Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at http://thecurbsiders.com/podcast .

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits:

• Written by: Matthew Watto MD and Joel Topf MD
• Produced by: Matthew Watto MD
• Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
• Guest: Joel Topf MD

Time Stamps

• 00:00 Announcements
• 01:02 Disclaimer
• 01:40 Intro and guest bio
• 04:00 Joel’s one liner
• 06:05 Joel’s “favorite failure”
• 11:45 Paul shares a failure
• 13:20 Tweetorials
• 16:39 Clinical case of non gap metabolic acidosis
• 18:06 Three buckets of NAGMA and GI losses
• 21:02 Chloride intoxication and normal saline
• 25:14 Renal tubular acidosis and normal role of kidney in acid base
• 35:03 Proximal (type 2) RTA
• 40:33 Cases of proximal RTA
• 43:38 Distal (type 1) RTA
• 53:15 Bicarbonate dosing and titration
• 55:28 Type 4 RTA (hypoaldosteronism)
• 62:09 Urinary anion gap and ammonium
• 67:26 Replacing GI losses of bicarbonate
• 70:25 Joel reviews quick cases of RTA and NAGMA
• 74:49 Outro 

Tags: renal, tubular, acidosis, non, gap, rta, nagma, metabolic, kidney, diarrhea, sodium, normal, saline, ringer's, lactate, tubule, bicarbonate, physiology, acid, base, ammonia, ammonium, nephrolithiasis, assist

Curbsiders’ Journal Club features rapid summary and critical appraisal of recent articles and news stories in internal medicine by The Curbsiders. This month’s topics include: asthma, maintenance versus as needed inhaler use, procalcitonin, Pneumocystis pneumonia prophylaxis, colon cancer screening, smoking cessation, cannabis and cognitive impairment, LDL cholesterol and mortality, plus some medical podcast recommendations.

Over the last month, we have developed a list of more than 40 interesting articles and news stories that we have been feeding our own brain holes. From this list we have plucked a select few that we really wanted to highlight and share with you.

Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

• Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
• Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
• Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
• Editor: Matthew Watto MD

Time Stamps:

• 00:00 Announcements
• 00:20 Disclaimer
• 01:00 Intro to Curbsiders Journal Club
• 03:07 Mild asthma and as needed versus maintenance inhaler use
• 09:50 Smoking cessation, e-cigarettes, and financial incentives
• 17:23 Pneumocystis pneumonia prophylaxis
• 22:18 Cannabis and cognitive impairment
• 26:15 Colorectal cancer screening update by American Cancer Society
• 30:37 Procalcitonin for lower respiratory tract infections in the ED
• 37:29 Cholesterol, baseline LDL-C, mortality and cardiovascular events
• 41:01 Incorrect symbology and some podcast recommendations
• 46:22 Outro

Tags: asthma, maintenance, inhaler, procalcitonin, Pneumocystis, pcp, pneumonia, prophylaxis, colon, cancer, screening, crc, smoking, cessation, marijuana, cannabis, cognitive impairment, LDL, cholesterol, mortality, cardiovascular, podcast, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed

Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology!

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits:

• Written by: Cyrus Askin MD
• Infographics: Beth Garbitelli
• Produced by: Cyrus Askin MD and Matthew Watto MD
• Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
• Guest: Scott Matherly MD

Time Stamps

• 00:00 Announcements
• 00:54 Disclaimer
• 01:30 Guest bio
• 02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis
• 06:56 Clinical case of decompensated cirrhosis
• 09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics
• 18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin
• 25:10 Timing of medical therapy
• 26:39 MAP of 82 mmHg, beta blockers and variceal bleeding
• 31:04 Use of midodrine for hypotension
• 33:45 Prophylaxis of SBP
• 36:05 Take home points
• 38:04 Outro

Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

Step up your primary care of cancer survivors with tips from Dr Regina Jacob, Assistant Professor of Medicine at Temple University. Care of the cancer patient does not end when their cancer treatment is over, and there is more to a past diagnosis of cancer than surveillance. We discuss cancer survivorship care with Dr. Regina Jacob, including the changing demographics of survivorship, the importance of survivorship care plans, and how survivorship is largely just good primary care.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].

Credits:

• Written by: Paul Williams MD
• Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD
• Produced by: Paul Williams MD
• Edited by: Matthew Watto MD
• Guest: Regina Jacob MD 

Time Stamps

• 00:00 Disclaimer
• 00:35 Intro to the topic and guest bio
• 02:15 Guest one liner, book and app recommendations
• 06:58 Paul’s pick of the week.
• 07:40 Clinical case, definitions, and phases survivorship
• 12:36 Survivorship statistics
• 15:04 Co-survivorship
• 17:41 Care models for survivorship
• 20:56 Assigning roles in care of cancer survivors
• 22:59 Sample survivorship care plan
• 27:39 Childhood, adolescent and young adult cancer survivorship
• 34:18 Sexual dysfunction in cancer survivorship
• Turn down Watto and Regina tracks
• 35:56 Stressors in young adult cancer survivors
• 37:33 Fatigue
• 43:28 Guidelines on survivorship
• 45:06 Late cardiac toxicity
• 46:23 Support groups and resources
• 49:04 Take home points
• 50:29 Outro 

Keep current with this monthly journal club covering landmark articles through May 2018, plus rapid fire hot takes from the medical literature and health news. We rate each article according to a highly scientific ‘Hotcakes’ scale to highlight what practice-changing knowledge we’ll take to work this month. Topics: Hypertension, blood pressure monitoring, prostate cancer screening, Intimate Partner Violence screening, alcohol is killing you, new diabetes drugs and mortality, DPP-4 inhibitors and IBD risk, NT-proBNP-guided therapy vs usual care, effect of teaching status on mortality, and more! If you’re a listener and have something interesting for us to discuss, please send it our way.

Join our mailing list to receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected]. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

• Written and produced by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH
• Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD
• Editor: Matthew Watto MD

Time Stamps: 

• 00:00 The Curbsiders need a web master
• 00:50 Disclaimer
• 01:25 Intro to the format
• 03:25 Ambulatory BP monitoring and mortality
• 09:08 Blood pressure treatment strategies: CVD risk score vs systolic BP targets
• 14:14 Repeated BP measurements important at office visits and future directions of BP management
• 21:25 Hot takes in order of appearance: Prostate cancer screening, intimate partner violence, alcohol, DPP4 inhibitors mortality and IBD, teaching status and mortality in US hospitals, 5 lifestyle factors that may add to life expectancy, NT pro-BNP, BNP and mortality
• 38:12 Outro