Core IM | Internal Medicine Podcast

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 ReferencesTime Stamps02:48 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 AwaysTag: life expectancy, CoreIMFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Eko Core 500 Digital Stethoscope: https://ekohealth.com/COREIM* Check out FIGS and use code FIGSRX for 15% off your 1st order: https://wearfigs.com* Check out Washington Red Raspberries for recipes, farmers' stories, and which grocery stores carry: https://www.coreimpodcast.com/redrazzAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dive deeper into hx of the influenza virus, how vaccines are made and vaccine effectiveness ! Time Stamps 02:59 The history of the influenza virus08:18 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 debatesShow Notes, Transcript and ReferencesGet CME-MOC credit with ACP!Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Eko Core 500 Digital Stethoscope: https://ekohealth.com/COREIM* Check out FIGS and use code FIGSRX for 15% off your 1st order: https://wearfigs.com* Check out Washington Red Raspberries for recipes, farmers' stories, and which grocery stores carry: https://www.coreimpodcast.com/redrazzAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Explore gaps in your knowledge about the home health world, particularly on home health aides!Get CME-MOC credit with ACP !Full transcript, show notes, referencesTime 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?Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Eko Core 500 Digital Stethoscope: https://ekohealth.com/COREIM* Check out FIGS and use code FIGSRX for 15% off your 1st order: https://wearfigs.com* Check out Washington Red Raspberries for recipes, farmers' stories, and which grocery stores carry: https://www.coreimpodcast.com/redrazzAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

 Get CME Credit with ACP! Full Transcript with references and show notes Time Stamps4:30 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 thrombocytopenia17:44 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 Recap42:25 Dr. Linkin’s story44:37 Pearl 5: Throwback to coronary calcium scores  Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Eko Core 500 Digital Stethoscope: https://ekohealth.com/COREIM* Check out FIGS and use code FIGSRX for 15% off your 1st order: https://wearfigs.com* Check out Washington Red Raspberries for recipes, farmers' stories, and which grocery stores carry: https://www.coreimpodcast.com/redrazzAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 Stamps02:33 Episode preview and Guest Introductions04:20 Definition of Gallows Humor07:25 Gallows Humor by Comedians vs Patients vs PhysiciansThe Good08:15 Benefits/Functions of Humor in General11:10 Connection13:07 Coping/Catharsis16:22 Resistance Against Oppression19:03 Humor as our Authenticity/HumanityThe Bad, The Ugly21:01 Unintended Audiences (e.g., patients, families)25:30 “Corporeal” Joking28:00 Toxic Role Modeling31:10 Desensitization/Losing EmpathyTips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes35:45 Excessive Gallows Humor: Signal of Distress?37:17 Using Gallows Humor: Questions to Ask Yourself38:40 Keeping the Faith!41:11 Excerpt from Man’s 4th Best Hospital by Samuel ShemTranscript and ReferencesTag: medical humanities, medical ethics, CoreIM, IMCoreFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Eko Core 500 Digital Stethoscope: https://ekohealth.com/COREIM* Check out FIGS and use code FIGSRX for 15% off your 1st order: https://wearfigs.com* Check out Washington Red Raspberries for recipes, farmers' stories, and which grocery stores carry: https://www.coreimpodcast.com/redrazzAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

A 65-year-old man's mysterious fatigue unfolds as hosts dive into outpatient diagnostics. They discuss the challenges of patient communication and the need for personalized approaches beyond standard tests. The spotlight turns to a complex case of anemia that leads to a life-changing diagnosis of endocarditis. Listeners learn the significance of logical reasoning in medicine and the development of illness scripts. The case concludes with a successful treatment story, urging engagement and reflection on clinical practices.

Dive into the fascinating world of blood cultures! Discover the guidelines for accurate testing and the surprising rates of false positives. Explore which clinical signs suggest positive blood cultures and their association with infections like bacteremia. Learn about the impact of blood cultures on patient outcomes and resource utilization. The discussion balances humor with critical insights into effective fever management and the complexities of diagnosing serious infections, highlighting the need for judicious testing practices.

Dr. Michael Fury, a tobacco use expert, and Dr. Scott Sherman, a primary care psychiatrist, share valuable insights on smoking cessation strategies. They discuss the best questions to ask patients contemplating quitting and whether to quit cold turkey or gradually. Technology’s role in supporting quitting efforts is explored, along with concerns about weight gain and effective nicotine replacement therapies. They also dive into contemporary approaches like e-cigarettes and the significance of tailoring cessation methods to individual patient needs.

Dr. David Alfandre, an ethics researcher and author, dives into the complex world of discharges Against Medical Advice (AMA). He discusses the demographics and factors influencing these decisions, emphasizing the critical role of clinician communication. The conversation reveals the challenges health professionals face when patients leave despite risks. Alfandre also explores the ethical dilemmas involved and shares strategies for improving shared decision-making, ensuring patient autonomy while enhancing care outcomes.

We hope these stories can make us more introspective and open minded on how these concepts can affect each one of us differently.Let's continue the discussion on the Women in Medicine Twitter chat on 8/25 at 9pm EST !Full Transcript and Show NotesTime Stamps2:07 Introduction to one woman’s journey3:00 Stereotype Threat6:15 Not all Anger is Created Equal10:17 Asking and Writing Your Own Job Description13:08 Imposter Syndrome15:50 Breaking Points to Self Care18:50 Work Life Integration21:40 Support NetworksFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Eko Core 500 Digital Stethoscope: https://ekohealth.com/COREIM* Check out FIGS and use code FIGSRX for 15% off your 1st order: https://wearfigs.com* Check out Washington Red Raspberries for recipes, farmers' stories, and which grocery stores carry: https://www.coreimpodcast.com/redrazzAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy