Dr. Vikramjit Mukherjee, critical care physician at NYU and Bellevue, joins Dr. Emily Gutowski for a review of septic shock management. They first review the diagnosis of SIRS vs. sepsis vs. severe sepsis vs. septic shock. Additional topics include identifying possible sources of infection, recognizing red flags, and initiating timely, adequate fluid resuscitation, including in special patient populations (e.g., CKD and CHF). Lastly, they briefly review the use of vasopressors in septic shock.

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Dr. Walker Redd interviews Dr. Brooke Matson, endocrinologist at UNC Chapel Hill, about osteoporosis. Together, they review the diagnosis of osteoporosis and osteopenia, the use of the FRAX calculator, and the basics of antiresorptive and anabolic therapies. They also cover lifestyle changes that patients with osteoporosis can incorporate to prevent fractures.

In this episode, Dr. Emily Gutowski interviews Dr. Michael Janjigian about preoperative assessment and perioperative medicine. They discuss the recent updates to perioperative management guidelines, the Revised Cardiac Risk Index (RCRI) and Gupta scores, and integration of laboratory data into preoperative visits. This episode also helps identify patients who may need additional testing prior to surgery.

Dr. Ryan Bonner returns to explore cardiovascular-kidney-metabolic (CKM) syndrome and its clinical implications through the lens of chronic kidney disease. The discussion walks through atherosclerotic risk, weight management, hypertension, and heart failure, offering a multidisciplinary, practical approach to managing CKM.

Dr. Walker Redd interviews Dr. Ryan Bonner, nephrologist at UNC School of Medicine, about principles of managing a patient with CKD. They discuss best practices in assessing a patient's true renal function, review the major classes of medications in CKD, and go over some common pitfalls in treating these patients.

Dr. Allison Greco, pulmonary and critical care specialist at Bellevue Hospital, sits down with Dr. Emily Gutowski and discusses the initial presentation, workup, and management of a patient with a pulmonary embolism. They go through diagnostic modalities, scoring systems, and the various treatment options for patients depending on their risk profile. They discuss provoked vs. unprovoked PEs, and recommendations for longer term anticoagulation.

In part 2 of our series on gout, Dr. Michael Pillinger is back to talk about treatment strategies in the acute setting, as well as how to approach urate-lowering therapies in the outpatient setting. He and Dr. Gutowski discuss the impact of lifestyle changes on gout control, and review the elements that may trigger a gout attack.

Dr. Emily Gutowski interviews Dr. Michael Pillinger, NYU rheumatologist and gout expert, about the initial presentation and workup of a patient with this gout. This is the first episode of a two-part series on gout. Join us for the next episode where we'll dive into acute management and long-term outpatient treatment strategies for this chronic condition.

Dr. Greg Katz, a cardiologist at NYU Langone Health, takes us through a comprehensive approach to preventing cardiovascular disease in a patient with multiple risk factors. Using a patient case, Dr. Katz explains how to balance lifestyle changes with medical interventions and the role of imaging in risk assessment. He also discusses advanced lipid testing including Apolipoprotein B (apoB) and lipoprotein(a) (Lp(a)), and the evolving use of medications like statins and GLP-1 agonists.

Here’s a quick update on some exciting changes at RTL and a look towards the future! Our goal is to deliver more consistent content with a continued focus on internal medicine, covering both inpatient and outpatient topics. Moving forward, rather than releasing episodes by organ system or specialty, we’ll be prioritizing episodes based on when we interview excellent guests for expert interviews. We are so grateful for your continued support and listenership!

Feel free to email us at [email protected] with any comments, suggestions, or questions.