The Intern At Work: Internal Medicine

Latest Episodes:

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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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