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Core IM | Internal Medicine Podcast
- 306 - #221 Colon Cancer Screening After Age 75 | 5 Pearls Segment Part 3
“Should you stop screening for colorectal cancer (CRC) at 75?”
This episode explores how to individualize screening decisions based on life expectancy, prior colonoscopy findings, and procedural risks. Learn how to navigate these nuanced conversations, avoid age-based assumptions, and use strategies like mailed FIT kits and offering screening choices to help more patients get screened.
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🔹Transcript and Show Notes
01:18 | Screening >75 yo?
10:06 | Takeaways on Colorectal Cancer Screening After 75
10:37 | Systems thinking: How do we get to an 80% screening rate
Tags: Core IM, Internal Medicine, Colorectal Cancer Screening, Gastroenterology, Cancer Screening
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 21 Oct 2026 - 305 - #220 Colon Cancer Screening Nuances: 5 Pearls Segment Part 2
“What’s the best way to screen?” This episode breaks down the pros, limitations, and follow-up needs of FIT, Cologuard, CT colonography, and colonoscopy to help you choose the right CRC screening option for your patients. Also learn practical colonoscopy surveillance intervals based on polyp size, number, and pathology.
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01:24 | Screening Options Besides Colonoscopy
11:22 | How FIT, FIT-DNA, and CT colonography differ and when each makes sense.
12:52 | Colonoscopy and Frequency
19:29 | How adenoma number, size, and histology guide surveillance intervals.
Tags: Core IM, Internal Medicine, Colorectal Cancer Screening, Gastroenterology, Cancer Screening
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 08 Oct 2026 - 304 - #219 Updates in Triglycerides
“The triglycerides are high. Now what?” This episode breaks down a practical approach to elevated TGs, from knowing when to check ApoB or non-HDL-C to choosing lifestyle changes, lipid-lowering medications, and when to suspect an underlying genetic disorder.
02:17 | Check a non-HDL-C or ApoB if TGs are ≥150 mg/dL
07:18 | Address waist circumference and lifestyle before meds for high TGs
10:52 | Dr. Watson’s 3-day carbohydrate responsiveness trial
17:07 | Order a fasting or nonfasting lipid panel?
19:00 | When do you reach for TG-lowering medications?
25:26 | Familial chylomicronemia syndrome (FCS)
Tags: CoreIM, Medical Education, Hypertriglyceridemia, ACC AHA lipid guidelines, lipid guidelines 2026, cardiovascular risk
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Privacy & Opt-Out: https://redcircle.com/privacyTue, 29 Sep 2026 - 303 - #218 Early-Onset Colon Cancer: 5 Pearls Segment Part 1
“Too young for colon cancer.”This episode unpacks the red flags of early-onset colorectal cancer (CRC), from blood in the stool and iron deficiency anemia to persistent abdominal pain and changes in bowel habits, and offers practical pearls for closing the clinical loop. Also learn why a “negative” family history may need a yearly refresh.
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01:45 | Colorectal cancer rising in younger adults
06:42 | Why screening starts at age 45
08:15 | What may be driving early-onset colorectal cancer
13:37| Key takeaways: symptoms, follow-up, and family history
Tags: Colorectal Cancer Screening, Internal Medicine, Gastroenterology, Cancer Screening, Oncology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 23 Sep 2026 - 302 - #217 Treatment for Alcohol Use Disorder: 5 Pearls Segment
“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and support their recovery. Also discover blind spots in detox and rehab centers.
🔹 Explore ACP’s Substance Use Disorder Education Hub for videos and an AI-powered patient simulation to practice alcohol-use conversations: https://www.coreimpodcast.com/SUDhub
Alcohol Use and Chronic Health Conditions Mini Video Series
01:55 | #1: Naltrexone
12:06 | #2 Acamprosate
16:15 | #3: Topiramate
21:12 | #4: Other meds
29:31 | #5: Detox and rehab blind spots
Tags: CoreIM, Medical Education, Addiction Medicine, Alcohol Withdrawal, Addiction Treatment, GLP-1, pharmacology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 16 Sep 2026 - 301 - #216 Clinician Grief: At the Beside Segment
Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always obvious. We also discuss ways to work through that grief, recognize when it becomes complicated, and lean on your team for support.
04:12 | What is Clinician Grief?
10:02 | Types of Losses
10:22 | Loss of a close relationship with a particular patient
12:56 | Loss due to a professional's identification with the pain of family members
13:56 | Loss of one's unmet goals and expectations and one's professional self-image and role
18:47 | Loss related to one's personal system of beliefs and assumptions about life
21:30 | Past unresolved losses or anticipated future losses
23:29 | The death of the self
25:44 | Coping
Tags: CoreIM, Medical Education, Clinician Wellbeing, Burnout, Secondary Traumatic Stress, Complicated Grief, Coping With Grief, Medical humanities, medical ethics
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Privacy & Opt-Out: https://redcircle.com/privacyTue, 08 Sep 2026 - 300 - #211 Breaking Down MASLD vs. MASH and the MAESTRO-NASH & ESSENCE Trials: Beyond Journal Club Segment
MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we finally entering an era where we can meaningfully treat MASH?
In this Beyond Journal Club episode, we unpack the evolving language of steatotic liver disease and take a close look at two major trials: MAESTRO-NASH studying resmetirom, the first FDA-approved liver-directed therapy for MASH, and ESSENCE, evaluating semaglutide in biopsy-confirmed disease.
Along the way, we explore what these biopsy-based histologic endpoints really mean, why placebo responses were surprisingly high, and whether improvements in steatohepatitis and fibrosis will ultimately translate into better clinical outcomes for patients.
This episode is for clinicians trying to understand where the field is headed, which patients deserve closer attention, and how metabolic liver disease is increasingly becoming part of everyday primary care and hospital medicine.
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01:57 | Understanding MASLD as a Systemic Disease
05:45 | MASLD vs MASH vs Met-ALD: Spectrum Steatotic Liver Disease
08:55 | How to Screen for Fibrosis (FIB-4 & FibroScan)
16:15 | Lifestyle Treatment & Weight Loss Targets
19:00 | ESSENCE Trial: Semaglutide for MASH
21:58 | MAESTRO-NASH Trial: Resmetirom
27:27 | Future Treatments for MASH
30:51 | Key Takeaways for Clinicians
Tags: CoreIM, Internal Medicine, Medical Education, Hepatology, Fatty Liver Disease, Metabolic Dysfunction Associated Steatohepatitis, Nonalcoholic Fatty Liver Disease, Liver Fibrosis
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 29 Jun 2026 - 299 - #209 Dialysis and Fluid Management: 5 Pearls Segment
Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis,why ESKD patients have unique physiology,and how volume overload, not just hypertension, drives many complications. Learn practical pearls on dry weight, sodium restriction, diuretics, and the strategies that can reduce hospitalizations and improve patient outcomes.
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02:49 | Pearl 1: Foundations of Dialysis
09:21 | Pearl 2: Distinct Physiology
11:42 | Pearl 3: Why is fluid management so important?
19:43 | Pearl 4: Fluid Management Pro-tips
25:31 | Pearl 5: Diuretics in Patients with Residual Kidney Function
Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, Dialysis, End-stage kidney disease, Hypertension, Kidney Health, Dry Weight, Volume Overload
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 10 Jun 2026 - 298 - #207 Is There a Doctor on Board? In-Flight Emergencies
We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but hopefully less than before.
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04:40 | Emergency Medical Kit (EMK) Standard Contents
08:50 | Role of Ground-Based Medical Support & Flight Diversion Decision-Making
19:35 | Interpreting Hypoxia at Altitude
22:06 | In-Flight Liability
23:35 | Common Chief Concerns & Useful Additional Medications
24:53 | How to Be Resourceful in an Austere Environment
Tags: CoreIM, Internal Medicine, Medical Education, In-flight Care, Medical Emergencies, Clinical Reasoning, Seizure Management, Hypoxia, Airway Management, Cardiac Emergency, Syncope, Respiratory Distress
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 18 May 2026 - 297 - #205 Nutrition Studies, Coffee and the CRAVE Trial: Beyond Journal Club with the NEJM Group
Is coffee helping or harming our patients’ hearts?
