD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Pattern

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Sponsor: Panacea Financial

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#438 Recap from SHM #Converge24 May 06, 2024

We went to it so you don’t have to
We recap the top pearls for the hospitalist from #SHM #Converge24 covering discussions on heart failure, gastrointestinal bleeds, sepsis, updates in critical care, updates in hospital medicine, oncologic emergencies, pneumonia, COPD, transitions of care, vulnerable populations, AI, and more!
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Show Segments

Intro
Picks of the Week
Heart Failure
Patients with Disabilities
POCUS on Inpatient Service
GI Updates
High Value Delivery of Medical Education
Molecular Testing for Infectious Diseases
Interhospital Transfers
Artificial intelligence in Inpatient Care
Care of the Incarcerated Patient
Periop Updates
Oncologic Emergencies--Neutropenic Fever
Oral vs IV Antibiotics
Updates in Hospital Medicine
Updates in Critical Care & Guidelines in Hospital Medicine
Post Acute Care
Things We Do For No Reason ™
Iron Deficiency Anemia
Updates in Community Acquired Pneumonia
Updates in Palliative Care
Outro

Credits

Written, produced and show notes by: Monee Amin MD, Caroline Coleman MD, Meredith Trubitt MD
Cover Art: Caroline Coleman MD
Hosts: Monee Amin MD, Meredith Trubitt MD
Reviewer: Rahul Ganatra, MD, MPH
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guests: Harika Gorti MD, Sneha Neurgaonkar MD

Sponsor: Freed

You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Sponsor: Pattern

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#437 Clinical Pearls ACP #IM2024 Apr 29, 2024

We cover angina, COPD-asthma overlap, home oxygen, colon cancer screening, cancer survivorship, tobacco cessation, e-cigarettes, step counts for health, new drugs, the RSV vaccine, addiction medicine, interstitial lung disease, APOL1-mediated kidney disease, testosterone therapy, antimicrobial resistance, office-based allergy testing and more! The Curbsiders review highlights, clinical pearls, and practice-changing updates from the American College of Physician Internal Medicine Meeting #IM2024!
No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro
ACP Pearls
Outro

Credits

Producers: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD
Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer:Matthew Watto MD FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

Sponsor: Beginly Health

Visit https://beginlyhealth.com/curbsiders for the job matching platform for every Physician and Advanced Practice Clinician, from training to practice
Sponsor: Freed

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#436 Endometriosis for the Internist with Dr. Cope & Dr. Green Apr 22, 2024

Energize your education on endometriosis! Learn common clinical presentations, optimal diagnostic imaging tests, and how to counsel patient on treatment options. We are joined by Dr. Adela Cope (Mayo Clinic) and Dr. Isabel Green @isabelgreenMD (Mayo Clinic).
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

00:00 Intro
03:00 Guest Introduction
06:45 Topic
07:30 Endo Definition & Symptoms
14:40 Endo phenotypes
21:30 Differential Diagnoses to Consider
25:47 Making a Diagnosis
31:00 Imaging to consider
37:40 Endo Hormonal Treatment Optiosn
48:30 Monitoring Treatment
52:20 When to Refer
57:30 Surgical Treatment
1:09:20 Pain Management
1:13:30 Take Homes
1:19:00 Outro

Credits

Producer, Show notes, Infographics: Carolyn Chan, MD, MHS
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi, MD, MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Adela Cope and Dr. Isabel Green

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Sponsor: Locumstory

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#435 Neck Pain with Dr. Anthony Mikula Apr 15, 2024

A real pain in the neck (Get it?! We have fun.)
Protect your neck! Learn how to evaluate a patient with neck pain, and differentiate between mechanical neck pain, radiculopathy, and myelopathy. You’ll learn who should be reassured, who should see a surgeon, and what nonoperative options are available. We’re joined by Dr. Anthony Mikula @anthony_mikula from Mayo Clinic.
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Show Segments

00:00 Introduction
06:14 Anatomy and Pain Generators
09:58 Approach to Neck Pain
22:57 Differentiating Radiculopathy from Non-Specific Neck Pain
24:05 Management of Mechanical Neck Pain
27:36 Indications for Imaging
29:21 Terminology and Explanation of Spondylosis, Spondylolisthesis, and Spondylolysis
30:48 Diffuse Idiopathic Skeletal Hyperostosis (DISH)
32:23 Imaging Terminology and Plain Films
36:19 Pathophysiology of Cervical Radiculopathy
38:34 Physical Examination for Cervical Radiculopathy
44:54 Diagnostic Work-up for Radiculopathy
51:53 Interventions for Cervical Radiculopathy
53:53 Considerations for Surgery
57:49 Recognizing Cervical Myelopathy
01:00:17 Natural History of Myelopathy
01:02:25 Referral and Treatment for Myelopathy
01:09:28 Summary and Takeaways

Credits

Written and Produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Anthony Mikula, MD

Sponsor: Freed

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#434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher Apr 08, 2024

It’s NOT Always a UTI!
Sounds like another UTI but it could be more than that! Time to explore the entire pelvic floor and see what more you can treat. School’s in session with the Bladder Teacher, Kellen Choi, DO from the University of Louisville @KellenChoi
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Show Segments

Intro
Rapid fire questions/Picks of the Week
Case #1 and Definitions
Bowel habits
Water intake
Case #2
Vaginal Estrogen
Non-antibiotic prophylaxis
Antibiotic in prophylaxis
Pelvic Floor Physical Therapy
Take-home points
Outro

Credits

Producer, Writer & Show Notes: Isabel Valdez, PA
Infographic & Covert Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Kellen Choi DO, FAOCS

Sponsor: Freed

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Sponsor: Locumstory

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#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns Apr 01, 2024

Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!
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Show Segments

00:00 Introduction and Diabetes Puns
01:00 Introduction of Guest and Topic
09:12 Qualifications and Eligibility for CGMs
11:32 Types of CGMs and Sensor Placement
24:47 Interpreting CGM Data and Alarms
34:30 Troubleshooting Patterns and Adjustments
35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses
36:15 The Rule of 15 and Addressing Hypoglycemia
37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia
38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
39:51 Managing Exercise-Induced Hypoglycemia
41:43 Preventing Exercise-Induced Hypoglycemia with Snacks
43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas
45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia
51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin
56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin
57:44 Addressing Adherence and Medication Barriers
59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management
01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap
01:05:49 Considering Patient Adherence and Barriers to Treatment

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jeff Colburn MD

Sponsor: Freed

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Sponsor: Panacea Financial

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#432 Hotcakes: E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, Lidocaine for neck pain, C diff risk by antibiotic type, and “dosing by clicks” for GLP1’s Mar 25, 2024

Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
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Credits

Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

Introduction and disclaimer
E-cigarettes for smoking cessation
Gabapentinoids and COPD exacerbations
Topical lidocaine for neck pain
Association between specific antibiotics and C. diff infection
Shortage of GLP-1 agonists and “dosing by clicks”

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Sponsor: Freed

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#431 Myocarditis and Pericarditis Mar 18, 2024

Show description:
Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter!
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Show Segments

Intro, disclaimer
A case of pericarditis
Diagnosing pericarditis
The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis
Etiologies of pericarditis and initial testing recommendations
Treatment of acute uncomplicated pericarditis
Using colchicine to prevent recurrent pericarditis
Patient counseling after diagnosing pericarditis
A case of myocarditis
Interpreting elevated troponin levels
Distinguishing between myocardial infarction and myocardial injury
Diagnostic testing for suspected myocarditis
When to pursue cardiac MRI and endomyocardial biopsy
The spectrum of myocarditis presentations
Fulminant myocarditis
Common etiologies of myocarditis
Immune checkpoint inhibitor myocarditis
Myocarditis from mRNA vaccines and from SARS-CoV-2 infection
Management of patients with myocarditis
Activity restrictions for patients with myocarditis
Outro

Credits

Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP
Guest: Vivek Kulkarni, MD, FACC
Producer, Script, and Show Notes: Adam Barelski, MD
Infographics and Cover Art: Edison Jyang
Reviewer: Leah Witt, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Sponsor: Freed

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Sponsor: Panacea Financial

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Unlocked Weight Management, Low Carb, Listener Q&A, Picks of the Weeks (Patreon #19) Mar 13, 2024

This episode has been Unlocked from patreon.com/curbsiders!
Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM #SGIM23 in Denver, Colorado This audio episode is only available on Patreon!
Below are links to the original interview & show notes.
#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips
Picks of the week:

Paul recommends: Blue Eye Samurai (Netflix)
Matt recommends: Live, Die, Repeat aka Edge of Tomorrow (film)

Show Segments
00:00 Introduction and Happy New Year
02:22 Overview of Obesity Medicine
04:13 Challenges in Weight Maintenance
06:07 Prevention of Obesity
08:04 Barriers to Obesity Care
09:29 Setting Realistic Weight Loss Goals
10:24 Counseling Patients on Weight Loss
11:45 Measuring Waist Circumference
12:44 Telemedicine and Tracking Apps
13:41 Psychological Considerations in Obesity Medicine
15:05 Low-Carb Diets
21:04 Managing Side Effects of GLP-1 Agonists
23:54 New Medication for Obesity
24:52 Prolia and Forteo for Osteoporosis
26:18 Statins and Lab Testing
29:30 Annual Labs and Urine Testing
32:37 Picks of the Week
35:02 Outro
Join our Patreon today and save 16% on an annual membership at patreon.com/curbsiders. Kashlak Admitting Privileges comes with ad-free episodes, access to the Kashlak Vault, which contains PDF files and graphics from over 400 Curbsiders shows, access to our private Discord group, plus twice monthly bonus episodes like this one!

#430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024! Mar 11, 2024

Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It’s NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl!
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Show Segments

Time stamps refer to the ad-free version

00:00 Introduction and Guest Bio
07:46 Case Presentation
08:42 Initial Approach to CKD Management
09:10 Metabolic Acidosis in CKD
13:30 Consequences of Metabolic Acidosis
22:28 Administration of Bicarbonate
23:54 Alternative Options for Bicarbonate Repletion
24:47 Citrate and Bicarbonate
26:02 Sodium Bicarbonate for CKD
30:19 Dietary Modifications
33:35 Renal Diet
38:20 Counseling CKD Patients
41:39 Veverimer and Other Treatments
44:36 Mistakes and Pitfalls
46:55 Conclusion

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Timothy Yau MD

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#429 Anxiety 2.0: with Dr. Jessi Gold Mar 04, 2024

Elevate your primary care management of anxiety. Become confident in counseling patients about a new anxiety diagnosis, 2nd and 3rd line medications, augmentation for anxiety treatment, and options for non-pharmacological anxiety treatment. We are joined by psychiatrist and mental health expert Dr. Jessi Gold, @drjessigold (University of Tennessee System; drjessigold.com).
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Show Segments

Intro
Case from Kashlak
Diagnosing anxiety
Explaining anxiety to patients
Non-pharmacological management of anxiety
Pharmacological management of anxiety
2nd and 3rd line treatments
Cannabis and anxiety
Outro

Credits

Writer, Producer, Show Notes, Infographic, Cover Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai Achi MD, MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jessi Gold MD

Sponsor: Locumstory

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Sponsor: Freed
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Sponsor: Allbirds

Visit Allbirds.com and use code CURB for a free pair of socks with a purchase of $48 or more.

#428 DIGEST: DVT prophylaxis in patients with cancer, anticoagulation in subclinical AFib, steroids in COPD exacerbations, breast cancer genetic testing guidelines, and at-home STI testing Feb 26, 2024

Join us as we review recent articles and news featured in The DIGEST #48, #49, and #50 including thromboprophylaxis for patients receiving chemotherapy, eosinophil count to guide steroids in COPD exacerbations, anticoagulation in subclinical atrial fibrillation, the new genetic testing recommendations for patients with breast cancer, and at-home STI testing–not to mention trial names galore. Fill your brain hole with a fully digestible meal! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).
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Credits

Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Nora Taranto MD
Reviewer: Emi Okamoto MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

00:00 Introduction + Pun
06:06 Target TP Trial: Thromboprophylaxis in Cancer Patients
13:07 Steroids for COPD Exacerbations
25:25 Anticoagulation in Subclinical Atrial Fibrillation
34:01 Genetic Testing in Breast Cancer
43:38 Home STI Testing

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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#427 Kittleson Rules Cardiac Amyloidosis Feb 19, 2024

The clinical picture of an underrecognized disease
Amyloidosis demystified. Learn the clinical clues that suggest possible amyloidosis and how to order the correct tests to diagnose this disease. We are joined by Dr. Michelle Kittleson who shows us the ropes of treating fibril accumulation, @MKittlesonMD (Cedars Sinai).
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Show Segments

Introduction
Case Presentation: Mr. Smith
Differential Diagnosis of Heart Failure with Preserved Ejection Fraction
Understanding Amyloidosis
Clinical Clues and Red Flags for Amyloidosis
Physical Examination Findings
Workup for Amyloidosis
Treatment Options
AL Amyloidosis and Hematologist's Role
ATTR Amyloidosis and Cardiologist's Role
Other Therapies for TTR Amyloidosis
Therapy on the Horizon
Cost and Access to Tafamidis
Alternative Therapies and Supplements
Monitoring and Side Effects of Tafamidis
Symptomatic Management and Anticoagulation
Take Home Points

Credits

Written and Produced by; Deborah Gorth, MD, PhD
Infographic and Cover Art: Meryl Gorth, RD, MPH and Deborah Gorth, MD, PhD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S. Achi MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Michelle Kittleson, MD, PhD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#426 Breast Cancer for the PCP With Dr Sandhya Pruthi Feb 12, 2024

Join us as Sandhya Pruthi, MD talks us through basics of breast cancer, specifically how to share a new diagnosis with a patient, the spectrum of disease from favorable to more aggressive, and the basics of what to expect with initial treatment. Feel more confident sharing a new diagnosis of breast cancer and supporting your patients through this journey.
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Show Segments

00:00 Introduction
02:18 Getting to Know Dr Sandhya Pruthi
09:49 Picks of the Week
12:35 Case 1: Diagnosis and Treatment of ductal carcinoma in situ (DCIS)
21:24 Risk Stratification and Active Surveillance for DCIS
23:43 Genetic Testing Recommendations
28:08 Case 2: Evaluation and Diagnosis of a Breast Lump
39:14 Invasive Ductal Carcinoma
47:49 Initial Management of invasive ductal carcinoma (IDC)
48:19 Preoperative Discussion and MRI
49:19 Lumpectomy and Sentinel Lymph Node Biopsy
50:16 Radiation and Hormonal Adjuvant Therapy
51:46 Considerations for Chemotherapy
55:51 Signs of Late Recurrence or Metastasis
58:20 Screening Guidelines and Age
01:02:25 Importance of Breast Self-Awareness

Credits

Written and produced, Show Notes: Molly Heublein MD
Infographic and Cover Art: Edison Jyang
Hosts: Molly Heublein MD, Era Kryzhanovskaya MD
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Sandhya Pruthi MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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#425 Perioperative Management of Antithrombotics with Dr. Poorvi Hardman Feb 05, 2024

Get rid of those clots around anticoagulation and antiplatelet management
Join us for a review of the perioperative risk assessment of bleeding and clotting and how to manage each patient’s own antithrombotics. We are joined by Dr. Poorvi Hardman from Ohio State University.
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Show Segments

Intro
Rapid Fire Questions/Picks of the Week
Case 1
Risk stratification of thromboembolism and bleeding
Review of types of surgeries and risk associated with surgical intervention
Utilizing scoring systems to aid decision making
Bridging
Considerations for VKAs, DOACs
Pitfalls to bridging
Case 2
Aspirin Management
P2Y12 Management
Consultants
Outro

Credits

Written, produced and show notes by: Jaimie Patel MD
Infographic and Cover Art by: Caroline Coleman MD
Hosts: Monee Amin MD; Meredith Trubitt MD
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Poorvi Hardman MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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R.S.V. Immunization with The Cribsiders Jan 31, 2024

The Curbsiders and Cribsiders are back with a very special Med-Peds collaboration on RSV immunizations! Dr. Buddy Creech, Pediatric Infectious Disease at Vanderbilt, walks us through these breakthrough “vaccines" for both adults and kids. He teaches us about their mechanisms of action, eligibility criteria, and why it’s been so challenging to find doses this season. Get ready for your next shot of fun!

#424 Hotcakes: Transfusion in Acute MI, COVID-19 Rebound after Paxlovid, Every-other-day Iron Revisited, Oral Phenylephrine Doesn’t Work, and Stop Correcting Serum Calcium Jan 29, 2024

Join us as we review recent practice-changing articles on transfusion thresholds in acute MI, COVID-19 rebound after treatment with ritonavir-boosted nirmatrelvir (PaxlovidTM), the prevalence of iron deficiency, as well as the debut of our new “corrections and omissions” section, in which we cover important knowledge updates on oral iron dosing and correcting serum calcium. And, find out why oral phenylephrine does not work and what you should prescribe instead for upper respiratory symptoms. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
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Credits

Written, Produced, and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

00:00 Introduction and Calcium Puns
03:11 Iron Deficiency and Iron Supplementation
12:20 Corrected Calcium
18:09 Virologic Rebound after nirmatrelvir/ritonavir (Paxlovid™)
32:09 Phenylephrine and its Ineffectiveness
37:00 Restrictive vs. Liberal Transfusion Strategy in MI (MINT trial)
49:20 Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#423 Dental Pain, Caries, Gingivitis, and Oral Care Tips & Tactics for Primary Care With Dr Lisa Simon Jan 22, 2024

Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice. Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction. Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.
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Show Segments

00:00 Introduction and Overview
09:13 Diagnosing Dental Pain and Examination Techniques
18:44 Treatment Options for Dental Pain
29:34 Complications and Emergencies in Dental Care
32:36 Post-operative Care and General Dental Advice
40:35 Dry Mouth and Treatment Options
44:05 Gingivitis
49:39 Temporomandibular Joint (TMJ) Dysfunction
55:43 Medications and Dental Side Effects
56:12 Anticoagulants and Dental Procedures
01:00:55 Endocarditis Prophylaxis
01:03:15 Joint Replacements and Antibiotic Prophylaxis
01:04:10 Oral Health in Patients with Opioid Use Disorder

Credits

Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Lisa Simon MD, DMD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#422 LIVE! Inpatient Management of Sickle Cell Crisis, Acute Pain, RBC Transfusions & Acute Chest Syndrome Jan 15, 2024

Learn practical tips for the inpatient management of patients with sickle cell disease and vaso-occlusive crisis from guest, Dr. Yoo Mee Shin (Emory). We cover acute pain management including adjuvant therapies, IV fluids, oxygen therapy, the management of acute chest syndrome, and when to perform simple vs exchange transfusions. Key takeaways include the importance of early triage and analgesia, addressing misconceptions about opioid use disorder in patients with sickle cell disease, and recognizing complications of vaso-occlusive crises.
Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

00:00 Intro
01:27 Getting to know our guest
07:48 Case Presentation and Initial Management of Sickle Cell Disease (SCD)
13:46 Misconceptions about opioid use disorder and sickle cell
17:02 Management of Acute Pain in Sickle Cell Disease
25:46 Adjuvant therapy for pain
29:04 Transition to outpatient care
32:46 General admission orders for sickle cell
38:44 Management of Acute Chest Syndrome
42:01 Simple vs exchange transfusion
47:08 Transfusion in preoperative and pregnant patients
48:03 Transitions and follow-up care
49:35 Key takeaways and Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art & Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Yoo Mee Shin MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#421 Antiphospholipid Syndrome with Dr. Arielle Langer Jan 08, 2024

Conquer your fear of antiphospholipid syndrome! Dr. Arielle Langer leads us through what clinical features raise suspicion for antiphospholipid syndrome, how to interpret laboratory testing, and the nuances of antiphospholipid syndrome management.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Case from Kashlak
What is antiphospholipid syndrome?
Clinical features that raise suspicion for antiphospholipid syndrome
Laboratory testing and diagnosis of antiphospholipid syndrome
Management of antiphospholipid syndrome: initial treatment
Management of antiphospholipid syndrome: managing recurrent thrombosis
Return to Case: Pregnancy in patients with a history of thrombotic APLS
Obstetric APLS
Final questions
Outro

Credits

Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Arielle Langer MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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REBOOT: #334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI) Jan 01, 2024

Discover DGBI! Learn its pathophysiology, evaluation and individualized treatments so you can leave the fear of managing DGBI behind. We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic)
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions (6:20)
Definition of Disorders of the Gut-Brain Interaction (7:30-11:00)
Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments (24:30-36:00)
Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00)
Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11)
Take home points
Outro

Credits

Producer: Elena Gibson MD
Writer:Andréa Perdigão, Elena Gibson
Show Notes and Infographics: Andréa Perdigão
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Dr. Xiao Jing (Iris) Wang MD

#420 Recap Extravaganza: 2023 Highlights and Top Stories Dec 25, 2023

Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders.
Our team needed a break so we did not make CME for this episode.

Show Segments

Time Stamps are for Patreon (Ad-Free) Version

00:00 Introduction and Overview
09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms
14:20 Understanding Hemochromatosis
19:24 Evaluation and Management of Hematuria
25:00 Updates in Diabetes Management
29:35 Xylazine Overdose and Withdrawal
35:35 Primary Aldosteronism
39:36 Resistant Hypertension
44:12 Delirium and its Implications
46:29 The Acorn trial and AKI risk
49:47 HIV trial: Reprieve
51:11 Updates in hospital medicine
56:00 Kratom and its implications
59:11 RSV vaccines and their effectiveness
01:05:38 Reflections and Gratitude

Credits

Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Matthew Watto MD, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.
You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.
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Glass, like a clinical reference text or podcast, should never replace clinician judgment.

REBOOT #281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais Dec 18, 2023

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry. Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).
Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!
Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry. Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).
Show Segments

Intro, disclaimer, guest bio
Dr. Pallais One-Liner
Case from Kashlak
Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin
Causes of hypercalcemia
How Lithium works!
Testing for Hypercalcemia: Get that PTH, and that phos
Symptoms of Hypercalcemia, and Questions on History
Indications for Surgery for Parathyroidectomy
Management of Hypercalcemia and Hypercalcemic Emergency
Outro

Credits

Producer, Writer, Infographic, Cover Art: Nora Taranto MD
Hosts: Matthew Watto MD, FACP; Nora Taranto MD
Reviewer: Yan Emily Yuan MD, MSc
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Carl Pallais MD, MPH

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Sponsor - Glass Health
Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.
Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context. You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.
Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI. You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS.
Glass, like a clinical reference text or podcast, should never replace clinician judgment.

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REBOOT #250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf Dec 11, 2023

We’re taking a short break, but we’ll be back in two week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 17 of them available to feed your brain hole! Yummy!
Time Stamps*

Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.
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Time Stamps*

*Note: Time Stamps refer to ad free version

Intro, disclaimer, guest bio - 00:00
Picks of the Week - 3:10
Case from Kashlak - 6:30
Nephrotic syndrome definition- 12:30
Proteinuria evaluation - 15:04
Additional lab testing - 27:08; 40:09
Types of Nephrotic syndrome - 30:15
Mechanism of nephrotic syndrome edema - 33:08
Management of nephrotic syndrome - 44:07
Second Kashlak Case- Glomerulonephritis - 55:05
Treatment of glomerulonephritis - 65:05
Outro and post-credits scene - 73:20

Credits

Producer, writer, infographic, cover art: Elena Gibson MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio)
Guest: Joel Topf MD

Sponsor - Pattern Life

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#419 Rapid Response Series: Sepsis with Dr. Mohleen Kang A shock to the system Dec 04, 2023

A shock to the system
Join us for an infectious conversation about sepsis as we learn about the recognition and initial management of sepsis on the wards. We are joined by Dr. Mohleen Kang (@KangMohleen, Emory University).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Rapid fire questions/Picks of the Week
Case
Managing rapid response logistics
Sepsis Scoring Systems
Diagnostic Work-up for Sepsis
Access
Antibiotic Management
Fluids
Pressors
Supportive Measures for Sepsis
Outro

Credits

Producers, Writers, and Hosts: Meredith Trubitt, MD and Monee Amin, MD
Show Notes: Meredith Trubitt, MD
Infographic and Cover Art: Sean Evans or Caroline Coleman
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Mohleen Kang, MD, MSc

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#418 DIGEST (Tofurkey Edition): Semaglutide for HFpEF, TCAs for IBS, Aspirin vs Clopidogrel after PCI, Pitavastatin for HIV, Starchy Vegetables & Weight Gain, Heavy Metals in Cannabis Nov 27, 2023

Join us as we review recent articles and news featured in The DIGEST #45 and #46, including semaglutide in HFpEF and obesity (STEP HFpEF), TCAs for irritable bowel syndrome (ATLANTIS), clopidogrel versus aspirin as long-term secondary prevention after PCI (HOST-EXAM), statins in HIV (REPRIEVE), weight changes and diet, and heavy metal exposure in cannabis users. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).
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Credits

Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewers: Nora Taranto MD; Paul Williams, MD, FACP; Matthew Watto MD, FACP; Sai Achi, MD MBA
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

Intro, disclaimer
STEP HFpEF: semaglutide for HFpEF in obesity
TCAs for IBS
HOST-EXAM and post-PCI clopidogrel versus aspirin after DAPT
REPRIEVE and pitavastatin in HIV
Starchy vegetables and weight changes
Cannabis and heavy metal content
Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#417 USPSTF Update: PrEP for HIV Prevention with Dr. John Wong MD Nov 22, 2023

Intro
What is PrEP?
USPSTF PrEP for HIV Prophylaxis recommendations
Defining Increased Risk for HIV
Counseling pearls
Types of PrEP, considerations about choice of PrEP
Talking about Safer Sex practices, HIV and STI screening on PrEP
Recap; outro

Credits

Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD
Hosts: Paul Williams MD, FACP, Beth Garbitelli MD
Reviewer:Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: John Wong MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

#416: Antifungals, Candida, Mucorales, Aspergillus, Pneumocystis: The Fungus Among Us with Dr. Ilan Schwartz MD Nov 20, 2023

“I collect spores, molds and fungus” - Dr. Egon Spengler
Dr. Ilan Schwartz MD PhD (@GermHunterMD) teaches us that we should always at least consider fungi in the differential diagnosis of unexplained sepsis, especially in patients with impaired immune systems or complex medical or surgical histories, and walks us through an approach to antifungals. Be sure to check out the Mycoses Study Group Education & Research Consortium (@MSG_ERC), an organization of clinicians who are dedicated to advancing diagnostics and treatment of fungal disease (where Dr. Schwartz serves on the board of directors!) Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Rapid fire questions, get to know our guest
Intentionally vague case; When should we be worried about fungal infection?
Overnight emergencies: Candidiasis and mucormycosis
Starting empiric anti-fungals
Testing basics: direct versus indirect
Fungemia, fungal endocarditis
Resistant candida; candida auris
Pneumocystis jiroveci pneumonia
Outro

Credits

Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Ilan Schwartz MD, PhD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#415 Bipolar Disorder With Dr. Kevin Johns Nov 13, 2023

Intro
Case
Screening for mania
History for diagnosing bipolar disorder
Definition
Mimickers
Treatment
Outro

Credits

Written and Produced by: Deborah Gorth MD, PhD
Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth MPH, RD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deborah Gorth MD, PhD
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Kevin Johns MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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Sponsor: Uncommon Goods

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REBOOT #300 Celiac Disease with Dr. Amy Oxentenko Nov 06, 2023

We’re taking a short break, but we’ll be back next week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 15 of them available to feed your brain hole! Yummy!
Tighten up your glute-n facts!
Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and understand diagnostic testing, management and proper follow-up for patients.
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
Workup for a typical celiac patient
Nonclassical features of CD
When to do a small bowel biopsy
Management of CD
Considerations for atypical celiac patient and differentials
Non-celiac gluten sensitivity
Outro

Credits

Production and Script: Matthew Watto MD, FACP
Production, Show Notes and Infographics: Edison Jyang
Cover Art: Kate Grant MBChB, MRCGP, DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Amy Oxentenko MD, FACG

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#414 Spooky Cakes: VKA vs DOACs in Frail Adults, RSV Vaccine, Cuff Size Matters, Bloating & Belching, AKI & Pip-Tazo Oct 30, 2023

Join us as we review recent practice-changing articles on VKAs vs DOACs in frail adults with atrial fibrillation, RSV vaccine for adults over 60, how much does blood pressure cuff size matter, cotton fever in people who inject drugs, new bloating and belching guidelines, and does pip-tazo cause more AKI than cefepime. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
Claim CME for this episode at curbsiders.vcuhealth.org!
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Credits

Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Sai Achi, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments

Intro, disclaimer
VKAs vs DOACs in frail adults with atrial fibrillation,
RSV vaccine for adults over 60,
how much does blood pressure cuff size matter?
cotton fever in people who inject drugs,
new bloating and belching guidelines,
does pip-tazo cause more AKI than cefepime?
Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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#413: Common Ear Complaints, Ear Exam 101, Cerumen Remedies, and more! Get an EARful with Dr. Angela Peng! Oct 23, 2023

Intro with great pun!
Rapid fire questions/Picks of the Week
Case #1: Inner ear complaint
Ear Exam 101
Eustachian Tube Dysfunction
Cholesteatoma
Case #2: Outer ear complaint
Malignant otitis externa
Open tympanic membrane treatments
Cerumen impaction
Itchy Ears
Outro

Credits

Producer, Writer, Show Notes, Cover Art and Infographics: Isabel Valdez, PA-C
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Angela Peng, MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

Sponsor: Pathway

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#24 Treating OUD in the Fentanyl Era: ASAM Treatment Week with Dr. Melissa Weimer Oct 17, 2023

Keep saving lives by prescribing methadone and buprenorphine. Learn how initiations of each have changed in the era of high-potency synthetic opioids (HPSOs) like fentanyl and how to continue to provide person-centered care to people with opioid use disorder. We’re joined by Dr Melissa Weimer, @DrMelissaWeimer (Yale University). This episode is in honor of National Addiction Treatment Week (treataddictionsavelives.org).
Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.
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Credits

Producers: Shawn Cohen MD, Kenneth Morford MD
Writer: Carolyn Chan MD MHS
Show Notes: Shawn Cohen MD
Infographic and Cover Art: Kenneth Morford MD
Hosts: Carolyn Chan MD. MHS Shawn Cohen MD, Natalie Stahl MD, Kenneth Morford MD
Reviewer: Kento Sonoda MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Melissa Weimer DO MCR

Show Segments

Intro, disclaimer, guest bio 00:00
Guest one-liner 05:02
National Addiction Treatment Week 06:00
Case from Kashlak; Definitions 08:30
Starting methadone 11:01
Common methadone pitfalls 15:00
Buprenorphine precipitated opioid withdrawal 23:50
High-dose buprenorphine 32:20
Treating buprenorphine precipitated withdrawal 36:50
Low-dose buprenorphine 41:50
Maintenance dose of buprenorphine 48:15
ER buprenorphine 49:00
Take home points 53:31

#412 Low Carb, Keto, Fasting: Lifestyle Interventions for Weight Management Oct 16, 2023

Semaglutide can’t fix everything…
Recommend lifestyle interventions for weight management with Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center and Interim Chief of Division of General Internal Medicine at Duke (@DrWillYancy). Learn about the ketogenic diet, lower carbohydrate diets, and exercise, and their impacts on your patients.
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Credits

Producer and writer: Fatima Syed, MD, MSc, FACP
Show Notes, Infographic, and Cover Art: Fatima Syed, MD, MSc, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Will Yancy, MD

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Full Transcript available HERE

#411 Adrenal Insufficiency with Dr. Atil Kargi Oct 09, 2023

Show description:
Feel confident diagnosing adrenal insufficiency. Learn how to accurately interpret a stimulation test, differentiate primary from secondary adrenal insufficiency, and teach patients about preventing an adrenal crisis with Dr. Atil Kargi (UNC School of Medicine)
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Case 1
Case 2
Topic
Outro

Credits

Written and Produced by: Elena Gibson, MD
Infographic and Cover Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi, MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Atil Kargi, MD

Sponsor: Pathway

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Full transcript available HERE

#410 Diabetic Foot Infections Oct 02, 2023

A Guide to Seeing Them and Stopping Them in Their Tracks
Bea step ahead of diabetic foot infections! Learn who really needs that MRI, when to call your vascular colleagues, and when you really need that pseudomonas and anaerobic coverage. We are joined by Dr. Andrew Webster, infectious disease physician and antimicrobial stewardship director at the Atlanta VA. Emory Division of Infectious Diseases
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Picks of the Week
Case
Definitions
Risk Stratifications
Diagnostic Work-up
Vascular evaluations
Treatment
Outro

Credits

Writer, producer and show Notes: Reaford Blackburn, Jr., MD
Cover Art and Infographic: Monee Amin, MD
Hosts: Monee Amin, MD and Meredith Trubitt, MD
Reviewer: Sai Achi, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Andrew Webster

Sponsor: Green Chef
Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping.

Sponsor: Pathway
Download the Pathway app today, 100% free for Curbsiders listeners at pathway.md

Sponsor: Birch Living
Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb when you use code BIRCHPARTNER20
Sponsor: Locumstory
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Full transcript available HERE

#409 Hormonal and Nonhormonal Therapy for Vasomotor Symptoms of Menopause Sep 25, 2023

Intro
Nonpharmacologic management of vasomotor symptoms (VMS)
Non-hormonal therapy for menopause
Taking a history for menopausal symptoms, VMS
Hormone therapy (HT) risk assessment, counseling
Prescribing Hormone therapy
Troubleshooting hormone therapy
Premature menopause and primary ovarian insufficiency
Discontinuation of hormone therapy
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Monica Christmas MD

Sponsor: Locumstory

Get a comprehensive view of locums and decide if it’s right for you at locumstory.com.
Full transcript available HERE.

#408 COPD in Older Adults with Leah Witt, MD & Amber Lanae Martirosov, PharmD Sep 18, 2023

Definitions, 4Ms & Inhaler Pro Tips
Level up COPD management in older adults. Start with learning the latest in COPD diagnosis and classification, then stay for the mind-blowing inhaler misuse & cost discussion. We’re joined by a dynamic (and interprofessional) duo: Dr. Leah Witt (@leahjwitt) and Dr. Amber Lanae Martirosov, PharmD (@AmberMartirosov).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Rapid Fire Questions
Case Part 1
COPD Definition
COPD alphabet soup: ABE
Case Part 2
Geriatric 4Ms & COPD
Inhaler Use & Cost
Outro

Sponsor: Indeed
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Sponsor: Babbel
Get 55% off at Babbel.com/CURB.
Full transcript available HERE

#407 DIGEST: Bempedoic acid and cardiac risk, Alpha-Gal Syndrome, Orforglipron, Zuranolone, DOACs for VTE of Malignancy, mAbs for Dementia, New Med for Smoking Cessation, Kiwis and Constipation Sep 11, 2023

Join us as we review recent articles and news featured in The DIGEST #43 and #44, including bempedoic acid to lower cardiovascular risk, Alpha-Gal Syndrome, tick bites and meat allergy, orforglipron an oral GLP1 agonist for weight loss, zuranolone for postpartum depression, DOACs for VTE of malignancy, monoclonal antibodies (mAbs) for Dementia, cytisinicline for smoking cessation, and two kiwis a day for constipation. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Credits

Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewers: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Sponsor: Netsuite

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Sponsor: Locumstory

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Sponsor: Grammarly

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Sponsor: Pathway

Download the Pathway app today by visiting pathway.md
Show Segments

Intro, disclaimer
Bempedoic Acid for CV risk reduction
DOACs to prevent recurrent VTE of malignancy
Cytisinicline for smoking cessation
Alpha-Gal Syndrome, tick bites, and meat allergy
Zuranolone for postpartum depression
Orforglipron, an oral GLP1 agonist, for weight management
mAbs for Alzheimer’s dementia
Kiwis to prevent constipation
Outro

REBOOT #293 The Best of Liver Tests with Dr. Elliot Tapper Sep 04, 2023

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!

Free CME for this episode at curbsiders.vcuhealth.org

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Credits

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

Sponsor: Panacea
If you’re ready to join the thousands of doctors who have declared independence from traditional banks, visit panaceafinancial.com today to open your free account.

Sponsor: Birch
Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb when you use code BIRCHPARTNER20!

CME Partner: VCU Health CEThe 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
Definitions of liver enzymes, liver function tests
Patterns of acute liver injury
Drug-induced liver injury
Isolated alkaline phosphatase elevation
Isolated total bilirubin elevation
Livery Injury During Pregnancy
Acute liver failure
Outro

REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen Aug 28, 2023

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!
Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.

Free CME for this episode at curbsiders.vcuhealth.org

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Credits

Writer: Matthew Watto, MD, FACP
Producers: Matthew Watto, MD, FACP and Malini Gandhi
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Jordy Cohen MD

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

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak: New diagnosis of hypertension
How to make a diagnosis of hypertension
When to start anti-hypertensive medication
Initial blood pressure regimen
Case from Kashlak: White coat hypertension
Case from Kashlak: Hypertension in chronic kidney disease
ACEis and ARBs in chronic kidney disease
Diuretics in chronic kidney disease
Case from Kashlak: Refractory hypertension
History and initial workup for refractory hypertension
Treatment of primary hyperaldosteronism
Outro

Sponsor: Green Chef
Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping.

REBOOT #324: Obesity Medicine FAQ with Dr. Fatima Cody Stanford Aug 21, 2023

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!
Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Not only that, we’ve been thinking about obesity the wrong way for decades. Join us with Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital as we reframe our approach to this disease and learn tips on prescribing older, but still very effective, medications used to treat obesity.
Free CME for this episode at curbsiders.vcuhealth.org

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Credits

Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C
Show Notes, Infographics: Maddison McLellan
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Monee Amin, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Fatima Cody Stanford, MD

Sponsor: Locumstory

Get a comprehensive view of Locumstory at locumstory.com

Sponsor: Babbel
.Get 55% off your Babbel subscription at Babbel.com/curb. Rules and restrictions apply.

CME Partner: VCU Health CEThe 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.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 by Dr. Fatima Cody Stanford
Case from Kashlak
Guidelines for treatment
Getting the history and discussing weight goals
The Care Team: Dietician, Behavioral Specialist, Provider
Medications: Phentermine, Topiramate, Bupropion, Naltrexone
Obesity treatment in pregnancy
Referring to bariatric surgery
Take home points
Outro

REBOOT #316 Lower Extremity Edema with The Curbsiders Aug 14, 2023

Your swell guide to the swollen leg
We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.

Credits

Written and produced by: Paul Williams, MD, FACP
Infographic and Cover Art: Matthew Watto, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto, MD, FACP
Editor: Clair Morgan of nodderly.com

Show Segments

Intro, disclaimer
Picks of the Week*
The case of Lynn Fedema
Pathophysiology of edema
Differential diagnosis of chronic edema
Chronic edema work-up
Management of chronic edema
Calvin Fedema and acute edema
Evaluation of acute edema
Outro

Sponsor: Pathway
Pathway is an innovative tool to improve your clinical decision-making process and enhance patient care. Download the app at pathway.md

REBOOT: #372 Endocrine Emergencies featuring Dr. Sara Markley Webster Aug 07, 2023

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm.
Free CME for this episode at curbsiders.vcuhealth.org
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Credits

● Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD
● Show Notes, Infographic and Cover Art: Caroline Coleman, MD
● Reviewer: Emi Okamoto, MD
● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Technical Production: PodPaste
● Guest: Sara Markley Webster, MD
Sponsor: Grammarly
Go to grammarly.com/GO to download and learn more about GrammarlyGO.
Sponsor: Locumstory
Get a comprehensive view of locums and decides if its right for you at locumstory.com
Sponsor: Birch Living
Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you use code BIRCHPARTNER20!

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 1 from Kashlak
● Adrenal crisis identification, workup and management
● Case 2 from Kashlak
● Myxedema identification, workup and management
● Case 3 from Kashlak
● Thyroid storm identification, workup and management
● Outro
Full transcript available HERE

#406 Kneedful Things: Knee Pain 201 with Dr. Ted Parks Jul 31, 2023

Ready for more knee pain? You’ve already memorized episode #98, so join us as Ted Parks to returns to teach us even more about common causes of knee pain (anterior knee pain, patellofemoral pain, knee bursitis, pain after knee replacement) and what to do about them!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Credits

Producer: Paul Williams, MD, FACP
Writer: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD, MSc
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Edward (Ted) Parks, MD

Sponsor: Pathway
Download the free Pathway app today by visiting https://www.pathway.md/
Full transcript available HERE

#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips Jul 24, 2023

Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM #SGIM23 in Denver, Colorado
Claim free CME for this episode at curbsiders.vcuhealth.org!

Show Segments

Intro
Barriers to treating medicine in primary care
Patient counseling and obesity pathophysiology
Motivational Interviewing
Telemedicine for obesity
Tools and tips for a weight loss program
Medications for Obesity
GLP1 agonist prescribing tips
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
In-studio Technical Production: Chris Chiu MD, FACP, FAAP
Technical Production: PodPaste
Guest: Kimberly Anne Gudzune MD, MPH

#404 Hematuria with Dr. Derek Fine Jul 17, 2023

When there’s blood in the water…
Work-up hematuria with confidence. Learn what you should be worrying about, what tests are worth considering, and how to figure out if this is a job for a urologist or nephrologist.
Claim free CME for this episode at https://curbsiders.vcuhealth.org!
Credits
Producer and writer: Paul Williams, MD, FACP
Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Derek Fine, MD

#403 Hotcakes: Ketamine, Kratom, Nonhormone therapy for menopause, Metformin for long COVID, and New Breast Cancer Screening Recs Jul 10, 2023

Join us as we review recent practice-changing articles on ketamine vs ECT for refractory depression, nonhormone treatment (fezolinetant) for menopause, metformin for long COVID, new breast cancer screening draft recommendations, and a primer on kratom.
Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
Go to https://thecurbsiders.com for more info
Become a Kashlak Memorial Hospital member and support us by joining our Patreon
Claim free CME for this episode at curbsiders.vcuhealth.org!

Addiction Medicine #12 - Listener Q & A on Substance Use Disorders Jul 06, 2023

Put on your Primary Care Cat-Hat
We are thrilled to be back to kick off season 2! Carolyn Chan, MD (@CarolynAChan) soon to be at the University of Cincinnati, Shawn Cohen MD (@ShawnCohen_MD) at Yale University, Kenneth Morford MD at Yale University, and Natalie Stahl MD (@NanouTheNomad) at Greater Lawrence Family Health Center are back and on this episode, they answer burning questions submitted by listeners. We cover topics such as targeted naltrexone, increasing buprenorphine doses, treating kratom dependence, and so much more!
Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.
Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

Credits

Producer, Show Notes: Kenneth Morford, MD
Infographic and Cover Art: Carolyn Chan, MD, MHS
Hosts: Carolyn Chan MD, MHS, Shawn Cohen MD, Kenneth Morford MD, Natalie Stahl MD, MPH
Reviewer: Payel Jhoom Roy, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste

#402 Don’t Get Caught with a CAUTI Jul 03, 2023

Please consolidate if performing multiple jobs (e.g. Written and Produced by: Cyrus Askin MD; cover art and infographic by Kate Grant)
Producer and Writer:: Noble Maleque MD
Show Notes: Caroline Coleman MD & Noble Maleque MD
Cover Art and Infographic: Caroline Coleoman MD & Sean Evans MD
Hosts: Monee Amin MD & Meredith Trubitt MD
Reviewer: Sai S Achi, MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Laila Woc-Colburn MD

#401 Updates in Addiction Medicine - SGIM 2023 Jun 26, 2023

We are far too classy for a “Rocky Mountain High” joke.
Live from SGIM 2023 in Aurora, Colorado! We talk to a panel of Addiction Medicine specialists who recap their outstanding talk on all of the exciting developments in treating addiction. We review major policy changes, trends in drug overdose, outpatient screening for alcohol use, and all of the ways we might be using psychedelics to treat addiction. We are joined by Stefan Kertesz, MD @StefanKertesz (University of Alabama at Birmingham), Ximena Levander, MD, MCR, FACP @XimenaLevander (OHSU), Kenneth L. Morford MD, FASAM (Yale), and Katherine Mullins, MD, AAHIV @_kmullins_ (NYU Langone).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Credits

Producer: Carolyn Chan, MD and Paul Williams, MD, FACP
Writer: Carolyn Chan, MD and Paul Williams, MD, FACP
Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP
Hosts: Carolyn Chan, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guests: Stefan Kertesz, MD, MSc; Ximena A. Levander, MD, MCR, FACP; Kenneth L. Morford, MD, FASAM; Katherine Mullins, MD, AAHIV

#400 Antiplatelets, Anticoagulation for Coronary Artery Disease and Afib Jun 19, 2023

Master the prescription of antiplatelets and anticoagulation for coronary artery disease and afib (atrial fibrillation). We discuss why, when, and how long to prescribe aspirin, clopidogrel, ticagrelor, prasugrel, and/or anticoagulation for primary, secondary, and “primary and a half” prevention including the definition and discussion of mono, dual, and triple therapy for patients with coronary disease who need anticoagulation for atrial fibrillation. We’re joined by preventive cardiologist, Dr. Donald Lloyd-Jones MD, ScM (@dmljmd from NMCardioVasc)! This episode was recorded in person at ACP’s (@ACPIMPhysicians) Internal Medicine Meeting 2023 #im2023 in San Diego.
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Getting to know our guest
Definition mono, dual, triple therapy, DAPT
Post-PCI for NSTEMI with existing afib
Stable CAD with new Afib
CABG with New Afib
Prior stent with New Afib
Antiplatelet therapy after Acute Coronary Syndrome
Primary Prevention
Primary “and a half” Prevention
Life’s Essential 8
Outro

Sponsor: Pattern https://www.patternlife.com/

Sponsor: Panacea Financial https://panaceafinancial.com/

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art & Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD, MSc
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Donal Lloyd-Jones MD, ScM

#399 Wisely Ordering Autoantibodies - ACP IM2023 Jun 12, 2023

The ANA, anti-CCP, RF, and beyond!
We all have ‘rheum’ to grow when it comes to making sense of autoantibodies and common markers. We talk through the nuances with rheumatologist Dr. Matthew B. Carroll (biography here!). Our interview covers physical exam tips for inflammatory arthritis, basic interpretation of rheumatologic testing, and what to do with the dreaded ‘vaguely positive’ speckled ANA!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Case 1
History clues
Physical exam pearls; what does synovitis look like?
Interpreting mixed labs
Rheumatoid Factor tips
Role for imaging
Importance of early diagnosis
New testing modalities
Case 2
Oh no– a vaguely positive ANA!
ANA testing basics
Outro

Credits

Showrunners, Hosts, Producers and Writers: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes, Infographic, Cover Art: Beth Garbitelli MD
Reviewer: Emi Okamoto MD
Technical Production: PodPaste
Guest: Matthew B. Carroll MD

Sponsor: Brooklinen
Visit Brooklinen.com today and get $20 off plus free shipping on orders of $100+ with code [CURB]
Sponsor: Grammarly
Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions.
Sponsor: Glass Health
You can get one month of Glass Pro free by signing up at glass.health and using the code: CURBSIDERS.

# 398:Live! From SHM: Inpatient Cirrhosis Management Jun 05, 2023

Learn to bust through inpatient cirrhosis management! The basics of ascites, HRS, portal vein thrombosis and hepatic encephalopathy management are all here. We’re joined by Dr. Suchita Sata (@suchitasata) (Duke University).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro
Austin Picks of the week
Case
Ascites
Portal Vein Thrombosis
AKI/HRS
SBP
Diuretic Management
Albumin
Case
HRS treatment
GIB Management
Hepatic Encephalopathy Management
Palliative Care
Outro

Credits

Producer, Writer: Monee Amin MD, Meredith Trubitt MD
Show Notes, Cover Art: Monee Amin MD
Infographic: Caroline Coleman MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Suchita Sata MD

Sponsor: Indeed

Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.

Sponsor: Birch Living

Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb

Sponsor: Green Chef

Go to GreenChef.com/curb60 and use code curb60 to get 60% off plus free shipping.
Sponsor: Glass Health

You can get one month of Glass Pro free by signing up at glass.health and using the code CURBSIDERS
Full Transcript available HERE

#397: Insulin, Type 2 Diabetes, Fanny Packs, and Hypoglycemia with Dr. Jeff Colburn May 29, 2023

Don’t be scared of insulin or hypoglycemia anymore! Our Kashlak Friend of the Pod Dr. Jeff Colburn gives us all the essentials you’ll need in your fanny pack for navigating the ups and downs of insulin in type 2 diabetes.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

Intro
Rapid fire questions/Picks of the Week
Case #1: Starting insulin
Types of basal insulin: glargine, detemir, NPH, 70/30 NPH/regular
Glucose monitoring while on insulin
Glucose targets when taking insulin
Overbasalization
Adding additional agents to basal insulin
Case #2: Deescalating insulin
Insulin use in the geriatric population
Hypoglycemia Rule of 15
Glucagon how-to
Outro

Credits

Producer, Writer, Show Notes, Infographic and Cover Art: Isabel Valdez, PA-C
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jeff Colburn, MD

Sponsor: Pattern

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Full Transcript available HERE

#396 Recap, Top Pearls from #SGIM23 May 22, 2023

Don’t miss this rapid-fire recap of our top pearls from #SGIM23 in Aurora, Colorado, including obesity medicine, GLP1 agonists, trauma-informed care, an update on hormone therapy for vasomotor symptoms of menopause, treating low sexual desire in women, dementia diagnosis and treatment, chronic pain and buprenorphine, complex persistent opioid dependence, chlorthalidone vs hydrochlorothiazide, the timing of blood pressure medication, how to prescribe CPAP or auto-PAP, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk), Chris Chiu (@cjchiu), Carolyn Chan (@CarolynAChanMD, Curbsiders Addiction Medicine), and Era Kryzhanovskaya (@EraKryzhMD, Curbsiders TEACH).
No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro
Recap, Top Pearls Part 1
Recap, Top Pearls Part 2
Outro

Credits

Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Carolyn Chan MD; Era Kryzhanovskaya MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Technical Production: PodPaste

Sponsor: Pattern

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#395 Dysphagia with Dr. Diana Snyder May 15, 2023

There might be a lot to swallow, but you will master an initial approach to dysphagia in this episode. Review the types of dysphagia, common etiologies, initial evaluations and treatment plans. We are joined by Dr. Diana Snyder @DianaSnyderMD (Mayo Clinic)
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro & Picks of the Week
Case
Dysphagia definitions
Oropharyngeal vs esophageal dysphagia
Associated symptoms and alarm signs
Outro

Credits

Producer, Writer & Show Notes: Elena Gibson MD
Show Notes: Elena Gibson MD
Cover Art & Infographic: Kate Grant MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Diana Snyder MD

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Full transcript available HERE

#394 Recap, Top Pearls from ACP #IM2023 May 08, 2023

Don’t miss this rapid fire recap of our top pearls from ACP #IM2023 in San Diego including hypertension, hypogonadism, frailty, afib, sleep medicine, in-flight emergencies, nephroprotective meds, order of antibiotics for pneumonia in the hospital, genitourinary syndrome of menopause, pickle juice for leg cramps, bristol stool scale and hepatic encephalopathy, coronary calcium, tirzepatide, cystatin c, functional dyspepsia, hair and nails, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk) and Chris Chiu (@cjchiu) of The Cribsiders Podcast.
No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro
Recap, Top Pearls Part 1
Recap, Top Pearls Part 2
Outro

Credits

Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

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Full transcript available HERE

#393 Live from SHM: Clinical Updates in Hospital Medicine May 01, 2023

Join us for this Hotcakes style episode as we talk through impactful literature for the hospitalist with Dr. Heather Nye (UCSF) and Dr. Rahul Ganatra (@rbganatra, Harvard University) who presented the Clinical Updates in Hospital Medicine at SHM #Converge23.
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Show Segments

Intro, disclaimer
Rapid fire questions/Picks of the Week
EMPULSE
ADVOR
STRONG-HF
CRISTAL
Perioperative Gabapentin
Waterfall
Midline catheters vs PICC lines
What’s in a Name?
Outro

Credits

Producer, Writer, Show Notes: Monee Amin MD; Rahul Ganatra, MD; Meredith Trubitt MD;
Cover Art: Monee Amin MD
Hosts: Monee Amin MD; Meredith Trubitt MD
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Rahul Ganatra and Dr. Heather Nye

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Full transcript available HERE

#392 Live! Opioid and Xylazine Withdrawal in the Hospital Apr 26, 2023

Dominate opioid and xylazine (aka tranq) withdrawal in the hospital with expert insights from Dr. Joseph D’Orazio (@dorazepam) recorded LIVE! at Pennsylvania Hospital Grand Rounds in Philadephia, PA. Xylazine, an alpha-2 adrenergic agonist, has emerged as a frequent contaminant in the opioid supply with a distinct withdrawal syndrome. You’ll learn to manage this common withdrawal syndrome while also addressing acute pain complaints and opioid withdrawal.
Sorry, no CME for this episode, but check out CME for past episodes at curbsiders.vcuhealth.org.
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Show Segments

Intro
Xylazine basics
Management of xylazine withdrawal
Opioid withdrawal and acute pain
Outpatient considerations for xylazine
Audience questions
Outro

Credits

Writer and Producer: Matthew Watto MD, FACP
Infographic and Cover Art: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Joseph D’Orazio MD

Full transcript available HERE

#391 Hypercoagulable Work-Up with Dr. Jean Connors Apr 24, 2023

Intro
Case from Kashlak: DVT after a trip to Singapore
History-taking in a patient with a venous thromboembolism (VTE)
Risk factors for VTE
Who to test for thrombophilia, and how this testing influences management
Thrombophilia panel: what to order
When to send thrombophilia testing
Case from Kashlak: potential obstetric antiphospholipid syndrome
Antiphospholipid syndrome: diagnosis
Antiphospholipid syndrome: management
Outro

Credits

Producers and Writers: Malini Gandhi and Nora Taranto MD
Show Notes, Infographics, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Jean Connors MD

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Full transcript available HERE

#390 Resistant Hypertension Apr 17, 2023

Hypertension FAQ Round #2 Dr. Jordy Cohen Strikes Back
Tackle resistant hypertension. Learn when it is pseudo resistant hypertension, and how to treat this pesky condition when it is true resistant hypertension. Dr. Jordy Cohen (@jordy_bc) leads us through her approach to keeping the BP where it should be (University of Pennsylvania).
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Show Segments

Intro
Case
Hypertension definition
Mechanisms of hypertension
Vascular stiffness and aging
Antihypertensive agents
Anxiety and hypertension
Escalating blood pressure management
Resistant hypertension
Ruling out pseudo resistant hypertension
Substance induced pseudo resistant hypertension
Pick of the Week
Outro

Credits

Written and Produced by: Deborah Gorth MD, PhD
Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD, MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jordy Cohen MD, MSCE

Sponsor: Indeed

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Full transcript available HERE

#389 Recap: SHM 2023 #Converge Apr 10, 2023

We recap the top pearls for the hospitalist from #SHM #Converge2023 covering discussions on syncope, heart failure, COPD, pneumonia, sickle cell pain management, nausea and dyspnea, complex pain management issues, delirium, geriatrics updates, severe infections from injection drug use, electrolyte management, perioperative anemia and anticoagulation, and GI updates.
Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.
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Show Segments

Intro
Picks of the Week
Syncope
Heart Failure
Nausea and Dyspnea
COPD and Pneumonia
Sickle Cell Pain Management
Pain Management for the Hospitalist
Delirium
Geriatrics Updates
Electrolyte Management
Perioperative Anticoagulation
Perioperative Anemia
Severe Infections from Injection Drug Use
GI updates
Outro

Credits

Written, Produced and Hosted by: Christina Sensabaugh MD, Meredith Trubitt MD, and Monee Amin MD
Cover Art: Monee Amin MD
Show Notes: Meredith Trubitt MD, Monee Amin MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

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Sponsor: Locumstory

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Sponsor: Indeed

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Full transcript available HERE

#388 HIV in Primary Care with Dr. Jonathan J. “JJ” Nunez MD Apr 03, 2023

LIVE! Updates in HIV management at Hershey
Highly active, high-yield points on HIV management in Primary Care! We are joined by Infectious Disease specialist Dr. Jonathan J. “JJ” Nunez MD (of Penn State Health - Hershey) to review basics of management, important comorbidities, and new horizons in HIV care.
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Show Segments

Intro
Establishing HIV Care, Initial History Taking
Privacy and HIV
Physical Exam Tips for HIV
Weight gain, managing cardiometabolic risks
Initial labs, tracking viral load
Undetectable = Untransmissible
Sexual history considerations, PEP, PrEP,
Anal paps, cervical cancer screening
Long-Acting HIV Medications
Take-home points
Outro

Credits

Producer, Writers: Paul Williams MD, FACP, Beth Garbitelli MD
Show Notes, Infographic, Cover Art: Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: J.J. Nunez MD

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Full transcript available HERE

#387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules Mar 27, 2023

Drop the pounds and the sugar with new guidelines
New rules to manage diabetes means using new tools. Leverage GLP-1 RA and SGLT2-i to drop with pounds and the sugars with the expert insight from our guest, Dr. Marie McDonnell.
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Show Segments

Puns and Intro.
Disclaimer and Guest bio
Case from Kashlak
Labs to distinguish type 1 from type 2 diabetes
Selecting initial therapy: Focus on weight loss and glucose control
HbA1c goals
Yeast infections and SGLT2-i
Using sulfonylureas and extended release metformin
Pancreatitis and GLP-1 RA
Cancer and GLP-1 RA
Semaglutide tips
Tirzepatide, how it works and benefits
Take home points
Outro

Credits

Producer: Matthew Watto, MD and Isabel Valdez, PA
Writer: Matthew Watto, MD
Show Notes, Cover Art and Infographics: Isabel Valdez, PA
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Marie E. McDonnell, MD

Sponsor: Locumstory
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Full transcript available HERE

#386 Primary Aldosteronism, MRAs, and Renovascular Hypertension: NephMadness Pod Crawl 2023 Mar 20, 2023

We demystify primary aldosteronism, MRAs (mineralocorticoid receptor antagonists), non-steroidal MRAs, and how to recognize and treat renovascular hypertension with nephrologist/hypertension expert, Dr. Matt Luther (@DrJMLuther) as part of the NephMadness PodCrawl 2023. Fill out a bracket for NephMadness and check out all eight NephMadness PodCrawl participants at NephMadness.com/podcrawl (list below) and the MRA region write-up by Micah Schub (@AcidBassMD).

The Curbsiders gets the skinny on mineralocorticoid receptor antagonists
Core IM will be covering Kidney Transplant in their classic Five Pearl format
The CardioNerds will be covering the effect of Heart Failure Devices on Kidney Health
Freely Filtered will try to understand thrombotic microangiopathy
ISN Global Kidney Care goes deep on IgA nephropathy
The Cribsiders look at transitions, first the Pediatrics to Adult nephrology transition and then from living to death with palliative nephrology
Fellow on Call will be covering Onconephrology
And finally, The Nephron Segment looks at Transgender Health and CKD

Intro
Diagnosis and Management of Primary Aldosteronism (PA)
MRAs vs non-steroidal MRAs (mineralocorticoid receptor antagonists)
NephMadness MRA region picks
Renovascular Hypertension
Outro

Credits

Writer and Producer: Matthew Watto MD
Show Notes: Matthew Watto MD
Cover Art & Infographic: Matthew Watto MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: J. Matthew Luther MD

Sponsor: Locumstory

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Full Transcript available HERE

#385 TIA/Stroke for the Hospitalist featuring Dr. Karima Benameur Mar 13, 2023

We’ve got the hard-hitting questions and must-know answers on all things TIA and stroke from neurology expert, Dr. Karima Benameur (Emory University). Topics: TIA and stroke supportive management, indicated workup, and anticoagulation and antiplatelet management pearls for the hospitalist.
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Show Segments

Intro, disclaimer, guest bio
Case 1 from Kashlak; Definitions
Initial stroke triage, imaging, and assessing for interventions
Supportive care for stroke
Managing patients already on antiplatelet or anticoagulant therapy
Inpatient stroke workup
Dual antiplatelet therapy
Case 2 from Kashlak; Definitions
TIA workup and management
Transitions of care: “the invisible deficits”
Brain health and nutrition
Guest questions and Picks of the Week*
Outro

Credits

Written, Produced, Infographic and Cover Art, Show Notes: Caroline Coleman MD
Hosts: Monee Amin MD; Meredith Trubitt MD, MPH; Caroline Coleman MD
Reviewer: Molly Heublein MD
Executive Producer: Karly Loy
Showrunner: Matthew Watto MD, FACP
Editor: Pod Paste
Guest: Karima Benameur MD

Sponsor: Indeed

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Full transcript available HERE

#384 Updates in Chronic Kidney Disease with Dr. Joel Topf Mar 06, 2023

Stay up-to-date with advances in chronic kidney disease (CKD)! Join our esteemed Chief of Nephrology at Kashlak Memorial Hospital, Dr. Joel Topf, as he leads us through the latest on SGLT2 inhibitors, finerenone, potassium binders, and treatment of CKD-associated metabolic acidosis.
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Show Segments

Intro, disclaimer, guest bio
Case from Kashlak
SGLT2i: when to initiate
SGLT2i: adverse effects
Finerenone
Potassium binders
Treatment of CKD-associated metabolic acidosis
Outro

Credits

Writer, Producer, Show Notes, Infographics, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Joel Topf MD

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Full transcript available HERE

#383 Hotcakes: Loop Diuretics for CHF, Time Restricted Eating, Breaks from Sitting, Early FMT for C. diff Feb 27, 2023

Join us as we review recent practice-changing articles on loop diuretics for heart failure exacerbation (torsemide vs furosemide), time-restricted eating vs small frequent meals for weight loss, how sedentary breaks from sitting effect blood glucose & blood pressure, early FMT for C. diff, and a brief rant on medications for obesity. Fill your brain hole with a delicious stack of hotcakes! Featuring Nora Taranto (@norataranto, The DIGEST), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer
Loop diuretics (torsemide vs furosemide) for heart failure exacerbation
Time-restricted eating vs small frequent meals for weight loss
Sedentary breaks for lowering blood glucose and blood pressure
Early fecal microbiota transplant (FMT) for C. diff infection
Outro

Credits

Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Full transcript available HERE

#382 Abnormal Uterine Bleeding Feb 20, 2023

With Dr Holly Wong Cummings
Listen in as we talk through abnormal uterine bleeding (AUB) with our esteemed guest Holly Wong Cummings, MD. We review the PALM-COEIN framework for AUB diagnosis and discuss options for acute and chronic treatment of AUB. We can get bleeding under control! Many of the treatments including progesterone only pills, combined oral contraceptives, and tranexamic acid are medications we in primary care should feel confident prescribing to our patients.
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Case from Kashlak
Normal Menstrual Cycle
Nomenclature for AUB- PALM COEIN
History and Physical Exam
Laboratory and radiologic evaluation
Structural causes for bleeding/interpreting the ultrasound
Acute treatment of AUB
When to refer to ED
Chronic treatment for AUB
When to refer to gyn
Take home points
Outro

Credits

Producer, Writer, Show Notes: Molly Heublein MD
Infographic: Edison Jyang
Cover Art: Sarah Phoebe Roberts
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD
Reviewer: Sai S Achi MD, MBA
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Holly Wong Cummings MD

Sponsor: Indeed

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Full transcript available HERE

#381 LIVE! Patient Centered Things We Do For No ReasonTM Feb 13, 2023

Join Drs. Amin and Trubitt as they go rogue and LIVE! from Southern Hospital Medicine to discuss Things We Do For No ReasonTM in the hospital that impact the patient experience. They cover NPO at midnight, fluid restriction, VTE chemoprophylaxis and routine vital signs via the hospital course of one poor, unfortunate soul.
Note No CME for this mini-episode but visit curbsiders.vcuhealth.org
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Show Segments

Intro
NPO at midnight
Fluid restriction
VTE chemoprophylaxis
Frequency of vital sign monitoring
Outro

Credits

Written and Produced by: Monee Amin MD and Meredith Trubitt MD
Cover art and presentation graphics: Caroline Coleman, MD
Show Notes: Monee Amin MD and Meredith Trubitt MD
Hosts: Monee Amin, MD and Meredith Trubitt MD
Technical Production: PodPaste
Showrunner: Matthew Watto MD, FACP

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Sponsor: Indeed

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Full Transcript available HERE

#380 Hemochromatosis with Elliot Tapper Feb 06, 2023

Recognize when to consider the diagnosis of hemochromatosis and how to recognize common mimics of an elevated ferritin level. We’re joined by Dr. Elliot Tapper,@ebtapper on twitter (University of Michigan)
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak; Definitions
Initial evaluation of Hemochromatosis
Etiology of elevated ferritin in liver disease
Potential mimics of hemochromatosis
Diagnosis of hemochromatosis
Evaluation of hepatic fibrosis in hemochromatosis
Manifestations & complications of hemochromatosis
Outro

Credits

Producer & Writer:: Elena Gibson MD
Infographic & Cover Art:Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer:
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Elliot Tapper

Sponsor: Green Chef

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Sponsor: Birch Living

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Full transcript available HERE

#379 Hearing Loss, Tinnitus, and Meniere's Disease Jan 30, 2023

With Dr Steven Rauch
Demystify hearing loss, identify who will benefit from hearing aids and learn to evaluate hearing complaints in primary care including an overview of tinnitus and how to recognize and treat Meniere’s disease with guest expert, Dr. Steven Rauch (Harvard University).

Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Case from Kashlak;
Definitions, etiology and risk factors for hearing loss
Initial workup for hearing loss
What is an audiogram and what does it show
Hearing loss red flags
How to manage hearing loss
Tinnitus: what can help patients
Diagnose, distinguish and treat Meniere’s disease
Outro

Credits

Script and Show Notes written by, Produced by: Kate Grant MBChB, MRCGP and Andréa Perdigão
Infographic and Cover Art: Kate Grant MBChB, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Steve Rauch MD

Sponsor: Better Help

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Full Transcript HERE

#378 Acute Exacerbations of COPD (AECOPD) Jan 23, 2023

Pro Tips & Practical Insights from Dr. Jim O’Brien
Are acute COPD exacerbations taking the wind out of YOUR sails? Join us as we navigate the stormy waters that can be AECOPD with our guest expert, Dr. Jim O’Brien from National Jewish Health Center.
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Show Segments

Intro, disclaimer, guest bio
What is a COPD
Case from Kashlak - Natalie Harrison
Knee jerk reaction: Determining level of illness & disposition
Initial work-up considerations
What’s in your differential?
The second-order assessment - shuffling the differential, honing in on the patient
AECOPD: Triggers & Pathophysiology
Treatment Pearls I: Steroids
Treatment Pearls II: Antibiotics
Treatment Pearls III: Bronchodilators
Treatment Pearls IV: Oxygen Therapy
Preparing for discharge
Take home points
Lightning Round! Getting to know Dr. O’Brien & Picks of the Week*
Outro

Credits

Writer & Producer: Cyrus Askin MD
Show Notes, Infographic & Cover Art: Cyrus Askin MD
Hosts: Meredith Trubitt MD, Monee Amin MD & Cyrus Askin MD
Reviewer: Sai Achi, MD MBA
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jim O’Brien MD

Sponsor: Medmastery

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Subscription.
Full Transcript available HERE

#377 Adrenal Incidentalomas, Primary Aldosteronism with Dr. William Young Jan 16, 2023

Conquer your fear of adrenal incidentalomas! We’re joined by Dr. William Young, who teaches us pearls for evaluating imaging characteristics of adrenal incidentalomas, tips for assessing and managing functioning adenomas, approaches to follow-up and surgical considerations, and more.
Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Case #1 from Kashlak; Definitions
Discussing adrenal incidentalomas with patients
Imaging characteristics of adrenal incidentalomas
Evaluation of hormonal hypersecretion - overview
Subclinical Cushing’s syndrome
Pheochromocytoma
Surgical considerations based on nodule size and imaging phenotype
Follow-up imaging
Case#2 from Kashlak
Primary hyperaldosteronism - work-up and management
Bilateral adrenal nodules
Guest Picks of the Week
Outro

Credits

Producer, Writer, Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: William Young MD

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Full Transcript HERE

#376 Hormone Therapy for Primary Prevention of Chronic Conditions in Postmenopausal Persons - a USPSTF update with Dr. Carol Mangione Jan 11, 2023

We have better tools for prevention, but let’s talk!
Should we be offering hormone therapy for primary prevention in postmenopausal patients? Dr. Carol Mangione (UCLA) talks us through the potential benefits and harms, and explains how this can be a jumping off point for important conversations about preventive care.
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Credits

Producers, Hosts: Elena Gibson MD and Paul Williams MD, FACP
Writer, Infographic, and Cover Art: Elena Gibson MD
Show notes: Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Production team: Podpaste
Guest: Carol Mangione MD

Full transcript available HERE

#375 Delirium in the Hospital featuring Dr. Esther Oh Jan 09, 2023

In this episode you will learn to master delirium in the hospital! We discuss preventing, recognizing, and managing this common and dangerous condition. We are joined by delirium expert and President of the American Delirium Society, Dr. Esther Oh @EstherOh_MDPhD (Johns Hopkins University)
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case 1 from Kashlak: hypoactive delirium
Definition of delirium
Delirium vs. encephalopathy vs. dementia
Delirium assessment tools
Prevention of delirium
Discharging patients with delirium
Case 2 from Kashlak: hyperactive delirium
Antipsychotics
Working up etiologies of delirium
Treatment/management pitfalls
Outro

Credits

Produced, Script, Show Notes: Adam Barelski MD
Infographic & Cover Art: Edison Jyang; Sarah Phoebe Roberts
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Adam Barelski MD
Reviewer: Molly Heublein MD
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Esther Oh MD, PhD

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Full transcript HERE

#374 ADHD with Dr. Kevin Simon Jan 02, 2023

Don’t get distracted, pay attention to the details, and manage ADHD in your patients!
Dr. Kevin Simon, @DrKMSimon (Boston Children’s Hospital) shows us how to stay focused and diagnose and manage attention deficit hyperactivity disorder (ADHD) in your patients. Learn how to make the right diagnosis, choose an appropriate medication, and modify therapy.
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Show Segments

Intro, disclaimer, guest bio
Case from Kashlak; Definitions and diagnosis of ADHD
Stimulant medications for ADHD
Non-stimulant medications for ADHD
Mitigating diversion of medications for ADHD
Managing ADHD in patients with substance use disorder
Lightning round and picks of the week
Outro

Credits

Written and Produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Kevin Simon, MD

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Full Transcript HERE

#373 Recap Extravaganza 2022 Dec 26, 2022

Celebrate the holiday season with top pearls on constipation, palpitations, hypertension, meds for obesity, cardiorenal syndrome, hepatitis C, staging the liver, vitamin supplementation and more! Plus, Watto and Paul share their reflections on seven years of podcasting, give their picks of the year, and tease upcoming episodes for 2023!
Note No CME for this episode but visit curbsiders.vcuhealth.org to claim credit for shows from 2022!
Episodes | Subscribe | Spotify | Swag! | Mailing List | askcurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer,
Reflections on 2022
Constipation,
Palpitations,
Hypertension,
Obesity medications,
Cardiorenal syndrome,
Hepatitis C,
Vitamin supplementation
Picks of the Year
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art design: Matthew Watto MD, FACP
Technical Production: Pod Paste

Full transcript HERE

#372 Endocrine Emergencies featuring Dr. Sara Markley Webster Dec 19, 2022

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm.
Free CME for this episode at curbsiders.vcuhealth.org
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Show Segments

● Intro, disclaimer, guest bio
● Guest one-liner, Picks of the Week*
● Case 1 from Kashlak
● Adrenal crisis identification, workup and management
● Case 2 from Kashlak
● Myxedema identification, workup and management
● Case 3 from Kashlak
● Thyroid storm identification, workup and management
● Outro

Credits

● Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD
● Show Notes, Infographic and Cover Art: Caroline Coleman, MD
● Reviewer: Emi Okamoto, MD
● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Technical Production: PodPaste
● Guest: Sara Markley Webster, MD

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Full Transcript HERE

#371 Prostate Cancer: Screening, Advanced Testing, and Survivorship Dec 12, 2022

Navigating guidelines, parsing through the PSA, Survivorship, & More!
Become a pro when addressing prostate cancer! We tackle the nuances surrounding screening for this all-to-common cancer and discuss important considerations in survivorship with our guest Dr. Petar Bajic (Twitter: @PBajicMD, Instagram: @the.sexdoc) of Cleveland Clinic! You’re IN for a good time listening to this episode!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

● Intro, disclaimer, guest bio
● Guest one-liner
● Case from Kashlak
● Epidemiology of Prostate Cancer
● Screening Basics
● What is the PSA?
● Next Steps After Elevated PSA
● Thresholds and techniques for biopsy
● Free PSA, Other testing modalities, Prostate MRI
● Active Surveillance Nuts and Bolts
● Survivorship
● Take home points, Outro
Credits

● Producer,Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli MD
● Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD
● Reviewer: Sai S Achi, MD MBA
● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Technical Production: PodPaste
● Guest: Dr. Petar Bajic MD

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Full Transcript HERE

#370 Parkinson’s Disease for Primary Care with Dr. Albert Hung Dec 05, 2022

Master the ins-and-outs of Parkinson’s Disease! We’re joined by Dr. Albert Hung, who teaches us pearls for the initial history and physical exam in a patient with undiagnosed Parkinson’s, a framework for management of early and advanced motor symptoms, tips for treating autonomic symptoms and cognitive / psychiatric features, and more.
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Initial history in a patient with undiagnosed Parkinson’s
“Pre-motor” symptoms of Parkinson’s disease
Physical exam in Parkinson’s disease
Drug-induced Parkinsonism
“Red flags” suggesting atypical parkinsonian syndromes
Role of imaging in diagnosis
Typical discussion with patient at initial diagnosis
Initial management of motor symptoms
Management of autonomic symptoms
Management of advanced motor symptoms
Management of cognitive and psychiatric symptoms
Outro

Credits

Producer, Writer, Show Notes, and Infographic: Malini Gandhi
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Albert Hung MD, PhD
Full transcript HERE

#369 Hand, Foot, Wrist and Ankle Pain, Myositis and Myopathy: A Rapid Review (TFTC) Nov 30, 2022

Recap and review the top pearls from recent episodes #339 Hand and Wrist Pain, #348 Foot and Ankle Pain, and #351 Myopathy and Myositis with Watto and Paul. 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 #339, #348 and #351!
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Show Segments

Intro, disclaimer, guest bio
Hand and Wrist pain: CMC joint arthritis, tenosynovitis, carpal tunnel syndrome, trigger finger
Foot and Ankle pain: Ankle sprains, Achilles tendon injuries, Posterior tibial tendon dysfunction
Myopathy and Myositis pearls
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

#368 Back Pain Update with Dr. Austin Baraki Nov 28, 2022

A Rational Approach: Who to Image, How to Treat, and More!
Back pain is one of the most common concerns our patients bring to us in the outpatient setting. It’s a lot more complicated than rest, ice, and NSAIDs! Fortunately, we have pain expert, strength coach, and academic internist Dr. Austin Baraki (Austin Baraki, MD (@AustinBaraki) / Twitter) to help us develop a comprehensive, patient centered approach to help our patients manage their pain and lead healthier lives. Take control of your patients’ back pain!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak
Introduction to Back Pain
Eliciting the Patient’s Story
Risk Stratification, Intro to Red Flags, and and the STarT Back Tool
The Importance of Language and Patient-Centered Outcomes
A Deeper Dive into Red Flags
Setting Expectations for Care
Therapeutics for Back Pain - Does anything work?
The Exercise Prescription

Credits

Producers: Isabel Valdez, PA-C & Cyrus Askin, MD
Writer, Cover Art and Infographics: Isabel Valdez, PA-C
Show Notes: Cyrus Askin, MD
Hosts: Matthew Watto MD, FACP; Isabel Valdez, PA-C
Reviewer: Molly Heublein, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Austin Baraki, MD

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Full transcript HERE

#367 Weekend Warriors, Fluids for Acute Pancreatitis, Colonoscopy Screening & Mortality, and SPRINT trial Revisited (Hotcakes) Nov 21, 2022

Join us as we review recent practice-changing articles addressing the questions: Do weekend warriors experience a mortality benefit from exercise? Is an aggressive fluid strategy superior to a moderate strategy in acute pancreatitis? Does an invite for colonoscopy decrease colon cancer-related mortality? Did the benefits of intensive blood pressure control continue after the SPRINT trial ended? Fill your plate with a stack of hot tofurkey cakes! Featuring Drs. Era Kryzhanovskaya (@erakryzhmd), Nora Taranto (@norataranto), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
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Show Segments

Intro, disclaimer
Do weekend warriors experience a mortality benefit?
Should you choose aggressive or moderate fluid resuscitation for acute pancreatitis?
Does an invite for screening colonoscopy reduce colon cancer and CRC-related mortality?
Did benefits from the SPRINT trial persist in observational follow up?
Outro

Credits

Written and Hosted by: Era Kryzhanovskaya, MD, Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste

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#366 Opioid Use Disorder and Acute Pain in the Hospitalized Patient Nov 14, 2022

With Carolyn Chan MD and Shawn Cohen MD
Conquer acute pain in the hospitalized patient with opioid use disorder! It’s challenging to treat opioid withdrawal and acute pain simultaneously. This episode features clinical pearls on prescribing methadone, buprenorphine, low-dose buprenorphine initiation, and how to incorporate opioids as part of multimodal pain treatment responsibly. We’re joined by The Curbsiders Addiction Medicine Podcast hosts, Drs. Carolyn Chan (@carolynachan) and Shawn Cohen (@shawncohen)!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Acute pain in the patient on buprenorphine maintenance
Acute pain in the patient on methadone maintenance
Acute pain in the patient with opioid withdrawal
Standard buprenorphine initiation
Methadone initiation
Low dose buprenorphine initiation
Take-home points
Outro

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Carolyn Chan MD and Shawn Cohen MD

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Full transcript HERE

#365: Perioperative Medicine with Anesthesiologist Dr. Angela Selzer Nov 07, 2022

We’ve Come a Long Way From Ether
Learn how an anesthesiologist approaches perioperative medicine from how to choose the right type of anesthesia (general anesthesia vs regional anesthesia vs MAC), to preoperative risk assessment, and how to avoid anesthesia related complications. Our guest, anesthesiologist, Dr. Angela Selzer (Denver, CO) helps us explore high yield pearls regarding the practice of anesthesiology to empower the internal medicine clinician to deliver team-based, perioperative care.
Claim Free CE credit for this episode through VCU Health CE at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Introduction to anesthesiology
Introduction to regional anesthesiology
Walk through what an anesthesiologist does in the operating room
Ambulatory surgery center exclusions
Approach to preop assessments
“Will it change management?” applied to anesthesiologists
ASA Classes
Anesthesia complications
Take Home Points; Outro; Bonus clip

Credits

Written and Produced by: Edison Jyang; Avital O’Glasser MD, FACP, SFHM
Cover Art: Sarah Phoebe Roberts, MPH
Infographic: Avital O’Glasser MD, FACP, SFHM; Edison Jyang
Show Notes: Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Avital O’Glasser MD, FACP, SFHM
Technical Production: Pod Paste
Reviewer: Sai S Achi, MD MBA
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Angela Selzer, MD

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Full transcript HERE

#364 Screening for syphilis: A USPSTF Update with Dr. Katrina Donahue Nov 02, 2022

We ran the numbers, and it’s still important!
Should patients be screened for syphilis? If so, which ones? Dr. Katrina Donahue (USPSTF) talks us through this re-affirmation of the USPSTF syphilis screening guideline, including who might be high risk and how to screen them.
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Credits

Producers: Elena Gibson, MD and Paul Williams MD, FACP
Writer: Elena Gibson, MD
Show notes: Paul Williams MD, FACP
Infographic and Cover Art: Elena Gibson, MD
Hosts: Paul Williams MD, FACP and Elena Gibson MD
Production team: Podpaste
Guest: Katrina Donahue MD

Full Transcript HERE

#363 Afib: Rhythm Control, Catheter Ablation, Afib in the hospital, and Left Atrial Appendage Closure Oct 31, 2022

Optimize and update your approach to atrial fibrillation (afib) as we discuss early rhythm control, antiarrhythmic drugs, TTE/cardioversion, afib ablation, new onset afib in the hospitalized patient, and left atrial appendage closure. Plus, we try to answer, Does afib burden matter? Our guest is cardiologist-electrophysiologist, Hugh Calkins MD, @hughcalkinsMD, Professor of Cardiology at Johns Hopkins, @hopkinsheart.
Sorry, but we won’t be offering CME for this episode. You can claim CME for past episodes at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak; Definitions
An approach to new-onset afib in the office
Rhythm control
Lifestyle modification is a pillar of afib treatment
Indications for hospitalization in afib
More on rhythm control and when to pursue afib ablation
Rhythm control in heart failure
New onset afib in the hospitalized patient
Does afib burden matter?
Left atrial appendage closure
Watto and Paul recap what we’ve learned
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover art and Infographic by:
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Hugh Calkins MD

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Full transcript HERE

#362 Migraine Headaches, Acute Hypoxemia: A rapid review (TFTC) Oct 26, 2022

Recap and review the top pearls from recent episodes #341 Migraine Headaches Update and #350 Acute Hypoxemia with Watto and Paul. 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 #341 and #350!

Show Segments

Intro, disclaimer, guest bio
Migraine Headaches Update
An approach to Hypoxemia
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

#361 Advanced Lipidology Oct 24, 2022

Lipids Update 2022: Cardiovascular Risk Reduction and New Medications on the Horizon with Erin Michos, MD
Show description:
Ready to take the next step in management of your patient with hyperlipidemia? Dr. Erin Michos (@erinmichos) returns to give us a lesson in Advanced Lipidology. She updates us on what new medications we can use for those difficult to treat lipids and what medications are on the horizon.
Unfortunately, this episode will not be available for CME. You can claim free CME for other episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro, Getting to know Dr. Erin Michos, Pick of the Week
Patient Case, Digging into ASCVD Risk
Coronary artery calcium scoring - why it’s important
What are “Risk Enhancing Factors”?
Biomarker testing, what is the significance of Lip a and how can we use it to drive management?
Introduction to PCSK9 inhibitors
More than just statins - other LDL-lowering medications
siRNAs, ASOs - Pelacarsen and more
Apollo Trial regarding Pelacarsen
Importance of Family History
What to do if maxed out on a statin or statin intolerance - Ezetimibe, PCSK9 inhibitors, MAB therapies, and more
Bempedoic Acid discussion
Medication side effects
Homozygous FH - approach to treatment, ANGPTL3 inhibitors
Triglycerides discussion, icosapent ethyl, the REDUCE-IT trial
Wrap-up and Take home points, Outtro

Credits

Producer and written by: Christopher Chiu MD, FACP, FAAP
Show Notes: James Antaki MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChB, DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Erin Michos MD, MHS

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Full transcript HERE

#360 Disease-Modifying Nutrition with Dr. Michelle McMacken Oct 17, 2022

The treatment your patients need but may not be getting!
Take a bite out of our latest episode featuring guest expert Dr. Michelle McMacken (@DrMcMacken) and learn how you can help your patients effectively and sustainably reap the health benefits of improved nutrition. Discover the enormous evidence base for nutritional recommendations, develop scripts to engage patients, and update your CVD, T2DM, and hyperlipidemia treatment plans to meaningfully incorporate nutrition. Get your truffle-hunting outfit on, it’s time to go foraging for some tasty knowledge food!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, favorite advice
Case from Kashlak; definitions
“Evidence-based nutrition” vs plant-based diet
Unifying the guidelines for patient care
Treating the skeptical patient
Tailoring recommendations to patients’ needs
Treating the motivated patient
Host questions
Outro

Credits

Written and Produced by: Deep Shah MD
Show Notes: Sarah Phoebe Roberts, Deep Shah MD
Infographic and Cover Art: Lyan Chang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deep Shah MD
Reviewers: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Michelle McMacken MD, FACP, DipABLM

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Super foods handout
Full transcript HERE

#359 Monkeypox with Dr. Boghuma Titanji Oct 10, 2022

Master the latest knowledge on the ongoing monkeypox outbreak with Dr. Boghuma Titanji (@Boghuma)! Learn how to recognize monkeypox in the clinic, how to test for monkeypox, how to approach management (including options for antiviral agents), and more.
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak
History of monkeypox - past and current outbreaks
Transmission of monkeypox
Risk factors for monkeypox
Clinical presentation of monkeypox
Testing for monkeypox
Management of monkeypox: supportive care and antivirals
Monkeypox in patients with HIV
Monkeypox in pregnancy
Monkeypox vaccines
Outro

Credits

Producer and Writer: Paul Williams MD, FACP
Show Notes: Malini Gandhi
Infographic: Sarah Phoebe Roberts
Cover Art: Kate Grant MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Boghuma Titanji MD

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Full Transcript HERE

#358 Oncologic Emergencies with Dr. Aditi Singh Oct 03, 2022

From Cord Compression to Tumor Lysis Syndrome
Do you freak out over oncologic emergencies like cord compression or tumor lysis syndrome? Join Dr. Aditi Singh (University of Pennsylvania, Abramson Cancer Center, @AditiSinghMD) for this comprehensive conversation on six commonly encountered oncologic emergencies we see in the hospital!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Cord Compression
SVC Syndrome
Malignant Obstruction
Tumor Lysis Syndrome
Blast Crisis
Outro

Credits

Producer, Writer, Hosts: Meredith Trubitt, MD MPH; Monee Amin, MD
Infographic and Cover Art: Caroline Coleman
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Aditi Singh, MD

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Full Transcript HERE

#357 Hotcakes: Ultra-short Antibiotics for Pneumonia, Acetazolamide for CHF, Psilocybin for AUD, and Asymptomatic Kidney Stone Removal Sep 28, 2022

Find out if ultra-short course (two days) antibiotics work for pneumonia, if acetazolamide improves diuretic efficiency in acute decompensated heart failure, should we prescribe psilocybin (magic mushrooms) to treat alcohol use disorder, and if removal of asymptomatic kidney stones decreases the incidence of future events! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto) catch up on recent practice-changing articles and guidelines!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer
Ultra-short Antibiotics for Pneumonia,
Acetazolamide for acute heart failure exacerbations,
Psilocybin for AUD,
Asymptomatic Kidney Stone Removal
Outro

Credits

Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste
Full transcript HERE

#356 Chronic Obstructive Pulmonary Disease (COPD) Update with Dr. Antonio Anzueto Sep 26, 2022

Brush up on your COPD skills and learn some new tips for diagnosis and management of this common respiratory condition from our expert Dr. Antonio Anzueto (University of Texas San Antonio).
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Epidemiology
Diagnosis
Workup
Characterization of disease
Treatment
Outro

Credits

Writer and Producer: Cyrus Askin, MD
Show Notes: Deborah Gorth MD, PhD
Infographic: Kate Grant MD
Cover Art: Kate Grant MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Antonio Anzueto, MD

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Full Transcript HERE

#355 GI Bleed with Dr. Tanvi Dhere Sep 19, 2022

Upper and Lower GI Bleed Diagnosis and Management
Handle the gush of upper and lower GI bleeds with ease thanks to Dr. Tanvi Dhere (@DhereMdEmory)! Learn diagnosis, initial management as well as post-procedure management including when to resume anticoagulation and antithrombotic therapy.
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak;
Upper GI bleed
Labs, Stool Studies
Initial Management of GI bleed
Endoscopy
Post-procedure management
Lower GI bleed
Colonoscopy
Imaging/Interventional Radiology
Outro

Credits

Producers and Writers: Meredith Trubitt MD, MPH; Monee Amin MD
Show Notes: Monee Amin, MD
Infographics and Cover Art: Caroline Coleman, MD
Hosts: Meredith Trubitt MD, MPH; Monee Amin MD
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Tanvi Dhere, MD
Sponsor: Birch

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Sponsor: Medmastery

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Sponsor: Indeed

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Full Transcript HERE

#354 Curbsiders Women in Medicine: Top 5 Challenges Faced by Women of Color in Academic Medicine Sep 14, 2022

We’re back with another women in medicine episode– this time Shreya and Leah interview their she-ro Dr. Kemi Doll, career coach extraordinaire to women of color in academic medicine. She is breaking down the biggest challenges she’s seen her clients face and how to tackle them!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Dr. Doll’s journey into coaching women of color in academic medicine
Top 5 challenges faced by women of color in academic medicine
Solutions to the challenges
Outro

Credits

Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD
Infographic and Cover Art: Shreya Trivedi, MD
Show Notes: Leah Witt, MD
Hosts: Leah Witt, MD, Shreya Trivedi, MD and Matthew Watto MD, FACP
Associate Editor: Emi Okamoto, MD
Showrunners: Leah Witt, MD and Shreya Trivedi, MD
Technical Production: PodPaste
Guest: Kemi Doll, MD

Full transcript HERE

#353 Colon Polyps Sep 12, 2022

Polyps, polypectomy & surveillance with Dr. Jennifer Maranki
Learn how to recommend a good bowel prep, read colonoscopy reports, and review recommended polyp surveillance with Dr. Jennifer Maranki, @jenmarankimd (Penn State Health)
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; definitions
Polyp definitions and categories
Bowel prep & colonoscopy quality
Colorectal polyp surveillance
Potential complications
When to consider polyposis syndromes
Outro

Credits

Producer & Writer: Elena Gibson MD
Show Notes: Elena Gibson MD
Infographic & Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Jennifer Maranki MD

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Full Transcript HERE

REBOOT #49 Vertigo and Dizziness: How to Treat, Who to Send Home, and Who Might Have a Stroke Sep 05, 2022

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here.
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Show Segments

Intro, Getting to know our guest
Clinical Case
Why can’t patients describe their dizziness?
Classifying dizziness
The 3 vestibular syndrome buckets defined
Episodic vestibular syndrome differential diagnosis
Acute vestibular syndrome differential diagnosis
Chronic vestibular syndrome differential diagnosis
Challenges of medical history taking
Approach to the acute vestibular syndrome/HINTS
How to evaluate nystagmus
How to perform the head impulse test (aka head thrust)
How to perform “test of skew” (alternate cover testing)
Recap of HINTS exam and discussion of MRI
Signs and symptoms of cerebellar stroke
Use of Dix-Hallpike for episodic vertigo
What happens when you choose the wrong test
Continuous versus triggered dizziness, or vertigo
Meclizine use in BPPV
How to cure horizontal canal BPPV
Treatment for vestibular neuritis
Treatment for Meniere’s disease
Who benefits from vestibular rehab/exercises
Dizziness and giddiness
Take home points
Outro

Credits

Produced and Written by: Cyrus Askin MD
Show Notes: Matthew Watto MD
Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: David Newman-Toker MD, PhD

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#352 H. pylori and Obesity Medicine FAQ: A rapid review (TFTC) Aug 31, 2022

Recap and review the top pearls from recent episodes #322 H. Pylori and #324 Obesity Medicine FAQ with Watto and Paul. 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 #322 and #324!
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Show Segments

Intro, disclaimer, guest bio
H. pylori
Obesity Medicine FAQ
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

REBOOT #284 An Antibiotics Primer, with @IDdocAdi Aug 28, 2022

On this Curbsiders classic, we discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)! This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! Original show notes here.
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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

Credits

Produced and Written by: 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

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#351 Live! Foot and Ankle Pain with Dr. Joan Ritter Aug 22, 2022

The Thrill of Victory and the Agony of the Feet
Don’t fear foot pain! Learn how to evaluate the painful foot and ankle, what needs imaging, and who needs rehab. We are joined by Dr. Joan Ritter (Walter Reed National Military Medical Center) for a special live Curbsiders episode!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Relevant anatomy
Ankle sprains
Achilles tendon rupture and tendonitis
Plantar fasciitis
Posterior tibial tendon dysfunction
Midfoot pain
Morton’s neuroma
Audience questions
Outro

Credits

Writer and Producer: Paul Williams MD, FACP
Show Notes and Infographic: Paul WIlliamsMD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Joan Ritter MD

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Fully Transcript HERE
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.

#350 Rapid Response Series: Acute Hypoxemia Aug 15, 2022

Diagnosing & Managing Acute Hypoxemia with Nick Mark MD
Quick! Your patient is desaturating! Have no fear, for in this installment of our Rapid Response series we have recruited pulmonologist/intensivist extraordinaire, the great Dr. Nick Mark of ICU One Pager, to share with us all the pitfalls and pearls we need to have under our collective belt when it comes to understanding, managing, and considering the etiologies of acute hypoxemia!
Free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Definitions
How does a pulse oximeter work?
Clinical approach to hypoxemia
The SIX causes of hypoxemia
Delivering supplemental oxygen

Credits

Written and Produced by: Cyrus Askin MD & Edison Jyang MS4
Infographic and Cover Art: Edison Jyang MS4
Show Notes: Cyrus Askin, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste

Guest: Nick Mark MD

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Full Transcript HERE
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.

#349 Hotcakes: Tirzepatide for weight loss, Personalized Antidepressants, Seasonal Edema, Nirmatrelvir for low-risk COVID-19 Aug 08, 2022

Find out how tirzepatide might revolutionize weight loss, pharmacogenomics might improve antidepressant prescribing, seasonal edema affects Google searches, and whether nirmatrelvir/ritonavir helps standard-risk patients with COVID-19, and patient-centered recommendations for inpatient care from SHM/Choosing Wisely! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, Picks of the Week
Case from Kashlak; Definitions
Tirzepatide for weight loss
Pharmacogenomics for personalized antidepressants
Seasonal Edema
Nirmatrelvir/ritonavir for standard-risk COVID-19
Hospital Medicine Choosing Wisely recommendations
Outro

Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste

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Full Transcript HERE
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.

#348 Myositis and Myopathy, LIVE! Aug 01, 2022

Learn to recognize myositis and myopathy (aka the idiopathic inflammatory myopathies), perform the appropriate initial testing, whether or not statins and exercise are safe to continue, and how to partner with our subspecialist colleagues to treat these patients in primary care. Recorded LIVE at Johns Hopkins, we’re joined by Dr. Lisa Christopher-Stine, @DrLisaCS of @HopkinsMedicine, a rheumatologist and leading expert on myositis and myopathy!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
History and Exam
Workup for suspected myositis
Cancer screening
Safety of statin use and exercise
Our role in primary care
Audience Questions
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Andréa Perdigão
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Technical Production: Pod Paste
Guest: Lisa Christopher-Stine MD, MPH
Sponsor: Grammarly

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Full Transcript HERE
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.

#347 USPSTF Update: Aspirin for Primary Prevention of CVD Jul 27, 2022

Producer & Writer: Elena Gibson MD
Show Notes: Elena Gibson MD
Cover Art & Infographic: Elena Gibson MD
Hosts: Paul Williams MD, FACP; Elena Gibson MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: John Wong, MD

Sponsor: Medmastery

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Full Transcript HERE

#346 Meningitis Jul 25, 2022

There’s nothing that gets a hospitalist more anxious and excited at the same time than a case of suspected meningitis. In this episode, we learn that if the thought crosses our mind, a lumbar puncture is almost certainly indicated. Our guest, Dr. Payal Patel, helps us with the balancing act that is diagnosing and managing meningitis!
Free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; history and physical
Initial workup for meningitis
Treatment choices and duration
Transitions of Care

Credits

Written and Produced by: Monee Amin MD, Meredith Trubitt MD, MPH
Infographic and Cover Art: Caroline Coleman, MD
Show Notes: Monee Amin, MD
Hosts: Matthew Watto MD, FACP; Monee amin,, MD
Reviewer: Rahul Ganatra, MD MPH
Executive Producer: Karly Loy
Showrunner: Matthew Watto MD, FACP
Editor: podpaste
Guest: Payal Patel, MD

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Full Transcript HERE
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.

#345 Vitamin and Mineral supplementation: A USPSTF Update with Dr. Michael Barry Jul 20, 2022

Can vitamins prevent CVD and cancer? We kind of don’t have the answer!
Is vitamin and mineral supplementation safe? Effective? Listen as our esteemed guest Dr. Michael Barry talks to us about the new United States Preventive Services Task Force recommendation regarding the role of vitamin and mineral supplementation in preventing cardiovascular disease and cancer.
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Credits

Producers: Paul Williams MD, FACP and Elena Gibson, MD
Writer: Paul Williams MD, FACP
Show notes: Paul Williams MD, FACP
Infographic and Cover Art: Elena Gibson, MD
Hosts: Paul Williams MD, FACP and Elena Gibson MD
Production team: Podpaste
Guest: Michael Barry MD
Full Transcript HERE

REBOOT #191 Lipids and Cardiovascular Risk Reduction with Erin Michos MD Jul 18, 2022

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow-up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! Get the original show notes here!
Prior lipid episodes: #37 Lipids, PCSK9, and ezetimibe: Lower is better. #10 Cholesterol, lipids, statins, fish oil. Become a Master Lipidologist.
Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro
Getting to know Dr. Erin Michos
Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel
Digging into ASCVD Risk Calculator
Who should get 10 year ASCVD Risk assessment and what are the categories?
How Dr. Michos discusses healthy lifestyle and “Primordial Prevention”
What are “Risk Enhancing Factors”?
Who should get biomarker testing vs CAC scoring?
How Dr. Michos discusses statin therapy with her patients
How to address risks of side effects
Primary vs Secondary Prevention
“What should my cholesterol be?”
How often to follow-up labs?
Differences between stain intensity
How to manage side effects
PCSK9 inhibitor discussion
Aspirin, Fibrates and Icosapent Ethyl
High Risk vs Stable ASCVD
Take home points and the future
Outro

Credits

Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli MD
Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA
Infographic: Beth “Garbs” Garbitelli MD
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP
Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Erin Michos MD MHS

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#344 Multiple Sclerosis with Dr. Annette Okai Jul 11, 2022

Recognize multiple sclerosis in the clinic, learn how to diagnose it, and partner with your neurology colleagues to help care for these patients. Dr. Annette Okai expertly walks us through multiple sclerosis (North Texas Institute of Neurology & Headache).
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Patient presentation
Physical exam
Labs and imaging
Pathophysiology
Treatment
Recognizing and treating relapses
Outro

Credits

Written and Produced by: Deborah Gorth MD, PhD
Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth
Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Annette Okai MD

Sponsor: Panacea Financial

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Full Transcript HERE
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.

Addiction Medicine Series #1 Methadone for OUD w/Dr. Ruth Potee Jul 07, 2022

Supercharge your knowledge on using methadone for the treatment of opioid use disorder! We discuss treatment goals, and how to start or continue methadone in the hospital. We’re joined by guest Dr Ruth Potee, addiction medicine physician, full-scope family medicine doc, feminist, and expert composter. She inspires us to be strong advocates for our patients.
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio 0:46
Guest one-liner 3:23
Case from Kashlak 5:00
Methadone for OUD 5:47
Methadone Dosing 16:35
72 hour Rule 25:35
What is a methadone clinic 31:00
Methadone Checklist 35:44
QTc Prolongation and Methadone 39:15
Confirming Methadone Dose 43:17
Managing Missed Methadone doses: 45:20
Outro 50:40

Credits

Producer, Writer: Kenneth Morford, MD
Show Notes, Infographic, Cover Art: Zina Huxley-Reicher, MD
Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD; Kenneth Morford, MD
Reviewer: Shawn Cohen MD
Showrunner: Carolyn Chan, MD
Technical Production: Castos
Guest: Dr. Ruth Potee

The Curbsiders Addiction Medicine are proud to partner with The American College of Addiction Medicine (ACAAM) to bring you this mini-series. ACAAM is the proud home for academic addiction medicine faculty and trainees and is dedicated to training and supporting the next generation of academic addiction medicine leaders. Visit their website at acaam.org to learn more about their organization.
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 #25 Master Hyperglycemia and DKA Jul 04, 2022

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn. Get the original show notes here!
Prior diabetes episodes: #330 & #331 Inpatient Diabetes with Dr. Dave Lieb #309 USPSTF Quick Update: Prediabetes & Type 2 Diabetes Screening #296 Diabetes FAQ with Dr. Jeff Colburn #243 Diabetes Triple Distilled #168 Diabetes Update with Jeff Colburn MD #96: Diabetes: A1C targets & ACP guidelines controversy #51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction
Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org!
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Show Segments

Intro
Rapid fire questions
Definitions and classification of diabetes
DKA in type 2 diabetes?
Pathophysiology of DKA
Severe hyperglycemia mislabeled as DKA
Which type 2 diabetics get DKA?
The cardinal issue is dehydration
Starvation ketosis vs DKA vs other
How to handle severe hyperglycemia in outpatients
Sick day management in type 1 diabetes
Initial testing for diagnosis of DKA
Subcutaneous or IV insulin for DKA
Initial evaluation and management in ER
Fluids and electrolyte management
SGLT2 inhibitors and euglycemic DKA

Credits

Writer, Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Stuart Brigham MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Jeffrey Colburn MD, FACP, FACE

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#343 Hypertension FAQ and Cardiorenal: A rapid review (TFTC) Jun 29, 2022

Recap and review the top pearls from recent episodes #321 Hypertension FAQ and #326 Cardiorenal Syndrome (NephMadness 2022) with Watto and Paul. 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 #321, and #326!
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Show Segments

Intro, disclaimer, guest bio
Hypertension FAQ
Cardiorenal syndrome
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

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Full Transcript HERE
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.

#342 Checkpoint Inhibitors: The power, and adverse effects, of immunotherapy (ACP 2022) Jun 27, 2022

With great power comes great immunogenicity. Learn about the ins and outs of immunotherapy–its indications, its power, and its adverse effects–in this episode with Dr. Christian Cable, hematologist/oncologist and medical educator extraordinaire. We learn a riveting history of immunotherapy and about how checkpoint inhibitors work, as well as the best practices for identifying downstream effects of checkpoint inhibitors and their immune system activation (it’s all about the -Itis!).
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Show Segments

Intro
What is Immunotherapy?
A History Lesson
Immune Checkpoint Inhibitors (ICIs)
Immune Related Adverse Events (irAEs)
Endocrine complications of checkpoint inhibitors
Rheumatologic complications of checkpoint inhibitors
Considerations before starting checkpoint inhibitors (and what labs to check)
Diagnosing and Managing irAEs
Common post-irAE questions
New Kids on the Block: CAR-T
Take Home Points

Credits

Written and Produced by: Nora Taranto MD
Hosted by: Molly Heublein MD; Nora Taranto MD; Paul Williams MD, FACP
Guests: Christian Cable MD
Show Notes: Nora Taranto MD
Cover Art: Andrea Perdigão
Infographics: Andrea Perdigão
Reviewer: Emi Okamoto MD, FACP
Production team: Pod Paste

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Full transcriptHERE
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

#341: Headache Update: Making Migraines Less Painful with Dr. Kevin Weber Jun 20, 2022

Dr. Kevin Weber @KwebMD (Ohio State University Wexner Medical School) takes the pain out of headache management! Have the confidence to prescribe new CGRP-antagonists and ditans for migraine prevention and acute relief. We also dive deep into when to order imaging and alternatives like infusions and devices.
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak Definitions
Imaging for headaches
Labs
Headache types
Acute Migraine Treatment
Ditans
Anti-cgrp medications
Prophylactic Migraine Treatment
CGRP antagonists
Devices
Take home points
Outro

Credits

Producer, writer, and show notes: Isabel Valdez PA-C
Infographic: Edison Jyang
Cover Art: Chris Chiu MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Chris Chiu MD
Reviewer: Molly Heublein MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Dr. Kevin Weber

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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.

#340 Gallbladder Disease Jun 13, 2022

Help your patients navigate gallbladder disease, including asymptomatic stones, incidental polyps, and uncomplicated cholecystitis. Dr. Rahul Pannala (@RahulPannala) talks us through how to diagnose biliary colic, what imaging to order, and what to anticipate for potential post-cholecystectomy complications (eg persistent pain or diarrhea). Feel confident in sending the right patients for cholecystectomy!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak; Definitions
Typical biliary pain
Imaging for cholelithiasis
Treatment for symptomatic gallstones
Post-cholecystectomy diarrhea and pain
Inpatient management of cholecystitis
Advanced imaging- HIDA scans and MRCP
Incidental gallbladder findings
Outro

Credits

Producer, Writer, Show Notes: Molly Heublein, MD
Infographic/Cover Art: Lyan Chang
Hosts: Molly Heublein, MD, Nora Taranto, MD; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Audio Engineer for this live episode: Chris Chiu, MD
Guest: Rahul Pannala, MD

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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.

#339 Hand and Wrist Pain with Dr. Ted Parks Jun 06, 2022

Intro, disclaimer, guest bio
Guest one-liner
Anatomy review: the thumb is the short one
Pathophysiology of De Quervain’s tenosynovitis
Physical examination for thumb pain
Management of DeQuervain’s and CMC arthritis
Pathophysiology of trigger finger
Management of trigger finger
Pathophysiology of carpal tunnel syndrome
Physical examination for carpal tunnel syndrome
Carpal tunnel syndrome management
Outro

Credits

Writer and Producer: Paul Williams, MD
Infographic and Cover Art: Paul Williams, MD
Hosts: Paul Williams MD and Molly Heublein, MD
Editor: Emi Okamoto, MD (written materials)
Guest: Ted Parks, MD

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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.

#338 LIVE! Medical Cannabis: Is it still dope? May 30, 2022

It’s high time we revisit the benefits and harms
Master the ins-and-outs of medical cannabis! Dr. Julia Arnsten (@DrArnsten) will lead us through the initial evaluation of a patient interested in medical cannabis, summarize the state of evidence for the benefits and harms, lay out a schema for dosing and formulations, provide pearls on how to counsel patients, and more!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Definitions and terminology
A brief history of medical cannabis
Case from Kashlak
History to obtain for a patient interested in medical cannabis
Medical cannabis dosing and formulations
Conditions for which the evidence supports considering medical cannabis
Risks of medical cannabis
Disparities in access to medical cannabis
Does medical cannabis reduce opioid use?
Outro

Credits

Producer and Writer: Matthew Watto MD, FACP
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt MD
Showrunner: Matthew Watto MD, FACP
Production Team: PodPaste
Guest: Julia Arnsten MD, MPH

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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.

#337 Palpitations, Erectile Dysfunction: A rapid review (TFTC) May 25, 2022

Recap and review the top pearls from recent episodes #320 Palpitations and #317 Erectile Dysfunction with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Palpitations: Diagnosis, Cardiac Monitors, Treatment, Patient Counseling
Erectile Dysfunction
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Edison Jyang
Technical Production: Pod Paste

Sponsor: Pattern

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#336 Updates in Addiction Medicine: Live from SGIM May 23, 2022

Learn from an expert panel in addiction medicine about a potpourri of fascinating topics, with updated data to guide clinical decision-making. We picked the brains of physicians Stefan Kertesz, Ximena Levander, Kenny Morford, and Katherine Mullins to learn about the latest updates in opioid tapering (don’t do it if there isn’t a good reason!), how to define recovery in alcohol use disorder, different options to treat methamphetamine use disorder, and Hepatitis C treatment in patients with active IV drug use. And there’s so much more, that we’re following this with a whole series in Addiction Medicine, set to come out in early July 2022!
Visit curbsiders.vcuhealth.org to claim CME credit for this episode.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro
Tapering long-term opioids
Perioperative buprenorphine management
Defining recovery in alcohol use disorder
The Fourth Wave
Treatment for methamphetamine use disorder
E-cigarettes for smoking cessation
Disparities in substance use disorder prevalence and treatment
Advocacy opportunities
Outro

Credits

Written and Produced by: Nora Taranto MD
Hosted by: Nora Taranto MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Guests: Stefan Kertesz MD MSc; Ximena Levander MD MCR FACP; Kenneth Morford MD FASAM; Katherine Mullins MD
Show Notes, Cover Art, Infographics: Nora Taranto MD
Reviewer: Molly Heublein MD
Production team: Pod Paste

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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.

#335 Generalized Anxiety Disorder May 16, 2022

Join us as we de-mystify the diagnosis, talk treatment strategies, parse through pharmaceutical options, and figure out follow-up in Generalized Anxiety Disorder with Dr. Dheepa Sekar (@DheepaSekarMD)! Anxiety disorders are one of the most common mental health concerns in our country and this episode will give you the tools to address it in clinic!
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Differential diagnosis for GAD
Counseling about diagnosis
Initial guidance on first-line management, apps for mindfulness
Prescribing basics, SSRI and SNRI considerations
Bridging with hydroxyzine and buspirone
Monitoring treatment response
Managing side effects
Tapering medication
Alternative agents, atypical antipsychotics, and benzos
Take Home points, Outro

Credits

Producer, Scriptwriter, Show Notes, Infographic/Cover Art: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Production Team: PodPaste
Guest: Dheepa Sekar MD

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Sponsor: Panacea Financial Visit panaceafinancial.com today to learn how a bank for doctors, by doctors can help you.
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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.

#334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI) May 09, 2022

Learn diagnostic and therapeutic management strategies for IBS, functional dyspepsia, and cyclic vomiting (aka disorders of gut brain interaction (DGBI))! It's like three episodes in one as we run through how to individualize evaluation and management for patients with functional dyspepsia, IBS, and cyclic vomiting. Topics: scripts for counseling patients, the pathophysiology of DGBI, which diagnostic tests are necessary, pharmacologic and nonpharmacologic options, and even hypnotherapy?! We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic)
Claim free CME for this episode at curbsiders.vcuhealth.org!
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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions (6:20)
Definition of Disorders of the Gut-Brain Interaction (7:30-11:00)
Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments (24:30-36:00)
Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00)
Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11)
Take home points
Outro

Credits

Producer: Elena Gibson MD
Writer:Andréa Perdigão, Elena Gibson
Show Notes and Infographics: Andréa Perdigão
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Dr. Xiao Jing (Iris) Wang MD

Sponsor: Ten Thousand

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Sponsor: Pattern

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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.

#333 Prescribing pearls, Periop Medicine, PMR, Gout, OSA, Nocturia, Food as Medicine, a new Obesity paradigm, and rethinking Afib! ACP #IM2022 Highlights May 06, 2022

We recap the top pearls from ACP #IM2022 including important drug interactions/intolerance (acetaminophen, tramadol, ticagrelor, nirmatrelvir-ritonavir), perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS), recognizing PMR, when to initiate urate-lowering therapy in gout, glucocorticoid-induced osteoporosis, food as medicine, dietary potassium, OSA, nocturia, telemedicine and health equity, a new obesity medicine paradigm, advances in HIV/PrEP, and rethinking atrial fibrillation!
Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments

Intro
Tapering long-term opioids
Physician Wellbeing
Common drug interactions (acetaminophen, ticagrelor, tramadol, Nirmatrelvir-ritonavir)
Perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS)
Nocturia and OSA
Food as Medicine
Rheumatology (how to diagnose PMR, when to initiate ULT for gout and steroid-induced osteoporosis)
Avi’s pearls on (diversity, telemedicine, telehealth, burnout)
Obesity medicine (a new paradigm and a new medication)
HIV in primary care (PrEP, long-acting injectable antiviral therapy)
Atrial fibrillation
Outro

Credits

Written, Produced, and Hosted by: Nora Taranto MD; Molly Heublein MD; Chris Chiu MD, FACP, FAAP; Avital O’Glasser MD, FACP; Alan Dow MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Chris Chiu MD, FACP, FAAP
Production team: Pod Paste

Sponsor: Indeed

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

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

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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

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

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Sponsor: Grammarly

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

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

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

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Sponsor: Indeed
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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

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

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

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

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: BetterHelp Visit betterhelp.com/curb for 10% of your first month.
Sponsor: MedMastery Visit 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

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

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REBOOT #145 Hepatorenal Syndrome Mar 28, 2022

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

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REBOOT #146 Pain Meds in CKD Mar 21, 2022

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:

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#326 Cardiorenal Syndrome, Biomarkers, Diuretic Resistance (NephMadness 2022) Mar 14, 2022

Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more. This episode is part of our first ever NephMadness Pod Crawl, so check out the other podcasts, and fill out your NephMadness 2022 brackets!
Credits

Producer, Writer, Show Notes, Infographics: Malini Gandhi
Cover Art: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD

Intro, disclaimer, guest bios
Guest one-liners, Introduction to Nephmadness 2022
Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine
Definition and pathophysiology of cardiorenal syndrome
Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome
Case #2 from Kashlak: the creatinine bump with diuresis
Approach to the creatinine bump with diuresis
Tips for the volume exam
Interpreting cardiac biomarkers in patients with chronic kidney disease
Case #3 from Kashlak: diuretic resistance
Maximizing loop diuretic efficacy
Sequential nephron blockade
Use of hypertonic saline
Outro

NephMadness 2022 Pod Crawl

Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast
Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders
Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com
Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/
Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered
Twitter: @thecurbsiders @TheCribsiders @NephJC_Podcast @drs_washington @upmynursinggame @medmyths

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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.

#325 Hotcakes: Fluid Wars revisited, Sleep & Weight Loss, Vitamin D, Pneumonia and HBV Vaccine Updates Mar 07, 2022

Find out whether balanced solutions beat saline in the ICU (fluid wars revisited), how sleep affects weight loss and calorie intake, whether or not Vitamin D can prevent autoimmune disease, new guidelines for pneumonia and hepatitis B (HBV) vaccination, and the utility of ultrasound to measure JVP! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Reviewer: Matthew Watto, MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!
Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb
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Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.
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.
Show Segments

Intro, picks of the week
Fluid wars: balance solution vs saline
Sleep and energy intake, weight loss
Vitamin D to prevent autoimmune disease
New ACIP guidelines for Pneumonia and Hepatitis B (HBV) vaccines
Ultrasound for JVP
Outro

NephMadness 2022 Pod Crawl is coming! Mar 05, 2022

Resuscitate your inner nephrology nerd with a bolus of kidney themed podcast episodes in the first annual NephMadness Pod Crawl featuring topics like cardiorenal syndrome, hemodialysis, chronic kidney disease (CKD), neonatal AKI, and inequalities in nephrology! The pod crawl starts Monday March 14, 2022 with The Curbsiders Cardiorenal episode and continues all week! See the schedule below, check out the other podcasts in the pod crawl, and fill out your brackets for NephMadness 2022 #nephmadness #NephPodCrawl
Pod Crawl Release schedule: Mon 3/14: The Curbsiders - Cardiorenal Syndrome. Listen on Apple or Spotify. Website: https://thecurbsiders.com
Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast
Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders
Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com
Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/
Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered

#324 Obesity Medicine FAQ Feb 28, 2022

Learn how to prescribe affordable, effective medications for obesity medicine! We discuss metformin, naltrexone, bupropion, phentermine, topiramate, GLP1 agonists, and how to counsel patients about the available weight loss modalities. Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital helps reframe our approach as she walks through these Obesity Medicine FAQs. Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long!
Claim free CME for this episode at curbsiders.vcuhealth.org!

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

Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C
Show Notes, Infographics: Maddison McLellan
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Monee Amin, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Fatima Cody Stanford, MD

Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount: use code IM22CURB. Visit annualmeeting.acponline.org to learn more.
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Sponsor: MedMastery Listers are eligible for a lifetime 15% off discount on subscription if you go to https://www.medmastery.com/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 and search for this episode to claim credit.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner by Dr. Fatima Cody Stanford
Case from Kashlak
Guidelines for treatment
Getting the history and discussing weight goals
The Care Team: Dietician, Behavioral Specialist, Provider
Medications: Phentermine, Topiramate, Bupropion, Naltrexone
Obesity treatment in pregnancy
Referring to bariatric surgery
Take home points
Outro

#323 Pelvic Pain, Constipation, Long COVID (TFTC) Feb 23, 2022

We recap the top pearls on pelvic pain, constipation, and Long COVID. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.
Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for shows #311, #314, and #315atcurbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

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

Sponsor: Birch Birch is giving 200 dollars off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb
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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.
Show Segments

Intro, disclaimer, guest bio
Pelvic Pain
Constipation
Long COVID
Outro

#322 H. Pylori Infection Feb 21, 2022

Say hi and bye to H. pylori infections! We review the basics of H. pylori screening, refresh your memory on testing basics, discuss treatment strategies, and talk through eradication testing with gastroenterologist Dr. George Saffouri (@gbsaff).
A special thanks to our listener Ana Maria Keilhauer Varona (@KeilhauerMa) of @UFMedu who pitched this episode. Her hard work formed the basis for our script!
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Pitch Writer and Initial Script: Ana Maria Keilhauer Varona
Producer, Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli
Script Co-Writer: Elena Gibson, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: George Saffouri, MD

Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.
Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb
Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain.
Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.
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.
Show Segments

Intro, disclaimer, pitch contest winner, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Conceptualizing gastritis vs. dyspepsia
When to screen for h.pylori
Gastric cancer and h.pylori infection
Cultural competency in screening
Other indications for h.pylori testing, ITP and h.pylori
How to test
Treatment modalities
Eradication testing, persistent infection

#321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen Feb 14, 2022

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Writer: Matthew Watto, MD, FACP
Producers: Matthew Watto, MD, FACP and Malini Gandhi
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Jordy Cohen MD

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

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Sponsor: Stamps.com
Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Just go to Stamps.com, click the microphone at the top of the page, and enter code CURB.
Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain.
Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!
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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak: New diagnosis of hypertension
How to make a diagnosis of hypertension
When to start anti-hypertensive medication
Initial blood pressure regimen
Case from Kashlak: White coat hypertension
Case from Kashlak: Hypertension in chronic kidney disease
ACEis and ARBs in chronic kidney disease
Diuretics in chronic kidney disease
Case from Kashlak: Refractory hypertension
History and initial workup for refractory hypertension
Treatment of primary hyperaldosteronism
Outro

#320 Palpitations with Dr. Joshua Cooper Feb 07, 2022

When should you fold or Holt onto your cards for palpitations? Learn about properly characterizing a patient’s palpitations, red flag symptoms, when to grab an echocardiogram and/or heart monitoring, and when certain “benign” ECG findings can be concerning. We’re joined by the director of cardiac electrophysiology at Temple University Hospital, Dr. Joshua Cooper (@narrowQRS) for this episode chock full of cardiac pearls to make your heart skip a beat.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Producer, Show Notes, Infographic, and Cover Art: Edison Jyang
Producer: Paul Williams MD, FACP
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: Joshua Cooper MD

Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb
Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.
Sponsor:Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.
Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.
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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Defining what the patient means by palpitations
Common causes and misdiagnoses
Red flag symptoms
Exposures and medications to consider
Sinus tachycardia
Workup for palpitations
Monitors
Script for a negative workup
Premature ventricular contractions
Outro

#319 Hotcakes: Afib, Chlorthalidone in CKD, Outpatient COVID Treatment Update Jan 31, 2022

Fill up your plate with a fresh stack of 2022 hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto help catch us up recent practice-changing articles and guidelines including patient-directed interventions in atrial fibrillation, the utilization of chlorthalidone in advanced CKD, and updates on outpatient COVID treatment.
Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH, Matthew Watto, MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

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Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!
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Sponsor: Provider Solutions & Development 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
Picks of the week, Listener Email
I-STOP Afib
Chlorthalidone in CKD
Outpatient COVID Treatment Update
Outro

#318 LUTS, BPH, and Urinary Incontinence Triple Distilled Jan 26, 2022

Master urinary tract symptoms! Paul and Matt recap, review, and update past episodes on BPH and urinary incontinence so you’ll be able to confidently manage lower urinary tract symptoms (LUTS) in primary care. Topics: categorizing urinary incontinence, lifestyle modifications for LUTS, nonpharmacologic & pharmacologic therapies for urinary incontinence and BPH, plus when to refer to surgery.
Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows!
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
Infographic by: Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: M3 Global Research To join M3 Global Research’s panel, go to M3research.info/curbsiders! Complete registration before Feb 28, 2022 for a $10 welcome bonus!
Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.
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. There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows!
Show Segments

Intro, disclaimer, guest bio
Urinary incontinence diagnosis, management
BPH diagnosis, management
Outro

#317 Erectile Dysfunction for Primary Care Jan 24, 2022

Listen as our expert guest Dr. Ashley Winter @AshleyGWinter (Northwest Kaiser Permanente, Portland, OR) helps us explore the spectrum of erectile dysfunction management for the internist and primary care clinician. This episode will empower you to provide evidence based, patient-centered care to erectile dysfunction while maintaining an astute and holistic diagnostic approach. We also explore treatment and patient counseling techniques.
Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Hannah R. Abrams, MD
Infographic and Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Show Notes: Hannah R. Abrams, MD; Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Hannah R. Abrams, MD
Reviewer: Molly Heublein, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Ashley Winter, MD

Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders
Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content.
Sponsor: SquareSpace
Go to squarespace.com/curb to save 10% off your first purchase of
a website or domain!
Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.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 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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Defining ED
Additional history, exam, and labs
How to talk about ED
Addressing ED for transgender and nonbinary patients
Treatment of ED
Advanced therapies and referral
Take Home Points; Outro; Bonus clip

#316 Lower Extremity Edema with The Curbsiders Jan 17, 2022

We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and produced by: Paul Williams, MD, FACP
Infographic and Cover Art: Matthew Watto, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto, MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Stamps.com Sign up with promo code CURBfor a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts.

Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb
Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.
Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.
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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.
Show Segments

Intro, disclaimer
Picks of the Week*
The case of Lynn Fedema
Pathophysiology of edema
Differential diagnosis of chronic edema
Chronic edema work-up
Management of chronic edema
Calvin Fedema and acute edema
Evaluation of acute edema
Outro

#315 Long COVID Jan 10, 2022

Explore the actively evolving clinical landscape of Long COVID as we discuss epidemiology, pathogenesis, manifestations, and patient-centered management options including the role of a dedicated Long COVID clinic.
Listen as our expert guest Dr. Monica Verduzco-Gutierrez @MVGutierrezMD (Long School of Medicine at UT Health, San Antonio) helps us navigate this rapidly emerging syndrome. This episode will empower you to provide evidence based, patient-centered care for this challenging facet of the ongoing COVID-19 pandemic. We explore the manifestations including fatigue, dyspnea, psychiatric symptoms, and other neurologic effects. We also examine the emergence of dedicated Long COVID clinics and the imperative of interdisciplinary care.
Update: The original version of this episode contained a brief, but incorrect characterization of mast cell disorders that was subsequently removed after feedback from our allergy/immunology colleagues. We apologize for this inconvenience and thank our colleagues for their peer review.
Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Avital O’Glasser MD, FACP, SFHM
Infographic: Edison Jyang
Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Show Notes: Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, SFHM
Reviewer: Hannah Abrams, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Monica Verduzco-Gutierrez, MD

Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB
Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.
Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.
Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.
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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case 1 from Kashlak
Definition of Long COVID or post-COVID symptoms
Pathogenesis of Long COVID
Illness script for mast cell activation
Epidemiology and risk factors for Long COVID
Interdisciplinary care for Long COVID
Illness script for POTS-like phenotype in Long COVID
Illness script for chronic fatigue syndrome/myalgic encephalomyelitis in Long COVID
Management of fatigue and post-exertional malaise (PEM)
Case 2 from Kashlak
Neuropsychiatric manifestations of Long COVID
Anosmia and smell training
Role of the patient voice and community in Long COVID
Disability assessments and management
Take Home Points; Outro; Bonus clip

#314 Constipation: When the Flow Won’t Go with Dr. Iris Wang Jan 03, 2022

Move smoothly through constipation evaluation and management. Learn how to evaluate for the various etiologies of constipation including pelvic floor dysfunction, IBS-C and more with our esteemed guest Dr. Xiao Jing (Iris) Wang @IrisWangMD!
Claim free CME for this episode at curbsiders.vcuhealth.org!

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

Producer, Show Notes, Infographic & Cover Art: Elena Gibson MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Xiao Jing (Iris) Wang MD

Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content.
Sponsor: SquareSpace https://www.squarespace.com
Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/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 and search for this episode to claim credit.
Show Segments (Note: timestamps are without ads)

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week* (6:00)
Case from Kashlak; Definitions (11:00)
Physiology of a bowel movement (10:00)
Definitions (16:00)
Bowel Habit Review of Systems (17:00)
Rectal Exam (33:00)
Initial Constipation Evaluation
Common categories of constipation (43:40)
Additional evaluation of Constipation (52:00)
Treatment options (1:10:00)
Outro

#313 Recap Extravaganza 2021 Dec 30, 2021

We recap the top pearls from 2021, including celiac disease, kidney stones, SGLT2 inhibitors for weight loss & HFpEF, smoking cessation, buprenorphine for acute pain, metabolic alkalosis, nephrotic syndrome, bronchiectasis, obesity hypoventilation syndrome, acute diarrhea, osteoporosis, and diabetes. Plus, Paul and Watto express their gratitude to The Curbsiders family and look forward to 2022. Finally, it’s our annual recap extravaganza 2021 with guest host Chris “the Chiu Man” Chiu (@cjchiu), providing a rapid review of previous Curbsiders episodes for your spaced learning.
Special thanks to the whole Curbsiders team and our listeners for an incredible six years of podcasting!
Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.
Click here for full show notes
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; Christopher Chiu MD, FACP FAAP
Cover Art: Beth Garbitelli
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

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.
Show Segments

Intro
Garbs’ picks: Pelvic pain, smoking cessation
Addiction medicine pearls: Nicotine use disorder; Acute pain in OUD
Nephrology: Kidney stones, nephrotic syndrome, metabolic alkalosis
Cardiology: Peripheral arterial disease (PAD), SGLT2 inhibitors for HFpEF
Pulmonology: Bronchiectasis, OHS
Gastroenterology: Celiac disease, Liver test abnormalities
Bariatric Medicine: Semaglutide for weight loss; bariatric surgery
Endocrinology: Osteoporosis; Diabetes FAQ
Outro

#312 Infective Endocarditis Dec 27, 2021

Master endocarditis! Don’t feel thwarted by a positive set of blood cultures. We’re joined by Dr. David Serota (@serotavirus) for a comprehensive discussion of the pathophysiology of infective endocarditis, frameworks for work-up and diagnosis, the TTE vs. TEE debate, indications for valve surgery, antibiotic tips, harm reduction strategies, and more!
Claim 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: Adam Barelski MD
Show Notes: Beth Garbitelli; Adam Barelski MD
Infographic: Adam Barelski MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Adam Barelski MD
Reviewer: Meredith Trubitt, MD
Executive Producer, Cover Art: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: David Serota MD

Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.
Sponsor: Southern California Permanente Medical Group Want to make a difference in a community that appreciates your passion and expertise? Then join SCPMG as an Outpatient Internal Medicine Physician. Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684.
Sponsor: P3 P3 is a revenue cycle management provider that takes over your workload for claim submissions, and denial management. P3 is offering a 10% discount on all invoices for a limited time period. Visit www.p3care.com/curb and avail your offer today!
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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
What to do with positive blood cultures
Initial workup for endocarditis
How to diagnose endocarditis
When to get a TTE and a TEE
Indications for valve surgery
Antibiotic tips
Oral vs IV antibiotics
Treatment considerations for patients who inject drugs
Take-home points
Outro

#311 Chronic Pelvic Pain Dec 20, 2021

Pelvic pain is not just a gyn issue! As a PCP, you can feel confident doing an initial workup and starting treatment for pelvic pain. Dr. Lamvu shares a great framework to narrow down your diagnosis and provides amazing resources for those who work in an under-resourced center. We’ll walk you through what to focus on in the history, a trauma-informed physical exam, and the first-line treatments. Feel confident with your ability to help your chronic pelvic pain patients.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Writers/Producer: Molly Heublein, MD
Infographic: Edison Jyang
Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Hosts: Beth Garbitelli, Molly Heublein, MD
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Georgine Lamvu, MD MPH

Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb
Sponsor: Locumstory Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine. Locumstory is your source for all things locum tenens! Check out their website, locumstory.com, for resources, FAQs, and more!
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.
Show Segments

Intro, disclaimer, guest bio
Guest introduction and recommendations
Picks of the Week
Case from Kashlak
Persistent Pelvic Pain Definitions
Differential diagnosis/organ system approach
History
Physical Exam
Trauma informed Care
First line Treatments
Resources for patient education and to build speciality team
Summary and take home points
Outro

Optimize your Feedback Conversations (TEACH ep. 1) Dec 16, 2021

Listen in as expert Dr Calvin Chou (UCSF) leads us through concrete tips to optimize your feedback dialogue with learners. We cover the importance of creating a relationship built on mutual goals of getting to our personal best, helping learners form SMART goals, the ARTful approach to a feedback conversation, ways to minimize bias, and you even get to hear Era role play!
This brand new weekly Curbsiders' mini-series, TEACH, is available on its own feed (Apple, Spotify) with new episodes every Tuesday.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Credits

Infographic: Andrew Delaat
Hosts, producers, writers: Era Kryzhanovskaya, MD; Molly Heublein, MD
Audio Editor: Clair Morgan of nodderly.com
Guest: Calvin Chou, MD

Sponsor: Masterworks
Masterworks uses data and technology to determine investment-grade works of art. Then they securitize them and allow anyone to invest in artwork at an affordable entry point. While making great art is difficult, investing in it is easier than ever. Go to masterworks.art/curbsiders to get started.
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.

Show Segments:

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week
Case from Kashlak
Definition of Feedback
Creating a relationship to give feedback
Helping learners set goals
ARTful approach
Giving feedback on hearsay
Reducing bias
Accepting feedback up the hierarchy
Outro

#310 No Tension About Inpatient Hypertension Dec 13, 2021

Don’t sweat inpatient hypertension any longer. Who needs guidelines when Dr. Noble Maleque (@nobility75, Emory University, Division of Hospital Medicine) explains the spectrum of hypertensive disorders in the inpatient setting, and an approach for thinking about treatment.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Production, Script, Infographic, and Cover Art: Monee Amin, MD, Meredith Trubitt, MD MPH
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Monee Amin, MD, Meredith Trubitt, MD MPH
Reviewer: Adam Barelski MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Noble Maleque MD

Sponsor: Panacea Financial
Join the growing number of doctors nationwide that expect more from their bank and have switched to Panacea Financial. Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Panacea Financial is a division of Primis, Member FDIC
Sponsor: Ten Thousand
Ten Thousand is offering our listeners 15% off your purchase! Go to tenthousand.cc and enter code CURB to receive 15% off your purchase!.
Sponsor: Locumstory
Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine. Locumstory is your source for all things locum tenens! Check out their website, locumstory.com, for resources, FAQs, and more!
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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Definitions
Case from Kashlak
Elevated blood pressure / hypertensive urgency
Contributing factors to elevated blood pressure in the hospital
Hypertensive urgency—to treat or not to treat
Transitions of care and case against intensification of treatment
Case from Kashlak
Hypertensive emergency diagnosis and treatment
Secondary Hypertension
Outro

Curbsiders TEACH is Coming Soon! Dec 07, 2021

Curbsiders Teach is THE internal medicine podcast for all things medical education. We use expert interviews to inspire the next generation of medical educators by providing listeners with teaching pearls, practice-changing knowledge, and a learning objective-based dosing of Edutainment (medical education, made entertaining).
This weekly mini-series will air every Tuesday starting December 14th, 2021 on our website or wherever you get your podcasts!
Subscribe on Apple Podcasts
Subscribe on Spotify
We are so excited to bring you this new series in the Curbsiders Family focusing on medical education. Molly Heublein, MD and Era Kryzhanovskaya, MD are your new hosts for the Curbsiders Teach- they are Clinician Educators with a passion for teaching.
Whether you precept students, teach small groups, are involved in curricular design, or give CME lectures, we think you’ll find valuable skills. We have the pleasure of interviewing a variety of amazing experts in topics ranging from bedside teaching, feedback conversations, learner mental health, and time-based competencies in medical education. We can’t wait to share their expertise with you!
Subscribe on Apple Podcasts
Subscribe on Spotify
Send questions or suggestions to thecurbsidersteach@gmail.com

#309 Prediabetes & Type 2 Diabetes Screening: A USPSTF Quick Update Dec 06, 2021

Sweeten your day with a review of the updated 2021 USPSTF Prediabetes and Type 2 Diabetes screening guidelines with expert guest Dr. Chien-Wen Tseng! We review the new screening recommendations, assess different testing modalities, talk through screening intervals, and emphasize other risk factors that impact screening!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Paul Williams MD & Elena Gibson MD
Cover Art: Beth Garbitelli
Hosts: Paul Williams MD, FACP; Elena Gibson MD
Reviewer: USPSTF Team
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Chien-Wen Tseng MD

Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: GreenChef The #1 Meal Kit for Eating Well! Go to GreenChef.com/curb10 and use the code curb10 to get 10 Free Meals including free shipping!
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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.
Time Stamps*

*Note: Time Stamps refer to ad free version.

Intro, disclaimer, guest bio: 0:33
Guest one-liner: 3:30
Picks of the Week: Sneaky pick at 3:00! Guest pick: 4:45
Case from Kashlak of Mr. Sugar: 5:30
Screening recommendations: 6:00
Testing modalities: 10:00
Possible harms of screening: 15:50
Screening intervals: 18:00
Prediabetes screening: 20:45
Other risk factors that impact screening: 26:30
Recap: 34:15
Outro: 36:25

#308 Metabolic Alkalosis and Hypokalemia: Kidney Boy Returns! Nov 29, 2021

@Kidney_Boy returns to school us on metabolic alkalosis and hypokalemia! What do diuretics, hyperaldosteronism, black licorice, and milk-alkali have in common? Our Chief of Nephrology, Dr. Joel Topf, talks through the pathophysiology of metabolic alkalosis, the utility of urine chloride and pH measurements, why normal saline is sometimes better than balanced solutions, when to reach for acetazolamide, and more! Urine for a good time ; )
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes, CME, Infographic and Cover Art by: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Joel Topf MD

Sponsor: ACP
Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.
Sponsor: Grammarly Take the stress out of getting the words right with Grammarly. Our listeners get 20% off Grammarly Premium 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 and search for this episode to claim credit.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Case of Al Kaline - metabolic alkalosis from vomiting
Pathophysiology of metabolic alkalosis
Case of Mike Arbonate - hypokalemic, metabolic alkalosis from aggressive IV diuresis and therapies to mitigate
Case of Fracture Franny - milk-alkali syndrome
Case of Hyper Al - metabolic alkalosis from excess mineralocorticoid receptor activation
Outro

#307 Spooky Tofurkey Cakes: SGLT2 for HFpEF, Diverticulitis, VTE update, Rotator Cuff Disease Nov 24, 2021

Fill up your plate with some spooky tofurkey cakes! Drs. Rahul Ganatra (@rbganatra) and Nora Taranto (@norataranto) help catch us up recent practice-changing articles and guidelines including EMPEROR-Reduced (SGLT2 inhibitors for HFpEF), the 2021 CHEST VTE guidelines update, whether or not antibiotics are needed for diverticulitis, and what treatments are most effective for rotator cuff disease!
Claim free CME for this episode at curbsiders.vcuhealth.org!

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

Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Beth Garbitelli
Hosts: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Birch by Helix

Birch is giving $200 off ALL mattresses and two free eco-rest pillows at BirchLiving.com/curb
Sponsor: BetterHelp

Get 10% off your first month at betterhelp.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 and search for this episode to claim credit.
Show Segments

Intro, disclaimer,
Picks of the Week
EMPEROR-Reduced (SGLT2 inhibitors for HFpEF)
GRASP trial for rotator cuff disease (physiotherapy and steroid injections)
DINAMO trial (no antibiotics for outpatients with uncomplicated diverticulitis)
2021 CHEST VTE Guidelines Update
Outro

#306 Bronchiectasis and NTM: You can’t get enough sputum! Nov 22, 2021

Take a deep breath and inhale high-yield knowledge molecules about the perplexing conditions known as bronchiectasis and NTM (nontuberculous mycobacteria)! Learn the pitfalls and pearls of diagnosis and management from one of the world’s experts, the great Dr. PJ McShane from UT Health - East Texas!
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Writers/Producers: Cyrus Askin MD; Leah Witt MD
Infographic & Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
Reviewer: PJ McShane MD
Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com
Guest: PJ McShane MD

Sponsor: Ten Thousand.
Ten Thousand is offering our listeners 15% off your next purchase! Go to https://www.tenthousand.cc and enter code: CURB to receive 15% off your purchase at checkout!
Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.
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.

Show Segments

Intro, disclaimer, guest bio
Guest introduction and recommendations
Case from Kashlak - Part I: The Basics
- What is bronchiectasis, how do we define it?
- Symptoms and history
- Why does it matter?
- What should you ask, how do you work this up?
- A brief discussion on antibiotics
Case from Kashlak - Part II: Getting into the Management
- Airway Clearance
Case from Kashlak - Part III: The Sputum (Plot) Thickens
- What is a bronchiectasis exacerbation?
- Pitfall and pearls regarding exacerbation management
Case from Kashlak - Part IV: The Sputum (Plot) Thickens Even Further!
- Non-tuberculous Mycobacterial Infections - the basics
- Triple Drug Therapy for MAC
- The new kid on the block: Liposomal Inhaled Amikacin for refractory MAC
Summary and take home points from Dr. McShane
Outro

#305 OB for the Internist: What to Expect Nov 15, 2021

What to expect when you’re taking care of a patient who’s expecting! This fantastic episode will help you work through preconception counseling with ease, assess and treat non-obstetrical acute concerns in pregnant patients, and help you conceptualize best practices for postpartum care. We are joined by expert guest Dr. Xiaolei Chen.
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Producer: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Show Notes by: Shelagh Browne
Cover Art and Infographic: Edison Jyang
Reviewer: Molly Heublein MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Xiaolei Chen MD

Sponsor: GreenChef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping!GreenChef.com/curb125
Sponsor: Need to hire? You need Indeed. Get started RIGHT NOW with a $75SPONSORED JOB CREDIT to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer valid through December 31st. Terms and conditions apply.
Sponsor: Provider Solutions & Development

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
Picks of the week
Preconception counseling
Lifestyle: caffeine, alcohol, exercise
Preconception medications
Management of acute complaints during pregnancy
Go-to medications for acute complaints during pregnancy
Chronic diseases during pregnancy
Postpartum management
Breastfeeding recommendations
Take-home points
Outro

#304 COVID Updates: The Outpatient Edition Nov 08, 2021

Who gets a COVID booster? Can we mix and match COVID vaccines? What are monoclonal antibodies and when should we use them? What is molnupiravir and does it work? Shots for kids? Ready yourself to answer these questions and more with our guest, Dr. Monica Gandhi @MonicaGandhi9.
Claim free CME for this episode at curbsiders.vcuhealth.org!

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

Producer and Writer: Isabel Valdez PA, Molly Heublein MD
Infographic: Edison Jyang
Cover Art: Edison Jyang, Isabel Valdez, PA
Hosts: Molly Heublein MD, Chris Chui MD, Isabel Valdez PA
Reviewer: Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Monica Gandhi MD

Sponsor: The American College of Physicians

Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.
Sponsor: Provider Solutions & Development

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 and search for this episode to claim credit.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Covid Boosters
Pfizer data
Moderna Data
DNA vaccines
Pediatric Vaccines
Monoclonal Antibodies
Molnupiravir
Dr Gandhi’s crystal ball
Outro

#303 Women in Medicine: Wellness & Workarounds Nov 01, 2021

Explore burnout and gender-based differences in well-being with our esteemed guests Drs. Clif Knight, Tammy Lin, and Kim Templeton. We discuss workarounds for leading our way to wellness.
Dr. Clif Knight is a family physician and Senior Vice President for Education at the American Academy of Family Physicians (AAFP) with extensive leadership and expertise in well-being.
Dr. Tammy Lin is an internal medicine specialist and a Voluntary Assistant Clinical Professor at the University of California, San Diego Health Sciences. We originally met her as a member of the Wellness through Equity and Leadership (WEL) Program and she started a podcast called "The DEI Shift" (pronounced The "Day" Shift), which focuses on diversity, equity, and inclusion within the medical field. Dr. Knight and Dr. Lin participated in the 2019-2020 WEL program-- six different specialty organizations came together to think about the core tenets of equity, well-being and leadership and how you really can’t have one without the other.

Dr. Kim Templeton is Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City. Her research focuses on women physicians and the inclusion of sex and gender medicine in medical education.
No CME for this episode, but claim CME for past episodes at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD
Infographic: Leah Witt, MD
Cover Art: Kate Grant MBChB MRCGP DipGUMed
Hosts: Matthew Watto MD, FACP; Leah Witt, MD, Shreya Trivedi, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Clif Knight, MD, Tammy Lin, MD, Kim Templeton, MD

Sponsor: Grammarly

Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB
Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.
Sponsor: Panacea Financial

Learn about their $1,000 giveaway at panaceafinancial.com/curb. Panacea Financial is a division of Primis member FDIC.
Sponsor: Provider Solutions & Development

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 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.

Show Segments

Intro, disclaimer, guest bios
Burnout & Wellness
The Case: Dr. Elizabeth Blackwell & her friend in primary care
The Part-Time Discussion
Outro

#302 LFTs Triple Distilled Oct 27, 2021

Fine-tune your approach to liver tests! It’s LFTs Triple Distilled! Paul and Matt channel the wisdom of hepatologist, Dr. Elliot Tapper (@ebtapper) to cover hepatocellular vs cholestatic vs mixed patterns, which tests to order, which ones to skip, how to handle isolated alkaline phosphatase elevation, mild, chronic ALT elevation, and even how to interpret liver test abnormalities in pregnancy.
Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #293 at curbsiders.vcuhealth.org!
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
Infographic by: Elena Gibson
Cover Art: Matthew Watto MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com

Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb

Sponsor: Locumstory Visit Locumstory.com to see if a locum tenens assignment is right for you.

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.

Show Segments

Intro, disclaimer, guest bio
Hepatocellular pattern
Cholestatic pattern
Chronic ALT elevation
Isolated Alkaline phosphatase elevation
Liver test abnormalities in pregnancy
Outro

#301 LIVE! Top Pearls 2021: A Rapid Fire Review of Systems Oct 25, 2021

Join us for this rapid fire review of systems featuring our top pearls and articles LIVE! from the TriService ACP conference. Matt and Paul serve up their favorite practice changing knowledge food on antibiotics, MRSA, hair loss, dementia, seizures, diabetes, medications for hypertension, foods for constipation, diverticulitis, colon cancer screening, colon polyps, chronic sinusitis, chronic cough, treatment of uterine bleeding, and more!
No CME for this episode, but check out curbsiders.vcuhealth.org for past CME offerings!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Sawyer Watto
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb.

Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay.

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.

Show Segments

Intro, disclaimer
ID: Shorter is better; MRSA swabs; Antibiotics for diverticulitis
Endo: Prediabetes in older adults,
MSK: Knee OA, orthopedic surgery
Derm: Alopecia
Neuro: Seizures, dementia quick typing
Cardio: Coffee and arrhythmias; Hypertension management, ACEi vs ARBs
Respiratory: Chronic cough and sinusitis
GI: CRC screening, foods for constipation
GU: treatment of uterine bleeding
Addiction Medicine: smoking cessation, buprenorphine
Outro

#300 Celiac Disease with Dr. Amy Oxentenko Oct 18, 2021

Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and understand diagnostic testing, management and proper follow-up for patients.
Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Production and Script: Matthew Watto MD, FACP
Production, Show Notes and Infographics: Edison Jyang
Cover Art: Kate Grant MBChB, MRCGP, DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Amy Oxentenko MD, FACG

Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay.

Sponsor: Grammarly 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 and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Definitions
Workup for a typical celiac patient
Nonclassical features of CD
When to do a small bowel biopsy
Management of CD
Considerations for atypical celiac patient and differentials
Non-celiac gluten sensitivity
Outro

Links

#299 Acute Pain Management for the Hospitalist Oct 11, 2021

Confidently manage acute pain in the hospital! In this episode listeners will learn how to develop a multimodal analgesia plan for acute pain in the hospital, as well as how to safely initiate and discharge a patient on opioids. We’re joined by Dr. Melissa Weimer @DrMelissaWeimer (Yale School of Medicine).
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer and Writer: Carolyn Chan, MD
Script: Carolyn Chan, MD, Avi O’Glasser, MD
Cover Art and Infographic: Edison Jyang
Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD
Reviewer: Emi Okamoto, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Melissa Weimer DO

Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay.

Sponsor: Green Chef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping!

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.

Show Segments

01:39 Intro, disclaimer, guest bio
03:20 Guest one-liner, Picks of the Week
09:18 Case from Kashlak; Definitions
11:00 Assessing Acute Pain
12:12 Types of Pain
15:08 Initiating Opioids
22:32 Counseling on Opioid Exit Strategy
25:26 Opioid Dependence vs. Opioid Use Disorder
29:50 Post-Op Pain Management
31:00 Other cool stuff
37:00 PCA
41:00 Opioid Taper
46:50 Acute Pain and Opioid Use Disorder
58:00 Methadone Titration
1:04:00 Outro

#298 Urinary Stone Disease Will Rock Your World Oct 04, 2021

Producer: Paul Williams MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Show Notes by: Shelagh Browne, Kate GrantMBChB MRCGP DipGUMed,
Cover Art and Infographic: Kate Grant MBChB MRCGP DipGUMed
Reviewer: Molly Heublein, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: David Goldfarb MD, FSN, FNKF, FACP

Sponsor: ACP’s National Internal Medicine Day 2021 acponline.org/NIMD21

Sponsor: Indeed indeed.com/internalmedicine

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

Guest book recommendation and advice
Common risk factors for urinary stone disease
Differential diagnosis of kidney stones
Symptomatology of kidney stones
Types of stones
Urine pH
Role of physical exam
Role of imaging
STONE score
Labs to order
Management of urinary stone disease
Prevention of urinary stones and approach to lifestyle/diet changes
Outro

#297 CRC Screening, Common Skin Complaints, and Antibiotic Pearls (TFTC #8) Sep 29, 2021

We recap the top pearls on CRC Screening, Common Skin Complaints, and Antibiotic Pearls. 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 #283, #284, and #285 at curbsiders.vcuhealth.org!
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, and Nora Taranto
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: ACP acponline.org/telemedicine201

Sponsor: Ten Thousand tenthousand.cc code = 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 and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
CRC Screening
Antibiotic Pearls
Derm Pearls (Common Skin Complaints)
Outro

#296 Diabetes FAQ with Dr. Jeff Colburn Sep 27, 2021

Stumped by diabetes care? Hungry for tips on diagnosis and management? We’ve got you covered with this high-yield Diabetes FAQ covering type 1 and type 2 diabetes. We’re joined by Dr. Jeff Colburn, a board-certified endocrinologist and clinician educator in San Antonio, Texas as we review initial diagnosis, interrogate insulin resistance versus insulin deficiency, delve into down-titrating insulin, discuss ‘tricky diabetes,’ and talk through dietary approaches!
Claim free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers and Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Writer: Matthew Watto MD, FACP
Show Notes, Infographic & Cover Art: Beth Garbitelli
Reviewer: Molly Heublein MD
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
Guest: Jeff Colburn, MD

Sponsor: BetterHelp betterhelp.com/curb

Sponsor: Birch by Helix birchliving.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 and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Initial Presentation of Diabetes
Type 1 or Type 2
Initial Labs, Managing new diagnosis
Using GLP-1 agonists, SGLT-2 inhibitors
How to down titrate insulin
Diabetes in geriatrics
Diets for diabetes management
Outro

#295 Advance Your Care Planning with Dr. Rebecca Sudore Sep 20, 2021

Advance your care planning with tips from our esteemed guest, Dr. Rebecca Sudore, @prepareforcare (UCSF). She helps us up our ACP game by defining advance care planning, and giving clear examples of how it can be incorporated into a busy primary care practice. It’s her life’s mission is to improve advance care planning and medical decision-making for culturally and ethnically diverse older adults. She is the creator of an interactive ACP website called PREPARE For Your Care, (after this episode, we are sure you’ll be sending patients there for advance care planning!)
Free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written by: Leah Witt, MD
Produced by: Leah Witt, MD & Molly Heublein, MD
Reviewer: Lingsheng Li, MD
Infographic and Cover Art: Leah Witt, MD
Hosts:Matthew Watto MD, FACP; Paul Williams MD, FACP, Leah Witt, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Rebecca Sudore, MD

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

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

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 Part 1: General ACP
Defining Advance Care Planning
Case from Kashlak Part 1: Dementia & ACP
Surrogate decision-makers
POLST
Outro

#294 Pulmonary Hypertension Update Sep 13, 2021

Join us as we take a six-minute walk through the definition, presenting symptoms, and diagnosis of pulmonary hypertension with our esteemed guest Dr. Estefania Oliveros, @EstefaniaOS (Temple University). She helps us get on the right side of hypertension on the right side of the heart!
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: Deborah Gorth MD, PhD
Infographic and Cover Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Estefania Oliveros MD

Sponsor: Indeed indeed.com/internalmedicine Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.

Sponsor: The American College of Physicians Telemedicine 201 ACP invites you to attend its free 4-part webinar series, Telemedicine 201. Episode one, “Video Visits Beyond the Simple Cases,” is on September 28th. Register today at acponline.org/telemedicine201.

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

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Case from Kashlak
Definitions
Discussion of testing for pulmonary hypertension
CTEPH diagnosis and management
Rundown of therapies for pulmonary hypertension
Outro

#293 The Best of Liver Tests with Dr. Elliot Tapper Sep 06, 2021

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean! Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

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

Sponsor: BetterHelp betterhelp.com/curb

Sponsor: Panacea Financial panaceafinancial.com

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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Definitions of liver enzymes, liver function tests
Patterns of acute liver injury
Drug-induced liver injury
Isolated alkaline phosphatase elevation
Isolated total bilirubin elevation
Livery Injury During Pregnancy
Acute liver failure
Outro

#292 Acute Heart Failure, CHF Triple Distilled Sep 01, 2021

Enjoy this rapid clinical overview of heart failure based on Episode #230 Kittleson Rules Acute Heart Failure Featuring Dr. Michelle Kittleson @MKittlesonMD (Cedars Sinai)!
This triple distilled episode is not available for CME, but claim CME for #230 Kittleson Rules Acute Heart Failure at curbsiders.vcuhealth.org!
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: Locumstory locumstory.com Visit Locumstory.com to see if a locum tenens assignment is right for you.

Show Segments

Intro, disclaimer, guest bio
The History, Failure mnemonic
CHF exam
CHF Labs, Swan (RHC)
Management of ADHF
Outro

REBOOT #230 Kittleson Rules Heart Failure Aug 30, 2021

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. Enjoy this Curbsiders classic and stay tuned this Wednesday, September 1, 2021 for a brand new CHF Triple Distilled episode.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
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: Ten Thousand tenthousand.cc Head to tenthousand.cc and enter our code CURB at checkout to save 15%.

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

Time Stamps* Time Stamps refer to ad-free version

00:00 Intro, disclaimer, guest bio
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

#291 CBC Abnormalities Triple Distilled Aug 25, 2021

Enjoy this rapid clinical overview of CBC abnormalities based on Episode #167 LIVE! Common CBC Abnormalities Featuring Dr. Mary Kwok! Production & graphics by our very own and very talented Dr. Matt Watto!
Unfortunately, this episode is not available for CME : (
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

Show Segments

Intro, disclaimer, guest bio
Approaching a mildly abnormal CBC, red flags
Build the diff,Fy(a-b-) phenotype
Physical exam and advanced testing
Polycythemia vera
Thrombocytopenia
Outro

Reboot #167 LIVE! CBC Abnormalities Aug 23, 2021

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

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: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

Time Stamps* Time Stamps refer to ad-free version

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

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

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

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

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

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

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

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

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

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

#283 CRC Screening: USPSTF Update with Dr. Michael Barry Jul 05, 2021

Review the 2021 USPSTF Guidelines on Colorectal Cancer (CRC) screening with our guest, Dr. Michael Barry (vice-chair of the U.S. Preventive Services Task Force). Topics include a breakdown of testing modalities (stool tests versus direct visualization), screening ages, what to do for patients older than 75, and more! Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Elena Gibson MD
Cover Art and Infographic: Elena Gibson MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Matthew Watto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Michael Barry MD

Sponsor: Indeed indeed.com/internalmedicine

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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Benefits of CRC screening
How to choose a testing modality
Testing in adults over 75 years old
Health disparities in CRC screening
Outro

#282 Bariatric Surgery, Osteoporosis, 2021 Conference Highlights! (TFTC #6) Jun 30, 2021

We recap the top pearls from our SGIM & ACP 2021 highlight shows (including gabapentin for pain, LGBTQ and Women’s health pearls, CCBs and edema, MRSA swabs, IPMNs, DILI, and more!) plus recent interviews on bariatric surgery and osteoporosis. It’s Tales from the Curbside! (TFTC #6), 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 #275 Bariatric Surgery and #277 Bone Up on Osteoporosis.
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: Sarah Roberts, Edison Jyang, and Isabel Valdez
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Qalo qalo.com/curb Head to qalo.com/curb to get 20% off.

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.

Show Segments

Intro, disclaimer
LGBTQ health, Gabapentin, Care of the Muslim Patient, MRSA swabs
IPMNs, DILI, CCB and Prescribing Cascades
Bariatric Surgery
Osteoporosis
Outro

#281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais Jun 28, 2021

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium, and what to do when that regulation goes awry. Not to mention that, at the end of the day, PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).
Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, Writer, Infographic, Cover Art: Nora Taranto MD
Hosts: Matthew Watto MD, FACP; Nora Taranto MD
Reviewer: Yan Emily Yuan MD, MSc
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Carl Pallais MD, MPH

Sponsor: Grammarly Grammarly.com/CURB
Sponsor: Native NativeDeo.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
Dr. Pallais One-Liner
Case from Kashlak
Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin
Causes of hypercalcemia
How Lithium works!
Testing for Hypercalcemia: Get that PTH, and that phos
Symptoms of Hypercalcemia, and Questions on History
Indications for Surgery for Parathyroidectomy
Management of Hypercalcemia and Hypercalcemic Emergency
Outro

#280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients Jun 21, 2021

Explore the intersection of hematology and women’s health as we discuss heavy menstrual bleeding (HMB), gynecologic risks of therapeutic anticoagulation, and prescribing contraception in the setting of venous thromboembolic disease.
Wondering how to expand your women’s health knowledge as an internist? Listen as our insightful guest Dr. Bethany Samuelson Bannow @bsamuelson_md (Oregon Health & Science University) helps us navigate the intersections between non-malignant hematology and menstrual health. This episode will empower you to tackle the stigma and overcome knowledge gaps with regard to abnormal menstrual bleeding, as well as learn treatment, and management pearls. We also explore the intersection between therapeutic anticoagulation, heavy menstrual bleeding, and thromboembolic disease of different contraceptive options. Finally, we face the themes of overcoming sexism, and even misogyny, in women’s health head-on throughout this episode. After all, half the population has a uterus.
Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Avital O’Glasser MD, FACP, FHM
Infographic: Avital O’Glasser MD, FACP, FHM
Cover Art : Kate Grant MBChB MRCGP DipGUMed
Show Notes: Kate Grant MBChB MRCGP DipGUMed, Maddie Morgan, and Avital O’Glasser MD, FACP, FHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM
Reviewer: Carolyn Chan, MD
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Bethany Samuelson Bannow, MD

Sponsor: Birch by Helix birchliving.com/curb
Sponsor: Green Chef GreenChef.com/curb100

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

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case 1 from Kashlak
Definitions related to menstrual health
Quantifying/defining heavy menstrual bleeding
Overcoming stigma of asking about menstrual history/health
Clinical evaluation/management of the patient with heavy menstrual bleeding
Case 2 from Kashlak
Risk of heavy menstrual bleeding (HMB) in the setting of therapeutic anticoagulation
Hormonal and nonhormonal therapy options for HMB while anticoagulated
Contraception options for someone who develops VTE
Case 3 from Kashlak
Counseling about VTE risk of different contraception options
Take Home Points; Outro; Bonus clip

#279 Dominate Stable Angina with the CardioNerds Jun 14, 2021

Learn how to dominate stable angina. Coronary artery disease with stable angina is a different beast than acute coronary syndrome. We deconstruct it’s pathophysiology, diagnosis, and management with Drs. Dan Ambinder and Rick Ferraro. Topics: When to order coronary CT vs Stress testing; An approach to non-obstructive coronary disease; What treatments are life prolonging; Medical therapy vs Stenting; An approach to antianginal therapy; and how to partner with each patient. Listen as we dive deep into the recent literature and recommendations to dominate stable angina.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Molly Heublein, MD
Writer: Molly Heublein, MD, Michael Sternberg MD
Show Notes: Molly Heublein, MD, Beth Garbitelli
Infographic, Cover Art: Beth Garbitelli
Hosts: Molly Heublein, MD; Paul Williams MD, FACP
Editor: (written materials); Cyrus Askin MD, Clair Morgan of nodderly.com
Guest: Daniel Ambinder, MD; Rick Ferraro, MD

Sponsor: Panacea Financial panaceafinancial.com Panacea Financial a nationwide digital bank built for doctors by doctors. Panacea offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com.
Panacea Financial is a division of Primis, member FDIC

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

Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for 30 days. Visit Audible.com/curb or text curb to 500-500.

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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Case from Kashlak
Definitions of stable angina, unstable angina
INOCA
Assessing risk
Treatment - life prolonging vs symptom relief
Diagnosis- stress testing vs anatomical studies
Angioplasty/stenting- ISCHEMIA trial
Take home points
Outro

#278 Neuro Mystery Case with The CPSolvers Jun 07, 2021

Delve into the neuro Ddx with expert diagnosticians the @CPSolvers, Drs. Reza Manesh (@DrRxEdu) and Rabih Geha (@rabihmgeha). Play along as they solve a neurology mystery case, and give us a tour of the neuraxis.
No CME for this episode, but claim it for past episodes at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Matthew Watto MD, FACP
Writer (case): Daniel Minter MD (@dminter89)
Show Notes: Matthew Watto, MD, FACP
Cover Art: Sawyer Watto
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guests: Reza Manesh MD and Rabih Geha MD

Sponsor: Panacea Financial panaceafinancial.com

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 and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Weakness and Falls
Localization on the neuraxis
NM junction
Lung Mass
Cognitive Autopsy
Outro

#277 Bone Up on Osteoporosis in Primary Care with Dr. Carolyn Crandall May 31, 2021

Bone up on osteoporosis in primary care! Don’t let osteoporosis sneak up on your patients with a vertebral fracture or a hip fracture! Make no bones about your osteoporosis knowledge, from knowing when to screen your patients to selecting a treatment that matches your patient’s lifestyle. Join us as we discuss these topics and more with osteoporosis expert and internal medicine physician, Dr. Carolyn Crandall (UCLA).
Free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Isabel Valdez, PA-C
Show Notes: Isabel Valdez, PA-C
Infographic: Isabel Valdez, PA-C
Cover Art: Kate Grant MD
Hosts: Isabel Valdez, PA-C; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD FACP and Leah Witt, MD (written materials); Clair Morgan of nodderly.com
Guest: Carolyn Crandall MD

Sponsor: Indeed indeed.com/internalmedicine Get started RIGHT NOW with a FREE $75 SPONSORED JOB CREDIT to upgrade your job post at indeed.com/internalmedicine. Offer valid through JUNE 30TH. Terms and conditions apply.

Sponsor: Native NativeDeo.com/curb Stay fresh, stay clean with Native by going to NativeDeo.com/curb, or use promo code curb at checkout, and get 20% off your first order!

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.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week
First Case from Kashlak
Definitions of Osteoporosis and Low Bone Density (formerly Osteopenia)
Patient Counseling on Treatment Side Effects
Frequency of Testing
Dental Clearance
CKD and Osteoporosis Treatment
Prevention
Vitamin D and Calcium
Take-home Points and Outro

#276 Chronic Diarrhea, Dementia, OHS, MSK Pearls (TFTC #5) May 26, 2021

Recap the top pearls from recent shows on Chronic Diarrhea, Dementia, OHS, and MSK (Shoulder, Hip, and Knee).. 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 #267 Chronic Diarrhea, #268 Dementia, and #269 OHS, and #274 MSK Triple Distilled.
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: Elena Gibson, Emi Okamoto, Cyrus Askin, and Matt Watto
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

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

Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500.
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.

Show Segments

Intro, disclaimer
Chronic Diarrhea,
Dementia,
OHS,
MSK: Shoulder, Hip, Knee
Outro

#275 Bariatric Surgery for the Internist with Dr. Vivian Sanchez May 24, 2021

What if we told you there was a powerful tool that could help promote significant weight loss, correct uncontrolled diabetes, improve quality of life, and even improve patient mortality? What if we told you it was offered less than 1% of the time to patients who qualify for it? Listen as our esteemed guest Dr. Vivan Sanchez (Boston University) talks us through the patient selection, preoperative workup, and postoperative considerations for bariatric surgery, and how it might benefit your patients.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Paul Williams MD, FACP
Infographic: Edison Jyang
Cover Art: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein, MD; Clair Morgan of nodderly.com
Guest: Vivian Sanchez, MD

Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping!

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.
Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week
Case from Kashlak
Criteria for bariatric surgery
Benefits of bariatric surgery
Presurgical workup
Postoperative management
Complications
Outro

#274 MSK Triple Distilled: Shoulder, Elbow, Hip, Knee May 17, 2021

Dominate MSK complaints in primary care! A packed recap from our past musculoskeletal episodes, triple distilled to what you need to know. Learn some buckets to consider when addressing knee pain, just how simple hip complaints are, when to urgently refer shoulder problems, and easy exam maneuvers to differentiate elbow pain. Use our simple framework to help with the top diagnoses walking into your primary care clinic.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Molly Heublein, MD
Show Notes by: Molly Heublein, MD
Cover Art and Infographics: Matthew Watto
Hosts: Stuart Brigham MD; Molly Heublein, MD Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD, FACP; Clair Morgan of nodderly.com (audio)

Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.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 and search for this episode to claim credit.

Show Segments

Intro, disclaimer
Case from Kashlak- general orthopedic complaints
Yellow flags
Case from Kashlak Knee
4 buckets of knee pain
Ligamentous injury
Meniscus
Patellofemoral
Knee exam
Knee Imaging
Osteoarthritis treatment
Case from Kashlak: hip
Three steps to hip diagnosis
Case from Kashlak: Shoulder
Case from kashlak: elbow
Take-home points

#273 ACP 2021: The Highlight Reel Part 2 May 10, 2021

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: primary care management of anxiety and depression, insomnia, medical marijuana, venous thromboembolism, COVID-19 and coagulopathy, syncope, diverticulitis, aspirin, and delirium!
Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Paul Williams MD, FACP; Chris Chiu MD FACP; Sarah Roberts MPH, Beth “Garbs” Garbitelli
Show Notes by: Beth Garbitelli
Cover Art: Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial panaceafinancial.com Panacea Financial offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com today to open your account and join a bank built with you in mind.
Panacea Financial is a division of Primis, member FDIC

Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

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 Top Pearls on:

Primary care management of anxiety and depression
Insomnia
Medical Marijuana
Venous Thromboembolism
COVID-19 and Coagulopathy
Syncope
Diverticulitis
Aspirin
Delirium

#272 ACP 2021: The Highlight Reel Part 1 May 03, 2021

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: Heart Failure, Hypertension, IV vs PO antibiotics, Hepatology, Kiwifruit for constipation, Perioperative Sleep Apnea, Thyroid, Bariatric Surgery, Neurology, Super Gonorrhea, and more!
Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Deborah Gorth; Paul Williams MD, FACP; Matthew Watto MD FACP; Avital O’Glasser MD, FACP; Molly Heublein MD
Show Notes by: Matthew Watto MD
Cover Art: Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial panaceafinancial.com

Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

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

Heart Failure
Oral vs IV antibiotics for osteomyelitis, bacteremia, and endocarditis
Inpatient Blood Pressure Management
Perioperative sleep apnea
Thyroid pearls (pregnancy and weekly dosing)
Bariatric Surgery pearls
GI disorders (Cdiff, constipation, diverticulitis)
Super Gonorrhea; Sunscreen!
Outro

#271 PAD, Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea (TFTC #4) Apr 28, 2021

Recap our top pearls from recent shows on peripheral arterial disease (PAD), Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea. 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 #260 PAD, #263 Iron CKD, and #266 Acute Diarrhea. CME is not available for #261-262 Abdominal Pain
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 and Edison Jyang
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.com/Curb.

Sponsor: Indeed Indeed.com/INTERNALMEDICINE Get a $75 credit at Indeed.com/INTERNALMEDICINE. Offer valid through JUNE 30TH. Terms and conditions apply.

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.

Show Segments

Intro, disclaimer
Peripheral Arterial Disease (Dx and Management)
Abdominal Pain and the Abdominal Exam
Iron deficiency and Anemia in CKD
Acute Diarrhea
Outro

#270 SGIM 2021: The Highlight Reel Apr 26, 2021

It’s SGIM 2021, #SGIM21! LGBTQ health, updates in primary care for patients of all ages, caring for the Muslim patient, periop pearls, MRSA in your nose, and more! It’s the most wonderful time of the year for internists: SGIM and ACP, all in one month! We’re here to help you make the most out of these action-packed virtual events, starting with our SGIM 2021 conference highlights. We hope you enjoy this grab-bag of clinical pearls, from LGBTQ healthcare to periop medicine to primary care, reproductive health, and beyond. Stay tuned for our upcoming ACP IMM2021 recaps for even more knowledge food!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Sarah Phoebe Roberts MPH; Becca Raymond-Kolker, Paul Williams MD, FACP; Chris Chiu MD, FACP, FAAP; Matthew Watto MD FACP
Show Notes by: Sarah Phoebe Roberts MPH
Cover Art and Infographic: Sarah Phoebe Roberts MPH
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process.

Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500.

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
Top Pearls on:

LGBTQ health
Gynecological health
Reproductive medicine
Primary Care
Hospital Medicine
Perioperative Medicine
Caring for the Muslim patient
Young adult medicine pearls (including COVID19; and Down Syndrome)
Reflections on SGIM 2021 and Outro

#269 Obesity Hypoventilation Syndrome (OHS) and the Didgeridoo with Dr Aneesa Das Apr 19, 2021

Does obesity hypoventilation syndrome (OHS) give you respiratory distress? Are you baffled by bilevel? The wait is over! Learn all the ins and outs about OHS from Dr. Aneesa Das, @AneesaDas, a sleep specialist and pulmonologist at The Ohio State University! You’ll learn tips and tricks regarding the diagnosis and management of OHS, the important role PCPs can play, and why on earth we’re discussing the didgeridoo!
Free CME for this episode at curbsiders.vcuhealth.org!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Cyrus Askin, MD
Infographic: Cyrus Askin, MD
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Cyrus Askin, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Reviewer: Leah Witt, MD
Editor: Matthew Watto, MD (written materials); Clair Morgan of nodderly.com
Guest: Aneesa Das, MD

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.
Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb
Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process.
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
Basic risk factors for OHS and red flags
That pathophysiologic trifecta
Physical Exam & History - OHS
Surveys and specific testing
Labs and other tests (PFTs, Echo, and more)
OSA, OHS, and Central Sleep Apnea
Treating OSA: CPAP vs Bilevel
The importance of weight loss
Keys for inpatient management
Perioperative considerations
Take-home points
Outro

#268 Dementia Made Simple with Dr. Josh Uy Apr 12, 2021

Dust off your dementia playbook and re-evaluate your approach as Dr. Josh Uy walks us through this common (yet perplexing) condition. Dr. Uy (@joshuy) is the geriatric fellowship director at University of Pennsylvania in addition to a nursing home director and shares his skills in simplifying dementia screening, management, and treatment. Set your chairs up for the “triad visit” and prepare to ‘stew in the milieu’ of dementia!
Free CME for this episode at curbsiders.vcuhealth.org!
Credits

Producer, cover art, infographic: Emi Okamoto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com
Guest: Josh Uy MD

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

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.
Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping!

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 and picks of the Week*
Case from Kashlak
Definitions of dementia and cognitive impairment
Subtyping dementia
Cases to refer and basic laboratory testing
Potential imaging
Management of dementia
Take-home points, Outro

#267 Diarrhea Disemboweled Part 2: Chronic Diarrhea with Dr. Iris Wang Apr 07, 2021

Producer: Elena Gibson MD
Writer: Elena Gibson MD, Beth Garbitelli
Cover Art: Kate Grant, MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written); Clair Morgan of nodderly.com (audio)
Guest: Xiao Jing (Iris) Wang MD

Sponsor: Express VPN ExpressVPN.com/curb Protect your online activity TODAY with the VPN rated #1 by CNET and Wired. Visit our exclusive linkExpressVPN.com/curband you can get an extra 3 months FREE on a one-year package!

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.

Show Segments

Intro, disclaimer, guest bio
Case from Kashlak
Osmotic diarrhea & stool osmotic gap
Causes of osmotic Diarrhea
Algorithm for evaluating diarrhea workup
Testing workup for chronic diarrhea
Endoscopic evaluation indications
Disorders of the Gut-Brain Axis

#266 Diarrhea Disemboweled Part 1: Acute Diarrhea with Dr. Iris Wang Apr 05, 2021

Flow with us through Diarrhea Disemboweled Part 1 as Dr. Xiao Jing (Iris) Wang @IrisWangMD walks us through the evaluation and management of acute diarrhea.
NOTE: CME will not Go LIVE until Wed 4/7/21 for both #266 and #267. Then, claim 2 hours credit in one shot!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Producer: Elena Gibson MD
Writer: Elena Gibson MD, Beth Garbitelli
Cover Art: Kate Grant, MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matt Watto MD (written); Clair Morgan of nodderly.com (audio)
Guest: Xiao Jing (Iris) Wang MD

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.
Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.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 and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Picks of the Week
Case from Kashlak
Definitions
Small bowel vs. Large bowel pathology
Red flags
Microbiologic evaluation of acute diarrhea
Non-Culture based testing panels
Supportive Management
Post infectious diarrhea
Oral Rehydration Solution
Take-Home points and Outro

#265 Hypertension Update, Sarcoidosis, Seizures (TFTC #3) Mar 31, 2021

Recap our top pearls from recent shows on hypertension, sarcoidosis, and seizure. It’s Tales from the Curbside (TFTC)!, our monthly series providing a rapid review of recent Curbsiders episodes.
Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #254, #256, and #257.
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 and Edison Jyang
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Show Segments

Intro, disclaimer
Hypertension pearls
Sarcoidosis pearls
Seizures pearls
Outro

#264 Hotcakes: Semaglutide for Weight Loss, Abx for Diverticulitis, Periop COVID19 Mar 29, 2021

Fresh hotcakes! Practice-changing articles that you need to know: semaglutide for weight loss; metronidazole plus a fluoroquinolone versus amoxicillin/clavulanic acid for uncomplicated diverticulitis; and the perioperative risks of COVID19. We’re joined by Dr. Adnan Khan (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced and hosted by: Rahul Ganatra MD, MPH; Adnan Khan MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Matthew Watto MD, FACP
Editor: Rahul Ganatra MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial panaceafinancial.com This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com. Panacea Financial, a Division of Sonabank, Member FDIC
Sponsor: ACP’s MKSAP 19 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at check out.
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
Pick of the week: Dark (Netflix TV series)
Preventive Medicine Updates
Semaglutide for weight loss
Amox-clav vs FQ-metronidazole for Diverticulitis
Perioperative COVID19 infection and timing of surgery
Rahul’s take-home points
Outro

#263 Iron Deficiency and Anemia of CKD (NephMadness 2021) Mar 22, 2021

Dominant iron deficiency and anemia of CKD! We discuss how to interpret iron studies, when and how to start treatment with PO vs. IV iron, and ESAs vs. the new HIF-PHIs! Iron deficiency in chronic kidney disease is common but frequently overlooked in primary care. This episode features Kashlak Memorial’s own Chief of Nephrology, Dr. Joel Topf (@kidney_boy), joined by NephMadness experts, Dr. Matthew Spark (@Nephro_Sparks), and Dr. Pascale Khairallah (@Khairallah_P)! Our guests lay out an easy-to-follow framework for primary care and give us some inside information to #Nephmadness! Read the Anemia Region scouting report.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Writer, Producer: Stuart Brigham, MD
Cover Art: Kate Grant MBChB, MRCGP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Joel Topf MD, Matt Sparks MD, Pascale Khairallah MD

Sponsor: Grammarly Grammarly.com/CURB Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB
Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping!
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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Segments

Intro, disclaimer, guest bio
Case from Kashlak
Approaching CKD in Primary Care
Iron and anemia labs in CKD
Ferritin Goals in CKD
Oral Replacement of Iron in CKD
IV Replacement of Iron in CKD
Discussing treatment option for Anemia of CKD
Basic information on HIF Stabilizers/ PHIs in CKD
Take-home points and Outro

#262 Subacute and Chronic Abdominal Pain: Physical Exam Series Mar 17, 2021

In this part 2 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of the DX: Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com Guest: Andrew Olson MD

Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.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.

#261 Acute Abdominal Pain: Physical Exam Series Mar 15, 2021

In this part 1 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of DX: the Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com Guest: Andrew Olson MD

Sponsor: Panacea Financial panaceafinancial.com This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com
Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders listeners get 10% off their first month at betterhelp.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.

#260 Peripheral Artery Disease with Dr. Vlad Lakhter Mar 08, 2021

A painless walk through the diagnosis and management of peripheral artery disease (PAD). PAD is one of those diagnoses that you know about, but maybe don’t feel comfortable diagnosing and managing. Listen as our esteemed guest Dr. Vladimir Lakhter @VladLakhter (Temple Health) talks us through its diagnosis and management. Dr. Lakhter gives us a straightforward framework for categorizing and triaging peripheral artery disease and talks us through the important components of medical management and who benefits from revascularization.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and produced by: Jake Kieserman and Paul Williams MD, FACP
Infographic: Edison Jyang
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Vladimir Lakhter, DO

Sponsor: Indeed INDEED.COM/INTERNALMEDICINE

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.

Time Stamps* *Note: Time Stamps refer to ad-free version.

Intro, disclaimer, guest bio- 00:33
Guest one-liner- 3:25
Dr. Lakhter book recommendations- 5:36
Case from Kashlak- 8:35
Definition and background for PAD- 10:25
Classification schema for PAD- 12:45
The physical examination- 21:05
ABIs and PVR in the diagnosis of PAD- 33:50
Exercise program for PAD- 46:08
Medication therapy- 52:05
Revascularization- 62:50
Outro- 68:45

#259 Addiction Medicine Triple Distilled Mar 01, 2021

Let's recap our favorite addiction medicine pearls! We cover the treatment of alcohol use disorder, opioid use disorder and discuss strategies surrounding the management of long-term opioid therapy. Please share your favorite addiction medicine pearls with us that we may have forgotten in the comments or by tagging us on Twitter @thecurbsiders.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers: Carolyn Chan MD; Nora Taranto MD
Infographics: Hannah R Abrams; Justin Berk MD, MPH, MBA; Carolyn Chan MD; Nora Taranto MD
Writer and Cover Art: Carolyn Chan, MD
Hosts: Carolyn Chan MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Justin Berk MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial
This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial, you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com
Panacea is also excited to announce their “Match Day Giveaway.” $500 will be awarded to five medical students entering the match in 2021. Entry is free, and students can enter the giveaway on their website until March 31, 2021. Winners will be selected randomly on April 1st, 2021. No purchase necessary for entry. Go to panaceafinancial.com/matchday today to learn more.
Panacea Financial, a Division of Sonabank, Member FDIC
Partner: The Cribsiders Pediatric Medicine Podcast A Pediatric Podcast here to feed pediatric knowledge food to your adult-sized brain hole & provide weight-based dosings of fun. New episodes drop every other Wednesday! https://thecribsiders.com/
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 to claim credit.

Time Stamps

Intro, disclaimer 00:00
Alcohol Use disorder (inpatient and outpatient management) 03:50
Sponsor -Panacea Finanicial 24:00
Partner -The Cribsiders Pediatric Medicine Podcast
Chronic Pain and Opioid Therapy (prescribing buprenorphine; microdosing) 25:30
Benzo Tapers 46:11
Outro

#258 Nephrotic Syndrome, Smoking Cessation, Prev Med Update (TFTC #2) Feb 24, 2021

Recap our top pearls from recent shows on nephrotic syndrome vs nephritic syndrome, smoking cessation and updates in preventive medicine. Tales from the Curbside (TFTC) is a monthly series providing a rapid review of recent Curbsiders episodes.
Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #250, #251 and #252.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Elena Gibson MD, Beth Garbitelli and Carolyn Chan MD
Cover Art: Matthew Watto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial
This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com
Panacea Financial, a Division of Sonabank, Member FDIC
Sponsor: Grammary grammarly.com/curb

#257 Carpe Diem: Seizure Basics for Primary Care Feb 22, 2021

Seize control of your differential for epilepsy! This week, we review the basics of seizure work-up and management with our esteemed guest Dr. Sara Dawit @DrSaraDawit a board-certified neurologist who is an Assistant Professor of Neurology and Neurophysiology Fellow at The Mayo Clinic, Scottsdale Campus. Dr. Dawit takes us through rapid response to witnessed seizure, how to approach first-time seizures and adult-onset seizure disorders, gives us some facts about non-epileptic seizure disorders, and describes how to approach medication management in epilepsy!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Paul Williams MD, Beth Garbitelli
Writer and Infographics: Beth Garbitelli
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Sara Dawit MD

Sponsor: ACP’s MKSAP
MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout.
Sponsor: Green Chef GreenChef.com/90curb

Sponsor: Indeed Indeed.com/INTERNALMEDICINE

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 .

#256 Sarcoidosis Feb 15, 2021

This grand overview of granulomas will leave you comfortable tackling an often breathtaking disease, sarcoidosis. Listen as our esteemed guests Dr. Mary Beth Scholand (University of Utah) and Dr. Jonathan Boltax (University of Utah) rheum-inate on sarcoidosis. We discuss the pathophysiology, diagnosis, and treatment of this disease, role of the primary care clinician and why sarcoidosis in the chart reminds Paul of Shakespeare.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Cyrus Askin MD and Deborah Gorth
Writer: Deborah Gorth
Infographic and Cover art: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Drs. Mary Beth Scholand & Jonathan Boltax

Sponsor: ACP’s MKSAP MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout.
Sponsor: birch by Helix
Visit birchliving.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.

Time Stamps

00:00 Intro, disclaimer, guest bio, Awful(ly good?) Pun
03:42 Guest one-liners
06:28 Sponsor - ACP’s MKSAP19
07:40 Case from Kashlak
08:40 Explaining sarcoidosis
12:19 Possible drivers of sarcoidosis
13:30 Taking a sarcoidosis history
17:26 Suggestions for catching sarcoidosis
21:44 Sponsor - birchliving.com/curb
23:52 Sarcoidosis physical exam, Diagnosis
33:00 Lofgren’s and Heerfordt’s syndromes; Imaging for sarcoidosis
40:44 Initiating therapy for sarcoidosis; Prognosis; the Treatment team
51:23 Primary care considerations for sarcoidosis
54:55 Diagnosing and treating a sarcoidosis exacerbation
61:20 Take home points and outro

#255 Hotcakes: Colchicine for CAD, and Gout flares, PT versus Steroids for Knee OA Feb 08, 2021

Fresh hotcakes! Practice changing articles that you need to know: low dose colchicine for stable CAD; colchicine vs naproxen for acute gout flares; and physical therapy vs glucocorticoid injection for chronic Knee osteoarthritis. We’re joined by Michael Sternberg (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Hosts: Rahul Ganatra MD, MPH; Michael Sternberg MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: ACP’s MKSAP18
MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021.

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 .

Time Stamps

Intro, disclaimer
01:45 Fun animal fact; Picks of the Week*
06:33 PT vs steroid injection for chronic knee OA
21:00 Colchicine for stable CAD
33:00 Low dose colchicine vs naproxen for acute gout flares

#254 Hypertension Update with Dr. Wanpen Vongpatanasin Feb 01, 2021

Listen as our esteemed guest Dr. Wanpen Vongpatanasin, @DrWanpen (UT Southwestern) discusses the nitty-gritty of blood pressure monitoring and hypertension treatment. We review the thresholds for HTN diagnosis and how to accurately measure blood pressure levels at home and in the office. Dr Vongpatanasin shares the latest guideline recommendations for first line pharmaceutical therapies as well as her pearls about how to treat special populations.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Produced by: Deborah Gorth and Isabel Valdez, PA
Written by: Deborah Gorth
Infographic and Cover Art: Edison Jyang
Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; Paul Williams, MD, FACP
Editor: Molly Heublein, MD (written materials); Clair Morgan of nodderly.com
Guest: Wanpen Vongpatanasin, MD

Sponsor: ACP’s MKSAP18
MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021.

Sponsor: Provider Solutions and 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.

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.

Time Stamps 00:00 Sponsors, Intro, disclaimer, guest bio 03:20 Guest one-liner 05:50 Sponsor - ACP’s MKSAP 18 07:05 Case from Kashlak; Defining hypertension and treatment thresholds 10:43 Measuring blood pressure (at home, in the office, validatebp.org) 16:46 Wrist BP cuff 19:50 Home monitoring and ambulatory BP monitoring; What time to take BP medication 31:23 Sponsor - Provider Solutions and Development 32:10 Approach to treatment; Combo pills; How to titrate meds 42:20 Treating resistant hypertension; hyperaldosteronism; Isolated systolic hypertension 52:04 Take home points and Outro

#253 COVID-19 Vaccines with Dr Monica Gandhi Jan 27, 2021

Answer all your burning questions (and your patients’ burning questions) about the different COVID-19 vaccines currently authorized in the US. Infectious diseases / HIV expert, Dr Monica Gandhi @MonicaGandhi9 (UCSF) joins us to cover: the Pfizer-BioNTech and Moderna novel mRNA vaccine mechanisms, trial data, and practicalities of who should receive them. We discuss data around the Oxford-AstraZeneca adenovirus vaccine, which is authorized in the UK and India, and may be available in the US later this year. Feel confident recommending COVID-19 vaccines to your patients!
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and Produced by: Molly Heublein, MD
Cover Art: Chris Chiu, MD, FACP, FAAP
Infographic: Tima Karginov
Hosts: Chris Chiu, MD, FACP, FAAP; Molly Heublein, MD; Paul Williams, MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Monica Gandhi, MD, MPH

Sponsor: Panacea Financial
This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com
Panacea Financial, a Division of Sonabank, Member FDIC

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.
Time Stamps

Intro, disclaimer, guest bio - 00:00
Guest one-liner, book recommendation - 3:40
Authorized vaccines in the US - 8:30
AstraZeneca vaccine mechanism- 9:26
mRNA vaccine mechanism - 10:30
Vaccine distribution issues (cold chain) - 16:05
mRNA safety - 18:24
mRNA vaccine efficacy/data from phase 3 trials - 19:40
How did we get this so quickly - 23:40
Vaccine impact on asymptomatic infection - 26:18
AstraZeneca trials - 28:20
Pregnancy - 35:10
Anaphylaxis - 37:10
Prior COVID-19 infection - 39:07
Side effects - 42:05
Pediatric patients - 45:12
Phases of role outs in the US -46:50
Herd immunity - 48:16
Thoughts of how to make this happen - 52:45
Preexisting conditions - 53:40
How long will immunity last - 57:15
Mutant strains - 58:25
Future of mRNA vaccines - 1:00:30
Take home points and Outro - 1:02:12

#252 Smoking Cessation Unfiltered Jan 25, 2021

Get all the details on varenicline, nicotine replacement therapy, and integrating psychosocial interventions into a comprehensive smoking cessation treatment plan! Smoking cigarettes is the leading cause of preventable death worldwide. Listen as our esteemed guest Dr. Steve Baldassarri (Yale) provides us expert pearls to help our patients quit smoking.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Written and produced by: Carolyn Chan, MD
Infographic: Edison Jyang
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin, MD (written materials); Clair Morgan of nodderly.com
Guest: Steve Baldassarri MD MHS

Sponsor: The American College of Physicians
Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org. (Prices shown online at registration pages reflect Discounted Rates.) Register now—Early Bird savings end January 31st!
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.
Time Stamps*

*Note: Time Stamps refer to ad free version.

03:02 Intro, disclaimer, guest bio
04:35 Guest one-liner
09:50 Tobacco Use Disorder - Chronic Disease
11:08 Case from Kashlak
11:56 Obtaining a history
13:39 Motivations for Smoking Cessation
15:29 Factors associated with challenges in smoking cessation:
21:40 Gradual Tapers vs Cold Turkey
25:18 Nicotine Replacement 32:40
28:57 Pharmacotherapy - “Controller” Medications
31:05 Pharmacotherapy - Short Acting Medications
33:20 Dosing Medications
38:35 Varenicline
39:00 Nicotine gum dosing
44:40 Duration of therapy
48:08 Bupropion
49:05 Behavioral Interventions
55:24 Vaping and electronic cigarettes
57:03 Vaping for smoking cessation
01:02:35 EVALI
01:05:49 Outro

#251 What the USPSTF? Preventive Medicine Updates with Dr. Amber-Nicole Bird Jan 18, 2021

What the USPSTF?! It’s time for some preventive medicine updates on: screening for unhealthy drug use, cervical cancer, hepatitis C and draft recs for colorectal cancer; plus how to interpret USPSTF screening recs. Dr. Amber-Nicole Bird @ABirdMD (Penn Medicine) refreshes our love for preventive medicine, with updates on the newest recommendations. She reviews how to appropriately interpret and adopt guidelines for our patients, being cognizant of the source. We shine light on the mechanism of USPSTF, including how their guidelines differ from others, so we can understand the value and context when utilizing the guidance in the clinic.

Credits

Produced and Written by: David Madick MD; Peter Wikoff MD; Paul Williams MD, FACP
Infographic: Beth Garbitelli
Cover Art: Chris Chiu MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto, MD (Show notes); Clair Morgan of nodderly.com
Guest: Amber-Nicole Bird, MD

Sponsor: The American College of Physicians

Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st!

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.

#250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf Jan 11, 2021

Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, writer, infographic, cover art: Elena Gibson MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio)
Guest: Joel Topf MD

Time Stamps*
*Note: Time Stamps refer to ad free version
Intro, disclaimer, guest bio – 00:00
Picks of the Week – 3:10
Case from Kashlak – 6:30
Nephrotic syndrome definition- 12:30
Proteinuria evaluation – 15:04
Additional lab testing – 27:08; 40:09
Types of Nephrotic syndrome – 30:15
Mechanism of nephrotic syndrome edema – 33:08
Management of nephrotic syndrome – 44:07
Second Kashlak Case- Glomerulonephritis – 55:05
Treatment of glomerulonephritis – 65:05
Outro and post-credits scene – 73:20
Sponsor: The American College of Physicians
Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.
“Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB.
Register now—Early Bird savings end January 31st!
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.

#249 Cellulitis, Bites, Vulvovaginitis, MGUS, SPEP (TFTC #1) Jan 04, 2021

Recap the top pearls from recent shows on vulvovaginitis, cellulitis and bites, MGUS and the SPEP. Tales from the Curbside (TFTC) is pilot project providing a rapid review of recent Curbsiders episodes. Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #244, #246 and #247.

Credits

Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Kate Grant MBChb, MRCGP, Beth Garbitelli and Nora Taranto MD
Cover Art: Matthew Watto
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: The American College of Physicians

Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.

“Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB.

Register now—Early Bird savings end January 31st!

Time Stamps*

*Note: Time Stamps refer to ad free versions.

00:00 Intro, disclaimer, guest bio
02:35 Vulvovaginitis
05:35 Cellulitis and Bites
09:45 SPEP it Up
15:15 Outro

#248 Top Pearls of 2020: Curbsiders' Recap Extravaganza Dec 28, 2020

Our team shares the top pearls of 2020 in our annual recap extravaganza featuring guest host, Chris “The Chiu Man” Chiu @cjchiu. Check out the video version at YouTube. Topics: hypothyroidism, women in medicine, hypothermia, diuretics, heart failure, AKI, lipids, post-op fever, refugee health, SGLT2 inhibitors, euglycemic DKA, UTIs, bat bites, rabies, ILD, statins in NAFLD, framework for hair loss, and more! Plus: Our picks of the year and the Curbsiders gift guide! Note: This episode is not available for CME but #208 through #247 are available for CME/MOC at curbsiders.vcuhealth.org for free!

Credits

Producer: Chris Chiu MD, FACP, FAAP
Written by: The Curbsiders Team
Show Notes: Matthew Watto MD, FACP
Cover Art: Chris Chiu MD, FACP, FAAP
Hosts: Chris Chiu MD, FACP, FAAP, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

#247 SPEP It Up: MGUS, Myeloma, and Immunology, Oh My! Dec 21, 2020

On this episode, Dr. Jorge Castillo (Harvard, Dana Farber) walks us through some immunology basics, teaches us the limitations of the SPEP, plus some additional tests that complement it (think Immunofixation), shares his clinical gestalt about when to suspect MGUS, Myeloma, Waldenstrom’s, and Amyloidosis--and finally, how to talk to patients about them. If you, like Stuart, have ever wondered what on earth to do with that pesky free light chain ratio or the SPEP that so often gets inboxed to you without explanation, then fear not, Dr Castillo has your back!

Credits

Written and Produced by Nora Taranto MD
Infographics by Nora Taranto MD
Cover Art by Kate Grant MBChB, MRCGP
Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, FACP, Nora Taranto MD
Editor: Matthew Watto MD, FACP ; Clair Morgan of nodderly.com
Reviewer: Jooho Chung MD, PhD
Guest: Jorge Castillo MD

Sponsor: Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: VCU Health CE

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your account!

#246 Take a Bite out of Cellulitis with Dr Boghuma Titanji Dec 14, 2020

Master common skin and soft tissues infections: cellulitis, abscesses, human and animal bites with returning guest, infectious diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED).

Credits

Written (including CME) and Produced by: Matthew Watto MD, FACP
Cover Art and Infographic by: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto (written materials); Clair Morgan of nodderly.com
Guest: Boghuma Titanji MD, M.Sc., DTM&H, PhD

Sponsor: Provider Solutions and 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.

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.

Time Stamps*

*Note: Time Stamps refer to ad free version.

00:00 Intro, disclaimer, guest bio
02:00 Picks of the Week
06:00 Definitions, Initial Approach to cellulitis
10:35 Nonpurulent cellulitis; antibiotic choice 18:10 Fish handler’s disease
24:30 Recurrent cellulitis
31:30 Purulent cellulitis and MRSA; Antibiotic choice; Step down therapy
47:33 Abscesses; Adjuvant antibiotics; Packing Wounds
53:30 Decolonization for recurrent MRSA infections
56:30 Human Bites (clenched fist injury); Dog bites and Cat bites
67:10 Take home points and Outro

ADHD: All that Fidgets is Not... (Cribsiders #13) Dec 09, 2020

Diagnosis, Management, and Social Implications of Attention Deficit Hyperactivity Disorder.

Ever gotten overwhelmed by all the categories of ADHD, or interpreting the scores on a Vanderbilt form? Join us with Dr. Sarah Vinson, a triple-boarded clinician in adult psychiatry, child psychiatry, and pediatrics who helps us optimize a diagnosis and management process for ADHD. What other conditions can masquerade as ADHD? Which type of stimulant should you use? Listen to find out more! Show notes at: https://thecurbsiders.com/cribsiders/13 Subscribe at: Apple , Google, Spotify

Credits

Writer, Producer, Infographic: Angela Zhang
Cover Art: Chris Chiu
Hosts: Justin Berk, Chris Chiu
Editor:Justin Berk; Clair Morgan of nodderly.com
Guest(s): Dr. Sarah Y. Vinson

Time Stamps

5:30 Diagnosis of ADHD
6:53 Considering a differential diagnosis of ADHD
8:43 Categories of ADHD
15:02 Ancillary Supports
18:27 Consequences of Misdiagnosis
19:53 Parent Counseling
22:08 Behavioral Interventions Treatment
25:56 Gender Differences in ADHD
28:00 Anaphylaxis Promo
28:39 Alternative Treatments
30:54 Pharmacotherapy for ADHD
37:29 Side Effects of Medical Treatments
44:33 Monitoring Progress
46:19 Treating concurrent mood disorders
49:21 ADHD in Young Adults
55:29 ADHD and Race
1:08:13 Future of ADHD

#245 COVID Cakes: Masks, Home Testing, Anticoagulation, Vaccines Dec 07, 2020

Learn about the latest in COVID-19: Do masks prevent infection?, SARS-CoV-2 home testing, vaccine advice, and how to prevent and treat VTE in COVID-19. Join us as our tzar-of-clinical-appraisal Curbsider/internist/epidemiologist Rahul Ganatra MD MPH (@rbganatra) talks us through the controversial DANMASK-19 trial, plus Watto reports back on his conversation with Dr Parth Rali @parthrali (Temple Lung Center) who helped write the CHEST anticoagulation guidelines for COVID-19.

Credits

Producer: Deb Gorth ScM
Show Notes, Cover Art, and CME by: Deb Gorth ScM and Matthew Watto MD
Written by: Matthew Watto MD, Paul Williams MD, and Rahul Ganatra MD MPH
Hosts: Rahul Ganatra MD MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: ACP’s I Raise the Rates

Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

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.

Time Stamps

00:00 Intro, disclaimer, Picks of the week* and Vaccines
08:00 DANMASK-19
25:00 Anticoagulation in COVID-19
35:06 COVID-19 home PCR testing
Outro

#244 Vulvovaginitis for All Ages with Dr. Monica Christmas Nov 30, 2020

Everything you need to know about vulvovaginitis: candidiasis, bacterial vaginosis, and Genitourinary Syndrome of Menopause. Join us on the journey of a lifetime as we learn all about diagnosing, treating and managing vulvovaginal conditions in patients of all ages. Plus, a bit on how to recognize and treat lichen sclerosus. Our brilliant guest for this episode is Dr. Monica Christmas (@drmonicaxmas on Twitter), who is a self-described yoga enthusiast, avid reader, wannabe artist and gynecologist. Dr. Christmas is currently an Assistant Professor at the University of Chicago in the section of Minimally Invasive Gynecologic Surgery where she is the director of the Menopause Program. Monica specializes in gynecologic surgery, abnormal uterine bleeding and menopause management with an interest in sexual dysfunction. Her focus is on helping women live healthy, vibrant, happy lives.

Credits

Produced by: Kate Grant MD; Sarah Phoebe Roberts MPH
Written by: Kate Grant MD
Show Notes by: Sarah Phoebe Roberts MPH, Kate Grant MD
Cover Art and Infographic: Kate Grant MD
Hosts: Kate Grant MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Monica Christmas, MD

Sponsor: ACP’s I Raise the Rates
Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

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.

#243 Diabetes Triple Distilled Nov 23, 2020

Listen in as we recap four of our favorite diabetes episodes to bring you the pearls you need to stay up to date on type 2 diabetes management in the clinic. We cover pitfalls of A1c testing, guidelines for A1C targets, when and how to use the newer medications SGLT-2 inhibitors and GLP-1 agonists. We wrap up with a discussion of managing DM2 in patients with kidney disease and in which patients to consider de-intensifying treatment. Feel confident managing diabetes with the latest data in 2020!

Listeners can claim 4 HOURS of Free CE credit for this episode 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: Molly Heublein, MD
Infographic and Cover Art: Isabel Valdez, PA
Show Notes: Isabel Valdez, PA; Molly Heublein, MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein, MD
Editors: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com

Sponsors:

ACP’s I Raise the Rates

Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

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

0:00 Intro,

2:45 Pitfalls of A1c testing,

7:00 Diabetes goals/A1c guidelines; Macrovascular vs Microvascular benefits,

16:20 Choosing between SGLT2 inhibitors vs GLP1 agonists,

19:10 Stuart rants on insulin for symptomatic hyperglycemia,

22:32 Start your patient on an SGLT2i and counsel them about potential adverse events,

30:30 GLP-1 agonists,

36:50 Deintensification; Diabetes Treatment in CKD,

Tags

Diabetes, hypoglycemia, SGLT2 inhibitors, GLP-1 agonist, metformin, CKD, primary care, assistant, doctor, education, family, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, physician, resident, student

#242 Wilderness Medicine: Prepare for Disaster Nov 16, 2020

Explore the essentials of Wilderness Medicine and prepare yourself for austere environments as we discuss Altitude Sickness, Frostbite, Animal Bites, Thermoregulation, Wound Care and the proper way to apply a tourniquet.

Thinking about outdoor escapes and vacations now more than ever? Listen as our esteemed guest Dr. Thomas DeLoughery @Bloodman (Oregon Health & Science University) takes us through the fascinating, and at times chilling, world of Wilderness Medicine. This episode will empower you to explore the great outdoors as safely as possible. We discuss the breadth of wilderness medicine, multiple unique clinical entities encountered in austere environments, and practical ways to protect yourself and others on your adventures. This episode is truly wild!

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, Produced, and Infographic by: Avital O’Glasser MD, FACP, FHM
Show Notes: Deborah Gorth ScM and Avital O’Glasser MD, FACP, FHM
Cover Art: Kate Grant, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Thomas DeLoughery MD, MACP, FAWM

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

Time Stamps

Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
Sponsor - VCU Health CE curbsiders.vcuhealth.org
00:00 Intro, disclaimer, guest bio
03:45 Guest one-liner, advice and Picks of the Week*
08:10 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
09:00 Case of mountaineering; What is Wilderness Medicine? 
12:05 What’s in your first aid kit? 
21:36 Altitude sickness: acute mountain sickness, high altitude cerebral edema and High altitude pulmonary edema 
31:25 Hypothermia
39:36 Frostbite  
47:25 Hyperthermia: Heat exhaustion and Heat stroke; How much water should you drink? 
51:55 Bat bites and rabies 
58:20 Snake bites 
66:03 Wound care and tourniquets 
75:40 Take Home Points; Outro; Bonus clip
Sponsor - VCU Health CE curbsiders.vcuhealth.org

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 the basics of wilderness medicine and how to approach a few common conditions.

Learning objectives

After listening to this episode listeners will…

Appreciate Wilderness Medicine as a medicine subspeciality and understand why or how someone might pursue this clinical focus area
Recognize signs and symptoms of high altitude sickness
Develop an approach to treating animal bites and injuries
Learn high yield tips for administering first aid in the wilderness including field hemostasis

Disclosures

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

Citation

O’Glasser AY, Gorth D, Deloughery T, Williams PN, Watto MF. “#242 Wilderness Medicine: Prfor Disaster”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date November 16, 2020.

Tags

Wilderness Medicine, Travel medicine, first aid, first aid kit, altitude sickness, acute mountain sickness, high altitude cerebral edema, high altitude pulmonary edema, acetazolamide, dexamethasone, hypothermia, frostbite, frostnip, heat exposure, heat exhaustion, heat syncope, hyperthermia, hyponatremia, animal bites, bats, rabies, snakes, antivenom, wound care, tourniquet, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#241 Chronic Cough Nov 09, 2020

Rejoice! as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward. 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). We hope you enjoy learning from this episode as much as we enjoyed producing it!

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; Stuart Brigham MD; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Brad Hayward MD

Sponsors: Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

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 - Panacea Financial panaceafinancial.comSponsor - VCU Health CE curbsiders.vcuhealth.org
00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week*
06:23 Sponsor - Panacea Financial panaceafinancial.com
07:30 Case of Post Infectious Cough; Basic definitions for cough
Important aspects of the history
Empiric therapies for post-viral cough
22:50 Case of idiopathic chronic cough; Physical exam
29:20 Basic testing and empiric therapy for the common causes of chronic cough
41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds
54:28 Take home message; Outro
Sponsor - VCU Health CE curbsiders.vcuhealth.org

Links*

90 Day Fiancé (show)
Below Deck Mediterranean (show)
Mastering Communication with Seriously Ill Patients by Anthony Back, Robert Arnold & James Tulsky (book)

*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 develop a pragmatic approach to evaluating subacute and chronic cough in adult patients.

Learning objectives

After listening to this episode listeners will be able to…

... define sub-acute vs chronic cough
... build a repertoire of history questions geared towards identifying the etiology of cough in a patient
... build a toolbox of diagnostic studies / tests that can be used in the evaluation of cough
... marry history, physical and diagnostic studies into a coherent approach to diagnosing subacute and chronic cough through a tiered/logical approach
... understand empiric therapies for cough that may have an advantageous risk-reward profile, even in the absence of diagnosis
... educate patients on common causes for subacute cough and chronic cough, as well as how to appropriately set expectations regarding symptoms severity and duration

Disclosures

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

Citation

Askin CA, Hayward B, Williams PN, Brigham SK, Okamoto E, Watto MF. “241: Chronic Cough”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date: November 9, 2020.

Tags

Cough, dyspnea, asthma, COPD, eosinophil, IL-5, allergy, ENT, allergist, pulmonary, pulmonologist, PFT, spirometry, post-nasal drip, GERD, reflux, eczema, rash, atopy, mucus, bronchiectasis, lung, antihistamine, CT, X-Ray, smoking, vaping, birds, dust, cockroaches, steroids, ICS, inhaled, gabapentin, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#240 Elbow Pain: Straighten it out Nov 02, 2020

Returning guest expert Dr Ted Parks helps us get the elbow straight with a simple approach to common causes of elbow pain for primary care. Listen as he guides Stuart through physical exam techniques (or watch them on YouTube) for epicondylitis and learn what the bursa is there for anyways. Find out what fracture you can treat in your office, why you shouldn’t stab straight into the olecranon bursa and when elbow pain should be referred. Feel confident when your patient comes in with elbow pain!

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: Molly Heublein, MD
Cover Art and Infographic: Edison Jyang
Hosts: Stuart Brigham MD, Matthew Watto MD, FACP; Molly Heublein, MD
Editor: Emi Okamoto, MD (written materials); Clair Morgan of Nodderly.com (audio/video)
Guest: Ted Parks, MD

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

Time Stamps

Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
Sponsor - VCU Health CE curbsiders.vcuhealth.org
00:00 Intro, disclaimer, guest bio
04:00 Picks of the Week*
Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/
09:50 Medial and lateral epicondylitis case, Elbow anatomy
13:00 Pathophysiology of epicondylitis, Epicondylitis exam, Epicondylitis treatment
34:11 Olecranon bursitis, Bursitis diagnosis and aspiration
46:12 Radial head fracture diagnosis, Radial head fracture treatment
55:30 Cubital tunnel nerve entrapment
57:45 Platelet rich plasma
60:39 Take home points, Plug and Outro
64:00 Bonus Pick of the Week
Sponsor - VCU Health CE curbsiders.vcuhealth.org

Goals

Listeners will have a working differential of elbow complaints that commonly present in primary care, and understand how to diagnose these and initiate treatment.

Learning objectives

After listening to this episode listeners will...

Perform an exam for medial and lateral epicondylitis.
Describe treatment options for medial and lateral epicondylitis
Identify when further evaluation for clinical olecranon bursitis beyond clinical exam is needed
Explain how radial head fractures differ from most other fractures, and why casting or surgery is generally not needed.

Links*

Molly’s Pick: The Warmth of Other Suns (book) by Isabel Wilkerson
Stuart’s Pick: The Fringe (TV show), JJ Abrams
Practical Office Orthopedics (textbook) by Ted Parks, MD

*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.

References

Johnson GW, Cadwallader K, Scheffel SB, Epperly TD. Treatment of lateral epicondylitis. Am Fam Physician. 2007 Sep 15;76(6):843-8. PMID: 17910298.
Simental-Mendía M, et al. Clinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials. Clin Rheumatol. 2020 Aug;39(8):2255-2265. doi: 10.1007/s10067-020-05000-y. Epub 2020 Feb 26. PMID: 32103373.
Parks, Ted. Practical Office Orthopedics. McGraw-Hill Education / Medical; 1st Edition (December 29, 2017).
Khodaee M. Common Superficial Bursitis. Am Fam Physician. 2017 Feb 15;95(4):224-231. PMID: 28290630.
Liow RY, Cregan A, Nanda R, Montgomery RJ. Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols. Injury. 2002 Nov;33(9):801-6. doi: 10.1016/s0020-1383(02)00164-x. PMID: 12379391.
Boone S, Gelberman RH, Calfee RP. The Management of Cubital Tunnel Syndrome. J Hand Surg Am. 2015 Sep;40(9):1897-904; quiz 1904. doi: 10.1016/j.jhsa.2015.03.011. Epub 2015 Aug 1. PMID: 26243318.

Tags

Elbow, orthopedics, olecranon bursitis, bursa, aspiration, septic joint, medial epicondylitis, lateral epicondylitis, radial head fracture, PRP, platelet rich plasma, humerus, olecranon, radius, tendonitis, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Disclosures

Dr Parks reports is the author of Practical Office Orthopedics (McGraw-Hill 2017) . The Curbsiders report no relevant financial disclosures.

Citation

Heublein M, Parks T, Jyang E, Brigham SK, Okamoto E, Watto MF. “#240 Elbow Pain: Straighten it out. A dabble into elbow care with Dr Ted Parks”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list November 02, 2020.

#239 Sinusitis: It’s Not That Tricky Oct 23, 2020

A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL).

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, Beth Garbitelli
Cover Art: Kate Grant MBChb, MRCGP
Infographic by: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio)
Guest: Dink Jardine, MD

Sponsors: National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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 – National Internal Medicine Day, The American College of Physicians
Sponsor - VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
03:00 Guest one-liner, Favorite failure, Pick of the Week*: Still Life by Louise Penny
Sponsor – National Internal Medicine Day, The American College of Physicians
09:30 Case 1 - Acute Viral Rhinosinusitis
10:40 Rhinosinusitis vs. Sinusitis
14:20 Physical exam in rhinosinusitis
20:40 Counseling patients about viral vs. bacterial infection
22:56 Sinus regimen/nasal irrigation - “Is there a sinus toilet”
27:10 Intranasal fluticasone and other intranasal medications
29:40 Rhinitis medicamentosa
30:40 Nasal spray positioning
33:50 Case 1 - Double Sickening
37:40 Worst case scenarios from rhinosinusitis
40:40 Antibiotic treatment for bacterial rhinosinusitis
43:20 Failed improvement on antibiotics? Second-line options
49:30 Case 2 - Chronic rhinosinusitis
52:28 Etiology of chronic rhinosinusitis
53:33 Making a diagnosis of chronic rhinosinusitis
55:25 Treating chronic rhinosinusitis
58:40 Vasomotor rhinitis
60:40 Sinus irrigation counseling and tips (YouTube)
65:30 Case 3 - Allergic Rhinitis
70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis
73:51 Take-home points

Links*

Still Life: A Chief Inspector Gamache Novel by Louise Penny, Chief Inspector Gamache series
“Dr. Adappa and Dr. Palmer teach you How to do Nasal Irrigation” https://www.youtube.com/watch?v=Br928VfiC1M

*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.

Goals

Listeners will develop an approach to the diagnosis and management of rhinosinusitis.

Learning objectives

After listening to this episode listeners will...

Classify rhinosinusitis, including acute, chronic, bacterial, and viral.
Discuss the microbiology and pathophysiology underpinning rhinitis and sinusitis.
Differentiate the presentation and management of acute bacterial and acute viral rhinosinusitis.
Develop an approach to the diagnosis and management of allergic rhinosinusitis.
Recognize and manage patients with non-allergic rhinitis.
Discuss the role of antibiotic therapy and surgery in the management of rhinosinusitis.

Disclosures

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

Citation

Williams PN, Garbitelli B, Jardine D, Heublein M, Watto MF.. “#239 Sinusitis: It’s not that tricky.” The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 26, 2020.

Tags

sinus, sinusitis, rhinitis, acute bacterial, rhinosinusitis, bacterial, viral, virus, nose, chronic sinusitis, ENT, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#238 DVT / PE Triple Distilled Oct 22, 2020

DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates.

Listeners can claim 2 hours of 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 by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

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

Time Stamps

00:00 Intro, disclaimer
01:40 Making the diagnosis of VTE
09:07 Triage and risk stratify Pulmonary Embolism
14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE
21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight, advanced CKD and in antiphospholipid syndrome
28:22 IVC filters
30:20 Outro

Links

Check out the full show notes from previous Curbsiders’ shows covering VTE.

Dr Oren Friedman #92 Pulmonary Embolism for the Internist
Dr Michael Streiff #154 DVT and PE Master Class

Goals

Listeners will feel confident in the diagnosis and management of VTE

Learning objectives

After listening to this episode listeners will...

Diagnose (VTE) DVT and PE using imaging, risk scores and clinical gestalt

Risk stratify patients with pulmonary embolism

Choose the appropriate initial anticoagulant for VTE

Decide duration of anticoagulation for VTE

Recall real risks and questionable benefits of IVC filters in DVT / PE

Determine need for cancer or thrombophilia workup in unprovoked DVT / PE

Disclosures

The Curbsiders report no relevant financial disclosures.

Citation

Watto MF, Williams PN, Brigham SK, Watto MF. “#238 DVT / PE Triple Distilled”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 22, 2020.

Tags

Pulmonary embolism, vte, dvt, pe, heparin, anticoagulation, right ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC filter, TPA, echocardiogram, CT scan, bleed, clot, deep, vein, thrombosis, DOAC, NOAC, anticoagulation, d-dimer, Wells, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#237 Ophthalmology for Primary Care Oct 19, 2020

Fun, fluorescein, and fundoscopy unite as our esteemed guest, Dr. Nisha Chadha @iEducatorMD (Mount Sinai School of Medicine) brings us ophthalmology for primary care! Dr. Chadha is a medical educator and the content creator of the med-ed simulation website 20/20 Sim. She teaches us the 3-vital signs of ophthalmology, how to recognize common diabetic eye diseases, how to explain diabetic retinopathy to our patients, how to optimize a patient for cataract surgery and so much more. This episode is truly vision-ary!

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, Produced, and Infographic by: Carolyn Chan, MD
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Nisha Chadha

Sponsors: National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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 – National Internal Medicine Day, The American College of Physicians
Sponsor – VCU Health Continuing Education
00:30 Intro, disclaimer, guest bio
03:21 Guest one-liner, Carolyn’s Pick of the Week
09:05 Picks of the Week*
10:13 Case from Kashlak, 3 - Vital Signs of Ophthalmology
17:09 Ocular complications of diabetes
20:22 Screening for diabetic retinopathy; Reports and Abbreviations
26:07 Counseling Patients: The eye is a camera; Clinical symptoms of ocular complications
32:07 Fluorescein Stain; Treatment Options for Diabetic Eye Disease: NPDR, PDR, VH, and RD
41:16 Eye Vitamins for Macular Edema
43:35 Cataracts
47:22 Missing Glaucoma Drops
50:50 Periop Optimization for Cataract Surgery, Anticoagulation and Other Medical Management
58:14 Take Home Points, Plug: 20/20 Sim; Outro
Sponsor – VCU Health Continuing Education

Links*

Mindset: The New Psychology of Success by Carol S. Dwek
Crackdown Podcast
20/20 Sim Site

*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 discuss screening, counseling, and management of common ocular diseases seen within primary care. Learning objectives

After listening to this episode listeners will…

Define and assess the three vital signs of ophthalmology.
List ocular complications of diabetes.
Counsel a patient on a new diagnosis of diabetic retinopathy.
Describe treatments for diabetic retinopathy.
Define proliferative retinopathy, non-proliferative retinopathy, and macular edema.
Compose a perioperative medication management plan for cataract surgery

Disclosures

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

Citation

Chan C., Chadha N., Okamoto E., Watto MF. “#237 Ophthalmology for Primary Care”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date October 19, 2020.

Tags

Eye, ophthalmology, ophtho, optometry, glaucoma, diabetes, diabetic retinopathy, macular edema, cataracts, cataract surgery, perioperative management, physical exam, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#236 Approach to Shortness of Breath: Physical Exam Series Oct 12, 2020

Learn which exam maneuvers are worthwhile and which ones are worthless in your approach to shortness of breath. In our evidence based series on the physical exam, we discuss the approach to the dyspneic patient with Dr. Brian Garibaldi (Hopkins, SBM), associate professor of pulmonary and critical care medicine at Johns Hopkins, and co-president of the Society of Bedside Medicine. We discuss the physical exam’s effect on our differential diagnosis, maneuvers that are commonly taught, and some simple tests with great data that may go overlooked. Be prepared, this episode may take your breath away!

Credits

Written and Produced by: Justin Berk, MD, MPH, MBA and Sam Masur, MD
Infographic: Sam Masur, MD, Beth Garbitelli
Cover Art: Beth Garbitelli
Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; and Paul Williams, MD, FACP
Editor:Justin Berk MD; Clair Morgan of nodderly.com
Guest(s): Brian Garibaldi, MD

Sponsors: National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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 – National Internal Medicine Day, The American College of Physicians
Sponsor – VCU Health Continuing Education
00:00 Intro, disclaimer, guest bio
Sponsor – National Internal Medicine Day, The American College of Physicians
03:47 Introduction to evidence-based exam, pre-test probability, and likelihood ratios
05:29 Case from Kashlak Memorial
06:51 Dr. Garibaldi’s initial maneuvers for the dyspneic patient
11:33 Recapping the exam maneuvers
14:05 Likelihood ratios for common maneuvers
18:25 Over 6/Under 6 maneuvers
25:30 Recap of Dr. Garibaldi’s go-to maneuvers
28:19 Role of labs and diagnostic imaging
31:03 Role of point-of-care ultrasound (POCUS)
34:10 Friday at 5pm
36:31 Take home points
39:25 Outro
Sponsor – VCU Health Continuing Education

Links*

Goal

Listeners will feel confident how to optimally use the physical exam to guide clinical decision-making in patients presenting with dyspnea.

Learning objectives

After listening to this episode listeners will…

Describe the effectiveness of the exam when it comes to aiding diagnosis in a patient with dyspnea
Identify specific exam maneuvers that can aid clinical decision-making
Identify exam maneuvers that may not offer more information compared to imaging such as POCUS

Disclosures

This episode was made with assistance from the Society of Bedside Medicine and funding from the New York Academy Medicine. Dr Garibaldi reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation

Masur S, Garibaldi BT, Watto M, Williams P, Brigham S, Berk J. #236 Physical Exam Series: Approach to Shortness of Breath. The Curbsiders Internal Medicine Podcast. https:/www.thecurbsiders.com/episode-list. Original Air Date October 12, 2020.

References

Mochizuki K et al. Importance of respiratory rate for the prediction of clinical deterioration after emergency department discharge: a single-center, case-control study. Acute Med Surg. Nov 2016. doi:10.1002/ams2.252
Sarkar M et al. Physical signs in patients with chronic obstructive pulmonary disease. Lung India. 2019. doi:10.4103/lungindia.lungindia_145_18
Fagan TJ. Letter: Nomogram for Bayes theorem. N Engl J Med. 1975;293(5):257. doi:10.1056/NEJM197507312930513
Simel, David, et al. Rational Clinical Examination, McGraw-Hill Professional Publishing, 2009. ProQuest Ebook Central
McGee, Steven. Evidence-based physical diagnosis [4th edition] Elsevier, 2018. Clinical Key
Benbassat, J., Baumal, R. Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?. J GEN INTERN MED 25, 865–872 (2010). https://doi.org/10.1007/s11606-010-1327-8
Al Deeb M et al. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-852. doi:10.1111/acem.12435
Yousefifard et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emerg (Tehran). 2016;4(1):1-10.
Martindale et al. Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016;23(3):223-242. doi:10.1111/acem.12878
Caldentey et al. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure). JACC Heart Fail 2014.. doi:10.1016/j.jchf.2013.10.004

Tags

Physical exam, dyspnea, shortness of breath, auscultation, PMI, percussion, heart failure, wheeze, POCUS, COPD, JVD, hepatojugular reflux, observation, asymmetry, Brian Garibaldi, practice, pallor, lung, heart, hands.

