Core IM | Internal Medicine Podcast

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

Transcript and Show Notes

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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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!

Transcript and Show Notes

ICIs & IrAEs 101 Episode

Behind The Scenes video

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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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YouTube Videos

1. Anion Gap Metabolic Acidosis: https://youtu.be/oE0lygmMANM
2. Inhaler Delivery Systems: https://youtu.be/yYPdjClm9Bg
3. Iron Deficiency in Pregnancy https://youtu.be/xTzYSXUbLsc

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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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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

Transcript and Show Notes

Tags: CoreIM, InternalMedicine, CriticalCare, Proton Pump Inhibitors, GIbleeding, ICU, ICU bleeding, Clinical Trials, Evidence Based Medicine, Patient Centered Outcomes, Deprescribing

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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?

Transcript and Show notes

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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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?

Transcript and Show notes

Behind the Scenes Youtube Interview

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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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Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?

Transcript and Show notes

Behind The Scenes YouTube Interviews

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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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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

Show notes & Transcript

Hospice 101 Episode 1

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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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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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Transcript and Show Notes

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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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Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!

Transcript and Show notes

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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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