In this Beyond Journal Club, we unpack the CRAVE trial and use it as a lens to answer a bigger question:
How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust?
Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle.
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00:00 | Challenges of interpreting nutritional research.
02:22 | Best practices for evaluating studies in nutrition.
12:35 | Delve into the CRAVE trial as an example of critically appraising nutritional investigations.
26:41 | Applying this to clinical practice for your patients.
Tags: IMCore, Internal Medicine, Medical Education, Epidemiology, Diet and Lifestyle
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 15 Apr 2026 - 296 - #215 Gallbladder & Biliary Testing: 5 Pearls Segment
How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about sphincterotomy, stents, and stone removal? Plus, how to interpret bile duct dilation without jumping straight to obstruction?
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🔹Transcript and Shownotes
02:11 | Pearl 1: Gallbladder Problems Spectrum
07:33 | Pearl 2: Choose Imaging Strategically: Start with RUQUS, Escalate as Needed
14:34 | Pearl 3: Biliary Tree Diagnostics
19:19 | Pearl 4: Invasives that are Diagnostic and Therapeutic
27:06 | Pearl 5: Stenting in ERCP
Tags: CoreIM, Internal Medicine, Medical Education, Gallstones, Cholecystitis, Biliary Disease, ERCP, Biliary Imaging
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Privacy & Opt-Out: https://redcircle.com/privacyTue, 25 Aug 2026 - 295 - #214 Hyponatremia Management: A Core IM Classic
Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia management, from fluids and solutes to loop diuretics and identifying the underlying cause.
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6:46 | Pearl 1: Key Principles
15:13 | Pearl 2: Fluids in hyponatremia
26: 03 | Pearl 3: Solutes in hyponatremia management
35:49 | Pearl 4: Lasix in hyponatremia management
40:05 | Pearl 5: Etiologies
Tags: CoreIM, Internal Medicine, Medical Education, SIADH, Fluid Restriction, Nephrology, Hospital Medicine, Urine Osmolality
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 12 Aug 2026 - 294 - #213 Hypertension First-Line Medications Troubleshooting | Bread & Butter Series
Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers, Thiazides) is the preferred first-line framework, and how to personalize medication choices based on comorbidities and side effects.
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03:00 | Diagnosing Hypertension
04:10 | When to Start Combination Therapy Instead of Monotherapy
07:00 | Choosing First-Line Therapy Using the ACT Framework
13:23 | Why ARBs Are Often Preferred Over ACE Inhibitors
16:02 | Choosing the Right ARB: Candesartan vs Losartan
18:39 | Comparing Potency & Duration Across First-Line Antihypertensives
20:54 | Amlodipine Edema: Why It Happens and How to Fix It
23:54 | Thiazides: Practical Tips, Electrolyte Problems & Class-Killer Side Effects
29:33 | Managing Patients Who 'Can't Tolerate' Blood Pressure Medications
Tags: Hypertension Management, High Blood Pressure, Primary Care, Internal Medicine, Core IM
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Privacy & Opt-Out: https://redcircle.com/privacyTue, 28 Jul 2026 - 293 - #212 Top 10 Highlights of the New Lipid Guidelines
Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines!Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change statin decisions, why LDL targets are back, and when to use Lp(a), ApoB, and coronary artery calcium (CAC) testing. Discover updated risk-enhancing factors, expanded indications for non-statin therapies, and practical strategies to personalize lipid management for both primary and secondary
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01:17 | Highlight #1 & #2: CPR and PREVENT Score
03:14 | Highlight #3: Updated ASCVD Risk Categories Using the PREVENT Score
05:30 | Highlight #4: LDL Targets Are Back
07:20 | Highlight #5: High-Risk Conditions That Bypass the PREVENT Score
08:41 | Highlight #6: Lp(a) Screening for Everyone
11:51 | Highlight #7: When to Use ApoB Testing
13:16 | Highlight #8: Reproductive Risk Factors
15:29 | Highlight #9: Using CAC to Guide Statin Therapy
19:09 | Highlight #10: Non-Statin Therapies
Tags: CoreIM, Internal Medicine, Medical Education, Cholesterol, Statins, LDL, ASCVD, Preventive Cardiology, LpA, ApoB, CAC, ACC2026, Cardiology, PrimaryCare
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 15 Jul 2026 - 291 - #210 HTN in Dialysis: 5 Pearls Segment
What blood pressure should we target in patients on hemodialysis? Why volume controlremains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability, antihypertensive selection, and strategies to prevent intradialytic complications while optimizing long-term outcomes.
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02: 19 | Pearl 1: Blood Pressure Targets
09: 40 | Pearl 2: Timing Medications and Dialyzability
15: 31 | Pearl 3 - Pharmacologic Management Nuances in Dialysis Patients
22: 57 | Putting It All Together: The Medication Hierarchy
Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, ESRD, End-Stage Kidney Disease, Hypertension, Kidney Health, Dry Weight, Volume Overload
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 17 Jun 2026 - 289 - #208 AI vs. Human with Post-Op AFib: Bread & Butter Series
Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between algorithms, uncertainty, and human judgment in modern medical care.
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02:51 | Broad workup for reversible causes and other etiologies of AFib that may occur post-op
05:10 | Considerations for management of post-op atrial fibrillation
13:00 | Stroke risk in atrial fibrillation
20:49 | Outpatient management of atrial fibrillation
25:54 | The role of AI in medical decision-making
Tags: CoreIM, Internal Medicine, Medical Education, Atrial Fibrillation, Cardiology, Open Evidence
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 May 2026 - 287 - #206 Eosinophilia: 5 Pearls Segment
Can you distinguish benign eosinophilia from asign of serious disease,and know exactly when to act at the bedside?
In this high-yield episode, test your clinical reasoning as we tackle:
When eosinophilia becomes dangerous and why it mattersHow to distinguish if its from atopy vs. systemic diseaseWhich medications to stop (and which to watch)How travel, diet, and exposure history shape your workupWhen to suspect malignancy before giving steroids02:34 | Why Do We Care About Eosinophilia? (Pearl 1)
10:24 | Atopy and Eosinophilia (Pearl 2)
18:57 | Drugs and Eosinophilia (Pearl 3)
27:29 | ID and Eosinophilia (Pearl 4)
33:54 | Pearl 5: Eosinophilia, Steroids, and Neoplasms (Pearl 5)
Tags: CoreIM, Internal Medicine, Medical Education, Eosinophilia, Hypereosinophilia, Allergy Immunology, Hematology, Pulmonology, Parasitic Infections, Atopy
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Privacy & Opt-Out: https://redcircle.com/privacyTue, 28 Apr 2026 - 285 - #204 Diabetic Foot Infections & Osteomyelitis: 5 Pearls Segment
Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach.
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02:15 | Pearl 1: Pathophysiology
08:20 | Pearl 2: Diagnosis
16:35 | Pearl 3: Treatment
20:35 | Pearl 4: Antibiotics
27:39 | Pearl 5: Wound Care
Tags: CoreIM, Internal Medicine, Medical Education, Diabetic Foot Infections, Osteomyelitis, Foot Ulcer, Wound Care
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 01 Apr 2026 - 284 - #203 POCUS for AKI & Dialysis | Real Cases That Changed Management
A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?
A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?
A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter?
And the classic inpatient dilemma: your heart failure patient looks better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going?
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00:52 | What is NephMadness?
02:19 | Detecting post-renal obstruction in a patient who reported normal urination
11:26 | POCUS for discharge or continue diurese
17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound
23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis line
Along the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside.
If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question.
Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUS
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 23 Mar 2026 - 283 - #202 Dementia Part 2: Gray Matters Segment
Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them.
• Do cholinesterase inhibitors really work?
• What should clinicians know about lecanemab and donanemab before referring patients?
• How much benefit should we expect and for how long?
• When should you deprescribe dementia medications?
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02:27 | Deep Dive 1: How do we deliver the news of a diagnosis of dementia?
09:41 | Deep Dive 2: Prescribing medications for cognitive decline
29:30 | Deep Dive 3: Patient-centered management for a patient with cognitive decline
35:46 | Deep Dive 4: Planning for an uncertain future
Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 12 Mar 2026 - 282 - #201: Dementia Part 1: Gray Matters Segment
Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI?
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01:12 | Cognitive Concerns During a Routine Follow-Up
03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues?
15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline?
31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline?
Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 25 Feb 2026 - 281 - #200: Insulin and QWINT-1 Trial in T2DM: Beyond Journal Club Segment with NEJM Group
From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden.
🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/
00.58 | Insulin Hx & Types
06:00 | Indications for Insulin and the Burden on Patients
08:26 | What is the QWINT-1 Trial?
16:18 | Discussion
Tags: CoreIM, Internal Medicine, Evidence-Based Medicine, Insulin Resistance, Clinical Reasoning, Hospital Medicine, Medical Education, Endocrine, Endocrinology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 11 Feb 2026 - 280 - #199 Privacy & Confidentiality: At the Bedside Segment
Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside, learn how clinicians should act when ethics, law, and trust collide.
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03:51 | What is the difference between Privacy and Confidentiality?
05:50 | Guidelines and laws
10:06 | Limits/appropriate breaches (competing principles/obligations)
22:03 | Privacy vs education
35:34 | Conclusion
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Jan 2026 - 279 - #198 Microskills for Change That are Big Enough to Matter, Small Enough to Win
Baby alligators - those betrayals of purpose , or, death by a thousand paper cuts !
Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:
Regulated curiosity
Strategic empathy
Small, well-chosen moves...
...and change that is big enough to matter, and small enough to win!
🔹 Sponsor: Caraway’s cookware set is a favorite for a reason.
For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout.
00:00 | What are “baby alligators” in medicine?
02:24 | Rifaximin & Workflow Fixes
14:17 | Verbal Orders Policy
18:39 | Micro Skills for Change
25:12 | Key Takeaways
#PhysicianBurnout #DoctorLife #HealthcareEfficiency, CoreIM, Internal Medicine, Career Development, Quality Improvement, QI
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 21 Jan 2026 - 278 - #197 Hypercoagulability Part 2: 5 Pearls Segment
Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?
When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.
🔹Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/
(2:56) - (13:15) | PEARL 1: Managing clots in the “unprovoked”/provoked-irreversible patient
(13:21) - (18:10) | PEARL 2: Managing provoked, “reversible” clots
(18:14) - (25:14) | PEARL 3: DOAC failure: time to step it up?
(25:20) - (37:25) | PEARL 4: APLAS: the exception to everything
Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 07 Jan 2026 - 277 - #196 Stories of Courage and Career Development with Horn Award
We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.
🔹 Sponsor: Oakstone CME
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(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life
(10:28) | How Dr. Carol Ward Created the Horn Award and Honored Mary Horn’s Legacy
(14:16) | Dr. Hilit Mechaber’s Story of Courage, Vision, and Impact Beyond the Award
(17:55) | Why does the Horn Award Matter?
Tags: CoreIM, Internal Medicine, Career Development Award, Mary O'Flaherty Horn Award, Clinical Care, Scholarship, Teaching, Leadership, Wellness and Care, Family Responsibilities
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 17 Dec 2025 - 276 - #195 Antibiotic Duration & BALANCE Trial: Beyond Journal Club with NEJM Group
Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?
🔹 Sponsor: Oakstone CME
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Timestamp
(02:58) | Host, Organism, Source: The Core Framework Behind Duration
(09:02) | How Evidence Shifted Practice
(11:27) | The BALANCE Trial: Short-Course vs Standard-Course Therapy
(18:55) | Where does this leave us?
Tags: CoreIM, Internal Medicine, Infectious disease, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 10 Dec 2025 - 275 - #194: Severe Hypertriglyceridemia: 5 Pearls Segment
How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?
(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast
(05:27) | Triglycerides as a Cardiovascular Risk Marker
(09:28) | Acute Management For Pancreatitis induced by Triglycerides
(14:34) | Lifestyle Counseling
(17:31) | Medications That Lower Triglycerides
(25:29) | How to Choose the Right Triglyceride Therapy
(27:56) | Genetic Causes and When to Suspect Familial Disorders
Tags: CoreIM, Internal Medicine, Lipidology, lipid, Cardiology, Metabolic Health, Triglycerides, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education, primary care
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 03 Dec 2025 - 274 - #193 Venous Congestion & VEXUS Interview with Dr. Ross Prager
Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score?
🔹 Sponsor: Oakstone CME
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(00:00) |Volume overload vs. Venous Congestion
(05:49) |Venous Congestion and AKI, mortality, possible delirium
(10:10) |Measuring Venous Congestion and the Role of VEXUS
(15:05) |Common Mistakes and Best Practices of VEXUS score
(23:13) |Assessing Fluid Tolerance and Risks with Venous Doppler in Acute Care
(25:29) |Fluid vs. Vasopressor Strategy Guided by Venous Assessment
Tags:CoreIM, Internal Medicine, Critical Care, Nephrology, Cardiology, Fluid Management, POCUS, Ultrasound, Doppler, Hospital Medicine, Clinical Reasoning, Medical Education
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 19 Nov 2025 - 273 - #192 Debate on First-Line Medications for Diabetes
SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use?
🔹 Sponsor:
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Timestamps:
(01:43) | Case 1: Managing Uncontrolled Diabetes in a 47-Year-Old Male
(07:15) | Understanding Cost and Insurance Barriers in Diabetes Care
(09:26) | Case 2: Addressing Weight Gain and Financial Stress in a 52-Year-Old Male
(14:16) | Case 3: Managing Coronary Artery Disease and CKD in a 66-Year-Old Male
(19:41) | Case 4: Severe Obesity and Pain Management in a 59-Year-Old Female
(24:19) | Case 5: High A1C and Vascular Comorbidities in a 67-Year-Old Female
(35:34) | Weighing Side Effects and Practical Use of GLP-1 and SGLT2 Inhibitors
Tags: CoreIM, Primary Care, Endocrinology, Diabetes Mellitus, Type 2 Diabetes, Type 1 Diabetes, Metformin, GLP-1, SGLT2, Insulin, CGM, A1C, DKA, Medical Education, Clinical Reasoning, Hospital Medicine
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 05 Nov 2025 - 272 - #191 Hepatorenal Syndrome Part 2 on Management: 5 Pearls Segment
What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care?
🔹 Sponsor: Oakstone CME
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Timestamps:
(00:12) | Introduction and Overview of Hepatorenal Treatment
(03:38) | Vasoconstrictors Focus: Terlipressin, Norepinephrine, and Midodrine
(12:32) | Finding the Right Dose of Albumin and Knowing When to Stop
(15:06) | Volume Management: Balancing MAP, Diuretics, and Creatinine
(21:42) | Understanding the High Mortality of HRS-AKI
(32:30) | Transplant, Dialysis, or Palliation Care
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Hepatorenal Syndrome, HRS-AKI, Cirrhosis, Nephrology, Liver Disease
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 22 Oct 2025 - 271 - #190: Hepatorenal Syndrome Part 1: 5 Pearls Segment
HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right?
🔹 Sponsor: Oakstone CME
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Timestamps:
(00:57) | Understanding the Pathophysiology of HRS
(03:42) | How Portal Hypertension Traps the Kidneys
(10:32) | Sorting the Differential of AKI in Cirrhosis Beyond HRS
(18:28) | Hyponatremia and Urine Sodium in Advanced Cirrhosis
(24:04) | Official Diagnosis and Evolving Criteria of HRS
(29:30) | Albumin: When It Helps and When to Hold Back
(34:00) | Recap and Future Directions
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Nephrology, renal, hepatology, Portal Hypertension, Liver Disease
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 15 Oct 2025 - 270 - #189 Bisphosphonates and Fracture Prevention Trial: Beyond Journal Club with NEJM Group
Who’s really at risk for fractures, and how should we be treating them?
Most fragility fractures occur in patients without osteoporosis. Should we rethink who gets treated? And could just one or two IV infusions (spread years apart) of zoledronate prevent fractures for years? Have the concerns about bisphosphonates been overblown?
Find out all the nuances on this episode of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.
🔹 Sponsor: Oakstone CME
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Timestamps:
(00:59) | Diagnosing Osteoporosis and Hidden Fracture Risk
(05:38) | Evolution of Bisphosphonate Use in Osteoporosis Treatment
(07:51) | Current Use of Bisphosphonates: Benefits, Risks, and Side Effects
(10:31) | Exploring Non-Bisphosphonate Options for Fracture Prevention
(11:44) | Teriparatide and Alternative Osteoporosis Medications
(14:53) | Inside the Latest Bisphosphonate Clinical Trial
(18:07) | Key Findings from the Zoledronate Fracture Prevention Study
(22:38) | Public Health Impact of Fracture Prevention Strategies
(24:24) | Final Takeaways and Expert Perspectives on Osteoporosis Care
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Osteoporosis, Fragility Fractures, Zoledronate, Bone Health
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 01 Oct 2025 - 269 - #188 Orthostatic Hypotension Part 2: Gray Matters Segment
Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic hypotension?
🔹 Sponsor: Oakstone CME’
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP
Timestamps (+/- 1-2 mins):
(00:28) | Case Recap: Beyond Non-Pharm Strategies
(03:07) | Midodrine: Timing, Testing, & Supine Hypertension
(06:23) | Fludrocortisone: Benefits vs. Risks
(09:01) | Droxidopa: Evidence, Side Effects, Access Issues
(10:11) | Pyridostigmine & NSAIDs: Secondary Options
(12:31) | Balancing Hypertension and Orthostatic Hypotension
(14:29) | Functional Hypotension & Risk Stratification
(18:45) | Symptomatic Patients: What to Stop, What to Continue
(20:19) | Autonomic Disease: Supine & Nocturnal Hypertension
(21:47) | Bed Elevation, Compression, & Non-Pharm Pearls
Tags: Internal Medicine, Geriatrics, Autonomic Dysfunction, Hypertension, Syncope, Falls, Patient Safety, Medical Education, physician assistant, nurse practitioner, hospitalist, primary care, neurology
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 22 Sep 2025 - 268 - #187 Orthostatic Hypotension Part 1: Gray Matters Segment
Learn specific, practical ways to counsel patients on non-pharmacologic interventions. What is our goal with OH treatment? Is it the blood pressure number that matters? How do we avoid missing neurogenic causes of orthostatic hypotension (OH)?
🔹 Sponsor: Oakstone CME’
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Timestamps:
(00:05) | Case Presentation: Urinary Retention → Lightheadedness
(02:37) | Defining Orthostatic Hypotension & Prevalence
(04:10) | Why Diagnosis Is Harder Than It Seems
(06:20) | How (and When) to Measure Orthostatic Vitals
(10:06) | Role of Heart Rate in Narrowing the Differential
(14:41) | Rethinking Treatment Goals: Function > Numbers
(17:52) | Recognizing Orthostatic Intolerance Symptoms
(22:14) | Non-Pharmacologic Strategies in the Hospital
Tags: Primary care, Internal Medicine, Physician Assistant, Nurse Practitioner, Geriatrics, Autonomic Dysfunction, Syncope, Falls, Patient Safety, Medical Education
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 11 Sep 2025 - 267 - #186 Pneumothorax: 5 Pearls Segment
Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks!
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Timestamps:
(02:50) | Xray vs. POCUS vs. CT for Pneumothorax Diagnosis
(07:29) | Do All PTXs Need Chest Tubes?
(11:55) | Explaining Pneumothorax to Patients
(14:58) | Understanding the Pleural Drainage System
(26:11) | Monitoring Air Leaks with the Water Seal Chamber
(32:27) | Managing Persistent Air Leaks
Tags: CoreIM, Internal Medicine, Pulmonology, Critical Care, Medical Education, 3-Chamber Drainage System, Endobronchial Valves and Pleurodesis
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 25 Aug 2025 - 266 - #185 Neutropenia: 5 Pearls Segment
How do you work up neutropenia? When is neutropenia benign? When do neutrophils recover? How can you diagnose neutropenic fever in the first 15 minutes and start antibiotics in the first 60 minutes? Do you always add MRSA coverages? Only Pseudomonas coverage? When do you add fungal coverage?
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Timestamps:
(02:24) | Approach to Neutropenia & Duffy Null
(11:38) | Dose and duration-dependent neutropenia vs. immune-mediated neutropenia
(19:46) | When do neutrophils recover?
(29:56) | Classifying Neutropenic Fever Syndromes
(29:53) | Strategies for Managing Low-Risk Neutropenic Fever
(33:02) | Antimicrobial Therapy and Duration in Febrile Neutropenia
Tags: CoreIM, Internal Medicine, Oncology, Hematology, Medical Education, Physician Assistant, Nurse Practitioner, Neutropenic Fever Management, Antibiotics
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 13 Aug 2025 - 265 - #184 Stories for the Feels
Have a good laugh and reflect deeply with these three stories that hit the feels in different ways.
If you'd love to hear more stories from Dr. Maria Rosasco, check out some of her other appearances on the podcast: July Stories and Handoffs & Contingency Planning.
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Timestamps:
(01:04) | Story 1: Sharing a Personal Story for Patient Care
(03:42) | Story 2: Leading a Family Meeting
(06:52) | Story 3: Early Days of the COVID-19 Pandemic
(10:22) | What Rituals and Values Guide Your Path in Medicine
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, Humanities
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 28 Jul 2025 - 264 - #183 Diagnose the Clinician: Hoofbeats Segment
What went wrong? What were the reasoning or contextual missteps that led us astray?
🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025
🔹 Transcript and Show Notes
Timestamps:
(00:02) | Case Presentation and Initial Diagnosis
(02:47) | Tachycardia and Early Impressions
(04:10) | Clinical Deterioration and New Clues
(07:19) | Problem Representation and Reflection
(21:45) | Lessons on Reasoning and Bias
(26:55) | Final Takeaways and Action Steps
Tags: Clinical Reasoning, Internal Medicine, Diagnostic Accuracy, Hoofbeats, Cognitive Bias, Medical Education, Illness Scripts
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 21 Jul 2025 - 263 - #182 Pleural Effusions: 5 Pearls SegmentImaging Pearls | (01:12)Deciding on Thoracentesis | (04:00)Light’s Criteria and Pseudoexudates | (07:00)Pleural Fluid Studies: pH and Cell Differential | (16:56)Diagnosing and Treating Parapneumonic Effusions | (23:32)Malignant Pleural Effusions: Diagnosis and Management | (30:39)
🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Tags: Internal Medicine, Medical Education, Pulmonology, CoreIM, Clinical Reasoning, critical care, pulm
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 09 Jul 2025 - 262 - #181 July Stories 3.0
Listen for some good laughs and relatable stories!
In this episode, we share raw and real stories from July — from rapid responses to unexpected kindness — and reflect on the emotional weight of starting out in medicine.
🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025
Prior July Stories:
July Stories 2.0 (2023)
July Stories (2019)
Timestamps:
(00:32) | Dr. Ali Trainor's First Day as an Intern
(03:00) | The Patient's Critical Condition and Emotional Response
(07:12) | Dr. George Tran's First Night Shift
(10:38) | Dr. Ali Trainor's Second Rotation Experience
(14:01) | The Importance of Co-Intern
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, Humanities
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 02 Jul 2025 - 261 - #180 Beta-Blockers & REDUCE-AMI Trial: Beyond Journal Club Segment with NEJM Group
How much do beta blockers help after a heart attack, even when the heart’s pumping well? In this episode, we revisit the origins of beta blockers in post-MI care, examine how evidence evolved, and explore the REDUCE-AMI trial, which questions whether beta blockers are still needed for all.
Listen to this latest episode of Beyond Journal Club, a collaboration between Core IM and NEJM Group, where we put research into context tracing the arc of evidence, dissecting the clinical question, and exploring what the findings could mean for real-world patient care
🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply!
Timestamps:
(00:48) | Background on Beta Blockers and Their Mechanism
(02:41) | Historical Context of Beta Blockers in Heart Disease
(04:56) | Capricorn Trial and Its Impact
(07:17) | Emergence of Doubts About Beta Blockers
(10:09) | Introduction to the REDUCED-AMI Trial
(15:52) | Discussion on Trial Interpretation and Clinical Implications
(16:18) | Comparison with Other Trials and Future Directions
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Cardiology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 25 Jun 2025 - 260 - #179 Invasive Fungal Disease: 5 Pearls Segment
🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46)
🔹 What are the main classes of fungi? (~11:35)
🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16)
🔹 How to increase the yield of blood cultures? How to interpret yeast growth in sputum/BAL and urine cultures? (~ 30:42)
🔹 How is invasive fungal disease treated? (~ 35:14)
📌 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Tags: CoreIM, IMCore, Infectious Disease, Hospital Medicine, Hospitalist, ICU, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, mold
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 11 Jun 2025 - 259 - #178 Continuous Glucose Monitor (CGM): 5 Pearls Segment
🔹What are clinically relevant limitations of an A1c vs. a CGM (1:40)
🔹What do the different parts of the ambulatory glucose profile tell you? (09:59)
🔹What are common pitfalls, medications, lifestyle patterns that are important to ask your patient about when seeing them for a visit to manage blood sugar? (15:19)
🔹 How can you titrate insulin based on when you see the hypoglycemia on the ambulatory glucose profile (20:00)
🔹 When there is too much hyperglycemia, how do you titrate insulin when adding on GLP-1 agonists? (26:30)
📌 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply!
Tags: CoreIM, IMCore, Endocrinology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, diabetes management, insulin titration
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 02 Jun 2025 - 258 - #177 Interventional Radiology (IR) 101: 5 Pearls Segment
🔹When is an U/S vs. CT vs. MRI helpful before consulting Interventional Radiology?
🔹What factors go into an IR pre-op evaluation?
🔹 When do drains go in, and when do they come out?
🔹 When a patient has trouble with a drain, what are things you can do before calling IR?
🔹 What does outpatient IR follow up entail, and what does a capping trial of PCN tubes entail?
📌 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion
Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP
Tags: CoreIM, IMCore, Gastroenterology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Medical Imaging, Bleeding Assessment, Drain Management, Procedural Sedation
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 14 May 2025 - 257 - #176 Constipation Medications: 5 Pearls Segment
🔹 High-yield reversible causes of constipation? (02:26)
🔹 Which type of fiber is more helpful? And is more hydration really better? And bulk-forming laxatives (9:03)
🔹 Osmotic vs Stimulant Laxatives (15:06)
🔹 Suppositories and enemas? (25:39)
🔹Best practices with opioid induced constipation (34:05)
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Tags: CoreIM, IMCore, Gastroenterology, GI Pharmacology, Digestive Health, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Laxatives, Stool Softeners, Senna, Bisacodyl, Polyethylene Glycol, Bowel Regimen, Magnesium Citrate, Lactulose
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 30 Apr 2025 - 256 - #175 A Revolution in HIV Prevention & The PURPOSE Trials: Beyond Journal Club Segment with NEJM Group
How good are we at preventing HIV? How do efficacy and effectiveness differ? We journey from oral pre-exposure prophylaxis (PrEP) to long-acting injectables, and then to the PURPOSE trials, which look at the use of long-acting lenacapavir as PrEP — a potential game-changer in the field of HIV.
Listen to this latest episode of Beyond Journal Club, a collaboration between CoreIM and NEJM Group, where we put research into context, telling the story of how we arrived at the current standard of care, appreciating the clinical question of the trial at hand, and interpreting what the findings may mean for these patients.
🔹 Sponsor: NEJM Fellowship Program, clickhere to learn more and/or apply!
Timestamps:
(02:25) | HIV PrEP Daily Truvada and Descovy
(07:48) | On-Demand Prep
(13:25) | Purpose Trials
(20:56) | Discussion of Effectiveness to Efficacy
Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, HIV Prevention, Infectious Disease
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 16 Apr 2025 - 255 - #174 Lp(a) and ASCVD Risk: 5 Pearls Segment
What does Lipoprotein(a) tell us that a standard lipid panel doesn’t? Should we be testing everyone for it? Dive into the genetics, clinical implications, and evolving management strategies for Lp(a). Learn how to interpret results, counsel patients, and navigate topics with limited data like aspirin and PCSK9 inhibitors in treatment.
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Timestamps:
(02:17) | Pearl 1: What makes Lp(a) unique? How does it raise ASCVD risk?
(10:32) | Pearl 2: Who should be tested for Lp(a)? When and why?
(16:54) | Pearl 3: Understanding and interpreting Lp(a) levels
(24:04) | Pearl 4: How does an elevated Lp(a) affect management?
(37:05)| Pearl 5: The role of aspirin and PCSK9 inhibitors in Lp(a)
Tags: CoreIM, Internal Medicine, Primary Care, Preventive Cardiology, Atherosclerosis, Lipid Management, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 02 Apr 2025 - 254 - #173 Hypercoagulability Workup: 5 Pearls Segment
A new way to think of clots beyond provoked vs. unprovoked: Learn all about how important it is to think about reversibility! What patient states affect the inherited thrombophilia testing? Learn the nuances and practical approaches!
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Timestamps:
(02:07) | Pearl 1: Reframing Provoked vs. Unprovoked to Reversibility
(09:12) | Pearl 2: How can Virchow's Triad help us categorize the etiology of a clot?
(17:01) | Pearl 3: What factors affect anti-thrombin III, Protein C and Protein S deficiency
(28:50) | Pearl 4: Is the Factor V Leiden or Prothrombin Gene Mutation as important as the family history?
(38:41) | Pearl 5: Spaced Repetition of Learning Points
Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 19 Mar 2025 - 253 - #172 Microplastics and Macro CV Health Problems: Beyond Journal Club on APACHe Study with NEJM Group
What is the impact of microplastics on human health? How can we use observational data to support the argument that microplastics may lead to poor health outcomes?
Join us as we tackle these questions and discuss the APAChE study on microplastics and cardiovascular disease on this episode of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.
🔹 Behind The Scenes YouTube Video
This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.
Timestamps:
(02:24) | Introduction to Plastic's Key Players
(07:59) | Bradhill/Observational Work
(10:33) | APAChE Study Deep Dive
(18:03) | Discussion
📢 Special Thanks:
🎙️ Audio Editing: Jerome Reyes
📊 Graphics: Dr. Jimin Hwang
Tags:
CoreIM, Environmental Health, Medical Education, IMCore, Public Health, Clinical Pearls, Physician, Medical Student, Nurse Practitioner, Epidemiology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 05 Mar 2025 - 252 - #171 Hospice Music Therapy: Bonus Episode
What is the last sense to go? How can music create connection, ease anxiety, and help process emotions at the end of life? Join Dr. Jafar Al-Mondhiry, Dr. Harry Han, and music therapist Bryanna Tobin as they explore the power of music therapy in hospice care, sharing moving stories and clinical insights.
🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.
Timestamps:
(00: 39) | 1st: What is Music Therapy in Hospice?
(07:59) | 2nd: A Powerful Story
(14:19) | 3rd: Challenges in the Field of Music Therapy
Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 27 Feb 2025 - 251 - #170 ILD and High-Risk Medication Prescribing: Gray Matters Segment
Incidental fibrosis on CT —what now? What does prone imaging tell you? Is it fibrosis, aspiration, or atelectasis? And once you diagnose ILD, does the “alphabet soup” really matter for treatment? Antifibrotics vs. immunosuppression?
Plus, how do we bridge the gap when social barriers make care unsafe?
🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.
Timestamps:
(01:26) | Deep Dive 1
(06:38) | Deep Dive 2
(12:37) | Deep Dive 3
(21:13) | Deep Dive 4
(28:06) | Deep Dive 5
Tags: CoreIM, Internal Medicine, Pulmonology, Clinical Pearls, Medical Education, IMCore, Radiology, Hospitalist, Physician Assistant, Nurse Practitioner, Medical Student, interstitial lung disease
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 05 Feb 2025 - 250 - #169 MGUS to Multiple Myeloma Diagnostics and Counseling: 5 Pearls Segment
SPEP vs. UPEP? What does it tell you and not tell you? What is the role for immunofixation and free light chains in diagnosis? Learn about paraneoplastic antibodies with MGCS and its renal, neurologic, and dermatologic manifestations!
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Behind The Scenes Youtube Interview with Dr. Vincent Rajkumar
Timestamps:
(01:26) | Pearl 1: What is a monoclonal gammopathy? What is our expected clinical presentation?
