Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview national and international experts to bring you clinical pearls and practice changing knowledge. Doctors Matthew Watto, Stuart Brigham, and Paul Williams deliver some knowledge food for your brain hole. No boring lectures here, just high value content and a healthy dose of humor. Fantastic podcast for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine. Topics include heart disease, obesity, diabetes, cardiac imaging, migraines, fibromyalgia, hypertension, cholesterol, osteoporosis, insomnia, testosterone, functional medicine, dementia, and more!
Solidify your knowledge of osteoporosis and osteopenia in this discussion with Endocrinologists and osteoporosis guideline authors, Dr. Rachel Pessah-Pollack, and Dr. Dan Hurley from the American Association of Clinical Endocrinologists (AACE). Learn when to start therapy after an acute hip fracture, how to use bone turnover markers to assess fracture risk, more on how to dose calcium and vitamin D, and finally, we discuss the new American College of Physicians (ACP) guidelines and how they differ from the AACE guidelines on osteoporosis.
For a more basic talk on osteoporosis check out episode #18 w/Dr. Pauline Camacho.
Full show notes available at http://thecurbsiders.com/podcast
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Time Stamps
00:00 Intro
03:00 Picks of the week
07:31 Guest and topic intro
10:25 Rapid fire questions
14:45 Clinical Case and defining osteoporosis
17:00 FRAX score
20:35 Secondary evaluation for cause of bone loss
20:54 Bone turnover markers (telopeptides)
23:17 Alkaline phosphatase
26:30 Calcium and Vit D
29:35 Recap of teaching points so far
31:25 Antiresorptive versus anabolic therapy
32:40 Aromatase inhibitors increase fracture risk
34:28 When to start therapy after fracture
35:44 Mechanism of action recombinant PTH
41:38 Vitamin D assay and dosing
46:53 Calcium intake, and formulations
49:45 Take home points
50:54 Recap and discussion of AACE vs ACP guidelines by The Curbsiders
59:42 Outro
Tags: bone, osteoporosis, anabolic, osteopenia, vitamin D, calcium, fracture, density, AACE, guidelines, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student
Master the evaluation of acute and chronic chest pain with coronary CT angiography (CCTA). We deconstruct this game changing technology w/experts from the Society for Cardiovascular Computed Tomography (SCCT), Dr. Todd Villines and Dr. Ahmad Slim. We’ve got answers on what to do when a patient with chest pain has a prior CAC score of zero, and/or a CCTA with non-obstructive disease. Plus: how to select, prepare, and counsel patients; how to interpret reports; choosing between myocardial perfusion study and CCTA, and more!
Special thanks to Dr. Emilio Fentanes from SCCT for setting up this interview.
Full show notes available at http://thecurbsiders.com/podcast
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Case: 45 yo F active duty Colonel with chronic chest pain syndrome despite negative conventional stress test and CAC score of zero.
Time Stamps
00:00 Intro
04:00 Rapid fire questions
08:23 Book recommendations
10:14 Defining terms CCTA vs CAC
12:47 Script for counseling patient about CCTA
14:34 Prep for CCTA
16:40 Why is CCTA controversial?
19:37 Patient selection for CCTA both acute and chronic
25:20 Chronic chest pain and CCTA
27:58 CAC and CCTA in high risk occupations
33:25 Clinical case
36:10 Acute chest pain in patient w/CAC score zero
39:18 Acute chest pain in patient w/CAC score zero and previous CCTA w/non-obstructive CAD
41:22 How to read a CCTA report
45:48 CCTA versus conventional testing and risk MI, death
49:18 Use of CCTA in outpatients
52:16 Plaque characteristics and risk ACS
55:51 CCTA w/non-obstructive disease in patients with acute chest pain
58:14 When is myocardial perfusion scanning better?
61:00 Listener question on small vessel disease
62:09 Take home points
65:00 Curbsiders recap
69:33 Outro
Update your management of heart failure (HF) with expert tips from Cardiologist Dr. Eric Adler, Associate Professor of Medicine and Director of Cardiac Transplant and Mechanical Circulatory Support at UC San Diego. We cover how to use BNP, a simple way to examine jugular venous distention, medical therapy for heart failure, the PARADIGM-HF trial, and how to use sacubitril/valsartan (Entresto).
