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The Intern At Work: Internal Medicine

A pan-Canadian learner-generated internal medicine podcast. The Intern at Work is written by residents for residents, and is meant to serve you better on the wards and on call. Disclaimer: This podcast is intended for educational use only and is not intended as the sole resource for clinical management. All scripts are original scripts. Podcasts produced out of Canada and may contain Canadian specific guidelines. Created by: Alison Lai Executive Producers: Laiya Carayannopoulos, Zahra Merali

Copyright: © 2021 The Intern At Work: Internal Medicine

Latest Episodes:

271. (Repeat) The Internist's Guide to VTE Feb 16, 2025

In this episiode, Dr. Sheliza Halani interview Dr. Jameel Abdulrehman (Hematology, Thrombosis) about the latest recommendations in the CHEST 2021 Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

Host: Dr. Sheliza Halani
Guest: Dr. Jameel Abdulrehman, Hematologist, Assistant Professor at University of Toronto
Sound Editing: Alison Lai

Do you ever feel like you can't get ahead of charting? Freed AI has an AI driven scribe for you! You can try Freed for free right now by going to getfreed.ai. Listeners can use the INTERN50 code for $50 off their first month!

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270. (Repeat) The Internist's Guide to Peri-operative Cardiac Risk Management Feb 09, 2025

In this episode, Dr. Maya Stein interviews Dr. Kevin Singh about the 2016 Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery.
Produced and Hosted By: Dr. Maya Stein (Internal Medicine resident)
Special Guest: Dr. Kevin Singh (General Internist)
Sound Editing by: Dr. Alison Lai (General Internist)

Do you ever feel like you can't get ahead of charting? Freed AI has an AI driven scribe for you! You can try Freed for free right now by going to getfreed.ai. Listeners can use the INTERN50 code for $50 off their first month!

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269. (Repeat) The Internist's Guide to Chronic Hypertension Feb 02, 2025

In this episode, Dr. Sheliza Halani speaks with Dr. Kevin Venus (General Internist) about the 2020 update to the Hypertension Canada Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension.
Host: Dr. Sheliza Halani
Sound Editing: Dr. Alison Lai
Producers: Dr. Catherine Leurer and Dr. Sheliza Halani

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268. Rounds Table x I@W - Rapid Fire Jan 27, 2025

This week, Dr. Mike Fralick and special guest, Dr. Laiya Carayannopoulos from the Intern at Work Podcast and our Medicine Pods collaboration, discuss two recent papers exploring oxygenation in acute respiratory failure and the use of ablation versus anti-arrhythmic medication for ventricular tachycardia. Two papers, here we go!

High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients with Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial (0:00 – 14:45).
Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia (14:45 – 22:55).

And for the Good Stuff:

Medicine Pods! (22:55 – 23:51).
Sign-up to our mailing list to receive link to attend the Royal College Epidemiology Crash Course hosted by Dr. Mike Fralick

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267. CSIM Special Episode: Serotonin Surprises Jan 20, 2025

Dr. John Fralick sits down with Dr. Nicole Hawe, a first-year Internal Medicine resident at the University of British Columbia, to discuss her third place winning clinical vignette from the Canadian Society of Internal Medicine Annual Meeting 2024.

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266. CSIM Special Episode - The GI Bleed You Can't (Un)See Jan 12, 2025

Dr. Laiya Carayannopoulos sits down with Nick Sanchez (MD student) to discuss his second place winning clinical vignette from the Canadian Society of Internal Medicine Annual Meeting. He takes us through a fantastic case of upper GI bleeding!

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265. CSIM Special Episode- When the Brain Gets the Jitters: A Curious Case of Hemichorea Jan 05, 2025

Dr. Zahra Merali (Host) sits down with Dr. Shaima Kaka (Internal Medicine resident) to discuss her first place winning clinical vignette (oral case report) from the Canadian Conference of Medicine Annual Meeting 2024. They discuss a curious case of hyperglycaemia and jitters!

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264. The Rounds Table- Top 5 RCTs of 2024 Dec 27, 2024

Happy Holidays Rounds Table Listeners! For our penultimate episode of 2024, we are back with a special treat! This week, Drs. Mike and John Fralick chat about the top five RCTs published over the past year:

Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (0:00 – 3:40).
Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (3:40 – 9:00).
Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (9:00 – 13:55).
Tirzepatide for Metabolic-Dysfunction Associated Steatohepatitis with Liver Fibrosis (13:55 – 20:00).
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections (the Balance Trial) (20:00 – 23:30).

And for the Good Stuff:

Toronto Star Santa Claus Fund, Calgary Food Bank, Epilepsy Canada (23:30 – 24:51).

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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263. Cytokines Everywhere All at Once: Approach to CRS and ICANS Dec 15, 2024

As a result of the rapid adoption CAR-T therapy for certain lymphoid malignancies and multiple myeloma, of these treatments, CRS and ICANS will become more common in IM wards in the coming years. Take a listen to learn about how to treat this emerging condition.
This episode was written by Dr. Veronica Ramirez (Internal Medicine Resident) and reviewed by Dr. Kelly Davison (Hematology) and Dr. Blair Schwartz (General Internist and Intensivist). Infographic by Neeloufar Grami (medical student).

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262. The Watermelon Phenomenon - A Deep Dive into Gastric Antral Vascular Ectasia Dec 08, 2024

Take a listen to learn everything there is to know about this less common GI diagnosis- GAVE! Written by Dr. Zuhal Mohmand (Internal Medicine resident) and reviewed by Dr. Elizabeth Squirell (Gastroenterologist), Dr. Michelle Ricci (Gastroenterologist) and Dr. Heather Johnson (General Internal Medicine). Infographic by Sapriya Birk (Medical Student).

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261. Trach 102 - An Approach to Tracheostomy Associated Emergencies Dec 01, 2024

Written by: Dr. Tharaniya Vallipuram (Internal Medicine Resident) & Dr. Liang Chen (General Internal Medicine & ICU Fellow)
Reviewed by: Dr. Jed Lipes (Intensivist & General Internist) & Dr. Evan Wong (Intensivist & General Surgeon)
Don't forget to check out Episode 238 - Tracheostomy 101 before listening to this week's episode on tracheostomy associated emergencies!

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260. The Internist's Guide to Peripheral Arterial Disease Nov 24, 2024

In this episode, Dr. Maya Stein (General Internal Medicine fellow) interviews Dr. Beth Abramson (Cardiologist) on the 2022 CCS guidelines for peripheral arterial disease.

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259. The Internist's Guide to PJP Nov 17, 2024

In this episode, Dr. Sheliza Halani interviews Dr. Nisha Andany (Infectious Diseases) about the latest guidelines regarding the epidemiology, clinical presentation, investigations, treatment and prevention of PJP.

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258. It Ain't Easy Being Wheezy - An approach to Chronic Asthma Management Nov 10, 2024

Written by: Dr. Yining (Nancy) Chen (Internal Medicine Resident)
Reviewed by: Dr. Shaun Ong (Respirologist) & Dr. Lori Wik (General Internist)

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257. Superfluous Production- Approach to Myeloproliferative Neoplasm's Nov 03, 2024

Let's talk about the BCR:ABL negative MPNs! Written by Dr. Sarah Ge (Internal Medicine Resident), reviewed by Dr. Christopher Hillis @HemeHillis (Hematology) and Dr. John Neary @jddneary (General Internal Medicine). Infographic by Dr. Caitlyn Vlasschaert @DrFlashHeart (Internal Medicine Resident).

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256. Snowmageddon - An approach to Leukostasis Oct 28, 2024

Written by: Dr. Roslyn Mainlaind (Internal Medicine Resident)
Reviewed by: Dr. Lindsay Anderson (General Internist) & Dr. Karine Gauthier (Hematologist)

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255. CSIM- Top Papers of the Year 2024 Live Episode Oct 22, 2024

Take a listen to our live recording of The Canadian Conference of Internal Medicine Top papers of the year 2024 session!
We talk about recent studies involving alzheimer's dementia, community acquired pneumonia, atrial fibrillation, MASLD and long covid.
Host: Dr. Zahra Merali, Expert: Dr. Rajender Hanmiah.
Check out www.medicinepods.com for a live video recording. You can also see a link to each paper there.

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254. Months of Monocytosis – An approach to CMML Oct 20, 2024

In this episode, we discuss the clinical presentation, work-up, and treatment of CMML. Our medicine minute discusses emerging evidence on the use of ruxolitinib for CMML treatment.
Written by: Dr. Elliot Smith (Internal Medicine Resident)
Reviewed by: Dr. Stephanie Lee (Hematology and Oncology) and Dr. Christophe Langois (General Internal Medicine)

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253. CSIM Special Episode- Internists can Help the Planet, Part 2 Oct 15, 2024

Up to 30% of all healthcare offers no clinical value to patients. Reducing this care has the co-benefit of decreasing healthcare's carbon footprint.
In this special CSIM episode, host Dr. Zahra Merali sits down with guests Dr. Billy Silverstein @WKSilverstein (General Internist, University of Toronto) and Dr. Owen Luo @OwenLuo5 (Internal Medicine Resident, McGill University) to discuss 4 of the Choosing Wisely Canada’s climate-conscious recommendations (https://choosingwiselycanada.org/climate/). They were integral in creating these recommendations, and have a wealth of practical tips about how we can implement them into our own practice!
Infographic by Julia Simone (medical student).
If you have not heard Part 1- make sure to go back and listen to other Canada-wide experts in this area.

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252. CSIM Special Episode - Top Papers Runners Up Part 3 Oct 09, 2024

In the final part of our series leading up to CSIM Dr. Mike Fralick of the Rounds Table sits down with Dr. Raj Hanmiah to discuss the papers that didn't make the cut for the top papers of the year. Join us as we record live at CSIM during the Top Papers breakfast session on October 17th for the reveal of the top 5 of the year!

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251. CSIM Special Episode- Internists can Help the Planet, Part 1 Oct 07, 2024

There are everyday practices we can stop or reduce that don’t add value to patient care and harm the environment.

In this special CSIM episode, host Dr. Zahra Merali sits down with guests Dr. Mathilde Gaudreau @MathildeGSimard (General Internist, University of Ottawa), Dr. Nabha Shetty (General Internist, Dalhousie University) and Dr. Valeria Stoynova (General Internist, Island Health/UBC Island Medical Program) to discuss 4 of the Choosing Wisely Canada’s climate-conscious recommendations (https://choosingwiselycanada.org/climate/). They were integral in creating these recommendations, and have a wealth of practical tips about how we can implement them into our own practice!

Infographic by Julia Simone (medical student). Keep tuning in to hear the rest of our CSIM special episodes and join us & the Planetary Health team as they present at CSIM! @CSIMSCMI

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250. A Little Too Sweet—The Internist’s Approach to Diabetes in Pregnancy Oct 06, 2024

In this episode, we review the screening, monitoring and treatment approaches to patients with diabetes in pregnancy. Our medicine minute reviews the MiTy trial - a landmark randomized controlled trial that provided direct safety data on the use of metformin in pregnancy.
Written by: Dr. Ryan Peters (Internal Medicine Resident)
Reviewed by: Dr. Katherine Steckham (General Internist, Obstetric Medicine fellow) and Dr. Amanda Huynh (General Internist, Obstetric Medicine)

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249. CSIM Special Episode - Top Papers Runners Up Part 2 Oct 02, 2024

In part two of our series leading up to CSIM Dr. Zahra Merali sits down with Dr. Raj Hanmiah to discuss the papers that didn't make the cut for the top papers of the year. Keep tuning in to hear the rest and join us as we record live at CSIM during the Top Papers breakfast session on October 17th for the reveal of the top 5 of the year!

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248. Unplugged - The Platelet Destroying Pathology of ITP Sep 29, 2024

In this episode, we discuss the epidemiology, clinical manifestations, investigations and treatment of ITP. Our medicine minute discusses the Harrington-Hollingsworth Experiment.
Written by: Dr. Vanessa Giuliano (Internal Medicine Resident)
Reviewed by: Drs. Taylor Dear and Zachary Liederman (Hematology) and Dr. Kevin Venus (General Internal Medicine)
Infographic by: Dr. Lilly Yu (Internal Medicine Resident)

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247. CSIM Special Episode - Top Papers Runners Up Part 1 Sep 25, 2024

In the first of our series leading up to CSIM we sit down with Dr. Raj Hanmiah to discuss the papers that didn't make the cut for the top papers of the year. Keep tuning in to hear the rest and join us as we record live at CSIM during the Top Papers breakfast session on October 17th for the reveal of the top 5 of the year!

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246. A Fungal Foe - An Approach to Invasive Aspergillosis Sep 22, 2024

In this episode, we discuss the history, epidemiology, clinical presentation, investigations and management for invasive aspergillosis.
Written by: Dr. Ravinder Sandhu (Internal Medicine Resident)
Reviewed by: Dr. Terrence Ho (Respirology) and Dr. John Neary (General Internal Medicine)
Sound Editing by: Tony Walsh

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245. Medical Assistance in Dying: Supporting Our Patients from Living to Dying Sep 15, 2024

In this episode, we discuss the history, related legislation and procedures regarding Medical Assistance in Dying. This episode discusses the state of Medical Assistance in Dying in Canada in 2024. We encourage listeners to continue to be up-to-date on the local legislation and practices.
Written by: Dr. Valerie Kim (Internal Medicine Resident)
Reviewed by: Dr. Mark Bonta (Internist) and Dr. Kayla Wolofsky (Internist, Palliative Care)

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244. I@W X RoundsTable - Rare Diseases Sep 14, 2024

This week, Dr. Laiya Carayannopoulos from the Intern at Work Podcast and Dr. Mike Fralick from The Rounds Table, our new Medicine Pods collaboration, discuss two recent papers exploring the novel management of two rare diseases – ATTR Amyloidosis and Hereditary Angioedema.
Two papers, here we go!

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243. Ask a Fellow- Medical & Surgical Management of The Hospitalized IBD Patient Sep 11, 2024

"Bad Gut Feeling" Medical & Surgical Management of The Hospitalized IBD Patient. This ask a fellow kicks off our first episode of the new academic year with one of our Queens site leads, Michael Scaffidi (Internal Medicine Resident) hosts Dr. Fiona Milne @not_shreks_wife (Gastroenterology fellow) and Dr. Daniel Potter (General Surgery Resident). Reviewed by Dr. Elizabeth Squirell (Gastroenterologist and IBD specialist) and Dr. Sunil Patel (Colorectal Surgeon).
Infographic by Sapriya Birk.

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Introducing Medicine Pods! Sep 09, 2024

Welcome to Medicine Pods! Your one stop shop for everything internal medicine, prn. Find us at www.medicinepods.com to find everything from The Intern at Work, The Rounds Table, Everything You Need To Know and Trial Files all in one place.

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242. July Special - Personal Finances ft. The Loonie Doctor Jun 30, 2024

For this year's special episode, we sat down with Dr. Mark Soth of the Loonie Doctor and Money Scope to talk about approaching creating a healthy financial future for yourself as a resident and beyond.

