Join us as we review recent practice-changing articles on loop diuretics for heart failure exacerbation (torsemide vs furosemide), time-restricted eating vs small frequent meals for weight loss, how sedentary breaks from sitting effect blood glucose & blood pressure, early FMT for C. diff, and a brief rant on medications for obesity. Fill your brain hole with a delicious stack of hotcakes! Featuring Nora Taranto (@norataranto, The DIGEST), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer Loop diuretics (torsemide vs furosemide) for heart failure exacerbation Time-restricted eating vs small frequent meals for weight loss Sedentary breaks for lowering blood glucose and blood pressure Early fecal microbiota transplant (FMT) for C. diff infection  Outro Credits Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Full transcript available HERE

With Dr Holly Wong Cummings Listen in as we talk through abnormal uterine bleeding (AUB) with our esteemed guest Holly Wong Cummings, MD.  We review the PALM-COEIN framework for AUB diagnosis and discuss options for acute and chronic treatment of AUB.  We can get bleeding under control! Many of the treatments including progesterone only pills, combined oral contraceptives, and tranexamic acid are medications we in primary care should feel confident prescribing to our patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak Normal Menstrual Cycle Nomenclature for AUB- PALM COEIN History and Physical Exam Laboratory and radiologic evaluation Structural causes for bleeding/interpreting the ultrasound Acute treatment of AUB When to refer to ED Chronic treatment for AUB When to refer to gyn Take home points Outro Credits Producer, Writer, Show Notes: Molly Heublein MD Infographic: Edison Jyang Cover Art: Sarah Phoebe Roberts Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD Reviewer: Sai S Achi MD, MBA Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Holly Wong Cummings MD Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full transcript available HERE

Join Drs. Amin and Trubitt as they go rogue and LIVE!  from Southern Hospital Medicine to discuss Things We Do For No ReasonTM in the hospital that impact the patient experience. They cover NPO at midnight, fluid restriction, VTE chemoprophylaxis and routine vital signs via the hospital course of one poor, unfortunate soul. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro NPO at midnight Fluid restriction VTE chemoprophylaxis Frequency of vital sign monitoring Outro Credits Written and Produced by: Monee Amin MD and Meredith Trubitt MD Cover art and presentation graphics: Caroline Coleman, MD Show Notes: Monee Amin MD and Meredith Trubitt MD Hosts: Monee Amin, MD and Meredith Trubitt MD Technical Production: PodPaste Showrunner: Matthew Watto MD, FACP Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions.  Sponsor: Indeed Visit indeed.com/internalmedicine to start hiring now.  Sponsor: BetterHelp  ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb  Full Transcript available HERE

Recognize when to consider the diagnosis of hemochromatosis  and how to recognize common mimics of an elevated ferritin level. We’re joined by Dr. Elliot Tapper,@ebtapper on twitter (University of Michigan) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Initial evaluation of Hemochromatosis  Etiology of elevated ferritin in liver disease Potential mimics of hemochromatosis  Diagnosis of hemochromatosis Evaluation of hepatic fibrosis in hemochromatosis Manifestations & complications of hemochromatosis  Outro Credits Producer & Writer:: Elena Gibson MD    Infographic & Cover Art:Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Elliot Tapper Sponsor: Green Chef Go to greenchef.com/curb60 and use code curb60 to get 60% off plus free shipping.  Sponsor: Birch Living  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Better Help  Visit betterhelp.com/curb to get 10% off your first month.  Full transcript available HERE

With Dr Steven Rauch Demystify hearing loss, identify who will benefit from hearing aids and learn to evaluate hearing complaints in primary care including an overview of tinnitus and how to recognize and treat Meniere’s disease with guest expert, Dr. Steven Rauch (Harvard University). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak;  Definitions, etiology and risk factors for hearing loss  Initial workup for hearing loss What is an audiogram and what does it show  Hearing loss red flags  How to manage hearing loss Tinnitus: what can help patients  Diagnose, distinguish and treat Meniere’s disease  Outro Credits Script and Show Notes written by,  Produced by: Kate Grant MBChB, MRCGP and Andréa Perdigão Infographic and Cover Art: Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Steve Rauch MD Sponsor: Better Help Visit betterhelp.com/curb to get 10% off your first month.  Full Transcript HERE