Full show notes available at http://thecurbsiders.com/podcast
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Time Stamps
00:00 Intro
04:25 Rapid fire questions
06:00 Palliative care and heart failure
08:40 Book recommendation
10:20 Advice for teachers and learners
12:27 Clinical case of HF
13:38 Classification and staging of HF
17:07 Discussion of BNP
19:35 How to perform neck vein exam for JVD
21:20 BNP for prognosis
23:00 BNP at hospital discharge
26:36 Factors that affect BNP
27:25 Initial patient counseling
32:35 Exercise in HF
34:00 Additional testing at time of diagnosis
36:28 Initial medical therapy
38:30 Discussion of diuretics and dosing
42:50 Aldosterone antagonists
44:30 PARADIGM-HF and entresto
51:27 Medications to avoid in HF
54:14 Digoxin
57:30 Dr. Adler’s take home points
59:11 Stuart questions dosing conventions
60:48 Outro
Tags: arni, assistant, care, diuretics, doctor, education, failure, family, foam, foamed, health, heart, hospitalist, hospital, internal, internist, neprilysin, nurse, management, medicine, medical, physician, practitioner, primary, resident, sacubitril, student
Master the safe and effective use of obesity medications with Endocrinologist, Dr. Karl Nadolsky (co-author of 2016 AACE Obesity guidelines), Director of the Diabetes, Obesity & Metabolic Institute at Walter Reed National Military Medical Center. We get under the hood of each FDA approved obesity medication plus some of our normal hijinks. Check out episode #23 for a more general overview of obesity.
Full show notes available at http://thecurbsiders.com/podcast
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Time Stamps
00:00 Intro
03:12 Picks of the week
08:44 Rapid fire questions
13:00 Counsel patients about obesity
14:40 Pathophysiology of obesity
18:00 Case
22:46 Phentermine/topiramate (Qsymia)
26:20 Bupropion/naltrexone (Contrave)
29:18 Liraglutide (Saxenda)
34:32 Orlistat (Alli, Xenical)
37:35 Cost issues
40:18 Lifelong medical therapy for obesity
42:44 Dr. Nadolsky’s take home points
44:45 The Curbsiders recap and discuss their experience with obesity medications
52:28 Outro
Tags: assistant, care, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, obesity, pharmacotherapy, weight loss, safety, side effects, orlistat, alli, naltrexone, bupropion, contrave, phentermine, topiramate, qsymia, lorcaserin, belviq, FDA
Load up on clinical pearls for your practice in this wide ranging discussion with expert clinician educator, Dr. Jon M. Sweet, Associate Professor of Medicine from Virginia Tech Carilion School of Medicine. Topics include cellulitis, tinea infections, dermatologic emergencies, smoking cessation, heart failure, hormone replacement therapy, iron supplementation, and vocal cord dysfunction. Plus, Stuart gives Paul a new nickname! Special thanks to the Dr. Patrick Alguire and Dr. Darilyn Moyer from the American College of Physicians for setting up this episode.
Full show notes available at http://thecurbsiders.com/podcast
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Time Stamps
00:00 Intro
02:12 Picks of the week
05:10 Guest intro
07:13 Rapid fire questions
15:25 Tinea infections
18:22 Misdiagnosis of cellulitis
23:53 AGEP (Dermatology)
29:03 DRESS syndrome (Dermatology)
35:28 Smoking cessation
36:55 Back pain, acetaminophen and acupuncture
41:42 Hot flashes and hormone therapy
43:05 Iron supplementation
49:55 Heart failure and sacubitril/valsartan
53:33 Vocal cord dysfunction
56:50 Response from Stuart and Paul
62:20 Outro
Tags: AGEP, ARNI, assistant, back pain, care, cellulitis, cessation, dermatology, DRESS, doctor, education family, foam, foamed, health, heart failure, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, smoking, student, tobacco, vocal cord dysfunction
Diagnose, prevent, and treat diabetic foot ulcers and infections like international expert, Dr. Andrew Boulton, Professor of Medicine at the University of Manchester (England). From how to perform a proper foot exam, to foot care, to ulcers and infections we cover the essentials for your practice.