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241. A Total Eclipse of the Heart - An Approach to Cardiogenic Shock Jun 16, 2024

Written by: Dr. Vijay Gupta (Internal Medicine Resident)
Reviewed by: Dr. Sabe De (Cardiologist) and Dr. Karen Geukers (General Internist)

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240. A not so nice ring to it: An Approach to Salicylate toxicity Jun 09, 2024

Written by Dr. Isaac Bonisteel (Internal Medicine). Reviewed by Dr Phil Laird (General Internal Medicine and Critical Care) and Dr. Dan Howes (Critical Care). Infographic by Sapriya Birk (Medical Student)

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239. A Liver-Kidney Conundrum - Hepatorenal Syndrome Jun 02, 2024

In this episode, we review the acute presentation of hepatorenal syndrome. We review the nomenclature, epidemiology, clinical presentation, investigations and management of hepatorenal syndrome. Our medicine minute reviews the utility of terlipressin in treatment of HRS.
Written by: Dr. Elias Hazan (Internal Medicine Resident)
Reviewed by: Dr. Cynthia Tsien (Transplant Hepatologist) and Rupal Shah (General Internal Medicine)
Sound Editing by: Tony Walsh

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238. Catch a Breath - Tracheostomy 101 May 26, 2024

In this episode, we provide a broad introduction to tracheostomies. This includes indications and contraindications, tracheostomy equipment, procedural options and potential complications of tracheostomies. The medicine minute discusses the TRACMAN trial published in JAMA in 2013.

Written by: Drs . Tharaniya Vallipuram (Internal Medicine Resident) and Liang Chen (General Internal Medicine & ICU Fellow)
Reviewed by: Drs. Peter Goldberg (Intensivist, Respirologist) and Jed Lipes (Intensivist, General Internist)
Sound Editing by: Tony Walsh

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237. Starting from Scratch - Intrahepatic Cholestasis of Pregnancy May 12, 2024

In this episode, we discuss the presentation, typical timing of onset, investigations and treatment for individuals with intrahepatic cholestasis of pregnancy. We also discuss the potential complications of ICP.
Written by: Dr. Kristina Wade (Internal medicine resident)
Reviewed by: Dr Giada Sebastiani (Hepatologist) and Dr Camille Simard (GIM/Ob Med)

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236. When Life Gives you Lemons- Perioperative Diabetes Management May 05, 2024

How can we best prevent diabetic related complications before surgery? Learn all about it in this weeks perioperative episode. This episode was written by Dr. Michael Wong (Internal Medicine Resident) and reviewed by Dr. Robyn Houlden (Endocrinology) and Dr. Kristen Marosi (General Internal Medicine). Infographic by Dr. Valarie Kim (Internal Medicine Resident).

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235. Galloping Gangrene - An Approach to Necrotizing Fasciitis May 01, 2024

Written by: Dr. Lori Israelian (Internal Medicine Resident)
Reviewed by: Dr. Eva Piessens (Infectious Diseases) & Dr. Jessica Huynh (General Internal Medicine)

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234. Stop the Attacks - An Approach to Familial Mediterranean Fever Apr 21, 2024

In this episode, we discuss the pathophysiology, clinical manifestations and treatment of familial mediterranean fever (FMF). Our medicine minute discusses the history of colchicine use in FMF.
Written by: Dr. Sara Choi (Internal Medicine Resident)
Reviewed by: Dr. Zijing Wu (General Internist) and Dr. Marie Clements-Baker (Rheumatologist)
Sound editing by: Tony Walsh

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233. Marrow’s Most Wanted- An Approach to Pancytopenia Apr 14, 2024

You may know an approach to anemia, or thrombocytopenia...but what about when all cell lines are down? Take a listen to our hematology focused episode of pancytopenia!
Written by Jia Li (Lily) Liu (Internal Medicine Resident) and Dr. Owen Dan Luo (Internal Medicine Resident) and reviewed by Dr. Laura Habib (Hematologist-Oncologist), and Dr. Natasha Nathoo (Internist).
Infographic by Dr. Valerie Kim (Internal Medicine Resident)

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232. In the Thick of the Action - An Approach to Hypertrophic Obstructive Cardiomyopathy Apr 07, 2024

In today's episode we take you through our approach to a disease with a wide array of clinical presentations and evolving treatment landscape - hypertrophic obstructive cardiomyopathy.
Written by: Dr. Kate Haichin (Internal Medicine Resident)
Reviewed by: Dr. Michael Chetrit (Cardiologist) & Dr. John Angelopoulos (General Internist)

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231. When life closes a door- An Approach to Mitral Stenosis Mar 24, 2024

Do you know you valvulopathies? Learn everything there is to know about mitral stenosis! This episode was written by Dr. David Ji (Internal Medicine Resident) and reviewed by Dr. Murray Kornbluth (Cardiology) and Dr. Samuel Mamane (General Internal Medicine). Infographic by Julie Simone (Medical Student).

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230. The Bleed of Sleep - An Approach to Paroxysmal Nocturnal Hemoglobinuria Mar 17, 2024

This week we go through the ultimate in rare diagnoses - PNH. We talk about when to suspect it, how patients may present, and an approach to treatment and management. Bonus points if you can correctly guess how many attempts it took to pronounce "phosphatidylinositol!"
Written by: Dr. Angela Dong (Internal Medicine Resident)
Reviewed by: Dr. Helena Dhamko (Hematologist) & Dr. Rupal Shah (General Internist)

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229. Ask a Fellow - Hyponatremia Rate of Correction Mar 14, 2024

Welcome to Part 2 of our collaboration with #NephMadness! This week we sit down with Dr. Jeff Kott (Nephrologist and Critical Care Fellow) from the NephMadness Exec to discuss the latest and greatest in hyponatremia correction rates.

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228. It's a Water Problem - An Approach to Hyponatremia Mar 12, 2024

We partnered up with the NephMadness team to release two special episodes on hyponatremia. In this one we take you through a new(er) approach to hyponatremia and its workup. Stay tuned later this week for our Ask a Fellow episode where we cover the latest and greatest controversy on rates of correction!
Written by: Dr. Caitlyn Vlasschaert (Internal Medicine Resident)
Reviewed by: Dr. Jeffrey Kott (Nephrologist & ICU Fellow) and Dr. Laiya Carayannopoulos (Intensivist & Internist)

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227. An Apple a Day- Nutritional Deficiencies Mar 11, 2024

In both the developed and underdeveloped world, it's important to be aware of common nutritional deficiencies and their manifestations in our adult patients! This episode was written by: Dr. Igor Sljivic (Internal Medicine Resident). Reviewed by: Dr. Andrew Appleton (General Internal Medicine) and Dr. Marko Markobrada (General Internal Medicine). Infographic by: Julia Simone (Medical Student)

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226. Don't Ignore IgG4 - Approach to IgG4 Related Disease Mar 03, 2024

This week we take you through a disease that can truly affect just about every organ system - IgG4 Related Disease. We will walk you through the presentation, work up, and approach to treatment

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225. Down to the Basics - An Approach to Acid Base Disorders Feb 25, 2024

In this episode, we discuss the physiology and pathophysiology behind acid-base disorders. We then outline a 5 step approach to interpreting acid-base disorders. For reference, please refer to the infographic on our website at www.theinternatwork.com.
Written by: Dr. Caroline Najjar, (Internal Medicine Resident)
Reviewed by: Dr. Bernard Unikowsky (Nephrologist) and Dr. Jesse Popov (General Internist)
Sound editing by: Tony Walsh

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224. An Uncontrollable Leak- The Approach to a VIPoma Feb 11, 2024

What is that rare endocrine tumour that can cause watery diarrhea? You may have heard of a VIPoma, but how much do you actually know about it?
This episode was written by Dr. Tiffany Mach (Internal Medicine Resident) and reviewed by Dr. Vincent Larouche (Endocrinology) and Dr. Maral Koolian (General Internal Medicine).
Infographic by Julia Simone (Medical Student)

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223. A Broken Heart - An Approach to Takatsubo Cardiomyopathy Feb 04, 2024

In this episode, we review the clinical presentation, diagnostic criteria, work-up and management of a patient presenting with Takatsubo (or stress-induced) Cardiomyopathy. Our medicine minute discusses the JAMA discusses the higher incidence of stress cardiomyopathy noted during the COVID-19 pandemic.
Written by: Dr. Mehras Motamed (Internal Medicine resident)
Reviewed y: Dr. Dennis Ko (Interventional Cardiologist) and Dr. David Juurlink (General Internist, Clinical Pharmacologist)

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222. I Am An Island - Approach to Solitary Pulmonary Nodule Jan 28, 2024

Ever wonder what to do with that finding of an unexpected nodule on chest xray? Here we walk you through the approach including risk stratification, follow-up, and work-up.
Written by: Dr. Brandon Luu (Internal Medicine Resident)
Reviewed by: Dr. Lee Fidler (Respirologist) and Dr. Laiya Carayannopoulos (Internist & Intensivist)

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221. Red Pulp, White Pulp - An approach to splenomegaly Jan 21, 2024

In this episode, we review the physiology and pathophysiology, etiology, clinical exam, investigations and treatment in patients with splenomegaly. Our medicine minute addresses the COMFORT II trial published in the New England Journal of Medicine in 2012.
Written by: Drs. Owen Luo and Jia Li (Lily) Liu (Internal medicine residents)
Reviewed by: Dr. Gizelle Popradi (hematologist) and Dr. Samuel Mamane (general internist)

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220. Little Room for Relaxation- Heart Failure Preserved Ejection Fraction Jan 14, 2024

HFpEF is the lesser talked about, but still equally important type of CHF! We discuss the evidence and give you a run-down on everything you need to know about HFpEF. Written by Dr. Aishwarya Roshan, Internal Medicine resident, and reviewed by Dr. Krishnan Ramanathan, Cardiology and CICU, and Dr. Alison Lai, Internal Medicine. Infographic by Dr. Caitlyn Vlasschaert, Internal Medicine Resident.

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219. One Carbon Too Few - An approach to Methanol Toxicity Dec 17, 2023

Written by: Dr. Sarah Hammond (Internal Medicine Resident)
Reviewed by: Dr. Marko Skrtic (Nephrology) and Dr. Zijing Wu (General Internal Medicine

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218. From Leeches to Personalized Medicine - Approaches to Polycythemia Vera and Essential Thrombocythemia Dec 10, 2023

This week we bring you a two-in-one! We cover polycythemia vera and essential thrombocytosis.
Written by: Dr. RuiQi (Richard) Chen (Internal Medicine Resident)
Reviewed by: Dr. Hassan Sibai (Hematology) and Dr. Christopher Langlois (GIM)

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217. HBV - The Most Viral Podcast Dec 03, 2023

In this episode, we review the epidemiology, diagnostic criteria, investigation and management of hepatitis B. Our medicine minute reviews the current CDC guidelines and recommendations for screening in the general population.
Written by: Drs. Amine Zoughlami and Ikram Abow-Mohamed
Reviewed by: Dr. Phillip wong (Hepatologist) and Dr. Sanabelle Zaabat (General Internist)

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216. Burning up- Serotonin Syndrome and Neuroleptic Malignant Syndrome Nov 26, 2023

In this weeks episode you'll learn about two often confused syndromes that cause elevated body temperature! Episode written by Dr. Thomas Kiebalo (Internal Medicine Resident) and reviewed by Dr. Peter Wu (Clinical Pharmacology and Toxicology and General Internal Medicine) and Dr. Gillian Spiegle (General Internal Medicine). Infographic by Dr. Shannon Gui (Internal Medicine Resident).

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215. How low can you go? An Approach to Hypoglycemia Nov 19, 2023

You may know what to do with hyperglyecmia- but do you know what to do when the glucose goes low? Learn how to treat this dangerous (and less taught) condition in this weeks episode!
This episode was written by Isabel Shamsudeen (Internal Medicine Resident), and reviewed by Dr. Tayyab Khan (Endocrinology) and Dr. Saira Zafar (General Internal Medicine).
Episode produced by Dr. Margaret Sun (Internal Medicine Resident). Infographic by Dr. Caitlyn Vlasschaert (Internal Medicine Resident).

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214. Small But Mighty - An Internist's Approach to Small Cell Lung Cancer Nov 12, 2023

In this episode, we review the clinical presentation, classification, investigations, treatment and prognosis of patients with small cell lung cancer. Our medicine minute discusses the CASPIAN trial.
Written by: Dr. Craig Rodrigues (Internal Medicine Resident)
Reviewed by: Dr. Susanna Cheng (Medical Oncologist) and Dr. Ignazio La Delfa (Internist)

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213. Stuck Together- Thrombosis in Malignancy Nov 05, 2023

Have you ever wondered about how to treat VTE in malignancy? This episode goes over all the ins and outs of this complex and nuanced topic! Written by Dr. Kevin Yijun Fan, Internal Medicine and reviewed by Dr. Helena Dhamko, (Hematology) and Dr. Ed Etchells (General Internal Medicine). Infographic by Valarie Kim (Internal Medicine Resident).

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212. Big Red - An Approach to Macrocytic Anemia Oct 29, 2023

In this episode, we review the etiologies, pathophysiology, investigations and management of macrocytic anemia. Our medicine minute addresses how to best supplement individuals with Vitamin B12 deficiency.
Written by: Dr. Haeyong Rho (Internal Medicine Resident)
Reviewed by: Dr. Martina Trinkaus (Hematologist) and Dr. Alison Lai (General Internist)

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211. Staining Congo Red - An approach to AL Amyloidosis Oct 22, 2023

In this episode, we provide an overdose of amyloidosis with a specific focus on AL amyloidosis. We include the clinical presentation, investigations, diagnostic criteria and treatment for AL amyloidosis.
Episode written by: Dr. Roslyn Mainland (Internal Medicine Resident)
Reviewed by: Dr. Zijing Wu (General Internal Medicine) and Dr. Bethany Monteith (Hematology)
Sound editing by: Dr. Margaret Sun (Internal Medicine Resident)

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210. Pancreas Gone Wild - An approach to Acute Pancreatitis Oct 15, 2023

In this episode we walk you through our approach to pancreatitis, including potential etiologies (not just the favourite scorpion bite!), and discuss recent evidence on management.
Written by: Dr. Ikram Abow-Mohamed & Dr. Amine Zoughlami (Internal Medicine Residents)
Reviewed by: Dr. Constantine Soulelis (Gastroenterologist) & Dr. Sanabelle Zaabat (General Internist)

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209. Fluid Matters- A Practical Dive into Peritoneal Dialysis Oct 01, 2023

What complications should you watch our for in patients on peritoneal dialysis? Let this once elusive topic become your expertise! This episode was written by Dr. Shareef Akbari (Internal Medicine Resident) and reviewed by Dr. Bogdan Momciu (Nephrology) and Dr. Steven Montague (General Internal Medicine)
Infographic by Dr. Caitlyn Vlasschaert (Internal Medicine Resident)
Sound editing by Margaret Sun (Internal Medicine Resident)

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208. Leak Out! - An approach to Aortic Regurgitation Sep 24, 2023

In this episode we cover your approach to chronic and acute aortic regurgitation including key physical exam findings and echocardiographic measures.
Written by: Dr. Kate Haichin (Internal Medicine Resident)
Reviewed by: Dr. Nadia Giannetti (Cardiologist) and Dr. Amal Bessissow (General Internist).

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207. The Deadly Storm - An approach to Hemophagocytic Lymphohistiocytosis Sep 17, 2023

Take a listen this week for a dive into the world of HLH. We cover primary and secondary HLH, your approach to the diagnosis and workup, as well as management and some info on recent trials.

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206. Conquering Consumption: An Approach to Tuberculosis Sep 10, 2023

Listen to this episode for a great summary on TB infection and TB disease! We also discuss new updates and Canadian specific guidelines. Episode written by Dr. Kevin Zhang, PGY2 Internal Medicine and reviewed by Dr. Jane Batt, Respirology and Dr. Kevin Venus, General Internal Medicine. Infographic by Dr. Valerie Kim.

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205. Beware of PEAR - An Approach to Seronegative Spondyloarthritides Sep 03, 2023

In this episode, we review the pathophysiology, clinical presentation, associated diseases, investigations and treatment for the seronegative spondyloarthritides. These include psoriatic arthritis, enteropathic or IBD-associated arthritis, ankylosing spondylitis and reactive arthritis - or PEAR!
Written by: Dr. Steven Cho (Internal Medicine Resident)
Reviewed by: Dr. Lori Albert (Rheumatologist) and Dr. Vanessa Zannella (General Internist)
Recorded and Produced by: Dr. Alison Lai

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204. The Internist's Guide to Gout Aug 27, 2023

In this episode, Dr. Catherine Leurer interviews Dr. Lori Albert about the most common type of inflammatory arthritis - Gout. Dr. Albert discusses the 2020 American College of Rheumatology Guideline for the Management of Gout, with a focus on both acute gout flares and chronic management of patients with gout.
Interviewer: Dr. Catherine Leurer (Geriatrics Subspecialty Fellow)
Special Guest: Dr. Lori Albert (Rheumatology)
Sound Editing: Dr. Alison Lai

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203. The Internist's Guide to Peri-operative Cardiac Risk Management Aug 20, 2023

In this episode, Dr. Maya Stein interviews Dr. Kevin Singh about the 2016 Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery.
Produced and Hosted By: Dr. Maya Stein (Internal Medicine resident)
Special Guest: Dr. Kevin Singh (General Internist)
Sound Editing by: Dr. Alison Lai (General Internist)

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202. The Internist's Guide to VTE in Pregnancy Aug 13, 2023

In this episode, Dr. Valerie Kim interviews Dr. Yayi Huang about Thrombosis Canada’s 2021 clinical guides on deep vein thrombosis and pulmonary embolism in the setting of pregnancy.
Episode produced and hosted by: Dr. Valerie Kim (Internal Medicine resident)
Special Guest: Dr. Yayi Huang (General Internist and Obstetric Internist)
Sound editing by: Dr. Alison Lai (General Internist)

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201. Special July Episode. ERAS Tour- Tips to Swiftly Go Through The Different Era's of Residency Jul 01, 2023

Disclaimer: This episode has nothing to do with Taylor Swift, although, we do love her. There's something in this for all of our trainees this July! Our host Dr. Zahra Merali (General Internist) sits down with Dr. Madeline Stephen (PGY3 Internal Medicine) and Dr. Dr. Mei-Ni Belzile (PGY3 Internal Medicine) to chat about how to navigate the subspecialty match... the discussion leads to general tips for transitioning through all phases in residency!

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200. A Window of Opportunity: Preventing and Treating HIV Opportunistic Infections Jun 26, 2023

Confused by all the possible opportunistic infections that patients with HIV may be vulnerable to? Take a listen! Written by: Dr. Valerie Kim (Internal Medicine Resident). Reviewed by: Dr. Nisha Andany (Infectious Disease Specialist) and Dr. Isaac Bogoch (Infectious Disease Specialist and Internal Medicine Physician). Infographic: Also by Dr. Valerie Kim.

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199. CABG - More than a Vegetable Jun 18, 2023

In this episode, we review the physiology and pathophysiology behind coronary artery disease. We also reviewed the current indications for CABG as per the CCS guidelines. The medicine minute discusses the recently released ISCHEMIA trial.
Written by: Dr. Cole Clifford (IM Resident)
Reviewed by: Dr. John Janevski (Cardiology) and Dr. Rupal Shah (General Internist)
Sound editing by: Alison Lai

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198. Tearing down and building up: An Aproach to Paget Disease of Bone Jun 11, 2023

Let's dive into endocrinology this week- to learn about Paget Disease of the Bone! Listen till the end to learn about Sir James Paget himself. This episode was written by Emaad Mohammad (Internal Medicine Resident) and reviewed by Dr. Robyn Houlden (Endocrinology) and Dr. Amelia Wilkinson (General Internal Medicine)

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197. Your Learning Is Not in Vein - An Approach to Inherited Thrombophilias Jun 04, 2023

In this episode, we cover when to suspect and investigate - or more importantly NOT investigate patients for potential inherited thrombophilias.
Written by: Chloe Gordon (Internal Medicine Resident)
Reviewed by: Dr. Eric Tseng (Hematologist) and Dr. Vicky Tagalakis (General Internist)

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196. The Heart has a Mind of its Own - An Approach to POTS May 28, 2023

In this episode, we discuss the clinical presentation, consensus diagnostic criteria and pharmacologic and non-pharmacologic strategies to manage a patient with Postural Orthostatic Tachycardia Syndrome (POTS).
Written by: Dr. David Bobrowski (Internal Medicine Resident)
Reviewed by: Dr. Tosin Osuntokun and Dr. Paula Harvey (Cardiologists) and Dr. James Rassos (General Internist)
Sound editing by: Alison Lai

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195. Biliary Off Track - An Approach to Cholecystitis and Cholangitis May 21, 2023

In this episode, we discuss the clinical presentation, severity grading, investigations and management for patients presenting with cholecystitis or cholangitis. Our medicine minute discusses a promising new technique for patients with non-operative cholecystitis.
Podcast written by: Drs. Amine Zoughlami and Ikram Abow-Mohamed (Internal Medicine residents)
Reviewed by: Dr. Constantine Soulellis (Gastroenterology) and Dr. Sanabelle Zaabat (Internal Medicine)
Sound editing by: Alison lai

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194. It's Lower Than You Think - Lower GI Bleed May 14, 2023

We covered upper GI bleed a few weeks ago, but we'd be remiss if we didn't address the other half of the GI tract! This week we take you through our approach to lower GI bleeding and its management, including recent guideline updates.
Written by: Dr. Ikram Abow-Mohamed & Dr. Amine Zoughlami (Internal Medicine Residents)
Reviewed by: Dr. Alan Barkun (Gastroenterology) & Dr. Sanabelle Zaabat (Internal Medicine).

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193. Not So Sweet Pee- Approach to Central Diabetes Insipidus May 07, 2023

Written by Dr. Tiffany Mach (Internal Medicine Resident) and reviewed by Dr. Vincent Larouche (Endocrinology) and Dr. Romina Pace (General Internal Medicine). Infographic by Vincent Li (Medical Student).

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192. Go Get the O2 - An Approach to Hypoxia Apr 30, 2023

In this episode, we discuss two main causes of hypoxia as well as the utility of the A-a gradient to help determine the underlying etiology. We discuss different methods of oxygen delivery and briefly review etiologies that may cause hypoxia. Our medicine minute discusses the discovery and current controversy regarding pulse oximeters.
Episode written by: Dr. Anna Tyker (Internal Medicine Resident)
Reviewed by: Dr. Christine D’Arsigny (Respirology and Critical Care) and Dr. Amelia Wilkinson (General Internal Medicine)
Sound editing by: Kiera Liblik (Medical Student)

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191. You put me in a state of SHOCK Apr 23, 2023

In this episode, we review the main causes of four different types of shock: hypovolemic, cardiac, obstructive and distributive (or vasoplegic). We discuss both initial assessment and management of a patient in shock, as well as more focused therapies for specific etiologies. Our medicine minute discusses the choice for initial vasopressors as well as the evidence behind current MAP targets.
Written by: Dr. Krish Bilimoria (Internal Medicine resident)
Reviewed by: Dr. Camille Simard (GIM, OB medicine) and Dr. Jed Lipez (GIM, Critical Care)
Sound editing by: Alison Lai

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190. Urine Trouble! An approach to AKI Apr 16, 2023

In this episode we cover the history of AKI and an approach to its diagnosis and management. We also cover landmark trials!
Written by: Dr. Thulasie Manokaran (Internal Medicine Resident)
Reviewed by: Tyrone Harrison (Nephrologist) and Dr. Michael Fisher (General Internist)

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189. Into the Bubble: Approach to Hypogammaglobulinemia Apr 09, 2023

Have you heard of the "bubble boy?" In this episode, we outline an approach to hypogammaglobulinemia - a fascinating outpatient medicine topic! Episode written by Dr. Vivian Szeto (Internal Medicine resident) and reviewed by Dr. Rongbo Zhu (Clinical Allergy and Immunology) and Dr. Marko Mrkobrada (General Internal Medicine). Infographic by Dr. Valarie Kim (Internal Medicine resident).

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188. Atopy, asthma, and dysphagia - oh my!: An approach to eosinophilic esophagitis Mar 26, 2023

This week we cover an increasingly common diagnosis - eosinophilic esophagitis. We will discuss the clinical presentation, diagnostic criteria, and help you remember the approach to treatment.
Written by: Dr. Michael Scaffidi (Internal Medicine Resident)
Reviewed by: Dr. Samir Grover (Gastroenterologist) and Dr. Don Thiwanka Wijeratne (General Internist)

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187. Breaking down the perPLEXing topic of TTP Mar 19, 2023

In this episode, we discuss the clinical presentation, laboratory abnormalities, initial work-up and treatment of TTP. We review the pathophysiology and also how to distinguish TTP from other MAHAs based on the patient's lab findings and clinical presentation. The medicine minute discusses the first known case of TTP and the timeline of discovery of the etiology behind TTP.
Written by:
Dr. Jodi Chiu (Internal Medicine resident)
Reviewed by:
Dr. Cyrus Hsia (Hematology) and Dr. Rasha Abdul Karim (General Internal Medicine)

Sound editing by:
Margaret Sun (Internal Medicine Resident)

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186. Ring the Alarm: Mast cell activation syndrome (MCAS) Mar 12, 2023

Today's episode is all about a rare disease that you may encounter on your allergy and immunology rotation! This episode was written by Dr. Candice Luo (Internal Medicine Resident) and reviewed by Dr. Paul Keith (Allergy and Immunology) and Dr. Zahira Khalid (General Internal Medicine). Infographic by Dr. Cailyn Vlasschaert (Internal Medicine Resident).

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185. Two Sizes Too Big - Dilated Cardiomyopathy Mar 05, 2023

In this episode we take you through all the need-to-knows for your next patient with dilated cardiomyopathy!
Written by: Dr. Jasper Ho (Internal Medicine Resident)
Reviewed by: Dr. Katie Connolly (Cardiologist) and Dr. John Neary (General Internist)

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184. Backed Up - An Approach to SVC Syndrome Feb 26, 2023

In this episode, we discuss the approach to a patient with SVC syndrome. This includes considering both malignant and non-malignant causes. Treatment focuses on relief of the obstruction and investigation and management of malignant causes. Our medicine minute discusses a 2021 trial reviewing endovascular therapy for SVC syndrome.
Written by: Dr. Samuel Chan (Internal Medicine Resident)
Reviewed by: Dr. John Goffin (Medical Oncologist) and Dr. Andrew Cheung (General Internist)
Podcast recorded by: Alison Lai
Infographic by: Jessica Nguyen (Medical Student)

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183. An Approach to PCOS Feb 19, 2023

At the intersection of endocrinology and gynaecology is an important topic- polycystic ovarian syndrome! This episode was written by Dr. Sooyoun Shin (Internal Medicine Resident) and reviewed by Dr. Shoba Sujana Kumar (Endocrinology) and Dr. Rupal Shah (General Internal Medicine). Podcast produced by Kiera Liblik (medical student). Infographic by Dr. Shannon Gui (Internal Medicine Resident).

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182. Matters of the Heart - An approach to myocarditis Feb 12, 2023

In this episode we break down the lengthy list of causes of myocarditis. We cover guidelines for biopsy and work-up and management approaches.
Written by: Dr. Dhruv Krishnan (Internal Medicine resident)
Reviewed by: Dr. Samir Hazra (Cardiologist) and Dr. Steven
Montague (General Internist)

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181. Bad Connection- An Approach to Sarcoma Feb 05, 2023

Sarcoma's are rare, and sometimes coined the "forgotten cancer." Learn more about sarcoma so that you don't miss this on your differential diagnosis of internal medicine patients! Written by Dr. Megan Smith-Uffen (Internal Medicine Resident) and reviewed by Dr. Richard Tozer (Medical Oncology) and Dr. John Neary (General Internal Medicine). Infographic by Dr. Valerie Kim (Internal Medicine Resident).

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180. The Crimson Cough - A practical approach to hemoptysis Jan 29, 2023

In this episode we cover a condition that is anxiety provoking for patients and healthcare workers alike. We take you through our approach to both life threatening and non life threatening hemoptysis.

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179. When the filters start to falter: An approach to CKD management Jan 22, 2023

In this episode, we review the staging, management and treatment options for chronic kidney disease. Though most patients may present asymptomatically at first, we review the symptoms and physical findings to look out for when examining a patient with CKD. Our medicine minute discusses EMPA-KIDNEY, and the evidence that supports the use of SGLT-2 inhibitors in CKD management.
Written by: Dr. Susan Thanabalasingam (Internal Medicine Resident)
Reviewed by: Dr. Christine A. White (Nephrologist) and Dr. Christopher Smith (GIM)
Produced by: Dr. Alison Lai
Sound editing by: Margaret Sun
Infographic by: Dr. Caitlyn Vlasschaert

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178. About Damn Spine - Approach To Ankylosing Spondylitis Jan 15, 2023

In this episode, we review the clinical presentation, specialized physical exam maneuvers, investigations and management of ankylosing spondylitis. Our medicine minute reviews the Choosing Wisely guidelines for Rheumatology.
Podcast written by: Dr. Emma Reesor (Internal Medicine Resident)
Reviewed by: Dr. Raj Carmona (Rheumatologist) and Dr. Stephen Gilick (General Internist)
Sound editing by: Alison Lai
Infographic Design by: Alison Lai

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177. "Con" Man: An Approach to Primary Hyperaldosteronism Jan 08, 2023

We're starting off the new year with an outpatient medicine episode! Take a listen to learn more about primary hyperaldosteronism, a common cause of resistant hypertension. Written by Dr. Isabel Shamsudeen, Internal medicine resident, and reviewed by Dr. Stan Van Uum, Endocrinology and Dr. Andrew Appleton, General Internal Medicine. Infographic by Dr. Shannon Gui, Internal Medicine Resident.

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176. TIAWxRounds Table: Digital Education and The Way Forward Dec 18, 2022

In this episode, Drs. Michael Fralick and Alison Lai get together to talk about the state of digital education in Internal Medicine across Canada. They talk about the origin stories of their podcast, how they stay up to date, and where they hope to see the digital education sphere! We then present the latest episode of The Rounds Table, hosted by brothers Dr. Michael Fralick and John Fralick.

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175. The Internist's Guide to C.Difficile Dec 11, 2022

In this episode, Dr. Sheliza Halani interviews special guest Dr. Alon Vaisman (Infectious Diseases) on the Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).
They discuss the definitions of severity of C. difficile, recommendations for current treatment and testing, prophylaxis and surgical management options.
Producer and Host: Dr. Sheliza Halani
Guest: Dr. Alon Vaisman (Infectious Diseases)
Sound Editing: Dr. Alison Lai

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174. The Internist's Guide to VTE (Repeat) Dec 04, 2022

In this episiode, Dr. Sheliza Halani interview Dr. Jameel Abdulrehman (Hematology, Thrombosis) about the latest recommendations in the CHEST 2021 Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

Host: Dr. Sheliza Halani
Guest: Dr. Jameel Abdulrehman, Hematologist, Assistant Professor at University of Toronto
Sound Editing: Alison Lai

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173. The Internist's Guide to Atrial Fibrillation (Repeat) Nov 27, 2022

In this episode, Dr. Sheliza Halani interviews Dr. Andrew Ha, cardiac electrophysiologist at the University Health Network whose interest and clinical focus is in atrial fibrillation.

They discuss the CCS/CHRS Comprehensive Guidelines for the Management of Atrial Fibrillation, released in 2020.
Host: Dr. Sheliza Halani
Guest: Dr. Andrew Ha
Sound Editing: We would like to thank Krzysztof Kowalik for producing this episode and editing the audio.

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172. The Internist's Guide to Dyslipidemia (Repeat) Nov 20, 2022

In this episode we have special guest Dr. Dominic Ng (Endocrinologist) review the 2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults with our host Dr. Catherine Leurer.

Host: Dr. Catherine Leurer
Special Guest: Dr. Dominic Ng (Endocrinologist)
Sound Editing: Kryzsztof Kowalik

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171. The Internist's Guide to Chronic Hypertension (Repeat) Nov 13, 2022

In this episode, Dr. Sheliza Halani speaks with Dr. Kevin Venus (General Internist) about the 2020 update to the Hypertension Canada Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension.
Host: Dr. Sheliza Halani
Sound Editing: Dr. Alison Lai
Producers: Dr. Catherine Leurer and Dr. Sheliza Halani

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170. The Internist's Guide to Dyspepsia (Repeat) Nov 06, 2022

In this episode, we discuss the CAG/ACG guidelines for management of Dyspepsia, released in 2017 with Dr. Piero Tartaro, Gastroenterologist.
Host: Dr. Catherine Leurer
Sound Editing: Krzysztof Kowalik
Producers: Dr. Sheliza Halani and Dr. Catherine Leurer

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169. The Internist's Guide to Heart Failure with Reduced Ejection Fraction (Repeat) Oct 30, 2022

In this episode, Dr. Catherine Leurer interviews Dr. Stephanie Poon (Cardiologist) on the 2021 CCS/CHFS Heart Failure Guidelines Update: Defining a New Pharmacologic Standard of Care for Heart Failure With Reduced Ejection Fraction.
Host: Dr. Catherine Leurer
Guest: Dr. Stephanie Poon (Cardiologist)
Sound Editing: Krzysztof Kowalik

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168. The Internist's Guide to Infective Endocarditis (Repeat) Oct 23, 2022

In this episode, we have Dr. Malika Sharma, Infectious Diseases physician take us through the 2015 Guidelines to the diagnosis, treatment and management of endocarditis. We also include some of the new 2020 updates as well!
Host: Dr. Sheliza Halani (Internal Medicine Resident)
Sound Editing: Alison Lai
Produced by: Dr. Sheliza Halani and Dr. Catherine Leurer

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167. The Internist's Guide to CKD (Repeat) Oct 16, 2022

In this episode, we have Dr. Lisa Dubrofsky (Nephrology, University of Toronto) speaking about the KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.
Host: Dr. Catherine Leurer (Geriatrics Fellow)
Sound editing by: Krzystof Kowalik

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166. Approach to Parathyroid Adenoma Oct 02, 2022

In this episode we walk you through the approach to work up, diagnosis and management of parathyroid adenoma, including the guidelines regarding surgical management!
Written by: Dr. Akshay Varghese (Internal Medicine Residence)

Reviewed by: Dr. Stan Van Uum (Endocrinologist) and Dr. Ian Brown (General Internal Medicine)

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165. A Tale of Two Symptoms... An Approach to Pallative Symptom Management Sep 25, 2022

Written by Dr. Justin Boyle (Internal Medicine Resident) and reviewed by Dr. Marie Leung (General Internal Medicine) and Dr. Danielle Kaine (Pallative Care). Infographic by Vincent Li.

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164. Happy Gut, Happy Mind - An Approach to IBS Sep 18, 2022

In this episode, we review the clinical presentation, history and physical examination as well as the ROME-IV diagnostic criteria for a diagnosis of IBS. We review the different subtypes of IBS as well as symptom management and emerging treatments for IBS. Our medicine minute focuses on the evidence supporting the use of eluxadoline in patients with IBS-D.
Podcast written by: Dr. Nawid Sayed (Internal Medicine Resident)
Reviewed by: Dr. David Rodrigues (Neurogastroenterology) and Dr. Laura Marcotte (General Internist)
Sound editing by: Dr. Alison Lai
Infographic by Dr. Caitlyn Vlasschaert

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163. Tetany Trouble- Hypocalcemia Sep 11, 2022

Written by: Dr. Samantha Bruzzese (Internal Medicine Resident)
Reviewed by: Dr.Joshua Lakoff (Endocrinology) Dr. Zijing Wu (General Internal Medicine)

Produced by: Margaret Sun
Infographic by: Lilly Yu

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162. Putting the Sick in Sicca - Approach to Sjogren's Syndrome Sep 04, 2022

This week we talk about symptoms that should prompt you to consider Sjogren's, key features on history and physical, and the appropriate tests for work-up.
Written by: Dr. Christina Ma (Internal Medicine Resident)
Reviewed by: Dr. Stephanie Garner (Rheumatologist) and Dr. Hugh Traquair (General Internist)
Episode Produced by: Kiera Liblink (Medical Student)

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161. Hell’s Fire - An Approach to Herpes Zoster Aug 28, 2022

This episode will take you through all the details about herpes zoster! We cover the approach, when you should take extra concern and refer to ophthalmology, and how to manage a whole spectrum of patients.
Written by: Dr. Lauren Winquist (Internal Medicine Resident)
Reviewed by: Dr. Megan Devlin (Infectious Diseases) and Dr. Rasha Abdul-Karim (General Internal Medicine)

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160. Stuck in the Middle - An Approach to Achalasia Aug 21, 2022

In this episode, we review the pathophysiology, history, work-up and management of Achalasia. Our medicine minute discusses the trial "Endoscopic or Surgical Myotomy in Patients with Idiopathic Achalasia" published in NEJM in 2019.

Written by: Dr. Grace Wang (Internal Medicine Resident)
Reviewed by: Dr. Teshima (Gastroenterology) and Dr. Laura Walker (General Internist)
Sound editing by: Nathan Doupnik (Medical Student)
Infographic by: Vincent Li (Medical Student)

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159. Derailed on the Trail - Malignant Emergencies Aug 14, 2022

In this episode we cover a host of malignant emergencies. We begin with their categorization, then walk through pertinent history details, physical exam, and your approach to diagnosis and treatment.
Written by: Dr. Claire Browne (Internal Medicine resident) and reviewed by Dr. Elena Tsvetkova (Medical Oncologist) & Dr. Jeff Yu (General Internist).

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158. Scoping Out for Dysplasia - An Approach to Barrett’s Esophagus Aug 07, 2022

In this episode, we review the clinical presentation, screening guidelines, diagnosis and management of Barrett's Esophagus - one of the risk factors for developing Esophageal Adenocarcinoma. In our medicine minute, we discuss a landmark trial that transitioned treatment for BE from esophagectomy to endoscopic ablation methods.
Podcast written by: Dr. Louis Huynh (Internal Medicine Resident)
Reviewed by: Dr. Robert Bechara (Gastroenterologist) and Dr. Don Thiwanka Wijeratne (General Internist)
Production and Sound Editing by: Alison Lai

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157. A Thick Skin- Understanding Scleroderma Jul 31, 2022

It's not always good to have "a thick skin!" Learn all about it in this weeks episode. Written by Dr. Laura Spatafora (Internal Medicine Resident) and reviewed by Dr. Stephanie Garner (Rheumatology) and Dr. Daniel Brandt Vegas (General Internal Medicine). Infographic by Kiera Liblik (Medical student).

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156. The Long Itch - An Approach to Chronic Urticaria Jul 24, 2022

In this episode, we discuss the clinical presentation, biochemical mediators and treatment of chronic urticaria. We discuss the importance of a thorough history and physical to identify potential triggers as well as the utility of challenge testing and desensitization for treatment. Tune into our medicine minute to hear about two life threatening kinds of chronic urticaria that require treatment with epinephrine.
Written by: Dr. Natasha Correa, Internal Medicine Resident
Reviewed by: Drs. Samira Jeimy, Allergist and Clinical Immunologist and Saira Zafar,Internal Medicine
Sound editing by: Dr. Nafis Hossain
Infographic by: Keerthana Pasumarthi, medical student

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156. Time is Tissue - An Approach to STEMI Jul 17, 2022

In this high yield episode, we review the clinical presentation, up front investigations, immediate and long-term management of patients who present with STEMIs - one of the 5 causes of life-threatening chest pain. Our medicine minute reviews the PLATO trial, which supports the use of ticagrelor over clopidogrel as the second agent in dual anti-platelet therapy in patients with ACS.
Written by: Drs. Varun Srivatsav and William Kennedy (Internal Medicine Residents)
Reviewed by: Dr. Jonathan Dean (GIM) and Dr. Andrea Lavoie (Cardiology)
Sound Editing by: Nathan Doupnik (Medical Student)
Infographic by: Drs. Varun Srivatsav and William Kennedy (Internal Medicine Residents)
Infographic edited by: Vincent Li (Medical Student)

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155. An Approach to Thalassemia Jul 10, 2022

In this episode we take a deep dive into thalassemia- discussing the types, aetiology ,work up and treatment. This episode was written by Dr. Catherine Lovatt (Internal Medicine Resident) and reviewed by Dr. Madeleine Verhovsek (Hematology) and Dr. Daniel Brandt Vegas (General Internal Medicine). Infographic by Jessica Nguyen.

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154. Special July Episode: IM Fireside Chat- Part 2 Jul 04, 2022

It's that time of year again ! To celebrate our newest Interns on July 1st we have an exclusive Fireside Chat with our team members Drs. Orly Bogler (Toronto Site Co-lead), Claire Browne (Western Site Co-lead), Shannon Gui (Infographic Designer and McMaster Site-Co Lead) and Nafis Hossain (Sound editor). In this episode they talk about how to stay afloat mentally during residency, and what they are excited and nervous about looking forward this July! Make sure to check out Part 1 from last week.
Infographic by Dr. Shannon Gui.

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153. Special July Episode: IM Fireside Chat- Part 1 Jun 26, 2022

It's that time of year again ! To celebrate our newest Interns on July 1st we have an exclusive Fireside Chat with our team members Drs. Orly Bogler (Toronto Site Co-lead), Claire Browne (Western Site Co-lead), Shannon Gui (Infographic Designer and McMaster Site-Co Lead) and Nafis Hossain (Sound editor). In this episode they talk about how they chose internal medicine, how they describe what IM is to others and how they think differently about IM now compared to when they started residency. Make sure to check out Part 2 next week.
Infographic by Dr. Shannon Gui.

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152. Going Out on a Limb - An Approach to Peripheral Arterial Disease Jun 19, 2022

In this episode, we discuss the clinical manifestations, diagnosis and management of peripheral arterial disease. Our medicine minute focuses on emerging evidence for the use of Rivaroxaban following the release of the COMPASS trial in 2020.
Written by: Dr. Palki Bhatt (Internal Medicine)
Reviewed by: Dr. Sonia Anand (Cardiology) and Dr. Kajenny Srivaratharajah (General Internal Medicine)
Sound Editing by: Dr. Alison Lai

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151. An Approach to HIT Jun 12, 2022

In this episode, we review the two types of HIT, with diagnosis and management on HIT Type II. We go through methods of risk stratification, including the 4T score and review the gold standard testing for diagnosing HIT.
Written by: Dr. Sabrina Allarakhia (Internal Medicine Resident)
Reviewed by: Dr. Jennifer Leung (Hematology) and Dr. Steven Montague (General Internal Medicine)
Recorded by: Dr. Laiya Carayanopolous
Produced by: Dr. Alison Lai

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150. A Granular Problem – How to Approach Eosinophilia Jun 05, 2022

This episode takes you through a commonly encountered problem that stumps many a clinician! Learn all about primary and secondary causes of eosinophilia, when to investigate for each, and how to do so.
Written by: Dr. Shreyash Dalmia (Hematology Fellow)
Reviewed by: Dr. Siraj Mithoowani (Hematology & Thrombosis) & Dr. John Neary (General Internal Medicine)

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149. The Internists Guide to Atrial Fibrillation Jun 03, 2022

In this episode, Dr. Sheliza Halani interviews Dr. Andrew Ha, cardiac electrophysiologist at the University Health Network whose interest and clinical focus is in atrial fibrillation.

They discuss the CCS/CHRS Comprehensive Guidelines for the Management of Atrial Fibrillation, released in 2020.
Host: Dr. Sheliza Halani
Guest: Dr. Andrew Ha
Sound Editing: We would like to thank Krzysztof Kowalik for producing this episode and editing the audio.

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148. In the Eye of the Storm - An Approach to Disseminated Intravascular Coagulation May 29, 2022

In this episode we review the pathophysiology, diagnosis, and approach to the patient with DIC. Listen closely for some key tips on diagnostic scores and the trap of an inappropriately normal fibrinogen!
Written by: Dr. Stefan Jevtic (Internal Medicine Resident), reviewed by Dr. Siraj Mithoowani (Hematologist) and Dr. John Neary (General Internist).

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147. For When Urine Trouble - An approach to Acute Renal Allograft Dysfunction in kidney transplant patients May 22, 2022

In this episode we take you through an approach to the kidney transplant patient presenting with acute allograft dysfunction. We will cover differential, key questions on history, and an overview to management.
Written by Dr. Susan Thanabalasingam (Internal Medicine Resident)
Reviewed by Dr. Khaled Shamseddin (Nephrologist) and Dr. David Taylor (General Internist)

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146. The Internist's Guide to VTE May 19, 2022

In this episiode, Dr. Sheliza Halani interview Dr. Jameel Abdulrehman (Hematology, Thrombosis) about the latest recommendations in the CHEST 2021 Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

Host: Dr. Sheliza Halani
Guest: Dr. Jameel Abdulrehman, Hematologist, Assistant Professor at University of Toronto
Sound Editing: Alison Lai

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145. Flush Away the Crush - An Approach to Rhabdomyolysis May 15, 2022

In this episode, we review the etiologies, diagnosis, investigations and management of rhabdomyolysis.
Written by: Dr. Dhruv Krishnan, Internal Medicine Resident
Reviewed by: Dr. Audrey Tran (General Internist) and Dr. Samuel Silver (Nephrologist)
Sound Editing: Alison Lai

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144. The Internist's Guide to Dyslipidemia May 10, 2022

In this episode we have special guest Dr. Dominic Ng (Endocrinologist) review the 2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults with our host Dr. Catherine Leurer.

Host: Dr. Catherine Leurer
Special Guest: Dr. Dominic Ng (Endocrinologist)
Sound Editing: Kryzsztof Kowalik

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143. All Around Us- Approach to Aspiration and HAP May 08, 2022

You've probably heard a lot about community acquired pneumonia- but what about aspiration pneumonitis, aspiration pneumonia and hospital acquired pneumonia (HAP)? In this episode, we break down these highly relevant etiologies. This episode was written by Shannon Tang (Internal Medicine Resident) and reviewed by Dr. Onofre Moran-Mendoza (Respirology) and Zijing Wu (General Internal Medicine). Infographic by Lucy Lan (medical student).