#235 Spooky Cakes: Dapa-CKD, Turmeric for Knee Pain, Honey for URTI Oct 05, 2020

Time for spooky cakes with a side of candy corn. We discuss Dapagliflozin (SGLT2i) for CKD, Turmeric for knee pain and Honey for URTI (cough) on this halloween themed hotcakes with Rahul Ganatra MD, MPH @rbganatra

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (Note: CME for this episode won’t be available until 10/12/20. We apologize for the inconvenience).

Credits

Producer: Sarah Phoebe Roberts
Written by: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH
Cover Art: Matthew Watto MD, FACP
Hosts: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors National Internal Medicine Day

Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

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

00:00 Sponsor – National Internal Medicine Day, The American College of Physicians
00:25 Sponsor – VCU Health Continuing Education
00:40 Intro, disclaimer, Picks of the Week
07:38 Sponsor – National Internal Medicine Day, The American College of Physicians
08:40 Dapa-CKD
20:00 Turmeric for Knee Osteoarthritis
32:10 Honey for URTI and Cough
46:32 Shout out to @votehealth2020 and PatientVoting.com
48:25 Outro
Sponsor – VCU Health Continuing Education

Links*

Candy Corn (autumn mix) and (classic)
Paul’s Halloween movie marathon: Cabin in the Woods, The Descent, The Witch, Ghostbusters

*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 review and perform critical appraisal of recent articles with the potential to change internal medicine practice

Learning objectives

After listening to this episode listeners will…

Review the potential benefits of dapagliflozin for prevent of CKD progression and death
Evaluate the utility of turmeric for osteoarthritis with inflammatory synovitis
Discuss the efficacy of honey for the treatment of acute upper respiratory tract infection and persistent post-infectious cough

Disclosures

The Curbsiders report no relevant financial disclosures.

Citation

Watto M, Ganatra R, Williams PN, Brigham SK, Roberts SP. “235 Spooky Cakes”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 5, 2020.

Tags

Dapagliflozin, slgt2i, sglt2 inhibitors, ckd, turmeric, curcumin, knee osteoarthritis, knee pain, synovitis, honey, urti, respiratory tract infection, cough, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

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

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

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

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, 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*

*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 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

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

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, 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)

*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.

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

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

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

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*

*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 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

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

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*

*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.

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

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

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.

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

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

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.

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

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

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.

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

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

Time Stamps

Introduction 1:00
How to answer “What do you think about school openings?” 11:30
Risk Assessment of School Re-openings 14:40
Evidence of Transmission among Children 17:10
What Other Countries Have Done 19:40
Community Threshold for Re-Opening and Using Protocols 20:30
The Reasons to Cohort 22:45
How to Address Scenarios 24:20
Health Disparities and Return to School 27:00
Existing Inequities and Children’s Sacrifice of Education 29:00
“Opting Out” of School Return and Feeling Safe 31:30
How Can Governments Help Support the Return 35:50
Guidance to give as PCP 37:50
School Alternatives / Innovations to Going Back 40:10
The Difference Between Equity and Equality 42:50
Testing in Schools 43:45
Resources to Follow For More Information 46:00
Take-Away Points 47:10
Optimism 48:25
Picks of the Week 53:50

#227 Baffled by NAFLD? Jul 27, 2020

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

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

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

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

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

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

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

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

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

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

#218 Trauma-Informed Care with Megan Gerber MD Jun 08, 2020

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment, modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255.

Credits

Producer/Writer/Graphics: Beth Garbitelli
Co-Producer: Paul Williams MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
Guest: Megan Gerber MD, MPH, FACP

Sponsor: ACP - Visit acponline.org/member

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

Time Stamps

Intro, disclaimer, guest bio (0:00 - 3:15)
Guest one-liner (3:30)
Kashlak Cases (13:45)
Epidemiology of trauma (15:18)
Trauma and #MeToo (18:10)
Defining Trauma-Informed Care (TIC) (19:00)
Integrating TIC into primary care (22:48)
Screening in TIC (25:00)
Containment and retraumatization (29:00)
Inquiring about trauma (30:45)
Recap and Office Visit Mechanics (35:30)
Building the Relationship (38:00)
Common Inquiry Mishaps (38:52)
TIC Physical Exam (40:20)
Resources for Patients (44:30)
Office Environment (48:00)
Provider Burnout (50:00)
TIC in Covid-19 (52:30)
Take-home Points (56:20)

Curious Clinicians Episode 1 - Clubbing Jun 03, 2020

Introducing our friends, The Curious Clinicians:

Why do human bodies work how they do? Why do medications work, or not work? Do you miss digging into the “why” behind what we do every day? Join Hannah Abrams (@hannarabrams), Tony (@tony_breu), and Avi (@AvrahamCooperMD) in the Curious Clinicians podcast as they delve into these questions & more, starting with episode 1: Why does fingernail clubbing happen in so many different diseases? https://curiousclinicians.com/

Check out their website and subscribe on your favorite podcast player.

#217 COVID Cakes the Fourth: ACTT-1, Triple Therapy, PCR, Serology Jun 01, 2020

Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross!

Credits

Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD
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

Sponsors: ACP and VCU Health CE

Time Stamps

00:00 Sponsors
00:30 Intro, disclaimer
02:40 Fomites, groceries and killer rats
08:22 Sponsor
09:22 ACTT-1 trial of remdesivir
18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon
33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests?
44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics
50:30 Outro

#216 Homeless Healthcare with Stefan Kertesz MD May 28, 2020

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!). Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is.

Credits

Written and Produced by Nora Taranto MD
Infographics by Nora Taranto MD
Cover Art by Kate Grant MBChB, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD
Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com
Guest: Stefan Kertesz MD

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
3:17 Guest one-liner
8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/
10:07 Case from Kashlak
10:56 Language: How to ask where a patient lives?
13:25 Terminology: Persons Experiencing Homelessness:
14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors
20:44 How to start the visit, and how to establish trust early on?
27:40 Why is the mortality rate higher?
35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C
54:15 COVID and homeless healthcare
57:00 Care Models
62:30 Take Home Points and Outro

#215 Medical Myths: Challenge Dogma with Dr. Douglas Paauw May 25, 2020

Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist.

Credits

Written and Produced by: Justin Berk, MD MPH MBA
Infographic and Cover Art: Beth Garbitelli
Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Douglas Paauw, MD

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories!
06:15 Medical Myth Definitions
10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol
19:09 Expired Medications; Military Stockpiling Study
24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap
31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%)
41:07 Epinephrine in extremity; RCT of Epi in Extremities
Study showing Experts use it; Podiatry journal
48:39 Take home points and Outro

#214 COVID Cakes 3: Llamas, Remdesivir, Strokes, Predicting the Future, and More! May 18, 2020

Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again!

Credits

Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD
Cover Art: Beth Garbitelli
Hosts: Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD , Sarah P. Roberts MPH,
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE

Time Stamps

00:00 Intro
02:10 Fun animal facts: Llama antibodies
09:10 Remdesivir RCT by Wang et al
12:40 Power and Sample Size
16:32 Baseline Characteristics, Results and Author’s conclusions
19:15 Rahul’s conclusions: How chance and bias affected the results
24:00 Right censoring; Viral load and timing of antivirals
30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial
33:53 Are patients really having fewer strokes and heart attacks?
38:20 Awake proning
43:30 Paul teaches us not to use the term “happy hypoxemic”
45:00 CIDRAP viewpoint on future waves and exit strategies
50:22 Outro

#213 Fatigue for Primary Care with Nina Mingioni MD - A Common Sense Framework May 11, 2020

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond!

Credits

Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams
Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Nina Mingioni MD, FACP

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio and a bad pun
03:00 Guest one-liner
07:10 Case from Kashlak, Defining fatigue; Taking a general history
11:36 Most common causes of fatigue and how to elicit them from the history
20:39 Physical exam for fatigue; Medications that cause fatigue;
25:25 Exam findings and LRs for anemia; Sleep apnea
30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme
47:55 Spiel to the patient when no answer is found
51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis
55:09 Take home points and Outro

#212 Inpatient Alcohol Withdrawal: Sober Talk with Joji Suzuki, MD May 07, 2020

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal! Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!).

Credits

Written and Produced by Nora Taranto MD
Infographic and Cover Art by: Nora Taranto MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Joji Suzuki MD

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film)
08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk
17:32 Outpatient Versus Inpatient Treatment
25:27 Gabapentin for alcohol withdrawal
27:10 Indicators for ICU level Care
31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs
36:55 And which benzo?
39:47 A Natural History of Withdrawal
44:10 Banana Bags and Thiamine Deficiency
48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing
56:36 Outro and Bonus clip

#211 COVID Cakes: Remdesivir, Anticoagulation, and Transmission May 01, 2020

In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us!

Credits

Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD
Writer: Emi Okamoto MD, Rahul Ganatra MD MPH,
Cover Art: Chris Chiu MD
Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors: Apollohct.com and VCU Health CE

Time Stamps

00:30 Intro, disclaimer
02:30 Picks of the Week
6:36 Remdesivir trial rundown
21:52 Thrombosis in COVID-19
29:50 Asymptomatic/Presymptomatic transmission
41:42 Quick takes
49:00 Outro

#210 Kidney Transplant for the Internist with Freely Filtered (NephMadness) Apr 27, 2020

It’s NephMadness! Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from the Freely Filtered Podcast led by Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist. Topics: indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME

Credits

Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew
Infographic: Cyrus Askin MD
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE

Time Stamps

00:00 Announcement, Intro to Freely Filtered and NephMadness
04:00 Case of advanced CKD; Who/when to refer for transplant
12:05 Benefits of renal transplant
16:22 Counseling patients with advanced CKD about transplant and a bit on living donors
20:40 Medications after transplant; Drug-drug interactions
25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness
32:07 Calcineurin inhibitor levels
36:42 Prophylaxis for long term complications
40:21 Allograft rejection; BAMF criteria
50:40 Cardiovascular risk; Statins
56:11 Malignancy after kidney transplant
60:00 NephMadness Transplant Region: Biomarkers vs Biopsy
72:23 Outro

#209 LIVE! Twitter, Social Media and Digital Scholarship Apr 23, 2020

LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Matthew Watto MD, FACP
Infographic: Michelle Brooks MD
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Michelle Brooks MD

Sponsor: VCU Health CE

Time Stamps

00:00 Guest one liner, favorite failure, career advice,
08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series)
11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles
23:04 Negative aspects of social media
26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer
37:14 Pros and Cons of #medtwitter
42:02 Tweetorials
44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media
51:34 Outro

#208 Hypothyroidism Master Class with Susan Mandel MD - How to dominate the diagnosis and management Apr 20, 2020

Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on!

Credits

Written and Produced by: Elena Gibson MD
Cover art and Infographic by: Dr Kate Grant MBChb MRCGP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com
Guest: Susan Mandel MD, MPH

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice
09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms
13:20 When to Test for Hypothyroidism
17:43 Biotin interaction
19:49 Which thyroid tests should we order?
26:15 Subclinical hypothyroidism
29:00 Etiology/Types of hypothyroidism
33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam
37:10 Levothyroxine replacement time of administration
42:10 TSH goal
46:00 Levothyroxine manufacturers
48:33 Dosing in older adults
50:27 T3 treatment
56:52 Pregnancy
59:42 Dose adjustments
61:43 Estrogen and thyroid binding protein
63:33 Who needs a referral?
65:40 Plugs, Outro

#207 How to create a medical podcast: Tales from The Curbside Apr 16, 2020

Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

Written and produced by: Matthew Watto MD
Cover art and Infographic by Matthew Watto MD
Hosts: Matthew Watto MD and Paul Williams MD
Editor: Clair Morgan of Nodderly.com

Time Stamps

00:00 Announcement, Intro, Disclaimer
02:53 Our top podcasting pearls
07:01 Find your niche
09:46 Logistics
13:25 Business, finances and legal matters
14:40 Equipment
21:48 Recording and editing
24:56 Website, web and media hosting
28:53 How to setup and record your podcast
35:08 Editing software
35:58 Search engine optimization
37:45 Post-processing
39:49 Take home points and outro

#206 Airway Management for the Non-Intensivist Apr 13, 2020

Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management in these challenging times. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD
Show Notes: Cyrus Askin MD
Infographic: Elena Gibson, MD
Cover Art: Dr. Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: COL Kevin Chung, MD, FACP

Sponsors: McGraw Hill

Time Stamps

00:00 Intro
03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice
07:40 Sponsor
08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs
16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation
23:40 Proning patients for hypoxemia
29:15 ARDS basics: diagnostic criteria, Brief Recap
33:22 Mechanical ventilation: Initial settings, following the blood gas
40:55 Peak and plateau pressure, Lung compliance and Troubleshooting a high pressures
51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs
62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19
68:10 Take home points; Plugs; Outro

#205 COVID Cakes and Hot Takes with Rahul Ganatra MD Apr 10, 2020

Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston). Plus, @Paulnwilliamz and @cjchiu give us some telehealth along with the usual antics. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

Written, Produced, Hosted by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art and Show Notes by: Matthew Watto MD, FACP
Editor: Matthew Watto MD
Guest: Rahul Ganatra MD

Time Stamps

00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week
07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site
11:50 Telehealth best practices
16:42 Convalescent plasma and Serology
21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report)
23:45 Inequality during the pandemic VOX and NYTimes articles on inequality
25:30 Critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial
49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)

#204 NephMadness 2020: SGLT2 Inhibitors Apr 06, 2020

Get under the hood of SGLT2 inhibitors! Listen as our guests Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf give us a tour through the NephMadness 2020 SGLT2i region! How do these promising drugs work, and what evidence is there for using them in non-diabetic kidney disease or kidney transplant patients. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

Written and Produced by: Hannah R. Abrams
Cover Art and Infographic by: Hannah R. Abrams
Hosts: Hannah R Abrams, Matthew Watto MD, FACP
Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written)
Guests: Harish Seethapathy MD; Matthew Sparks MD; Joel Topf MD

Sponsor: McGraw Hill

Time Stamps

00:00 Sponsor
00:26 Intro, disclaimer, guest bio
02:57 Guest one-liner and Picks of the Week*: Michael Pollan audiobook on Coffee and Caffeine Addiction
03:52 SGLT2i definition, background, and why we now consider CV endpoints in diabetes
11:16 Sponsor
12:00 Tubuloglomerular feedback; Balloon analogy
17:40 Other mechanisms for SGLT2i
23:05 Back to the case; Risks from SGLT2i; Counseling and Monitoring
34:18 SGLT2i for non-diabetic kidney disease; Possible mechanisms: Joel’s caution against early adoption
41:42 SGLT2 inhibitors in kidney transplant
45:20 Take home points and picks for the SGLT2 inhibitor region
49:50 Outro

#203 How to Create an Online Curriculum for Medical Education Apr 02, 2020

Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running.

Credits

Written and Produced by: Paul Williams MD, FACP
Cover art and Show notes by: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Kat Zechar MD and Amreet Sidhu MD

Time Stamps

00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020.
01:22 Intro, disclaimer and guest bios
03:38 Guest one-liners, Picks of the week
09:30 Why you might need an online meded curriculum
16:33 Overview of Amreet and Kat’s online curriculum
21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment
36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org)
46:35 Time commitment
50:55 Take home points and Outro

#202 LIVE! Lymphadenopathy: Taking Your Lumps - with Carrie Thompson MD Mar 30, 2020

LIVE! from Mayo Clinic, a practical approach to lymphadenopathy with Carrie Thompson MD @cathompsonmd (Hematology Oncology, Mayo Clinic). Dr. Thompson provides her simplified approach to the history, differential diagnosis, high yield lab testing, imaging, how to counsel patients with adenopathy and tips on when, where and how to biopsy!

The Curbsiders are insanely grateful to the Mayo Clinic Internal Medicine Residency Chief Residents @mayomn_imres (@JasonEckmannMD @SamiRyanMD @BHuffmanMD @CourtHarrisMD) and their amazing program director @AmyOxentenkoMD for an amazing trip to Rochester!

Credits

Written and Produced by: Carrie Thompson MD and Matthew Watto MD, FACP
Infographic: Matthew Watto MD, FACP
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Carrie Thompson MD

Time Stamps

00:00 Announcement: We’re looking for Medical Student members. Send applications to thecurbsiders@gmail.com by April 10, 2020.
01:20 Intro, guest bio, one-liner, career advice; Pick of the week*: In Shock by Rana Awdish
07: 00 Lymphatic system
09:19 Differential diagnosis for lymphadenopathy
11:38 Taking a history (ALL AGES mnemonic), Red Flags
19:15 Physical exam for lymphadenopathy
22:30 Which labs to order; Flow cytometry
26:05 Imaging
28:30 Counseling patients with LAD
31:10 Biopsy: How to choose type and location
37:35 Take Home Points
39:00 Audience Questions
42:25 Outro

#201 COVID Narratives: Stories from Physicians at the Front Lines Mar 26, 2020

Listen as the pioneers of the COVID pandemic share their experiences taking care of some of the first COVID patients in the US. Our guests have a broad range of expertise and experiences. This episode features hospitalist Dr. Francisco Alvarez (University of California at San Francisco, @fnalvarez), Infectious Disease fellow Dr. Karolina Maciag (University of Washington, @KMaciag), Critical Care and Pulmonology Fellow Dr. David Furfaro (Columbia University, @david_furfaro

Credits

Written and Produced: Justin Berk MD MPH MBA
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Justin Berk MD MPH MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Francisco Alvarez, Dr. Karolina Maciag, Dr. Dave Furfaro, Dr. Nick Mark

Sponsors: Cayuga

Time Stamps

00:00 Intro
04:28 Francisco: Process leading up to first case
07:42 Karolina: The perspective of the consultant- calm in the storm
11:40 (Karolina) Seattle Flu Study as early warning
16:00 Dave: ICU patients
20:30 Nick: making decisions with a moving target
25:05 Sponsor
25:53 Francisco: data available on Twitter
28:00 Francisco: the role of generalist during the COVID pandemic
31:15 Karolina: on vulnerable populations during pandemic
38:26 Dave/Nick: how generalists should be preparing themselves
45:16 Avoiding aerosolized procedures / nebulizers
47:46 What was the big surprises
54:20 How do you address the anxiety
60:12 Plugs
64:20 Outro

#200 COVID-19 with Paul Sax MD - Transmission, quarantine, PPE, diagnosis and management Mar 22, 2020

Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral!Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits

Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP
Cover Art and Infographic by: Beth Garbitelli
Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Paul Sax MD

Sponsor: Cayuga

Time Stamps

00:00 Intro
04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza
07:00 Rahul highlights areas of caution interpreting COVID cases studies
12:35 Sponsor
13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms
18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity
21:15 Who merits testing for COVID-19
23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine
25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital
30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible?
32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine
36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces?
40:20 Do exposed HCWs without symptoms require quarantine?
41:30 Personal Protective equipment (PPE)
45:00 COVID-19 in pregnancy
47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.)
50:45 Where should you get your COVID-19 information?
52:30 Closing remarks and outro

#199 NephMadness: Hyperkalemia, Diet, Potassium Binders, Exercise Mar 16, 2020

NephMadness 2020 is here! Listen as Dr. Ryann Sohaney (@ryannsohaney), Dr. Deborah Clegg and Dr. Joel Topf (@kidney_boy) discuss this year’s first Nephmadness topic, Hyperkalemia in CKD. They will (1) review the use of potassium binders for management of hyperkalemia in CKD (2) identify the potential health benefits of dietary potassium and challenge the use of low-potassium diets in CKD, and (3) describe how exercise influences serum potassium and consider exercise recommendations in CKD.

Check out the regions and fill out your brackets for NephMadness 2020 here! Sign-up as a part of The Curbsiders team!

Credits

Written and Produced by: Elena Gibson MD
Infographic: Caitlyn Vlasschaert MD
Cover Art: Elena Gibson MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan Nodderly.com (audio)
Guest: Ryann Sohaney, MD; Deborah Clegg, PhD; Joel Topf, MD

Time Stamps

00:00

#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD Mar 09, 2020

Polycystic ovary syndrome (PCOS) is more common than we think! Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!).

Credits

Written and Produced by: Molly Heublein, MD
Cover Art and Infographic: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Molly Heublein, MD
Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Katherine Sherif, MD

Time Stamps

00:00 Sponsors - AccessMedicine.com (McGraw-Hill)

#197 Pulmonary Nodules and Lung Cancer Screening with Denitza Blagev MD Mar 02, 2020

Join us as we demystify the world of pulmonary nodules & lung cancer screening. During this episode, Dr. Denitza Blagev (@mybetterdoctor) makes her triumphant return to The Curbsiders to help us tackle this topic. She is currently the Medical Director for Quality/Specialty-Based Care at Intermountain Healthcare and a Pulmonary & Critical Care physician. We learn to take command of the recommendations for lung cancer screening, disambiguate the terms used by pulmonologists and radiologists, and appreciate some of the nuances of lung cancer screening all with the hope of making YOU a better primary care physician!

Credits

Written and Produced by: Cyrus Askin MD & Leah Witt, MD
Infographic: Leah Witt, MD
Cover Art: Dr. Kate Grant MBChB DipGUMed
CME/MOC: Cyrus Askin, MD
Hosts: Cyrus Askin MD; Leah Witt, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editors: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Denitza Blagev, MD

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps

00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders
00:15 Intro, disclaimer, guest bio
02:15 Guest one-liner;

#196 LIVE! Refugee Health with Tanuja Devaraj MD Feb 24, 2020

Develop your approach to refugee health in the primary care setting. We discuss important considerations for primary care of the refugee patient with Dr. Tanuja Devaraj (Penn State), an internist with expertise in migration health. We review barriers to primary care, how to take a migration history, and common health concerns that occur in this patient population. We also discuss strategies for screening for trauma and mental health issues, which are common among patients who have gone through migration.

Credits

Producer: Paul Williams MD, FACP
Writer: Tanuja Devaraj MD and Paul Williams MD, FACP
Infographic: Emi Okamoto MD
Cover Art: Paul Williams MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written)
Guest: Tanuja Devaraj MD

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps

00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders
00:15 Intro, disclaimer, guest bio
02:08 Guest one-liner, book recommendations, career advice
07:12 Picks of the Week*:

#195 TWDFNR 3: Potassium, Oxygen, and antipsychotics Feb 17, 2020

Discover common practices that persist in the hospital wards despite no proven benefit! We review how potassium replacement goals should not drive you bananas, extra oxygen should not give you comfort, and how you should maybe calm down with antipsychotics for delirium. Join returning guests: high-value care specialist Dr. Lenny Feldman (@DocLennyF, Johns Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 3 of “Things We Do for No Reason^TM.

SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.

Credits

Written and Produced by: Burton H. Shen MD, Justin Berk, MD MPH MBA
Infographic:
Cover Art:
Hosts: Justin Berk MD MPH MBA; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FaCP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Lenny Feldman MD, Tony Breu MD

The Society of Hospital Medicine

Hospital Medicine 2020 (HM20) is the Society of Hospital Medicine’s Annual Conference April 15th through the 18th in sunny San Diego. Don’t miss the largest hospital medicine meeting. Register now at https://shmannualconference.org/ and use the code CURBSIDERS to receive a $50 discount.

Primary Care Internal Medicine of Ithaca

#194 Treatment of Alcohol Use Disorder with Dr. Marlene Martin MD Feb 10, 2020

Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder. Your patients need you!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Carolyn Chan, MD
Cover Art and Infographic: Carolyn Chan, MD
Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Marlene Martin, MD

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps

00:00 Sponsor -ACP’s MKSAP 18

#193 LIVE! The Struggling learner with Dr. Melissa McNeil Feb 03, 2020

Join us as we discuss how to approach “The Struggling Learner” with Dr. Melissa McNeil (@missydoc0128), Professor Medicine and Associate Chief of General Internal Medicine at the University of Pittsburgh Medical Center (UPMC), recorded LIVE in Pittsburgh, PA! In this episode, we discuss how to approach the struggling learner, highlighting the 5-Step process discussed in a recent article co-written by Dr. McNeil (Merriam 2019). This episode is not intended to give educators a roadmap for how to develop and implement a corrective action plan, but was put together to provide a common toolset on how to approach a struggling learner. As such, the topics discussed can be applied to all kinds of learners that struggle, not just in medicine. However, the techniques discussed involve a common framework routinely taught in medical education (assessment, diagnosis, and referral) and, therefore, is communicated using this shared language.

Credits

Written and Produced by: Stuart Brigham MD
Infographic: Matthew Watto MD, FACP
Cover Art: Stuart Brigham MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham, MD
Editor: Stuart Brigham MD (written materials); Clair Morgan at Nodderly.com
Guest: Melissa McNeil MD, MACP
Special thanks to Dr. William Kelly, FACP, FCCP

Sponsor

ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

#192 Dialysis for the Internist with Joel Topf MD Jan 27, 2020

Kidney Boy Returns! Compare the types of dialysis, learn how nephrologists approach medication management in ESRD, and avoid the most common mistakes non-nephrologists make in patients on dialysis! Kashlak Chief of Nephrology Dr. Joel Topf, @kidney_boy, walks us through what you need to know to take care of a patient on dialysis and gives us an idea of how nephrologists think through mineral bone disease (calcium, phosphorus and vitamin D), anemia, iron repletion, and hypertension. We answer all your questions about co-managing patients on dialysis!

Credits

Producer: Hannah R. Abrams
Written and produced by: Hannah R. Abrams
Cover Art and Infographic by: Hannah R. Abrams
Hosts: Hannah R. Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials), Clair Morgan of Nodderly.com (audio)
Guest: Joel Topf MD

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps

00:00 Sponsor -ACP’s Internal Medicine Meeting 2020
00:15 Intro, disclaimer, guest bio
01:45 Guest one-liner, Picks of the Week*: KidneyCon, CATS (film)
06:00 Sponsor -ACP’s Internal Medicine Meeting 2020
06:50 Case of Anne Yuric; Assessing risk of progression to dialysis; Candidacy for dialysis and renal

#191 Lipids Update with Erin Michos MD Jan 20, 2020

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

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Credits

Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli
Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA
Infographic: Beth “Garbs” Garbitelli
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP
Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Erin Michos MD MHS

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps

00:00:00 Intro
00:01:52 Getting to know Dr. Erin Michos
00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and

REBOOT #137 Hyperkalemia Master Class with Joel Topf MD Jan 13, 2020

A Curbsiders classic with a fresh intro by Hannah Abrams @hannahRabrams (soon to be MD)! 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. Get deeper into potassium physiology with a FREE pdf copy of Joel’s book The Fluid Electrolyte and Acid Base Companion here.

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits

Written, edited and produced by: Matthew Watto MD, FACP
Intro: Hannah R Abrams
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Infographic and Cover Art: Matthew Watto MD, FACP
Guest: Joel Topf MD

Time Stamps

00:00 Sponsor -ACP’s IM Meeting 2020 in LA
00:28 Disclaimer, intro and guest bio
03:00 Guest one-liner
Picks of the week* —Peloton indoor bike;

REBOOT #129 Depression and Physician Suicide with Elisabeth Poorman MD Jan 06, 2020

Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic!

Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that.

The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line.

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at doctorpoorman@gmail.com, or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need.

New episodes return January 20, 2020!

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits

Written and produced by: Nora Taranto MD, Shreya Trivedi MD
Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD
Edited by: Matthew Watto MD
Guest: Elisabeth Po

#190 Recap Extravaganza 2019 Dec 30, 2019

Recap extravaganza 2019 featuring top pearls from our staff’s favorite episodes of 2019 and voicemails from Kashlak faculty, Dr. Avital O’Glasser (@aoglasser), Dr. Kimberly Manning (@gradydoctor), Dr. Renee Dversdal (@DrSonosRD) and The Curbsiders team. Topics include: HFpEF, the PARAGON-HF trial, Buprenorphine, Opioid Use Disorder, Cirrhosis, Coagulopathy, SBP, Hyperkalemia treatment, Multimorbidity, and how to think about NNT. Plus, the team shares a bunch of other favorite moments and random pearls!

Upcoming shows: The next two weeks will feature REBOOT episodes with fresh intros from The Curbsiders team. Season 9 starts January 20, 2020 with a Lipid Update from Cardiologist Dr. Erin Michos (@ErinMichos)

Credits

Produced by: Sarah Phoebe Roberts MPH and Chris Chiu MD, FACP, FAAP
Writer: Sarah Phoebe Roberts MPH
Infographic: Sarah Phoebe Roberts MPH
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Chris Chiu MD, FACP, FAAP; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Chris Chiu MD, FACP, FAAP (audio), Matthew Watto MD, FACP (show notes)

Time Stamps

00:00 Intro and disclaimer
04:25 Picks of the year*: The Expanse (TV show) -Chiu Man’s pick;

#189 Medical Overuse: Common Cases of Overtesting, Overdiagnosis, Overtreatment Dec 23, 2019

Team up with the authors of the JAMA Medicine series on Medical Overuse, Dr. Dan Morgan @dr_dmorgan (University of Maryland) and Dr. Deborah Korenstein @DKorenstein (Memorial Sloan Kettering). We discuss procalcitonin (again!), the dangers of incidentalomas, risks of chest CT for lung cancer screening, the easiest place to get antibiotics for a viral infection, and why not to treat subclinical hypothyroidism despite guidelines. Trying to find ways to shed the fat off of some common medical practices? Look no further.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Justin Berk, MD MPH MBA
Infographic: Justin Berk, MD MPH MBA
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein MD, Matthew Watto MD, FACP, Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Daniel Morgan MD, Deborah Korenstein MD, FACP

Time Stamps

00:00 Intro, disclaimer, guest bios
04:45 Guest one-liners
Picks of the Week*: The Fifth Season is part of

#188 GERD and Dyspepsia with Dr. Amy Oxentenko MD Dec 16, 2019

Delve into the diagnosis and management of GERD and dyspepsia with Dr. Amy Oxentenko (@AmyOxentenkoMD), Gastroenterologist and the Internal Medicine Residency Program Director, Associate Chair for the Department of Internal Medicine, and Professor of Medicine at Mayo Clinic in Rochester, MN. Our discussion features a review of the standard presentations of GERD and dyspepsia, alarm symptoms and who needs referral for endoscopy or other specialized testing (pH, impedance testing, screening for Barrett’s esophagus). Additionally, we comprehensively cover proton pump inhibitor (PPI) therapy including: choice of agent, dose, frequency, how taper, how to counsel patients about risk, what labs should be monitored and the use of adjuvant therapies like H2 blockers, antacids and even carafate. After this episode, you will be flexing on reflux!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli
CME Questions: Beth Garbitelli, Matthew Watto MD, FACP
Infographic: Beth Garbitelli
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan at Nodderly.com
Guest: Amy Oxentenko MD

Time Stamps

00:00 Intro, disclaimer, guest bio
02:47 Guest one-liner, Picks of the Week*: Reality TV Shows: Survivor and

#187 Buprenorphine Master Class: Managing Opioid Use Disorder for the Generalist Dec 09, 2019

How to initiate buprenorphine like a pro. Treating people with Opioid Use Disorder can be the most rewarding part of your practice! Get comfortable with counseling and pharmacotherapy for OUD with tips from Dr. Michael Fingerhood, Associate Professor of Medicine at Public Health at Johns Hopkins. We review building a therapeutic relationship with people with substance use disorders, the differences between the three FDA-approved medications for opioid use disorder (buprenorphine, methadone and extended-release naltrexone), and the nitty-gritty of prescribing buprenorphine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Justin Berk, MD MPH MBA, Joseph “Seffy” Muller MD
Infographic: Hannah R Abrams and Justin Berk MD, MPH, MBA
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Justin Berk, MD MPH MBA
Editor: Matt Watto MD, FACP (written materials), Clair Morgan at Nodderly.com (audio)
Guest: Michael Fingerhood MD

Time Stamps

00:00: Introduction
04:40: Guest introduction & questions (great stories about addiction)
Picks of the Week*: Papillon (film) and Papillon (book) per Dr. Fingerhood;

#186 Sarcopenia: Raising the Bar in Primary Care Dec 02, 2019

Make some gains with Drs. Feigenbaum (@Jordan_theCoach) & Baraki (@AustinBaraki) of Barbell Medicine as we delve into the topic of sarcopenia! Together we’ll learn what exactly is sarcopenia, how it is diagnosed, and explore approaches to both management and counseling including: exercise prescriptions, recommendations for protein intake, and even how to treat patients with multiple comorbidities.

Credits

Written and Produced by: Cyrus Askin MD
Infographic: Cyrus Askin MD, Hannah Abrams
Cover Art: Dr. Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editors: Matthew Watto MD, FACP; Clair Morgan of Nodderly.com
Guests: Jordan Feigenbaum MD; Austin Baraki MD

Check Out our friends at Barbell Medicine!

Learn more about Barbell Medicine through their website at www.barbellmedicine.com or their YouTube channel - Barbell Medicine. They also have their own Podcast, The Barbell Medicine Podcast and can be found on Instagram: @barbell_medicine, Twitter via @BarbellMedicine.
Drs. Feigenbaum and Baraki can

#185 Hotcakes: Updates on CAP, Asthma & Red Meat! Nov 27, 2019

“Guidelines” galore! From Community-Acquired Pneumonia to asthma to...red meat? While you may be listening to this around Thanksgiving, we actually recorded on October 30th‒the best and spookiest time of the year. To really set the mood I wanted to include some terrible skeleton puns, but the ones I found weren’t humerus. What we do have for you are some tasty knowledge treats, courtesy of our ghosts‒oops, I mean our HOSTS‒Chris, Matt, Stuart and Paul. Join us as we review the most terrifyingly relevant research findings and creepiest clinical pearls!

Today also marks the debut of our newest Hotcakes team member, the frighteningly talented Dr. Rahul Ganatra. Rahul will now be our resident statistician/study design expert, and will use his research skulls‒no wait, SKILLS‒to provide even more insight into the practice-changing findings we love to highlight for you.

ACP members can claim CME-MOC at CME credit https://www.acponline.org/curbsiders. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Statistics Expert: Rahul Ganatra MD
Editors: Christopher Chiu MD (audio/text), Emi Okamoto MD (text)
Cover-Art: Sarah Phoebe Roberts MPH
Music: Stuart Brigham MD

Time stamps

00:00 Introduction/Disclaimer
03:18 Getting to know Dr. Rahul Gantra
05:35 Community-Acquired Pneumonia Guidelines
15:13 Sarah explains Hotcakes ratings
16:45 A new Asthma Strategy
17:26 Chris forgets what LABA stands for
27:37 Stuart makes a joke
29:00 A lot of meat talk
37:22 Rahul’s Napkin Calculations
51:40 Honorable Mentions
52:42 Take-away Points & Outtro

Meet Rahul:

Rahul Ganatra is a Medical Attending and Director of Continuing Medical Education for the Medical Service at the VA Boston Healthcare System. He fell in love with clinical epidemiology and public health while taking night classes for his MPH during medical school. and we

#184 Update in Sleep Medicine: LIVE from CHEST 2019! Nov 25, 2019

Score some great insights and clinical pearls from Dr. Christine Won on the incredibly important topic of sleep medicine during this live recording at CHEST! On this episode we’ll tackle why we sleep, how to treat insomnia, the “Z-drugs” and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Cyrus Askin MD, Matthew Watto MD, FACP
Infographic: Matthew Watto MD, FACP
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Christine Won, MD MSc

Sponsor

The American College of Chest Physicians

Time Stamps

00:00 Intro, disclaimer, guest bio
06:10 Guest one-liner
10:15 Picks of the Week*: Become Your Child’s Sleep Coach (book) by Lynelle Schneeberg;
Sleep in Art: How artists portrayed sleep and dreams in the last 7000 years (book) by Meir Kryger; The Toxic Avenger (film);

#183 Longevity, Healthspan and Lifespan with Peter Attia MD Nov 18, 2019

We want to live longer… and healthier too! Dr Peter Attia, a physician focusing on the applied science of longevity, walks us through lifespan and healthspan, exploring tactics aimed at extending both. Listeners will challenge the conventional approach to primary care and explore tactics to optimize exercise, nutrition, and health, including counseling on different dietary patterns, fasting, exercise, emotional well-being and how to prepare for the Centenarian Olympics!

Credits

Written and Produced by: Matthew Watto MD, FACP and Elena Gibson MD
Cover Art and Infographic: Elena Gibson MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD
Audio Editor: Clair Morgan of Nodderly
Guest: Peter Attia MD

Time Stamps

00:00 Intro, disclaimer, guest bio
04:22 Guest one-liner, Career Advice, Picks of the Week*
14:30 Case: A couple seeking maximize longevity; Defining longevity, healthspan, lifespan and the 4 types of death
19:30 Lifespan, the longevity curve and the long tail
23:50 Peter’s approach to shepherding patients toward longevity; Exploring motivations
32:06 Back to our couple: What exercises should they perform
42:09 Peter’s advice on nutrition; the standard American diet; Intermittent fasting; Dietary Restriction
51:20 Periodic fasting and water only fasting
54:33 Genetics and longevity
56:40 Metformin;

#182 Becoming a PGY3: Not Just a Repeat of PGY2 Nov 11, 2019

This podcast covers several concrete steps that residents can do or program directors can suggest to help residents transition to assuming the role of PGY3. A year is a long time, but requires a strategic approach to ensure that residents get the most out of it. It’s our latest offering from ACP’s IMpower series for residents featuring our friends from Walter Reed IM Residency: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray).

If you are a PGY3 you should: LEAD like someone’s life depends on it!

Credits

Written and Produced by: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD
Infographics: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guests: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray)

Sponsor - ACP IMpower: Catalyzing your professional future

Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.

Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

Time Stamps

00:00 Sponsor, disclaimers, intro, guest bios
05:10 Guest one-liners
07:43 Precocious Passion for teaching
09:30 Picks of the Week*: High Life (film);

#181 The Multimorbidity Games Nov 04, 2019

Learn how to approach the geriatric patient with multimorbidity and how to parse through and prioritize a mile-long problem list with Dr Josh Uy, master geriatrician at the University of Pennsylvania. We review different approaches to a clinic visit with a patient who takes fifteen daily medications with just as many chief complaints, all in a thirty minute (or less!) appointment time. We discuss what the term “multimorbidity” even means, how to ask about patient preferences and use them to inform the treatment plan, and what the evidence has to say about adjusting treatment goals of common conditions for individual patients. (Spoiler alert: It all depends on the patient, comorbid conditions and goals!)

Full show notes 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

Producer: Nora Taranto MD
Writer: Nora Taranto MD, Leah Witt MD
Infographic: Leah Witt MD
Cover Art: Nora Taranto MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Leah Witt MD, Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Clair Morgan
Guest: Josh Uy MD

Time Stamps

00:00 Pun, Intro, disclaimer, guest bio
04:30 Guest one-liner; Career advice;
Picks of the Week*: Unbroken (book), Down Dog Yoga (app); Check out Dimash’s music on YouTube; Off Your Rocker (TV show); Finishing Well to the Glory of God (book)
12:30

#180 CHEST 2019 Recap Part 2 Oct 30, 2019

CHEST 2019 Recap Part 2 featuring random pearls and highlights from #CHEST2019 in New Orleans including: tips for addressing futile end-of-life care, bleeding in the ICU, DOAC reversal agents, use of procalcitonin and monocyte distribution width to identify sepsis, vitamin C for sepsis treatment, small particles and lung cancer risk, augmented reality/virtual learning, and tech as a teaching tool. Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality.

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, produced, and co-hosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP
Edited by: Matthew Watto MD, FACP
Special Guests: Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Chidinma Chima-Melton MD, FCCP (@LABritishLady), Kim Fabyan MD (@kfabsMD)

Time Stamps

00:00 Pun, Disclaimer, Intro
03:58 Dr Erin Narewski on end of life conversations
13:30 Bleeding in the ICU
15:40 DOACs and reversal agents
18:40 Dr Chidinma Chima-Melton on ICU visiting hours
22:50 Vitamin C use in the ICU, Stuart’s Vitamin C rant
29:22 Monocyte distribution width for identifying patients with sepsis
30:55 Sarah Phoebe Roberts on Procalcitonin and CRP for sepsis
39:36 Dr Nina on technolo

#179 CHEST 2019 Recap Part 1 Oct 28, 2019

Recap of random pearls and highlights from #CHEST2019 including: A pop quiz on inhaler use, interstitial lung disease, pulmonary fibrosis (IPF), limitations of supplemental oxygen, lung cancer screening, imposter syndrome, and is it safe to use beta blockers in COPD.

Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality.

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, produced, and cohosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP
Edited by: Matthew Watto MD, FACP
Special Guests: Leah Witt MD (@leahJwitt); Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Hassan Bencheqroun MD, FCCP (@drBcalifornia); Chidinma Chima-Melton MD, FCCP (@LABritishLady)

Time Stamps

00:00 Intro, disclaimer
05:20 Dr Leah Witt @leahwitt (UCSF) quizzes us on inhalers.
09:55 Dr Leah Witt on ILD in geriatric patients
13:09 Dr Erin Narewski @erinnarewski (Temple) on supplement oxygen.
15:07 Dr Erin Narewski discusses the brand new BLOCK trial.
18:11 Dr Chidinma Chima-Melton

#178 Tuberculosis Updates with Laila Woc-Colburn MD Oct 21, 2019

Catch up on the latest guidelines and insights on tuberculosis with help from Dr. Laila Woc-Colburn, @docwoc71 (Baylor)! We cover new recommendations for screening health care workers, treatment of both latent and active TB, and best practices for counseling patients throughout the process. Listen to find out more… And say goodbye to the annual PPD?

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full notes 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: Hannah R. Abrams
Cover Art and Infographic by: Hannah R. Abrams
Hosts: Hannah R. Abrams; Matthew Watto MD, FACP
Editors: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Laila Woc-Colburn, MD, FACP

Partners

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two rec

#177 Osteoarthritis Master Class with Tuhina Neogi MD, PhD Oct 14, 2019

ACR osteoarthritis guidelines author, Dr. Tuhina Neogi (Boston University; @tuhinaneogi) schools us on all things OA, including new understandings of pathophysiology, diagnosis, when to order imaging and labs, and an overview of pharmacologic and nonpharmacologic therapies. Plus, get answers to your questions from Twitter on CBD, turmeric, glucosamine, chondroitin, NSAIDS, intra-articular steroid and hyaluronic acid injections, tai chi, and more!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes 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 (including CME questions) and Produced by: Beth Garbitelli and Matthew Watto MD, FACP
Cover Art and Infographic by: Beth Garbitelli
Hosts: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: Tuhina Neogi MD, PhD

Partners

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

In-Flight Emergencies REBOOT Oct 07, 2019

Dominate the most common in-flight emergencies with tools and tips from this classic Curbsiders episode. Our guest, Angelica Zen MD, (formerly an IM Chief Resident at UCLA), recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane. Original air date November 21, 2016.

Full show notes 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, produced and edited by: Matthew Watto MD, FACP
Cover Art by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Matthew Watto MD, FACP
Guest: Angelica Zen MD

Partners

Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Time Stamps

0

#176 Survive Intern Year: Becoming a PGY1 Oct 02, 2019

Tools, tips and tactics to survive intern year from Alex Glaser MD (PENN) and Saumil Chudgar MD @saumilchudgar (Duke). It’s our latest offering from ACP’s IMpower series for residents!
The transition from medical student to intern is one of the world’s most notorious times in a career, and tales of woe from intern year have even permeated into TV shows and movies. Ultimately, while the transition seems daunting with multiple challenges, it should not be feared. Many physicians look back fondly on this early time in their training, and life-long friendships often develop among an intern class. This is a time of major growth, and unease about intern year should be met with excitement for the career that is yet to come!
For meeting notes, a discussion guide and facilitators guide visit https://www.acponline.org/impower. 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: Alex Glaser MD
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD; Matthew Watto MD, FACP
Guests: Alex Glaser MD, Saumil Chudgar MD

Sponsor - ACP IMpower: Catalyzing your professional future

Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.
Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

#175 Cervical Cancer Screening and HPV Sep 30, 2019

We dive deep into the relationship between HPV and cervical cancer and identify when and how to screen women with tips from Dr. Karen Smith-McCune (UCSF), Professor in the Department of Obstetrics and Gynecology! We review common cytology findings, screening guidelines, and basic indications for HPV vaccination.
Full show notes 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

Producer: Molly Heublein MD
Writer: Elena Gibson MD and Molly Heublein MD
Infographic: Beth Garbitelli MS2
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Molly Heublein MD; Matthew Watto MD, FACP
Editor: Emi Okamoto MD; Matthew Watto MD, FACP
Guest: Karen K. Smith-McCune MD, PhD

Sponsors

Win a prize! Help ACP Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

#174 Dominate Perioperative Medication Management Sep 23, 2019

Dominate perioperative medication management with tips from Kashlak’s newly minted Chief of Perioperative Medicine, @aoglasser, Avital O’Glasser MD, FACP, FHM (OHSU). We cover perioperative anticoagulation, why “bridging is dead”, aspirin, dual antiplatelet therapy, DMARDS, diabetic medications, buprenorphine, and much more! Be sure to check out Dr. O’Glasser’s previous episode #135 Perioperative Medicine: Assess and Optimize Risk to get a full overview of perioperative medicine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes 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: Avital O’Glasser MD, FACP, FHM and Matthew Watto MD, FACP
CME Questions: Matthew Watto MD, FACP
Infographic: Matthew Watto MD, FACP
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: Avital O’Glasser MD, FACP, FHM

Time Stamps

00:00 Intro, disclaimer, guest bio
03:20 Guest one-liner
04:46 Picks of the Week*: A Moment of Lift (book) by Melinda Gates; Crawl (film); Rich Roll (podcast) episodes w/

#173 Hotcakes: Imposter syndrome, Vacations, Pneumonia vaccine, More! Sep 16, 2019

Dr Kimberly Manning joins to discuss imposter syndrome, how vacations affect health, and an update on the pneumonia vaccine, PCV13. Plus, hot takes on the dangers of vaping, and using procalcitonin and CRP to determine need for antibiotics.
Howdy, gentle listeners! It’s that special time of year when the school doors reopen, classrooms are awash in ‘new pencil’ smell, and FOAMed fans grab their trays and head to the cafeteria for some tasty knowledge food. Rest assured your Curbsiders friends have saved you a seat at the lunch table for this very special September 2019 episode!
Today we are joined by Dr. Kimberly Manning MD, FACP, FAAP, who is an Associate Professor of Medicine at Emory University School of Medicine. Dr. Manning authors a blog (“Reflections of a Grady Doctor”) that was named in 2010 by ‘O’ The Oprah Magazine as one of “four top medical blogs you should read.” She can also be found on Twitter, @gradydoctor. Thanks for listening!
Full show notes at https://thecurbsiders.com/episode-list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD, FACP, FAAP
Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH, Paul Williams MD, FACP; and Christopher Chiu MD, FACP, FAAP
Editor: Christopher Chiu MD, FACP, FAAP; Emi Okamoto MD
Cover-Art: Christopher Chiu MD, FACP, FAAP
Guest: Kimberly Manning MD, FACP, FAAP

#172 Cost-of-Care Conversations Sep 11, 2019

Recognize the importance of cost-of-care conversations and identify resources to facilitate these discussions with help from Gwen Darien, executive vice president at the National Patient Advocate Foundation, and Dr. Jessica Dine, Associate Professor and Chief of the division of Pulmonology and Critical Care at Perelman School of Medicine. We review barriers to cost-of-care conversations and identify tools to help make these conversations a part of routine care discussions.
Full show notes 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: Elena Gibson, MD
Infographic and Cover Art: Elena Gibson, MD
Hosts: Elena Gibson MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Gwen Darien and Jessica Dine MD

Partners and Grant Support

The American College of Physicians. Check out this supplement to the Annals of Internal Medicine from May 2019 on Fostering Productive Health Care Cost Conversations https://annals.org/aim/issue/937992

The Robert Wood Johnson Foundation https://www.rwjf.org provided grant support for this episode.

#171 Lupus in Primary Care with Beth Jonas MD Sep 09, 2019

Diagnose and treat lupus in primary care with tips from rheumatologist, Beth Jonas MD, FACR (UNC). We discuss the history and exam findings in lupus, initial lab workup, the dreaded ANA, who needs expanded lab testing, lifestyle factors in lupus, vaccinations, the basics of treatment...and Jethro Tull?!
Full show notes at https://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: Kate Grant MBChB DipGUMed; Matthew Watto MD, FACP
Infographic: Matthew Watto MD, FACP
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: Beth Jonas MD, FACR

#170 Hypernatremia is Easy with Joel Topf MD Sep 02, 2019

Solve hypernatremia with tips and tactics from Dr. Joel Topf, MD (@kidney_boy), our Kashlak Chief of Nephrology. We review the diagnostic workup for hypernatremia, polydipsia and polyuria, review the pathophysiology of diabetes insipidus, and how to differentiate between nephrogenic and central DI. Plus, we walk through how to treat hypernatremia in the acute setting and Dr. Topf shares clinical pearls on why hypernatremia is the opposite of hyponatremia… It’s easy!
Full show notes 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 by Hannah R. Abrams and Joel Topf MD
Producer: Hannah R. Abrams
Cover Art and infographic by: Hannah R. Abrams
Hosts: Hannah R. Abrams; Stuart Brigham MD; Matthew Watto MD, FACP
Editors: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Joel Topf MD

Check out Dr. Topf’s podcast!

The NephJC podcast, Freely Filtered, discusses the latest NephJC topic every two weeks. Subscribe here or on iTunes.

#169 PGY3 and Beyond with Alia Chisty MD Aug 28, 2019

Search and secure your first job after residency. Dr. Alia Chisty (Penn State) returns to school us on surviving the PGY3 and beyond, part of ACP’s IMpower series. Topics: finding mentors, how to plan ahead as an intern and PGY2, master the interview day, avoid common pitfalls and confidently enter your early career. We’re joined by Curbsider and recent graduate Justin Berk MD, MPH, MBA who shares his experiences from the job trail.
Flip the classroom!

For meeting notes, a discussion guide and facilitators guide visit visit IMpower: Catalyzing your professional future.
Credits

Written and Produced by: Paul Williams MD, FACP and Alia Chisty MD, MS
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guests: Alia Chisty MD, MS; Justin Berk MD, MPH, MBA

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 The American College of Physicians today! Resident members get exclusive access to IMpower: Catalyzing your professional future.

#168 Diabetes Update with Jeff Colburn MD Aug 26, 2019

Step up your diabetes game! We answer your questions from #MedTwitter with help from returning guest, Jeff Colburn MD, FACP, FACE (USU) Topics include: the pitfalls of A1C testing, the A1C target controversy, lifestyle interventions, continuous glucose monitoring, pathophysiology of T2DM, use of SGLT2 inhibitors, GLP1 agonists, and how to initiate and titrate insulin therapy. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).
Full show notes at https://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

Writer (including CME Questions) and Producer: Matthew Watto MD, FACP
Cover Art and Infographic: Bryan Brown MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Jeff Colburn MD, FACP, FACE

#167 LIVE! Common CBC Abnormalities with Mary Kwok MD Aug 19, 2019

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.
Full show notes at https://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, 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

#166 Advocacy and Hot Topics in Healthcare Policy with Robert McLean MD, FACP Aug 14, 2019

Join us for this roundtable discussion of advocacy in healthcare and a rundown of hot topics: coding and billing, the Affordable Care Act, universal healthcare, gender equity, women’s health, gun violence and more! Returning guest, Dr. Robert McLean (@rmmclean84), current president of the American College of Physicians, helps us answer questions like, What is advocacy in healthcare? What are the issues that are impacting your profession? What can your medical home do for you? He’s been heavily involved in advocacy throughout his career including testifying before Congress. Guest hosts Drs. Fatima Syed MD, MSc and Deep Shah MD, MSc join!
Full show notes available at https://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: Fatima Syed, MD, MSc; Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Fatima Syed, MD, MSc; Deep Shah, MD, MSc
Editor: Matthew Watto MD, FACP
Guest: Robert McLean MD, FACP

#165 Things We Do For No Reason™ Part 2 Aug 12, 2019

Discover more common practices that persist in the hospital wards despite no proven benefit! We review how hospitals prescribe a “crapload” of docusate which only clogs up the medication list, how unnecessary echocardiograms are ordered enough times to make your head spin, and how basal insulin needs to slide back into your inpatient diabetes management instead of correctional insulin monotherapy. Join high-value care specialist Dr. Lenny Feldman (@DocLennyF, Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 2 of “Things We Do For No Reason™.”
SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.
Full show notes at https://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: Justin Berk, MD MPH MBA, Matthew Watto MD
Infographic: Justin Berk MD MPH MBA
Cover Art: Matthew Watto MD
Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD
Editor: Matthew Watto MD, Emi Okamoto MD
Guest: Lenny Feldman MD, Tony Breu MD

Sponsor

The Society of Hospital Medicine / Journal of Hospital Medicine - Things We Do For No Reason™series. Check out all the Things We Do For No ReasonTM articles here: Master Index of TWDFNR articles .

Reboot #108 POCUS: Point-of-care Ultrasound for the Internist Aug 07, 2019

Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at www.acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine.

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 by: Christopher Chiu MD, FACP and Renee Dversdal MD, FACP
Produced and CME questions by: Christopher Chiu MD, FACP
Edited by: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Christopher Chiu MD, FACP
Guest Expert: Renee Dversdal MD, FACP

Special thanks to our POCUS friends!

