Core IM | Internal Medicine Podcast
- Episodes
- 231
- Released
- every two weeks
- Latest episode
- Nov 11, 2026
About the podcast
Core Internal Medicine via following series: 5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do? Gray Matters || Management Reasoning Hoofbeats || Dissecting clinical reasoning At the Bedside || Explore everyday challenges
Episodes 231
#223 Amyloidosis Presentation: Gray Matters Segment
“Could amyloidosis be the reason behind a patient’s unexplained symptoms?” This episode explores the clinical clues that should prompt clinicians to consider AL amyloidosis and recognize patterns of organ …
Show notes
“Could amyloidosis be the reason behind a patient’s unexplained symptoms?” This episode explores the clinical clues that should prompt clinicians to consider AL amyloidosis and recognize patterns of organ involvement that may otherwise be easy to overlook. Learn how to connect the findings, spot important red flags, and bring amyloidosis into your differential diagnosis.
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00:55 Aliquot 1
04:38 Deep Dive 1: When to suspect Amyloid - Warning Signs
10:31 Aliquot 2
12:28 Deep Dive 2: Organ System Involvement
24:38 Aliquot 3
Tags: IMCore, Internal Medicine, Medical Education, Nephrotic Syndrome, Restrictive Cardiomyopathy, Periorbital Purpura, Unexplained Proteinuria, Hematology
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Privacy & Opt-Out: https://redcircle.com/privacy#222 AFib Stroke Prevention: WATCHMAN, DOACs, and the CHAMPION-AF Trial | Beyond Journal Club Segment with NEJM Group
If your patient asks you about a left atrial appendage closure device, what should you tell them? In the latest episode of the Beyond Journal Club podcast from CORE IM and NEJM Group, the hosts will help you …
Show notes
If your patient asks you about a left atrial appendage closure device, what should you tell them?
In the latest episode of the Beyond Journal Club podcast from CORE IM and NEJM Group, the hosts will help you:
- Understand the trade-offs: stroke prevention, bleeding, procedural risks, and medications afterward.
- Build clinical judgment: weigh which approach may better serve the individual patient, beyond the trial’s headline.
- Learn from thoughtful counseling: hear how you might discuss the evidence, acknowledge uncertainty, and explore what matters to your patients.
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01:09 | What the Watchman is, and why it should work?
05:58 | The checkered history: PROTECT-AF and PREVAIL
09:06 | The plot continues: PRAGUE-17, OPTION, OCEAN, and CLOSURE-AF
12:35 | CHAMPION-AF: the biggest test yet
15:03 | Reading the fine print
19:23 | A local solution to a systemic problem
22:45 | How patients hear about it
25:44 | So what do we tell our patients?
29:52 | Takeaways
Tags: IMCore, Internal Medicine, Medical Education, WATCHMAN device, Atrial Fibrillation, Cardiology, DOAC Anticoagulation, Primary Care, Hospital Medicine
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Privacy & Opt-Out: https://redcircle.com/privacy#221 Colon Cancer Screening After Age 75 | 5 Pearls Segment Part 3
“Should you stop screening for colorectal cancer (CRC) at 75?” This episode explores how to individualize screening decisions based on life expectancy, prior colonoscopy findings, and procedural risks. Learn …
Show notes
“Should you stop screening for colorectal cancer (CRC) at 75?”
This episode explores how to individualize screening decisions based on life expectancy, prior colonoscopy findings, and procedural risks. Learn how to navigate these nuanced conversations, avoid age-based assumptions, and use strategies like mailed FIT kits and offering screening choices to help more patients get screened.
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🔹Transcript and Show Notes
01:18 | Screening >75 yo?
10:06 | Takeaways on Colorectal Cancer Screening After 75
10:37 | Systems thinking: How do we get to an 80% screening rate
Tags: Core IM, Internal Medicine, Colorectal Cancer Screening, Gastroenterology, Cancer Screening
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Privacy & Opt-Out: https://redcircle.com/privacy#220 Colon Cancer Screening Nuances: 5 Pearls Segment Part 2
“What’s the best way to screen?” This episode breaks down the pros, limitations, and follow-up needs of FIT, Cologuard, CT colonography, and colonoscopy to help you choose the right CRC screening option for …
Show notes
“What’s the best way to screen?” This episode breaks down the pros, limitations, and follow-up needs of FIT, Cologuard, CT colonography, and colonoscopy to help you choose the right CRC screening option for your patients. Also learn practical colonoscopy surveillance intervals based on polyp size, number, and pathology.
