Core IM | Internal Medicine Podcast

In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?Show notes & TranscriptTime Stamps02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis05:35 Deep Dive 2: FFP effect on bleeding risk15:43 Deep Dive 3: Risks of FFP19:45 Deep Dive 4: Indwelling pleural catheters30:31 RecapTags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonaryFind 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

How long can fatigue last for after radiation? Are all patient post radiation immunocompromised?  What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes & TranscriptWhiteboard Animation Video of Radiation PhysiologyTime Stamps02:37 Systemic Radiation Side Effects14:29 Lung Radiation Side Effects18:22 Breast Radiation Side Effects21:45 Prostate Radiation Side Effects24:54 Brain Radiation Side EffectsTags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapyFind 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

What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?Show notes & TranscriptWhiteboard Animation Video of Radiation PhysiologyTime Stamps02:04 What is radiation?03:17 How does radiation therapy work?04:50 How is today’s radiation different from the past?05:40 What role does radiation play in cancer treatment?07:48 What are the different types of radiation?15:34 How do you write a rad onc one-liner as an internist?19:59 What is palliative radiation and how/when should we use it?Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapyFind 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

What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?Show notes & TranscriptTime Stamps01:12 Learning Journey05:58 Lifelong Learning11:14 Time Management16:38 Role Modeling19:59 Re-Calibrating FailureTags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time managementFind 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

What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric? Show notes, Transcript and ReferencesTime stamps00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test03:03 Hemoglobin A1c08:26 Fructosamine and Glycated Albumin10:50 Continuous Glucose Monitoring15:44 The Overlooked Issue of Insulin Resistance19:11 SummaryTags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complicationFind 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

When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?21:28 How to determine which type of device your patient has?25:10 What can a device interrogation tell you and doesn't tell you?32:13 Do all patients with bacteremia need their implantable cardiac devices taken out? 38:44 End-of-life considerations with pacemakers vs. ICDs Tags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacingFind 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

How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps03:49 Episode start07:13 Dialysis vs. kidney transplant morbidity and mortality11:44 Eligibility for kidney transplant and when to refer21:34 Pre-transplant evaluation process25:38 How long are wait times on the transplant list?36:21 What benefits of living donation? What are risks to the kidney donor?Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidneyFind 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

What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation?Behind the Scenes YouTube InterviewGet CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E10Show notes, Transcript and References: https://www.coreimpodcast.com/2023/03/08/trac/Time stamps2:56 Trach Components12:47 Trach Complication Management27:48 Airway Clearance34:53 Speaking Valve38:54 DecannulationTags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacyFind 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

Why are safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care?Show notes, Transcript and References:https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/Timestamps:0:00 Hahnemann University Hospital4:36 What is a Safety Net Hospital?11:11 The Origins and Paradox of the Safety Net HospitalLinks to other episodes:A Complex Patchwork of Supplemental Payments:https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/The Future of Safety Net Hospitals & Payment Policies:https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/Tags: IM Core, CoreIM, health policy, health disparities, insurance, medicare and medicaidFind 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

How does your problem representation change as we get more history in this episode? How can we use Oxaam's razor & Hickman's dictum as powerful diagnostic tools IF used properly?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/15/25438/Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Time stamps01:51 Intro07:57 Case 13:09 Differential16:15 Diagnosis22:20 Problem Representation Tags: IM Core, CoreIM, diagnostic tools, Occam's razor, Hickam's dictum, data collection, mental model, clinical reasoning, rheumatologyFind 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