Core IM | Internal Medicine Podcast

Discover the critical implications of long-term proton pump inhibitor (PPI) therapy, especially in elderly patients. Learn about the potential risks like vitamin B12 deficiency and osteoporosis. Find out effective strategies for discontinuing PPI use and managing symptoms through lifestyle changes. Explore how to properly time PPI administration to maximize benefits in treating GERD. Finally, dive into five essential insights that enhance patient education and care related to PPIs.

Explore a clinical case of a 57-year-old woman with confusion and word finding difficulties, emphasizing the challenges of diagnosing patients with incomplete medical histories. Delve into a medical mystery involving ambiguous symptoms and the importance of creating multiple causal models for diagnostics. Navigate the complexity of clinical diagnoses and the risks of overfitting data. Unpack the challenges of dealing with diagnostic uncertainty in medicine and the ethical responsibility of sharing uncertainties with patients.

Lets go deeper into the misunderstood side of Vancomycin!Where did vancomycin come from, and why is it so controversial? (0:28)What is vancomycin-induced nephrotoxicity and how common is it? (4:37)Vancomycin trough monitoring – what is it good for? (7:28)AUC to MIC ratio – the real math behind vancomycin dosing (7:53)Review of teaching points (10:27)Full show notes: https://www.coreimpodcast.com/2018/08/01/mind-the-gap-vancomycin/Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dr. Kate Lawrence, a third-year internal medicine resident at NYU, and Dr. Jennifer McNeely, an associate professor specializing in addiction medicine, delve into the nuances of unhealthy alcohol use. They clarify the distinction between alcohol use disorder and unhealthy drinking patterns. The conversation covers crucial screening methods, the implications of moderate alcohol consumption, and the importance of tailored assessments. The duo also highlights screening strategies for hepatocellular carcinoma in chronic hepatitis B patients, emphasizing collaboration in primary care.

Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here:Part one of case (0:56)Cognitive ease and strain (03:51)Metacognition and routine diagnostic timeout (08:15)Think outside the box of organ systems (11:19)Illness behavior (12:30)Part two of case (14:06)Algorithms (17:57)Fast thinking & pattern recognition (19:30)Slow thinking & analytical reasoning (21:31)Diagnosis (25:15)Takeaways (26:52)For full show notes: https://www.coreimpodcast.com/2018/06/27/hoofbeats-54m-with-diarrhea/Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Be inspired by why so many are proud to be in General Internal Medicine (GIM)!Episode page: https://www.coreimpodcast.com/2018/06/23/celebrating-proudtobegim/Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Let’s take your breath away… with a review on steroids in treating COPD exacerbations!Time StampsHow does GOLD (Global Initiative for Chronic Obstructive Lung Disease) define a COPD exacerbation? (2:44)What outcomes do steroids actually improve in treating a COPD exacerbation? (5:08)What is the evidence behind a 5 day steroid “burst”? (7:20)Are IV steroids more powerful than PO? (9:00)For full show notes: https://www.coreimpodcast.com/2018/05/30/mind-the-gap-steriods-in-copd/Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dive into the world of contrast-induced nephropathy (CIN) with engaging insights on its diagnostic criteria and risk factors. Discover how intra-arterial and intra-venous exposures differ in risk. Learn about preventive measures that can significantly reduce CIN and how even hemodialysis patients can face this challenge. The discussion is enriched with humor and critical analysis, making complex topics more accessible. Don't miss the recap that ties all these pearls of wisdom together!

Dissect an interesting case and think about the way clinicians think! So many clinical reasoning pearls here:Part 1 Case (2:05)Framing bias (7:07)Data-driving reasoning (11:48)Hypothesis-driven approach (12:38)Periodic paralysis syndromes (16:08)Representativeness heuristic (17:26)Part 2 Case (20:51)Pivot Points (31:36)Diagnosis (35:55)Take aways (37:20)Check out the key teaching points: https://www.coreimpodcast.com/2018/05/02/hoofbeats-a-36f-with-weakness/Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Solidify your knowledge on adrenal insufficiency! Quiz yourself on the 5 pearls we will be covering:What are signs and symptoms of chronic adrenal insufficiency (AI)? What is the most sensitive? (2:02)How do we diagnose and differentiate types of adrenal insufficiency? (6:05)How sensitive and specific are the diagnostic tests for AI & at what cutoffs? (12:06)Can we both test and treat adrenal insufficiency at the same time? (16:40)Throwback: How do hypokalemia and hepatic encephalopathy connected? (24:55)Dr. Nidhi Agrawal Recap (19:20)For full show notes: https://www.coreimpodcast.com/2018/04/18/5-pearls-chronic-adrenal-insufficiency/Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy