Core IM | Internal Medicine Podcast – Details, episodes & analysis

Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”

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Transcript and Show notes

Cardiorenal Considerations: 5 Pearls Segment

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension

(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output

(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion Pressure

Tags: IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical care

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Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.

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Show notes & transcripts

Behind the Scenes YouTube Interview

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(02:44) | What makes this patient different from others with similar symptoms or diagnosis?

(07:28) | Does your covering team have the tools to follow up on tasks and information they need for success? 

(16:06) | Is the handoff updated? 

(18:26) | What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients? 

(22:41) | What are we still uncertain about? 

(25:30) | Closing thoughts 

Tags: IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalist

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How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula?  What is a Fishbane reaction? And how is it different from anaphylaxis?

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Behind the Scenes YouTube Interview

Transcript and Show Notes

Time stamps:

(02:09) | Spaced repetition from the last Gray Matters Episode

(05:29) | Choosing between oral and IV iron

(11:17) | Considerations with oral iron repletion

(24:02) |Considerations with IV iron repletion

(32:36) | Complications and side effects of IV iron

Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant

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Episode Outline

1. Disconnection/connection: Patients
2. Disconnection/connection: Family/friends
3. Disconnection: Security, Certainty
4. Connection: Other clinicians

• Sharing fears, supporting each other)
• Shared ethos in healthcare (one workforce, no division of specialty or hierarchy)

1. Conclusion: Post-traumatic growth / Peri-Traumatic Growth

Thank you to everyone we interviewed, particularly to the voices you heard:

Dr. Kimberly Manning (@gradydoctor)

Dr. John Hwang (Hoofbeats segment)

Dr. Steve Liu (Mind the Gap segment)

Dr Katherine Arthur

Dr. Maria Garcia-Jimenez

Dr. Kelsey Luoma

Hosts:

Dr. Margot Hedlin (@MargotHedlin) - Introduction and Ending

Dr. Tamar Schiff

Dr. Michael Shen (also audio editing)

Dr. Jafar Al-Mondhiry (@mondhiry)

 

tags: COVID19, COVID-19, CoreIM, coronavirus, narrative medicine

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What is your approach to goals of care conversations, particularly during COVID-19? How do you navigate some of the new challenges with COVID19?

Show notes, transcript and references: https://www.coreimpodcast.com/2020/04/22/goc-on-inpatient-service-during-covid-19/

Time stamps:

• 05:54 Laying the groundwork
• 08:56 Asking permission, eliciting values and making a recommendation
• 15:55 When a patient is dying
• 16:42 Sharing the prognosis first
• 20:28 Functional status post-CPR
• 21:52 Headline statement
• 23:40 Virtual and PPE Communication Challenges
• 25:28 Separate process from outcome

Tag: coronavirus, COVID, CoreIM, Sars-cov-2, medicine floors, wards, advanced care planning

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How do you organize your day? How do you minimize exposure of yourself and your colleagues? What are the new things to keep in mind with discharging patients?

Show notes, transcripts and references:

CME Credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time Stamps

• 02:37 Entrance and Exit strategy
• 04:25 Prioritizing patient acuity
• 08:14 PPE uses
• 11:11 Respiratory concerns in COVID-19 patients
• 16:35 Patient examination
• 18:49 Family updates
• 20:56 Oxygen requirements
• 23:12 Medications
• 24:08 Discharging patients
• 31:00 What we mean by isolation

tag: coronavirus, COVID, CoreIM, sars-cov-2, medicine wards

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Practical tips on starting estrogen or testosterone on patients who are transgender and approach to primary care with cancer screening.

CME Credit with ACP; https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Show notes, transcripts, and references: https://www.coreimpodcast.com/2020/04/01/5-pearls-on-transgender-health-hormone-therapy-and-preventive-screening/

Time Stamps:

• 02:54 Hormone therapy contraindications
• 07:09 Time course for hormone changes
• 10:21 Hormone risks
• 19:09 Hormone treatment options
• 25:22 Preventative Care Screening

Tags: CoreIM, gender affirming care

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Practical tips on Gender Affirming Care!

Show notes, transcript and references

Time Stamps:

• 02:43 The Gender Unicorn and how it helps us better understand gender identity, expression, and sex assigned at birth
• 11:15 Gender dysphoria
• 14:16 The organ or anatomical inventory
• 16:46 The inevitability of mistakes
• 18:39 Ways to ensure gender-affirming care in clinic

 

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What goes into a capacity assessments? Is it just reciting risks, benefits and alternatives? Explore this and more on this At the Bedside Episode!

Show notes, Transcript and References: https://www.coreimpodcast.com/?p=22310

Time Stamps:

• 2:04 Introduction to decision making
• 4:12 Choice
• 8:24 Understanding
• 11:22 Appreciation
• 13:58 Reasoning
• 21:55 Common myths and misconceptions
• 25:11 When and how to call a psychiatry consult for capacity assessment
• 27:47 Conclusion

Tags: CoreIM, AMA Discharges, Psych, Competency, medical ethics, medical humanties

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• What are the new guidelines for influenza treatment? What are the diagnostic ratios of flu symptoms and tests? Time Stamps03:10 The art of diagnosing the flu
• 05:17 Bayesian statistics and the diagnostic odds ratio
• 07:09 The ins and outs of diagnostic testing for the flu
• 08:44 Changes in influenza guidelines - testing and treatment
• 11:17 The not-so-rosy origin story of neuraminidase inhibitors (NAIs)
• 13:47 Neuraminidase inhibitors (NAIs), mortality benefit and limitations of studies
• 15:49Take aways

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