Core IM | Internal Medicine Podcast

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=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

20 Qs with Core IM Team vs. Expert Discussant !Full Transcript and Show notesGet CME-MOC Credit for listening to this episode (live at 09:00 am EST on 8/7)Time Stamps00:20 The game of medical Twenty Questions04:37 Case introduction05:50 The CoreIM team attempts to solve the case15:36 The discussant’s diagnostic schema for abnormal bleeding23:37 Primary versus secondary hemostasis30:33 The pathology report !37:38 Criteria for the final diagnosis38:46 Dissecting a diagnostic coup49:42 ConclusionDo you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.comTags: Coagulopathy, Bleeding Disorder, Diagnostic Schema, Von Willebrand's Disease, Clinical ReasoningFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Explore the debate on whether statins should be taken at night or during the day, considering the physiology of cholesterol synthesis and evidence supporting nighttime use. Discuss the impact of nighttime statin dosing on cholesterol levels and patient outcomes, highlighting the importance of individualized treatment plans and patient adherence.

Explore the crucial differences between functional stress tests and anatomical cardiac tests. Delve into the role of coronary artery calcium scores in managing coronary artery disease and their implications for risk stratification. Learn how coronary CT angiography compares with traditional stress tests and when to avoid using CTA. The discussion also highlights effective communication strategies for conveying CTA results to patients, ensuring clarity in their treatment options.

In ‘At The Bedside’, our newest podcast segment, we tackle important topics that *aren’t* easily indexable in guidelines and UpToDate article – topics that are better discussed…well…at the bedside. Our first episode examines the all-too-common trope of the ‘difficult’ patient.01:13   Introduction05:27   Question 1: What makes a patient difficult for you?13:22   Question 2: What is a “good outcome” when working with difficult patients?23:05   Question 3: What have you learned from your difficult patients?31:56   ConclusionShow notes, Transcript, Further ReadingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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.Lets continue conversation over social media. Which stories moved you? Which July stories can you relate to? Tweet us, find us on instagram at coreimpodcast or Facebook. Good luck this coming July !Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dissect clinical reasoning and dive deeper into an interesting case!02:04   Initial Presentation03:03   The Core IM team tackles the case09:30   Social History16:05   Physical Exam22:47   An exercise in Bayesian inference36:35   Pre-mortem43:37   Revealing the diagnosis48:57   How do we define diagnostic success?Full transcript with references and show notes Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy