How much of D5W vs. isotonic saline contributes to intravascular volume? How do you distinguish between oncotic pressure and tonicity? What balanced solutions do you reach for? What is the data behind using colloids like albumin as an intravascular expander? How much do pRBCs stay in the plasma? 

Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/04/27/fluids-colloids-5-pearls-segment/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im 

Time stamps:

• 02:14 Intro
• 04:26 Pearl 1
• 11:08 Pearl 2
• 20:43 Pearl 3
• 31:06 Pearl 4
• 35:06 Pearl 5

Tags: IM Core, CoreIM, fluids, hypertonic, volume, crystalloid, tonicity, blood, nephrology, hospital medicine

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What do you include in your initial basic work-up for suspected pulmonary hypertension? Do you know how to calculate the PASP on the ECHO? What physiological insults that can cause high pulmonary pressures? How can we interpret the E/e’ ratio?

Whiteboard animation video on YouTube

Show notes, Transcript and References

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Time stamps:

• 02:18 | Intro
• 05:27 | Pearl 1 
• 12:17 | Pearl 2
• 16:13 | Pearl 3
• 24:04 | Pearl 4
• 30:08 | Pearl 5

Tags: IM Core, CoreIM, PASP, Echo, hypoxia, PA pressure, vascular resistance

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How can we use food as medicine? How can we best counsel our patients on their diets? Which pre-set diets can we recommend for or against? How can we make the changes sustainable? 

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/03/23/obesity-and-nutr…-2021-sgim-recap/

Time stamps:

• 03:10 Trends in weight and dieting
• 06:01 Counseling patients on diet
• 09:35 Food group recommendations
• 14:53 Pre-set diets
• 20:47 Making sustainable changes

Tags: Core IM, IM Core, diet, salt intake, fiber, weight

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What are some tricks to help you perform a virtual physical exam? What role do these visits play in our overall care for the patient? What tools do we have at our disposal for a more thorough evaluation?

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/03/09/telemedicine-and…-2021-sgim-recap/

Tags: IM Core, CoreIM, tele visit, gizmos, history taking, virtual, physical exam, assessment, functional status, tips

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How long should you anticoagulant for a PE? When can you safely stop anticoagulation for thrombogenic patients who need an urgent biopsy? Should an IVC filter be placed to prefer further embolization of a DVT? What percentage of patients with cancer associated blood clots will have progression while on anticoagulation?

Show Notes, Transcript, and References: https://www.coreimpodcast.com/2022/02/23/24433/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time Stamps:

• 02:40 Deep Dive #1 Anticoagulation
• 08:50 Deep Dive #2 DOACs
• 14:08 Deep Dive #3 IVC Filter
• 17:49 Deep Dive #4 Biopsy
• 25:00 Recap

Tags: Core IM, IM Core, Anticoagulation, Bleeding, DOACs, IVC, reflections, clots

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How can you implement effective note taking for virtual learning? Do you use interleaving during rounds? What is the 5/10/30 rule and how does it apply to mentorship? Does implicit bias affect gender performance scores in clinical rotations? How common are biased patient behaviours? How can you foster a safer learning environment for trainees? How can you promote antiracism?

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/02/09/medical-educatio…ng-core-im-recap/

Time stamps

• 02:10 Make it Stick Virtually
• 08:35 Mentoring in the Modern Era: More than the Traditional Dyad
• 13:29 Clinical Update in Medical Education
• 20:58 Anti-Racism in Medical Education: Concrete Actions to Further Social Justice and Racial Equity

Tags: IM Core, CoreIM, virtual learning, note taking, feedback, mentorship, microaggressions, gender bias, sterotype threat

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What’s your comfort level with managing hyponatremia and how does it change in unfamiliar environment? How can you vary your practice to build up adaptive exerptise? 

Show notes, Transcript & References:  https://www.coreimpodcast.com/2022/01/26/hoofbeats-consult-case/ 

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time stamps

• 01:36 Case
• 10:42 Case analysis 
• 22:45 An unfamiliar domain
• 25:50 Lab review
• 40:04 Conclusions

Tags: IM Core, CoreIM, hyponatremia, preeclampsia, reasoning, adaptive expertise, situational awareness

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Have you ever thought about where the 1g/dL hemoglobin appropriate bump after 1 unit of pRBC transfusion? How does the patient's intravascular volume affect this? What rise in hemoglobin should you expect? What factors can impact this?

Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/01/05/1-to-1-prbc-bump…-the-gap-segment/

Time stamps

• 01:22 Unpacking the question 
• 01:55 The math 
• 04:32 Functional hemoglobin
• 08:50 Donor and Patient 
• 11:18 Scenarios
• 12:58 Summary
• 14:34 Clarification 

Tags: IM Core, CoreIM, hemoglobin, intravascular volume, irradiation, donation

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Let’s apply to cases! We use the 7 questions framework to 3 practical cases

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/12/22/treatment-over-objection-part-2/

Time stamps

• 2:19 Case 1: Review of Framework
• 7:59 Case 2
• 9:04 Consent vs. Assent 
• 11:11 Role of Consult Services
• 13:16 Role of Surrogates
• 15:29 Conclusion

 

Tags: IM Core, CoreIM, autonomy, capacity, human dignity, non-maleficence, ethics, medical humanities

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Get a very useful framework to help you weigh the risks and benefits of treatment over objection!

Show notes, Transcript and References: https://www.coreimpodcast.com/2021/12/08/treatment-over-objection/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im 

Time stamps

• 03:02 Ethical and emotional challenges
• 10:08 Case 1
• 18:55 Study of the 7 Questions
• 22:46 Conclusion 

 

Tags: IM Core, CoreIM, autonomy, capacity, human dignity, non-maleficence, ethics, medical humanties

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