ACP

We can speak first hand that the following courses are amazing POCUS learning experiences! Sign up today

Point-of-Care Ultrasound: Foundational Skills for Internists

November 7-8, 2019 and November 9-10, 2019 (same 2-day course repeated back to back)
Crowne Plaza O’Hare Hotel and Conference Center, Rosemont, IL
Registration is now open at acponline.org/pocus

Point-of-Care Ultrasound: Foundational Skills for Internists

April 21-22, 2020 (during Internal Medicine Meeting 2020)
Los Angeles Convention Center
Registration will open at the end of September

Point-of-Care Ultrasound: Advanced Skills for Outpatient Practice

April 22, 2020 (during Internal

#164 Stroke and TIA Deconstructed Aug 05, 2019

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! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).
Full show notes at https://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

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

#163 Hotcakes: Burnout, iron for heart failure, aspirin & VTE prevention Jul 29, 2019

Summary

The sun is shining, the cakes are hot, and the takes are even hotter. Welcome to our July 2019 Hotcakes episode! Join us as our beloved hosts Chris, Matt, Stuart and Paul share some of the latest practice-changing knowledge, news and research in medical science. Today’s discussion covers studies on the use of IV iron supplementation for heart failure, aspirin as VTE prophylaxis after arthroplasty, and the relationship between physician burnout and ability to address patients’ social determinants of health. Honorable mentions include a throwback to the life-changing magic of Pokémon GO.
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: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Editor: Christopher Chiu MD, Emi Okamoto MD
Cover-Art: Matthew Watto MD

#162 Gender & Sexual Harassment in Medicine, #MeToo Jul 22, 2019

Dr. Reshma Jagsi (TIME’S UP Healthcare; UMichigan) schools us on sexual harassment and describes the systemic and cultural changes that need to happen to effect real change. She unpacks the definition of sexual harassment, describes the state of the #MeToo and TIME’s UP movements across the science and medicine fields and highlights how we all can recognize/respond to harassment.
This is the third episode of our Women in Medicine series. Last August, you heard us talk to Dr. Vinny Arora about the paucity of women in leadership positions, finding sponsors for career advancement, and being bold about career decisions. In December, we spoke to Dr. Susan Hingle about work-life integration. Her advice? Stop worrying about what other people think, acknowledge that being a doctor is hard, especially for women due to disproportionate out-of-work responsibilities, and define a beautiful life that is individualized to you.
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: Leah Witt MD, Shreya Trivedi MD, Nora Taranto MD, Sarah P. Roberts MPH.
Editor: Matthew Watto MD
Hosts: Shreya Trivedi MD, Chris Chiu MD, Leah Witt MD
Guest: Reshma Jagsi MD, DPhil
Special thanks to: Hannah Abrams MS4, Beth Garbitelli MS2, and Molly Heublein MD

#161 A Rash Approach to Rashes with Helena Pasieka MD Jul 15, 2019

Tackle rashes with wisdom from Kashlak’s resident Skinternist (or Internist-Externist) Dr. Helena Pasieka (MedStar, Georgetown), board certified in both Internal Medicine and Dermatology. She offers “a rash approach to rashes” including: initial triage, ‘inside job’ vs ‘outside job’, differential diagnosis, a review of common culprits, basic management techniques, and how to determine if the reaction is life-threatening. Plus, Dr Pasieka teaches us how to handle family and friends asking, “Can you take a look at this rash?”.
Full show notes at https://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: Beth Garbitelli MS2
Infographic and Cover Art: Beth Garbitelli MS2
Hosts: Stuart Bringham MD, Matthew Watto MD, Paul Williams MD
Editor: Matthew Watto MD
Guest: Helena Pasieka MD

#160 Hotcakes: E-cigarettes, UTIs, Heart Failure Jul 10, 2019

Confession: we have been holding out on you. Specifically, we’ve been sitting on a special episode of Hotcakes and Hot Takes that we recorded this March, with featured guest Armand Gottlieb, MD of the online publication The Scope. But here it is! We hope you’ll enjoy our discussion of topics like the ever-controversial e-cigarettes for smoking cessation question, outcomes related to antibiotic treatment of UTIs among elderly adults, and the role of sacubitril-valsartan for acute decompensated heart failure in inpatient settings (the PIONEER-HF study). Special guest is Dr. Armand Gottlieb @ArmandGottlieb, who was a third year internal medicine resident at Columbia University Medical Center in New York City at the time of recording. He is a co-Editor of the The Scope, a free and brief weekly roundup of the most recent and relevant medical literature.
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: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Guest Presenter and Content Planning: Armand Gottlieb, MD
Editor: Christopher Chiu MD
Cover-Art: Christopher Chiu MD

Pick of the Week

The SCOPE. The week’s best in evidence-based medicine, written in plain language and delivered to your inbox. Sign-up for weekly emails or download the app.

#159 Atrial Fibrillation Review and Update with James Furgerson MD Jul 08, 2019

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! Full notes at https://thecurbsiders.com.
ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).
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

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

#158 Medicine and Incarceration Jul 01, 2019

Expand your knowledge about how--and how well--we manage the health of incarcerated patients in the United States, with the expert knowledge of correctional health experts Drs. Aaron Fox @adfoxmd, Jon Giftos @JonGiftosMD, and Emily Wang @ewang422. Correctional medicine is a black box for many providers who do not work in prison and jail settings. But it’s ever more relevant to primary care physicians everywhere, with increasing rates of incarceration the last decade. In this episode, recorded live at SGIM 2019 #SGIM19, Dr. Fox, Dr. Giftos, and Dr. Wang talk us through the variability of the correctional healthcare systems throughout the country, the challenges to health for patients both while incarcerated and in the transition after release, and some essential nuts and bolts for providers about how to provide better care to this vulnerable population.
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: Justin Berk MD MPH MBA, Nora Taranto MD
Cover Image: Beth Garbitelli MS2
Infographic: Beth Garbitelli MS2
Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MPH MBA
Edited by: Matthew Watto MD
Guests: Aaron Fox MD, Jon Giftos MD, Emily Wang MD MAS

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

#156 Chronic Pain, Opioids, Tapers Jun 24, 2019

Rethink how you’re diagnosing and managing chronic pain with high-yield tips from pain experts and primary care doctors Soraya Azari MD @azarimugs (UCSF), and Phoebe Cushman MD, MS (UMass Memorial). Because let’s face it, managing chronic pain can be very difficult. Expand your toolbox for management-- including the importance of activity, empowering your patient, risk stratification for patients prior to opioid initiation, how to identify opioid use disorder, and how to taper opioids. Plus, updates on recent practice changing articles in chronic pain.
Full show notes at https://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: Nora Taranto MD
Hosts: Nora Taranto MD, Paul Williams MD, Matthew Watto MD
Edited by: Emi Okamoto MD, Matthew Watto MD
Guests: Soraya Azari MD; Phoebe Cushman MD, MS

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

#155 LGBT Health in Primary Care Jun 17, 2019

Build your knowledge base to improve primary care for LGBT patients! This episode is chock full of clinical pearls and updates for LGBT health from SGIM presenters, Dr. Jenny Siegel (Boston University) and Dr. Megan McNamara (Louis Stokes Cleveland VAMC). They define common gender identity terms and provide tips on how to take a sexual history. You’ll develop an approach to the unique clinical concerns of LGBT patients and learn how to phrase medical information in a gender neutral framework. This is a must listen episode for all health care providers!
Full show notes at https://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: Carolyn Chan MD Graphics: Hannah Abrams Hosts: Carolyn Chan MD, Paul Williams MD, Matthew Watto MD Guest: Megan McNamara MD, Jenny Siegel MD
Sponsor This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

#154 DVT and PE Master Class with Michael Streiff MD Jun 10, 2019

What do Judas Priest, surfing, and clots have in common? They are the passionate interests of expert Dr. Michael Streiff who guides us through the diagnosis and management of DVT and PE aka venous thromboembolism (VTE). By the end of the episode you will know how to catch a clot very Wells! We dive deep into the treatment options, literature, and some unique cases. ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).
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 (including CME questions): Justin Berk MD, MPH, MBA
Cover art by: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Edited by: Matthew Watto, MD, FACP
Guest: Michael Streiff MD

#153 Heart Disease in Women with Dr Bairey Merz Jun 03, 2019

Expand your idea of ischemic heart disease to include non-obstructive patterns, which as our guest, Dr Noel Bairey Merz, a clinical investigative cardiologist whose multiple roles include Director of the Barbra Streisand Women’s Heart Center and the Preventive Cardiac Center at the Smidt Cedars-Sinai Heart Institute, shares with us, is incredibly common, especially in women. Learn to recognize these women and treat according to guidelines, preventing unnecessary IHD mortality in our female (and some male) patients. We review a variety of non-obstructive pathologies and the best techniques to evaluate them.
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: Shreya Trivedi MD, Molly Heublein MD
Hosts: Paul Williams MD, FACP; Shreya Trivedi MD; Molly Heublein MD
Edited by: Matthew Watto MD, FACP; Emi Okamoto MD
Graphics by: Hannah Abrams
Guest: Dr. C Noel Bairey Merz MD, FACC, FAHA

Curbsiders' Schwag!

We’ve got the perfect father’s day gift for every internal medicine nerd. The Curbsiders have opened our own online shop. Get your Curbsiders t-shirts, hoodies, stickers, and coffee mugs. Help support the show and gain instant bragging rights. Note: All purchases come with admitting privileges at Kashlak Memorial Hospital!

#152 Dare to Lead: Becoming a PGY2 May 29, 2019

Dare to lead. Master the transition to PGY2 with tips from expert educator Abby Spencer MD, MS, FACP, IM Residency Program Director and Vice Chair for Education for the Medicine Institute at Cleveland Clinic and Shreya Trivedi MD, GIM Fellow at NYU School of Medicine. Topics include: how to run work rounds, preparing your team for attendings rounds, how to teach on the fly, finding your leadership style, and what to read during residency. This is the first of three episodes that we’re co-developing with the American College of Physicians for their Resident Transitions Series.
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: Shreya Trivedi MD
Graphics and Show Notes by: Hannah R Abrams
Hosts: Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP; Shreya Trivedi MD
Guest: Abby Spencer MD, MS, FACP

Sponsor

The Resident Transitions Series is brought to you by The American College of Physicians with support from its Council of Resident/Fellow Members. Visit acponline.org/resident to learn more about the benefits of Resident/Fellow Membership and join our proud internal medicine community today!

#151 Anaphylaxis with Dr Olajumoke Fadugba MD May 27, 2019

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?! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).
Full show notes available at https://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

Writer (interview, show notes & CME questions) and cover art: Emi Okamoto MD
Infographic by: Emi Okamoto MD
Hosts: Matthew Watto MD, FACP; Stuart Brigham MD
Editors: Matthew Watto MD, FACP
Guest: Olajumoke Fadugba MD
Special thanks to Sarah Phoebe Roberts MPH for booking!

#150 HFpEF with Dr Clyde Yancy MD May 20, 2019

HFpEF (heart failure with preserved ejection fraction) with master cardiologist, Dr Clyde Yancy MD, Chief of Cardiology and Professor of Medicine (Cardiology) and Medical Social Sciences, Northwestern, Feinberg School of Medicine. Topics include: pathophysiology, HFpEF phenotypes, how to interpret a borderline ejection fraction, evidence based therapies, diuretics, and future directions (pulmonary artery monitors, intra-atrial shunts, ARNI compounds), and more!
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: Paul Williams MD, FACP; Sarah Phoebe Roberts MPH
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Show Notes: Justin Berk MD, MPH, MBA; and Beth Garbitelli MS1
Infographics: Beth Garbitelli MS1
Editor: Matthew Watto MD, FACP
Guest: Clyde Yancy MD, MSc, MACC, FAHA, MACP, FHFSA

Recap SGIM19 Day 2 May 17, 2019

Recap of random pearls and highlights from SGIM19 Day 2 including: methadone and buprenorphine, perioperative buprenorphine, medical cannabis, HPV vaccination, young adult medicine, academic promotions, long term sequelae of childhood kidney disease, stage 1 hypertension, some great free resources in addiction medicine, and more! Special thanks to the Society for General Internal Medicine for their hospitality.
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, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Nora Taranto MS4 (soon to be MD!)
Edited by: Matthew Watto MD

Recap SGIM19 Day 1 May 13, 2019

Recap of random pearls and highlights from SGIM19 Day 1 including: Kidney stone treatment (roller coasters, sex and tamsulosin), aspirin, SGLT2 inhibitors to reduce kidney events, oral antibiotics for endocarditis, preferred physician attire, sexual harassment, writing letters of recommendation, triple therapy for COPD, DAPT for stroke, and more! Special thanks to the Society for General Internal Medicine for their hospitality.
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, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Abby Spencer MD, MS, Nora Taranto MS4 (soon to be MD!)
Edited by: Matthew Watto MD
Special Guest: Abby Spencer MD, MS

#149 Hip Pain for Primary Care May 06, 2019

Identify and treat the most common causes of hip pain in the outpatient setting with returning guest, Dr Ted Parks. A large majority of hip pain in the office setting will be due to one of three conditions (hip osteoarthritis, greater trochanteric pain syndrome, and lumbo-sacral back pain). Learn to easily identify these conditions, how to initiate conservative treatment, and more about hip replacements. 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, Nora Taranto MS4 CME questions by: Molly Heublein MD, Nora Taranto MS4 Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein MD Edited by: Matthew Watto MD, Emi Okamoto MD Guest Presenter: Ted Parks MD

Telehealth with Ana María López MD May 02, 2019

Electric cars, virtual reality, nanotechnology, and now… telemedicine? We chat with Dr. Ana María López MD, FACP about the future of telehealth, how to implement it in your practice, and the challenges you might face in doing so. Dr. López is immediate past president of the American College of Physicians (ACP) as well as Vice Chair of Medical Oncology and Chief of New Jersey Division Sidney Kimmel Cancer Center of Thomas Jefferson University. Her main areas of professional interest and expertise include cancer prevention and equity, integrative oncology, implementation of innovations in health care including telemedicine, and women’s health. We learned immensely from our talk with her and we hope you will, too! ACP members can claim free CME & MOC credit at https://acponline.org/curbsiders. Download Dr Brigham’s telehealth cheat sheet as a PDF 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: Hannah Abrams, Stuart Brigham MD Cohosts: Matt Watto MD, Stuart Brigham MD, Paul Williams MD, Hannah Abrams Guest: Ana María López MD

#148 Benign Prostatic Hyperplasia for the Internist Apr 29, 2019

This week we narrow in on the enlarging prostate and decipher the common issue of benign prostatic hyperplasia with Adam C. Reese MD, Associate Professor of Urology at the Lewis Katz School of Medicine at Temple University and Chief of Urologic Oncology at Temple University Hospital. Learn how to interpret the symptom profile for patients presenting with common urinary issues, what to feel for in the digital rectal exam, how to treat BPH, and when to refer.
ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).
See you at SGIM 2019!

Find us in our red Curbsider’s t-shirts handing out Curbsiders and Kashlak stickers/patches at SGIM 2019 in Washington DC! We’ll be recording full length shows and daily recaps!
Credits

Written and produced by: Paul Williams MD
Hosts: Paul Williams MD, Matthew Watto MD
Images and infographics: Elena Gibson, Beth Garbitelli
Show Notes: Elena Gibson, Beth Garbitelli
Edited by: Matthew Watto MD, Chris Chiu MD
Guest: Adam Reese MD
Time Stamps

00:00 SGIM announcement
00:30 Disclaimer, intro and guest bio
03:20 Guest one liner, book recommendation, favorite failure and surgical M&M
10:56 Case of benign prostatic hyperplasia, defining terms and obstructive/voiding versus storage/irritative symptoms
16:11 IPSS score and evaluating symptoms
22:10 Digital rectal exam. Will this give any useful information?
26:55 Taking a history about BPH and some lifestyle modifications
29:20 Lab studies for urinary tract symptoms and interpreting PSA and free PSA
36:20 Initial therapy for BPH and managing patient expectations, alpha blocker side effects
39:25 Choice of agent and monitoring symptoms on therapy
42:25 Nonpharmacologic management of bladder complaints
45:10 Who and when to refer to urology
47:33 Counseling about use of 5 alpha reductase inhibitors, their side effects and is there a risk for high grade cancer?
52:35 Phosphodiesterase inhibitors for BPH symptoms
53:50 Urethral milking. NOT prostate milking
54:55 Desmopressin for nocturia
56:20 Take home points
59:03 Prostate volume and PSA
61:10 Outro
Full show notes available at http://thecurbsiders.com/episode-list.

Random Pearls #IM2019 Day 3 Apr 22, 2019

Random pearls from ACP #IM2019 Day 3. The Curbsiders crew is joined by Dr Alan Dow of VCU to discuss highlights from ACP’s Internal Medicine Meeting in Philadelphia including: sleep deprivation, the glymphatics system, inflammatory back pain, heart failure, dermatology pearls, a new definition for pulmonary hypertension and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

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.

#IM2019 Curbsiders Crew

Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
Director of operations: Chris Chiu MD
Twitter: Cyrus Askin MD, Hannah Abrams MS3
Instagram: Beth Garbitelli MS1
Facebook: Chris Chiu MD
Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4
Marketing: Jen Watto

Random Pearls #IM2019 Day 2 Apr 19, 2019

Random pearls from ACP #IM2019 Day 2. The Curbsiders crew is joined by Dr Alia Chisty (future PD at Penn State Hershey) at ACP’s Internal Medicine Meeting in Philadelphia to discuss highlights including: baloxavir a new drug for flu, stress testing and coronary CT angiography pearls, celiac disease, H. pylori pearls, and a bunch of random pearls from infectious diseases, palliative care and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

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.

#IM2019 Curbsiders Crew

Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
Director of operations: Chris Chiu MD
Twitter: Cyrus Askin MD, Hannah Abrams MS3
Instagram: Beth Garbitelli MS1
Facebook: Chris Chiu MD
Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4
Marketing: Jen Watto

Random Pearls #IM2019 Day 1 Apr 15, 2019

Random pearls from #IM2019 Day 1. The Curbsiders crew is joined by Kashlak’s POCUS Chief, Renee Dversdal MD at ACP’s Internal Medicine Meeting in Philadelphia to discuss day 1 highlights inlcuding: POCUS, lyme rash, back pain, syphilis, women’s health, patient handoffs, the flip-flop fungal sign a ton of cardiology pearls (ie diuretics, paracentesis for CHF, beta blockers, LBBB, when is it safe to have intercourse after an MI?) and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

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.

#IM2019 Curbsiders Crew

Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
Director of operations: Chris Chiu MD
Twitter: Cyrus Askin MD, Hannah Abrams MS3
Instagram: Beth Garbitelli MS1
Facebook: Chris Chiu MD
Off-air producer: Sarah Phoebe Roberts MPH
Marketing: Jen Watto

#147 Rheumatoid Arthritis for the Internist Apr 08, 2019

Join(t) us in learning about rheumatoid arthritis care for the internist with Robert McLean MD, rheumatologist, Associate Clinical Professor at Yale, and President Elect of the ACP! We discuss the complexity of rheumatoid arthritis, how to differentiate from other arthritic conditions, and how to have a patient-centered framework for the evaluation and treatment of affected patients. ACP members can claim CME-MOC credit at on ACP's site..
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
Writer (Interview & CME questions): Cyrus Askin MD

Show Notes and Infographic by: Elena Gibson MS4

Hosts: Matthew Watto MD, Stuart Brigham MD

Editors: Matthew Watto MD, Emi Okamoto MD

Guest: Robert McLean MD

#146 NephMadness: Pain Meds in Chronic Kidney Disease Apr 01, 2019

Pain management in patients with chronic kidney disease (CKD) often goes something like this: NSAIDs are evil, acetaminophen hardly works, opioids are dangerous, and all the rest (tramadol, gabapentinoids, antidepressants) are messy. But, we tackle the complexities of pain management in patients with chronic kidney disease in this special @NephMadness 2019 episode that, on a scale of 1-10, will leave you feeling very relieved in addressing pain.
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.
Earn CME and read about each region in NephMadness 2019 at AJKD blog.
Credits

Written and produced by: Justin Berk MD, Samantha Gelfand MD
NephMadness Pun Contest produced by: Hannah R Abrams MS3
Cover art by: Kate Grant MBChB, Dip GUMed
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto MD, Emi Okamoto MD
Guests: Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

#145 NephMadness: Hepatorenal Syndrome vs AKI Mar 25, 2019

Does your sympathetic nervous system get activated when you notice acute kidney injury in patients with cirrhosis? Ever wonder how to really diagnose hepatorenal syndrome (HRS)? Think you have the bile-acid-stones to start diuretics on a patient requiring pressor support for kidney failure? You have come to the right place! Listen to @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) tackle the complex pathophysiology and treatment of hepatorenal syndrome in this NephMadness 2019 special episode!
Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Earn CME and read about each region at AJKD blog.
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: Justin Berk MD, Nora Taranto MS4
Infographic by: Alex M @nephroguy

Hosts: Matthew Watto MD
Edited by: Matthew Watto MD, Emi Okamoto MD
Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD
Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

HCP: Primary Care Workforce with Fatima and Deep Mar 20, 2019

Some precocious policy wonks take a deep dive into the evolving trends and future directions for our primary care workforce. Experts, Dr. Fatima Syed and Dr. Deep Shah return to school us on Physician Supply and Demand, the Access Gap, role of NPs and PAs, Retail Clinics, and Managed Care Clinics. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).
Catch up on our previous discussions with Dr. Syed and Dr. Shah: Episode #62: Pod Save Health Care: The Curbsiders Foray into health policy and Episode #120 Health Policy, Patients, Payments, Paperwork for more context. We also did an overview of health care policy essentials with Dr. Sue Bornstein in Episode #64: Stuff You Should Know About Health Policy

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: Fatima Syed MD, MSc; Deep Shah MD, MSc
CME questions by: Chris Chiu MD, Beth Garbitelli MS1,
Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD,
Images and infographics: Beth Garbitelli MS1
Edited by: Matthew Watto MD, Chris Chiu MD
Guest: Fatima Syed MD, MSc, Deep Shah MD, MSc

#144 NephMadness: Inpatient Hypertension Mar 18, 2019

Inpatient hypertension is tricky. What’s the best way to answer those overnight nursing phone calls for elevated blood pressures? What’s the role of treating hypertensive urgency in the hospital? Plus, Our nephrology experts put a new issue on the generalist’s radar: are ACE-inhibitors dangerous to give (or hold) during an operation? This NephMadness 2019 episode, features special guests Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) to better understand the role of anti-hypertensives in the inpatient setting and keep your blood pressure down on those overnight calls.
Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders!
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: Justin Berk MD, MPH, MBA; Pascale Khairallah MD
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto, MD
Guest: Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD
Sponsor Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

#143 NephMadness: Fluid Wars Mar 15, 2019

The battle over the superiority of resuscitation fluids is coming to a boil. Enter the Fluid Wars. Are Lactated Ringers superior to normal saline? Will LR increase a patient’s lactate? What about albumin? The Curbsiders quench the thirst for knowledge by turning to masters Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) for guidance in this special @NephMadness episode that will get your feet wet with the complicated world of fluid resuscitation.
Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders!
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.
Credits
Written and produced by: Justin Berk MD, Pascale Khairallah MD
NephMadness Pun Contest produced by: Hannah R Abrams MS3
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto MD
Guest: Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD

#142 Cirrhosis TIPS for Acute Complications Mar 11, 2019

Cirrhosis TIPS for the decompensated cirrhotic & acute on chronic liver failure from expert hepatologist and keto-practitioner Scott Matherly MD, @liverprof and chief hepatologist at @KashlakHospital. We walk through acute management of variceal bleeds, when to suspect SBP in decompensated cirrhosis (all the time, it turns out), how much fluid to remove in paracentesis, and some definitions about what decompensated cirrhosis and acute on chronic liver failure really mean.
Take our pretest on cirrhosis!
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, Matthew Watto MD
Pretest by: Cyrus Askin MD
Hosts: Matthew Watto MD, Paul Williams MD,
Images and infographics: Hannah Abrams MS3
Edited by: Matthew Watto MD
Guest: Scott Matherly MD
Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Reboot - Diuretics, leg cramps, and resistant hypertension Mar 04, 2019

Listen to our first ever discussion with @kidney_boy, Joel Topf MD. It’s a classic episode with a fresh intro as we prepare for @NephMadness 2019 with our friends from Twitter and @AJKDonline

Dominate leg cramps, diuretic therapy, and resistant hypertension with tips from @kidney_boy, Joel Topf MD @kidney_boy, Chief of Nephrology Kashlak Memorial Hospital, co-creator @NephMadness. We start with basic renal physiology and build up to the treatment of resistant hypertension.

Corrections: Dr Topf posted the following corrections on his blog PBfluids.com 3/22/2017

“I enjoyed the experience immensely, but in an hour of talking off the cuff I made some embarrassing mistakes:

In describing water reabsorption I said it occured in the cortical collecting duct rather than the medullary collecting duct.

In describing my cure for cramps I tell the story of Gitelman’s and say it is like congenital loop diuretics rather than congenital thiazide diuretics

I mucked up the story about the MRFIT story and how it allowed a head to head comparison of HCTZ and chlorthalidone. I really oversold what happened.”

Full show notes at https://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written by: Matthew Watto MD

Produced by: Stuart Brigham MD and Matthew Watto MD

Cohosts: Stuart Brigham MD and Matthew Watto MD

Guest: Joel Topf MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 201

#141 Wound Care Pearls Feb 25, 2019

Demystify chronic wound care management with high yield pearls from wound care expert Dr. Elizabeth (Foy) White-Chu. She takes us through a simple yet thorough approach to manage complex chronic wounds. We discuss everything from selecting a dressing, to pain management, and what kind of water should you really use when cleansing a wound. Answers to all of these burning questions and more await you, so don’t waste anymore time! Press play and let Dr. White-Chu take you on a journey through evidence based practices for the management of chronic wounds. 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 by: Carolyn Chan MD

CME questions by: Justin Berk MD

Produced by: Matthew Watto MD

Hosts: Matthew Watto MD, Paul Williams MD, Carolyn Chan MD

Guest: Dr. Elizabeth (Foy) White-Chu

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

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

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

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

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

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

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

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).

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: 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

“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!

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: 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

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.

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: 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

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

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.

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: 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.

Time Stamps

00:00 Announcement, disclaimer, intro, guest bio
01:20 Picks of the week
05:42 How Reza fell in love with clinical reasoning
08:58 Case of 50 yo male with abdominal pain
21:14 Some unexpected findings
43:00 Case conclusion/answer, cognitive autopsy and Reza’s take home points
48:35 Outro

#131 A Case of Cough and Dyspnea Dec 17, 2018

Hone your diagnostic skills with this mystery case of cough and dyspnea http://hdx.org/pdp (click link to follow along). The Curbsiders deconstruct the case and discuss their diagnostic schemas for these common problems with the help of returning guest, Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx.

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

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: 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.

Time Stamps

00:00 Announcement, disclaimer, intro, guest bio
03:13 When and how to practice clinical reasoning
05:53 Creating diagnostic schemas and Clinical Problem Solvers Podcast
09:40 A bit on Human Dx and the show format
12:00 Case of a 40 yo male with a cough
23:22 Some insights from Reza on “signal versus noise”
37:10 Case conclusion/answer, cognitive autopsy and Reza’s take home points
45:36 Outro

#130 Work-Life Fit: Women In Medicine Dec 13, 2018

Create a successful partnership and career withs tips from Wonder Woman, Sue Hingle MD of ACP.
Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro tip: stop worrying about what others think!). Dr. Hingle is Professor in the Department of Internal Medicine and Vice Chair of Education and Faculty Development and Associate Internal Medicine Residency Program Director at Southern Illinois University. She is also the Immediate Past Chair of the Board of Regents of the American College of Physicians (ACP). She has served at the ACP in a variety of ways, including as a member of the ACP Women’s Task Force. Her clinical expertise is in women’s health, health promotion, and disease prevention. Enjoy the episode!
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. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits

Written and produced by: Nora Taranto MS4, Shreya Trivedi MD, Leah Witt MD, Sarah P. Roberts MPH.

CME Questions by: Shreya Trivedi MD

Editors: Matthew Watto MD and Chris Chiu MD

Hosts: Shreya Trivedi MD, Paul Williams MD, Leah Witt MD

Guest: Susan Hingle MD

Time Stamps

00:00 Disclaimer, intro and guest bio
02:52 Guest one liner, WIM Moment of awakening, advice for her younger self
07:45 Picks of the week
10:30 Physician with family and caregiver responsibility; How to plan for personal and professional goals
18:20 What to look for in a partner, how to work with them to achieve work life fit, and non-traditional roles
28:35 Advice on family planning
31:40 Residency programs and life events
32:55 Should you go part-time?
39:43 Work life balance? Or work life fit? And some examples/tips for success
49:54 Take home points
50:45 Outro

#129 Depression and Suicide: Occupational Hazards of Practicing Medicine Dec 10, 2018

Dr Elisabeth Poorman MD joins us to discuss the natural history of physician depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line. The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat).
N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available either via email, private msg on FB or twitter (@DrPoorman), or any of us on twitter. We are happy to talk and see that you get support you need.
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: Nora Taranto MS4, Shreya Trivedi MD
Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD
Edited by: Matthew Watto MD
Guest: Elisabeth Poorman, MD

#128 Aspirin Overhyped and Overused Dec 03, 2018

Aspirin’ to figure out if ASA can help prevent a heart attack? Interpreting all the new trials doesn’t have to cause chest pain! Join Dr. Ambarish Pandey from UT Southwestern as he helps The Curbsiders ASCEND the mountains of the latest studies to ARRIVE at some well-informed conclusions on the role of aspirin in primary prevention for cardiac events. The team also discusses secondary prevention, aspirin and dual (or triple) antiplatelet therapy, and whether it’s okay to stop giving aspirin to older adults without known CAD (Spoiler alert: it’s okay). 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: Justin Berk MD, Matthew Watto MD

CME questions by: Justin Berk MD

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

Edited by: Matthew Watto MD and Chris Chiu MD

Guest: Dr. Ambarish Pandey MD

Time Stamps

00:00 Disclaimer, intro and guest bio
04:15 Guest one liner, book recommendation, career and research advice
11:07 Case of aspirin for primary prevention, aspirin’s public persona, and nocebo effects of statins
21:40 ARRIVE and ASCEND trials
28:14 Aspree trial
32:38 Coronary artery calcium; aspirin use for secondary prevention
37:42 Dual antiplatelet therapy and the DAPT score
41:25 Should we continue aspirin when a patient also needs a DOAC?
46:14 Should we continue DAPT in a patient who needs a DOAC (or warfarin)?
49:40 Deprescribing aspirin for primary prevention in older adults?
50:51 Closing remarks
52:33 Outro

Hotcakes: Exercise, Aspirin, Fish Oil and Hypertension Nov 29, 2018

Tony Breu MD joins us for some hotcakes, and “cold cakes” including: how aspirin and zodiac sign affect the treatment of acute MI, a recent study on how exercise is probably still good for you, the recently announced REDUCE-IT trial, and the evidence (or lack thereof) for the treatment of hypertensive urgency. Welcome to another edition of Hotcakes and Hot Takes, where we discuss the most interesting articles and news that we have been reading. Special guest is the prolific Dr. Tony Breu (@tony_breu) who is an Assistant Professor of Medicine at Harvard Medical School and a Hospitalist and Director of Internal Medicine Resident Education at the VA Boston Healthcare System. He is known for his series on "Things We Do For No Reason” as well as his thought-provoking “Tweetorials” online. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST on day of release).

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: Sarah Phoebe Roberts MPH, Christopher Chiu MD

CME Questions: Christopher Chiu MD

Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD

Guest Presenter and Content Planning: Anthony Breu MD

Editor: Christopher Chiu MD

Cover-Art: Christopher Chiu MD

Time stamps

00:00 Disclaimer, intro, guest bio
05:53 Discussion on Tweetorials
08:00 Cold Cake: ISIS-2 and the treatment of acute MI with aspirin
14:04 ISIS-2 and zodiac subgroup analysis
16:19 What is the relationship between cardiorespiratory fitness on mortality?
24:40 Discussion of the REDUCE-IT study
33:00 Cold Cake: VA Cooperative study and the evidence for treating essential hypertension
36:42 TWDFNR and the treatment of hypertensive urgency
46:36 Wrap-up and outro

#127 STIs: Syphilis, Gonorrhea and Chlamydia Nov 26, 2018

Master the diagnosis and management of common STIs (sexually transmitted infections) with tips from expert, Dana Dunne MD, Associate Professor of Medicine in Infectious Diseases at Yale. Topics include: the stages and many presentations of syphilis, syphilis treatment and counseling, the natural history, diagnosis, and screening guidelines for gonorrhea and chlamydia, treatment options in the age of growing resistance, and a discussion of 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: Bryan Brown MD

Hosts: Bryan Brown MD, Paul Williams MD, Matthew Watto MD

Guest: Dana Dunne MD

Special thanks to Kate Grant MBChB, Dip GUMed for her contribution of knowledge and artwork.

Time Stamps

00:00 Announcement, disclaimer, intro and guest bio
04:29 Guest onliner, book recommendation, advice for learners/teacher, and picks of the week
11:00 A case of syphilis, clinical manifestations and discussion of the stages
26:05 Testing for syphilis
39:05 Mandatory reporting and partner tracing
42:40 Counseling patients with syphilis
44:44 A case of gonorrhea and chlamydia, clinical manifestations, screening guidelines
52:30 How to counsel patients to obtain samples from urethra, rectum, vagina, oropharynx; Mycoplasma genitalium
59:40 CDC treatment guidelines, Super gonorrhea, test of cure, and treatment of partners
72:35 Take home points
74:30 Outro

#126 Kashlak Morning Report with Human Dx Nov 19, 2018

Practice solving diagnostic puzzles with The Curbsiders and Internist / Diagnostician, Reza Manesh MD, Assistant Program Director for Clinical Reasoning of the Osler Medical Training Program at Johns Hopkins! Solve along with us at these links: Case 1 http://hdx.org/I2B and Case 2 http://hdx.org/uM2. Topics include: clinical reasoning terminology, how to use cases to practice diagnostic reasoning, how to build a diagnostic schema, and how to conduct your own cognitive autopsy.

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: Hannah Abrams

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

Guest: Reza Manesh MD

Special thanks to: Doctors Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing cases

Time Stamps

00:00 Disclaimer, intro and guest bio
04:02 Guest one liner, book recommendation, favorite failure, advice for learners
11:27 Human Dx Project and Global Morning Report
15:35 Diagnostic terminology
21:25 Case #1, Reza solves
33:40 Diagnostic autopsy and teaching points for case #1
38:00 Case #2, The Curbsiders solve
57:30 Diagnostic autopsy and teaching points for case #2
61:33 Take home points and a plug
64:30 Outro

#125 Hidden Curriculum Nov 15, 2018

Check out this audio treasure map to find the hidden curriculum and learn how it can change your practice. Learn how positive teaching spans not just the classroom or bedside but, how we simply talk about patients. Sanjay Desai MD, coauthor of ACP’s Position Paper on Hidden Curriculum and Internal Medicine program director at Johns Hopkins guides us through several cases that illustrate how our institutional norms can shape the practice of medicine...for better or worse. 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: Sanjay Desai MD; Justin Berk MD, MPH, MBA; Matthew Watto MD

CME questions by: Justin Berk MD

Editors: Chris Chiu MD & Matthew Watto MD

Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD

Guest: Sanjay Desai MD

Time Stamps

00:00 Disclaimer, Intro and guest bio
04:00 Guest one liner, book recommendations, career advice
10:50 Intro to the hidden curriculum and ACP’s three recommendations
22:00 Case #1: A patient with schizophrenia
32:10 Case #2: The iPatient
38:07 Case #3: Attending forgets to wash their hands
41:10 Case #4: A dying patient’s primary care doctor saves the day
46:26 Case #5: A case of violating duty hours
60:10 Take home points
62:00 Outro

#124 The Shoulder - Simplify Your Approach Nov 12, 2018

Shoulder pain made simple. Develop your confidence and skills with tips from sports medicine specialist Dr. Carlin Senter MD. We discuss her simplified approach to the basic shoulder exam, including when and how to do special tests, high yield exam maneuvers, when to refer shoulder pain patients to orthopedic surgery, and who can be managed conservatively.

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: Molly Heublein MD and Nora Taranto MS4

Editor: Matthew Watto MD

Hosts: Molly Heublein, MD, Paul Williams MD, Matthew Watto MD

Guest: Carlin Senter, MD

Time Stamps

00:00 Disclaimer, intro, and guest bio
03:15 Guest one liner, book recommendation, career advice, and some picks of the week
13:20 Clinical case of shoulder pain; helpful historical features
18:54 Differentiating referred pain from c-spine pathology from shoulder pathology
21:00 A framework for shoulder pain, HIP-ROT, and using ROM to generate a differential
27:40 Frozen shoulder aka adhesive capsulitis
31:57 Glenohumeral joint arthritis
33:52 Rotator cuff disease
40:53 Specific testing for rotator cuff tears
51:45 Impingement syndrome versus bursitis
56:25 Counseling patient with shoulder pain or injury
59:03 Steroid injections, topical therapy, and AC joint arthritis
65:18 When to refer to surgery and some take home points

#123 Sleep Apnea Pearls and Pitfalls Nov 05, 2018

The sleep apnea episode that won’t put you to sleep. Become a sleep apnea guru with incredible insights from Barbara Phillips MD, MSPH, FCCP an expert in pulmonary medicine, critical care and sleep medicine who is also a past president of CHEST! We discuss high-yield topics in the world of obstructive sleep apnea including: home sleep studies vs in-lab polysomnography, the importance of oxygen saturation (the T90 and ODI) when interpreting sleep study results, tricks to improve CPAP adherence, and alternatives therapies for obstructive sleep apnea. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes.

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: Cyrus Askin MD

CME questions by: Cyrus Askin MD

Editor: Chris Chiu MD & Matthew Watto MD

Hosts: Cyrus Askin MD & Matthew Watto MD

Guest: Barbara Phillips, MD

Cover-Art & Infographic - Beth Garbitelli, MS1

Time Stamps

00:00 Disclaimer, intro, guest bio
03:00 Guest one liner, book recommendation, advice for trainees
08:10 Clinical case of sleep apnea, some basic stats, and key predictors of sleep apnea
12:38 Barriers to diagnosis and treatment of OSA
15:23 Discussion of T90, hypoxemia and sleep fragmentation
17:05 How to read a sleep study report
21:55 Home sleep apnea testing
24:15 What are the consequences of sleep apnea
28:30 What is the efficacy of cpap for lowering blood pressure and mortality
31:45 Counseling a patient who is new to cpap
33:45 Choice of mask
40:10 Do alternatives to cpap work? e.g. surgery, mandibular advancement devices
44:17 Modafinil and z-drugs
47:15 Driver’s license issues in sleep apnea
48:35 Future of sleep medicine and take home points

#122 Headaches Advanced Class Oct 29, 2018

We delve into advanced management of headaches, including novel therapies, migraines with aura, migraines in complicated patients, and headaches of short duration with Dr. Rebecca Burch, a headache medicine specialist at the John R. Graham Headache Center at Brigham and Women’s Hospital.

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: Paul Williams MD

Edited by: Matthew Watto MD

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

Guest: Rebecca Burch MD

Time Stamps

00:00 Disclaimer, intro and guest bio
03:28 Guest one-liner, movie and podcast recommendations, favorite failure and picks of the week from The Curbsiders
10:38 Clinical case of migraines; diagnosis and classification
14:12 Does medication overuse headache exist?
16:16 Chronic daily headache; Conversion from episodic to chronic and vice versa
21:43 Approaches to medication overuse headache
25:54 Case 2: migraine with aura and other types of migraine (retinal, hemiplegic, etc.)
32:09 Pathophysiology of migraine; how triptans work; How should aura effect management?
38:44 Migraine cocktails
41:15 Comorbid mood disorders; Use of psych meds and triptans
45:08 Migraines and oral contraceptives
48:42 Botulinum toxin and new CGRP therapies
53:36 What does success look like in migraine therapy?
55:32 Nonpharmacologic management
60:45 Case 3: headaches of short duration
66:36 Headache red flags; Imaging for headaches; pathophysiology of high and low pressure headaches
72:00 Idiopathic intracranial hypertension
75:25 Take home points
77:00 Outro

#121 HIV Care for the Internist Oct 22, 2018

HIV care for the internist with author and HIV expert, Michael Saag MD, Professor of Infectious Diseases at University of Alabama and founder of the 1917 Clinic. We discuss the specifics of screening & diagnostic testing in HIV, monitoring CD4 counts and viral loads, first line antiretroviral therapy, harm reduction, and how to provide excellent HIV care in your primary care clinic.

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 & Produced by: Elena Gibson MS4, Justin Berk MD MBA MPH

Artwork by: Elena Gibson MS4

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

Editor: Matthew Watto MD

Guest: Michael Saag MD

Time Stamps

00:00 Disclaimer, intro, and guest bio
04:35 Getting to know our guest, a movie recommendation, and words of wisdom
08:48 Clinical case, HIV screening, in-depth discussion of HIV testing & diagnosis
15:56 New diagnosis of HIV, counseling after diagnosis, confirmation, follow-up testing, the second visit
24:20 Treatment - what to start and when; some basic comments on therapy
30:05 Primary care after diagnosis, vaccines, cancer screening, cardiovascular disease prevention
34:35 Monitoring CD4 counts and viral load; interpreting CD4 count; time course of response for CD4 and viral load
42:02 Harm reduction counseling; addressing medication non-adherence
47:40 PCP prophylaxis
49:43 The 1917 Clinic, Ryan White Clinics, and linking patients to care
53:10 Take home points
55:40 Plugs
57:45 Will a cure or vaccine for HIV emerge?
59:16 Outro

#120 Policy, Patients, Payments, Paperwork Oct 19, 2018

Join us in this roundtable discussion of patients before paperwork, administrative burden, the new CMS payment model proposal, and a bit on health insurance with cohost, Fatima Syed MD MSc and guest, Deep Shah MD MSc. Doctors Syed and Shah are both early career physicians with masters degrees in comparative social policy from Oxford University and are active members of the American College of Physicians. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode.

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: Fatima Syed MD MSc and Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Fatima Syed MD MSc, Matthew Watto MD

Guest: Deep Shah MD MSc

Time Stamps

00:00 Disclaimer, intro, and guest bios
02:18 Guest one liners, book recommendations, picks of the week
11:00 Administrative burden
16:00 Will the documentation problem get better? Suggestions for improvement
25:11 Why do CMS rules spread to the private insurance sector?
29:30 What innovations might reduce administrative burden?
32:40 The Affordable Care Act, health insurance, price transparency
40:20 Take home points
43:20 Outro

#119 Nutrition Pearls, Heart Health and Bacon Oct 15, 2018

Nutrition pearls from integrative cardiologist, Steven Devries MD, Associate Professor of Medicine, Northwestern Feinberg School of Medicine, Executive Director of The Gaples Institute. Clinicians receive little formal nutritional training in medical school and residency. It’s time to fill that gap! We discuss the strength of the literature supporting dietary interventions for cardiovascular health and review practical tips to help patients achieve healthy eating patterns. Patients need to hear from us that nutrition matters!
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 & Produced by: Molly Heublein MD

Hosts: Matthew Watto MD, Paul Williams MD, Molly Heublein MD

Guest: Stephen Devries MD

Editor: Matthew Watto MD

Special thanks to Elena Gibson MS4 for writing our show notes

#118 Female Sexual Problems with Stacy Lindau MD Oct 08, 2018

Houston, we have a female sexual dysfunction problem. Female sexual problems, which can affect women of all ages, are underdiagnosed and undertreated--in part because clinicians are not the best at asking about sex in primary care visits. In the course of this episode, learn about how to have that sex talk you’ve (maybe) been avoiding, what to ask when working up sexual problems in women, and find the words to talk to patients about sex. Today, we’re lucky to have the female sexual health expert of experts, Dr. Stacy Lindau, MD, MA, Professor of Obstetrics and Gynecology and Medicine-Geriatrics at the University of Chicago Medicine, on the show to teach us the best “sex talk” language, the differential for female sexual problems, and explore therapies. Sadly, there’s no sildenafil-like magic bullet, but a multidisciplinary team can make real impact on female sexual problems. Don’t forget to check out http://womanlab.org

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: Nora Taranto MS4

Hosts: Leah Witt MD and Matthew Watto MD

Infographic: Leah Witt MD

Editor: Matthew Watto MD

Guest: Stacy Lindau MD

Time Stamps

00:00 Disclaimer
00:35 Intro and guest bio
03:30 Guest one liner, book recommendations, favorite failure, career advice and picks of the week
12:57 Clinical Case of female sexual dysfunction and some definitions
15:08 Are sexual problems a normal part of aging?; How to take a sexual history; Etiology of sexual dysfunction; “Diagnostic sex”; Red flags
27:54 Medications that contribute to sexual dysfunction
31:00 Labs
34:45 Treatment: pelvic PT, medications, counseling, flibanserin, herbal supplements
49:05 Screening for female sexual problems
51:58 Take home points; WomanLab.org
55:19 Outro

#117 Clostridium Difficile: IDSA Guidelines, Bad Puns, and Random Pearls Oct 01, 2018

Summary

Conquer Clostridium difficile (Clostridioides difficile) with this “spore-tacular” episode featuring infectious diseases expert, Dr. Curtis Donskey, Professor at Case Western Reserve University and clinician at the Louis Stokes VA Hospital. We discuss the updates in the 2017 IDSA C. difficile guidelines plus a bunch of random pearls. If you have ever laid awake at night wondering how many pills are needed for a fecal transplant, then this is the episode for you! We discuss why metronidazole was dropped as the first line therapy for Clostridium difficile infection (CDI) along with other hot topics such as two-step testing, loperamide use, which antibiotics are the least likely to cause CDI, and more. Do not miss this episode!
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 by: Carolyn Chan MD

Produced by: Matthew Watto MD

Hosts: Carolyn Chan MD, Matthew Watto MD, Paul Williams MD

Editor: Matthew Watto MD

Guest: Curtis Donskey, MD

#116 Geriatric Psychiatry: Sleep, Dementia, and Behavioral Disturbances Sep 27, 2018

Geriatric psychiatry returns. We tackle sleep problems and behavioral disturbances in patients with dementia with returning guest, and Geriatric Psychiatrist Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: pharmacologic and nonpharmacologic management of insomnia; treating agitation and irritability; medical management of psychotic symptoms and paranoia; ethical concerns about the treatment of challenging behaviors in dementia; and the shortage of geriatricians and geriatric psychiatrists.

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 & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

00:00 Intro and guest bio
01:55 Case of sleep disturbance in a patient with dementia; medications for sleep disturbances; nonpharmacologic strategies for sleep
11:32 Irritability and agitation versus paranoia, or psychotic symptoms; benzodiazepines in older adults
15:40 Antipsychotic medications, the black box warning and ethical concerns
23:50 Geriatricians, geriatric psychiatrists in short supply; Behavioral interventions
28:16 Outro

Tags

psychiatry, psych, geri, geriatrics, dementia, paranoia, psychosis, sleep, insomnia, agitation, antipsychotics, atypical, black, box, warning, adverse, zolpidem, benzodiazepine, side, effects, therapy, mirtazapine, gabapentin, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#115 Geriatric Depression Sep 24, 2018

Summary

Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and titrate medications, and how long to continue therapy. Stay tuned for part two of our discussion with Dr Popeo on managing sleep and behavioral problems in older adult patients with dementia.

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 & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

00:00 A question for you, the listeners
01:12 Disclaimer, intro and guest bio
05:00 Getting to know our guest, recommendations for reading, and career advice
14:13 Case of geriatric depression; effective history taking; recognizing associated symptoms; depression scales
19:03 Suicide in older adults; firearm safety
24:26 Choice of therapy; Pharmacologic agents; Counseling patients and managing expectations; Dose titration and tracking symptoms
34:41 Augmenting therapy versus cross-titration to another agent; When is it okay to stop an antidepressant
40:50 Take home points
44:40 Outro

Tags: psychiatry, psych, geri, geriatrics, depression, mdd, sleep, insomnia, appetite, agitation, suicide, SSRIs, side, effects, therapy, diagnosis, serotonin, mirtazapine, bupropion, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#114 High Value Care: Assess Quality, Mitigate Diagnostic Uncertainty, Overcome Barriers Sep 17, 2018

Kick up the quality of your care with tips and tactics from Caitlin Clancy MD, coauthor of ACP’s High Value Care Curriculum. We learn to define quality and value in healthcare; the most common barriers to high value care; use of probability and likelihood ratios to boost clinical reasoning and combat diagnostic uncertainty; some useful tools to estimate cost; sources of healthcare waste; and some general pearls on how the healthcare system works...or doesn’t. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

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 & Produced by: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Caitlin Clancy MD

Time Stamps

00:00 Disclaimer, intro and guest bio
03:50 Guest one-liner, some discussion on non traditional paths, and picks of the week
12:10 Case 1: Defining value, cost, quality; sources of healthcare waste; and how to avoid the waste of daily labs
23:00 Case 2: An uninsured patient who needs major surgery; costs for uninsured versus insured patients
28:35 Do insured patients have better outcomes?
31:15 How to determine cost and “fair market price”
36:29 Case 3: Clinical case of suspected heart failure
45:45 Case 4: Clinical case of patient requesting antibiotics; barriers to high value care and how to overcome them
57:05 Outro

Tags: high, value, care, quality, cost, diagnostic, uncertainty, likelihood, ratio, testing, treatment, consumer, acp, college, american, insured, uninsured, bill, charge, reimbursement,

#113 Gout: Uric acid targets, urate lowering therapy, and random questions from social media Sep 10, 2018

Master the management of gout with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. Topics include: how to initiate and titrate urate lowering therapy, guidelines controversy over uric acid targets, colchicine & NSAIDS for anti-inflammatory prophylaxis, uricosuric agents, febuxostat, HLA B5801, use of uric acid levels in the acute setting and more random gout facts.

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: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Tuhina Neogi MD, PhD

Time Stamps

00:00 Intro and guest bio
01:30 Allopurinol initiation and titration
07:10 Uricosuric therapy
09:10 Controversy over uric acid targets for gout
17:40 Parachutes and randomized controlled trials
19:15 Colchicine or NSAIDS for prophylaxis
23:20 Who needs febuxostat?
26:20 When to refer for gout, HLA B5801, and checking uric acid levels in the acute setting
33:29 Take home points
36:15 Outro

Tags: allopurinol, uric, urate, acid, level, therapy, management, gout, flare, crystal, arthritis, titration, probenecid, febuxostat, target, acr, acp, guidelines, nsaids, colchicine, hla b5801, septic, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#112 Gout Flares: Bathtubs and Firefighting Sep 03, 2018

Crystalize your knowledge of gout and stop flares in their tracks with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. On this first of two gout episodes we learn to diagnose gout with or without arthrocentesis, how to treat flares, and how to counsel patients about gout, which apparently involves fire fighting and bathtubs. Don’t miss next week’s episode on urate lowering therapy, gout guidelines controversy, and answers to your gout questions from social media.

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: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Tuhina Neogi MD, PhD

Time Stamps

00:00 Disclaimer, intro
01:40 Guest bio
03:20 Guest one liner, music recommendations, advice for researchers, and some comments on failure
09:15 Clinical diagnosis of gout
12:15 Is taking a diet history useful?
14:30 Classification criteria for gout
17:35 MSK ultrasound and Physical exam findings in gout
21:06 Arthrocentesis and MSU crystals
24:45 A recap of how to make the diagnosis of gout
26:50 The bathtub analogy and how to counsel a patient with a new diagnosis of gout
30:55 Pathophysiology of gout
34:55 Treatment for acute gout flares (steroids, colchicine, NSAIDS. And topical NSAIDS?)
45:30 Outro

Tags: gout, crystal, colchicine, steroids, nsaids, joint, flare, acute, chronic, urate, uric, acid, arthritis, acr, exam, diagnosis, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#111: Hotcakes - Complementary Medicine in Cancer, Dosing Aspirin by Body Weight, Marijuana & Respiratory Symptoms, Penicillin Allergies and More! Aug 31, 2018

Dr. Neda Frayha (@nedafrayha) of Primary Care RAP (Hippo Education) joins us this month for our thoughts and analysis of some recent (and not so recent) journal articles that interested us this month. Our articles spanned topics that include at cancer survival among patients pursuing treatment with complementary medicine, the effect of body weight on effectiveness of preventive aspirin dosing, strategies to promote physician leadership, respiratory symptoms in those with marijuana use and MRSA risk among patients with penicillin allergies. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you!

Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

Written by: Sarah Phoebe Roberts MPH, Neda Frayha MD, Christopher Chiu MD
Producers: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Editor: Matthew Watto MD

Time stamps:

00:00 Disclaimer, intro, guest bio
05:05 Do patients using complementary medicine for cancer therapy have worse outcomes?
13:11 Does low dose aspirin work for primary prevention of major adverse cardiac events?
19:16 Do physicians make better leaders?
24:55 Does marijuana cause respiratory symptoms?
30:40 Does penicillin allergy confer increased risk for C Diff and MRSA infection?
38:40 Wrap-up and outro

Tags: aspirin, cardiac risk, mortality, cancer, complementary, alternative, conventional, therapy, marijuana, cannabis, respiratory, symptoms, leader,

#110: Driver’s safety for Older Adults: When is it Time to Give Up the Keys? Aug 27, 2018

Get schooled on driver’s safety for older adults by expert, Alice Pomidor MD, Professor of Geriatrics at Florida State University. Whether or not older adults can continue to drive is a huge problem faced by for primary care clinicians, and will remain one until driverless cars become ubiquitous. Topics covered include: how to take a driving history, red flags, physical exam, cognitive exam, and vision assessment for driver’s safety, resources, when to refer, alternate means of transportation, and the legal repercussions of reporting...or not reporting.

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: Matthew Watto MD and Elizabeth Garbitelli MD Candidate 2022
Editor: Matthew Watto MD
Cover Image by: Kate Grant MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Alice Pomidor MD

Time Stamps

00:00 Disclaimer
00:35 Intro and guest bio
03:10 Guest onliner, book recommendations, and career advice
10:43 Clinical case, and the 5 Rs of clinicians responsibility
19:15 Taking a history from older adult drivers
26:28 The clinical exam for driver’s safety (cognition, vision, and MSK tests)
37:24 How can we avoid patient anger towards clinician and family members?
41:10 When and where to refer for driving evaluation
47:00 Alternative transportation
52:00 What to do if someone refuses or forgets to stop driving
59:45 Reporting requirements and legal ramifications
69:15 Take home points
72:00 Outro

Tags: driving, elderly, geriatrics, dementia, treatment, prevention, cognition, seniors, drivers, safety, crash, motor, vehicle, car, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#109: Things We Do For No Reason: A High Value Episode Aug 20, 2018

Things We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound and urine electrolytes in acute kidney injury (AKI), folate deficiency and anemia work-up, prealbumin and malnutrition, blood transfusions, shellfish and contrast allergies, monitoring after switch from IV or oral antibiotics, and “against medical advice” discharges.

Don't forget to check out Clinicwiki.orga free, online resource for teaching ambulatory medicine.
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: Justin Berk MD, MPH, MBA
Editor: Matthew Watto, MD
Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD, FACP
Guest: Lenny Feldman MD, FACP

Time Stamps

00:00 Announcements
00:38 Disclaimer, intro, and guest bio
03:53 Guest one liner, some recommendations, and advice
08:35 Defining high value care and things we do for no reason (TWDFNR)
12:40 Why do clinicians order useless testing?
14:58 Urine electrolytes for acute kidney injury
20:30 Renal ultrasound for acute kidney injury
25:54 Stop ordering folate for anemia workup
31:47 How many units should I transfuse?
34:40 Prealbumin and albumin for malnourishment.
43:24 Iodine, shellfish and contrast allergy
50:28 Patient leaving against medical advice
56:45 Switching from IV to oral antibiotics
63:27 Dr Feldman’s plugs
65:36 Outro

#108: Point-of-care Ultrasound for the Internist Aug 13, 2018

Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine.

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 by: Christopher Chiu MD and Renee Dversdal MD
Produced and CME questions by: Christopher Chiu MD
Edited by: Matthew “Mike” Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Christopher Chiu MD
Guest Expert: Renee Dversdal MD

Tags: point-of-care, acp, impocus, ultrasound, bedside, POCUS, CLUE, exam, training, lifestyle, management, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#107: Women in Medicine, Be Bold Aug 06, 2018

“Women in medicine, be bold.” Medical World, powerful women are here to stay. Dr. Vineet (Vinny) Arora, Professor of Medicine at University of Chicago, an exemplary Woman in Medicine and Leadership, shares snippets of her own story, valuable career advice to folks at all levels of training, and fascinating data about the gender disparities that exist in training, promotion, and pay. We hope you’ll learn from this episode, whether you have faced or anticipate facing these struggles as a Woman in Medicine or as a member of another marginalized group, or whether you’re an ally and want to learn more about the issue.
Women are entering medical school now more than ever, and are learning to provide the best possible care to patients (didn’t you see that patients of female physicians have significantly lower mortality rates than patients of male physicians? (Tsugawa et al., 2016)). The modern medical woman wants to teach, mentor, and lead--and be fairly evaluated, and promoted. That’s where We In Medicine (both women and men) have some work to do. Because gender disparities (and other disparities hinging on identity) do exist.
N.b. This episode is our inaugural in what we hope will be a Women in Medicine series for the Curbsiders. We have many more topics with which we’d like to engage, from career trajectory to imposter syndrome to sexual harassment to balancing career and personal lives (as inequity is not only at work (Khullar. Being a Doctor is Hard. It’s Harder for Women. NYT 2017)), to conversations about race, gender, and LGBTQ identity in medicine. We’re passionate, at The Curbsiders, about all these topics, and we want to dive deep into how to make Medicine a more welcoming and ceiling-less place for all. We can’t wait to bring this series to you, not to mention to bring some more fabulous female experts on air.

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: Leah Witt MD, Shreya P. Trivedi MD, Nora Taranto AB, Sarah Phoebe Roberts MPH, Molly Heublein MD, Beth Garbitelli, Hannah R Abrams,
Images by: Beth Garbitelli and Hannah Abrams
Editor: Matthew Watto MD
Hosts: Leah Witt MD, Shreya P. Trivedi MD, Matthew Watto MD
Guest: Vineet Arora MD

#106: Hotcakes: Cardiac risk, diabetes, pulmonary embolism, opioid use disorder, neck ties and nose picking? Jul 30, 2018

Short on time but hungry for knowledge? Curbsiders’ Journal Club gives you the speedy article analysis you crave. We provide brief summaries of recent research and news items in the field of internal medicine, so you can save time and stay on top of the literature. On this episode, we were joined by Kashlak Memorial’s very own Chair of Medicine, Dr. Robert Centor AKA @medrants on Twitter or “Uncle Bob” to the Curbsider Crew. This month’s topics include: estimating atherosclerotic cardiovascular disease risk, whether CT pulmonary angiography (CTPA) effectively rules out pulmonary embolism, discharging low risk patients with pulmonary embolism from the ED, metformin and risk of acidosis in patients with CKD, treating opioid use disorder after a nonfatal overdose, Canagliflozin and renal protection in type 2 diabetes, screening for diabetes among patients below age 40, and the association between nose-picking and staphylococcus. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).
Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you!
Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.
Credits:

Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Editor: Matthew Watto MD
Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
Guest: Robert Centor MD

#105: Lyme Disease and Tick-Borne Illness with ID Expert Paul Sax Jul 23, 2018

Lyme disease and tick-borne illness deconstructed by Infectious Diseases expert, Paul E. Sax MD, of episode 78 fame. Oh, Summer Nights. The time for romance between Danny Zuko and good girl Sandy, the time to sit in the backyard around the bonfire, the time for sunset hikes in the woods and mountains…..and don’t forget, it’s also the time for those pesky woodland ticks who’ll go for a ride on you and maybe suck your blood (gross!). Dr. Sax takes us through the essentials of tick-borne illness, with a focus on Lyme Disease: diagnosing it, treating it, identifying possible co-infections, and managing Post-Lyme residual symptoms.
Our (And Dr. Sax’s) Disclaimer about this episode, and the shownotes: Tick-borne illness is a very serious problem in public health in the US, but management is quite a controversial issue. We’ve done our best with this episode to stay as evidence-based as possible. Moreover, given the limited time we have on air, we have tried to focus on what we think is most clinically relevant.

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 by: Shreya P. Trivedi MD, Nora Taranto AB
Produced by: Shreya P. Trivedi MD, Nora Taranto AB
Editor: Matthew Watto MD
Images by: Hannah R. Abrams
Hosts: Shreya P. Trivedi MD, Matthew Watto MD, Paul Williams MD
Guest: Paul E. Sax MD

#104: Renal tubular acidosis with Kidney Boy, Joel Topf MD Jul 16, 2018

Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis 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 by: Matthew Watto MD and Joel Topf MD
Produced by: Matthew Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Joel Topf MD

Time Stamps

00:00 Announcements
01:02 Disclaimer
01:40 Intro and guest bio
04:00 Joel’s one liner
06:05 Joel’s “favorite failure”
11:45 Paul shares a failure
13:20 Tweetorials
16:39 Clinical case of non gap metabolic acidosis
18:06 Three buckets of NAGMA and GI losses
21:02 Chloride intoxication and normal saline
25:14 Renal tubular acidosis and normal role of kidney in acid base
35:03 Proximal (type 2) RTA
40:33 Cases of proximal RTA
43:38 Distal (type 1) RTA
53:15 Bicarbonate dosing and titration
55:28 Type 4 RTA (hypoaldosteronism)
62:09 Urinary anion gap and ammonium
67:26 Replacing GI losses of bicarbonate
70:25 Joel reviews quick cases of RTA and NAGMA
74:49 Outro

Tags: renal, tubular, acidosis, non, gap, rta, nagma, metabolic, kidney, diarrhea, sodium, normal, saline, ringer's, lactate, tubule, bicarbonate, physiology, acid, base, ammonia, ammonium, nephrolithiasis, assist

#103: Train Your Brain: Mapping out your road to expertise Jul 09, 2018

Expert diagnostician, Dr. Gurpreet Dhaliwal, again joins The Curbsiders to dive deeper into the topic of clinical expertise. Topics include, and are mainly focused on, Dr. Dhaliwal’s “training regimen:” feedback, simulation, quizzing, learning from consultants, and how to read the medical literature as a clinician. While we found this episode to be incredibly useful (and entertaining to record), don’t let our bias sway your opinion! In fact, just listen to the episode and listen for practical advise on how to improve your own clinical acumen.
Dr Brigham’s comment: Be forewarned, much of what we talk about is seemingly common sense, but, upon listening to the episode many times, I realize that we have, over time, overly complicated the fundamentals of expertise. I’m just as guilty as the next physician.
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: Stuart Brigham MD
Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD
Guest: Gurpreet Dhaliwal MD
Images by: Beth Garbitelli
Edited by: Matthew Watto MD

#102: Hotcakes: Asthma, Smoking Cessation, PCP Prophylaxis, Procalcitonin Jul 02, 2018

Curbsiders’ Journal Club features rapid summary and critical appraisal of recent articles and news stories in internal medicine by The Curbsiders. This month’s topics include: asthma, maintenance versus as needed inhaler use, procalcitonin, Pneumocystis pneumonia prophylaxis, colon cancer screening, smoking cessation, cannabis and cognitive impairment, LDL cholesterol and mortality, plus some medical podcast recommendations.

Over the last month, we have developed a list of more than 40 interesting articles and news stories that we have been feeding our own brain holes. From this list we have plucked a select few that we really wanted to highlight and share with you.

Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! We are also on Facebook, Instagram, and Twitter: @thecurbsiders.
Credits:

Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
Editor: Matthew Watto MD

Time Stamps:

00:00 Announcements
00:20 Disclaimer
01:00 Intro to Curbsiders Journal Club
03:07 Mild asthma and as needed versus maintenance inhaler use
09:50 Smoking cessation, e-cigarettes, and financial incentives
17:23 Pneumocystis pneumonia prophylaxis
22:18 Cannabis and cognitive impairment
26:15 Colorectal cancer screening update by American Cancer Society
30:37 Procalcitonin for lower respiratory tract infections in the ED
37:29 Cholesterol, baseline LDL-C, mortality and cardiovascular events
41:01 Incorrect symbology and some podcast recommendations
46:22 Outro

Tags: asthma, maintenance, inhaler, procalcitonin, Pneumocystis, pcp, pneumonia, prophylaxis, colon, cancer, screening, crc, smoking, cessation, marijuana, cannabis, cognitive impairment, LDL, cholesterol, mortality, cardiovascular, podcast, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed

#101: Cirrhosis: Medications, decompensation, complications Jun 25, 2018

Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology!

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 by: Cyrus Askin MD
Infographics: Beth Garbitelli
Produced by: Cyrus Askin MD and Matthew Watto MD
Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Scott Matherly MD

Time Stamps

00:00 Announcements
00:54 Disclaimer
01:30 Guest bio
02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis
06:56 Clinical case of decompensated cirrhosis
09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics
18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin
25:10 Timing of medical therapy
26:39 MAP of 82 mmHg, beta blockers and variceal bleeding
31:04 Use of midodrine for hypotension
33:45 Prophylaxis of SBP
36:05 Take home points
38:04 Outro

Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

#100: Cirrhosis: Initial Evaluation and Management Jun 18, 2018

Cirrhosis. Finally. Take your liver game to the next level with tips from @liverprof, Scott Matherly MD, Assistant Professor of Medicine at Virginia Commonwealth University. Topics include: exam findings in cirrhosis, interpreting liver function tests, incidental cirrhosis on imaging, fatty liver disease, steatohepatitis, hep c, shear wave elastography, screening for varices and hepatocellular carcinoma, pathophysiology, and lifestyle measures for initial management. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date).
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 by: Cyrus Askin MD
CME questions by: Cyrus Askin MD
Produced by: Cyrus Askin MD and Matthew Watto MD
Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Scott Matherly MD

#99 Cancer Survivorship: What to do when the treatment is done Jun 11, 2018

Step up your primary care of cancer survivors with tips from Dr Regina Jacob, Assistant Professor of Medicine at Temple University. Care of the cancer patient does not end when their cancer treatment is over, and there is more to a past diagnosis of cancer than surveillance. We discuss cancer survivorship care with Dr. Regina Jacob, including the changing demographics of survivorship, the importance of survivorship care plans, and how survivorship is largely just good primary care.

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 by: Paul Williams MD
Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD
Produced by: Paul Williams MD
Edited by: Matthew Watto MD
Guest: Regina Jacob MD

Time Stamps

00:00 Disclaimer
00:35 Intro to the topic and guest bio
02:15 Guest one liner, book and app recommendations
06:58 Paul’s pick of the week.
07:40 Clinical case, definitions, and phases survivorship
12:36 Survivorship statistics
15:04 Co-survivorship
17:41 Care models for survivorship
20:56 Assigning roles in care of cancer survivors
22:59 Sample survivorship care plan
27:39 Childhood, adolescent and young adult cancer survivorship
34:18 Sexual dysfunction in cancer survivorship
Turn down Watto and Regina tracks
35:56 Stressors in young adult cancer survivors
37:33 Fatigue
43:28 Guidelines on survivorship
45:06 Late cardiac toxicity
46:23 Support groups and resources
49:04 Take home points
50:29 Outro

#98 Knee Pain: History, exam, bracing, x-rays, and injectables Jun 04, 2018

Knee pain is easy with practical tips from Orthopedist, medical educator, car-builder, and inventor extraordinaire Dr. Ted Parks. He teaches us the four buckets of knee pain, how to perform a 30-second knee exam, choose a knee brace, order x-rays, and the red flags to look for in a history and physical that should have you shouting for your closest neighborhood orthopedic surgeon. This episode is brought to you in partnership with the American College of Physicians. ACP members can claim free CME-MOC credit at acponline.org/curbsiders. Check out our video of the Parks-Approved 30-second knee exam!
Credits:

Written by: Nora Taranto BA, Matthew Watto MD
Produced by: Chris Chiu MD and Nora Taranto BA
Edited by: Matthew Watto MD.
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD.
Guest: Ted Parks MD.

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.

#97 Hotcakes: Hypertension, Prostate Cancer Screening, Lifestyle & Mortality May 28, 2018

Keep current with this monthly journal club covering landmark articles through May 2018, plus rapid fire hot takes from the medical literature and health news. We rate each article according to a highly scientific ‘Hotcakes’ scale to highlight what practice-changing knowledge we’ll take to work this month. Topics: Hypertension, blood pressure monitoring, prostate cancer screening, Intimate Partner Violence screening, alcohol is killing you, new diabetes drugs and mortality, DPP-4 inhibitors and IBD risk, NT-proBNP-guided therapy vs usual care, effect of teaching status on mortality, and more! If you’re a listener and have something interesting for us to discuss, please send it our way.

Join our mailing list to 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. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

Written and produced by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
Editor: Matthew Watto MD

Time Stamps:

00:00 The Curbsiders need a web master
00:50 Disclaimer
01:25 Intro to the format
03:25 Ambulatory BP monitoring and mortality
09:08 Blood pressure treatment strategies: CVD risk score vs systolic BP targets
14:14 Repeated BP measurements important at office visits and future directions of BP management
21:25 Hot takes in order of appearance: Prostate cancer screening, intimate partner violence, alcohol, DPP4 inhibitors mortality and IBD, teaching status and mortality in US hospitals, 5 lifestyle factors that may add to life expectancy, NT pro-BNP, BNP and mortality
38:12 Outro

#96 Diabetes: A1C targets & ACP guidelines controversy May 21, 2018

Get schooled on hemoglobin a1c targets in type 2 diabetes mellitus by American College of Physicians guidelines coauthor, Devan Kansagara MD MCR, Associate Professor of Medicine, Oregon Health Sciences University. We summarize outcomes from the landmark diabetes trials (ACCORD, ADVANCE, VADT, UKPDS 33 & 34), how a1c targets effect microvascular and macrovascular events, estimating life expectancy, and how to personalize diabetes control for your patients. We’re proud to announce our new partnership with the ACP to provide free CME credit and MOC points on select episodes of The Curbsiders. ACP members can visit acponline.org to redeem free CME/MOC credit.
Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list to 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, produced, and edited by: Matthew Watto MD.
Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD.
Guest: Devan Kansagara MD, MCR

Time Stamps

00:00 Announcement
00:48 Disclaimer and intro
03:11 Getting to know our guest: one liner, book recommendation, mentorship
06:50 How and why did ACP write their guidance statement on diabetes, A1C targets
09:18 Landmark trials in type 2 diabetes
11:36 Does tight control prevent micro or macrovascular complications
13:20 Trials of newer agents like SGLT2i, GLP-1 and DPP4i
14:33 How do ACP’s guidelines differ from other published guidelines
17:20 Quick recap of landmark trial findings
22:24 Personalizing glycemic control
24:30 Controversy over an A1C goal of 7-8%
28:05 Clinical inertia
30:26 Legacy effect and metabolic memory
34:00 Deintensifying therapy
38:29 Life expectancy and comorbid conditions
43:15 Performance measures in diabetes
44:42 Take-home points
46:30 The Curbsiders recap and give some closing remarks
49:13 Outro

#95 Food allergy, food intolerance and celiac disease May 14, 2018

Separate the wheat from the chaff when it comes to food allergy, food intolerance, and celiac disease. Featuring renowned gastroenterologist and current president of the American Gastroenterological Association, Dr. Sheila Crowe MD FRCPC FACP FACG AGAF, we discuss how to differentiate a food allergy from an intolerance, what diagnostic testing is appropriate, and why fructans might be the real culprit in patients with ‘gluten sensitivity’.
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 by: Sarah P. Roberts, MPH
Guest: Sheila Crowe, MD
Hosts: Matthew Watto, MD; Stuart Brigham, MD; Paul Williams, MD
Producers: Sarah P. Roberts, MPH and Chris Chiu, MD
Editor: Matthew Watto, MD

Time Stamps:

00:00 Disclaimer
03:35 Getting to know our guest, book recs, and career advice
10:35 Clinical case
11:40 Defining allergy, intolerance
14:05 Food intolerance and FODMAP
18:02 Taking a history in patient with potential food allergy vs intolerance
21:34 Dermatitis herpetiformis, gluten ataxia, and extraintestinal manifestations of celiac
26:12 Diagnosing celiac disease
30:53 Next steps if celiac testing is negative; lactose, fructose intolerance, IBS
33:48 Non-celiac gluten sensitivity (NCGS)
37:48 Study of NCGS
40:41 Olmesartan and drug-induced enteropathy
43:38 Dieticians, dietary recs, elimination diets
48:10 “Voodoo” testing
52:36 Counseling patients on diet
54:35 Take home points
55:50 Outro

#94: Random Pearls: Microbiome, POTS, Gabapentin, and Leonardo Da Vinci May 07, 2018

A random serving of knowledge food for your brain hole with returning guest, Dr. Alan Dow, Professor of Internal Medicine at Virginia Commonwealth University School of Medicine. Our final live recap show from ACP 2018 covering: human microbiome, copper deficiency, POTS syndrome, substances of abuse, drugs for delirium and how to be more like Leonardo Da Vinci. Please let us know what you liked, didn’t like and how we can make the show better.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Time stamps:

00:00 Disclaimer
01:30 Guest bio
03:19 Getting to know our guest, podcast, and book recommendations
08:55 Human microbiome
11:05 A case of anemia and neuropathy
13:30 Physiology and treatment of POTS syndrome
17:00 Novel substances of abuse
20:17 Benzodiazepines for delirium
24:00 Leonardo Da Vinci versus the modern physician
27:18 Outro

Tags: microbiome, transplant, bupropion, gabapentin, pregabalin, copper, POTS, substance, use, disorder, leonardo, da, vinci, acp, journal, article, literature, news, media, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#93 Clinical Pearls ACP 2018 with Nina Mingioni MD Apr 30, 2018

A fast moving recap of hot topics and clinical pearls live from Internal Medicine’s largest national conference, ACP 2018 in New Orleans! Dr. Nina Mingioni, Clinical Associate Professor and director of Undergraduate Medical Education in Internal Medicine at Thomas Jefferson University Hospital serves up some knowledge food for our brain holes. Topics: the athlete as a patient, sports physicals, food as medicine, medical marijuana (cannabis), and more! Listeners, please let us know what you liked, didn’t like and how we could make this better. YouTube video of this episode available here: ACP 2018 Recap with Nina Mingioni.

You can 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. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Time stamps:

00:00 Music and disclaimer
02:48 Getting to know our guest
06:07 The athlete as a patient
10:20 Relative energy deficiency in sports
12:00 Drug interactions
15:51 Food as medicine
21:56 Marijuana
30:24 Outro

Credits:

Written by: Nina Mingioni MD, Hannah Abrams. Producer/videographer: Chris Chiu MD. Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD. Editor: Matthew Watto MD

Tags: food, microbiome, marijuana, athlete, ekg, ecg, physical, sports, training, energy, relative, deficiency, cannabinoid, entourage, effect, cannabidiol, thc, cannabis, acp, 2018, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#92: Pulmonary Embolism for the Internist Apr 23, 2018

Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz

Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

5:10 - Start of Interview / Introduction
10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology
16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”)
23:30 - Other ways to risk-stratify (Other CT findings, clot burden)
28:45 - What does a low-risk patient look like?
30:35 - When to consider treatment modalities other than general anticoagulation
35:12 - Anticoagulation treatment options
36:38 - Next step intensive interventions after anticoagulation
42:00 - Evidence behind catheter-directed lysis
44:05 - IVC Filter discussion
47:22 - Discharge criteria for PE
50:00 - Incidental PEs
52:40 - Interdisciplinary PERT Team

Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

Random Clinical Pearls ACP 2018 Day 2 Apr 21, 2018

Random clinical pearls from day 2 of ACP 2018 live in New Orleans. Topics include: Perioperative medicine, DOACs, anticoagulation, reversal agents, ACP statements on hidden curriculum, physician well being and burnout, modeling behavior, dermatology pearls, rashes, venous stasis ulcers, pentoxifylline, biotin and Grave's disease, dermatology pearls, Stuart's tips on sports doping, and how chocolate milk improves recovery time. Doctors Chris Chiu and Chris Thrash join us to discuss their favorite teaching points from today's sessions.

Cochrane Review on Venous Ulcers https://bit.ly/2JdQAMu

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Random Clinical Pearls ACP 2018 Day 1 Apr 20, 2018

The Curbsiders share random clinical pearls from day 1 of ACP 2018 live in New Orleans. Topics covered include: breast density and cancer risk, patients before paperwork, diverticulitis, social determinants of health, migraine prevention, PrEP and thunderclap headaches. Doctors Chris Chiu and Chris Thrash join us on air to discuss their favorite teaching points from today's sessions.

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#91 Hotcakes: Fluid Wars, Barbershops, HTN, Aromatherapy, Coffee Apr 16, 2018

Keep up-to-date with this fast moving discussion of recent journal articles and thought-provoking headlines in medicine. Welcome to the first-ever Curbsiders journal club covering landmark articles from March to April 2018, plus rapid fire hot takes and the unveiling of our new hotcake based rating system. Please let us know what you liked, didn’t like and how we can make this better next month. Topics: Resident work hours, saline versus balanced IV fluids, barber shops and hypertension, coffee causes cancer, Twitter based medicine, clonidine versus spironolactone, opioids versus nonopioids and aromatherapy for nausea!

Written by: Chris J Chiu, MD; Producer: Sarah Phoebe Roberts MPH; Edited by: Matthew Watto, MD

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Time stamps:

00:00 Disclaimer
00:35 Host intros, featuring special guest and correspondent Chris Chiu, MD
01:30 Introducing a new Curbsiders segment!
03:20 First article: Duty-Hour Flexibility Trial
08:55 Second article: Trial of Blood-Pressure Reduction in Black Barbershops
14:27 Third article: SALT-ED Trial
20:00 Hot takes—intro
20:36 Hot take #1, Dr. Milton Packer and Twitter-based medicine
24:07 Hot take #2, Coffee and cancer risk
26:24 Hot take #3 Aromatherapy for nausea
28:10 Hot take #4 Opiates vs. non-opiates for chronic pain
29:00 Hot take #5, Surgeon general’s statement on naloxone
29:46 Hot take #6, Spironolactone vs clonidine for resistant HTN
31:54 Outro & announcements

#90 Clinical Reasoning: Become an expert diagnostician Apr 09, 2018

Become an expert diagnostician like Dr Gurpreet Dhaliwal, Professor of Medicine at UCSF. Join us for this deep dive into clinical reasoning and how doctors think! Topics include: how to improve your own clinical reasoning and diagnostic skills, how to teach these skills, and the initial steps to building your own expertise/mastery in clinical medicine! Dr. Osler once admonished his students to build experiential wisdom and follow-up with their clinical cases (clear cases, doubtful cases, and mistakes), but to do so, one must “...learn to play the game fair, no self-deception, no shrinking from the truth; mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.” Test yo’ self: Take our quiz here

Written and produced by: Stuart Brigham, MD; Images by Hannah Abrams; Edited by: Matthew Watto, MD
Full show notes available at http://thecurbsiders.com/podcast

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#89 Conjunctivitis: Red Eye in Pr-eye-mary Care with Dr Glaucomflecken Apr 02, 2018

Revolutionize your approach to the red eye in pr-eye-mary care! Dr. Glaucomflecken (of GomerBlog/Twitter--fame) teaches us to recognize and manage common eye complaints. You’ll develop an approach to diagnosing and treating your patient with the dreaded red eye. We answer: What presentations should have us running down the hallway for that prized ophtho consult? What on earth does glaucomflecken stand for? Which eye drops are best? What is an eye dentist? Plus, answers to your twitter questions, and so much more! By the end of this episode, you’ll be sure to say “Eye Understand!” Self Assessment Questions: Take the ophtho self-assessment!

Donate at FirstDescents.org to support young cancer survivors like Dr. Glaucomflecken!
Written and produced by: Nora Taranto AB, Carolyn Chan MD; Original art by: Bryan Brown, MD. Edited by: Matthew Watto, MD.
Full show notes available at http://thecurbsiders.com/podcast

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#88 Acid base, boy bands, and grandfather clocks with Joel Topf MD Mar 26, 2018

Dominate acid-base disturbances with the wisdom of @kidney_boy aka Joel Topf, MD, Chief of Nephrology at Kashlak Memorial Hospital. Master his 5 key steps for interpreting acid-base disorders and decode any ABG, VBG, and BMP to find the primary disorder, and any other disorders tucked away in the ABG! Plus: Henderson-Hasselbach and pH simplified; the anion gap, should your correct it?; choice of IV fluid; osmolar gaps, methanol, ethylene glycol, isopropyl alcohol; and how metabolic disorders are like a boy band. Be sure to follow along the Dr. Topf’s brilliant acid-base powerpoint.
Written and produced by Joel Topf MD, Shreya Trivedi MD, Xavi Jimenez MD; Images by Hannah Abrams; Edited by Matthew Watto MD
Full show notes available at http://thecurbsiders.com/podcast

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#87 Toxicology 101: Talking Tox with The Dantastic Mr. Tox & Howard Mar 19, 2018

Want to look cool like a toxicology consultant, sipping coffee on rounds? Ever check a patient for armpit sweat? Learn the secrets of tox from the titans of toxicology podcasting, The Dantastic Mr. Tox & Howard (AKA Dr. Dan Rusyniak and Dr. Howard Greller), as they loquaciously dish on all things tox. Topics include: how to approach the patient with an unknown overdose, are toxidromes clinically useful, clues on physical exam, is GI decontamination still recommended, and why they hate bupropion and tramadol. We recommend cautious ingestion of fluids while listening because this was a seriously funny episode. Try our Self Assessment Questions Toxicology 101 Quiz.

Written and produced by: Christopher Chiu, MD; Graphics by: Beth Garbitelli; Edited by: Matthew Watto, MD
Full show notes available at http://thecurbsiders.com/podcast

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#86 COPD: Diagnosis, treatment, PFTs, and nihilism Mar 12, 2018

Take a deep breath and tune in to this week’s episode full of COPD diagnosis and management pearls, with expert Dr. Denitza Blagev, a pulmonologist, intensivist, and Medical Director for Quality, Speciality Care at Intermountain Healthcare in Utah with a particular interest in physician wellness and issues related to women in medicine. We cover: history taking, interpreting PFTs, patient counseling, inhalers and medications, exacerbations, antibiotics, steroids, and who needs BIPAP...so basically everything you ever wanted to know about chronic obstructive pulmonary disease. Take our self assessment here.
Sponsored by @nephmadness. Registration opens March 15th at AJKDblog.org

Written and produced by: Leah Witt, MD, Cyrus Askin, MD. Edited by Matthew Watto, MD
Full show notes available at http://thecurbsiders.com/podcast

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#85: Contraceptives: Pills, mini pills, and tiny pills Mar 05, 2018

Contraception simplified with clinical pearls from reproductive health and family planning experts, Dr Angeline Ti, and Dr Moira Rashid. We cover it all including: the menstrual cycle, mechanism of action for various methods of birth control, hormonal versus nonhormonal contraceptives (e.g. intrauterine devices, patches, pills, rings, implants), patient counseling, and lots of resources to make your job easier. Women’s health correspondent, Dr Molly Heublein returns as cohost. Take our self-assessment quiz!

Written by: Molly Heublein, MD, Beth Garbitelli and Sarah Roberts, MPH. Edited by Matt Watto, MD
Full show notes available at http://thecurbsiders.com/podcast

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#84: Anemia, Iron Deficiency, IV iron, and Tony Stark Feb 26, 2018

Abolish anemia, and iron deficiency w/tips on IV iron therapy from real life iron man, Michael Auerbach, MD, FACP, Clinical Professor of Medicine Georgetown University School of Medicine. Topics include oral versus IV iron therapy, safety of IV iron, ferritin cutoffs, and how to diagnosis/ treat iron deficiency in patients with chronic inflammation, chronic kidney disease, pregnancy, heart failure, and more! Take our Self Assessment Test Here.
Images by Beth Garbitelli; Written and produced by Justin Berk, MD and Matthew Watto, MD.
Full show notes available at http://thecurbsiders.com/podcast

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#83 Valvular heart disease, anticoagulation, TAVR, and primary care Feb 19, 2018

Get the latest on valvular heart disease: TAVR vs SAVR, choice of valve type, rheumatic heart disease, antibiotic prophylaxis for endocarditis, who needs an echocardiogram, and anticoagulation goals with tips from cardiologist, Dr Eli Gelfand, Section Chief of General Cardiology at Beth Israel Deaconess Medical Center in Boston and an Assistant Professor of Medicine at Harvard Medical School. Correspondent Dr Kate Grant joins us for this conversation w/Dr Gelfand about his common sense approach to the evaluation and management of valvular heart disease.
Written by Kate Grate, MD and Matthew Watto, MD.
Full show notes available at http://thecurbsiders.com/podcast

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#82 Dementia Dos and Don’ts: The GeriSiders Feb 12, 2018

Challenge your beliefs on the efficacy of pervasive treatments used in dementia with expert Eric Widera, MD, Professor and clinician-educator in the Division of Geriatrics at the University of California-San Francisco. We explore the use of cholinesterase inhibitors, antipsychotics for behavior disturbances, feeding tubes, medications and supplements used for weight gain (inspired by Choosing Wisely and the American Geriatric Society’s “Ten Things Clinicians and Patients Should Question”). Plus, we introduce our new correspondent, Dr. Leah Witt, Geriatrics Fellow at UCSF.

Written and produced by: Jordana Kozupsky, NP, Nora Taranto, MS3, Leah Witt, MD; Edited by: Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

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Self Assessment Questions Take the quiz now!

Time Stamps

00:00 Disclaimer
00:37 Guys set up the show
02:00 Dr Widera’s bio
03:15 Getting to know our guests
13:10 Picks of the week
16:40 Clinical case: new diagnosis of dementia
17:40 Discussing dementia with patients and caregivers
23:42 Cholinesterase inhibitors
27:35 Stopping cholinesterase inhibitors
33:35 Follow up to therapy
36:05 Dealing with behavior disturbances
39:15 DICE approach
44:17 Risks of antipsychotic medications
48:00 Use of benzos or sedative hypnotics
49:45 Melatonin for delirium or sleep
52:00 Mirtazapine
53:54 Clinical case: patient with dementia not eating
54:40 Feeding tubes
59:40 Dysphagia and NPO orders
62:04 Misinformation on malnutrition and girth creep
65:10 Thickened liquid challenge
70:25 Appetite stimulants
72:38 Megestrol
73:54 Take home points from Dr Widera
79:17 Outro

Tags: dementia, donepezil, cholinesterase, inhibitor, antipsychotic, behavior, disturbance, agitation, benzodiazepine, supplement, feeding, tube, restraints, thickened, liquids, geriatric, choosing, wisely, american, society, ags, assistant, care, doct

#81: Placebos, nocebos, and the doctor as a placebo Feb 05, 2018

Boost treatment efficacy and amplify the “doctor as a placebo” phenomenon with tips from placebo expert (and ex-cartoonist), Mark W. Green, MD, Director of Headache/Pain Medicine and Professor of Neurology, Anesthesiology, and Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai. Topics include: What’s that pesky sugar pill actually doing to us? Why do we get a boost from taking medicines that have no active compounds within them? How does placebo work? How can it be leveraged? What does it mean for study design/blinding? And what’s with its pesky dark twin--the nocebo effect? “Enjoy this, our only placebo-controlled episode” (Thanks, Stuart!).
Written and produced by: Molly Heublein, MD and Nora Taranto MS3; Edited by: Matthew Watto, MD
Full show notes available at http://thecurbsiders.com/podcast

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#80 Pulmonary hypertension, freeways, and cows in heart failure Jan 29, 2018

Pulmonary hypertension deconstructed with clinical pearls from cardiologist, John J. Ryan MD, FACC, FAHA, director of University of Utah Pulmonary Hypertension Center. We discuss classification, diagnosis/differentiation, initial workup, additional testing, echo findings, how to counsel patients with pulmonary hypertension, and why cows never get ankle edema!
Written and produced by: Jordana Kozupsky, NP and Matthew Watto, MD
Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps:

00:00 Disclaimer
01:30 Introducing our new Correspondent Jordy
03:05 Listener feedback
04:40 Guest bio
06:25 Getting to know Dr Ryan
09:33 Picks of the week
15:20 Clinical case
16:35 How to explain pulmonary hypertension to a patient
18:12 Groupings of pulmonary HTN
21:20 Taking a history. Ask these questions.
23:30 Physical exam
25:45 Initial testing
27:40 Overnight pulse oximetry
29:00 Echo findings in pulmonary HTN
31:30 Transpulmonary gradient
33:33 What is a normal pulmonary artery pressure
35:15 Accuracy of PA pressure estimate by echo
39:04 Mechanism of shortness of breath in PH
40:10 Should you hold PAH meds in a hypotensive patient?
41:55 Therapy for PH and follow up
46:28 Who to refer
47:40 PAH risk factors
52:09 Mortality in PH
58:22 Take Home Points & Outro

#79 Dermatitis: Atopic to Remember w/The DermSiders Jan 22, 2018

Differentiate, diagnose, and treat the various forms of dermatitis and stop the ‘itch that rashes’ with this in-depth, myth-busting episode of “The Dermsiders” with Dr. Kalman Watsky Clinical Professor of Dermatology at Yale Medical School. Topics include: how to differentiate between and diagnosis various forms of dermatitis, topical therapies, common pitfalls, patch testing, and more! Special thanks to Bryan Brown and Beth Garbitelli who wrote and produced this episode and the show notes!

Written by: Bryan Brown, MD and Beth Garbitelli
Edited by: Matthew Watto, MD
Infographics by: Bryan Brown, MD
Cover image by: Beth Garbitelli

Full show notes available at http://thecurbsiders.com/podcast

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#78 ID Pearls with Paul Sax MD Jan 15, 2018

It's a potpourri of Infectious Diseases with tips from expert, Dr Paul Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women's Hospital, and Professor of Medicine at Harvard Medical School. We discuss the man flu, the flu vaccine, travel medicine, malaria, lyme disease, post lyme syndrome, chronic lyme, shingles, cellulitis, abscesses, antibiotics, c diff, antibiotic associated diarrhea, the dangers of fluoroquinolones, why doxycycline is awesome, and more! Told you it was a potpourri. Dr Shreya Trivedi joins Matt and Paul as guest host.

Show Notes, MCQ by Shreya Trivedi, MD
Edited by Matthew Watto, MD
Infographics and cover image by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps:

00:00 Announcement
01:38 Intro
03:46 Picks of the Week
06:47 Guest bio
08:47 Getting to know our guest
15:40 Flu vaccination
19:54 Barriers to the flu vaccine
23:34 Can you give the flu vaccine to an ill patient
24:14 Man flu
26:27 Travel Medicine
30:35 Tick bites
33:49 Lyme serologies
35:38 Lyme prophylaxis
37:37 Chronic lyme disease and post lyme syndrome
38:55 Penicillin and antibiotic allergies
41:48 Fluoroquinolones and adverse reactions
45:24 Should antibiotics be given after an I&D of an abscess
49:34 Antibiotic associated diarrhea, C diff
52:10 Probiotics, stool transplantation, and C diff
54:50 Shingles, recurrent zoster, complications, and the new subunit vaccine
61:45 Using salad tongs at a buffet
63:04 Take home points
64:26 Outro

Tags:

ID, infectious, diseases, disease, flu, influenza, lyme, doxycycline, cdiff, antibiotics, infection, cellulitis, abscess, vaccine, zoster, shingles, malaria, travel, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

#77 Hypertension Guidelines Showdown Jan 08, 2018

Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes.

Time Stamps

00:00 The setup
02:15 Disclaimer
03:32 Picks of the Week
08:13 Getting to know Dr Forciea
13:35 Broad overview and a clinical case of geriatric hypertension
14:45 Brief history on BP targets
18:05 How do you measure a blood pressure? What type of monitors are available?
22:13 How to standardize BP in the office?
23:55 Ambulatory BP monitoring
24:55 Home blood pressure monitoring
26:11 Standing blood pressure readings and orthostatic hypotension
27:53 How guidelines are written
30:51 Evaluating evidence quality and strength of recommendation
32:35 Timeline and process for guideline generation
34:27 How to read guidelines with a “critical eye”
36:15 Return to our case of uncontrolled hypertension
38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults
40:33 Counsel patients on BP targets
42:25 Low diastolic blood pressure
45:35 SPRINT and the ACP BP guidelines
48:58 Take home points from Dr Forciea
50:07 HTN targets and pay for performance in clinical practice
51:45 Curbsiders recap the ACP guidelines
53:45 Matt and Paul recap the AHA guidelines
54:47 AHA definitions of hypertension
56:15 Diagnosing hypertension and how to measure a blood pressure
60:35 Choosing a blood pressure monitor and HBPM
62:29 Blood pressure goals in ACC guidelines
66:08 Non-pharmacologic measures
69:15 Will we follow these new strict targets?
72:45 Outro

Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resid

#76 Pneumonia Pearls with Dr Robert Centor Jan 01, 2018

Conquer community acquired pneumonia and avoid misdiagnosis with tips from Dr. Robert Centor, Professor Emeritus University of Alabama and newly appointed Chair of Medicine at Kashlak Memorial Hospital. We discuss diagnosis, misdiagnosis, procalcitonin, steroids for severe pneumonia, pneumonia severity index versus CURB-65, and how to determine antibiotic choice and duration. Special thanks to Correspondents Neela Bhajandas (cohost), Justin Berk and Bryan Brown who all contributed several articles, resources, and questions to prep for this show. Cover image by Dr Kate Grant paintscientific.com.
Full show notes available at http://thecurbsiders.com/podcast

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#75 Recap, highlights, and clinical pearls extravaganza for The Curbsiders 2017 Dec 25, 2017

Join us for this recap of the key clinical pearls and favorite fan voted episodes from 2017 including: lipids, asthma, diuretics, hyponatremia, CKD, vertigo, and dizziness. Plus, Picks of the Year, exciting announcements for 2018, and Paul reveals that he has a wife! Matt, and Paul are joined by Curbsiders Correspondent, Dr. Chris Chiu, who wrote and produced this episode. Stuart was out with the Man Flu. My apologies to Dr. Bryan Brown whose name I forgot to shout-out when listing our Correspondents. Thanks to Kate Grant for her beautiful cover image.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro
01:18 Getting to know Chris Chiu introduction
03:07 Picks of the week and
06:10 Picks of the year and discussion of vancomycin and pip-tazo causing AKI
11:41 Recap of Scott Weingart and EM vs IM episode
17:45 Discussion of Lipids, PCSK9, CAC, CCTA
27:10 Asthma pearls recapped
32:43 Dizziness and vertigo recapped
38:40 Diuretics, diuretic resistance, and secondary hypertension diagnosis and treatment
44:35 Diuretic dosing
46:25 Hyponatremia, volume status, solute loads and SIADH
50:08 CKD, when to refer, and an argument about low protein diets
54:25 Matt, Paul, and Chris reflect on important lessons learned from 2017
59:32 Listener questions and comments
63:35 Wrap-up, and shout outs
66:22 Announcements for 2018
67:25 Outro

Tags: hyponatremia, salt, kidney, ckd, asthma, vancomycin, zosyn, injury, weingart, emcrit, emergency, lipids, pcsk9, statin, dizziness, vertigo, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

#74 Opioid use disorder, pain, detox, tapers, health policy, and more! Dec 22, 2017

Combat opioid use disorder and the opioid epidemic as we review common clinical scenarios with addiction medicine specialists, Dr. Stefan Kertesz, University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton,Virginia. We need all hands on deck, and that means you! Learn the basics of opioid use disorder treatment as Dr. Manhapra gives us the scoop on “bup, bup, bup” (buphrenophine), and Dr. Kertesz primes us on opioid related health care policy and reminds us that “We can all do something about the opioid crisis”. Plus, Stuart and Paul express some concerns about how to approach these patients. Do not miss this episode filled with clinical pearls, policy, and joy! Special thanks to writers and producers, Dr. Carolyn Chan and Elena Gibson (MD Candidate, MS4), for their hard work on both of our addiction medicine episodes.
Full show notes available at http://thecurbsiders.com/podcast

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#73: Opioid Addiction, Chronic Pain, and Abstinence Dec 18, 2017

Take the pain out of pain management with clinical pearls from addiction medicine specialists Dr. Stefan Kertesz at the University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton, Virginia. They walk us through an approach to pain management in persons with a history of opioid use disorder (OUD), discuss treatment options for OUD, plus hot tips on how to interpret guidelines surrounding opioids, and more! What are you waiting for? Hit the play button! Special thanks to Elena Gibson, MD and Carolyn Chan, MD
Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits

Producer: Elena Gibson and Carolyn Chan
Writer: Carolyn Chan
Infographic: Elena Gibson
Cover Art: Elena Gibson
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Stefan Kertez and Dr. Ajay Manhapra

Time Stamps

00:00 Intro
01:58 Host picks of the week
04:10: Intro to the episode
04:35: Guest Bios
12:32: Case from Kashlak Memorial
13:40 Define substance dependence, substance use, unhealthy use
17:42 Where to go next conversation about pain control
17:54: Assessing risk of relapse
19:35 Screening Tools
20:10 Risk factors for developing OUD when initiating opioids.
25:10: CDC Guidelines length of prescription and risk of substance use disorder (7)
27:00: Defining optimal length of opioid after common surgical procedures (6)
30:30: Long term use of opioids
33:50: OUD treatment options
37:30: Duration of buprenorphine/naloxone treatment, tapering risks (8)
38:50: POATs: Prescription opioids (9)
40:05 Social support and mental health services for SUD treatment
41:10 Risk of abstinence and adverse outcomes
42:35 Protracted withdrawal
43:35: Editorial BMJ Golden Month of Opioid use disorder (10)
44:00 Overdose risk in patients on long term opioids
44:40 Op-Ed on the Hill (11)
45:40 Example of protracted withdrawal syndrome
47:40 Reducing Harms: Naloxone, who to prescribe to?
50:30 Take home points
53:40 Outro

#72 Transgender Care in Primary Care Dec 11, 2017

Trans patients need excellent primary care and you can provide it with expert tips from endocrinologists, Dr Vin Tangpricha, Professor of Medicine at Emory University School of Medicine, and Dr Jeffrey Colburn, Assistant Professor of Medicine at Uniformed Services University. Learn practical tips in caring for transgender patients including: defining terms like gender dysphoria, gender nonconformity, transgender; use of pronouns; patient counseling; fertility concerns; initiating and monitoring hormonal therapy; surgical options; and how to help trans patients navigate the complexities of gender affirming therapy.
Full show notes available at http://thecurbsiders.com/podcast

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#71 Asthma Made Simple Dec 04, 2017

Knock the wind out of asthma with tips from Dr Denitza Blagev, a pulmonologist and intensivist who currently serves as Director for the Schmidt Chest Clinic at Intermountain Medical Center in Murray, Utah. We simplify the approach to diagnosis, spirometry, patient counseling, choice of agent, stepwise therapy, and de-escalation...plus, a little myth busting. Special thanks to Dr Cyrus Askin for writing and producing this episode and to Dr Bryan Brown for his wonderful infographics.
Full show notes available at http://thecurbsiders.com/podcast

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#70 KevinMD: Kevin Explains Everything Dec 01, 2017

Dr Kevin Pho, founder KevinMD.com “Social Media’s Leading Physician Voice" schools Matt, Paul and Stuart on a potpourri of topics including physician advocacy, the dangers and benefits of social media, the pros and cons of electronic health records, health policy, health advocacy and lastly primary care and the integration of advanced practice providers/clinicians. Special thanks to Dr Chris Chiu who helped produce the show and write our show notes.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps:

00:00 Intro
00:54 Picks of the week
06:58 Getting to know our guest
10:30 Why physicians need to understand health policy
11:21 Best advice Dr Poh has received in his career and why variety is important to avoid burnout
13:45 Advice to young physicians about to start using social media
16:40 Why are physicians afraid of social media
18:54 Risks of social media
21:20 Discussion of “Twitter bates” aka debates
23:20 Physician advocacy and social media
26:18 The next big health care debate...is it a right?
31:03 Why electronic health records are so painful to use?
34:49 How can charting be worked into clinic workflow?
37:50 Conspiracy theories on EHRs
39:11 Advanced practice providers/clinicians
46:40 Primary care shortage
50:16 Growth of medical administrators and how to take back control as physicians
52:38 Advice on how to break into medical writing
54:08 Paul ends the show with some wisdom and steals the show
55:59 Outro

Tags: kevinmd, advocacy, policy, health, care, ehr, chart, advanced, practice, clinician, physician, meded, foamed, social, media, twitter, kevin, pho, nurse, practitioner, medicine, internal, family, primary, education, internist, hospitalist

#69 CKD: Prescribing Do’s and Dont’s with @kidney_boy, Joel Topf Nov 27, 2017

Making all your nephrology dreams come true with part 2 of our interview with @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Flush away your bad prescribing habits when it comes to nephrotoxic drugs in this fast paced run down of the medications which must stay on or off Santa’s naughty-list, backed up with a sack full of memorable research studies. Special thanks to Annie Medina, Justin Berk and Kate Grant for writing/producing this show and to physician artist, Kate Grant for her lovely/hilarious artwork (more at paintscientific.com).

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro
03:00 Which medications should we exercise caution over in CKD?
03:31 Bactrim (Trimethoprim+Sulfamethoxazole)
07:00 NSAIDS
08:29 NSAIDS and the ‘Precision’ Trial NEJM 2016 looking at cardiovascular safety
12:50 The Male Physician Study JAMA 2001
13:50 Discussion about Nurses Health Study and use of analgesia, and CKD
15:15 Acute Interstitial Nephritis, Beta Lactam Antibiotics, and the risk of Acute kidney injury +/- CKD with Proton Pump Inhibitors
18:20 Advice for co-prescribing NSAIDS,ACE inhibitors and diuretics
20:39 Creatinine levels and ACE/ARB prescribing. How High can you go?
24:55 Facebook question from listener: measures to reduce proteinuria in hypertensive patients
27:20 Empagliflozin and renal protection in diabetic patients
32:00 Contrast Induced Nephropathy, the AMACING trial 2016.
38:00 Take Home Points
39:57 Outro

Tags: chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, medications, pharmacology, bactrim, nsaid

#68 Tremors: One degree of Kevin Bacon? Nov 20, 2017

Steady your hand and annihilate tremor with tips from Neurologist, and Movement Disorder specialist, Andres Deik, MD, Assistant Professor of Clinical Neurology at Kashlak Memorial Hospital (we can’t tell you where he really works: ) We teach you to differentiate benign causes of tremor from Parkinson’s disease with simple history and physical exam skills, plus nonpharmacologic and pharmacologic therapies for tremor. Special thanks to Beth Garbitelli and Chris Thrash who wrote and produced this episode and the show notes!

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro and disclaimer
01:08 Listener feedback - Paul is not fired.
02:09 Picks of the week.
05:35 Dr. Deik intro
07:19 Icebreaker questions
12:20 Wikipedia definition
13:02 Classifying tremor
14:33 Postural tremor vs. reemerging rest tremor
15:48 Important history questions
17:58 Medications that can induce tremor
21:39 Physical exam techniques
27:30 Exam characteristics between typical PD tremor and ET
28:36 History components to distinguish between PD and ET
34:10 Misdiagnosis of Parkinson’s
36:54 Imaging workup
39:03 Case from Dr Deik
41:33 Nonpharmacologic management
44:18 Pharmacologic management
49:06 Dosing propranolol
51:07 Distinguishing between physiologic tremor and pathologic tremor’
54:06 Website recommendations
55:50 Handwriting
59:14 Take home points
61:34 Outro

Tags: tremor, essential, postural, neurology, Parkinsons, disease, beta, blockers, primidone, movement, disorders, antidepressants, occupational, therapy, rest, intention

#67 Chronic Kidney Disease Pearls with @kidney_boy, Joel Topf Nov 13, 2017

Take control of chronic kidney disease with tools, and tips from @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Learn which equation is best for eGFR, how to counsel patients about progression/prognosis, how to monitor patients in CKD, and who needs a referral to Nephrology. Special thanks to Annie Medina, and Justin Berk for writing/producing this show and to physician-artist, Kate Grant for her lovely and hilarious artwork (more at paintscientific.com).

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.

Time Stamps

00:00 Intro
03:13 Pick of the weeks
08:49 Clinical Case
09:36 How to explain CKD to patients
12:16 Loss of GFR with age
13:22 Which equation should be used to estimate GFR
18:05 Creatinine clearance from 24 hour urine collection
22:25 Initial workup upon diagnosis of CKD
25:40 Interpreting tests for proteinuria
26:52 Staging and prognosis in CKD
32:00 Completing the initial workup for CKD
33:52 Who needs a referral to nephrology?
35:53 What labs to check in CKD and a discussion of secondary hyperparathyroidism
40:32 Take home points
42:30 Outro

Tags: chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, prognosis, monitoring, iron, pth, proteinuria, hypertension, nephropathy, diabetes, albumin, protein, anemia, hyperparathyroidism, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine, medical, primary, physician, resident, student

#66 Hepatitis C: Workup and Treatment in Primary Care Nov 06, 2017

Hiding from Hep C? Dive in with experts Dr. Gina Simoncini, MD, MPH Associate Professor of Clinical Medicine at Temple University Hospital, & Dr. David Koren, PharmD, BCPS, AAHIVP, board-certified pharmacotherapy specialist and infectious diseases clinical pharmacist at Temple University Hospital. They walk us through a simplified approach on whom to screen, how to start antiviral therapy, what to follow up on, and how to navigate insurance waters along the way. Special thanks to Sarah Roberts and Jordana Kozupsky who wrote and produced this episode and the show notes!
Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro
01:00 Guest bios
03:00 Getting to know our guests
05:35 Picks of the week
10:05 Clinical case
10:54 Diagnosing HCV
12:00 ASCEND study
13:14 Restrictions on HCV treatment
15:17 Ordering and interpreting pre-treatment tests
19:30 Prescribing medication
22:00 Genotyping and drug resistance
24:10 Patient counseling
25:49 Understanding drug classes
27:33 Drug interactions
30:06 Multidisciplinary approach to treatment
33:01 Follow-up
36:47 Reinfection/cure rates
39:35 Patient counseling revisited
41:25 Side effects of treatment
42:53 Screening
44:02 Take home points

Tags: hepatitis, virus, hcv, direct-acting, antiviral, therapy, management, primary, care, liver, ultrasound, fibrosis, cirrhosis, side, effects, monitoring, hcc, hiv, infectious, disease, assistant, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine,

#65 Scott Weingart of EMCrit on Emergency versus Internal Medicine: The Devil of the Gaps Oct 30, 2017

Fighting with Emergency Medicine colleagues is stupid. Learn how EM doctors think and avoid the petty infighting with tips from Dr. Scott Weingart, MD FCCM FUCEM DipHTFU, host of the EMCrit podcast, Clinical Associate Professor and Chief, Division of Emergency Critical Care at Stony Brook Hospital, NY. We discuss decision making, how to avoid anchoring bias, the devil of the gaps, why the elderly always get admitted, how to build relationships with the ED, and Scott’s pet peeves.
Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps 00:00 Intro 01:10 Picks of the week 05:28 Guest bio 07:00 Getting to know our guest 12:00 Do EM and IM docs hate each other? 14:04 Where conflicts arise. 17:05 System 1 versus system 2 thinking 20:19 When the patient doesn’t match the story 23:55 Why does every 85 year old get admitted? 26:05 Transitions of care: form ED to medical ward 32:08 Is face-to-face signoff only needed for sick patients? 36:28 The devil in the gaps 41:03 Scott’s beer recommendation 42:17 BP cutoff for discharge home 43:44 Scott’s biggest pet peeve with primary care 45:04 How to make friends and collaborate with your EM colleagues 47:14 Take home points 50:35 Outro
Tags: emergency, department, room, em, ed, im, conflict, devil, gaps, post-test, probability, illness, serious, system, one, bias, heuristic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

#64 Stuff You Should Know About Health Policy Oct 27, 2017

Get schooled on medical homes, payer reform, and what the future might look like for primary care with Dr. Sue Bornstein, MD, FACP and Executive Director of the Texas Medical Home Initiative and Chair of the Health and Public Policy Committee at the ACP.

