The Curbsiders Internal Medicine Podcast

Electric cars, virtual reality, nanotechnology, and now… telemedicine? We chat with Dr. Ana María López MD, FACP about the future of telehealth, how to implement it in your practice, and the challenges you might face in doing so. Dr. López is immediate past president of the American College of Physicians (ACP) as well as Vice Chair of Medical Oncology and Chief of New Jersey Division Sidney Kimmel Cancer Center of Thomas Jefferson University. Her main areas of professional interest and expertise include cancer prevention and equity, integrative oncology, implementation of innovations in health care including telemedicine, and women’s health. We learned immensely from our talk with her and we hope you will, too! ACP members can claim free CME & MOC credit at https://acponline.org/curbsiders. Download Dr Brigham’s telehealth cheat sheet as a PDF at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Hannah Abrams, Stuart Brigham MD Cohosts: Matt Watto MD, Stuart Brigham MD, Paul Williams MD, Hannah Abrams Guest: Ana María López MD

This week we narrow in on the enlarging prostate and decipher the common issue of benign prostatic hyperplasia with Adam C. Reese MD, Associate Professor of Urology at the Lewis Katz School of Medicine at Temple University and Chief of Urologic Oncology at Temple University Hospital. Learn how to interpret the symptom profile for patients presenting with common urinary issues, what to feel for in the digital rectal exam, how to treat BPH, and when to refer. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). See you at SGIM 2019! Find us in our red Curbsider’s t-shirts handing out Curbsiders and Kashlak stickers/patches at SGIM 2019 in Washington DC! We’ll be recording full length shows and daily recaps! Credits Written and produced by: Paul Williams MD Hosts: Paul Williams MD, Matthew Watto MD Images and infographics: Elena Gibson, Beth Garbitelli Show Notes: Elena Gibson, Beth Garbitelli Edited by: Matthew Watto MD, Chris Chiu MD Guest: Adam Reese MD Time Stamps 00:00 SGIM announcement 00:30 Disclaimer, intro and guest bio 03:20 Guest one liner, book recommendation, favorite failure and surgical M&M 10:56 Case of benign prostatic hyperplasia, defining terms and obstructive/voiding versus storage/irritative symptoms 16:11 IPSS score and evaluating symptoms 22:10 Digital rectal exam. Will this give any useful information? 26:55 Taking a history about BPH and some lifestyle modifications 29:20 Lab studies for urinary tract symptoms and interpreting PSA and free PSA 36:20 Initial therapy for BPH and managing patient expectations, alpha blocker side effects 39:25 Choice of agent and monitoring symptoms on therapy 42:25 Nonpharmacologic management of bladder complaints 45:10 Who and when to refer to urology 47:33 Counseling about use of 5 alpha reductase inhibitors, their side effects and is there a risk for high grade cancer? 52:35 Phosphodiesterase inhibitors for BPH symptoms 53:50 Urethral milking. NOT prostate milking 54:55 Desmopressin for nocturia 56:20 Take home points 59:03 Prostate volume and PSA 61:10 Outro Full show notes available at http://thecurbsiders.com/episode-list.

Dr. Alan Dow from VCU sheds light on key takeaways from the ACP's Internal Medicine Meeting, diving into topics like sleep deprivation's critical impact on health and the glymphatic system's role. Emi Okamoto shares vital insights on dermatology and immigrant health, emphasizing the need for trauma-informed care. They discuss innovative treatment options for chronic back pain, heart failure management, and the shifting landscape of medical marijuana in tackling pain and sleep issues. Humor and camaraderie shine through their lively conversation.

Discover the latest in medical innovation, like baloxavir, a game-changing flu treatment with its single-dose convenience. Unpack important insights about penicillin allergies and their treatment implications. Learn about non-invasive coronary assessment using supercomputers, which could reshape cardiac practices. Dive into the latest strategies for stress testing and managing syncope, comparing guidelines from the UK and the US. Plus, enjoy lighthearted banter on hiring challenges in academia amidst serious medical discussions!

Join Renee Dversdal, Chief of POCUS at Cashlack Memorial, as she shares insights from the ACP’s Internal Medicine Meeting in Philadelphia. She dives into the significance of point-of-care ultrasound in diagnosis. The conversation also touches on Lyme disease treatment, management of back pain, and the latest on sexually transmitted infections. Listeners will benefit from invaluable pearls on cardiology, including when it’s safe to resume intimacy after a myocardial infarction and the flip-flop fungal sign in pulmonology. Tune in for a wealth of practical medical knowledge!

Join(t) us in learning about rheumatoid arthritis care for the internist with Robert McLean MD, rheumatologist, Associate Clinical Professor at Yale, and President Elect of the ACP! We discuss the complexity of rheumatoid arthritis, how to differentiate from other arthritic conditions, and how to have a patient-centered framework for the evaluation and treatment of affected patients. ACP members can claim CME-MOC credit at on ACP's site.. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer (Interview & CME questions): Cyrus Askin MD Show Notes and Infographic by: Elena Gibson MS4 Hosts: Matthew Watto MD, Stuart Brigham MD Editors: Matthew Watto MD, Emi Okamoto MD Guest: Robert McLean MD

Explore the complexities of pain management in chronic kidney disease (CKD), including the risks and benefits of opioids, gabapentin, tramadol, and NSAIDs. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in CKD is discussed, along with alternative options like topical NSAIDs. Discover pain management options for neuropathy and arthritis, and hear predictions and analysis of various pain meds in the NephMadness tournament.

Does your sympathetic nervous system get activated when you notice acute kidney injury in patients with cirrhosis? Ever wonder how to really diagnose hepatorenal syndrome (HRS)? Think you have the bile-acid-stones to start diuretics on a patient requiring pressor support for kidney failure? You have come to the right place! Listen to @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) tackle the complex pathophysiology and treatment of hepatorenal syndrome in this NephMadness 2019 special episode! Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Earn CME and read about each region at AJKD blog. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Justin Berk MD, Nora Taranto MS4 Infographic by: Alex M @nephroguy Hosts: Matthew Watto MD Edited by: Matthew Watto MD, Emi Okamoto MD Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD Sponsor Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Some precocious policy wonks take a deep dive into the evolving trends and future directions for our primary care workforce. Experts, Dr. Fatima Syed and Dr. Deep Shah return to school us on Physician Supply and Demand, the Access Gap, role of NPs and PAs, Retail Clinics, and Managed Care Clinics. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Catch up on our previous discussions with Dr. Syed and Dr. Shah:  Episode #62: Pod Save Health Care: The Curbsiders Foray into health policy and  Episode #120 Health Policy, Patients, Payments, Paperwork for more context. We also did an overview of health care policy essentials with Dr. Sue Bornstein in  Episode #64: Stuff You Should Know About Health Policy Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Fatima Syed MD, MSc; Deep Shah MD, MSc CME questions by: Chris Chiu MD, Beth Garbitelli MS1, Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD, Images and infographics: Beth Garbitelli MS1 Edited by: Matthew Watto MD, Chris Chiu MD Guest: Fatima Syed MD, MSc, Deep Shah MD, MSc

Three nephrology experts discuss inpatient hypertension, including how to respond to overnight nursing calls for elevated blood pressures and the role of treating hypertensive urgency in the hospital. They also explore the question of whether ACE-inhibitors are dangerous to give or hold during an operation. This episode provides insights into the role of anti-hypertensives in the inpatient setting.