The Curbsiders Internal Medicine Podcast

Join us as Sandhya Pruthi, MD talks us through basics of breast cancer, specifically how to share a new diagnosis with a patient, the spectrum of disease from favorable to more aggressive, and the basics of what to expect with initial treatment. Feel more confident sharing a new diagnosis of breast cancer and supporting your patients through this journey. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction 02:18 Getting to Know Dr Sandhya Pruthi 09:49 Picks of the Week 12:35 Case 1: Diagnosis and Treatment of ductal carcinoma in situ (DCIS) 21:24 Risk Stratification and Active Surveillance for DCIS 23:43 Genetic Testing Recommendations 28:08 Case 2: Evaluation and Diagnosis of a Breast Lump 39:14 Invasive Ductal Carcinoma 47:49 Initial Management of invasive ductal carcinoma (IDC) 48:19 Preoperative Discussion and MRI 49:19 Lumpectomy and Sentinel Lymph Node Biopsy 50:16 Radiation and Hormonal Adjuvant Therapy 51:46 Considerations for Chemotherapy 55:51 Signs of Late Recurrence or Metastasis 58:20 Screening Guidelines and Age 01:02:25 Importance of Breast Self-Awareness Credits Written and produced, Show Notes:  Molly Heublein MD Infographic and Cover Art: Edison Jyang Hosts: Molly Heublein MD, Era Kryzhanovskaya MD  Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Sandhya Pruthi MD Transcript Disclaimer We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content. Sponsor: Freed You can try Freed for free right now by going to freed.ai Listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Babbel Get 50% off at Babbel.com/CURB Sponsor: NetSuite Get your own KPI Checklist at NetSuite.com/CURBSIDERS

Get rid of those clots around anticoagulation and antiplatelet management Join us for a review of the perioperative risk assessment of bleeding and clotting and how to manage each patient’s own antithrombotics. We are joined by Dr. Poorvi Hardman from Ohio State University.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid Fire Questions/Picks of the Week Case 1 Risk stratification of thromboembolism and bleeding Review of types of surgeries and risk associated with surgical intervention Utilizing scoring systems to aid decision making Bridging Considerations for VKAs, DOACs  Pitfalls to bridging Case 2 Aspirin Management P2Y12 Management Consultants Outro Credits Written, produced and show notes by: Jaimie Patel MD Infographic and Cover Art by: Caroline Coleman MD Hosts: Monee Amin MD; Meredith Trubitt MD   Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Poorvi Hardman MD Transcript Disclaimer We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content. Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Pathway Improve your clinical decision-making process and enhance patient care. Download the Pathway app today by visiting pathway.md

Dr. Buddy Creech, Pediatric Infectious Disease at Vanderbilt, talks about RSV immunizations, including eligibility criteria and challenges in finding doses. The discussion covers the importance of RSV immunizations for all age groups, the concept of pre-fusion and post-fusion in relation to the virus's fusion protein, alternatives to Bayfortas, health equity for indigenous populations, and key takeaways such as preventing lower respiratory tract disease.

In this podcast, the hosts cover a range of intriguing topics including transfusion thresholds in acute MI, COVID-19 rebound after treatment with nirmatrelvir, the prevalence of iron deficiency, the ineffectiveness of oral phenylephrine, and the liberal vs restrictive transfusion strategy in MI. They also discuss challenges in transfusion decision making, highlight the unreliability of corrected calcium levels, and explore iron supplementation for anemia. A humorous introduction and calcium puns add entertainment to the episode.

Dr. Lisa Simon, an expert in dental care for primary care physicians, discusses a range of topics including dental pain, caries, gingivitis, dry mouth, TMJ dysfunction, and dental side effects of medications. She provides tips for diagnosing dental pain, treatment options, and post-operative care. She also talks about managing complications and emergencies in dental care, as well as oral health in patients with opioid use disorder. Additionally, she addresses the use of anticoagulants during dental procedures and offers recommendations for antibiotic prophylaxis.

Dr. Yoo Mee Shin shares practical tips for managing patients with sickle cell disease in the hospital. Topics discussed include acute pain management, adjuvant therapies, IV fluids, oxygen therapy, acute chest syndrome, and simple vs exchange transfusions. Key takeaways include early triage and analgesia, addressing misconceptions about opioid use disorder, and recognizing complications of vaso-occlusive crises.

Dr. Arielle Langer, an expert in antiphospholipid syndrome, discusses clinical features, laboratory testing, and management of the syndrome. Topics include suspicion for antiphospholipid syndrome, interpreting laboratory testing, managing recurrent thrombosis, and obstetric APLS. The challenges of diagnosing APS based on pregnancy history are also explored. Importance of referring patients to specialists and promoting support is emphasized.

Dr. Xiao Jing (Iris) Wang from Mayo Clinic joins to discuss disorders of the Gut-Brain Interaction (DGBI), including IBS, functional dyspepsia, and cyclic vomiting. Topics include diagnostic criteria and treatments for functional dyspepsia, testing algorithms and treatments for irritable bowel disease, and diagnosis and management of cyclic vomiting syndrome and cannabis hyperemesis syndrome.

The podcast covers a range of interesting topics including menopause therapy, hemochromatosis, hematuria management, diabetes updates, xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, AKI risk, statin therapy in HIV patients, inpatient heart failure management, kratom use implications, and effectiveness of RSV vaccines.

Dr. Carl Pallais, an expert in Hypercalcemia, discusses the regulation of calcium in the body and what happens when it goes wrong. Topics covered include the importance of PTH and phosphorus, causes of hypercalcemia, testing for hypercalcemia, symptoms and history, indications for surgery, and management of hypercalcemia.