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Core IM | Internal Medicine Podcast

Updated 13 days ago

Rank #13 in Business News category

Education
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Business News
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Core Internal Medicine via following segments:5 Pearls || Clinically relevant pearls on IM topics!Mind the Gap || Why do we do what we do?Hoofbeats || Dissecting clinical reasoning!

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Core Internal Medicine via following segments:5 Pearls || Clinically relevant pearls on IM topics!Mind the Gap || Why do we do what we do?Hoofbeats || Dissecting clinical reasoning!

iTunes Ratings

511 Ratings
Average Ratings
470
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8
8
4

Great podcast!

By het_111 - Jun 14 2019
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Easy to digest and great sound quality!

Great learning resource

By roomto - Jun 04 2019
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Very well produced. I learn a lot each time.

iTunes Ratings

511 Ratings
Average Ratings
470
21
8
8
4

Great podcast!

By het_111 - Jun 14 2019
Read more
Easy to digest and great sound quality!

Great learning resource

By roomto - Jun 04 2019
Read more
Very well produced. I learn a lot each time.
Cover image of Core IM | Internal Medicine Podcast

Core IM | Internal Medicine Podcast

Latest release on May 20, 2020

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Core Internal Medicine via following segments:5 Pearls || Clinically relevant pearls on IM topics!Mind the Gap || Why do we do what we do?Hoofbeats || Dissecting clinical reasoning!

Rank #1: #49 Smoking Cessation: 5 Pearls Segment

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Practical tips on smoking cessation! Get CME Credit with ACP!

Full Transcript with References and Show Notes

Time Stamps

  • 04:50 What questions are important to ask after a patient who contemplative about quitting tobacco?
  • 07:00 Is quitting abruptly on a quit date or gradual cessation to a quit date better?
  • 08:10 How can technology help support patients who are trying to quit?
  • 08:49 How should we prepare patients who quit smoking and are worried about weight gain?
  • 11:06 How can we try to convince patients to use medication as assistance to quit smoking?
  • 11:50 What is the most effective nicotine replacement approach?
  • 13:54 What are the potential side effects of the nicotine patch?
  • 15:00 What should we prescribe for patients who smoke <5 cigarettes a day?
  • 16:28 How can we determine how severe a patient’s nicotine dependence is?
  • 18:26 When is the ideal frequency of nicotine gum or lozenge?
  • 21:45 How does varenicline work?
  • 25:05 Can you start varenicline in patients who have had psychiatric history?
  • 27:15 What major side effect is seen in patients taking bupropion?
  • 29:15 How do e-cigarettes work?
  • 31:18 How should we approach adding e-cigarettes into a patient’s plan for quitting?
  • 31:42 How should we discuss e-cigarette use with our patients?
  • 33:47 Recap
  • 39:54 Screening for Barrett’s Esophagus

Sep 18 2019

42mins

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Rank #2: #53 Heparin-Induced Thrombocytopenia: 5 Pearls Segment

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Get CME Credit with ACP! Full Transcript with references and show notes
Time Stamps
  • 4:30 What is the daily risk of thrombosis if HIT Is left untreated?
  • 5:40 What happens during platelet activation?
  • 07:11 How long does it take for patients to develop for IgG antibodies to Heparin to form?
  • 09:52 Is HIT common?
  • 10:28 Who is at higher risk for HIT?
  • 11:48 Why does low molecular weight heparin have a lower risk for HIT than unfractionated heparin?
  • 15:30 Approach to thrombocytopenia
  • 17:44 How do medications cause thrombocytopenia?
  • 18:38 With medications, what is the time course between medication initiation and thrombocytopenia?
  • 22:20 What is the sensitivity and specificity of anti-PF4 antibody?
  • 23:58 How does the serotonin-release assay (SRA) work?
  • 29:10 What type of anticoagulant do you choose for treating HIT?
  • 31:58 Why is it important to not use warfarin in patients with platelet counts <150,000?
  • 33:32 What is the treatment duration for a patient has confirmed HIT?
  • 36:29 Dr. Cuker’s story and the "Scarlet H"
  • 39:07 Dr. Linkin’s Recap
  • 42:25 Dr. Linkin’s story
  • 44:37 Pearl 5: Throwback to coronary calcium scores

Nov 13 2019

47mins

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Rank #3: 5 Pearls Ep2: Iron Deficiency Anemia

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Solidify your knowledge on iron deficiency anemia! Quiz yourself on the 5 Pearls we will be covering:
  1. Should patients be screened for iron deficiency? If so, who and how often? (1:40)
  2. What are the indications for diagnostic endoscopy in iron deficient patients? (3:23)
  3. How should you advice patients to take oral iron? (5:53)
    • What is optimal dosing for oral iron?
  4. In which patients would you consider IV iron? What are the risks? (11:41)
  5. Throwback Question: What is a medication-overuse HA? (14:44)
For full shownotes: https://www.coreimpodcast.com/2017/11/15/5-pearls-on-iron-deficiency-anemia/

Nov 15 2017

17mins

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Rank #4: #39 Stress Testing: 5 Pearls Segment

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Solidify your knowledge on stress tests! Quiz yourself on the 5 pearls we will be covering:

  • What are the indications for a stress test? (2:18)
  • How to choose  stress protocol in a stress test? (8:29)
  • How to choose diagnostic modality in a stress test? (14:46)
  • How do we interpret results from stress tests, and how should this be communicated to patients? (24:08)
  • Pearl Recap (31:13)
  • Risk of contrast induced nephropathy between arterial and venous contrast load (36:02)

For full transcript, infographic and show notes: https://www.coreimpodcast.com/2019/04/24/stress-testing/

Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology

Apr 24 2019

40mins

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Rank #5: #22 Proton-Pump Inhibitors: 5 Pearls segment

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Solidify your knowledge on Proton-Pump Inhibitors (PPIs) and more! Quiz yourself on the 5 pearls we will be covering:

  1. What are associated adverse effects for patients are on long-term PPIs? (2:02)
  2. What are strategies to get your patient off PPIs?  (10:57)
  3. How do histamine-2 (H2) receptor antagonists blockers work and how can it explain why H2 blockers might not be as effective as PPIs? (13:30)
  4. How should you educate patients to take PPIs to get the maximize benefit? (16:48)
  5. How do you manage ongoing symptoms in patients on PPIs? (21:41)

For full transcript of the podcast and references: https://www.coreimpodcast.com/2018/08/29/5-pearls-on-ppis/

Aug 29 2018

27mins

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Rank #6: #13 Chronic Adrenal Insufficiency: 5 Pearls segment

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Solidify your knowledge on adrenal insufficiency! Quiz yourself on the 5 pearls we will be covering:

  1. What are signs and symptoms of chronic adrenal insufficiency (AI)? What is the most sensitive? (2:02)
  2. How do we diagnose and differentiate types of adrenal insufficiency? (6:05)
  3. How sensitive and specific are the diagnostic tests for AI & at what cutoffs? (12:06)
  4. Can we both test and treat adrenal insufficiency at the same time? (16:40)
  5. Throwback: How do hypokalemia and hepatic encephalopathy connected? (24:55)
  6. Dr. Nidhi Agrawal Recap (19:20)

For full show notes: https://www.coreimpodcast.com/2018/04/18/5-pearls-chronic-adrenal-insufficiency/

Apr 18 2018

26mins

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Rank #7: #31: Troponins: 5 Pearls Segment

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Solidify your knowledge on troponins and more! Quiz yourself on the 5 pearls we will be covering:

  1. What aspects of the history are concerning in a patient with a positive troponin? (4:00)
  2. What is the difference between the TIMI, GRACE, and HEART scores, and how should we use them in the evaluation of a patient with an elevated serum troponin? (8:42)
  3. How does the change in troponin over time help with diagnosis, and what should we consider in a patient with uptrending troponins but an unremarkable ECG? (14:48)
  4. What can a “negative but detectable” troponin tell you about any patient, not just those with suspected ACS? (21:31)
  5. Pearls Recap (25:26)
  6. Throwback – what are the first-line medications for alcohol use disorder? (28:36)

For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2019/01/04/5-pearls-on-troponins/

Tags: chest pain, cardiology, myocardial infarction, acute coronary syndrome

Jan 02 2019

31mins

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Rank #8: #51 A 65M with Fatigue: Hoofbeats Segment

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1st outpatient clinical reasoning case on Core IM Hoofbeats!

Get CME-MOC Credit (live at 9AM EST on 10/16)

Time Stamps

  • 01:18 Case introduction
  • 11:40 The Casablanca strategy
  • 23:17 The diagnosis revealed
  • 25:30 Logical fallacy: Denying the antecedent
  • 33:22 Components of illness scripts
  • 41:37 Conclusion

Show notes, transcripts and references!

Do you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.com

Tag: normocytic anemia, splenomegaly, CoreIM, endocarditis, clinic case

Oct 16 2019

44mins

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Rank #9: #35 Acute Coronary Syndrome and TIMI Risk Score: Mind the Gap Segment

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Let's go deeper into the world of ACS and the origin of the TIMI score and major adverse cardiac events "MACE" outcomes!
  • The basics – what is acute coronary syndrome? (4:08)
  • Clinical context matters – angina pectoris, atypical chest pain, and troponins (5:22)
  • You can’t just “cath” everyone – risk stratification to identify patients with high mortality risk (9:42)
  • TIMI isn’t perfect – the issues with the score and MACE outcomes (14:00)
  • Review of teaching points (17:58)

For full transcript and show notes: https://www.coreimpodcast.com/2019/02/27/acute-coronary-syndrome-acs-and-the-timi-score/

Feb 27 2019

20mins

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Rank #10: CORE IM podcast: Mind The Gap on Admission Paracentesis

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You have always been told to do a diagnostic paracentesis on admission in cirrhotics with ascites, but why? Can you just get away with clinical judgement to rule out SBP? Is faculty judgement any better? And if you’re going to do a paracentesis on admission, do you need to do it right away? Go deeper with Dr. Steve Liu and Dr. Janine Knudsen!

Click the link for the full show notes: https://www.coreimpodcast.com/2017/11/01/mind-the-gap-admission-paracentesis/

Time Stamps

  1. What do guidelines say about diagnostic paracentesis in cirrhotics with ascites? (1:51)
  2. Can we just use clinical judgement to decide if paracentesis is warranted? (3:13)
    • Do attendings have better clinical judgement than residents to rule out SBP?
  3. Does timing of paracentesis on admission matter for mortality? (6:33)

Nov 01 2017

10mins

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Rank #11: Hepatic Encephalopathy: 5 Pearls Edition Ep3

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Cement your knowledge on Hepatic Encephalopathy (HE)! Quiz yourself on the following 5 Pearls we’ll be covering on HE: 
Time Stamps
  1. What are other causes of altered mental status in cirrhotics? (1:45)
    • What are common precipitants for an acute episode of HE?
  2. What is asterixis? (6:10)
    • What is the diagnostic utility of a cirrhotic with asterixis?
  3. How do lactulose & rifaximin reduce symptoms of HE? (11:00)
    • What are their indications?
  4. What is the connection between hypokalemia and HE? (14:10)
  5. What is the discriminatory power of an ammonia level in HE? (16:40)
    • In what situation does the NH3 has stronger predictive value?

For full shownotes: https://www.coreimpodcast.com/2017/12/13/5-pearls-on-hepatic-encephalopathy/

Dec 13 2017

21mins

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Rank #12: #50 Blood Cultures: Mind the Gap Segment

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Go deeper into the world of blood cultures!

Time stamps

  • 04:10 Review of Choosing Wisely Guidelines
  • 05:55 What are estimated incidences of positive blood cultures?
  • 06:17 Which clinical signs or patient history is more likely to have positive blood cultures?
  • 09:48 What is the estimated incidence of false positive blood cultures?
  • 11:01 What infections more likely to have bacteremia?
  • 13:50 How do positive blood cultures impact patient outcomes and the use of resources?

Show notes, transcript, and references

Tags: Infectious disease, CoreIM, pyelonephritis, cellulitis, community acquired pneumonia

Oct 02 2019

18mins

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Rank #13: #52 Gallows Humor: At the Bedside Segment

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House of God author, Samuel Shem and Prof Katharine Watson share thought-provoking takes on Gallows Humor.
Laugh and listen to this captivating take on the different shades of humor in the day-to-day of medicine.

Time Stamps

  • 02:33 Episode preview and Guest Introductions
  • 04:20 Definition of Gallows Humor
  • 07:25 Gallows Humor by Comedians vs Patients vs Physicians

The Good

  • 08:15 Benefits/Functions of Humor in General
  • 11:10  Connection
  • 13:07 Coping/Catharsis
  • 16:22 Resistance Against Oppression
  • 19:03 Humor as our Authenticity/Humanity

The Bad, The Ugly

  • 21:01 Unintended Audiences (e.g., patients, families)
  • 25:30 “Corporeal” Joking
  • 28:00 Toxic Role Modeling
  • 31:10 Desensitization/Losing Empathy
  • Tips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes
  • 35:45 Excessive Gallows Humor:  Signal of Distress?
  • 37:17 Using Gallows Humor: Questions to Ask Yourself
  • 38:40 Keeping the Faith!

  • 41:11 Excerpt from Man’s 4th Best Hospital by Samuel Shem

Transcript and References

Tag: medical humanities, medical ethics, CoreIM, IMCore

Oct 30 2019

47mins

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Rank #14: #21 57F with confusion: Hoofbeats segment

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Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here:

  1. Case history and exam 00:40
  2. Causal models 11:24
  3. Facets versus diagnoses 13:25
  4. Problem representation 16:37
  5. Part two of the case 17:10
  6. Occam’s razor, Hickam’s dictum, and Crabtree’s bludgeon 23:00
  7. Diagnostic uncertainty 27:10
  8. Learning points 34:24

For show notes: https://www.coreimpodcast.com/2018/08/15/hoofbeats-57f-with-confusion/

Aug 15 2018

35mins

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Rank #15: #14 A 36F with weakness: Hoofbeats segment

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Dissect an interesting case and think about the way clinicians think! So many clinical reasoning pearls here:

  1. Part 1 Case (2:05)
  2. Framing bias (7:07)
  3. Data-driving reasoning  (11:48)
  4. Hypothesis-driven approach (12:38)
  5. Periodic paralysis syndromes (16:08)
  6. Representativeness heuristic (17:26)
  7. Part 2 Case (20:51)
  8. Pivot Points (31:36)
  9. Diagnosis (35:55)
  10. Take aways (37:20)
Check out the key teaching points: https://www.coreimpodcast.com/2018/05/02/hoofbeats-a-36f-with-weakness/

May 02 2018

38mins

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Rank #16: #9 COPD Classifications: Mind the Gap segment

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Let’s go deeper into to why we think about diseases the way we do: COPD Classifications through the years!

Time Stamps:
  1. How did prior understanding of COPD pathophysiology lead to COPD classifications in the past? (3:25)
  2. How is COPD diagnosed? (6:13)
  3. How has COPD been classified and why? (6:42)

For full show notes: https://www.coreimpodcast.com/2018/02/14/mind-the-gap-copd-classifications/

Feb 14 2018

12mins

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Rank #17: #34 47M with chest pain : Hoofbeats segment

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Dissect an interesting case and improve your clinical reasoning skills!