(10:12) | Pearl 2: What is our initial workup? Understanding SPEP, Immunofixation, and Free Light Chains
(24:13) | Pearl 3: Do we need urine testing? When urine testing is necessary and when it is not.
(26:26) | Pearl 4: How should we differentiate monoclonal gammopathies? The continuum of MGUS, SMM, and MM.
(41:35) | Pearl 5: Demystifying Monoclonal gammopathy of clinical significance (MGCS)
Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 22 Jan 2025 - 249 - #168 Immune Checkpoint Inhibitor Adverse Events 2.0: 5 Pearls Segment
How do you differentiate immune checkpoint inhibitor-related adverse events aka IrAEs from other conditions like infection? Join as we go through pneumonitis, colitis, dermatitis and endocrinopathies due to immune checkpoint inhibitor toxicity!
Sponsor:
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Timestamps:
(03:14) | Pearl 1
(13:34) | Pearl 2
(24:42) | Pearl 3
(30:34) | Pearl 4
(35:21) | Pearl 5
Tags: CoreIM, Internal Medicine, ClinicalPearls, Skin Toxicity, Medical Education, IMCore, oncology, hospitalist, physician assistant, nurse practitioner, medical student
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 08 Jan 2025 - 248 - #167 Best of YouTube 2024: Anion Gap Metabolic Acidosis, Inhaler Use, Iron Deficiency in Pregnancy
YouTube Videos
- Anion Gap Metabolic Acidosis: https://youtu.be/oE0lygmMANMInhaler Delivery Systems: https://youtu.be/yYPdjClm9BgIron Deficiency in Pregnancy https://youtu.be/xTzYSXUbLsc
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
01:27 | Anion Gap Metabolic Acidosis (Dr. Nick Villano)
02:52 | Inhaler Delivery Systems (Dr. Allie Sheridan)
04:44 | IDA in Pregnancy (Dr. Michael Auerbach)
Tags:IMCore, Medical Education, IDA, hospitalist medicine, hospitalist, primary care, nurse practitioner, chalktalks, hematology, asthma, COPD, pregnancy care, Medical Podcast, Clinical Teaching
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 30 Dec 2024 - 247 - #166 Stress Ulcer Prophylaxis in the ICU and REVISE Trial: Beyond Journal Club with NEJM Group
What’s the evidence been for the use of PPIs in mechanically ventilated patients? What do more recent studies reveal about PPIs and possible harmful side effects of aspiration pneumonia and C. difficile colitis? To find out, tune into the second season of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.
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Timestamps:
(02:13) | Define the problem / Clinically important bleeding Outcome/Risk benefit /Risk factors]
(05:58) | Hx and H2 antagonists
(10:42) | SUP-ICU
(15:12) | PEPTIC
(19:30) | REVISE trial
(27:28) | Deprescribing
(29:06) | Outstanding questions
Tags: CoreIM, InternalMedicine, CriticalCare, Proton Pump Inhibitors, GIbleeding, ICU, ICU bleeding, Clinical Trials, Evidence Based Medicine, Patient Centered Outcomes, Deprescribing
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 11 Dec 2024 - 246 - #165 Peripheral Arterial Disease: 5 Pearls Segment
Why are we missing peripheral arterial disease (PAD)? How is it diagnosed using the Ankle-Brachial Index (ABI)? What treatments improve symptoms and reduce cardiovascular risks? When should revascularization be considered?
Behind The Scenes YouTube Interview
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Timestamps:
(02:23) | PEARL 1: When to suspect PAD? Risk factors?
(07:34) | PEARL 2: How to work up PAD?
(16:26) | PEARL 3: Improving symptoms and quality of life
(25:38) | PEARL 4: Approach to therapy: Preventing CV mortality
(33:53) | PEARL 5: Deeper Dive into Antithrombotic Therapy and Anticoagulation
(39:09) |PEARL 6: Who needs revascularization?
Tags: CoreIM, PAD, Peripheral Arterial Disease, ABI, claudication, vascular medicine, revascularization, internal medicine, smoking cessation, lipid management, primary care, physician assistant, nurse practitioner, cilostazol. supervised exercise therapy
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 Nov 2024 - 245 - #164 TPN/PPN Parenteral Nutrition: 5 Pearls Segment
How is TPN and PPN similar and how is it different? When should each be used? How does bacterial overgrowth lead to complications? Does TPN cause diarrhea?
Behind the Scenes Youtube Interview
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(01:35) | PEARL 1: Basics of PN: What makes up parenteral nutrition?
(06:54) | PEARL 2: Indications and Contraindications for TPN and PPN: When should I order parenteral nutrition?
(13:40) | PEARL 3: Complications of parenteral nutrition: What are the common adverse effects of parenteral nutrition?
(19:41) | PEARL 4: Parenteral nutrition myths: What should patients know before they start TPN?
(23:56) | PEARL 5: Recap on Tube Feeds: How do we determine the amount of free water to give out patients on tube feeds?
Tags: IMCore, CoreIM, parenteral nutrition, TPN, PPN, clinical nutrition, nutritional support, complications, patient safety, gastrointestinal disorders, critical care, internal medicine, fluid management, ICU, Crit Care, GI, gastroenterology
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 14 Nov 2024 - 244 - #163 Urine Drug Screening Nuances: 5 Pearls Segment
Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?
Behind The Scenes YouTube Interviews
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(03:01) | PEARL 1:Basics to Urine Drug Screen (UDS)
(08:03) | PEARL 2: Types of urine drug tests, and what are immunoassays (IA)?
(18:44) | PEARL 3: What are gas chromatography/mass spectrometry (GC/MS)-based tests?
(26:51) | PEARL 4:How do you address unexpected test results on a UDS?
(30:29) | PEARL 5:Throwback to “5 Pearls on Stigma in Opioid Use Disorder” episode
Tags: IMCore, CoreIM, primary care, urine drug screening, opioid use disorder, substance use, harm reduction, addiction medicine, clinical toxicology, patient safety, compassionate care
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 30 Oct 2024 - 243 - #162 Hospice 102: Practical Tips and Nuances
What if a patient can't afford hospice? Which medications do you deprescribe when on hospice? What happens when patients who are on hospice return to the hospital or ED?
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Behind the Scenes Youtube Interview
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Timestamps:
A hospitalized patient elects to enroll in hospice, now what?
What treatments are typically covered by hospice?
What medications to continue and discontinue?
Code status in hospice
Approaching the hospice patient coming back to the hospital
Hospice enrollment and re-enrollment is voluntary.
Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant
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Our Sponsors:
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 16 Oct 2024 - 242 - #161 Transfusion Thresholds and the MINT Trial: Beyond Journal Club with NEJM Group
Can the MINT trial change how we treat anemia in acute MI? The largest trial of its kind compared liberal vs. restrictive transfusion strategies in patients with myocardial infarction.
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Timestamps:
(01:29) | History of Transfusion Guidelines/Studies
(06:49) | Pathophysiology of Anemia in heart disease
(10:04) | Transfusion in MI Studies
(13:45) | MINT Trial
(22:20) | Takeaways/Discussion
Tags:Tags: CoreIM, IMCore, cardiology, internal medicine, myocardial infarction, anemia, transfusion, physician assistant, nurse practitioner, pharmacist, clinical trials, MINT trial, transfusion strategies, restrictive vs. liberal transfusion, heart attack
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Our Sponsors:
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 02 Oct 2024 - 241 - #160 Moral Distress Part 2: At the Bedside Segment
Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(01:07) | Strategies for Addressing Moral Distress
(09:25) | Strategies for Address Moral Injury
(20:52) | Conclusion
Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethics
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 18 Sep 2024 - 240 - #159 Moral Distress Part 1: At the Bedside Segment
What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?
Sponsor: Whether you're looking to open your own practice or buy into a group, Panacea Financial understands the unique needs of physicians and offers tailored financial solutions.
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(04:59) | Definitions
(06:50) | Moral Distress
(09:01) | Moral Residue
(09:01) | Moral Residue
(11:34) | Moral Injury
(13:32) | Causes of Moral Distress and Moral Injury
(18:18) | Consequences
Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanism
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 11 Sep 2024 - 239 - #158 Diuretics Resistance Cases
Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”
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Cardiorenal Considerations: 5 Pearls Segment
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension
(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output
(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion Pressure
Tags:IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical care
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Aug 2024 - 238 - #157 Handoffs: Contingency Planning
Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.
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Use promo code COREIM for 1 month of free access to Glass Pro for unlimited A.I queries !
Behind the Scenes YouTube Interview
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(02:44) | What makes this patient different from others with similar symptoms or diagnosis?
(07:28) | Does your covering team have the tools to follow up on tasks and information they need for success?
(16:06) | Is the handoff updated?
(18:26) | What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients?
(22:41) | What are we still uncertain about?
(25:30) | Closing thoughts
Tags:IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalist
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 07 Aug 2024 - 237 - #156 Hospice 101: Nuts and Bolts
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Behind the Scenes Youtube Interview
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Timestamps:
(03:04) | What is the philosophy of hospice?
(06:13) | Who qualifies for hospice?
(08:17) | Who makes up the hospice team?
(17:24) | Who pays for hospice?
(21:31) | What are the different levels of care?
(31:57) | What are some limitations of the hospice medicare benefit?
Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 24 Jul 2024 - 236 - #155 Microskills: Small Actions, Big Impact
Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention.
Book by Dr. Adaira Landry, Dr. Resa E. Lewiss:
MicroSkills: Small Actions, Big Impact
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Tags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 03 Jul 2024 - 235 - #154 Does Invitation To Screening Colonoscopy Save lives? Beyond Journal Club with NEJM Group on the NordICC Trial
Does colonoscopy prevent colon cancer, and does it save lives? There has never been a randomized controlled trial on screening colonoscopies before NordICC trial, even though it is a guideline based recommendation for everyone over 45! How did this come to be? What do we tell our patients who are on the fence about undergoing screening colonoscopy? To find out, tune into the sixth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
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Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamp:
(00:00) | Introduction
(02:28) |Pathophysiology of Colorectal Cancer & Why Screening Makes Sense
(06:15) | General Cancer Screening – Observational Studies
(09:17) | General Cancer Screening – Randomized Controlled Trials
(14:40) | NordICC Trial
(22:36) | Implications for Patient Care
Tags:IMCore, CoreIM, primary care, gastroenterology, nurse practitioner, pharmacist, physician assistant, sigmoidoscopy, per protocol analysis and intention to treat analysis
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 19 Jun 2024 - 234 - #153 HFpEF: 5 Pearls Segment
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Behind The Scenes YouTube Interviews
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Timestamps:
(01:59) | What causes HFpEF?
(11:22) | Does diastolic dysfunction imply HFpEF?
(19:21) | Is the BNP levelhelpful in HFpEF?
(25:06) | What scoring systemscan be helpful in ruling in HFpEF?
(32:03) | What's the treatment for HFpEF?
Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, heart failure with preserved ejection fraction
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 05 Jun 2024 - 233 - #152 Immune Checkpoint Inhibitors & IrAEs 101: 5 Pearls Segment
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Behind the Scenes YouTube Interview
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Timestamps:
(01:56) | How do immune checkpoint inhibitors work?
(07:15) | How do you organize the different immune-related adverse events (irAEs)?
(13:42) | Generally, when do different adverse events can present?
(22:20) | What makes someone more likely to develop an adverse effect?
(26:38) | What role does complementary & alternative medicineplay in this patient population?
Tags: Side effects, oncology, cancer, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, pharmacology
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Timestamps:
(02:05) | Urinalysis in a patient with AKI from purely cardiorenal syndrome?
(08:47) | What is bioavailability, duration of action, and outcomes with furosemide, torsemide, and bumetanide?
(18:08) | How can spot urine sodium measurementsbe used to assess diuretic response?
(27:35) | What are the differences between thiazides (PO Metolazone vs. IV Chlorothiazide) and acetazolamide augment diuresis?
(35:08) | Spaced Repetition: RAAS inhibitors or SGLT2 inhibitors as GMDT in CKD?
Tags: nephrology, cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, diuretic resistance
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 13 May 2024 - 231 - #150 Rhythm Control in Afib: 5 Pearls Segment
What are the benefits of early rhythm control versus rate control alone? When is electrical cardioversion used and what information can it tell us? What side effects for amiodarone, dofetilide, and sotalol, propafenone and flecainide? When should catheter ablation be considered in patients with atrial fibrillation?
Behind the Scenes YouTube Interview
Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!
Time stamps:
(02:05) | Pearl 1 - Rhythm control
(11:23) | Pearl 2 - Electrical cardioversion
(17:53) | Pearl 3 - Class III antiarrhythmics and side effects
(26:31) | Pearl 4 - Class Ic antiarrhythmics and side effects
(31:55) | Pearl 5 - Catheter ablation
Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillation
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 24 Apr 2024 - 230 - #149 Asthma Management and the MANDALA Trial: Beyond Journal Club with NEJM Group
Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care.
Timestamps:
(01:47) | Evolving story of asthma management
(03:26) | Pathophysiology of asthma management
(06:01) | Key players & terms
(08:56) | Story of asthma through the decades
(17:55) | MANDALA Trial
Tags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalers
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 10 Apr 2024 - 229 - #148 Iron Deficiency Treatment: 5 Pearls Segment
How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula? What is a Fishbane reaction? And how is it different from anaphylaxis?
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Behind the Scenes YouTube Interview
Time stamps:
(02:09) | Spaced repetition from the last Gray Matters Episode
(05:29) | Choosing between oral and IV iron
(11:17) | Considerations with oral iron repletion
(24:02) |Considerations with IV iron repletion
(32:36) | Complications and side effects of IV iron
Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 Mar 2024 - 228 - #147 Iron Deficiency: Grey Matters Segment
What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history?
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Behind The Scenes YouTube Videos
Time stamps:
(03:43) | Iron deficiency labs and interpretation in inflammation
(16:08) | Heavy menstrual bleeding evaluation
(27:04) | When should a premenopausal woman with iron deficiency have endoscopy?
(35:15) | Recap
Tags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosis
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 13 Mar 2024 - 227 - #146 Tube Feeds: 5 Pearls Segment
Uncover many blind spots on tube feeds!
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Behind the Scenes Youtube Interviews:
Short-term enteral accessDurable enteral accessWhat is venting aka decompression?Timestamps:
(02:21) | Indications for tube feeds
(09:36) | Routes of enteral access
(19:20) | Components of tube feeds
(27:03) | Tube feeds complications
(34:50) | Counseling patients before discharge and medication interactions
Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feeds
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Feb 2024 - 226 - #145 Heart Failure in Older Adults & Guardianship: Gray Matter Segment
How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship?
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Behind The Scenes YouTube Interview
Timestamps:
(04:03) | Deep Dive 1:How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult?
(11:55) | Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship?
(28:30) | Deep Dive 3:How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred?
(33:27) | Reflections
(37:06) | Recap
Tags:IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case management
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 14 Feb 2024 - 225 - #144 RSV & What Makes Vaccine Trials Different: Beyond Journal Club on the RENOIR and AReSVi Trials
How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
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Time Stamps:
(02:30) | Epidemiology of RSV
(03:46) | Development of RSV vaccine
(05:55) | Vaccine trial design
(12:22) | ARESVI and RENOIR Trials
(18:18) | Who should we recommend the RSV vaccine to?
(19:50) | What don’t we know?
Tags:IMCore, CoreIM, primary care, infectious disease, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 31 Jan 2024 - 224 - #143 Hypomagnesemia and Hypophosphatemia: 5 Pearls Segment
When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement?
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Youtube interview on key points on magnesium
Youtube interview on key points on phosphate
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamps:
(01:37) | Pearl 1: Magnesium
(09:39) | Pearl 2: Framework for hypomagnesemia
(16:53) | Pearl 3: Magnesium repletion
(22:39) | Pearl 4: Phosphorous
(28:36) | Pearl 5: Phosphorous repletion
Tags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renal
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 17 Jan 2024 - 223 - #142 Managing Conflict: At the Bedside Segment
Sharpen your de-escalation skills!