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142. A Scoping Review- Approach to Crohn’s disease May 01, 2022

In this episode, we go over an approach to one of the two inflammatory bowel diseases- Crohn's disease! Written by Dr. Prem Bhoey (Internal Medicine Resident), Reviewed by Dr. Sawhn Sean Pritchett (Gastroenterology) and Dr. Thiwanka Wijeratne (General Internal Medicine). Infographic by Lucy Lan.

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141. The Internist's Guide to Heart Failure with Reduced Ejection Fraction Apr 28, 2022

In this episode, Dr. Catherine Leurer interviews Dr. Stephanie Poon (Cardiologist) on the 2021 CCS/CHFS Heart Failure Guidelines Update: Defining a New Pharmacologic Standard of Care for Heart Failure With Reduced Ejection Fraction.
Host: Dr. Catherine Leurer
Guest: Dr. Stephanie Poon (Cardiologist)
Sound Editing: Krzysztof Kowalik

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140. The Long Run - An Approach to Chronic Diarrhea Apr 24, 2022

In this episode, we review the pathophysiology and diseases associated with chronic diarrhea. We use the MISO acronym to divide up etiologies as well as our work-up. We review basic treatments as well as approaches to symptom management. As always, we have an associated infographic at www.theinternatwork.com.
Episode written by: Dr. Sechiv Jugnundan (Internal Medicine Resident)
Reviewed by: Dr. Nadia Griller (Gastroenterologist) and Dr. Kevin Venus (General Internist)
Sound Editing by: Dr. Nafis Hossain (Internal Medicine Resident)

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139. The Internist's Guide to Chronic Hypertension Apr 19, 2022

In this episode, Dr. Sheliza Halani speaks with Dr. Kevin Venus (General Internist) about the 2020 update to the Hypertension Canada Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension.
Host: Dr. Sheliza Halani
Sound Editing: Dr. Alison Lai
Producers: Dr. Catherine Leurer and Dr. Sheliza Halani

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138. Statin Island- An Approach to Lipids Apr 17, 2022

Take a listen to learn all about cholesterol, lipids and cardiovascular risk prevention! Written by Dr. Parm Khakh (Internal Medicine Resident) and reviewed by Dr. Samir Hazra (Cardiology) and Dr. Steven Montague (General Internal Medicine). Infographic by Rachel Ahle (Physicians Assistant).

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137. The Internist's Guide to Dyspepsia Apr 14, 2022

In this episode, we discuss the CAG/ACG guidelines for management of Dyspepsia, released in 2017 with Dr. Piero Tartaro, Gastroenterologist.
Host: Dr. Catherine Leurer
Sound Editing: Krzysztof Kowalik
Producers: Dr. Sheliza Halani and Dr. Catherine Leurer

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136. The Internist's Guide to Infective Endocarditis Apr 12, 2022

In this episode, we have Dr. Malika Sharma, Infectious Diseases physician take us through the 2015 Guidelines to the diagnosis, treatment and management of endocarditis. We also include some of the new 2020 updates as well!
Host: Dr. Sheliza Halani (Internal Medicine Resident)
Sound Editing: Alison Lai
Produced by: Dr. Sheliza Halani and Dr. Catherine Leurer

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135. Isn't Life Swell - An Approach to Hereditary Angioedema Apr 10, 2022

In this episode we discuss the types of angioedema, clues to help differentiate them on history, and the management of patients with a diagnosis of hereditary angioedema.
Written by: Dr. Maggie Jiang (Internal Medicine Resident)
Reviewed by: Dr. Stephen Betschel (Clinical Immunology and Allergy) and Dr. Laura Walker (General Internal Medicine)

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134. The Internist's Guide to CKD Apr 07, 2022

In this episode, we have Dr. Lisa Dubrofsky (Nephrology, University of Toronto) speaking about the KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.
Host: Dr. Catherine Leurer (Geriatrics Fellow)
Sound editing by: Krzystof Kowalik

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133. Cystic Fibrosis: Unplugged Apr 03, 2022

In this episode we discuss our approach to cystic fibrosis. You will learn about the pathophysiology, diagnosis and new management tools.
Written by: Dr. Rigya Arya (Internal Medicine Resident)
Reviewed by: Dr. Elizabeth Tullis (Respirology) and Dr. Michael Fralick (General Internal Medicine

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132. Small and Non-Small Cells - An Approach to Lung Cancer Mar 27, 2022

In this episode, we discuss the different types of lung cancers. We review the common clinical presentation, work-up and diagnosis of lung cancer. We also discuss an overview of treatment for lung cancer.
Written by: Dr. Coralea Kappel, Internal Medicine Resident
Reviewed by: Dr. Peter Ellis (Medical Oncology) and Dr. Daniel Brandt Vegas (General Internal Medicine)
Sound Editing by: Nathan Doupnik (Medical Student)

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131. What is the Wells' Score? An approach to DVT and PE Mar 20, 2022

March is deep vein thrombosis awareness month... and just in time, we have an episode to teach you all about venous thromboembolism! Learn about the pathophysiology, physical examination, laboratory investigations, imaging and management of VTE's in this timely episode. Written by Dr. Danyal Ladha (internal medicine resident) and reviewed by Dr. James Zhang (General Internist) and Dr. Deborah Siegal (Hematology/Thrombosis). Produced by Nathan Dupnik (Medical student), infographic by Lilly Yu.

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130. Going Backwards – An Approach to Mitral Regurgitation Mar 13, 2022

In this episode, we discuss the etiology, clinical features of mitral regurgitation. Acute, chronic, management of both, we've got it all!
Written by: Dr. Arjun Sharma (Internal Medicine Resident)
Reviewed by: Dr. Siddhartha Srivastava (General Internist) and Dr. Aws Almufleh (Cardiologist)
Infographic by: Dr. Shannon Gui (Internal Medicine Resident)

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129. Too Fast, Too Furious - An Approach to SVT Mar 06, 2022

In this episode, we review the approach to SVT with a focus on AVRT and AVNRT. We discuss the common clinical manifestations, etiology, investigations and management, with a special medicine minute on the REVERT trial.
Written by: Dr. Chris Olesovsky (Internal Medicine Resident)
Reviewed by: Dr. Sean Balmain (Cardiology) and Dr. Pete Wu (General Internal Medicine)
Sound Editing by: Nafis Hossain (Internal Medicine Resident)
Infographic by: Alison Lai

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128. When it Goes Low, We Go Slow - An Approach to Hypothyroidism Feb 27, 2022

In this episode, we review the etiologies, clinical presentation and treatment of hypothyroidism. We also review the clinical presentation and treatment of myxedema coma - a potentially life threatening illness.
Written by: Dr. Mohammed Bucheeri (Internal Medicine Resident)
Reviewed by: Dr. Robert Silver (Endocrinology) and Dr. Trevor Jamieson (Internal Medicine)
Infographic by: Lucy Lan (Medical Student)
Sound editing by: Nafis Hossain (Internal Medicine Resident)

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127. The Gift of Life - Organ Donation after Neurological Death Feb 20, 2022

This week we discuss the clinical criteria required to diagnose neurological death, and the steps to caring for the neurologically deceased organ donor.

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126. Good Bug Gone Bad - Staph Aureus Bacteremia Feb 13, 2022

In this episode we discuss the clinical manifestations, diagnosis and management of both MSSA and MRSA bacteremia.
Written by: Dr. Helen Genis (Internal Medicine Resident)
Reviewed by: Dr. Philip Lam (ID) and Dr. Jonathan Alon (Internal Medicine)
Infographic by: Dr. Caitlyn Vlasschaert (Internal Medicine Resident)
Sound Editing by: Dr. Nafis Hossain (Internal Medicine Resident)

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125. Medication or Libation? - The Beer's List Feb 06, 2022

In this episode, we take you through a case-based approach to applying the Beer's List medications. We discuss why medication pharmacokinetics and pharmacodynamics are different in older adults, and cover high risk medications and approach to finding safer alternatives.

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124. Mad Hatter- TCA Overdose Jan 30, 2022

What does "mad as a hatter" make you think of in medicine? In this episode we go over the nuances of a medical emergency- TCA overdose! Written by Dr. Leah Kosyakovsky (Internal medicine resident at the time of writing, now cardiology fellow). Reviewed by Dr. Pete Wu (General internal medicine and pharmacology/toxicology) and Dr. David Juurlink (General internal medicine and pharmacology/toxicology). Infographic by Dr. Shannon Gui (Internal Medicine Resident). Produced by Dr. Nafis Houssain (Intern Medicine Resident)

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123. Sweating the Organophosphates - Organophosphate poisoning Jan 23, 2022

In this episode, we discuss the mechanisms, consequences and treatment of organophosphate poisoning. We include the three stages of organophosphate poisoning and their associated clinical syndromes.
Written by: Dr. William Kennedy (IM resident)
Reviewed by: Dr. Jonathan Zipursky (Clinical Pharmacology and Toxicology) and Dr. Jonathan Dean (General Internal Medicine)
Sound editing by: Nathan Doupnik
Infographic by: William Kennedy, and edited by Shannon Gui

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122. A Pressing Pressure Problem: Hypertensive Urgency and Emergency Jan 16, 2022

In this episode we cover your approach to the management of acute hypertension as well as the work-up of secondary causes.

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121. Bursting Pipes: An Approach to Primary Hypertension Jan 09, 2022

Today we discuss one the most common medical diagnoses- hypertension! We take a deep dive in Hypertension Canada guidelines to discuss the diagnosis, symptoms, signs and treatment of primary hypertension. Written by Dr. Ryan Peters (Internal medicine resident) and reviewed by Dr. Marie Leung (General Internal Medicine) and Dr. Zijing Yu (General Internal Medicine). Infographic by Dr. Caitlyn Vlasschaert (Internal medicine resident) and produced by Nathan Dupnik (Medical Student).

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120. Ask a Fellow- Vaccine Anaphylaxis after mRNA SARS-CoV-2 Vaccination Dec 22, 2021

This time instead of asking a fellow- we ask an expert attending physician Dr. Samira Jeimy (Allergy and Immunology) all about anaphylaxis in relation to the COVID vaccine! If someone has had a previous allergy to vaccines, can they safely get the mRNA COVID vaccine? If someone has a reaction to dose 1, can they get dose 2 or 3? What is PEG and does this prevent people from getting the vaccine? If a patient comes to me with concerns about vaccine allergy, what should I do? Special guest host Dr. Vivian Szeto (Internal Medicine resident). Infographic by Dr. Shannon Gui (Internal Medicine Resident).

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119. Syphilis and the Imitation Game Dec 19, 2021

In this episode, we discuss the various clinical stages and presentation of syphilis as well as their associated treatment. We discuss the approach to diagnosis as well as the various diagnostic tests available. We also review the follow-up strategies to ensure appropriate response to therapy. Our medicine minute discusses the Tuskegee study and how it led to changes in medical bioethics and clinical trial regulations around the world

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118. Picking Up the Prolactinoma - Approach to Prolactinoma Dec 12, 2021

This episode was written by Dr. Anna Liu (Internal Medicine Resident) and reviewed by Dr. Dr. Stan Van Uum (Endocrinologist) and Dr. Kenneth Gilbert (GIM).

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117. The World’s Most Common Infection: An Approach to H Pylori Infection Dec 05, 2021

Did you know that the majority of people colonized with H pylori acquire it during infancy, and in the vast majority of cases infection is asymptomatic? Today we talk about the pathophysiology, history/exam, investigations and management of the world's most common infection- H. pylori! Written by Dr. Sama Anvari (internal medicine resident) and reviewed by Dr. Eric Greenwald (gastroenterologist) and Dr. John Neary (General Internist). Infographic by Lucy Lan (Medical Student)

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116. Body on Fire - Approach to Hyperthyroidism Nov 28, 2021

In this episode, we discuss the diagnosis, management and treatment of hyperthyroidism. We also take a brief detour to talk about the diagnosis and management of thyroid storm. Our medicine minute talks about a randomized control trial that looked at the use of cholestyramine for treatment of hyperthyroidism.
Written by: Dr. Tanisha Birk (Internal Medicine resident)
Reviewed by: Dr. Alescia Azzola (Endocrinology) and Dr. Florence Morriello (Internal Medicine and Critical Care)
Infographic by: Dr. Caitlyn Vlasschaert

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115. Take your breath away- Understanding Sleep Apnea Nov 21, 2021

Today we discuss a common outpatient respriology diagnosis- Obstructive sleep apnea!
Written by Dr. Jennifer D'Cruz (Internal Medicine Resident), reviewed by and Dr. Alia Kashgari (Respirology) and Dr. Karen Guekers (General Internal Medicine). Sound editing by Nathan Dupnik (Medical Student). Infographic by Rachel Ahle (Medical Student).

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114. A Viral Delay - Hepatitis C Nov 14, 2021

In this episode we talk about one of the chronic viral hepitides - Hep C! We discuss risk factors, work-up and management which has changed drastically in the past several years! Listen to our medicine minute to hear how a Canadian contributed to the history and treatment of Hep C.

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113. Toxin in your medicine cabinet- Acetaminophen Toxicity Nov 07, 2021

There's a toxin in your medicine cabinet... it's called APA, paracetamol, tylenol, or acetaminophen (depending on where you're listening)! Today we take you through the pathophysiology of tylenol toxicity, as well as clues to a patients presentation and acute management
Written by Dr. Alisa Lagrotteria (Internal Medicine Resident) and reviewed by Dr. Keith Tsoi (Gastroenterology) and Dr. Amanda Huynh (General Internal Medicine). Produced by Nathan Dupnik (Medical Student). Infographic by Lilly Yu (Medical Student)

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112. Blue Blood - What to do when Methemoglobinemia is the Suspect Oct 31, 2021

In this episode we take a deep dive on methemoglobinemia. We discuss when to suspect it, diagnosis, treatment, and some great medical trivia!
Written by: Dr. Lorenzo Madrazo (Internal Medicine Resident)
Reviewed by: Dr. Andrew Appleton (General Internal Medicine) and Dr. Wael Haddara (Critical Care)

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111. Approach to Pulmonary Function Tests (Part 2) Oct 27, 2021

This episode we apply our knowledge of the sections of PFTs to specific respiratory pathophysiologic processes.

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110. Approach to Pulmonary Function Tests (Part 1) Oct 24, 2021

In this episode, we discuss normal respiratory mechanics, indications for PFTs and their main components. Tune in later this week for Part 2 where we will discuss how to interpret them!

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109. A Drop in the Bucket - An Approach to ILD Oct 03, 2021

In this episode, we review the pathophysiology, clinical presentation and diagnostic approach to ILD - a heterogenous group of lung disorders characterized by diffuse parenchymal lung disease. We will talk briefly about management and treatment, as well as the PANTHER-IPF trial that shaped the treatment of IPF - a subtype of ILD.
Written by: Dr. Jung-In Choi (Internal Medicine Resident)
Reviewed by: Dr. Janice Leung (Respirology) and Dr. Laura Kuyper (General Internist)
Sound Editing by: Dr. Nafis Hossain (Internal Medicine Resident)
Infographic by: Dr. Shannon Gui (Internal Medicine Resident)

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108. Scars that Don't Fade - Pulmonary Fibrosis Sep 26, 2021

In this episode we cover the approach to a patient with suspected pulmonary fibrosis. This episode discusses history, physical exam, treatments and management of acute exacerbations.
Written by: Dr. Aninditee Das (Internal Medicine Resident)
Reviewed by: Dr. Karen Geukers (Internal Medicine) and Dr. Marco Mura (Respirology)

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107. Sorting out a bloody mess: an overview of anticoagulation Sep 19, 2021

In this episode we take a deep dive into the different anticoagulants! It's more than just warfarin folks.
Written by: Dr. Nicholas Chornenki ( Internal Medicine Resident)
Reviewed by: Dr. Janet Lui (hematologist) and Dr. Marie Leung (General Internist)
Produced by: Dr. Nafis Hossain (Internal Medicine Resident)
Infographic by: Lucy Lan (Medical Student)

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106: What's the DILI-O: Approach to Acute Liver Failure Sep 12, 2021

In this episode, we discuss the clinical manifestations, investigations and management of acute liver failure.
Written by: Dr. Fiona Milne (Internal Medicine Resident)
Reviewed by: Dr. Melissa Kelley (Gastroenterologist) and Dr. Zijing Wu (General Internist)
Infographic by: Hailey Pineda (Undergraduate Student)
Sound Editing by: Nathan Doupnik

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105: So the Clot Thickens - Antiphospholipid Syndrome Sep 05, 2021

Have you ever wondered why we call it antiphospholipid syndrome? Take a listen to this episode to find out all about why we've named it this, and how to diagnose, investigate and manage patients with APS.
Written by: Dr. Stefan Jevtic (IM Resident)
Reviewed by: Dr. Mark Crowther (Hematology) and Dr. Serena Gundy (GIM)
Sound Editing: Dr. Nafis Hossain (IM Resident)
Infographic: Dr. Shannon Gui (IM Resident)

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104. Taking Action on the Ejection Fraction - Chronic Management of Heart Failure Aug 29, 2021

In this episode we discuss the long-term management of congestive heart failure. We cover both reduced and preserved ejection fraction as well as the latest CCS guidelines!

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103. The Leaky Filter- Nephrotic Syndrome Aug 22, 2021

What happens when the glomerular filtration system breaks down? This episode is all about nephrotic syndrome. We go through the pathophysiology of the kidney (comparing it to a coffee filter), the key history and physical exam one might expect with this condition, investigations to order and management specifics. Check out the related infographic at www.theinternatwork.com.

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102. An Emphasis on Bronchiectasis Aug 15, 2021

What is bronchiectasis? In this episode, we discuss the etiologies of bronchiectasis, the diagnostic work-up of choice and the treatments available for patients with this disease. We also discuss the EMBRACE trial that has led to change in guidelines for treatment of bronchiectasis.
Podcast written by: Drs. Aram Karkar and Yassmin Behzadian (Internal Medicine residents),
Reviewed by: Dr. Sophie Corriveau and Dr. Michael Nicholson (Respirologists) and
Dr. Leslie Martin and Dr. Jeff Yu (General Internists)
Sound Editing by: Nafis Hossain

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101. Biting the Bullet - Sedation in the ICU Aug 08, 2021

In this episode we cover scales for assessing depth of sedation in the ICU, as well as medications used for analgesia and sedation.

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100. The Black Flood: An Approach to Gastro-Esophageal Varices Aug 01, 2021

In this episode, we discuss the clinical presentation, investigations and management of Variceal bleeds - a type of upper GI bleed that can cause mortality in up to 1/3 of patients with cirrhosis.
Written by: Dr. Maria Mikail (Internal Medicine resident)
Reviewed by: Dr. Anouar Teriaky (Gastroenterology) and Dr. Karen Geukers (General Internal Medicine)
Sound Editing by: Nathan Doupnik
Infographic by: Lucy Lan (Medical student)

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99. Ask a Fellow- Hypersensitivity Pneumonitis Jul 28, 2021

Time for a respirology "ask a fellow"! In this episode we go through this niche respiratory diagnosis and cover the new 2020 ATS hypersensitivity pneumonitis guidelines. Written by Dr. Dan Gillet (Respirology Fellow) and Dr. Jennifer D'Cruz (Internal Medicine Resident). Reviewed by Dr. Cory Yamashita (Respirology)

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98. Under Pressure- Approach to Pneumothorax Jul 25, 2021

As internists, we're always scared of surgical complications of our medical procedures. But pneumothoraces can occur for many reasons, and it is essential to know how to recognize and treat them! In this episode, we go over the types of pneumothoraces, approach to diagnosis, investigation and management.

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97. A Narrowing In the Pipes - An Approach to Stable CAD Jul 18, 2021

In this episode, we review the clinical presentation, diagnostic work-up and management of patients with suspected stable CAD. Our medicine minute this week reviews the indications for early revascularization in patients with stable CAD.
Written by: Dr. Ciara Pendrith (IM Resident)
Reviewed by: Dr. Kenneth Melvin (Cardiology) and Drs. Jonathan Ailon (GIM) and Alison Lai (GIM)

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96. Broken Factory - An Approach to Myelodysplastic Syndrome Jul 11, 2021

This week we cover our approach to patients with MDS. We discuss signs and symptoms, diagnostic criteria and treatment, and have a great medicine minute about advances in therapy.
Written by: Dr. Eugene Brailovski (Internal Medicine Resident
Reviewed by: Dr. Martina Trinkaus (Hematologist) and Dr. Steve Shumak (General Internist)
Sound editing by: Nathan Doupnik

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95. A Bump in the Road - An Approach to the Thyroid Nodule Jul 04, 2021

What is your approach to an incidental thyroid nodule? This episode takes us through the work up of this common internal medicine issue including key findings on history and physical exam, essential lab values and an approach to work up and management. This episode was written by Samantha Bruzzese and reviewed by Dr. Sara Awad (Endocrinologist) and Dr. Laura Marcotte (General Internal Medicine). Produced by Nathan Duopnik (medical student). Infographic by Rachel Ahle (Physicians assistant)

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94. Ask a Fellow- Spilling the Subspecial-TEA (Part 2) Jun 30, 2021

A dilemma every internal medicine resident faces is- how do you choose your subspecialty? Join us on this special July episode, where we first catch up with your favourite executive producers and then dive into a panel discussion with 3 Canadian fellows. Zahra asks them about their own paths that led them to choose their subspecialty using your questions from twitter! This episode was sponsored by MD Financial Management.

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93. Ask a Fellow- Spilling the Subspecial-TEA (Part 1) Jun 23, 2021

A dilemma every internal medicine resident faces is- how do you choose your subspecialty? Join us on this special July episode, where we first catch up with your favourite executive producers and then dive into a panel discussion with 3 Canadian fellows. Zahra asks them about their own paths that led them to choose their subspecialty using your questions from twitter! This episode was sponsored by MD Financial Management.

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92. Giant Troubles - Approach to GCA and Polymyalgia Rheumatica Jun 13, 2021

In this episode we discuss the approach to diagnosis and management of GCA and Polymyalgia Rheumatica.
Written by: Dr. Haonan Mi (Internal Medicine Resident)
Reviewed by: Dr. Tanveer Towheed (Rheumatology) and Dr Zijing Wu (General Internal Medicine)

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91. The Uninvited Granulomas - An Approach to Sarcoidosis May 30, 2021

In this episode, we talk all about Sarcoidosis. This disease is one of non-caseating granulomas. Though most typically found in the lungs and lymph nodes, Sarcoidosis can be found anywhere in the body. It is associated with two main symptoms - Heerfordt's Syndrome and Lofgren's Syndrome. Tune in to listen to how we diagnosis and treat sarcoidosis.
Episode written by: Dr. Julie Semenchuk
Reviewed by: Dr. Chris Li (Respirology) and Dr. James Rassos
Associated Infographic by: Shannon Gui (Medical Student)
Sound Editing by: Nathan Doupnik
www.theinternatwork.com

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90. The Poppy's Curse, Part II - Opioid Use Disorder May 23, 2021

This week we discuss the long term management of opioid use disorder, with a focus on opioid agonist therapy.
Written by: Dr. Clara Lu (General Internal Medicine Fellow)
Reviewed by: Dr. Lori Regenstreif (Addictions Medicine Specialist) and Dr. Leslie Martin (General Internal Medicine)

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89. The Poppy's Curse, Part I - Opioid Use Disorder May 16, 2021

This week we discuss your approach to a patient with opioid overdose and withdrawal, as well as the management of both conditions including naloxone and buprenorphine.

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88. Ask a Fellow: Iron Deficiency in Pregnancy (Part 2) May 12, 2021

In Part 2 of this Ask a Fellow, Hematology Fellow Dr. Jennifer Teichman and Dr. Heather Vandermeulen discuss why iron deficiency is both underdiagnosed and undertreated in pregnant women. They raise salient points about equity in our health care system and provide suggestions on how to ensure women get more timely access to care for their iron deficiency.

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87. Ask a Fellow: Iron Deficiency in Pregnancy (Part 1) May 05, 2021

In this episode, Hematology fellows Dr. Jennifer Teichman and Dr. Heather Vandermeulen discuss how to diagnosis, investigate and treat iron deficiency in pregnancy. This is part 1 of a 2 part episode, so stay tuned for our next episode on how iron deficiency in pregnancy is related to inequities in our health care system.

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86. Every Breath You Take - Long Term Management of COPD May 02, 2021

In this episode, we'll discuss how to manage patients with chronic COPD. We'll go through a large variety of interventions and highlight which interventions have a symptomatic benefit and which interventions have a mortality benefit. Our guidelines are based on the GOLD COPD guidelines. Check out our associated infographic at www.theinternatwork.com.
Written by: Dr. Shayan Kassirian (Internal Medicine Resident)
Reviewed by: Dr. Cory Yamashita (Respirology) and Dr. Jeffrey You (General Internal Medicine)

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85. Sorting it ALT Out - Approach to Abnormal Liver Enzymes Apr 18, 2021

This week we discuss our approach to deranged liver enzymes, the difference between liver enzymes and liver function tests, and the various patterns of abnormality.

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84. A shock to the system- Toxic Shock Syndrome Apr 04, 2021

Within this episode we take a deep dive into a fatal infectious disease topic- toxic shock syndrome. Written by Dr. Hosay Said, reviewed by Dr. Tim O'Shea (Infectious Diseases) and Dr. Leslie Martin (General Internal Medicine). Infographic by Rachel Ahle.

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83. Tearing up: An Approach to Aortic Dissection Mar 21, 2021

In this episode, we discuss the common causes and pathophysiology of one of the more ominous reasons for chest pain - aortic dissection. We'll go through clinical presentation, history and physical exam as well as provide information about the JAMA Rational Clinical Exam findings that support the diagnosis. Finally, we'll talk about management of both Type A and Type B dissections both in the acute and chronic phase. Our medicine minute tackles the ADD-RS score - when to use it, and how to interpret it when seeing a patient with a suspected aortic dissection.
Written by: Dr. Leah Kosyakovsky (Intenral Medicine Resident)
Reviewed by: Dr. Stephanie Poon (Cardiology) and Dr. Steve Shumak (General Internist)
Sound editing: Nathan Doupnik
Infographic: Caitlyn Vlasschaert

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82. We Wheat Again- Celiac Disease Mar 07, 2021

Written by: Dr. Conor Bell (Internal Medicine resident)
Reviewed by: Dr. Kumran Khan (Gastroenterology) and Dr. Leslie Martin (General Internal Medicine)
Infographic by: Lucy Lan (Medical Student)
Join us this week to learn about celiac disease ! We go deep into the pathophysiology of the disease, discuss an approach to physical examination and investigations, and finally discuss management of this common GI condition.

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81. Pain in the Brain – An Approach to Headache Feb 21, 2021

Time for some neurology! Today, we will focus on the common primary and the dangerous secondary headaches that must be ruled out when your patient has a new onset headache.

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80. Beyond the Limit - Alcohol Induced Cardiomyopathy Feb 07, 2021

In this episode, we discuss one of the consequences of alcohol misuse - alcohol induced cardiomyopathy. We'll consider a broad differential to dilated cardiomyopathies, and review the history, physical exam and work-up for dilated cardiomyopathy. We'll then discuss the treatment and management of alcohol induced cardiomyopathy as well as the prognosis of individuals with this diagnosis.

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79. Small Sized, Big Disguise – Shedding a ray of light on GPA Jan 27, 2021

Our first ask a fellow episode of 2021! In this episode, Dr. Melissa Holdren (rheumatology fellow) takes us through a rare but serious rheumatological diagnosis- granulomatosis with polyangiitis. She discusses the typical signs/symptoms, an approach to diagnosis and acute and chronic management. Special guest host Dr. Jennifer D'Cruz. Infographic by Rachel Ahle.

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78. What speeds up must slow down- Alcohol Intoxication and Withdrawal Jan 24, 2021

In this episode we discuss acute alcohol intoxication and withdrawal. We go into the pathophysiology of EtOH intoxication, a common approach to patients with intoxication and withdrawal, and an approach to management plans. Finally, we finish off by discussing the JAMA rational clinical exam article "Will this Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?”. Written by Dr. Nikita-Kiran Singh (internal medicine resident) and edited by Dr. Peter Wu, Internal Medicine and Clinical Pharmacology/Toxicology specialist, and Dr. Gillian Spiegle, General Internal Medicine specialist. Infographic by Dr. Caitlyn Vlasschaert.

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77. MDSOAPBRAIN - An Approach to Systemic Lupus Erythematosus Jan 10, 2021

In this episode we take you through the presentation and approach to a patient with suspected SLE. We will discuss clinical mainfestations, investigations and management.
Written by: Dr. Haonan Mi (Internal Medicine Resident)
Reviewed by: Dr. Mala Joneja (Rheumatologist) & Dr. Zijing Wu (General Internist)
Infographic by: Shannon Gui

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76. Pheochromocytomas and the Adrenaline Rush - Approach to Pheochromocytoma Dec 13, 2020

In this episode we lay out an approach to diagnosis and management of pheochromocytomas. This includes work up, physical exam and peri-operative management.
Written by: Dr. Alexandra Kobza & Dr. Olivia Cook (Internal Medicine Residents)
Reviewed by: Dr. Zubin Punthakee (Endocrinologist) & Dr. Mohamed Panju (General Internist)

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75. The Missing Factor - Von Willebrand Disease Nov 29, 2020

In this episode we take a deep dive into a rare bleeding disorder- Von Willebrand Disease! We discuss the importance of VW factor, the different types of VWD, common symptoms, pertinent investigations and an approach to management. Check out our associated infographic at www.theinternatwork.com.

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74. Ask a Fellow: Type 1 Diabetes Nov 15, 2020

In this Ask a Fellow episode, we talk to Clinical Associate Dr. Lisa Alexander about Type 1 DM. Learn about pump basics 101, the challenges in transitioning from pediatric to adult care, advances in monitoring Type 1 DM and more!

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73. A Foray into RA – Rheumatoid Arthritis Nov 01, 2020

Arthritis affects over 6 million Canadians, that’s 1 in 5, and rheumatoid arthritis specifically affects as much as 1% of the population worldwide. Today's episode discusses how to differentiate RA from other degenerative processes, how to complete a detailed RA history and exam, which tests to order to aid clinical decisions, and an approach to management options! Keep listening for a history of the first "cortisone" injection.

