The Curbsiders Internal Medicine Podcast

Fill up your plate with some spooky tofurkey cakes! Drs. Rahul Ganatra (@rbganatra) and Nora Taranto (@norataranto) help catch us up recent practice-changing articles and guidelines including EMPEROR-Reduced (SGLT2 inhibitors for HFpEF), the 2021 CHEST VTE guidelines update, whether or not antibiotics are needed for diverticulitis, and what treatments are most effective for rotator cuff disease! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art: Beth Garbitelli Hosts: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Rahul Ganatra MD, MPH Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and two free eco-rest pillows at BirchLiving.com/curb   Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer,  Picks of the Week EMPEROR-Reduced (SGLT2 inhibitors for HFpEF) GRASP trial for rotator cuff disease (physiotherapy and steroid injections) DINAMO trial (no antibiotics for outpatients with uncomplicated diverticulitis) 2021 CHEST VTE Guidelines Update Outro

Take a deep breath and inhale high-yield knowledge molecules about the perplexing conditions known as bronchiectasis and NTM (nontuberculous mycobacteria)! Learn the pitfalls and pearls of diagnosis and management from one of the world’s experts, the great Dr. PJ McShane from UT Health - East Texas! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Writers/Producers: Cyrus Askin MD; Leah Witt MD Infographic & Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD    Reviewer: PJ McShane MD Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com Guest: PJ McShane MD  Sponsor: Ten Thousand.  Ten Thousand is offering our listeners 15% off your next purchase! Go to https://www.tenthousand.cc  and enter code: CURB to receive 15% off your purchase at checkout! Sponsor: The American College of Physicians  Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.   CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest introduction and recommendations Case from Kashlak - Part I: The Basics What is bronchiectasis, how do we define it? Symptoms and history Why does it matter? What should you ask, how do you work this up? A brief discussion on antibiotics Case from Kashlak - Part II: Getting into the ManagementAirway Clearance Case from Kashlak - Part III: The Sputum (Plot) Thickens What is a bronchiectasis exacerbation? Pitfall and pearls regarding exacerbation management Case from Kashlak - Part IV: The Sputum (Plot) Thickens Even Further! Non-tuberculous Mycobacterial Infections - the basics Triple Drug Therapy for MAC The new kid on the block: Liposomal Inhaled Amikacin for refractory MAC Summary and take home points from Dr. McShane Outro

What to expect when you’re taking care of a patient who’s expecting! This fantastic episode will help you work through preconception counseling with ease, assess and treat non-obstetrical acute concerns in pregnant patients, and help you conceptualize best practices for postpartum care. We are joined by expert guest Dr. Xiaolei Chen.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli  Show Notes by: Shelagh Browne Cover Art and Infographic: Edison Jyang  Reviewer:   Molly Heublein MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Xiaolei Chen MD Sponsor: GreenChef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping! GreenChef.com/curb125 Sponsor: Need to hire? You need Indeed. Get started RIGHT NOW with a $75SPONSORED JOB CREDIT to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer valid through December 31st. Terms and conditions apply.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org . Show Segments Intro Picks of the week  Preconception counseling Lifestyle: caffeine, alcohol, exercise  Preconception medications  Management of acute complaints during pregnancy  Go-to medications for acute complaints during pregnancy Chronic diseases during pregnancy Postpartum management Breastfeeding recommendations Take-home points Outro 

Who gets a COVID booster? Can we mix and match COVID vaccines?  What are monoclonal antibodies and when should we use them? What is molnupiravir and does it work? Shots for kids? Ready yourself to answer these questions and more with our guest, Dr. Monica Gandhi @MonicaGandhi9.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer and Writer: Isabel Valdez PA, Molly Heublein MD Infographic: Edison Jyang Cover Art:  Edison Jyang,  Isabel Valdez, PA Hosts: Molly Heublein MD, Chris Chui MD, Isabel Valdez PA Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Monica Gandhi MD Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Covid Boosters Pfizer data Moderna Data DNA vaccines Pediatric Vaccines Monoclonal Antibodies Molnupiravir Dr Gandhi’s crystal ball Outro

Explore burnout and gender-based differences in well-being with our esteemed guests Drs. Clif Knight, Tammy Lin, and Kim Templeton. We discuss workarounds for leading our way to wellness.  Dr. Clif Knight is a family physician and Senior Vice President for Education at the American Academy of Family Physicians (AAFP) with extensive leadership and expertise in well-being.  Dr. Tammy Lin is an internal medicine specialist and a Voluntary Assistant Clinical Professor at the University of California, San Diego Health Sciences. We originally met her as a member of the Wellness through Equity and Leadership (WEL) Program and she started a podcast called "The DEI Shift" (pronounced The "Day" Shift), which focuses on diversity, equity, and inclusion within the medical field. Dr. Knight and Dr. Lin participated in the 2019-2020 WEL program-- six different specialty organizations came together to think about the core tenets of equity, well-being and leadership and how you really can’t have one without the other.  Dr. Kim Templeton is Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City.  Her research focuses on women physicians and the inclusion of sex and gender medicine in medical education. No CME for this episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD Infographic: Leah Witt, MD Cover Art: Kate Grant MBChB MRCGP DipGUMed Hosts: Matthew Watto MD, FACP; Leah Witt, MD, Shreya Trivedi, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Clif Knight, MD, Tammy Lin, MD, Kim Templeton, MD Sponsor: Grammarly Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Panacea Financial Learn about their $1,000 giveaway at panaceafinancial.com/curb. Panacea Financial is a division of Primis member FDIC. Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer, guest bios Burnout & Wellness The Case: Dr. Elizabeth Blackwell & her friend in primary care The Part-Time Discussion Outro

Fine-tune your approach to liver tests!  It’s LFTs Triple Distilled! Paul and Matt channel the wisdom of hepatologist, Dr. Elliot Tapper (@ebtapper) to cover hepatocellular vs cholestatic vs mixed patterns, which tests to order, which ones to skip, how to handle isolated alkaline phosphatase elevation, mild, chronic ALT elevation, and even how to interpret liver test abnormalities in pregnancy.  Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #293 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographic by: Elena Gibson Cover Art: Matthew Watto MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb  Sponsor: Locumstory Visit Locumstory.com to see if a locum tenens assignment is right for you. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Hepatocellular pattern Cholestatic pattern Chronic ALT elevation Isolated Alkaline phosphatase elevation Liver test abnormalities in pregnancy Outro

Join us for this rapid fire review of systems featuring our top pearls and articles LIVE! from the TriService ACP conference. Matt and Paul serve up their favorite practice changing knowledge food on antibiotics, MRSA, hair loss, dementia, seizures, diabetes, medications for hypertension, foods for constipation, diverticulitis, colon cancer screening, colon polyps, chronic sinusitis, chronic cough, treatment of uterine bleeding, and more!  No CME for this episode, but check out curbsiders.vcuhealth.org for past CME offerings! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Matthew Watto MD, FACP; Paul Williams MD, FACP    Cover Art: Sawyer Watto Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb.         Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer ID: Shorter is better; MRSA swabs; Antibiotics for diverticulitis Endo: Prediabetes in older adults,  MSK: Knee OA, orthopedic surgery Derm: Alopecia Neuro: Seizures, dementia quick typing Cardio: Coffee and arrhythmias; Hypertension management, ACEi vs ARBs Respiratory: Chronic cough and sinusitis GI: CRC screening, foods for constipation GU: treatment of uterine bleeding Addiction Medicine: smoking cessation, buprenorphine Outro

Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and  understand diagnostic testing, management and proper follow-up for patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Production and Script: Matthew Watto MD, FACP Production, Show Notes and Infographics: Edison Jyang Cover Art: Kate Grant MBChB, MRCGP, DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli    Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Amy Oxentenko MD, FACG Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. Sponsor: Grammarly Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB  CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; Definitions Workup for a typical celiac patient Nonclassical features of CD When to do a small bowel biopsy Management of CD Considerations for atypical celiac patient and differentials Non-celiac gluten sensitivity Outro Links Crucial Conversations (book) Gluten-free flour (flour) Pie crust recipe (recipe) What Remains of Edith Finch (game) Doughboys (podcast)

Confidently manage acute pain in the hospital! In this episode listeners will learn  how to develop a multimodal analgesia plan for acute pain in the hospital, as well as how to safely initiate and discharge a patient on opioids. We’re joined by Dr. Melissa Weimer @DrMelissaWeimer  (Yale School of Medicine). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer and Writer: Carolyn Chan, MD Script: Carolyn Chan, MD, Avi O’Glasser, MD Cover Art and Infographic: Edison Jyang Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD Reviewer: Emi Okamoto, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Melissa Weimer DO Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. Sponsor: Green Chef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping! CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments 01:39 Intro, disclaimer, guest bio 03:20 Guest one-liner, Picks of the Week 09:18 Case from Kashlak; Definitions 11:00 Assessing Acute Pain 12:12 Types of Pain 15:08 Initiating Opioids 22:32 Counseling on Opioid Exit Strategy 25:26  Opioid Dependence vs. Opioid Use Disorder 29:50 Post-Op Pain Management 31:00 Other cool stuff 37:00 PCA 41:00 Opioid Taper 46:50 Acute Pain and Opioid Use Disorder 58:00 Methadone Titration 1:04:00 Outro

Do kidney stones have you saying “this too shall pass?” Our guest Dr. David S. Goldfarb, MD, FASN, FNKF, FACP can help! In this episode he takes us through risk factors as well as treatment and prevention for urinary stone disease.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli  Show Notes by: Shelagh Browne, Kate GrantMBChB MRCGP DipGUMed,  Cover Art and Infographic: Kate Grant MBChB MRCGP DipGUMed  Reviewer: Molly Heublein, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: David Goldfarb MD, FSN, FNKF, FACP  Sponsor: ACP’s National Internal Medicine Day 2021 acponline.org/NIMD21 Sponsor: Indeed indeed.com/internalmedicine CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org . Show Segments Guest book recommendation and advice   Common risk factors for urinary stone disease Differential diagnosis of kidney stones Symptomatology of kidney stones Types of stones  Urine pH Role of physical exam Role of imaging  STONE score Labs to order  Management of urinary stone disease Prevention of urinary stones and approach to lifestyle/diet changes  Outro