The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast
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May 7, 2020 • 58min

#212 Inpatient Alcohol Withdrawal: Sober Talk with Joji Suzuki, MD

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal!  Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!). Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME Credits Written and Produced by Nora Taranto MD Infographic and Cover Art by: Nora Taranto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Joji Suzuki MD Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film) 08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk 17:32 Outpatient Versus Inpatient Treatment 25:27 Gabapentin for alcohol withdrawal 27:10 Indicators for ICU level Care 31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs 36:55 And which benzo? 39:47 A Natural History of Withdrawal 44:10 Banana Bags and Thiamine Deficiency 48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing 56:36 Outro and Bonus clip
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May 1, 2020 • 50min

#211 COVID Cakes: Remdesivir, Anticoagulation, and Transmission

In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD Writer: Emi Okamoto MD, Rahul Ganatra MD MPH, Cover Art: Chris Chiu MD Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsors: Apollohct.com and VCU Health CE Time Stamps 00:30 Intro, disclaimer 02:30 Picks of the Week 6:36 Remdesivir trial rundown 21:52 Thrombosis in COVID-19 29:50 Asymptomatic/Presymptomatic transmission 41:42 Quick takes 49:00 Outro
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6 snips
Apr 27, 2020 • 1h 14min

#210 Kidney Transplant for the Internist with Freely Filtered (NephMadness)

It’s NephMadness! Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from the Freely Filtered Podcast led by Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist. Topics: indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME Credits Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew Infographic: Cyrus Askin MD Cover Art: Kate Grant MBChB DipGUMed Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE Time Stamps 00:00 Announcement, Intro to Freely Filtered and NephMadness 04:00 Case of advanced CKD; Who/when to refer for transplant 12:05 Benefits of renal transplant 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors 20:40 Medications after transplant; Drug-drug interactions 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness 32:07 Calcineurin inhibitor levels 36:42 Prophylaxis for long term complications 40:21 Allograft rejection; BAMF criteria 50:40 Cardiovascular risk; Statins 56:11 Malignancy after kidney transplant 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy 72:23 Outro
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Apr 23, 2020 • 52min

#209 LIVE! Twitter, Social Media and Digital Scholarship

LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media.  Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Infographic: Michelle Brooks MD Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Clair Morgan of nodderly.com Guest: Michelle Brooks MD Sponsor: VCU Health CE Time Stamps 00:00 Guest one liner, favorite failure, career advice, 08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series) 11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles 23:04 Negative aspects of social media 26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer 37:14 Pros and Cons of #medtwitter 42:02 Tweetorials 44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media 51:34 Outro
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Apr 20, 2020 • 1h 9min

#208 Hypothyroidism Master Class with Susan Mandel MD - How to dominate the diagnosis and management

Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Elena Gibson MD Cover art and Infographic by: Dr Kate Grant MBChb MRCGP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com Guest: Susan Mandel MD, MPH Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice 09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms 13:20 When to Test for Hypothyroidism 17:43 Biotin interaction 19:49 Which thyroid tests should we order? 26:15 Subclinical hypothyroidism 29:00 Etiology/Types of hypothyroidism 33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam 37:10 Levothyroxine replacement time of administration 42:10 TSH goal 46:00 Levothyroxine manufacturers 48:33 Dosing in older adults 50:27 T3 treatment 56:52 Pregnancy 59:42 Dose adjustments 61:43 Estrogen and thyroid binding protein 63:33 Who needs a referral? 65:40 Plugs, Outro
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Apr 16, 2020 • 43min

#207 How to create a medical podcast: Tales from The Curbside

Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com   Credits Written and produced by: Matthew Watto MD Cover art and Infographic by Matthew Watto MD Hosts: Matthew Watto MD and Paul Williams MD Editor: Clair Morgan of Nodderly.com   Time Stamps 00:00 Announcement, Intro, Disclaimer 02:53 Our top podcasting pearls 07:01 Find your niche 09:46 Logistics 13:25 Business, finances and legal matters 14:40 Equipment 21:48 Recording and editing 24:56 Website, web and media hosting 28:53 How to setup and record your podcast 35:08 Editing software 35:58 Search engine optimization 37:45 Post-processing 39:49 Take home points and outro  
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16 snips
Apr 13, 2020 • 1h 11min

#206 Airway Management for the Non-Intensivist

Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management  in these challenging times. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD Show Notes: Cyrus Askin MD Infographic: Elena Gibson, MD Cover Art: Dr. Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: COL Kevin Chung, MD, FACP Sponsors: McGraw Hill Time Stamps 00:00 Intro 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice 07:40 Sponsor 08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs 16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation 23:40 Proning patients for hypoxemia 29:15 ARDS basics: diagnostic criteria, Brief Recap 33:22 Mechanical ventilation: Initial settings, following the blood gas 40:55 Peak and plateau pressure, Lung compliance and  Troubleshooting a high pressures 51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs 62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19 68:10 Take home points; Plugs; Outro
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Apr 10, 2020 • 45min

#205 COVID Cakes and Hot Takes with Rahul Ganatra MD

Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston). Plus, @Paulnwilliamz and @cjchiu give us  some telehealth along with the usual antics. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written, Produced, Hosted by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art and Show Notes by: Matthew Watto MD, FACP Editor: Matthew Watto MD Guest: Rahul Ganatra MD Time Stamps 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site 11:50 Telehealth best practices 16:42 Convalescent plasma and Serology 21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report) 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality 25:30 Critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial 49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)
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12 snips
Apr 6, 2020 • 50min

#204 NephMadness 2020: SGLT2 Inhibitors

Explore the exciting world of SGLT2 inhibitors with Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf. They discuss the mechanisms and benefits of these inhibitors for glucose control, cardiovascular health, and chronic kidney disease. The speakers delve into the hemodynamics and regulation of glomerular filtration and explore the various mechanisms of action of SGLT2 inhibitors, emphasizing their impact on inflammation, fibrosis, insulin sensitivity, and more. They also discuss the cancellation of Neffmatin and make predictions for the winners in the NephMadness 2020 SGLT2i region.
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Apr 2, 2020 • 55min

#203 How to Create an Online Curriculum for Medical Education

Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Paul Williams MD, FACP Cover art and Show notes by: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Kat Zechar MD and Amreet Sidhu MD Time Stamps 00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020. 01:22 Intro, disclaimer and guest bios 03:38 Guest one-liners, Picks of the week 09:30 Why you might need an online meded curriculum 16:33 Overview of Amreet and Kat’s online curriculum 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org) 46:35 Time commitment 50:55 Take home points and Outro

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