Pro Tips & Practical Insights from Dr. Jim O’Brien Are acute COPD exacerbations taking the wind out of YOUR sails? Join us as we navigate the stormy waters that can be AECOPD with our guest expert,  Dr. Jim O’Brien                                                                          from National Jewish Health Center. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio What is a COPD  Case from Kashlak - Natalie Harrison Knee jerk reaction: Determining level of illness & disposition Initial work-up considerations What’s in your differential? The second-order assessment - shuffling the differential, honing in on the patient AECOPD: Triggers & Pathophysiology Treatment Pearls I: Steroids Treatment Pearls II: Antibiotics Treatment Pearls III: Bronchodilators Treatment Pearls IV: Oxygen Therapy Preparing for discharge Take home points Lightning Round! Getting to know Dr. O’Brien &  Picks of the Week* Outro Credits Writer & Producer:  Cyrus Askin MD Show Notes, Infographic & Cover Art: Cyrus Askin MD  Hosts: Meredith Trubitt MD, Monee Amin MD & Cyrus Askin MD    Reviewer:  Sai Achi, MD MBA  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jim O’Brien MD Sponsor: Medmastery Go to www.medmastery.com/curbsiders to claim a 15% discount off an annual Medmastery Pro Subscription.  Full Transcript available HERE

Conquer your fear of adrenal incidentalomas! We’re joined by Dr. William Young, who teaches us pearls for evaluating imaging characteristics of adrenal incidentalomas, tips for assessing and managing functioning adenomas, approaches to follow-up and surgical considerations, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case #1 from Kashlak; Definitions Discussing adrenal incidentalomas with patients Imaging characteristics of adrenal incidentalomas Evaluation of hormonal hypersecretion - overview Subclinical Cushing’s syndrome Pheochromocytoma Surgical considerations based on nodule size and imaging phenotype Follow-up imaging Case#2 from Kashlak  Primary hyperaldosteronism - work-up and management Bilateral adrenal nodules Guest Picks of the Week Outro Credits Producer, Writer, Show Notes, Infographic, and Cover Art: Malini Gandhi  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: William Young MD Sponsor: Grammarly Go to grammarly.com/podcast to sign up for an account and download! And when you’re ready to upgrade to Grammarly Premium, get 20% off.  Sponsor: BetterHelp Visit betterhelp.com/curb to get 10% off your first month.  Full Transcript HERE

We have better tools for prevention, but let’s talk! Should we be offering hormone therapy for primary prevention in postmenopausal patients?  Dr. Carol Mangione (UCLA) talks us through the potential benefits and harms, and explains how this can be a jumping off point for important conversations about preventive care. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers, Hosts: Elena Gibson MD and Paul Williams MD, FACP Writer, Infographic, and Cover Art: Elena Gibson MD Show notes: Paul Williams MD, FACP Reviewer: Molly Heublein MD Production team: Podpaste Guest: Carol Mangione MD Full transcript available HERE

In this episode you will learn to master delirium in the hospital!  We discuss preventing, recognizing, and managing this common and dangerous condition.  We are joined by delirium expert and President of the American Delirium Society, Dr. Esther Oh @EstherOh_MDPhD (Johns Hopkins University) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case 1 from Kashlak: hypoactive delirium Definition of delirium Delirium vs. encephalopathy vs. dementia Delirium assessment tools Prevention of delirium Discharging patients with delirium Case 2 from Kashlak: hyperactive delirium Antipsychotics Working up etiologies of delirium Treatment/management pitfalls Outro Credits Produced, Script, Show Notes: Adam Barelski MD  Infographic & Cover Art: Edison Jyang; Sarah Phoebe Roberts Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Adam Barelski MD    Reviewer: Molly Heublein MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Esther Oh MD, PhD Sponsor: Panacea Financial  Visit panaceafinancial.com to open your free account. Full transcript HERE

Don’t get distracted, pay attention to the details, and manage ADHD in your patients! Dr. Kevin Simon, @DrKMSimon (Boston Children’s Hospital) shows us how to stay focused and diagnose and manage attention deficit hyperactivity disorder (ADHD)  in your patients.  Learn how to make the right diagnosis, choose an appropriate medication, and modify therapy.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak; Definitions and diagnosis of ADHD Stimulant medications for ADHD Non-stimulant medications for ADHD Mitigating diversion of medications for ADHD Managing ADHD in patients with substance use disorder Lightning round and picks of the week Outro Credits Written and Produced by: Paul Williams, MD, FACP Show Notes: Paul Williams, MD, FACP Infographic and Cover Art: Paul Williams, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed, MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Kevin Simon, MD Sponsor: Better Help Save 10% off your first month at betterhelp.com/curb Sponsor: Birch Living  Visit birchliving.com/curb to get $400 off all mattresses and 2 free eco-rest pillows.  Full Transcript HERE