Core IM | Internal Medicine Podcast

Exploring the use of steroids in community-acquired pneumonia (CAP), discussing conflicting findings, the CAPE COD trial, and the potential for improved outcomes. Analyzing the impact of steroids on CAP mortality rates, including significant reduction in mortality risk. Discussing whether the findings should change clinical practice for severe pneumonia. Exploring the use of steroids in hypoxic and unresponsive patients, highlighting the need for further research.

This podcast discusses topics such as approaching syncope history in patients with implantable devices, distinguishing between benign vagal episodes and life-threatening arrhythmias, avoiding heparin products for patients with pacemakers or ICDs, new technologies and devices for contractility and heart failure, and anticoagulation and technology update.

Explore the pros and cons of using Cr or Cystatin C to assess eGFR in CKD staging. Learn about the limitations of creatinine as a biomarker for kidney function and the importance of considering glomerular filtration rate and albuminuria. Discover the implications of low GFR in patient care, the advantages of using cystatin C and measuring albuminuria, and the flaws of using creatinine in evaluating renal function.

Learn about the importance of genetic counseling and incorporating Lynch syndrome into clinical practice. Discover the challenges and reclassification in genetic testing, the role of general internists in managing hereditary disorders, and the impact of GINA on insurance coverage. Explore prevention and treatment options for Lynch syndrome, and the need for primary care providers to have knowledge about genetic testing.

Dr. Melanie Honig, an ophrologist, joins the hosts to discuss the evidence, framework, goals, and treatment options for hypokalemia in internal medicine. They explore the relationship between potassium levels and cardiac complications, discuss treatment options including the benefits of using torsamide over furosemide, and question the necessity of routinely checking morning labs. They also emphasize the importance of engaging with all clinicians to bring about change in hypokalemia treatment.

#136 How Did Diabetes Medications Become Weight Loss Meds? SURMOUNT-1 trial explores the difference between semaglutide and tirzepatide in outcomes and mechanism. Discussion on the history of obesity treatment and how medications for diabetes were found to have a weight loss benefit. The effectiveness of tirzepatide as a weight loss drug compared to semaglutide. Speculations on future medications with similar potential.

Discussion on starting, continuing, and stopping GDMT medications for heart failure patients with kidney disease. Exploring the use of hydralazine and isosorbide dinitrate in hypertension management. Insights on ivabradine as a medication for heart failure. Considerations for starting GDMT inpatient versus outpatient. Addressing the question of EF recovery in patients on GDMT.

Explore improving diagnostic errors, cognitive biases, and practices to decrease error in medical education research. Emphasize the importance of building knowledge base and illness scripts. Highlight significance of reflection, feedback, and creative ways to obtain feedback in clinical practice.

Topics discussed in this podcast include side effects of tacrolimus and mycophenolate, medication interactions, unique causes of acute kidney injury in transplant recipients, viral syndromes associated with fever, signs and symptoms of rejection, immunosuppression, medication reconciliation, infections in transplant patients, transplant rejection, cancer after transplant, the role of steroids in post-kidney transplant maintenance, medication management and adherence, challenges and treatment options for hydro-nephrosis, viral serologies and risk factors, and cancer screening in immunocompromised patients.

In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.Show notes & TranscriptAccess to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.Timestamps00:50 Question REVIVED addressed01:44 Revascularication in HFrEF06:32 Revascularization in stable CAD10:02 REVIVED trial12:20 Summary and takeawaysTags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicineFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics: https://branchbasics.com/COREIM and use the code CoreIM for 15% * Check out Uncommon Goods: https://uncommongoods.com/COREIM* Check out Washington Red Raspberries: https://redrazz.orgAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy