Core IM | Internal Medicine Podcast

Interns face tough realities as they embark on their medical journeys, confronting critical patient situations that unearth feelings of imposter syndrome. Emotional support from mentors and peers becomes essential in navigating these challenges. Anxiety peaks during night shifts, but personal connections with patients offer surprising comfort. Humorous camaraderie shines through, highlighting how small gestures can uplift colleagues during difficult times. These raw stories encapsulate the highs and lows of starting a medical career.

Chris Kodanidis, an editorial fellow at the New England Journal of Medicine, dives into the evolving role of beta blockers following heart attacks. He discusses the historical significance of these medications and critiques their effectiveness in light of the REDUCE-AMI trial findings. The conversation emphasizes the importance of individualized treatment approaches, challenging outdated norms in cardiology. Additionally, they explore Goodhart's Law and its implications on clinical decision-making, ultimately advocating for a more nuanced understanding of patient care.

Dive into the complexities of invasive fungal diseases and learn who’s at the highest risk for these infections. Discover the main classes of fungi and the diagnostic challenges with tests like beta-glucan and galactomannan. Uncover how to enhance blood culture yields and accurately interpret culture results. Explore treatment strategies and the implications of drug-drug interactions with antifungal medications. This episode sheds light on a critical area of infectious disease that is often overlooked.

Discover the impactful differences between Continuous Glucose Monitoring and A1C testing in diabetes management. Learn how to interpret ambulatory glucose profiles to spot hypoglycemia and hyperglycemia patterns. The discussion highlights personalized insulin management strategies, including when to adjust doses based on glucose data. Common pitfalls in patient lifestyle and medication that affect blood sugar levels are examined. There's a focus on the role of GLP-1 agonists in optimizing treatment, ensuring patients receive tailored care.

Olamude Olalade, an Interventional Radiology Fellow at Brigham and Women's Hospital, shares insights into the fascinating world of interventional radiology. He discusses when to utilize ultrasound, CT, or MRI before consulting IR, and the key factors involved in pre-op evaluations. Listeners will learn about drain management, including tips for troubleshooting issues before reaching out for assistance. Olalade also touches on the importance of outpatient follow-up and practical guidelines for drain placement and removal.

Discover the high-yield reversible causes of constipation and which type of fiber is truly beneficial. Dive into the debate on hydration and the effectiveness of bulk-forming laxatives versus osmotic and stimulant options. Learn about the intricacies of suppositories and enemas as treatment methods. Get insights on managing opioid-induced constipation with innovative alternatives like peripheral opioid receptor antagonists. This enlightening discussion equips you with practical recommendations for optimizing patient care!

The discussion delves into the evolution of HIV prevention strategies, comparing oral PrEP options like Truvada to innovative long-acting injectables. The groundbreaking PURPOSE trials showcase lenacapavir's impressive efficacy, particularly in diverse populations, revealing zero infections among treated cisgender women. Barriers to access and adherence are critically examined, emphasizing the need for equitable solutions. With promising results on the horizon, the future of HIV prevention looks brighter, potentially revolutionizing care for those at risk.

Dr. Steve Nissen from Cleveland Clinic, a leading figure in lipoprotein(a) research, joins Dr. Greg Katz from NYU to delve into crucial insights about this underappreciated lipid layer. They discuss why Lp(a) is essential for evaluating cardiovascular risk and who should be tested. Listeners will learn about interpreting results, managing elevated levels, and the potential roles of aspirin and PCSK9 inhibitors. The episode highlights the evolving strategies in understanding and treating Lp(a), offering a fresh perspective on patient care.

Dr. Rebecca Carpley, a hematologist at Massachusetts General Hospital, dives into the complexities of hypercoagulability and the nuances of clot management. She discusses reframing clots by reversibility, shedding light on how Virchow's triad categorizes clot etiology. Dr. Carpley addresses inherited protein deficiencies, emphasizing factors influencing testing. The conversation also examines the reliability of genetic tests like Factor V Leiden, considering the critical role of family history in assessing thrombosis risks. Insights into individualized care for women of childbearing age add depth to this engaging discussion.

Dive into the untapped world of microplastics and their alarming connection to cardiovascular health. Discover how microplastics infiltrate our bodies and their potential role in heart disease, as highlighted by the APAChE study. The discussion navigates the challenges of educating families about plastic exposure, especially for children, and emphasizes the urgent need for further research. With a focus on informed decision-making, the podcast sheds light on a pressing environmental health issue that affects us all.