Night and Day… join us for part II of our exploration into why we prescribe medications in the morning vs. at night, featuring statins!

03:28 How do statins and cholesterol synthesis work again, anyway?

04:00 Power in numbers - what do the meta-analyses say about timing of statins?

04:40 The long and short of it - how half-life may dictate when to take your statin.

07:35 Effect magnitude - does medication timing actually really impact patient outcomes?

10:30 Practical matters - so what should we tell patients?

11:05 Review of teaching points

Show notes, transcripts and references

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Solidify your knowledge on Coronary calcium scores and Coronary CTAs!

ACP members can claim CME-MOC Credit !

Quiz yourself on the 5 pearls we will be covering below:

• 3:10 What are the big picture differences of functional stress tests and anatomical cardiac tests?
• 7:48 What is the role of coronary artery calcium scores in managing coronary artery disease (CAD)?
• 16:20 How do coronary CTAs compare to stress tests?
• 24:28 When should we avoid CTA?
• 29:33 How do we communicate coronary CTA results with patients?
• 36:02 Recap

Full transcript, infographics and show notes !

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In ‘At The Bedside’, our newest podcast segment, we tackle important topics that *aren’t* easily indexable in guidelines and UpToDate article – topics that are better discussed…well…at the bedside. Our first episode examines the all-too-common trope of the ‘difficult’ patient.

• 01:13   Introduction
• 05:27   Question 1: What makes a patient difficult for you?
• 13:22   Question 2: What is a “good outcome” when working with difficult patients?
• 23:05   Question 3: What have you learned from your difficult patients?
• 31:56   Conclusion

Show notes, Transcript, Further Reading

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Transitions can be hard. Laugh, commiserate and be inspired by these July stories in medicine!

Very big thank you to everyone who told their stories !

Let's help each other feel a little less alone in the struggle, be more understanding and compassionate or laugh at ourselves. Please share this episode with colleagues. Do you have a July story? Email us at [email protected].

Lets continue conversation over social media. Which stories moved you? Which July stories can you relate to? Tweet us, find us on instagram at coreimpodcast or Facebook. Good luck this coming July !

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Dissect clinical reasoning and dive deeper into an interesting case!

• 02:04   Initial Presentation
• 03:03   The Core IM team tackles the case
• 09:30   Social History
• 16:05   Physical Exam
• 22:47   An exercise in Bayesian inference
• 36:35   Pre-mortem
• 43:37   Revealing the diagnosis
• 48:57   How do we define diagnostic success?

Full transcript with references and show notes

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Dive deeper into why we prescribe medications in the morning vs. at night !

• Why do we dose warfarin at night? (2:45)
• Back to the basics - what are the pharmacodynamics of warfarin and how does vitamin K intake matter? (4:28)
• Practical matters - so what should we tell patients (6:14)
• Dippers and non-dippers - what happens to blood pressure (BP) at night? (9:32)
• The surprising link between dipping and cardiovascular outcomes (11:15)
• Timing is everything… or is it? The evidence behind taking BP meds at night (11:58)
• Review of teaching points (15:58)

What is your prescribing practice with blood pressure medications? Leave a comment, tweet us or share with us on instagram or facebook on how you dose BP meds?

Transcript with references and show notes

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Solidify your knowledge on stress tests! Quiz yourself on the 5 pearls we will be covering:

• What are the indications for a stress test? (2:18)
• How to choose stress protocol in a stress test? (8:29)
• How to choose diagnostic modality in a stress test? (14:46)
• How do we interpret results from stress tests, and how should this be communicated to patients? (24:08)
• Pearl Recap (31:13)
• Risk of contrast induced nephropathy between arterial and venous contrast load (36:02)

For full transcript, infographic and show notes: https://www.coreimpodcast.com/2019/04/24/stress-testing/

 

Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology

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Dissect 3 interesting cases and improve your clinical reasoning skills! Time Stamps:

• New features in this episode [0:30]
• Case one: 66M w RUQ pain [1:09]
• Case two: 41M w Afib in RVR [9:26]
• Case three: 50M w Syncope [14:33]
• Reveal [19:57]
• Retrieving illness scripts [22:29]
• Typical versus Atypical presentation of diseases [26:12]

For full transcript and show notes: https://www.coreimpodcast.com/?p=21028

Tag: medical education, clinical cases, expert clinicians, internal medicine podcast

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Check out part 1: Acute Coronary Syndrome and TIMI Risk Score

Lets go deeper into

1) How the chest pain history correlates with pathophysiology? [2:40]

2) How has high-sensitivity troponin changed the way we think about unstable angina? [7:34]

For transcript, infographic and show notes: https://www.coreimpodcast.com/2019/03/27/unstable-angina/

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Solidify your knowledge on inpatient pain management! Quiz yourself on the 5 pearls we will be covering:

• How effective are non-opioids? ( 3:17)
• Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51)
• What are the best practices for patients who require opioid analgesia? (19:00)
• When prescribing opioids at discharge what can we do to minimize harm? (25:02)
• Throwback to mechanism of acetaminophen and NSAIDs (27:14)
• How do we believe tylenol works and how does that compare to NSAIDS? (28:27)

For full transcript of the audio and show notes: https://www.coreimpodcast.com/2019/03/13/5-pearls-on-pain-management/

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