Time Stamps:

  • New features in this episode [00:25]
  • Data point 1: Early hypothesis generation? [03:20]
  • Data point 2: Pertinent negatives? [11:18]
  • Data point 3: Representativeness heuristic over-represented in medical education? [13:28]
  • Data point 4: Economical hypothesis generation by expert clinicians [19:20]
  • Data point 5: Diagnosing diagnostic error [22:10]
  • Data point 6: Moving toward a final diagnosis [27:11]
  • Case resolution [29:50]
For full transcript and show notes: https://www.coreimpodcast.com/2019/02/13/hoofbeats-47m-with-chest-pain/

Feb 13 2019

37mins

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Rank #18: #44 Coronary Calcium Score and CTAs: 5 Pearls Segment

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Solidify your knowledge on Coronary calcium scores and Coronary CTAs!

ACP members can claim CME-MOC Credit !

Quiz yourself on the 5 pearls we will be covering below:

  • 3:10 What are the big picture differences of functional stress tests and anatomical cardiac tests?
  • 7:48 What is the role of coronary artery calcium scores in managing coronary artery disease (CAD)?

  • 16:20 How do coronary CTAs compare to stress tests?

  • 24:28 When should we avoid CTA?

  • 29:33 How do we communicate coronary CTA results with patients?

  • 36:02 Recap

Full transcript, infographics and show notes !

Jul 10 2019

44mins

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Rank #19: #36 Pain Management: 5 Pearls Segment

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Solidify your knowledge on inpatient pain management! Quiz yourself on the 5 pearls we will be covering:
  • How effective are non-opioids? ( 3:17)
  • Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51)
  • What are the best practices for patients who require opioid analgesia? (19:00)
  • When prescribing opioids at discharge what can we do to minimize harm? (25:02)
  • Throwback to mechanism of acetaminophen and NSAIDs (27:14)
  • How do we believe tylenol works and how does that compare to NSAIDS? (28:27)

For full transcript of the audio and show notes: https://www.coreimpodcast.com/2019/03/13/5-pearls-on-pain-management/

Mar 13 2019

31mins

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Rank #20: #18: A 54M with diarrhea: Hoofbeats segment

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Dissect an interesting case and think about the way clinicians think! Many clinical reasoning pearls here:

  1. Part one of case (0:56)
  2. Cognitive ease and strain (03:51)
  3. Metacognition and routine diagnostic timeout (08:15)
  4. Think outside the box of organ systems (11:19)
  5. Illness behavior (12:30)
  6. Part two of case (14:06)
  7. Algorithms (17:57)
  8. Fast thinking & pattern recognition (19:30)
  9. Slow thinking & analytical reasoning (21:31)
  10. Diagnosis (25:15)
  11. Takeaways (26:52)

For full show notes: https://www.coreimpodcast.com/2018/06/27/hoofbeats-54m-with-diarrhea/

Jun 27 2018

28mins

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#67 Salt Restriction in Heart Failure: Mind the Gap Segment

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Let's dive deeper into the dogma of salt restriction in heart failure!
Show notes, transcript and references: https://www.coreimpodcast.com/2020/05/20/salt-restriction-in-heart-failure-mind-the-gap-segment/
Get CME-MOC credit with ACP!
Time Stamp
  • 01:37 Sodium restriction guidelines
  • 07:13 Current data in outpatient data
  • 11:32 Do inpatient studies show signal?
  • 13:44 Physiology behind sodium balance
  • 16:27 Take away and clinical applicability

May 20 2020

20mins

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#66 Outpatient Advance Care Planning with COVID19

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How do you navigate new challenges with goals of care with your patients in clinics?

Show Notes, Transcript, References: https://www.coreimpodcast.com/2020/05/06/outpatient-advanced-care-planning-during-covid-19/

Time Stamps

  • 01:32 COVID Crisis as an Outpatient and Advance Care Planning (ACP)
  • 08:06 The virtual visit
  • 12:44 Vital Talk Mnemonic:  “CALMER”
  • 22:03 Challenges to Outpatient COVID Care
  • 26:03 Parting Thoughts

May 06 2020

29mins

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#65 COVID Reflections- Disconnections and Connections: At the Bedside Segment

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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)
  5. 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

Apr 29 2020

18mins

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#64 Inpatient Goals of Care with COVID-19

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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

Apr 22 2020

29mins

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#63 Practical Tips for COVID-19 Floors

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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

Apr 12 2020

34mins

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#62 Transgender Health, Hormone Therapy and Preventive Screening: 5 Pearls Segment

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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

Apr 01 2020

32mins

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#61 Transgender Health, Gender Affirming Care: 5 Pearls Segment

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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

Mar 18 2020

22mins

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#60 Capacity Part 1: At the Bedside Segment

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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

Mar 04 2020

30mins

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#59 Flu Diagnosis and Treatment: Mind the Gap Series

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What are the new guidelines for influenza treatment? What are the diagnostic ratios of flu symptoms and tests?

Time Stamps
  • 03:10 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

Feb 19 2020

18mins

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#58 Case Managers and Social Workers: Interprofessional Education Series

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What is the difference between a case manager and social worker? What are the limitations that social workers and case managers face? How do you create a safe space for the interdisciplinary team?

Show Notes and References

Get CME-MOC credit with ACP!

Time Stamps:

  • 03:54 What are the various roles within a multidisciplinary teams?
  • 10:42 Understanding limitations of social workers and case managers
  • 15:55 The “behind the scenes” paperwork
  • 18:42 Insurance and medications
  • 22:17 Insurance and disposition options
  • 25:08 The importance of creating a safe space for better communication

Feb 06 2020

32mins

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Novel Coronavirus: What the Clinician Needs to Know Interview

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What are the symptoms? What distinguishes coronavirus from other influenza-like illness? When coronavirus is suspected, what should you do?

Show notes and references

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

ACP Interactive Learning Module

Time Stamps

  • 01:30 Novel parts of coronavirus

  • 03:00 What symptoms do patients present with for the novel coronavirus?

  • 04:22 What distinguishes coronavirus from other influenza-like illness?

  • 05:31 When coronavirus is suspected, what should you do?

  • 07:13 What does testing for coronavirus entail?

  • 09:06 What kind of isolation is required?

  • 10:13 Do patients need to be isolated in biocontainment units?

  • 10:42 What is treatment for the novel coronavirus?

  • 12:30 Potential for vaccines

  • 15:23 What is R0?

  • 17:12 Animal reservoirs with 2019-nCoV, SARS, and MERS

  • 19:18 What should we tell patients for prevention?

Feb 04 2020

24mins

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#57 A 39M on Inpatient Psychiatry with a Fever: Hoofbeats Segment

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How do you learn from diagnostic errors? Walk through a case that the host had initially gotten wrong and uncover possible reasons as why from data gathering to hypothesis generation to the interplay between hypothesis generation and evaluation. Learn interesting tidbits on prior work in medical education around how we think, particularly around diagnostic failures.

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

Time Stamps

  • 02:39 Case Introduction
  • 04:46 Yes/No questions with our first two discussants
  • 18:43 The diagnosis is revealed
  • 21:14 Why did I miss the diagnosis?
  • 27:44 Using diagnostic problem solving to break down the case and understand our errors
  • 30:20 The importance of data gathering
  • 30:49 Introducing our third clinician
  • 34:17 Hypothesis generation
  • 37:11 The interplay between hypothesis generation and evaluation
  • 38:34 The win-stay, lose-shift heuristic
  • 41:33 Cognitive forcing strategies
  • 49:32 Knowledge vs. experience

Tags: Dermatology, rash, DRESS, AGEP, varicella

Jan 22 2020

55mins

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#56 Prognosis: At the Bedside Segment

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Why is prognostication hard? How do we improve at communicating prognosis? How should we approach uncertainty? Explore this and more on this At the Bedside episode!

Prognosis Calculators, Transcript and References

Time Stamps

  • 02:48 What is prognosis?
  • 04:00 Why offer prognostication?
  • 08:32 Why is prognostication hard?
  • 16:41 How do we improve at communicating prognosis?
  • 21:56 How should we approach uncertainty?
  • 31:06 Take Aways

Tag: life expectancy, CoreIM

Jan 01 2020

32mins

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#55 Influenza History and Vaccine: Mind the Gap Segment

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Dive deeper into hx of the influenza virus, how vaccines are made and vaccine effectiveness !

Time Stamps

  • 02:59 The history of the influenza virus
  • 08:18 What does the influenza vaccine target?
  • 13:20 Chickens, and bugs, and mammalian cells, oh my! How the vaccine is made.
  • 14:00 What to do about egg allergies.
  • 15:53 Vaccine effectiveness and herd immunity.
  • 17:43 Waning immunity and other debates

Show Notes, Transcript and References

Get CME-MOC credit with ACP!

Dec 18 2019

22mins

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#54 Home Health Aides: Interprofessional Education Series

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Explore gaps in your knowledge about the home health world, particularly on home health aides!

Time Stamps:

02:33 What support do our patients have at home and how does those people play a role in their care?

06:00 Are there various types of home care workers?

07:25 What role do home attendants play in caring for a patient?

08:31 What tasks do home health aides do?

10:11 What are the types of "skilled carez'?

13:17 What can Medicare cover for older adults in terms of home health aides?

15:17 How does Medicare define homebound?

16:03 How does having Medicaid impact access to home care?

19:10 What if a patient isn’t eligible for Medicare or Medicaid?

19:43 What is the cost to use a private agency for home health services?

24:02 What are some challenges that home health aides face?

25:42 What are “plans of care”?

30:01 Who makes up the home care workforce?

31:52 When patients get discharged from the hospital, do they go home to the same home care assistance?

Nov 27 2019

39mins

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#53 Heparin-Induced Thrombocytopenia: 5 Pearls Segment

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Get CME Credit with ACP! Full Transcript with references and show notes
Time Stamps
  • 4:30 What is the daily risk of thrombosis if HIT Is left untreated?
  • 5:40 What happens during platelet activation?
  • 07:11 How long does it take for patients to develop for IgG antibodies to Heparin to form?
  • 09:52 Is HIT common?
  • 10:28 Who is at higher risk for HIT?
  • 11:48 Why does low molecular weight heparin have a lower risk for HIT than unfractionated heparin?
  • 15:30 Approach to thrombocytopenia
  • 17:44 How do medications cause thrombocytopenia?
  • 18:38 With medications, what is the time course between medication initiation and thrombocytopenia?
  • 22:20 What is the sensitivity and specificity of anti-PF4 antibody?
  • 23:58 How does the serotonin-release assay (SRA) work?
  • 29:10 What type of anticoagulant do you choose for treating HIT?
  • 31:58 Why is it important to not use warfarin in patients with platelet counts <150,000?
  • 33:32 What is the treatment duration for a patient has confirmed HIT?
  • 36:29 Dr. Cuker’s story and the "Scarlet H"
  • 39:07 Dr. Linkin’s Recap
  • 42:25 Dr. Linkin’s story
  • 44:37 Pearl 5: Throwback to coronary calcium scores

Nov 13 2019

47mins

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#52 Gallows Humor: At the Bedside Segment

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House of God author, Samuel Shem and Prof Katharine Watson share thought-provoking takes on Gallows Humor.
Laugh and listen to this captivating take on the different shades of humor in the day-to-day of medicine.

Time Stamps

  • 02:33 Episode preview and Guest Introductions
  • 04:20 Definition of Gallows Humor
  • 07:25 Gallows Humor by Comedians vs Patients vs Physicians

The Good

  • 08:15 Benefits/Functions of Humor in General
  • 11:10  Connection
  • 13:07 Coping/Catharsis
  • 16:22 Resistance Against Oppression
  • 19:03 Humor as our Authenticity/Humanity

The Bad, The Ugly

  • 21:01 Unintended Audiences (e.g., patients, families)
  • 25:30 “Corporeal” Joking
  • 28:00 Toxic Role Modeling
  • 31:10 Desensitization/Losing Empathy
  • Tips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes
  • 35:45 Excessive Gallows Humor:  Signal of Distress?
  • 37:17 Using Gallows Humor: Questions to Ask Yourself
  • 38:40 Keeping the Faith!

  • 41:11 Excerpt from Man’s 4th Best Hospital by Samuel Shem

Transcript and References

Tag: medical humanities, medical ethics, CoreIM, IMCore

Oct 30 2019

47mins

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#51 A 65M with Fatigue: Hoofbeats Segment

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1st outpatient clinical reasoning case on Core IM Hoofbeats!

Get CME-MOC Credit (live at 9AM EST on 10/16)

Time Stamps

  • 01:18 Case introduction
  • 11:40 The Casablanca strategy
  • 23:17 The diagnosis revealed
  • 25:30 Logical fallacy: Denying the antecedent
  • 33:22 Components of illness scripts
  • 41:37 Conclusion

Show notes, transcripts and references!

Do you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.com

Tag: normocytic anemia, splenomegaly, CoreIM, endocarditis, clinic case

Oct 16 2019

44mins

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#50 Blood Cultures: Mind the Gap Segment

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Go deeper into the world of blood cultures!

Time stamps

  • 04:10 Review of Choosing Wisely Guidelines
  • 05:55 What are estimated incidences of positive blood cultures?
  • 06:17 Which clinical signs or patient history is more likely to have positive blood cultures?
  • 09:48 What is the estimated incidence of false positive blood cultures?
  • 11:01 What infections more likely to have bacteremia?
  • 13:50 How do positive blood cultures impact patient outcomes and the use of resources?

Show notes, transcript, and references

Tags: Infectious disease, CoreIM, pyelonephritis, cellulitis, community acquired pneumonia

Oct 02 2019

18mins

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#49 Smoking Cessation: 5 Pearls Segment

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Practical tips on smoking cessation! Get CME Credit with ACP!

Full Transcript with References and Show Notes

Time Stamps

  • 04:50 What questions are important to ask after a patient who contemplative about quitting tobacco?
  • 07:00 Is quitting abruptly on a quit date or gradual cessation to a quit date better?
  • 08:10 How can technology help support patients who are trying to quit?
  • 08:49 How should we prepare patients who quit smoking and are worried about weight gain?
  • 11:06 How can we try to convince patients to use medication as assistance to quit smoking?
  • 11:50 What is the most effective nicotine replacement approach?
  • 13:54 What are the potential side effects of the nicotine patch?
  • 15:00 What should we prescribe for patients who smoke <5 cigarettes a day?
  • 16:28 How can we determine how severe a patient’s nicotine dependence is?
  • 18:26 When is the ideal frequency of nicotine gum or lozenge?
  • 21:45 How does varenicline work?
  • 25:05 Can you start varenicline in patients who have had psychiatric history?
  • 27:15 What major side effect is seen in patients taking bupropion?
  • 29:15 How do e-cigarettes work?
  • 31:18 How should we approach adding e-cigarettes into a patient’s plan for quitting?
  • 31:42 How should we discuss e-cigarette use with our patients?
  • 33:47 Recap
  • 39:54 Screening for Barrett’s Esophagus

Sep 18 2019

42mins

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iTunes Ratings

511 Ratings
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Great podcast!

By het_111 - Jun 14 2019
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Easy to digest and great sound quality!

Great learning resource

By roomto - Jun 04 2019
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Very well produced. I learn a lot each time.