
Alert and Oriented
We are a medical student-led podcast aiming to promote the development of clinical reasoning skills in early learners by providing a field to practice swinging for the fences. Although we all strike out here or there along the way, it is our true hope to improve diagnosis in medicine through repetition.
Latest episodes

Aug 19, 2022 • 1h 16min
#22 - Alert & Disoriented - Summer 2022
Very alert, a little disoriented - The team got together after hours to have cocktails and talk medicine. It was a dynamic discussion, filled with digressions and reflections, that covered 1) hypertensive intervention in the inpatient setting, 2) procalcitonin, 3) new acute leukemia presentation - what to watch out for. We hope you enjoy.Listening is best paired with your favorite cocktail, cheers!Here's a link for a 'Naked & Famous', which was enjoyed during this recording.- The A&O Team - Kevin, Rich, Megan & Nick(09:15) - Intervening on an inpatient with hypertension - Nick(23:45) - Procalcitonin - Megan(40:10) - A new acute leukemia patient exercise - KevinFollow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Aug 15, 2022 • 26min
#26 - Clerkship Review Series - Hypercalcemia
Megan Kotzin has been hard at work creating a high-yield topic-based clerkship review series. This episode provides an approach to hypercalcemia including important things to include on your differential as well as possible management strategies.(02:30) - Corrected Calcium(05:30) - Pseudohypercalcemia(06:50) - PTH(11:30) - Severity(14:30) - Lab Data(16:45) - Acute Treatment(21:00) - Long Term ManagementFollow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Aug 8, 2022 • 36min
#21 - A Pain In The Butt
A&O is excited to kick things off with the team we have been putting together at Northwestern. We are thrilled to introduce two new team members. Lauren Smith, who is a M4 student applying into IM, joins Kevin Grudzinski for this episode. You will soon also get to meet Dr. Bruce Henschen when he joins us during an upcoming episode.Lauren presents a case that she saw on a consult service to Northwestern M4s Caroline Zhao & Kelly Vogel. The team discusses diarrhea, BRBPR, and proctitis in a returning traveler. We hope to leave you with a great framework and make this problem a little bit less of a pain in the butt.Follow us on Twitter:A&ORich AbramsKelly VogelA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Jul 18, 2022 • 54min
#20 - The King's Evil
The A&O team at Rush, led by Megan Kotzin & Nick Rigler, present a case of a patient initially seen in clinic to M4s Sameera Khan & Erin Keizur. The team has a wide-ranging discussion centered around the chief complaint of a new neck lump. Check out our post on Twitter that includes a clinical picture.Follow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Jun 16, 2022 • 1h 8min
#19 - Let's Flip the Script
Nick Rigler & Megan Kotzin flip the script and present a recent case to Dr. Abrams and Dr. Kevin Grudzinski. They reason through multi-system findings and look for a unifying connection. Although they do get close, Megan and Nick ultimately stumped Kevin and Dr. Abrams. This one definitely requires a deep dive into your knowledge bank.After listening, please get in contact with us if you were thinking along the right track.We encourage you to briefly pause after each aliquot and test your reasoning in real time!Follow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

May 25, 2022 • 54min
#18 - Jelly Belly
Nick Rigler & Megan Kotzin host (fresh) M4's Luke Detloff & Eric Azua. They, along with Dr. Abrams and (Dr.) Kevin Grudzinski, discuss an exciting case that Dr. Abrams recently had while on service. Bayesian reasoning, plausibility vs. probability, and schematic branch points help guide these two to the most likely diagnosis.We encourage you to briefly pause after each aliquot and test your reasoning in real time!Follow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.References:Symptom to Diagnosis: An Evidence-Based Guide, 4e Stern SC, Cifu AS, Altkorn D. Stern S.C., & Cifu A.S., & Altkorn D(Eds.),Eds. Scott D.C. Stern, et al. McGraw Hill, 2020

Apr 25, 2022 • 40min
#17 - The Johns deLIVER
Excited to welcome back John Levinson and John Stathopoulos to discuss an exciting case with a unique presentation and rather unexpected findings in a young adult. It was fun to sit back and listen to the Johns' navigate this case, impressively reasoning through each aliquot, showing off how much their clinical reasoning skills have grown since their last appearance on A&O.We encourage you to briefly pause after each aliquot and test your reasoning in real time!Follow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Mar 30, 2022 • 48min
#16 - thromBROcytopenia
We are back after taking a short break for match festivities! Nick Rigler & Megan Kotzin present a case of acute intermittent epistaxis. Future orthoBROs Sam Rudisill & Al Hornung reason through thrombocytopenia, proving they know more than just bone stuff!Follow us on Twitter:A&ORich AbramsAl HornungA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Feb 24, 2022 • 57min
#15 - The Sodium Queens
Nick Rigler and Megan Kotzin team up to discuss a case of everyone's favorite, hyponatremia! M3 roommates, Emma St. John and Veena Ganesan, earn the title of Sodium Queens after navigating serum & urine osmolality and urine sodium like electrolyte masters. You will be equally impressed with how they are able to frame their problem representation and give appropriate consideration to some conflicting data, but ultimately do not waiver on their path to the diagnosis.Test your reasoning with each aliquot alongside Emma and Veena!This was our first episode using new audio recording equipment and unfortunately had microphone difficulties with one of our speakers. There are clips throughout where we were not able to clean up the background noise without losing our speaker's voice. We are learning as we go and will continue to work to improve our audio quality!Follow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Jan 24, 2022 • 1h 1min
#14 - When it Rains it Pours
Our newest team member, Nick Rigler, put together an amazing case and leads a discussion that starts off with a complaint of back pain. M3 duo, Aaron Park and Jesus 'Berto' Varela, walk us through their reasoning in real-time and naturally turn to Bayes Theorem as things get challenging. We highlight back pain red flags, cardiac physiology, synovial fluid analysis, and plenty more along the way.Test your reasoning with each aliquot alongside Aaron and Berto!Follow us on Twitter:A&ORich AbramsA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.