Dr Alex Lane of Cooper University Hospital joins Matt as cohost!

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

02:42 Guest CV and background

04:42 Getting to know our guest

10:40 Helpful resources for learning health policy

12:10 Who are the major players/influencers in health care and how do their interests align

15:02 Defining “medical home”

18:45 Where did the idea for a “medical home” originate

22:33 How does medical home affect cost

29:45 Payer reform and the quality payment program (QPP)

33:06 Recap and defining terms

37:18 How will the QPP be implemented?

41:04 Repeal and replace

43:37 Cuts in funding for safety net hospitals that care for the poorest, sickest patients

46:59 Take home points

48:55 Outro

Tags: medicare, medicaid, health, care, policy, spending, quality, improvement, advanced, payment, macra, mips, qpp, apm, medical, home, pcmh, affairs, super, utilizer, texas, physician, doctor, assistant, nurse, practitioner, foamed, meded

#63 Medical Marijuana: Is it really dope? Oct 23, 2017

Expand your consciousness around medical cannabis (aka marijuana) with expert Dr Donald Abrams, Chief of the Hematology-Oncology Division at San Francisco General Hospital and a Professor of Clinical Medicine at the University of California San Francisco. We explain the cannabinoid system, THC, CBD aka cannabidiol, limitations surrounding cannabis research, current and future medical uses for medical cannabis (marijuana), and potential conditions it may benefit. We take a deep dive on the potential harms of medical cannabis and how to counsel patients on safe use. Plus, the return past guest and new correspondent, Dr Molly Heublein, Assistant Professor of Medicine from UCSF.
Thanks to Dr Molly Heublein for writing and producing this episode and it’s show notes!
Full show notes available at http://thecurbsiders.com/podcast

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Clinical case from Kashlak Memorial: MM is a 62 yo woman with a history of osteoarthritis and breast cancer, now on an aromatase inhibitor. She struggles with aching and stiffness in her hands, shoulders, knees, and hips. A friend suggested she try medical marijuana. She wants her provider’s opinion on if this is safe and effective.
Time Stamps

00:00 Intro
01:30 Picks of the week
03:40 Guest bio
05:11 Getting to know our guest
11:03 Clinical case
11:40 Limitations for cannabis research
12:59 Discussion of THC and cannabidiol
14:50 Smoking versus ingesting cannabis products
16:40 Recap of cannabinoid mechanism of action
18:30 Cannabis and cannabinoid products available
20:20 Synthetic THC (dronabinol)
21:46 How “recommending” cannabis and dispensaries work
25:46 Conditions that respond to medical cannabis
29:15 Potential harms of medical cannabis
34:51 Future directions of cannabinoid medicine research
37:24 Cannabis induced hyperemesis syndrome
39:00 Possible lung cancer risk
40:12 Take home points
42:54 The Curbsiders recap and share their views on the medical cannabis controversy
49:40 Outro

#62 Pod Save Health Care: The Curbsiders Foray into health policy Oct 16, 2017

Remedy your ignorance as we review some basics of health care policy with Dr. Fatima Syed, Chair of the Council of Residents and Fellows for the American College of Physicians. Dr. Syed is early career physician whose work is already affecting health policy at a national level. You can do it too and we’ll teach you where to start along with defining basic, but poorly understood concepts like The Affordable Care Act, universal health care, single payer health care, MACRA, MIPS, and how “quality” is really measured. Don’t miss this part one in our health care policy for beginners series.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

03:20 Getting to know our guest

07:23 How to get involved in a professional organization

09:37 Resources to learn health policy

14:06 The Affordable Care Act and ObamaCare

17:56 What is MACRA, MIPS and how do they affect physicians?

23:09 Nationalized health care in the US versus other countries

25:33 Universal and “single payer” health care defined

27:00 How is quality health care defined? Why is the US rated so poorly?

32:53 Recap and summary of what we’ve learned

34:09 Dr. Syed’s take home points

35:36 Outro

Tags: policy, healthcare, macra, mips, aca, affordable, care, act, health, acp, advocacy, quality, payments, reimbursement, kaiser, commonwealth, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

#61 Vasculitis and Giant-Cell Arteritis: ‘Rheum’ for improvement Oct 09, 2017

Keep your cool in the face of inflammation, and make the path to vasculitis diagnosis less tortuous with Dr. Rebecca Sharim, Rheumatologist and Assistant Professor of Medicine at Temple University. In this episode, we go with the flow from large vessel to small vessel vasculitides, and then learn how to make the diagnosis and management of Giant Cell Arteritis (GCA) and polymyalgia rheumatica (PMR) less of a headache. Correspondent, Dr. Bryan Brown cohosts!

Special thanks to Dr. Bryan Brown for writing our show notes, and creating figures for our handouts.

Full show notes available at http://thecurbsiders.com/podcast

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Case from Kashlak Memorial: A 75 year-old woman with a PMHx of hypertension presents to the ED with three days of worsening left sided headache, now with left sided vision loss during a Norwegian folk festival. On review of systems, she also endorses a week of soreness of her shoulders and hips. This has never happened to her before.

Time Stamps

00:00 Intro

03:07 Picks of the week

09:13 Getting to know our guest

15:00 Clinical case of vasculitis

15:59 Defining and classifying vasculitis

20:55 Workup for suspected vasculitis

23:17 How to explain GCA to a patient

25:08 Typical symptoms of vasculitis

28:00 Chewing gum test

29:34 Interpreting ESR

32:54 Basic exam and lab workup for vasculitis

35:23 Headache and suspicion for GCA/temporal arteritis

38:10 Is a temporal artery biopsy still mandatory?

39:20 Polymyalgia rheumatica

40:59 Steps to take when GCA/temporal arteritis suspected in clinic

43:55 PCP prophylaxis with high dose steroids

46:30 DMARDs and steroid sparing agents

48:12 Imaging studies to aid in diagnosis of GCA

50:50 Complications of long term steroid therapy

52:31 Take home points

53:26 Outro

Tags: giant, cell, arteritis, gca, vasculitis, steroids, temporal, biopsy, artery, esr, pmr, polymyalgia, rheumatica, vessel, headache, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

#60: Masters of MKSAP on Medical Education Oct 02, 2017

How to individualize learning for yourself, and your learners with tips from Dr. Philip A. Masters, editor-in-chief of MKSAP and IM Essentials, Vice President of Membership/International Programs at the American College of Physicians (ACP) and an Adjunct Professor of Medicine at the University of Pennsylvania School of Medicine. Dr. Masters schools us on work life balance, how to recognize and diagnose struggling learners, what resources to use, teaching exercises, and how to generate a study plan.

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.

Time Stamps

00:00 Intro

01:50 Listener feedback

04:18 Announcements

04:58 Picks of the Week

10:37 Guest bio and credentials

12:36 Getting to know our guest

18:05 Wellness and work life balance

22:55 How medical education has changed

28:55 Choosing resources as a learner

38:00 Case of a struggling learner

41:50 Learners with knowledge deficits and the role of the clinician (non-professional educator)

47:56 Resources to improve your skills as a medical educator

51:01 Take home points

Tags: study, resources, MKSAP, acp, learner, educator, academic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, primary, physician, resident, student

#59: Back pain and Sciatica: Straighten out your practice Sep 25, 2017

Solidify your approach to back pain and sciatica with Dr. Chris Miles, Assistant Professor, Family & Community Medicine and Associate Director, Sports Medicine program, Wake Forest Baptist Medical Center. He schools us on red/yellow flags, physical exam maneuvers, when to order imaging, and practical tools and tips for evidence-based management! Correspondent Dr. Shreya Trivedi cohosts!

Full show notes available at http://thecurbsiders.com/podcast

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Case from Kashlak Memorial: 53 yo M construction worker with a BMI of 29 and PMhx of DM2, HTN, depression presenting with right low back pain. He can't remember any trauma or injury. Denies radiation, no bowel or bladder dysfunction, saddle anesthesia, weakness

Case from Kashlak Memorial: 48 yo F nurse who has had intermittent back pain for years presented with acute flare after helping lift a patient. The pain similar to previous episodes but more severe and also radiates to her left foot. She has tried naproxen and exercises/mindful stress reduction for months without improvement. It is unbearable for her to work.

Time Stamps

00:00 Intro

02:14 Listener feedback

03:44 Announcements

05:14 Picks of the week

08:20 Millenial learners

10:40 Topic intro and guest bio

12:06 Getting to know our guest

17:30 Clinical case of back pain

20:18 How to hand sensory deficits

21:51 Red and yellow flag symptoms

25:44 How to approach patient with yellow flag symptoms

28:00 Physical exam for back pain

30:00 Special testing: Trendelenburg, Slump test, and Straight leg raise

35:48 Classifying types of back pain and a quick recap of teaching points so far

39:28 How to manage patient expectations

40:42 Treatment of non-radicular back pain

46:33 Home exercises and YouTube training

49:31 When to follow up after initial treatment trial

51:35 The patient with severe acute pain

53:33 Some pearls on muscle relaxants

55:22 Clinical case and how to treat radicular pain

59:40 Invasive treatment of back pain

65:04 Back pain treatments that don’t work

#58: Concussion, traumatic brain injury, and post-concussive syndrome Sep 18, 2017

Summary:

Get a-HEAD of concussions (aka traumatic brain injuries) with tools, tips, and tricks from The Concussion Guy, Dr. Evan Ratner, Medical Director of Gridiron Heroes. Learn to recognize concussions/traumatic brain injury, what questions to ask, physical exam maneuvers, and how to counsel patients and families on safe return-to-learn/play.

Full show notes available at http://thecurbsiders.com/podcast

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Case from Kashlak Memorial: 29F with no significant PMH presents to primary care office less than 24 hours after she accidentally struck her head on the metal of her car door. She experienced temporary altered consciousness lasting about one hour along with a headache. No nausea, vomiting, speech, or vision changes. She rested at home last night, but didn’t feel up to reading, or watching TV. She drove herself to your office today.

Time Stamps

00:00 Intro

02:33 Listener feedback

05:35 Picks of the week

12:15 Getting to know our guest

19:41 Defining and classifying concussion

23:00 What questions to ask your patient

26:34 Physical exam for patient with concussion

28:50 Use of neurocognitive testing in concussion

30:45 Specifics of testing eye movements and balance

35:00 Who needs imaging?

41:51 Recap of what we’ve learned so far

43:40 Can you let someone with a concussion go to sleep?

47:08 Return-to-learn protocol

50:30 Return-to-play protocol

52:30 Post-concussive syndrome

53:55 Medications for post-concussive symptoms

58:58 Second impact syndrome

64:40 Counseling the patient with multiple concussions

67:08 Take home points

69:09 The Curbsiders recap their favorite teaching points

71:30 Outro

Tags: concussion, post, concussive, syndrome, tbi, traumatic, brain, injury, return, play, school, cognitive, rest, treatment, diagnosis, assistant, care, education, doctor, family, foam,

#57: Polypharmacy and deprescribing Part 2: More thinking and thoughts Sep 15, 2017

Improve your prescribing practices with tips from The Curbsiders as Matt, Stuart and Paul “Pwilliams” discuss safe prescribing in frail, older adults with diabetes, chronic kidney disease, hypertension, and/or dementia in this part two episode on polypharmacy and deprescribing.

Full show notes available at http://thecurbsiders.com/podcast

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Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, diabetes, hypertension, kidney, chronic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#56: Polypharmacy and deprescribing Part 1: Living better through chemicals Sep 11, 2017

Avoid common pitfalls, recognize prescribing cascades, and deprescribe like a champ with tips from Clinical Pharmacist, Dr. Sean M. Jeffery, Clinical Professor of Pharmacy at the University of Connecticut School of Pharmacy, and Chair of the Polypharmacy Special Interest Group for the American Geriatrics society. We discuss how to create better medication lists, tools and tips for deprescribing, how to counsel patients on polypharmacy, and safe use of medication in the elderly.

Special thanks to the American Geriatrics Society for setting up this interview.

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.

Time Stamps

00:00 Intro

01:12 Listener feedback

01:56 Picks of the week

06:28 Topic intro and guest bio

07:49 Getting to know our guest

13:05 Defining polypharmacy and related terms

16:30 Clinical Case of polypharmacy

20:34 Making better medication lists

25:01 Clinical Case from Kashlak Memorial

28:40 Beers Criteria

35:41 Statins in frail, elderly patients

38:00 Treating insomnia in the elderly

44:15 Dosing of meds in patients with CKD

45:50 Tool for analysis of drug-drug interactions

48:10 Take home points from Dr. Jeffery

50:00 Outro

Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#55: Eating disorders: Specified and Not Otherwise Specified Sep 04, 2017

Enhance your skills in the identification and management of eating disorders with clinical pearls from Dr. Rosalind Kaplan, Clinical Associate Professor of Medicine at Thomas Jefferson University and a Primary Care Physician in Jefferson Women's Primary Care. We learn who to screen for eating disorders, what questions to ask, criteria for diagnosis, common complications, and how to manage them. This is a must listen if you’re like us and don’t know much about eating disorders specified and not otherwise specified.

Full show notes available at http://thecurbsiders.com/podcast

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Case from Kashlak Memorial Hospital: 24yo F medical student with history of anxiety, weight loss, and restricting food senior year of high school. She regained weight with psychotherapy. Now she is a medical student who is over exercising, and abusing laxatives. She passes out one day after class and is referred to you at Kashlak.

Time Stamps:

00:00 Intro

01:19 Listener feedback

02:43 Picks of the week

06:50 Topic intro and guest bio

09:10 Getting to know our guest

15:18 Clinical case

20:15 Broad overview of eating disorders

26:40 Eating disorder not otherwise specified

29:19 Underreporting and under diagnosis in men

30:25 Who to screen and how to do it

34:33 Questionnaires: SCOFF, ESP, and Binge Eating Disorder Inventory

38:42 Initial lab workup for eating disorders

42:38 Bone density screening, treatment

45:41 Back to the case: Initial patient counseling

49:22 Medical therapy

52:20 Can we use bupropion?

54:02 What’s the role for primary care?

58:14 Hyponatremia in eating disorders

60:34 Complications of purging

66:25 How to be an ally for your patient

69:12 Treatment for binge eating

72:51 Take home points

74:30 Outro

Tags: anorexia, nervosa, bulimia, eating, disorder, weight, loss, binge, binging, purge, electrolytes, not, otherwise, specified, ideal, body, image, treatment, screening, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#54: Upper Respiratory Infections: Coughs, colds, gargling, and antibiotic underuse?! Aug 28, 2017

Don’t miss life threatening upper respiratory infections, and stop underusing antibiotics with tools and tips from our wonderful guests: Dr. Robert Centor, Professor of Medicine at University of Alabama, known for developing the Centor Criteria for pharyngitis, and his excellent blog and Twitter feed @medrants; and Dr. Alexandra Lane, Assistant Professor of Medicine, and Director of the Resident Clinic at Cooper University Hospital. We cover red flag signs in upper respiratory tract infections, diagnostic testing, physical exam maneuvers, antibiotic therapy, and symptom management. Plus, we’ll teach you have to counsel patients about upper respiratory infections and recommend some great learning resources.

Full show notes available at http://thecurbsiders.com/podcast

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Case from Kashlak Memorial Hospital: 39 yo F with obesity, HTN, fibromyalgia who presents with 3 days of chills, subjective fevers, sinus pressure/congestion, post-nasal drip, and cough with some green/yellow mucus. She says, “I get this every year and it only goes away with antibiotics. They usually give me a z-pack”.

Tags: upper, respiratory, infections, cough, cold, nasal, pharyngitis, bronchitis, rhinosinusitis, sinusitis, decongestant, spray, symptoms, management, pneumonia, pertussis, influenza, antibiotics, overuse, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#53: Urinary Incontinence: Tips and strategies to stay dry. Aug 21, 2017

Get control of urinary incontinence with tips from Internist and Women’s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you’re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder.

Full show notes available at http://thecurbsiders.com/podcast

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Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else.

Time Stamps

00:00 Intro

01:06 Listener feedback

02:43 Announcements

03:43 Picks of the week

09:07 Getting to know our guest

14:27 Case of urinary incontinence (UI)

15:30 Epidemiology of UI

16:34 Screening for UI

17:30 The 3IQ Questionnaire

18:44 Additional testing in UI

21:23 Classifying UI

24:00 Nonpharmacologic therapy for UI

32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy

34:50 Case continued. Changing medications

37:42 Mirabegron as an alternative to anticholinergics

40:18 More options for stress UI management

41:40 Next line therapies for urge UI, overactive bladder

44:38 Surgery for stress urinary incontinence

45:50 Botox therapy for urge UI, overactive bladder

48:30 Do we need any more fancy diagnostic tests?

50:30 Take home points

55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds

56:40 Outro

Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, educ

#52: Anemia: Tips, and tools for diagnosis and treatment Aug 14, 2017

Master the anemia algorithm, and take a deep dive on iron deficiency, anemia of chronic kidney disease, anemia of chronic inflammation, causes of macrocytic anemia and more in this discussion with international expert, Dr. David P. Steensma, Senior Physician from Dana Farber Institute, and Associate Professor of Medicine at Harvard Medical School.

Full show notes available at http://thecurbsiders.com/podcast

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Cases from Kashlak Memorial:

62 yo M with diabetes and CKD with asymptomatic Hgb 10, MCV 90, and Cr. 1.9?
72 yo F with HTN with asymptomatic Hgb of 11, MCV 85 and Cr. 0.6.
72 yo F with breast cancer in remission after lumpectomy, adjuvant chemo, and XRT treated 6 years ago presents with fatigue and some dyspnea on exertion. Hgb 9.6, MCV 102.

Time Stamps

00:00 Intro

01:18 Listener feedback

04:05 Announcement: We’re looking for on air correspondents to join The Curbsiders

05:05 Picks of the week

11:12 Getting to know our guest

17:50 Case #1 Normocytic anemia

19:15 Defining anemia (WHO criteria)

21:10 Epidemiology of anemia

23:45 Normocytic anemia

25:55 Erythropoietin for diagnosis and treatment

28:22 Anemia of CKD or chronic inflammation?

31:37 Discussion of ferritin and soluble transferrin receptor

33:47 Case #1 Conclusion

35:45 Hemoglobin targets in CKD

36:53 Case #2 Microcytic anemia

37:43 Correct reticulocyte count and reticulocyte index

40:45 Deciding on dose and route for iron repletion

43:44 Does vitamin C improve iron absorption?

45:27 Case #3 Macrocytic anemia

46:54 Vitamin B12 deficiency

51:54 Medication related B12 deficiency

52:35 Myelodysplastic syndrome

55:00 Side effects of common MDS treatments

56:18 Take home points

57:35 The Curbsiders post game analysis

64:16 Outro

Tags: anemia, hemoglobin, i

#51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction Aug 07, 2017

Get cozy with these new drugs for diabetes. Don’t be scared, they won’t bite. On this episode, we interview Endocrinologist and current president of AACE, Dr. Jonathan D. Leffert, MD, FACP, FACE, ECNU about how to utilize the myriad of new diabetes drugs on the marketplace including SGLT2 inhibitors, DPP4 inhibitors, GLP1 agonists, and new ultra long acting insulins. Plus, we’ll teach you how to choose between agents, common side effects, A1C goals, and the cardiovascular benefits of these newer agents.

Full show notes available at http://thecurbsiders.com/podcast

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Case: Case from Kashlak Memorial Hospital: 49 yo M with HTN, BMI 29, hyperlipidemia, family history of premature CAD (dad age 45yo), and DM2 with A1C increase from 6.4% to 9% while on metformin monotherapy.

Time Stamps

00:00 Intro

04:33 Getting to know our guest

09:50 Clinical case of diabetes

12:40 Latent autoimmune diabetes

15:16 Life expectancy and A1C goal

16:47 Anemia’s effect on A1C

18:40 Back to our case, choice of agent

20:57 Lifestyle changes effect on A1C

22:55 Starting an SGLT2 inhibitor, what to look for

26:45 SGLT2 inhibitor use in patient already on diuretic

27:53 Discussion of CV risk reduction and newer DM meds

33:27 Euglycemic DKA

34:30 Choice of agent GLP1 vs SGLT2

37:10 Use of DPP4 inhibitors

38:55 Back to the case

39:37 Degludec, long acting insulin

41:34 Clinical case conclusion

43:03 Take home points

45:15 Outro

Tags: diabetes, medications, glucose, insulin, oral, therapy, drug, hypoglycemia, a1c, blood, cardiac, risk, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#50: How to read the medical literature like a journal editor Jul 31, 2017

Master this practical approach to reading the medical literature (*No statistics needed!) with expert tips from Dr. Christine Laine, Editor in Chief, Annals of Internal Medicine, and Dr. Darren Taichman, Executive Deputy Editor, Annals of Internal Medicine. They teach us what we should be reading, and detail their thought processes as they appraise an article. Topics covered include: Is 3 minute critical appraisal possible? What’s the deal with P-values? What are common sources of bias? How does the approach differ with clinical trials versus observational studies versus meta-analyses?

*Minimal statistics needed ; )

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

01:13 Listener comment on Entresto

02:50 Picks of the week

09:36 Getting to know our guests

14:00 How to stay up on the medical literature

17:15 Three minute critical appraisal

19:15 Step 1: Assess the outcome being studied

20:50 Statistical versus clinical significance

22:33 Evaluating composite endpoints

24:47 Statistical power

28:58 Evaluating for bias

34:40 Recap of what we’ve learned so far

36:33 Is PICO useful?

39:01 Observational studies and bias

41:09 Evaluating a meta-analysis

46:05 Take home points

50:35 The Curbsiders recap the episode

53:02 Outro

Tags: literature, appraisal, meta, analysis, analyze, critical, read, medical, journal, study, randomized, observational, systematic, review, clinical, trial, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#49: Vertigo and Dizziness: How to Treat, Who to Send Home and Who Might Have a Stroke Jul 24, 2017

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab.
Special thanks to Dr. Cyrus Askin who found our expert, wrote the questions for this episode, and acted as our cohost.
Full show notes available at http://thecurbsiders.com/podcast

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Case: A 45-year-old man presents to the emergency department because of continuous dizziness, nausea, vomiting and unsteady gait that began 18 hours earlier.

#48: Hyponatremia Deconstructed Jul 17, 2017

Step up your salt game. We deconstruct hyponatremia with expert tips from our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer. Topics include: true versus false hyponatremia, SIADH, tea and toast/beer potomania, safe rates of sodium correction, fluid restriction, salt tablets, IV fluid choice, DDAVP clamps, and more.
Full show notes available at http://thecurbsiders.com/podcast

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Case: 85yo F with anxiety, asthma, HTN (on a CCB), hypothyroidism with TSH of 3 on therapy. Sodium was 128 from previous values 134-137 mg/dL. She is more fatigued than usual.
Time Stamps

00:00 Intro
03:00 Guest interview
06:45 Pick of the week w/Dr. Topf
15:50 Clinical case of hyponatremia
17:18 False hyponatremia normal osmolality
19:04 False hyponatremia high osmolality
20:06 Understanding why osmolality matters
22:58 Workup false hyponatremia
24:15 Recap of discussion so far
25:10 ADH dependent vs independent hyponatremia
26:30 Psychogenic polydipsia
28:45 Renal failure and hyponatremia
29:33 Tea and toast, and Beer Drinker’s potomania
34:42 ADH dependent hyponatremia
37:45 Volume versus osmolality
39:30 Volume status exam
44:44 Additional testing with urine lytes and uric acid
47:00 Treatment for SIADH
52:12 Discussion of the vaptans
57:51 Additional testing in SIADH
62:20 When to admit patient for hyponatremia
63:29 Clinical case of hyponatremia complications
68:26 Fluids and rate of correction
73:06 DDAVP clamp
76:00 Moderate hyponatremia
78:05 Diuretic dosing DOES matter!
81:29 Loop diuretics for SIADH
83:55 Take home points
86:55 Outro

#47: Osteoporosis Part 2: bone markers, fracture risk, and more on calcium and Vitamin D Jul 10, 2017

Solidify your knowledge of osteoporosis and osteopenia in this discussion with Endocrinologists and osteoporosis guideline authors, Dr. Rachel Pessah-Pollack, and Dr. Dan Hurley from the American Association of Clinical Endocrinologists (AACE). Learn when to start therapy after an acute hip fracture, how to use bone turnover markers to assess fracture risk, more on how to dose calcium and vitamin D, and finally, we discuss the new American College of Physicians (ACP) guidelines and how they differ from the AACE guidelines on osteoporosis.

For a more basic talk on osteoporosis check out episode #18 w/Dr. Pauline Camacho.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

03:00 Picks of the week

07:31 Guest and topic intro

10:25 Rapid fire questions

14:45 Clinical Case and defining osteoporosis

17:00 FRAX score

20:35 Secondary evaluation for cause of bone loss

20:54 Bone turnover markers (telopeptides)

23:17 Alkaline phosphatase

26:30 Calcium and Vit D

29:35 Recap of teaching points so far

31:25 Antiresorptive versus anabolic therapy

32:40 Aromatase inhibitors increase fracture risk

34:28 When to start therapy after fracture

35:44 Mechanism of action recombinant PTH

41:38 Vitamin D assay and dosing

46:53 Calcium intake, and formulations

49:45 Take home points

50:54 Recap and discussion of AACE vs ACP guidelines by The Curbsiders

59:42 Outro

Tags: bone, osteoporosis, anabolic, osteopenia, vitamin D, calcium, fracture, density, AACE, guidelines, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#46: Chest pain, coronary CT angiography, and coronary artery disease Jul 03, 2017

Master the evaluation of acute and chronic chest pain with coronary CT angiography (CCTA). We deconstruct this game changing technology w/experts from the Society for Cardiovascular Computed Tomography (SCCT), Dr. Todd Villines and Dr. Ahmad Slim. We’ve got answers on what to do when a patient with chest pain has a prior CAC score of zero, and/or a CCTA with non-obstructive disease. Plus: how to select, prepare, and counsel patients; how to interpret reports; choosing between myocardial perfusion study and CCTA, and more!

Special thanks to Dr. Emilio Fentanes from SCCT for setting up this interview.

Full show notes available at http://thecurbsiders.com/podcast

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Case: 45 yo F active duty Colonel with chronic chest pain syndrome despite negative conventional stress test and CAC score of zero.

Time Stamps

00:00 Intro

04:00 Rapid fire questions

08:23 Book recommendations

10:14 Defining terms CCTA vs CAC

12:47 Script for counseling patient about CCTA

14:34 Prep for CCTA

16:40 Why is CCTA controversial?

19:37 Patient selection for CCTA both acute and chronic

25:20 Chronic chest pain and CCTA

27:58 CAC and CCTA in high risk occupations

33:25 Clinical case

36:10 Acute chest pain in patient w/CAC score zero

39:18 Acute chest pain in patient w/CAC score zero and previous CCTA w/non-obstructive CAD

41:22 How to read a CCTA report

45:48 CCTA versus conventional testing and risk MI, death

49:18 Use of CCTA in outpatients

52:16 Plaque characteristics and risk ACS

55:51 CCTA w/non-obstructive disease in patients with acute chest pain

58:14 When is myocardial perfusion scanning better?

61:00 Listener question on small vessel disease

62:09 Take home points

65:00 Curbsiders recap

69:33 Outro

#45: Heart failure: update and guidelines review Jun 26, 2017

Update your management of heart failure (HF) with expert tips from Cardiologist Dr. Eric Adler, Associate Professor of Medicine and Director of Cardiac Transplant and Mechanical Circulatory Support at UC San Diego. We cover how to use BNP, a simple way to examine jugular venous distention, medical therapy for heart failure, the PARADIGM-HF trial, and how to use sacubitril/valsartan (Entresto).

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

04:25 Rapid fire questions

06:00 Palliative care and heart failure

08:40 Book recommendation

10:20 Advice for teachers and learners

12:27 Clinical case of HF

13:38 Classification and staging of HF

17:07 Discussion of BNP

19:35 How to perform neck vein exam for JVD

21:20 BNP for prognosis

23:00 BNP at hospital discharge

26:36 Factors that affect BNP

27:25 Initial patient counseling

32:35 Exercise in HF

34:00 Additional testing at time of diagnosis

36:28 Initial medical therapy

38:30 Discussion of diuretics and dosing

42:50 Aldosterone antagonists

44:30 PARADIGM-HF and entresto

51:27 Medications to avoid in HF

54:14 Digoxin

57:30 Dr. Adler’s take home points

59:11 Stuart questions dosing conventions

60:48 Outro

Tags: arni, assistant, care, diuretics, doctor, education, failure, family, foam, foamed, health, heart, hospitalist, hospital, internal, internist, neprilysin, nurse, management, medicine, medical, physician, practitioner, primary, resident, sacubitril, student

#44: Obesity Medication Overview from AACE 2017 Jun 19, 2017

Master the safe and effective use of obesity medications with Endocrinologist, Dr. Karl Nadolsky (co-author of 2016 AACE Obesity guidelines), Director of the Diabetes, Obesity & Metabolic Institute at Walter Reed National Military Medical Center. We get under the hood of each FDA approved obesity medication plus some of our normal hijinks. Check out episode #23 for a more general overview of obesity.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

03:12 Picks of the week

08:44 Rapid fire questions

13:00 Counsel patients about obesity

14:40 Pathophysiology of obesity

18:00 Case

22:46 Phentermine/topiramate (Qsymia)

26:20 Bupropion/naltrexone (Contrave)

29:18 Liraglutide (Saxenda)

34:32 Orlistat (Alli, Xenical)

37:35 Cost issues

40:18 Lifelong medical therapy for obesity

42:44 Dr. Nadolsky’s take home points

44:45 The Curbsiders recap and discuss their experience with obesity medications

52:28 Outro

Tags: assistant, care, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, obesity, pharmacotherapy, weight loss, safety, side effects, orlistat, alli, naltrexone, bupropion, contrave, phentermine, topiramate, qsymia, lorcaserin, belviq, FDA

#43 Random Clinical Pearls: ACP Highlights and Recap Part 2 Jun 12, 2017

Load up on clinical pearls for your practice in this wide ranging discussion with expert clinician educator, Dr. Jon M. Sweet, Associate Professor of Medicine from Virginia Tech Carilion School of Medicine. Topics include cellulitis, tinea infections, dermatologic emergencies, smoking cessation, heart failure, hormone replacement therapy, iron supplementation, and vocal cord dysfunction. Plus, Stuart gives Paul a new nickname! Special thanks to the Dr. Patrick Alguire and Dr. Darilyn Moyer from the American College of Physicians for setting up this episode.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

02:12 Picks of the week

05:10 Guest intro

07:13 Rapid fire questions

15:25 Tinea infections

18:22 Misdiagnosis of cellulitis

23:53 AGEP (Dermatology)

29:03 DRESS syndrome (Dermatology)

35:28 Smoking cessation

36:55 Back pain, acetaminophen and acupuncture

41:42 Hot flashes and hormone therapy

43:05 Iron supplementation

49:55 Heart failure and sacubitril/valsartan

53:33 Vocal cord dysfunction

56:50 Response from Stuart and Paul

62:20 Outro

Tags: AGEP, ARNI, assistant, back pain, care, cellulitis, cessation, dermatology, DRESS, doctor, education family, foam, foamed, health, heart failure, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, smoking, student, tobacco, vocal cord dysfunction

#42: The Diabetic Foot: Diagnose, prevent, and treat ulcers and infections Jun 05, 2017

Diagnose, prevent, and treat diabetic foot ulcers and infections like international expert, Dr. Andrew Boulton, Professor of Medicine at the University of Manchester (England). From how to perform a proper foot exam, to foot care, to ulcers and infections we cover the essentials for your practice.

For full show notes visit http://thecurbsiders.com/podcast

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Tags: assistant, care, diabetes, diabetic, doctor, education, family, foam, foamed, foot, health, hospitalist, hospital, infection, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, ulcer

#41: HIV, PrEP, and STI screening May 29, 2017

Prevent HIV infections with pre-exposure prophylaxis (PrEP), and learn to perform appropriate screening for sexually transmitted infections with tips from expert, Dr. Gina Simoncini, Associate Professor of Medicine at Temple University Hospital. Learn how to implement PrEP in your practice, plus tips on vegetable gardens, fellowships, and where to get the best samosas, in this wide ranging discussion.

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

04:50 Rapid fire questions

16:23 Defining preexposure prophylaxis

18:50 Who benefits from PrEP

21:43 Case discussion

23:45 PrEP during pregnancy, breastfeeding

24:45 Baseline testing and STI screening before PrEP use

28:15 Counseling on adherence, side effects

31:25 Adverse effects of PrEP

34:00 Monitoring patients on PrEP

36:46 Collaborative practice

37:30 Discussion of high risk behaviors on PrEP

39:30 Does PrEP promote viral resistance?

41:51 Insurance reimbursement for PrEP

42:50 Take home points

44:24 Outro

Tags: assistant, care, doctor, education, emtricitabine, family, foam, foamed, health, HIV, hospitalist, hospital, infection, internal, internist, nurse, meded, medicine, medical, physician, practitioner, primary, prophylaxis, resident, sti, student, tenofovir

#40: Pseudo endocrine disorders, fatigue, and the Schmerbsiders? May 22, 2017

Learn “weird” endocrine stuff! How to approach vague complaints like fatigue and weight gain. Reverse T3 syndrome, Wilson’s T3 syndrome, and adrenal fatigue; Do they exist? Learn how to help the challenging patient who is convinced they have an endocrine disorder in this discussion recorded live from AACE 2017 with Dr. Michael T. McDermott, Professor of Medicine, University of Colorado Denver School of Medicine.

For full show notes visit http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

05:36 Guest intro

07:50 Definition of “pseudo” endocrine

10:02 Case introduction

13:39 “Reverse T3 Syndrome”, the thyroid and fatigue

20:45 Growth hormone

25:10 Fatigue, and where to start

33:00 Adrenal fatigue

38:00 Lab testing

39:34 Take home points

42:12 Stuart on the thyroid and reverse T3

45:30 Paul’s approach to multisystem complaints

51:12 Outro

Tags: adrenal, assistant, care, doctor, education, endocrine, family, fatigue, foam, foamed, growth, health, hormone, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, thyroid, t3

#39: Secondary hypertension, hyperaldosteronism, Cushing’s, and pheochromocytoma May 15, 2017

Expert tips on the diagnosis and management of secondary hypertension in this conversation with Dr. Richard Auchus MD, PhD, Professor of Pharmacology and Internal Medicine & Director of the Diabetes, Endocrinology, & Metabolism Fellowship Program at the University of Michigan. Topics include: primary hyperaldosteronism, use of spironolactone, Cushing’s syndrome, pheochromocytoma, and which tests to utilize.

Full show notes available at http://thecurbsiders.com/podcast

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Tags: assistant, care, cushing's, doctor, education, endocrine, family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nurse, medicine, medical, pheochromocytoma, physician, practitioner, primary, resident, resistant, spironolactone, student

#38: Hospice and palliative care: How to manage end of life symptoms May 08, 2017

Recognize and manage end of life symptoms with competence and confidence. In this extensive discussion with Dr. Brooke Worster, Assistant Professor of Medicine at Sydney Kimmel Medical College and Medical Director, of the Palliative Care Service at Thomas Jefferson University Hospitals we discuss scripts for having difficult conversations, managing patient/family expectations, what comes in the hospice “E” kit, terminal delirium, the “death rattle”, air hunger, and more.

Full show notes available at http://thecurbsiders.com

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Time Stamps

00:00 Intro

03:10 Rapid fire questions

08:33 Defining hospice and palliative care

11:28 Case discussion

21:28 Gunderson, MI and Respecting Choices

24:25 How to counsel patients about home hospice?

37:10 Hospice “E” kit and how to use it

42:09 Air hunger, terminal delirium, death rattle, and Cheyne Stokes breathing

52:48 What is the PCM’s role while patient is on hospice?

58:19 Cancer survivorship and palliative care

60:33 Take home points

62:20 Outro

Tags: assistant, care, doctor, end, education, family, foam, foamed, health, hospice, hospitalist, hospital, internal, internist, life, nurse, medicine, medical, palliative, physician, practitioner, primary, resident, student, symptom

#37: Lipids, PCSK9, and ezetimibe: Lower is better. May 01, 2017

Learn the latest in lipid lowering therapy in this extensive discussion with Dr. Paul S. Jellinger, MD, MACE, Professor of Medicine at the University of Miami and Chair of the writing committee for the American Association of Clinical Endocrinologists (AACE) 2017 Guidelines for the Management of Dyslipidemia and Prevention of Cardiovascular Disease (CVD). Topics include ezetimibe, PCSK9, FOURIER trial, statin myopathy, CoQ10, fish oil, fibrates and more. For a more basic discussion of dyslipidemia check out episode #10.

Full show notes are available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

03:10 Rapid fire questions

08:15 Dyslipidemia defined

10:26 Classifying dyslipidemia

13:21 Diagnosing Familial Hypercholesterolemia

17:48 A difficult lipid case discussed

22:40 Lp (a), Apo B and LDL particle concentration

28:40 What labs to order

31:31 ACC/AHA versus other risk scores

38:21 IMPROVE-IT

41:35 Non-statin medications discussed

45:05 Hypertriglyceridemia fibrates and fish oil

48:25 How often to check the lipid panel

49:58 Statin Myopathy and CoQ10

54:17 FOURIER, PCSK9 and very low LDLs

59:43 Extreme risk category discussed

62:34 Is plaque regression possible?

64:12 Take home points

67:08 Outro

Tags: assistant, care, cholesterol, doctor, education family, fish oil, foam, foamed, health, hospitalist, hospital, internal, internist, ldl, lipid, medicine, medical, myopathy, nurse, pcsk9, physician, practitioner, primary, statin, resident, student

#36: Random Clinical Pearls: ACP Highlights and Recap Part 1 Apr 24, 2017

A recap and highlights from ACP 2017, Internal Medicine's largest national conference, with Dr. Alan Dow MD, MSHA, FACP, Professor of Medicine from Virginia Commonwealth University. We discuss iron supplementations, shellfish allergies and IV contrast, proton pump inhibitors, and more!

For full show notes visit http://thecurbsiders.com/podcast.

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Tags: acp, allergy, assistant, care, contrast, doctor, education, family, foam, foamed, health, hepcidin, hospitalist, hospital, internal, internist, iron, nurse, medicine, medical, physician, ppi, practitioner, primary, resident, shellfish, student

#35: Depression: MDD with DJ MMC Apr 17, 2017

Master the management of major depressive disorder (MDD) with clinical pearls from Dr. Marius Marcel Commodore, Associate Professor of Clinical Medicine and Psychiatry from Temple University Hospital. We cover diagnosis, patient counseling, choice of agent, dose titration, augmentation...and DJ names?

For full show notes visit http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

02:08 Rapid fire questions

11:04 Initial diagnosis and screening

13:06 Tools for diagnosis discussed

17:07 Shared decision making in choice of agent

19:40 Monitoring and follow up

21:51 Choice and comparison of agents

27:38 Augmentation and the STAR-D study

31:03 Quick recap

33:52 Cognitive behavior therapy

40:58 Medication titration and duration of therapy

45:18 Bipolar disorder screening

47:38 Screening for suicidality

49:58 Difficulty getting patients into specialty care

53:38 Mood disorders in health care providers

58:31 Listener Questions

60:48 Take home points

64:10 Outro

Tags: antidepressant, assistant, care, depression, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, mood, physician, practitioner, primary, psychiatry, ssri, snri, resident, student

#34: Super Utilizers, hot spotting, and difficult patients Apr 10, 2017

An approach to super utilizers, and difficult patients with Dr. Alex Lane, Assistant Professor of Medicine at Cooper University Hospital. In this wide ranging discussion we cover books, learning, super utilizers, hot spotting, and how to approach difficult patients.

For full show notes visit http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

02:04 Getting to know you

06:12 Best advice

07:13 Alex’s tips on keep up with EBM

11:22 Something about Alex we won’t forget

13:06 Listener Mail

15:00 Super Utilizers defined

17:00 Hot spotting defined

24:55 ACE score discussed

30:15 Team based approach to care

33:16 Getting involved in your community

36:18 Outro

Tags: assistant, care, difficult, doctor, education family, foam, foamed, health, hot, hospitalist, hospital, internal, internist, nurse, medicine, medical, patient, physician, practitioner, primary, resident, spotting, student, super, utilizer

#33: The Dementia Episode You Won’t Forget Apr 03, 2017

Dominate the diagnosis and management of dementia with tips from international expert Dr. Stephen Dekosky, Professor of Neurology, and deputy director of the McKnight Brain Institute at the University of Florida. Filled with clinical pearls, we cover everything from basic testing to advanced imaging modalities, as well as current and future therapies for dementia. This episode is a must listen. Big thanks to the American Academy of Neurology for setting up this interview.

Full show notes are available at http://thecurbsiders.com/podcast

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Time Stamps

00:00 Intro

02:20 Rapid fire questions

04:40 Defining dementia

08:40 Choosing a clinical test for dementia

17:20 Diagnostic labs

19:00 Genetic and CSF testing

25:46 Advanced brain imaging

28:18 Preclinical Alzheimer’s disease (AD)

32:17 Routine CNS imaging

36:18 Initiating medical therapy

39:35 Differentiating MCI and dementia

41:45 Vascular Dementia

44:10 CSF testing for AD

45:15 Vitamins, supplements, and foods as treatment or prevention

50:56 Mental exercise for AD prevention

52:36 Anticholinergic, benzos and dementia

54:46 Future directions

57:55 Outro

Tags: Alzheimers, assistant, care, education, dementia, disease, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, neurology, nurse, medicine, medical, mri, pet, primary, physician, resident, student, vascular

#32: Syncope Deconstructed Mar 27, 2017

Dominate syncope with tools, tips, and tricks from The Curbsiders. No guest on this episode, just doctors Watto, Brigham, and Williams deconstructing the frustrating topic of syncope to provide listeners with some shiny clinical pearls and practice changing knowledge.

For full show notes visit http://thecurbsiders.com/podcast

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Tags: assistant, cardiology, care, doctor, education, epilepsy, family, foam, foamed, guideline, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, presyncope, primary, resident, student, syncope

#31: Diuretics, leg cramps, and resistant hypertension with The Salt Whisperer Mar 20, 2017

Dominate leg cramps, diuretic therapy, and resistant hypertension. Our guest, Dr. Joel Topf, is a clinical nephrologist, pioneer in the use of social media for medical education, and Assistant Clinical Professor at Oakland University William Beaumont School of Medicine, best known for his blog, Precious Bodily Fluids, and hilarious/informative Twitter feed @kidney_boy. We start with basic renal physiology and build up to the treatment of resistant hypertension.

For full show notes visit http://thecurbsiders.com/podcast.

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Tags: assistant, care, diuretics, doctor, education family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nephrology, nurse, media, medicine, medical, physician, physiology, practitioner, primary, social, renal, resident, resistant, student

#30: Mastering Menopause Mar 13, 2017

Dominate the treatment of menopause with tips from expert, Dr. Amy Tremper, Assistant Professor of Obstetrics and Gynecology at the University of Michigan Medical School. We discuss hormone replacement therapy, the Women’s Health Initiative, bio-identical hormones...and game shows?!

For full show notes visit http://thecurbsiders.com/podcast.

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Tags: assistant, care, doctor, education family, foam, foamed, health, hormone, hospitalist, hospital, hot flashes, internal, internist, nurse, medicine, medical, menopause, physician, practitioner, primary, replacement, resident, student, therapy

#29: Neuropathy Deconstructed Mar 06, 2017

Stop the madness! Diagnose and treat neuropathy like expert guest, Dr. Grace Kimbaris, Assistant Professor of Clinical Neurology from University of Pennsylvania. We cover the basics along with some random pearls on fluoroquinolones, small fiber neuropathy, alpha lipoic acid, and more!

For full show notes visit http://thecurbsiders.com/podcast.

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Tags: assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medical, medicine, nerve, neuropathy, primary, physician, resident, student

#28: Coronary artery calcium scoring: The ultimate cardiovascular risk assessment Feb 27, 2017

Individualize cardiovascular risk, and optimize risk reduction using cardiac CT with coronary artery calcium (CAC) scoring. Our expert guests from The Society for Cardiovascular Computed Tomography (SCCT), Dr. Harvey Hecht, Professor of Medicine from Mount Sinai, and Dr. Matthew Budoff, Professor of Medicine from UCLA, school us on the use of this powerful tool. Special thanks to Dr. Emilio Fentanes from the SCCT for setting up this interview.

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Get full show notes at http://thecurbsiders.com/category/podcast

Tags/keywords: artery, assistant, cac, calcium, care, cardiovascular, coronary, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#27: Conquer Irritable Bowel Syndrome Feb 20, 2017

Diagnose and treat irritable bowel syndrome (IBS) like master clinician, Dr. Brooks Cash of the American College of Gastroenterology. This condition frustrates clinicians and patients alike, but we’ll give you the tools to conquer IBS. Now with our theme song included!

Recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Get full show notes at http://thecurbsiders.com/category/podcast

Tags: assistant, bowel, care, doctor, education, family, foam, foamed, gastroenterology, health, hospitalist, hospital, internal, internist, irritable, nurse, medicine, medical, primary, physician, resident, student, syndrome

#26: What’s the deal with Radiation Oncology? Feb 13, 2017

Anticipate, and dominate the side effects of radiation therapy. On this episode we interview Dr. John J. Cuaron, Radiation Oncologist from Memorial Sloan Kettering Cancer Center in New York to better understand, “What’s the deal with radiation oncology?”.

Recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Get full show notes at http://thecurbsiders.com/category/podcast

Tags: assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

#25: Master hyperglycemia and DKA Feb 06, 2017

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn.

Recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Get full show notes at http://thecurbsiders.com/category/podcast

Tags: assistant, care, diabetes, dka, doctor, endocrinology, family, health, hospitalist, hospital, hyperglycemia, internal, internist, ketoacidosis, nurse, medicine, medical, primary, physician, student, resident

#24: Curbside Round Table: Pondering Obesity Jan 30, 2017

More tools, tips, and tricks so you can master obesity in clinic. On this first roundtable episode, The Curbsiders give their take on the management of obesity, and offer their own practice changing tips. Also, Paul announces his goal to watch 365 movies in 365 days, and the guys give more great book, movie, and TV recommendations.
Got feedback? Email thecurbsiders@gmail.com
Picks of the week

Matt’s pick - Never Eat Alone by Keith Ferrazzi
Paul’s pick - Sing Street (film)
Stuart’s pick - Lemony Snicket's: A series of unfortunate events

Clinical pearls (from Recap and response OR Brief topic review)

Obesity is a DISEASE. Not a lifestyle choice.
Percent weight loss by intervention
- Diet and lifestyle 5-10%
- Medications >10%
- Bariatric surgery >30%
Utilize specialist referral to gain resources e.g. dietician, and psychologist through bariatric surgery referral
Put faith in your patients ability to change and they will hold themselves accountable

Coding tips

If BMI >35 then code “morbid obesity” to increase medical decision making
Code “BMI” in addition “Morbid obesity”
Be sure to code comorbid conditions e.g. hypertension, diabetes, hyperlipidemia, OSA

Time Stamps

00:00 Intro
01:29 Picks of the week
06:07 Recap and responses to our obesity interview with Dr. Garvey
08:55 Mechanisms of obesity
10:15 Discussion of relapse rates, weight gain
11:23 Percent weight loss per therapy
14:35 Treating obesity on a budget
18:51 Coding tips
20:43 Diet, lifestyle counseling and how to leverage resources
26:38 Closing remarks
28:40 Outro
Disclosures:

The Curbsiders report no relevant financial disclosures, but as always hope to have lots of them in the future.

#23: The Obesity Epidemic: The Curbsiders size it up Jan 16, 2017

Obesity is of epidemic proportions in the United States and, unfortunately, many physicians are ill-equipped to tackle this disease. In this episode, we talk with Dr. Timothy Garvey, MD, FACE, one of the world’s leading experts in obesity research. We asked the American Association of Clinical Endocrinology to recommend an obesity expert and they gave us the best!
Got feedback? Email thecurbsiders@gmail.com

#22: Best of 2016 Recap and Recommendations Jan 02, 2017

Summary:

Consolidate your knowledge and reinforce the learning you’ve done with us in 2016. Enjoy this holiday helping of knowledge food for your brain hole. The guys offer their best of recommendations for 2016 and recap key teaching points from the past year so you have the tools to dominate 2017.

Recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Clinical Pearls:

SPRINT trial debate

Bias effects results seen in this trial. e.g. stopped early
Blood pressure (BP) control may have been overestimated based on how BP was measured leading to increased CV events (Stuart’s view).
BP measurements in trial likely reflected out of office BP so results are useful (Paul’s view).
Lower BP is probably safe, even in the elderly so be reluctant to back off on meds.

HTN Urgency

Verify BP reading and measurement technique
Evaluate for pain, anxiety, volume overload, nonadherence, or noncompliance
Treat high BP with long term goals in mind (i.e. go up on chronic/long-acting meds)

Anticoagulation

Avoid warfarin in patients with gastric bypass or Crohn’s with ileitis.
Use SPARC tool to visually demonstrate risks and benefits of anticoagulation in Afib.
Physicians commonly underestimate benefit of anticoagulation in older sicker patients and overestimate risk of bleeding.

Fibromyalgia and chronic pain

Recognize the constellation of fatigue, memory problems, sleep disturbance, and multifocal pain as fibromyalgia.
Use the 2011 American College of Rheumatology criteria for diagnosis. No tender point exam required!
Nonpharmacologic therapies and education are most effective (see video links below).
Chronic painful conditions like rheumatoid arthritis, or lupus can lead to fibromyalgia.

Functional Medicine

At least 80% of your food should be whole foods.
Use the Dirty Dozen and Clean 15 to guide organic food choices.
Knowledge of pathophysiology and biochemistry can be used to treat disease e.g. treating small intestinal bacterial overgrowth can fix iron deficiency and indirectly treat iron deficiency.

Lipids

Lowering LDL is key. Some s

#21: Find a dream job and jumpstart your career Dec 19, 2016

Summary:

Advance your career and expertly navigate the job hunt with guidance from Dr. Alia Chisty of Temple University Hospital. Highlights include Dr. Chisty offering up her personal email address for mentorship and Dr. Watto announcing our first contest. This episode is full of wisdom to enhance your career whether you're gainfully employed or looking for your first job.

Clinical Pearls:

Meet with your mentors at the start of the process. They can:
1. Help clarify your goals
2. Activate your network
Look for jobs 9 months in advance.
An ideal job: incorporates your interests, skills, and values.
Leverage your network (friends, mentors, program director) to identify available opportunities
Email your cover letter (typically an email) and CV to the division chair or section chief
1. Craft your elevator pitch.
2. Do your homework.
3. Explain how you will add value.
When interviewing:
Give yourself credit! Highlight experiences in your CV (e.g. conference attendance, lectures given, etc.)
Have someone review and proofread your CV.
If an employer makes a promise, then have it included in your contract. Don’t just take their word!
Have a lawyer review your contract.

Goal: Listeners will learn to craft a systematized approach to finding their perfect job.

Learning objectives:

By the end of this podcast listeners will:

Recognize timeline for applications and finding or switching jobs.
Design an effective CV and cover letter.
Recognize the importance and utility of mentors in the application process

Disclosures:

Dr. Chisty reports no relevant financial disclosures.

Time Stamps

0:20 Intro

03:40 Rapid fire questions

07:10 When to start looking for jobs

09:22 How to narrow your focus

11:33 Too many choices may be worse

13:05 Asking yourself the right questions

14:40 Quick recap of what we

#20: Hypertensive urgency and severe hypertension Dec 05, 2016

Summary:

On this episode we’ll teach you to dominate hypertensive urgency and severe hypertension (HTN) in the clinic, the ER, or on the hospital wards. The Curbsiders offer you this delicious serving of knowledge food so you can manage high blood pressure (BP) without making the same egregious errors that we made during our more formative years.

Of note, The Curbsiders are guestless for this episode. Guestless? Is that a word? Our guest for this episode was supposed to be Dr. Wallace Johnson, a Cardiologist, and expert on HTN from the University of Maryland. He did a fantastic job, but, unfortunately, technical difficulties caused us to lose any useable audio. Our sincerest gratitude and deepest apologies to Dr. Johnson. Nevertheless, we pressed on and used one of our own, the illustrious Dr. Paul Williams, as our expert guest.

Clinical Pearls:

Hypertensive crisis is divided into hypertensive emergency and hypertensive urgency.
- “Emergency” needs IV therapy NOW
- “Urgency” needs increased oral therapy over next 24-72 hours
History, physical exam, and familiarity with the patient are key for triage (e.g. verify BP readings, assess compliance, etc.)
Severe HTN and hypertensive urgency can often be treated in the outpatient setting
IV agents are not indicated outside of true hypertensive emergency (i.e. objective end organ damage)
We recommend increasing dose or frequency of existing BP meds as 1st line (better long-term solution)
Intermittent dosing of oral labetalol, clonidine, and captopril can be considered as 2nd line (short-term solution)
Rule out uncontrolled pain, volume overload, alcohol withdrawal, illicit drug, and missed medications as cause of severe HTN
Evidence from observational studies suggests that headaches are NOT caused by HTN
Untreated severe HTN was historically fatal in months to years prior to development of antihypertensives

Goal: Listeners will become proficient in the appraisal of severe hypertension/ hypertensive urgency and employ safe and practical management strategies.

Learning objectives:

By the end of this podcast listeners will:

Confidently triage patients with severe hypertension and provide appropriate disposition in a variety of settings
Employ a safe and common sense approach to the treatment of severe hypertension in the clinic, the ER, or on the wards
Be familiar with pharmacologic management of severe hypertension in a variety of settings
Recognize the common causes of severe blood pressure elevation in the inpatient setting

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