Core IM | Internal Medicine Podcast

How do you approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/Time stamps04:45 What do we mean by “futility”?11:20 Definitions20:23 Ethical Analysis39:13 RecommendationsTags: IM Core, CoreIM, ATS, autonomy, justice, values, emotions, communication, medical humanities, ethicsFind 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

Check out original interviews on our Youtube channel!What does the duration of afib tell you about the thromboembolic risk? When do you start anticoagulation for post-op afib? What do the most recent guidelines recommend for perioperative anticoagulation management? How many devices do you know that can be useful in post-discharge cardiac monitoring in new atrial fibrillation? How can we improve our communication regarding afib management?Behind The Scenes videosGet CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps01:12 Intro03:51 Deep Dive 108:16 Deep Dive 215:25 Deep Dive 321:05 Deep Dive 427:07 Deep Dive 5Tags: IM Core, CoreIM, Devices, cardiac, risk, perioperative, stroke, surgery, anticoagulationFind 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

Is it enough to look at LDL-C? What is Apo-B? How do you use TG/HDL ratio to understand your patients cardiovascular risk? Do you need to get a fasting lipid panel? How does it affect the triglycerides and LDL?Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/12/15/reimagining-the-…-the-gap-segment/Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E8Time stamps01:24 Intro 03:37 Fasting vs. Nonfasting Lipid Panel05:11 Current guidelines07:43 Pathophysiology Overview09:04 Pathophysiology of Apo-B vs. LDL-C with traffic analogy11:23 Apo-B15:40 TG-to-HDL ratio17:06 TakeawaysTags: IM Core, CoreIM, risk, USPSTF, ACC/AHH, family medicine, cardiology, primary careFind 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 some ways you address unrealistic hopes with your patients? How can you build a portfolio of hope with your patients? Can you learn to guide your patients hope?Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/11/23/hope/Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E7Time stamps01:20 Intro 04:37 What are some definitions of hope?09:57 How can we address unrealistic hope? 21:39 Addressing hope in clinical practice 32:10 ConclusionTags: IM Core, CoreIM, care, communication, goal setting, support, strategies , medical humanitiesFind 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 tests and history points help with the diagnosis of alcohol-associated hepatitis? What other etiologies should be ruled out? To steroid or not to steroid? What are the medications for alcohol use disorder? Do you make sure your patients have a late night snack? How do you prognosticate? Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/11/09/alcoholic-hepati…5-pearls-segment/Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps01:42 Intro 04:37 Pearl 1: Diagnosis 13:20 Pearl 2: Differential & Treatment20:48 Pearl 3: Nutrition & Alcohol Cessation 27:45 Pearl 4: To steroids or to not steroids?!35:34 Pearl 5: Throwback Tags: IM Core, CoreIM, ALT, AST, liver abnormalities, gastroenterology, alcohol use disorder, nutrition, MELD, Lille, Steroids, Alcoholic HepatitisFind 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 do you educate your patients on aspirin use? For what reasons do you start, continue or stop aspirin? What does trial data tell us? How does aspirin exerts its effect?Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E6ACP CME: http://bit.ly/CIMCMEShow notes, Transcript and References:  https://www.coreimpodcast.com/2022/10/19/mind-the-gap-asp…imary-prevention/Time stamps03:03 Guideline recommendations 07:00 How does Aspirin work? 09:11 Trial Data13:00 ASCVD Risk Calculator18:07 Starting vs. Stopping Aspirin 22:11 Summary Tags: IM Core, CoreIM, guidelines, atherosclerosis, ASCVD, plaque, bleeding, shared decision-makingFind 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

Is a positive ANA always significant? What does the titer mean? Is the pattern of the ANA helpful? What patient histories should you not get an ANA for and which aspects of the history would raise suspicion for autoimmunity? How can you use the physical exam to assess likelihood of autoimmune disease? What is the ddx for a positive ANA?Whiteboard animation video on YouTubeShow notes, Transcript and ReferencesGet CME-MOC credit with ACPSponsor: Visit www.medmastery.com/coreim for 15% off on all subscriptions. Discount code: “COREIM”Timestamps:01:37 Pearl 103:54 Pearl 213:53 Pearl 318:07 Pearl 429:30 Pearl 5Tags: IM Core, CoreIM, autoimmune, joint disease, titers, Raynaud's, lupus, 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

Explore the complexities of incidental findings, especially lung nodules discovered via CT scans. Learn how to assess when these nodules require inpatient or outpatient follow-up. The discussion also highlights the innovative concept of 'fast forward rounds' to improve outpatient care. Delve into effective communication strategies for discharge summaries and the importance of collaboration with primary care providers. Navigate the challenges of creating robust follow-up plans to enhance patient safety and avoid oversights in care.

Can you identify where along the clinical reasoning pathway the learner is struggling? What coaching exercises can be helpful? What feedback do you fall back on when working with learners? What are common challenges?Show notes, Transcript and References: https://www.coreimpodcast.com/2020/12/09/hoofbeats-strugg…inical-reasoning/ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-imFind 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

Hear personal stories about racial trauma or stereotype threat. How can we respond and how do we differentiate an up stander from a bystander? What barriers exist when we try to respond?Show notes, Transcript and References:   https://www.coreimpodcast.com/2022/08/24/upstander/ Time stamps04:51Overview of Microaggressions08:11 Prevalence11:43 How to respond21:03 Barriers to appropriate response26:00 ConclusionTags: IM Core, CoreIM, bystander, race, microaggressions, hidden curriculum, DEIFind 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