Episodes

How much of D5W vs. isotonic saline contributes to intravascular volume? How do you distinguish between oncotic pressure and tonicity? What balanced solutions do you reach for? What is the data behind using colloids like albumin as an intravascular expander? How much do pRBCs stay in the plasma? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/04/27/fluids-colloids-5-pearls-segment/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-po...

What do you include in your initial basic work-up for suspected pulmonary hypertension? Do you know how to calculate the PASP on the ECHO? What physiological insults that can cause high pulmonary pressures? How can we interpret the E/e’ ratio? Whiteboard animation video on YouTube Show notes, Transcript and References Get CME-MOC credit with ACP Time stamps: 02:18 | Intro 05:27 | Pearl 1 12:17 | Pearl 2 16:13 | Pearl 3 24:04 | Pearl 4 30:08 | Pearl 5 Tags: IM Core, CoreIM, PASP, Echo, hy...

How can we use food as medicine? How can we best counsel our patients on their diets? Which pre-set diets can we recommend for or against? How can we make the changes sustainable? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/03/23/obesity-and-nutr…-2021-sgim-recap/ Time stamps: 03:10 Trends in weight and dieting 06:01 Counseling patients on diet 09:35 Food group recommendations 14:53 Pre-set diets 20:47 Making sustainable changes Tags: Core IM, IM Core, diet, ...

What are some tricks to help you perform a virtual physical exam? What role do these visits play in our overall care for the patient? What tools do we have at our disposal for a more thorough evaluation? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/03/09/telemedicine-and…-2021-sgim-recap/ Tags: IM Core, CoreIM, tele visit, gizmos, history taking, virtual, physical exam, assessment, functional status, tips Find the best disability insurance for you: https://www.patt...

How long should you anticoagulant for a PE? When can you safely stop anticoagulation for thrombogenic patients who need an urgent biopsy? Should an IVC filter be placed to prefer further embolization of a DVT? What percentage of patients with cancer associated blood clots will have progression while on anticoagulation? Show Notes, Transcript, and References: https://www.coreimpodcast.com/2022/02/23/24433/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podca...

How can you implement effective note taking for virtual learning? Do you use interleaving during rounds? What is the 5/10/30 rule and how does it apply to mentorship? Does implicit bias affect gender performance scores in clinical rotations? How common are biased patient behaviours? How can you foster a safer learning environment for trainees? How can you promote antiracism? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/02/09/medical-educatio…ng-core-im-recap/ Time s...

What’s your comfort level with managing hyponatremia and how does it change in unfamiliar environment? How can you vary your practice to build up adaptive exerptise? Show notes, Transcript & References: https://www.coreimpodcast.com/2022/01/26/hoofbeats-consult-case/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps 01:36 Case 10:42 Case analysis 22:45 An unfamiliar domain 25:50 Lab review 40:04 Conclusions Tags: IM Core, Cor...

Have you ever thought about where the 1g/dL hemoglobin appropriate bump after 1 unit of pRBC transfusion? How does the patient's intravascular volume affect this? What rise in hemoglobin should you expect? What factors can impact this? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/01/05/1-to-1-prbc-bump…-the-gap-segment/ Time stamps 01:22 Unpacking the question 01:55 The math 04:32 Functional hemoglobin 08:50 Donor and Patient 11:18 Scenarios 12:58 Summary 14:...

Let’s apply to cases! We use the 7 questions framework to 3 practical cases Show notes, Transcript and References: https://www.coreimpodcast.com/2021/12/22/treatment-over-objection-part-2/ Time stamps 2:19 Case 1: Review of Framework 7:59 Case 2 9:04 Consent vs. Assent 11:11 Role of Consult Services 13:16 Role of Surrogates 15:29 Conclusion Tags: IM Core, CoreIM, autonomy, capacity, human dignity, non-maleficence, ethics, medical humanities Find the best disability insurance for you: h...

Get a very useful framework to help you weigh the risks and benefits of treatment over objection! Show notes, Transcript and References: https://www.coreimpodcast.com/2021/12/08/treatment-over-objection/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps 03:02 Ethical and emotional challenges 10:08 Case 1 18:55 Study of the 7 Questions 22:46 Conclusion Tags: IM Core, CoreIM, autonomy, capacity, human dignity, non-maleficence, e...

What degree of hyperkalemia makes you worried enough to send your patient to the ED? Are ECG changes sensitive in detecting hyperkalemia? Do you know how to advise your patient on dietary changes? What medications can you effectively use in the outpatient setting? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/11/17/hyperkalemia-mind-the-gap-segment/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps 01:0...

What are pearls and pitfalls when assessing an older patient for the first time?Time Stamps:* 02:25 Initial Office Visit* 08:08 Mobility Assessment * 13:25 Cognitive Evaluation * 19:27 Medications * 26:29 Throwback PearlShow notes, Transcript and References: https://www.coreimpodcast.com/2021/10/31/5-pearls-on-geriatric-care/ (https://www.coreimpodcast.com/2021/10/31/5-pearls-on-geriatric-care/)Tags: Core IM, IM Core, delirium, goals of care, dementia, mini cog, MOCA, deprescribing Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out FIGS: https://wearfigs.com * Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIM Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Should we use oral diabetes agents in our hospitalized patients? Do you hold metformin for fear of lactic acidosis? Do you typically order an insulin sliding scale? When can you comfortably restart PTA meds? Time Stamps: 02:25 Can we give metformin in the hospital? 10:50 Incretin-based therapies 14:49 Sodium Glucose Cotransporter-2 Inhibitors 16:27 Sulfonylurea & Thiazolidinediones 18:00 Basal Insulin inpatient Show notes, Transcript and References: https://www.coreimpodcast.com/2021/10/1...

What are practical phrases can you incorporate to help patients who use drugs? What changes can you make to ensure person-first language? What safe drug practices can you advise? What is MOUD? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/09/29/5-pearls-on-stig…oid-use-disorder/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamps: 04:24 Starting the Conversation 10:43 The Shared Agenda 14:46 Exploring patient goals 18:54 ...

A very practical episode around nuanced code status conversations with many examples! Time Stamps: 00:08 Introduction 04:01 Information Gathering 20:41 Informed Consent 29:47 Giving Recommendations 36:47 Mistakes 48:22 Wrap Up Show notes, Transcript and References: https://www.coreimpodcast.com/2021/09/12/code-status Tags: Core IM, IM Core, DNR/DNI, CPR, intubation, goals of care, shared decision making, documentation, conversations, recommendations Find the best disability insurance fo...

What are the differences in resources, nursing and clinician oversight and who pays for what?! Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps: 04:07 SAR vs SNF 13:35 Long term Nursing Home Care 18:30 Assisted Living Facility 24:40 Acute rehab 26:11 LTACH 27:49 Home Tags: Subacute rehab,...

What are the indications for a stress test? How to choose stress protocol in a stress test? How to choose diagnostic imaging in a stress test? How do we interpret results from stress tests, and how should this be communicated to patients? 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, C...

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 Tags: CoreIM, AMA Discharges, Psych, Competency, medical ethics, medical humanties Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out FIGS: https://wearfigs.com * Click for 15% off Premium ...

20 Qs game with Core IM Team vs. Expert Discussant ! Full Transcript and Show notes Get CME-MOC Credit for listening to this episode Time Stamps 00:20 The game of medical Twenty Questions 04:37 Case introduction 05:50 The CoreIM team attempts to solve the case 15:36 The discussant’s diagnostic schema for abnormal bleeding 23:37 Primary versus secondary hemostasis 30:33 The pathology report ! 37:38 Criteria for the final diagnosis 38:46 Dissecting a diagnostic coup 49:42 Conclusion Fi...

Transitions can be hard. Laugh, commiserate, and be inspired by these July stories in medicine! Very big thank you to everyone who told their stories ! Let's help each other feel a little less alone in the struggle, be more understanding and compassionate or laugh at ourselves. Please share this episode with colleagues. Do you have a July story? Email us at hello@coreimpodcast.com. Tags: Narrative Medicine, CoreIM, IMcore, imposter syndrome Find the best disability insurance for you: https:/...

How can we help colleagues that we think are struggling with substance use disorder? What options are available for physicians? Are these different state to state? What deterrents do physicians face when seeking help? Time Stamps: 00:21 Introduction 02:59 Scope/Definitions 08:05 Systems for Physician Impairment 13:50 Barriers to Care 24:48 Helping an Impaired Physician 28:44 Systems Level Change Show notes, Transcript and References: https://www.coreimpodcast.com/2021/06/09/physician-cli...

Debunk common myths of penicillin allergies! What's the best way to ask about allergies? How can you challenge patients to determine if they have a true allergy? Organic chemistry buffs, what mediates cross-reactivity? What medications can you safely give your patients? Show note, Transcript and References: https://www.coreimpodcast.com/2021/06/02/5-pearls-on-penicillin-allergy/ Time Stamps: 02:49 Penicillin Myths 07:20 Penicillin Allergy 11:21 Allergic Reactions 19:01 Managing allergic rea...

What are good habits in QI? What are the areas of expertise needed to have a successful career in QI? How can you get involved in quality improvement? What projects can you get involved with, and how do you work outside of your own interests? How can you partner with your healthcare system to make changes? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/05/08/quality-improvement-careers-series/ Time Stamps: 01:36 Getting started 05:01 Formal training 08:27 What are ...

How does cost, potency, and bleeding risk affect which antiplatelet you choose P2Y12 inhibitors? How long after starting, do you feel comfortable stopping DAPT on a patient? How do you manage DAPT in patients who need anticoagulation? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/04/07/5-pearls-on-dual…platelet-therapy/ Join Our Team Time stamps 02:35 Indications 08:52 Medications 17:37 Duration 28:23 De-escalation 30:55 Anticoagulation Tags: IM Core, CoreIM, a...