Core IM | Internal Medicine Podcast

What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?

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Transcript and Show notes

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Timestamps:

(04:59) | Definitions

(06:50) | Moral Distress

(09:01) | Moral Residue

(09:01) | Moral Residue

(11:34) | Moral Injury

(13:32) | Causes of Moral Distress and Moral Injury

(18:18) | Consequences

Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanism

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Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”

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Transcript and Show notes

Cardiorenal Considerations: 5 Pearls Segment

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Timestamps:

(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension

(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output

(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion Pressure

Tags: IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical care

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Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.

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Show notes & transcripts

Behind the Scenes YouTube Interview

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Timestamps:

(02:44) | What makes this patient different from others with similar symptoms or diagnosis?

(07:28) | Does your covering team have the tools to follow up on tasks and information they need for success? 

(16:06) | Is the handoff updated? 

(18:26) | What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients? 

(22:41) | What are we still uncertain about? 

(25:30) | Closing thoughts 

Tags: IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalist

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Behind the Scenes Youtube Interview

Show notes & Transcript

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Timestamps:

(03:04) | What is the philosophy of hospice?

(06:13) | Who qualifies for hospice?

(08:17) | Who makes up the hospice team?

(17:24) | Who pays for hospice?

(21:31) | What are the different levels of care?

(31:57) | What are some limitations of the hospice medicare benefit?

Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant

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Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention.

Book by Dr. Adaira Landry, Dr. Resa E. Lewiss:

MicroSkills: Small Actions, Big Impact

Show notes & Transcript

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Tags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistant

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Does colonoscopy prevent colon cancer, and does it save lives? There has never been a randomized controlled trial on screening colonoscopies before NordICC trial, even though it is a guideline based recommendation for everyone over 45! How did this come to be? What do we tell our patients who are on the fence about undergoing screening colonoscopy? To find out, tune into the sixth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. 

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Show notes & Transcript

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamp:

(00:00) | Introduction

(02:28) |Pathophysiology of Colorectal Cancer & Why Screening Makes Sense

(06:15) | General Cancer Screening – Observational Studies

(09:17) | General Cancer Screening – Randomized Controlled Trials

(14:40) | NordICC Trial

(22:36) | Implications for Patient Care

Tags: IMCore, CoreIM, primary care, gastroenterology, nurse practitioner, pharmacist, physician assistant, sigmoidoscopy, per protocol analysis and intention to treat analysis

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Behind The Scenes YouTube Interviews

Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(01:59) | What causes HFpEF?

(11:22) | Does diastolic dysfunction imply HFpEF?

(19:21) | Is the BNP level helpful in HFpEF?

(25:06) | What scoring systems can be helpful in ruling in HFpEF?

(32:03) | What's the treatment for HFpEF?

Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, heart failure with preserved ejection fraction

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Behind the Scenes YouTube Interview

Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(01:56) | How do immune checkpoint inhibitors work?

(07:15) | How do you organize the different immune-related adverse events (irAEs)?

(13:42) | Generally, when do different adverse events can present?

(22:20) | What makes someone more likely to develop an adverse effect?

(26:38) | What role does complementary & alternative medicine play in this patient population?

Tags: Side effects, oncology, cancer, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, pharmacology

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Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(02:05) | Urinalysis in a patient with AKI from purely cardiorenal syndrome?

(08:47) | What is bioavailability, duration of action, and outcomes with furosemide, torsemide, and bumetanide?

(18:08) | How can spot urine sodium measurements be used to assess diuretic response?

(27:35) | What are the differences between thiazides (PO Metolazone vs. IV Chlorothiazide) and acetazolamide augment diuresis?

(35:08) | Spaced Repetition: RAAS inhibitors or SGLT2 inhibitors as GMDT in CKD?

Tags: nephrology, cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, diuretic resistance

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What are the benefits of early rhythm control versus rate control alone? When is electrical cardioversion used and what information can it tell us? What side effects for amiodarone, dofetilide, and sotalol, propafenone and flecainide? When should catheter ablation be considered in patients with atrial fibrillation?

Behind the Scenes YouTube Interview

Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Time stamps:

(02:05) | Pearl 1 - Rhythm control

(11:23) | Pearl 2 - Electrical cardioversion

(17:53) | Pearl 3 - Class III antiarrhythmics and side effects

(26:31) | Pearl 4 - Class Ic antiarrhythmics and side effects

(31:55) | Pearl 5 - Catheter ablation

Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillation

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