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72. Not too Hot, Not too Cold - Autoimmune Hemolytic Anemia Oct 18, 2020

This short but sweet episode takes you through the approach to understanding warm and cold hemolytic anemia, as well as what to ask on history, and appropriate investigations.
Written by: Dr. Adam Suleman (Internal Medicine Resident
Reviewed by: Dr. Eric Tseng (Hematology) & Dr. Yuna Lee (Internal Medicine)

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71. Dermatologic Emergencies Oct 04, 2020

In this episode, we discuss the fundamentals of evaluating a patient with a dermatologic emergency. There are four main dermatologic emergencies that we'll cover in this podcast: Drug hypersensitivity syndrome (formerly known as DRESS), SJS/TEN, Serum sickness like reaction (SSLR) and acute generalized exanthematous pustulosis (AGEP). We discuss management for each of the conditions - but the most important management point to take away is stop the offending drug!
Written by: Dr. Niko MacLellan
Reviewed by: Dr. Phil Doiron (Dermatology) and Dr. Daniel Brandt Vegas (GIM).

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70. When the pressure stays high, go looking with a closer eye - Resistant Hypertension Sep 20, 2020

Did you know that about 5-10% of patients with resistant hypertension have a secondary cause that is potentially curable? In this episode, we cover how to work-up a patient for secondary hypertension as well as which patients to suspect a secondary cause. Further, we discuss management of both resistant and secondary hypertension!
Listen to our podcast on adrenal incidentalomas as an adjunct!
Written by: Dr. Claudia Frankfurter (IM resident)
Reviewed by: Dr. Paula Harvey (Cardiology) and Dr. Tom MacMillan (GIM)

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69. Ask a Fellow: Non-Tuberculous Mycobacterial Infections Sep 06, 2020

In this episode, we talk about non-tuberculous mycobacterial infections - the most common of which is Mycobacterium Avium Complex (MAC) in North America. Dr. Jessica Kapralik - Respirology Fellow, takes us through the tricky diagnosis, work-up and helps clarify when and who to treat for these often insidious infections.

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68. Not So Difficult to Swallow - An Approach to Dysphagia Aug 23, 2020

In this episode we discuss an approach to differentiating oropharyngeal from esophageal dysphagia, as well as appropriate investigations and management options. We also cover data on the safety of PPIs and discuss their indications!
Written by: Dr. Peter Wang (Internal Medicine Resident), reviewed by: Dr. David Reed
(Gastroenterologist) and Dr. Stephen Gauthier (General Internist).

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67. The Fungus Among Us- Candidemia Aug 09, 2020

Join us this week to learn about a deadly blood stream infection - candidemia. We go over the basic microbiology of candida and cover a diagnostic and therapeutic approach to your patient with candidemia. Written by Dr. Nischal Ranganath (internal medicine resident) and reviewed by Dr. Zain Chagla (Infectious Disease Specialist) and Dr. Leslie Martin (General Internal Medicine).

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66. Caught Red-Handed: The Adrenal Incidentaloma Jul 26, 2020

What happens when you find a mass lesion on the adrenal gland? We've got answers in in this episode! Dr. Shirley Shuster walks us through the diagnosis, work-up and treatment for an incidentally found adrenal mass.
Podcast written by: Dr. Shirley Shuster (Internal Medicine resident), and reviewed by Dr. Joshua Lakoff (Endocrinologist) and Dr. Steven Montague (General Internist)

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65. Heating the Log Cabin - Phosphate Level Optimization. Jul 12, 2020

Today we take you through our approach to hyper and hypophosphatemia - diagnosis, workup, management, we've got it all!
This episode was written by: Dr. Caitlyn Vlasschaert (Internal Medicine Resident)
Reviewed by: Dr. Matt Lanktree (Nephrologist), Dr. Rachel Holden (Nephrologist), and Dr. Steven Montague (General Internist)

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64. Calling the SMR: Transitioning to your SMR Year (Part 2) Jun 28, 2020

Part 2 of our Transitioning to SMR episodes! We're still answering some of your questions from twitter, but also answering some questions that we had when we were going into our second year of internal medicine residency. What do you do when you don't know what to do overnight? What's your best tip for choosing a specialty? How do you maintain wellness? And finally, what our executive board is most looking forward to as they transition to their next stage in medicine!
First released: June 28, 2020

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63. Calling the SMR: Transitioning to your SMR year (Part 1) Jun 21, 2020

In this episode, we answer your questions about becoming a senior medical resident! Transitioning to your PGY2 year can be daunting, exciting, overwhelming and fun all at once, and we're here to give you some tried and true tips from our executive team to yours. How do I manage many emergency consults at once? How do I incorporate teaching into my day? How do I supervise juniors and avoid being a helicopter parent? We're here to help. Part 2 to be released next week!
Released June 21, 2020

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62. No More Clerking Around: Part 2! Jun 14, 2020

Originally released in June 2019.
For our newest interns at work, this is our second Q&A podcast as a follow-up to part 1.
You asked us some questions and we answered!
We answer questions about rounding on a team you don't know, attending to an unresponsive patient, a lot about code blues and more!
Good luck to our newest doctors on the ward, we're rooting for you!

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61. No More Clerking Around! Jun 14, 2020

Originally released in June 2019.
For our newest interns at work, this podcast is for you!
You asked us some questions and we answered!
As residents, we talk about resources we like, how to get involved in research and thinking about the subspecialty match as you guys start your newest journey as Internal Medicine residents.

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60. The Clot Thickens- Ask a Fellow: VTE in Pregnancy Jun 07, 2020

Join us on our GIM ask a fellow episode where we discuss VTE in pregnancy with Dr. Amanda Huynh and Dr. Jessica Huynh! We cover several guidelines such as Thrombosis Canada and SOGC and discuss everything from incidence of DVT/PE in pregnancy, to risk factors, to diagnosis and management!

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59. Feeling the Pressure- Hypertension in Pregnancy May 24, 2020

Take a listen to our first obstetric medicine episode where we discuss gestational hypertension and preeclampsia. Did you know that women who have preeclampsia will have an increased risk of developing cardiovascular complications later in life?
This episode was written by Dr. Stephanie Chan (internal medicine resident) and reviewed by Dr. Lisa Nguyen (General Internal Medicine) and Dr. Steven Montague (General Internal Medicine).

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58. Patterns of Parkinson's - History and examination of the patient with Parkinson's Disease May 10, 2020

In this episode we cover your approach to the patient with Parkinson's Disease. We discuss key features on history, as well as a focused examination for the features key to this diagnosis.
Written by: Dr. Olivia Geen (Internal Medicine Resident)
Reviewed by: Dr. Sharon Marr (Geriatrician) and Dr. John Neary (General Internist)

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57. In Shift Out - Hyperkalemia May 07, 2020

In this episode, we follow the mantra "in, shift, out!" We talk about the clinical presentation and management of hyperkalemia, and how to treat it swiftly and quickly.

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56. Ask a Fellow: Saving Brain - Endovascular Clot Retrieval Apr 26, 2020

This episode we sat down with Dr. Christine Hawkes, neurointerventional fellow to discuss clot retrieval therapy.
We cover indications and contraindications, number needed to treat, and what to consider when approaching a patient with large vessel occlusion.

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55. Congestive Heart Failure Apr 23, 2020

In this episode, we talk about congestive heart failure! From patient assessment to treatment of congestive heart failure exacerbations, we've got it covered. Ever wonder how we choose to dose diuretics? Look no further! Congestive heart failure made easy just for you.

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54. Spontaneous Combustion - Tumour Lysis Syndrome Apr 12, 2020

In this episode we take you through the approach to a patient with tumour lysis syndrome. We explain the Cairo-Bishop scoring, and cover the treatment of all facets of the syndrome.

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53. A Tighter Squeeze - An Introduction to Pressors Apr 05, 2020

In this episode, we go through an approach to vasopressors. We talk about the physiology of the receptors they act on, and the scenarios in which we would use the 5 most common vasopressors: Norepinephrine, Vasopressin, Epinephrine, Dopamine and Phenylephrine.
We also introduce our latest initiative Medicine Basecamp - which can be found here at www.theinternatwork.com/basecamp.

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52. Transfusion without Confusion – a Practical Guide to Transfusion Medicine (Part 2) Mar 29, 2020

Written by Dr. Grace Zhang (internal medicine resident)

Reviewed by Dr. Graeme Quest (Hematopathologist)

Dr. Siddhartha Srivastava (General Internist)

Infographic by: Lucy Lan (Medical Student)

Part 2 of our blood transfusion series goes into acute and delayed transfusion reactions. From fever, to TACO to graft vs. host, we cover it all. Most importantly, ABC's, stop the transfusion, call for help, and keep the blood products and tubing to send to the blood bank!

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51. Transfusion without Confusion – a Practical Guide to Transfusion Medicine (Part 1) Mar 29, 2020

Written by Dr. Grace Zhang (internal medicine resident)

Reviewed by Dr. Graeme Quest (Hematopathologist)

Dr. Siddhartha Srivastava (General Internist)

Infographic by: Lucy Lan (Medical Student)
In this episode we go over the indications and typical uses of blood products: including red blood cells, platelets, fibrinogen, PCC and albumin.

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50. Ask a Fellow: Asthma Exacerbation Mar 22, 2020

Respirology Fellow Dr. Alina Blazer takes us through the management of Acute Asthma Exacerbations! This is not your COPD patient, and clinical manifestations and treatment is different for patients with asthma exacerbations. Also, we talk about long-term management and emerging therapies for asthma exacerbation prevention in the future.
As always, extra resources and infographic available at www.theinternatwork.com

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49. When the Mind Plays Tricks - An Approach to Delirium Mar 08, 2020

Delirium can be a tricky diagnosis to make! In this episode, we walk you through the diagnosis, etiologies, and management of delirium.

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48. Community Acquired Pneumonia Mar 01, 2020

In this episode, we talk about the microbiology, clinical manifestations and treatment of one of the oldest diseases in the books - Pneumonia!

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47. Lumps and Bumps: An Approach to Lymphadenopathy Feb 23, 2020

In this episode, we talk about a general approach to lymphadenopathy, with a focus on work-up and treatment for Hodgkin Lymphoma.
Written by: Dr. Oksana Motalo (Internal Medicine Resident)
Reviewed by: Dr. Kylie Lepic (Malignant Hematologist), and Dr. John Neary (General Internist)

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46. Coronavirus nCoV-2019: What learners need to know Feb 09, 2020

In this special episode, we speak with Dr. Isaac Bogoch (Infectious Diseases, University of Toronto, Toronto General Hospital) about the epidemic of the novel coronavirus in 2019. This podcast was recorded on February 5, 2020 and we are seeing new information and learning more about the virus every day. Stay up-to-date with your institutional policies and the news that is coming out from reputable sources. If you need a place to start - follow Dr. Isaac Bogoch @BogochIsaac on twitter!

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45. When Stress Alone Is Not Enough - Adrenal Insufficiency Jan 26, 2020

Feel like your knowledge about the adrenal glands is... insufficient? In today's episode we discuss the approach to a patient with adrenal insufficiency, including primary vs secondary, work up and management.
Written by: Dr. Hernan Franco (Internal Medicine Resident)
Reviewed by: Dr. Meera Luthra (Endocrinologist) and Dr. Kajenny Srivaratharajah (General Internist).

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44. The Pink Ribbon- Ask a fellow: Breast Cancer Jan 12, 2020

In this episode we sit down with Dr. Roochi Arora (Breast malignancy and melanoma fellow), who takes us through the pertinent components of an approach to breast cancer for the internist. In particular, we go through a case of a patient returning to hospital with metastatic breast cancer- how to manage her potential complications, work up of the malignancy itself, and an overview of treatment options.
Special Guest: Dr. Emily Jackson (Internal Medicine Resident)
Host: Dr. Zahra Merali (Internal Medicine Resident)
Infographic: Shannon Gui (Medical Student)

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43. Approach to the Ulcerative Colitis flare Dec 15, 2019

This episode helps us understand the concept of autoimmunity first, taking us through the complex pathophysiology of ulcerative colitis. We then discuss intestinal and extra-intestinal manifestations of the disease and an approach to the acute UC flare.
Written by: Dr. Anthony Sandre (Internal Medicine Resident)
Reviewed by: Dr. Ted Xenodemetropoulos (Gastroenterologist) and Dr. Andrew Cheung (General Internist)
Infographic by: Dr. Caitlyn Vlasschaert (Internal Medicine Resident)

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42. The COUNTdown is On - Febrile Neutropenia Dec 01, 2019

In this episode, we cover the definition of febrile neutropenia, management, and risk stratification for inpatient vs outpatient treatment.
Written by: Dr. Anna Whalen-Browne (Internal Medicine Resident)
Reviewed by: Dr. Paul Barnfield (Medical Oncology) & Dr. Sara Piran (General Internal Medicine)

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41. A Hot Mess- Acute Monoarthritis Nov 17, 2019

This week we discuss a common E.D presentation- acute monoarthritis! First: rule out septic arthritis. Then: consider other diagnoses such as gout, seronegative arthritis and hemarthrosis. We go through the pathophysiology, diagnostic techniques and management of these common conditions.
Written by: Dr. Teresa Semalulu (Internal Medicine Resident) and Dr. Deborah Koh (Internal Medicine Resident)

Reviewed by: Dr. John Neary (General Internist), Dr. Mark Matsos (Rheumatology)

Infographic by: Rachel Ahle (Physician Assistant Student)

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40. Not for the Faint Hearted - Syncope Nov 03, 2019

In this episode, we take you through the differential diagnosis for patients presenting with syncope, including common mimickers. We discuss cardiac and non-cardiac causes, and when further investigations are warranted, and more!
Written by: Nikita Malhotra (Cardiology Fellow)
Reviewed by: Dr. Juan Guzman (General Internist), Dr. John Neary (General Internist) and Dr. Craig Ainsworth (Cardiologist)

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39. Ask a Fellow: The Great Unknown - Cancers of Unknown Primary Oct 20, 2019

Our medical oncology fellow, Dr. Michelle Nadler, takes us through the diagnostic and therapeutic challenges of treating a cancer of unknown primary.

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38. Crossing the Bridge - Preparing the Heart for Surgery: Perioperative Cardiac Assessment Oct 06, 2019

This episode walks you through our approach to perioperative management, with a focus on cardiovascular risk and medications - featuring the most recent CCS guidelines!

Written by: Dr. Jonah Himelfarb (Internal Medicine Resident)

Reviewed by: Dr. Louise Harris (Cardiologist) and Dr. Savannah Cardew (General Internist)

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37. The Essentials: An Approach to Thrombocytosis Sep 22, 2019

In this episode, we discuss the etiologies, clinical presentation and treatment of thrombocytosis. From reactive thrombocytosis to autonomous thrombocytosis, we talk about it all. Our medicine minute addresses a World War II era therapy that is no longer used, but might be considered for a specific population!
If you haven't already, listen to our accompanying podcast - A Paucity of Platelets, to learn about the opposite disorder - Thrombocytopenia!

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36. The Little Ventricle That Could- Pulmonary Hypertension Sep 08, 2019

On this weeks episode we discuss the ins and outs of pulmonary hypertension- from the WHO 5 classifications of pulmonary hypertension, what to look out for on physical exam, diagnostic considerations and new guideline updates in the field.
Written by: Sameer Kushwaha (Internal Medicine Resident)
Reviewed by: Dr. John Thenganatt (Respirology)
Dr. Gillian Spiegle (General Internal Medicine)
Infographic by: Caitlyn Vlasschaert (Internal Medicine Resident)

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35. Ask a Fellow: Taking the Zzz out of Sleep- Benzodiazepine (Mis)use in Hospital Aug 25, 2019

Guest Fellow: Dr. Sam Thrall (Geriatric Medicine)
Special Guest: Dr. Olivia Geen (Internal Medicine Resident)
Host: Dr. Zahra Merali (Internal Medicine Resident)
Episode reviewed by: Dr. Joye St. Onge (Geriatrician)
Take a listen to our ask a fellow episode on benzodiazepines! Although they are the 10th most prescribed medication in older adults, these drugs are associated with many negative side effects including delirium and falls. We discuss Choosing Wisely Canada guidelines and the Beers List, as well as deprescribing methods and the EMPOWER trial. Sam also tells us about useful facts relating to commonly used sleeping aids and drugs used for aggressive behaviour. Lessons learned: Start low, go slow.

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34. Crisis in the Suburbs: Approach to Diabetic Foot Infection Aug 11, 2019

Learn to manage a common infectious disease scenarios. This podcast takes you through the clinical presentation and appropriate history and physical, as well as management of diabetic foot infections based on the most recent IDSA guidelines.

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33. Find the Leak - The bloody truth about bleeding disorders Jul 28, 2019

This episode reviews the management of an outpatient with a bleeding phenotype. How does one grade severity and what tools might we use? What are signs on physical exam that should be assessed? Consider both inherited and acquired bleeding disorders when assessing your patients. Lastly, we discuss the initial management and some evidence behind these management strategies in our medicine minute!
Podcast written by: Dr. Ying Ling
Reviewed by: Dr. Michelle Shozlberg and Dr. Jonathan Ailon
As always, we have associated resources and infographics at www.theinternatwork.com.

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32. A Pain in the Neck - Meningitis Jul 14, 2019

Tune in this week to hear about a life threatening illness- meningitis! In this episode, Dr. Katherine Steckham goes over the approach to bacterial meningitis. In addition, we go cover IDSA guidelines, why we use dexamethasone, and what to do if your patient has a beta lactam allergy!
Associated Infographic: www.theinternatwork.com
This episode was reviewed by Dr Nishma Singhal (Infectious diseases) and Dr. John Neary (internal medicine).

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31. Approach to Anemia Jul 07, 2019

Anemia made easy! In this episode we talk about the classification of anemia and some of their leading etiologies. We focus on the assessment and treatment of iron deficiency anemia, and talk briefly about the choosing wisely guidelines for transfusion thresholds in anemic patients.

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30. Cellulitis Jun 23, 2019

What's red, hot and requesting medical attention? In this episode we talk about cellulitis! From patient assessment to learning about it's most common pathogens and treatment, we give you all the basics to see and treat a patient with cellulitis. As a bonus, we've included five important facts about cellulitis to come in our medicine minute.

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29. Ask a Fellow: Ace the Airway - Intubation Jun 09, 2019

Does the thought of intubating a sick patient make you anxious? Us too! In this episode, we sit down with Dr. Jessica Spence (Anaesthetist, Critical Care fellow) to discuss her approach to intubation to ensure she optimizes the chances of success. We cover pre-intubation checklists, predictors of challenging airway and more!
Associated infographic can be found at www.theinternatwork.com
Guest Fellow: Dr. Jessica Spence (Anaesthetist, Critical Care Fellow, McMaster University)
Host: Laiya Carayannopoulos

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28. The Racing Heart - Atrial Fibrillation May 26, 2019

The most common arrhythmia in patients greater than 65 years old! Listen up on how to approach a patient with atrial fibrillation. We take you through managing both the stable and unstable patient, including how to choose between rhythm and rate control, and the indications for anticoagulation.

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27. Not Another PEEP: An Approach to ARDS May 12, 2019

In this episode, we discuss the approach to a sick patient with Acute Respiratory Distress Syndrome. We talk about diagnosis, classification of severity, common triggers and strategies for treatment. Also, tune in to our medicine minute to learn about the evidence behind ECMO in patients with ARDS!

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26. Heart of the Infection - Infective Endocarditis Apr 28, 2019

This week's episode is all about infective endocarditis. We discuss the approach to a patient presenting with suspected endocarditis, review work up, antibiotic therapy and surgical indications, and highlight the updated AHA/ACC prophylaxis guidelines!
Podcast written by: Dr. Liam Finlay (Internal Medicine Resident)
Reviewed by: Dr. Zain Chagla (Infectious Disease Specialist) and Dr. Leslie Martin (General Internist)
Infographic by: Howard Ong (Medical Student)

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25. Ask a Fellow: Rash Decisions - Penicillin Allergy Apr 14, 2019

Drs. Derek Chu and David McCullagh chat with us about the approach to a patient with documented penicillin allergy and the importance of exploring this label in detail. We cover risk stratification, allergy testing and an approach to test dosing.
As always, we post an associated infographic at www.theinternatwork.com
Guest Fellows: Dr. David McCullagh (Infectious Diseases Fellow, McMaster University) and Dr. Derek Chu (Allergy and Immunology Fellow, McMaster University)
Hosts: Zahra Merali and Laiya Carayannopoulos

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24. Blood is Thicker Than Water- Multiple Myeloma Mar 31, 2019

To finish off Multiple Myeloma Awareness Month, we have our second episode of a two part series- this one's on Myeloma! We discuss the definitions of smoldering myeloma vs. multiple myeloma as well as a breakdown of the pathophysiology (with our mnemonic CRAB) and a brief overview of treatment. Make sure to listen to our episode on MGUS first.
As always, we have an associated infographic as well as relevant resources at www.theinternatwork.com.
This episode was written by Dr. Zahra Merali (Internal Medicine Resident) and reviewed by Dr. Laura Habib (Malignant Hematology Fellow), Dr. Mohammed Aljama (Malignant Hematologist) and Dr. Rajendar Hanmiah (General Internist). Infographic by Nikhita Singhal.

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23. Bad Blood- MGUS (Monoclonal Gammopathy of Undetermined Significance) Mar 24, 2019

It's Myeloma Awareness Month, and to spread the word we are releasing 2 concurrent episodes- MGUS and Myeloma. This week you are in the outpatient GIM clinic and our episode is all about Monoclonal Gammopathy of Undetermined Significance. We delve deeper into what it means to order SPEP, UPEP, serum immunofixation and serum free light chains, and we overview the International Myeloma Working Group definitions of MGUS.
As always, we have an associated infographic as well as relevant resources at www.theinternatwork.com.
This episode was written by Dr. Zahra Merali (Internal Medicine Resident) and reviewed by Dr. Laura Habib (Malignant Hematology Fellow), Dr. Mohammed Aljama (Malignant Hematologist) and Dr. Rajendar Hanmiah (General Internist). Infographic by Nikhita Singhal.

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22. A Tight Squeeze- Pericarditis, Pericardial Effusion and Cardiac Tamponade Mar 10, 2019

This episode is all about the fibroelastic sac surrounding your heart- the pericardium! We discuss the continuum of pericarditis, pericardial effusions and cardiac tamponade- including symptoms/signs to look out for and an approach to management.
As always, we have an associated infographic as well as relevant resources at www.theinternatwork.com.
This episode was written by Dr. David Dorian (Internal Medicine Resident) and reviewed by Dr. Ken Melvin (Cardiologist), Dr. Rupal Shah (General Internist) and Dr. Nadine Abdullah (General Internist).

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21. Ask a Fellow: The Fatal Mismatch- Massive Pulmonary Embolism Feb 24, 2019

Dr. Kim Lewis (Critical Care Fellow, McMaster University) takes us through the approach to a patient with suspected massive pulmonary embolism. Stay tuned for five take home points to remember when treating a patient with this medical emergency as well as recommendations form Thrombosis Canada.
As always, we post an associated infographic at www.theinternatwork.com
Guest Fellow: Dr. Kim Lewis (Critical Care Fellow, McMaster University)
Faculty reviewer: Dr. Waleed Alhazzani (Intensivist and Gastroenterologist)

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20. Go Look For The Adenoma Please - Pituitary Adenoma Feb 10, 2019

This episode is all about an approach to the patient with pituitary adenoma! We discuss signs and symptoms, as well as where to begin with your investigations. Finally, we discuss complications to be aware of post-operatively, and how to manage them.
This episode was written by Dr. Tehmina Ahmad (Internal Medicine Resident), and reviewed by Dr. Jeanette Goguen (Endocrinologist) and Dr. Shital Gandhi (General Internist). Our associated infographic can be found at www.theinternatwork.com

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19. Dousing the Flames - Sepsis Jan 27, 2019

This episode is all about sepsis! We discuss various identification and risk stratification scores, as well as the work up and management of the patient with sepsis.
As always, we have an associated infographic as well as relevant resources at www.theinternatwork.com.
This episode was written by Dr. Laiya Carayannopoulos (Internal Medicine Resident) and reviewed by Dr. Alison Fox-Robichaud (Intensivist, President of Canadian Sepsis Foundation), Dr. Waleed Alhazzani (Intensivist and Gastroenterologist, Methodology Chair of Surviving Sepsis Campaign), and Dr. Rebecca Kruisselbrink (Internist and Intensivist).

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18. Sweet Pee - Non-insulin Anti-Hyperglycemic management of Type II Diabetes Jan 13, 2019

In this episode, we describe all of the lifestyle and non-insulin pharmacological management of type II diabetes.
As always, we have an associated infographic as well as relevant resources at www.theinternatwork.com.
This episode was written by:
Dr. Sapna Shah (Internal Medicine Resident) and reviewed by Dr.Shoba Sujana Kumar (Endocrinology) and Dr. Peter Wu (Internal Medicine and Clinical Pharmacology and Toxicology)

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17. Ask a Fellow: Pulmonary Renal Syndrome Dec 16, 2018

Dr. Tooba Ali (Rheumatology Fellow, Queen's University) takes us through the approach to a patient with suspected pulmonary renal syndrome and the initial treatment. Stay tuned for five take home points to remember when treating a patient with Pulmonary Renal Syndrome as well as some of the latest evidence around ANCA-associated vasculitis.
As always, we post an associated infographic at www.theinternatwork.com
Guest Fellow: Dr. Tooba Ali (Rheumatology Fellow, Queen's University)
Faculty reviewer: Dr. Christian Pagnoux (Rheumatologist, University of Toronto)

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16. Pockets of Fluid - Pleural Effusions Dec 02, 2018

In this episode, we talk about the 5,6,7 rule for classifying pleural effusions, lead you through Light's criteria and consider the broad differential and treatments for pleural effusion!
Visit www.theinternatwork.com for the associated infographic.
Episode written by: Dr. Jessica Kapralik (Internal Medicine Resident)
Episode Reviewed by: Dr. Andrew Cheung (General Internist)

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15. A Stroke of (Bad) Luck - Ischemic Stroke Nov 18, 2018

Today we address a source of anxiety for many a learner - approach to ischemic stroke. In this episode we discuss everything stroke related - physical exam, investigations, acute management, and secondary prevention. Remember to visit www.theinternatwork.com for our infographic and links to relevant resources, including the NIH stroke scale.

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14. Ask a Fellow: "Broken Down" - Hemolysis Nov 04, 2018

Today we break down an approach to hemolysis! This episode establishes an approach to diagnosis, clinical and laboratory evaluation and treatment of one of the most fatal hemolytic anemias - TTP. Thanks to our fellow Dr. Chenchen Hou for taking us through this complex topic.
Visit our website www.theinternatwork.com for an associated infographic.

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13. Drop the Beat - Bradyarrhythmia Oct 21, 2018

A heart that is well conditioned, or well worth worrying about? In this podcast we discuss the physiology, diagnosis, and management of bradyarrythmias! Don't forget to check out www.theinternatwork.com for a summary infographic.

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12. Bones, Stones, Moans and Groans - Hypercalcemia Oct 07, 2018

A common problem with complex physiology! Learn all about our approach to the diagnosis and management of hypercalcemia.
Be sure to check out www.theinternatwork.com for our accompanying infographic.

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11. Where salt goes, water follows - Ascites Sep 23, 2018

Ascites is the pathologic accumulation of fluid in the abdominal cavity. In this episode, we review the pathophysiology, clinical presentation, diagnosis and management of ascites, with a focus on ascites secondary to liver cirrhosis. Be sure to check out www.theinternatwork.com for our accompanying infographic.

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10. Ask A Fellow: "Blasted Blasts" - Blasts in the peripheral blood smear Sep 09, 2018

The first episode in our new "Ask A Fellow" series, geared towards senior level learners. In this episode, we sit down with a fellow and discuss their approach to Blasts in the peripheral blood smear. Be sure to check out www.theinternatwork.com for the associated infographic!

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9. Bugs in Your Blood- Bacteremia Aug 26, 2018

Have you ever gotten the phone call "your patient has grown gram + cocci in groups"? In this episode, we outline an approach to bacteremia- particularly what to do if your cultures have not yet speciated.

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8. When the Pipe Bursts - Upper GI Bleed Aug 12, 2018

How do you solve a problem like melena? In this episode, we discuss the clinical presentation, management, and investigations for patients who present with Upper GI bleeds.

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7. The Engine That Could - DKA Jul 29, 2018

Does being asked to manage DKA make you nervous and uncomfortable? Well never fear, the Intern At Work has your back! In this episode, we outline an approach to assessment and management of the patient with DKA. Insulin infusions, electrolyte management, this podcast has it all. **This episode has been re-uploaded to reflect a correction. In the initial podcast, we state that insulin infusion must be overlapped with subcutaneous rapid acting insulin, when it should in fact read LONG acting insulin.

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6. The Disease of Kings - Gout Jul 15, 2018

In this episode, it's all about gout! From our residents to yours, we go through a simple approach to gout including clinical presentation, diagnosis and treatment.

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5. A Paucity of Platelets - Thrombocytopenia Jul 01, 2018

In this episode we talk all about platelets! We outline the physiology of platelets, common etiologies of thrombocytopenia, investigations and management. Finally, we'll take you through the need to know risks of platelet transfusions to help you in talking to patients on the ward!

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4. The Tight Valve - Part 2: Aortic Stenosis Jun 17, 2018

Did you enjoy Part 1 of The Tight Valve? If you haven't heard it yet, take a listen to part 1 of The Tight Valve which discusses everything from the history to the clinical presentation of patients with aortic stenosis. In this episode, we talk about the physical exam, work-up and management of aortic stenosis. In our medicine minute we go through the class 1A indications of aortic valve replacement.

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3. The Tight Valve - Part 1: Aortic Stenosis Jun 10, 2018

In this episode we talk about the most common valvular disease - aortic stenosis! In part 1 of 2 on aortic stenosis, we'll talk about the physiology and pathophysiology of aortic stenosis, as well as the natural history and clinical history of a patient with aortic stenosis!

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1. Chronic Obstructive Pulmonary Disease Jan 20, 2018

In this episode, we talk about COPD. We talk about classifying severity and the GOLD guidelines, recognition and treatment of a COPD exacerbation and include a quick review of relevant evidence that guides our treatment of patients with COPD.

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2. Acute Coronary Syndrome Jan 20, 2018

In this episode we focus on the presentation, diagnosis and treatment of acute coronary syndromes. From unstable angina to STEMIs, we have it covered!

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