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Timestamps:
02:26 Difficult Patients10:25 Mediation Toolkit17:20 Maxims of Mediation26:46 When the Conversation Still Breaks Down35:11 ConclusionTags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnout
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 27 Dec 2023 - 222 - #141 Do Steroids Have a Role in Community-Acquired Pneumonia? Beyond Journal Club on the CAPE COD Trial
In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.
01:50 Pathophysiology of Steroids and Infection03:50 Steroids in PNA Studies08:56 CAPE COD Trial14:13 Discussion of CAPE COD Trial18:36 Takeaways/DiscussionTags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 06 Dec 2023 - 221 - #140 Bonus Pacemaker & ICDs: 5 Pearls Segment
Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!
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Timestamps:
01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?06:31 Pearl 2: Considerations for patients with implantable devices before surgery.12:26 Pearl 3: Considerations for patients with implantable devices before MRI.14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-rayTags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 29 Nov 2023 - 220 - #139 CKD Staging (Cr vs. Cystatin C, Albuminuria & more): Mind The Gap Segment
Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria?
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CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamp:
00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage
04:20" What's wrong with how we estimate GFR?
06:50 Why is creatinine flawed as an estimator of GFR?
10:52 Enter new contender...Cystatin C!
16:16 Importance of the A Stage!
20:21 Which patients should you measure proteinuria in?
22:10 Treatments for albuminuria!
24:27 Summary and Closing
Tag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 08 Nov 2023 - 219 - #138 Incorporating Cancer Genetics into Your Practice: Lynch Syndrome and Beyond!
Check out the original interview on Youtube:
Essentials on Genetic Counselor | Lynch Syndrome
Who should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting!
Behind the Scenes YouTube Interview
Timestamp
03:13 Part 1: Who should be referred to genetic counseling?11:23 Part 2: How do we set up genetic counselors for success?22:38 Part 3: Genetic counseling myth busting!Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, nurse practitioner, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 25 Oct 2023 - 218 - #137 Hypokalemia & Potassium Repletion: 5 Pearls Segment
See some of the original interviews on Youtube!
What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?!
CME : http://bit.ly/CIMCME || Show Notes & Transcript
Behind the Scenes YouTube Interview
Timestamp
01:45 Pearl 1: Evidence for potassium repletion 09:10 Pearl 2: Framework for hypokalemia17:09 Pearl 3: Repletion goals23:00 Pearl 4: Options for hypokalemia treatment29:13 Pearl 5: Frequency of lab checks and repletionTags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional education
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 18 Oct 2023 - 217 - #136 How Did Diabetes Medications Become Obesity Meds? Beyond Journal Club on SURMOUNT-1 Trial
What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?
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02:08 Framework for thinking about obesity03:42 History of obesity treatment06:29 Gila monsters and GLP and GIP mechanisms08:29 Story of how medications for diabetes were found to have a weight loss benefit12:50 SURMOUNT-1 trialTags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 04 Oct 2023 - 216 - #135 Guideline Directed Medical Therapy Part II: 5 Pearls Segment
With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers?
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CME : http://bit.ly/CIMCME || Show Notes & Transcript
Timestamps
01:54 Pearl 1 – Recap of GDMT and CKD09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate 20:59 Pearl 3 – Ivabradine 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT30:55 Pearl 5 – Ejection Fraction RecoveryTags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiology
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 20 Sep 2023 - 215 - #134 Diagnostic Errors & Excellence
What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?
Timestamps
01:00 System 1 vs. System 207:46 Cognitive Biases13:46 Case for Knowledge18:29 Other Practices to Decrease Error28:26 ConclusionCME: http://bit.ly/CIMCME || Show Notes & Transcript
This episode is made in part of ACP’s Diagnostic Excellence curriculum
Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflection
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 06 Sep 2023 - 214 - #133 Post-Kidney Transplant: 5 Pearls Segment
What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection?
Behind The Scenes YouTube Interview
Timestamps
02:41 Types of Immunosuppression14:31 Medication Reconciliation22:36 AKI in the Transplant Patient31:53 Infections in the Transplant Patient40:00 Transplant rejection, cancer after transplantCME: http://bit.ly/CIMCME || Show Notes & Transcript
Tags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressive
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 16 Aug 2023 - 213 - #132 Does PCI Save Lives in Heart Failure and CAD? Beyond Journal Club on the REVIVED Trial
In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.
How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.
Access to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.
Timestamps
00:50 Question REVIVED addressed01:44 Revascularication in HFrEF06:32 Revascularization in stable CAD10:02 REVIVED trial12:20 Summary and takeawaysTags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicine
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 02 Aug 2023 - 212 - #131 July Stories 2.0
Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories !
Listen to the original July Stories: https://bit.ly/3Y4n8jG
Behind The Scenes videos on YouTube
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Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedback
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 19 Jul 2023 - 211 - #130 Cort (ACTH) Stim Test
BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?
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Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue
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Privacy & Opt-Out: https://redcircle.com/privacyThu, 06 Jul 2023 - 210 - #129 Steroids: 5 Pearls Segment
How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?
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Time Stamps
02:59 Types of Corticosteroids14:31 Side Effects of Steroids21:15: Prophylaxis 27:32 Steroid Weaning 33:38 Steroid Weaning LimitationsTags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndrome
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 28 Jun 2023 - 209 - #128 Cirrhosis Bleeding Risk, FFP and Indwelling Pleural Catheters: Gray Matters Segments
In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?
Time Stamps
02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis05:35 Deep Dive 2: FFP effect on bleeding risk15:43 Deep Dive 3: Risks of FFP19:45 Deep Dive 4: Indwelling pleural catheters30:31 RecapTags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonary
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 14 Jun 2023 - 208 - #127 Radiation Oncology Side Effects: 5 Pearls Segment
How long can fatigue last for after radiation? Are all patient post radiation immunocompromised? What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?
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Whiteboard Animation Video of Radiation Physiology
Time Stamps
02:37 Systemic Radiation Side Effects14:29 Lung Radiation Side Effects18:22 Breast Radiation Side Effects21:45 Prostate Radiation Side Effects24:54 Brain Radiation Side EffectsTags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapy
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 31 May 2023 - 207 - #126 Radiation Oncology Part 1: 5 Pearls Segment
What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?
Whiteboard Animation Video of Radiation Physiology
Time Stamps
02:04 What is radiation?03:17 How does radiation therapy work?04:50 How is today’s radiation different from the past?05:40 What role does radiation play in cancer treatment?07:48 What are the different types of radiation?15:34 How do you write a rad onc one-liner as an internist?19:59 What is palliative radiation and how/when should we use it?Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 24 May 2023 - 206 - #125 Learning Habits, Time Management, and Leadership: Wisdom from Dr. Kelly Graham
What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?
Time Stamps
01:12 Learning Journey05:58 Lifelong Learning11:14 Time Management16:38 Role Modeling19:59 Re-Calibrating FailureTags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time management
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Privacy & Opt-Out: https://redcircle.com/privacyMon, 15 May 2023 - 205 - #124 A1c & Glucose Measurements: Mind the Gap Segment
What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric?
Show notes, Transcript and References
Time stamps
00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test03:03 Hemoglobin A1c08:26 Fructosamine and Glycated Albumin10:50 Continuous Glucose Monitoring15:44 The Overlooked Issue of Insulin Resistance19:11 SummaryTags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complication
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 26 Apr 2023 - 204 - #123 Pacemakers & ICDs: 5 Pearls Segment
When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?
Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps
02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?21:28 How to determine which type of device your patient has?25:10 What can a device interrogation tell you and doesn't tell you?32:13 Do all patients with bacteremia need their implantable cardiac devices taken out? 38:44 End-of-life considerations with pacemakers vs. ICDsTags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacing
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 12 Apr 2023 - 203 - #122 Kidney Transplant Preparation: 5 Pearls Segment
How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?
Use promo code COREIM for 1 month of free access to Glass Proat https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps
03:49 Episode start07:13 Dialysis vs. kidney transplant morbidity and mortality11:44 Eligibility for kidney transplant and when to refer21:34 Pre-transplant evaluation process25:38 How long are wait times on the transplant list?36:21 What benefits of living donation? What are risks to the kidney donor?Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidney
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Privacy & Opt-Out: https://redcircle.com/privacyWed, 29 Mar 2023
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