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01:24 | Screening Options Besides Colonoscopy
11:22 | How FIT, FIT-DNA, and CT colonography differ and when each makes sense.
12:52 | Colonoscopy and Frequency
19:29 | How adenoma number, size, and histology guide surveillance intervals.
Tags: Core IM, Internal Medicine, Colorectal Cancer Screening, Gastroenterology, Cancer Screening
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Privacy & Opt-Out: https://redcircle.com/privacy#219 Updates in Triglycerides
“The triglycerides are high. Now what?” This episode breaks down a practical approach to elevated TGs, from knowing when to check ApoB or non-HDL-C to choosing lifestyle changes, lipid-lowering medications, and …
Show notes
“The triglycerides are high. Now what?” This episode breaks down a practical approach to elevated TGs, from knowing when to check ApoB or non-HDL-C to choosing lifestyle changes, lipid-lowering medications, and when to suspect an underlying genetic disorder.
02:17 | Check a non-HDL-C or ApoB if TGs are ≥150 mg/dL
07:18 | Address waist circumference and lifestyle before meds for high TGs
10:52 | Dr. Watson’s 3-day carbohydrate responsiveness trial
17:07 | Order a fasting or nonfasting lipid panel?
19:00 | When do you reach for TG-lowering medications?
25:26 | Familial chylomicronemia syndrome (FCS)
Tags: CoreIM, Medical Education, Hypertriglyceridemia, ACC AHA lipid guidelines, lipid guidelines 2026, cardiovascular risk
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Privacy & Opt-Out: https://redcircle.com/privacy#218 Early-Onset Colon Cancer: 5 Pearls Segment Part 1
“Too young for colon cancer.” This episode unpacks the red flags of early-onset colorectal cancer (CRC), from blood in the stool and iron deficiency anemia to persistent abdominal pain and changes in bowel …
Show notes
“Too young for colon cancer.” This episode unpacks the red flags of early-onset colorectal cancer (CRC), from blood in the stool and iron deficiency anemia to persistent abdominal pain and changes in bowel habits, and offers practical pearls for closing the clinical loop. Also learn why a “negative” family history may need a yearly refresh.
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01:45 | Colorectal cancer rising in younger adults
06:42 | Why screening starts at age 45
08:15 | What may be driving early-onset colorectal cancer
13:37| Key takeaways: symptoms, follow-up, and family history
Tags: Colorectal Cancer Screening, Internal Medicine, Gastroenterology, Cancer Screening, Oncology
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Privacy & Opt-Out: https://redcircle.com/privacy#217 Treatment for Alcohol Use Disorder: 5 Pearls Segment
“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and …
Show notes
“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and support their recovery. Also discover blind spots in detox and rehab centers.
🔹 Explore ACP’s Substance Use Disorder Education Hub for videos and an AI-powered patient simulation to practice alcohol-use conversations: https://www.coreimpodcast.com/SUDhub
Alcohol Use and Chronic Health Conditions Mini Video Series
01:55 | #1: Naltrexone
12:06 | #2 Acamprosate
16:15 | #3: Topiramate
21:12 | #4: Other meds
29:31 | #5: Detox and rehab blind spots
Tags: CoreIM, Medical Education, Addiction Medicine, Alcohol Withdrawal, Addiction Treatment, GLP-1, pharmacology
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Privacy & Opt-Out: https://redcircle.com/privacy#216 Clinician Grief: At the Beside Segment
Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always …
Show notes
Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always obvious. We also discuss ways to work through that grief, recognize when it becomes complicated, and lean on your team for support.
04:12 | What is Clinician Grief?
10:02 | Types of Losses
10:22 | Loss of a close relationship with a particular patient
12:56 | Loss due to a professional's identification with the pain of family members
13:56 | Loss of one's unmet goals and expectations and one's professional self-image and role
18:47 | Loss related to one's personal system of beliefs and assumptions about life
21:30 | Past unresolved losses or anticipated future losses
23:29 | The death of the self
25:44 | Coping
Tags: CoreIM, Medical Education, Clinician Wellbeing, Burnout, Secondary Traumatic Stress, Complicated Grief, Coping With Grief, Medical humanities, medical ethics
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Privacy & Opt-Out: https://redcircle.com/privacy#215 Gallbladder & Biliary Testing: 5 Pearls Segment
How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about …
Show notes
How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about sphincterotomy, stents, and stone removal? Plus, how to interpret bile duct dilation without jumping straight to obstruction?
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🔹Transcript and Shownotes
02:11 | Pearl 1: Gallbladder Problems Spectrum
07:33 | Pearl 2: Choose Imaging Strategically: Start with RUQUS, Escalate as Needed
14:34 | Pearl 3: Biliary Tree Diagnostics
19:19 | Pearl 4: Invasives that are Diagnostic and Therapeutic
27:06 | Pearl 5: Stenting in ERCP
Tags: CoreIM, Internal Medicine, Medical Education, Gallstones, Cholecystitis, Biliary Disease, ERCP, Biliary Imaging
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Privacy & Opt-Out: https://redcircle.com/privacy#214 Hyponatremia Management: A Core IM Classic
Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you …
Show notes
Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia management, from fluids and solutes to loop diuretics and identifying the underlying cause.
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6:46 | Pearl 1: Key Principles
15:13 | Pearl 2: Fluids in hyponatremia
26: 03 | Pearl 3: Solutes in hyponatremia management
35:49 | Pearl 4: Lasix in hyponatremia management
40:05 | Pearl 5: Etiologies
Tags: CoreIM, Internal Medicine, Medical Education, SIADH, Fluid Restriction, Nephrology, Hospital Medicine, Urine Osmolality
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Privacy & Opt-Out: https://redcircle.com/privacy#213 Hypertension First-Line Medications Troubleshooting | Bread & Butter Series
Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the …
Show notes
Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers, Thiazides) is the preferred first-line framework, and how to personalize medication choices based on comorbidities and side effects.
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03:00 | Diagnosing Hypertension
04:10 | When to Start Combination Therapy Instead of Monotherapy
07:00 | Choosing First-Line Therapy Using the ACT Framework
13:23 | Why ARBs Are Often Preferred Over ACE Inhibitors
16:02 | Choosing the Right ARB: Candesartan vs Losartan
18:39 | Comparing Potency & Duration Across First-Line Antihypertensives
20:54 | Amlodipine Edema: Why It Happens and How to Fix It
23:54 | Thiazides: Practical Tips, Electrolyte Problems & Class-Killer Side Effects
29:33 | Managing Patients Who 'Can't Tolerate' Blood Pressure Medications
Tags: Hypertension Management, High Blood Pressure, Primary Care, Internal Medicine, Core IM
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Privacy & Opt-Out: https://redcircle.com/privacy#212 Top 10 Highlights of the New Lipid Guidelines
Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines! Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change …
Show notes
Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines! Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change statin decisions, why LDL targets are back, and when to use Lp(a), ApoB, and coronary artery calcium (CAC) testing. Discover updated risk-enhancing factors, expanded indications for non-statin therapies, and practical strategies to personalize lipid management for both primary and secondary
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01:17 | Highlight #1 & #2: CPR and PREVENT Score
03:14 | Highlight #3: Updated ASCVD Risk Categories Using the PREVENT Score
05:30 | Highlight #4: LDL Targets Are Back
07:20 | Highlight #5: High-Risk Conditions That Bypass the PREVENT Score
08:41 | Highlight #6: Lp(a) Screening for Everyone
11:51 | Highlight #7: When to Use ApoB Testing
13:16 | Highlight #8: Reproductive Risk Factors
15:29 | Highlight #9: Using CAC to Guide Statin Therapy
19:09 | Highlight #10: Non-Statin Therapies
Tags: CoreIM, Internal Medicine, Medical Education, Cholesterol, Statins, LDL, ASCVD, Preventive Cardiology, LpA, ApoB, CAC, ACC2026, Cardiology, PrimaryCare
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Privacy & Opt-Out: https://redcircle.com/privacy#211 Breaking Down MASLD vs. MASH and the MAESTRO-NASH & ESSENCE Trials: Beyond Journal Club Segment
MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a …
Show notes
MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we finally entering an era where we can meaningfully treat MASH?
In this Beyond Journal Club episode, we unpack the evolving language of steatotic liver disease and take a close look at two major trials: MAESTRO-NASH studying resmetirom, the first FDA-approved liver-directed therapy for MASH, and ESSENCE, evaluating semaglutide in biopsy-confirmed disease.
Along the way, we explore what these biopsy-based histologic endpoints really mean, why placebo responses were surprisingly high, and whether improvements in steatohepatitis and fibrosis will ultimately translate into better clinical outcomes for patients.
This episode is for clinicians trying to understand where the field is headed, which patients deserve closer attention, and how metabolic liver disease is increasingly becoming part of everyday primary care and hospital medicine.
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01:57 | Understanding MASLD as a Systemic Disease
05:45 | MASLD vs MASH vs Met-ALD: Spectrum Steatotic Liver Disease
08:55 | How to Screen for Fibrosis (FIB-4 & FibroScan)
16:15 | Lifestyle Treatment & Weight Loss Targets
19:00 | ESSENCE Trial: Semaglutide for MASH
21:58 | MAESTRO-NASH Trial: Resmetirom
27:27 | Future Treatments for MASH
30:51 | Key Takeaways for Clinicians
Tags: CoreIM, Internal Medicine, Medical Education, Hepatology, Fatty Liver Disease, Metabolic Dysfunction Associated Steatohepatitis, Nonalcoholic Fatty Liver Disease, Liver Fibrosis
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Privacy & Opt-Out: https://redcircle.com/privacy#210 HTN in Dialysis: 5 Pearls Segment
What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on …
Show notes
What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability, antihypertensive selection, and strategies to prevent intradialytic complications while optimizing long-term outcomes.
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02: 19 | Pearl 1: Blood Pressure Targets
09: 40 | Pearl 2: Timing Medications and Dialyzability
15: 31 | Pearl 3 - Pharmacologic Management Nuances in Dialysis Patients
22: 57 | Putting It All Together: The Medication Hierarchy
Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, ESRD, End-Stage Kidney Disease, Hypertension, Kidney Health, Dry Weight, Volume Overload
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Privacy & Opt-Out: https://redcircle.com/privacy#209 Dialysis and Fluid Management: 5 Pearls Segment
Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis, why ESKD patients have unique physiology, and how volume overload, not just …
Show notes
Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis, why ESKD patients have unique physiology, and how volume overload, not just hypertension, drives many complications. Learn practical pearls on dry weight, sodium restriction, diuretics, and the strategies that can reduce hospitalizations and improve patient outcomes.
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02:49 | Pearl 1: Foundations of Dialysis
09:21 | Pearl 2: Distinct Physiology
11:42 | Pearl 3: Why is fluid management so important?
19:43 | Pearl 4: Fluid Management Pro-tips
25:31 | Pearl 5: Diuretics in Patients with Residual Kidney Function
Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, Dialysis, End-stage kidney disease, Hypertension, Kidney Health, Dry Weight, Volume Overload
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Privacy & Opt-Out: https://redcircle.com/privacy#208 AI vs. Human with Post-Op AFib: Bread & Butter Series
Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical …
Show notes
Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between algorithms, uncertainty, and human judgment in modern medical care.
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02:51 | Broad workup for reversible causes and other etiologies of AFib that may occur post-op
05:10 | Considerations for management of post-op atrial fibrillation
13:00 | Stroke risk in atrial fibrillation
20:49 | Outpatient management of atrial fibrillation
25:54 | The role of AI in medical decision-making
Tags: CoreIM, Internal Medicine, Medical Education, Atrial Fibrillation, Cardiology, Open Evidence
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Privacy & Opt-Out: https://redcircle.com/privacy#207 Is There a Doctor on Board? In-Flight Emergencies
We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes …
Show notes
We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but hopefully less than before.
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04:40 | Emergency Medical Kit (EMK) Standard Contents
08:50 | Role of Ground-Based Medical Support & Flight Diversion Decision-Making
19:35 | Interpreting Hypoxia at Altitude
22:06 | In-Flight Liability
23:35 | Common Chief Concerns & Useful Additional Medications
24:53 | How to Be Resourceful in an Austere Environment
Tags: CoreIM, Internal Medicine, Medical Education, In-flight Care, Medical Emergencies, Clinical Reasoning, Seizure Management, Hypoxia, Airway Management, Cardiac Emergency, Syncope, Respiratory Distress
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Privacy & Opt-Out: https://redcircle.com/privacy#206 Eosinophilia: 5 Pearls Segment
Can you distinguish benign eosinophilia from a sign of serious disease, and know exactly when to act at the bedside?In this high-yield episode, test your clinical reasoning as we tackle:When eosinophilia …
Show notes
Can you distinguish benign eosinophilia from a sign of serious disease, and know exactly when to act at the bedside?