For full show notes visit http://thecurbsiders.com/podcast
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Tags: assistant, care, diabetes, diabetic, doctor, education, family, foam, foamed, foot, health, hospitalist, hospital, infection, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, ulcer
Prevent HIV infections with pre-exposure prophylaxis (PrEP), and learn to perform appropriate screening for sexually transmitted infections with tips from expert, Dr. Gina Simoncini, Associate Professor of Medicine at Temple University Hospital. Learn how to implement PrEP in your practice, plus tips on vegetable gardens, fellowships, and where to get the best samosas, in this wide ranging discussion.
Full show notes available at http://thecurbsiders.com/podcast
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Time Stamps
00:00 Intro
04:50 Rapid fire questions
16:23 Defining preexposure prophylaxis
18:50 Who benefits from PrEP
21:43 Case discussion
23:45 PrEP during pregnancy, breastfeeding
24:45 Baseline testing and STI screening before PrEP use
28:15 Counseling on adherence, side effects
31:25 Adverse effects of PrEP
34:00 Monitoring patients on PrEP
36:46 Collaborative practice
37:30 Discussion of high risk behaviors on PrEP
39:30 Does PrEP promote viral resistance?
41:51 Insurance reimbursement for PrEP
42:50 Take home points
44:24 Outro
Tags: assistant, care, doctor, education, emtricitabine, family, foam, foamed, health, HIV, hospitalist, hospital, infection, internal, internist, nurse, meded, medicine, medical, physician, practitioner, primary, prophylaxis, resident, sti, student, tenofovir
Learn “weird” endocrine stuff! How to approach vague complaints like fatigue and weight gain. Reverse T3 syndrome, Wilson’s T3 syndrome, and adrenal fatigue; Do they exist? Learn how to help the challenging patient who is convinced they have an endocrine disorder in this discussion recorded live from AACE 2017 with Dr. Michael T. McDermott, Professor of Medicine, University of Colorado Denver School of Medicine.
For full show notes visit http://thecurbsiders.com/podcast
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Time Stamps
00:00 Intro
05:36 Guest intro
07:50 Definition of “pseudo” endocrine
10:02 Case introduction
13:39 “Reverse T3 Syndrome”, the thyroid and fatigue
20:45 Growth hormone
25:10 Fatigue, and where to start
33:00 Adrenal fatigue
38:00 Lab testing
39:34 Take home points
42:12 Stuart on the thyroid and reverse T3
45:30 Paul’s approach to multisystem complaints
51:12 Outro
Tags: adrenal, assistant, care, doctor, education, endocrine, family, fatigue, foam, foamed, growth, health, hormone, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, thyroid, t3
Expert tips on the diagnosis and management of secondary hypertension in this conversation with Dr. Richard Auchus MD, PhD, Professor of Pharmacology and Internal Medicine & Director of the Diabetes, Endocrinology, & Metabolism Fellowship Program at the University of Michigan. Topics include: primary hyperaldosteronism, use of spironolactone, Cushing’s syndrome, pheochromocytoma, and which tests to utilize.
Full show notes available at http://thecurbsiders.com/podcast
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Tags: assistant, care, cushing's, doctor, education, endocrine, family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nurse, medicine, medical, pheochromocytoma, physician, practitioner, primary, resident, resistant, spironolactone, student
Recognize and manage end of life symptoms with competence and confidence. In this extensive discussion with Dr. Brooke Worster, Assistant Professor of Medicine at Sydney Kimmel Medical College and Medical Director, of the Palliative Care Service at Thomas Jefferson University Hospitals we discuss scripts for having difficult conversations, managing patient/family expectations, what comes in the hospice “E” kit, terminal delirium, the “death rattle”, air hunger, and more.
Full show notes available at http://thecurbsiders.com
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Time Stamps
00:00 Intro
03:10 Rapid fire questions
08:33 Defining hospice and palliative care
11:28 Case discussion
21:28 Gunderson, MI and Respecting Choices
24:25 How to counsel patients about home hospice?
37:10 Hospice “E” kit and how to use it
42:09 Air hunger, terminal delirium, death rattle, and Cheyne Stokes breathing
52:48 What is the PCM’s role while patient is on hospice?
58:19 Cancer survivorship and palliative care
60:33 Take home points
62:20 Outro
Tags: assistant, care, doctor, end, education, family, foam, foamed, health, hospice, hospitalist, hospital, internal, internist, life, nurse, medicine, medical, palliative, physician, practitioner, primary, resident, student, symptom
