The Curbsiders Internal Medicine Podcast

Robert Centor, seasoned internist and Chair of Medicine known for practical clinical teaching. Rapid-fire discussion covers updated ASCVD risk estimates and statin implications. Debates CT pulmonary angiography’s ability to rule out PE and outpatient management of low-risk PE. Reviews metformin safety at lower eGFR, SGLT2 renal effects, MOUD after overdose, expanded diabetes screening, and quirky links like nose-picking and neckties.

Paul E. Sax, infectious diseases expert and Harvard professor known for clinical teaching and writing, guides a tour of Lyme and tick-borne illnesses. He covers recognizing rashes and where ticks bite. He explains limits of testing, when to treat, doxycycline tips, co-infections like Babesia and Anaplasma, tick removal, prophylaxis decisions, and practical prevention steps.

In this episode, Joel Topf, Chief of Nephrology at Kashlak Memorial Hospital and known as @Kidney_Boy, breaks down renal tubular acidosis (RTA) with humor and insight. He discusses the three types of non-gap metabolic acidosis and dives into common causes and treatment challenges. The conversation highlights the kidney's role in acid-base balance and the implications of choice in IV fluids. Joel also shares valuable insights from clinical cases, making a complex topic accessible and engaging for both professionals and enthusiasts in nephrology.

Dr. Gurpreet Dhaliwal, a Professor at UCSF and an expert in clinical education, shares his insights on mastering medical expertise. He discusses the essentials of brain training and the significance of feedback, simulation, and mentorship in honing clinical skills. Dr. Dhaliwal emphasizes active learning through challenging cases and practical strategies for improving knowledge retention. He highlights how structured practice can enhance decision-making and ultimately lead to better patient care, making this a valuable listen for any medical professional.

The podcast discusses topics such as asthma inhaler use, smoking cessation, procalcitonin in respiratory infections, new colorectal cancer screening guidelines, cannabis use and cognitive impairment, and the association between LDL cholesterol and cardiovascular mortality.

Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Cyrus Askin MD Infographics: Beth Garbitelli Produced by: Cyrus Askin MD and Matthew Watto MD Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Scott Matherly MD Time Stamps 00:00 Announcements 00:54 Disclaimer 01:30 Guest bio 02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis 06:56 Clinical case of decompensated cirrhosis 09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics 18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin 25:10 Timing of medical therapy 26:39 MAP of 82 mmHg, beta blockers and variceal bleeding 31:04 Use of midodrine for hypotension 33:45 Prophylaxis of SBP 36:05 Take home points 38:04 Outro Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

Cirrhosis. Finally. Take your liver game to the next level with tips from @liverprof, Scott Matherly MD, Assistant Professor of Medicine at Virginia Commonwealth University. Topics include: exam findings in cirrhosis, interpreting liver function tests, incidental cirrhosis on imaging, fatty liver disease, steatohepatitis, hep c, shear wave elastography, screening for varices and hepatocellular carcinoma, pathophysiology, and lifestyle measures for initial management. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at  acponline.org/curbsiders (goes live at 9am on release date).Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Cyrus Askin MD CME questions by: Cyrus Askin MD Produced by: Cyrus Askin MD and Matthew Watto MD Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Scott Matherly MD

Step up your primary care of cancer survivors with tips from Dr Regina Jacob, Assistant Professor of Medicine at Temple University. Care of the cancer patient does not end when their cancer treatment is over, and there is more to a past diagnosis of cancer than surveillance. We discuss cancer survivorship care with Dr. Regina Jacob, including the changing demographics of survivorship, the importance of survivorship care plans, and how survivorship is largely just good primary care. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Paul Williams MD Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD Produced by: Paul Williams MD Edited by: Matthew Watto MD Guest: Regina Jacob MD  Time Stamps 00:00 Disclaimer 00:35 Intro to the topic and guest bio 02:15 Guest one liner, book and app recommendations 06:58 Paul’s pick of the week. 07:40 Clinical case, definitions, and phases survivorship 12:36 Survivorship statistics 15:04 Co-survivorship 17:41 Care models for survivorship 20:56 Assigning roles in care of cancer survivors 22:59 Sample survivorship care plan 27:39 Childhood, adolescent and young adult cancer survivorship 34:18 Sexual dysfunction in cancer survivorship Turn down Watto and Regina tracks 35:56 Stressors in young adult cancer survivors 37:33 Fatigue 43:28 Guidelines on survivorship 45:06 Late cardiac toxicity 46:23 Support groups and resources 49:04 Take home points 50:29 Outro 

Dr. Ted Parks, an orthopedic surgeon and clinical professor, shares his expertise on managing knee pain. He breaks down the four buckets of knee pain and teaches a quick 30-second knee exam that's a game-changer for practitioners. Discussions include choosing the right knee brace, identifying red flags in history taking, and insights into effective injections like cortisone and PRP. Dr. Parks emphasizes the importance of thorough assessments and innovative approaches to treatment, making knee pain a less daunting challenge.

A brisk journal-club romp through recent literature on blood pressure monitoring, treatment strategies, and the mortality links of ambulatory, white coat, and masked hypertension. Rapid-fire takes cover prostate cancer screening changes, intimate partner violence screening, alcohol and mortality, diabetes drug mortality data, DPP-4 inhibitors and IBD risk, teaching hospital mortality differences, biomarker-guided therapy, and lifestyle factors for longevity.