What are common mistakes with protein on the UA? What questions should you ask while obtaining a history that could clue you into nephrotic syndrome? Are kidney biopsies risky business? Is there an associated clot risk in patients with nephrotic syndrome?

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

Show note, Transcript and References: https://www.coreimpodcast.com/2020/09/02/5-pearls-on-nephrotic-syndrome/

Amboss Article on Nephrotic Syndrome: https://www.amboss.com/us/knowledge/Nephrotic_syndrome?utm_source=affiliate&utm_medium=link&utm_campaign=coreim-01

Time Stamps:

• 03:22 Evaluating Proteinuria
• 09:37 Nephrotic Syndrome specifics
• 22:31 Who to biopsy
• 31:39 Diuretics
• 37:16 Thrombosis Risk

Tags - CoreIM, IM Core, edema, proteinuria, kidneys, thrombosis, urinalysis, diuresis 

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How tough is it to forge your career in clinical research? What struggles do physicians face in finding protected time? Are there setbacks and frequent rejections? How can you follow your passion and find success?

Show note, Transcript and References: https://www.coreimpodcast.com/2020/08/19/research-careers…rs-in-gim-series/

Time Stamps:

1:28 Origins

6:57 Mentorship

14:30 Reality, Roadbumps, and Failures

18:17 The path of many fellowships

 

Tags - CoreIM, IM Core, clinical investigator, general internal medicine

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Are fall prevention programs helping our patients? Should patients receive outpatient PT based on clinical diagnosis? How has the landscape changed because of insurance reimbursement?

Show note, Transcript and References: https://www.coreimpodcast.com/2020/08/05/physical-therapi…education-series/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-imTime Stamps:

• 01:47 Functional Assessment
• 07:47 Documentation
• 14:35 Outpatient PT
• 18:14 Durable Medical Equipment
• 22:55 Reimbursement

Tags: Core IM, IM Core, physical therapy, durable medical equipment, IPE, multidisciplinary team, interdisciplinary

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What goes into decision making? What are the invisible tugs that may keep patients from acting in line with their values? Why isn't it part of the formal capacity assessment?

Show notes, Transcript and References: https://www.coreimpodcast.com/2020/07/22/capacity-2-0-and-voluntarism/

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

Time Stamps:

• 2:57 Defining voluntarism
• 5:36 Four elements that influence voluntarism
• 10:26 How do you incorporate voluntarism into the capacity assessment?
• 16:11 Discussions with uncooperative patients
• 19:14 Protecting unrepresented patients
• 21:30 Clinician perspective
• 25:06 Moral distress

Tags: medical humanities, ethics, psychiatry, IM Core, CoreIM

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Unpack a famous historical legend's medical dilemma on a special "Historical CPC" episode!

Show notes, transcript and references: https://www.coreimpodcast.com/2020/07/08/22729/

Time Stamps:

• 02:55 HPI
• 07:33 Past Medical History
• 04:25 Physician Exam findings
• 24:22 Historical Figure Revealed
• 26:30 Reflections on top 3 diagnosis

Tags: cognitive and neuropsychiatric disturbances, rabies, mercury poisoning, cholera, delirium, COREIM, IMCORE, clinical reasoning case

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Packed with so many clinically relevant points taking care of a patient with decompensated heart failure on general medicine floors!

Time Stamps:

• 03:17 What are the key initial clinical variables in evaluating heart failure admissions?
• 10:09 What are key lab findings for patients with heart failure exacerbation?
• 17:14 Which guideline-directed medical therapy, and in what circumstances?
• 22:12 What are diuretics dosing strategies and monitoring tips to help guide initial volume removal?
• 28:43 What role do thiazides and ultrafiltration play in diuresis, why does diuretic-induced metabolic alkalosis happen and what should you do about it?
• 38:09 Expert Recap

Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/24/5-pearls-on-inpatient-heart-failure/

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

 

Tag: Cardiology, BNP, cardiorenal syndrome, beta-blockers, CoreIM, IMCore

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SNF vs. NH? SAR vs. SNF? What are the differences in resources, nursing and clinician oversight and who pays for what?!

Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/

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

Time stamps:

• 04:07 SAR vs SNF
• 13:35 Long term Nursing Home Care
• 18:30 Assisted Living Facility
• 24:40 Acute rehab
• 26:11 LTACH
• 27:49 Home

Tags: Subacute rehab, skilled nursing facility, long-term acute care hospital, CoreIM, Core_IM, hospital medicine, family medicine, emergency medicine, physician assistant, nurse practitioner, interprofessional education

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Let's dive deeper into the dogma of salt restriction in heart failure! Show notes, transcript and references: https://www.coreimpodcast.com/2020/05/20/salt-restriction-in-heart-failure-mind-the-gap-segment/ Get CME-MOC credit with ACP! Time Stamp

• 01:37 Sodium restriction guidelines
• 07:13 Current data in outpatient data
• 11:32 Do inpatient studies show signal?
• 13:44 Physiology behind sodium balance
• 16:27 Take away and clinical applicability

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How do you navigate new challenges with goals of care with your patients in clinics?

Show Notes, Transcript, References: https://www.coreimpodcast.com/2020/05/06/outpatient-advanced-care-planning-during-covid-19/

Time Stamps

• 01:32 COVID Crisis as an Outpatient and Advance Care Planning (ACP)
• 08:06 The virtual visit
• 12:44 Vital Talk Mnemonic: “CALMER”
• 22:03 Challenges to Outpatient COVID Care
• 26:03 Parting Thoughts

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Episode Outline

1. Disconnection/connection: Patients
2. Disconnection/connection: Family/friends
3. Disconnection: Security, Certainty
4. Connection: Other clinicians

• Sharing fears, supporting each other)
• Shared ethos in healthcare (one workforce, no division of specialty or hierarchy)

1. Conclusion: Post-traumatic growth / Peri-Traumatic Growth

Thank you to everyone we interviewed, particularly to the voices you heard:

Dr. Kimberly Manning (@gradydoctor)

Dr. John Hwang (Hoofbeats segment)

Dr. Steve Liu (Mind the Gap segment)

Dr Katherine Arthur

Dr. Maria Garcia-Jimenez

Dr. Kelsey Luoma

Hosts:

Dr. Margot Hedlin (@MargotHedlin) - Introduction and Ending

Dr. Tamar Schiff

Dr. Michael Shen (also audio editing)

Dr. Jafar Al-Mondhiry (@mondhiry)

 

tags: COVID19, COVID-19, CoreIM, coronavirus, narrative medicine

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