In this high-yield episode, test your clinical reasoning as we tackle:
- When eosinophilia becomes dangerous and why it matters
- How to distinguish if its from atopy vs. systemic disease
- Which medications to stop (and which to watch)
- How travel, diet, and exposure history shape your workup
- When to suspect malignancy before giving steroids
02:34 | Why Do We Care About Eosinophilia? (Pearl 1)
10:24 | Atopy and Eosinophilia (Pearl 2)
18:57 | Drugs and Eosinophilia (Pearl 3)
27:29 | ID and Eosinophilia (Pearl 4)
33:54 | Pearl 5: Eosinophilia, Steroids, and Neoplasms (Pearl 5)
Tags: CoreIM, Internal Medicine, Medical Education, Eosinophilia, Hypereosinophilia, Allergy Immunology, Hematology, Pulmonology, Parasitic Infections, Atopy
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Privacy & Opt-Out: https://redcircle.com/privacy#205 Nutrition Studies, Coffee and the CRAVE Trial: Beyond Journal Club with the NEJM Group
Is coffee helping or harming our patients’ hearts?In this Beyond Journal Club, we unpack the CRAVE trial and use it as a lens to answer a bigger question:How should clinicians interpret nutrition research …
Show notes
Is coffee helping or harming our patients’ hearts?
In this Beyond Journal Club, we unpack the CRAVE trial and use it as a lens to answer a bigger question:
How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust?
Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle.
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00:00 | Challenges of interpreting nutritional research.
02:22 | Best practices for evaluating studies in nutrition.
12:35 | Delve into the CRAVE trial as an example of critically appraising nutritional investigations.
26:41 | Applying this to clinical practice for your patients.
Tags: IMCore, Internal Medicine, Medical Education, Epidemiology, Diet and Lifestyle
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Privacy & Opt-Out: https://redcircle.com/privacy#204 Diabetic Foot Infections & Osteomyelitis: 5 Pearls Segment
Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students …
Show notes
Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach.
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02:15 | Pearl 1: Pathophysiology
08:20 | Pearl 2: Diagnosis
16:35 | Pearl 3: Treatment
20:35 | Pearl 4: Antibiotics
27:39 | Pearl 5: Wound Care
Tags: CoreIM, Internal Medicine, Medical Education, Diabetic Foot Infections, Osteomyelitis, Foot Ulcer, Wound Care
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Privacy & Opt-Out: https://redcircle.com/privacy#203 POCUS for AKI & Dialysis | Real Cases That Changed Management
A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?A patient arrives …
Show notes
A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?
A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?
A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter?
And the classic inpatient dilemma: your heart failure patient looks better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going?
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See here for Neph Madness details
See here for the POCUS region of NephMaddness
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00:52 | What is NephMadness?
02:19 | Detecting post-renal obstruction in a patient who reported normal urination
11:26 | POCUS for discharge or continue diurese
17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound
23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis line
Along the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside.
If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question.
Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUS
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Privacy & Opt-Out: https://redcircle.com/privacy#202 Dementia Part 2: Gray Matters Segment
Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to …
Show notes
Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them.
• Do cholinesterase inhibitors really work?
• What should clinicians know about lecanemab and donanemab before referring patients?
• How much benefit should we expect and for how long?
• When should you deprescribe dementia medications?
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02:27 | Deep Dive 1: How do we deliver the news of a diagnosis of dementia?
09:41 | Deep Dive 2: Prescribing medications for cognitive decline
29:30 | Deep Dive 3: Patient-centered management for a patient with cognitive decline
35:46 | Deep Dive 4: Planning for an uncertain future
Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy#201: Dementia Part 1: Gray Matters Segment
Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do …
Show notes
Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI?
🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com
01:12 | Cognitive Concerns During a Routine Follow-Up
03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues?
15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline?
31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline?
Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacy#200: Insulin and QWINT-1 Trial in T2DM: Beyond Journal Club Segment with NEJM Group
From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you …
Show notes
From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden.
🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/
00.58 | Insulin Hx & Types
06:00 | Indications for Insulin and the Burden on Patients
08:26 | What is the QWINT-1 Trial?
16:18 | Discussion
Tags: CoreIM, Internal Medicine, Evidence-Based Medicine, Insulin Resistance, Clinical Reasoning, Hospital Medicine, Medical Education, Endocrine, Endocrinology
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Privacy & Opt-Out: https://redcircle.com/privacy#199 Privacy & Confidentiality: At the Bedside Segment
Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if …
Show notes
Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside, learn how clinicians should act when ethics, law, and trust collide.
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03:51 | What is the difference between Privacy and Confidentiality?
05:50 | Guidelines and laws
10:06 | Limits/appropriate breaches (competing principles/obligations)
22:03 | Privacy vs education
35:34 | Conclusion
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Privacy & Opt-Out: https://redcircle.com/privacy#198 Microskills for Change That are Big Enough to Matter, Small Enough to Win
Baby alligators - those betrayals of purpose , or, death by a thousand paper cuts !Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:Regulated …
Show notes
Baby alligators - those betrayals of purpose , or, death by a thousand paper cuts !
Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:
Regulated curiosity
Strategic empathy
Small, well-chosen moves...
...and change that is big enough to matter, and small enough to win!
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00:00 | What are “baby alligators” in medicine?
02:24 | Rifaximin & Workflow Fixes
14:17 | Verbal Orders Policy
18:39 | Micro Skills for Change
25:12 | Key Takeaways
#PhysicianBurnout #DoctorLife #HealthcareEfficiency, CoreIM, Internal Medicine, Career Development, Quality Improvement, QI
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Privacy & Opt-Out: https://redcircle.com/privacy#197 Hypercoagulability Part 2: 5 Pearls Segment
Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?When dose-reduced DOACs make sense for long-term secondary prevention? …
Show notes
Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?
When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.
🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/
(2:56) - (13:15) | PEARL 1: Managing clots in the “unprovoked”/provoked-irreversible patient
(13:21) - (18:10) | PEARL 2: Managing provoked, “reversible” clots
(18:14) - (25:14) | PEARL 3: DOAC failure: time to step it up?
(25:20) - (37:25) | PEARL 4: APLAS: the exception to everything
Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematology
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Privacy & Opt-Out: https://redcircle.com/privacy#196 Stories of Courage and Career Development with Horn Award
We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.🔹 Sponsor: Oakstone CMEUse the code "CORE30" …
Show notes
We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.
🔹 Sponsor: Oakstone CME
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP
(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life
(10:28) | How Dr. Carol Ward Created the Horn Award and Honored Mary Horn’s Legacy
(14:16) | Dr. Hilit Mechaber’s Story of Courage, Vision, and Impact Beyond the Award
(17:55) | Why does the Horn Award Matter?
Tags: CoreIM, Internal Medicine, Career Development Award, Mary O'Flaherty Horn Award, Clinical Care, Scholarship, Teaching, Leadership, Wellness and Care, Family Responsibilities
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Privacy & Opt-Out: https://redcircle.com/privacy#195 Antibiotic Duration & BALANCE Trial: Beyond Journal Club with NEJM Group
Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and …
Show notes
Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?
🔹 Sponsor: Oakstone CME
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Timestamp
(02:58) | Host, Organism, Source: The Core Framework Behind Duration
(09:02) | How Evidence Shifted Practice
(11:27) | The BALANCE Trial: Short-Course vs Standard-Course Therapy
(18:55) | Where does this leave us?
Tags: CoreIM, Internal Medicine, Infectious disease, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education
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Privacy & Opt-Out: https://redcircle.com/privacy#194: Severe Hypertriglyceridemia: 5 Pearls Segment
How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which …
Show notes
How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?
(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast
(05:27) | Triglycerides as a Cardiovascular Risk Marker
(09:28) | Acute Management For Pancreatitis induced by Triglycerides
(14:34) | Lifestyle Counseling
(17:31) | Medications That Lower Triglycerides
(25:29) | How to Choose the Right Triglyceride Therapy
(27:56) | Genetic Causes and When to Suspect Familial Disorders
Tags: CoreIM, Internal Medicine, Lipidology, lipid, Cardiology, Metabolic Health, Triglycerides, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education, primary care
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