What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?

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Show Notes & Transcript

• 02:08 Framework for thinking about obesity
• 03:42 History of obesity treatment
• 06:29 Gila monsters and GLP and GIP mechanisms
• 08:29 Story of how medications for diabetes were found to have a weight loss benefit
• 12:50 SURMOUNT-1 trial

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

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With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers? 

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CME : http://bit.ly/CIMCME || Show Notes & Transcript

Timestamps

• 01:54 Pearl 1 – Recap of GDMT and CKD
• 09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate 
• 20:59 Pearl 3 – Ivabradine 
• 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT
• 30:55 Pearl 5 – Ejection Fraction Recovery 

 

Tags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiology

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What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?

Timestamps

• 01:00 System 1 vs. System 2
• 07:46 Cognitive Biases
• 13:46 Case for Knowledge
• 18:29 Other Practices to Decrease Error
• 28:26 Conclusion

 

CME: http://bit.ly/CIMCME || Show Notes & Transcript

This episode is made in part of ACP’s Diagnostic Excellence curriculum

Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflection

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What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection?

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Timestamps

• 02:41 Types of Immunosuppression
• 14:31 Medication Reconciliation
• 22:36 AKI in the Transplant Patient
• 31:53 Infections in the Transplant Patient
• 40:00 Transplant rejection, cancer after transplant

CME: http://bit.ly/CIMCME || Show Notes & Transcript

Tags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressive

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In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.

How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.

Show notes & Transcript

Access to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.

Timestamps

• 00:50 Question REVIVED addressed
• 01:44 Revascularication in HFrEF
• 06:32 Revascularization in stable CAD
• 10:02 REVIVED trial
• 12:20 Summary and takeaways

Tags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicine

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Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories !

Listen to the original July Stories: https://bit.ly/3Y4n8jG

Behind The Scenes videos on YouTube

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Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedback

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BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?

Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim 

Behind The Scenes video on YouTube

Show notes & Transcript

Subscribe to our new Youtube Channel !

Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue

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How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?

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Show notes & Transcript

Time Stamps

• 02:59 Types of Corticosteroids
• 14:31 Side Effects of Steroids
• 21:15: Prophylaxis 
• 27:32 Steroid Weaning 
• 33:38 Steroid Weaning Limitations 

Tags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndrome

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In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?

Show notes & Transcript

Time Stamps

• 02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis
• 05:35 Deep Dive 2: FFP effect on bleeding risk
• 15:43 Deep Dive 3: Risks of FFP
• 19:45 Deep Dive 4: Indwelling pleural catheters
• 30:31 Recap

Tags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonary

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How long can fatigue last for after radiation? Are all patient post radiation immunocompromised?  What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?

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Show notes & Transcript

Whiteboard Animation Video of Radiation Physiology

Time Stamps

• 02:37 Systemic Radiation Side Effects
• 14:29 Lung Radiation Side Effects
• 18:22 Breast Radiation Side Effects
• 21:45 Prostate Radiation Side Effects
• 24:54 Brain Radiation Side Effects

Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapy

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