Core IM | Internal Medicine Podcast

Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between algorithms, uncertainty, and human judgment in modern medical care. 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here.🔹Transcript and Shownotes:  02:51 | Broad workup for reversible causes and other etiologies of AFib that may occur post-op05:10 | Considerations for management of post-op atrial fibrillation13:00 | Stroke risk in atrial fibrillation20:49 | Outpatient management of atrial fibrillation 25:54 | The role of AI in medical decision-makingTags: CoreIM, Internal Medicine, Medical Education, Atrial Fibrillation, Cardiology, Open EvidenceFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but hopefully less than before.🔹Sponsor: Oakstone CMEUse the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes:  04:40 | Emergency Medical Kit (EMK) Standard Contents08:50 | Role of Ground-Based Medical Support & Flight Diversion Decision-Making19:35 | Interpreting Hypoxia at Altitude22:06 | In-Flight Liability23:35 | Common Chief Concerns & Useful Additional Medications24:53 | How to Be Resourceful in an Austere EnvironmentTags: CoreIM, Internal Medicine, Medical Education, In-flight Care, Medical Emergencies, Clinical Reasoning, Seizure Management, Hypoxia, Airway Management, Cardiac Emergency, Syncope, Respiratory DistressFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Can you distinguish benign eosinophilia from a sign of serious disease, and know exactly when to act at the bedside?In this high-yield episode, test your clinical reasoning as we tackle:When eosinophilia becomes dangerous and why it mattersHow to distinguish if its from atopy vs. systemic diseaseWhich medications to stop (and which to watch)How travel, diet, and exposure history shape your workupWhen to suspect malignancy before giving steroids🔹Transcript and Shownotes: 02:34 | Why Do We Care About Eosinophilia? (Pearl 1)10:24 | Atopy and Eosinophilia (Pearl 2)18:57 | Drugs and Eosinophilia (Pearl 3)27:29 | ID and Eosinophilia (Pearl 4)33:54 | Pearl 5: Eosinophilia, Steroids, and Neoplasms (Pearl 5)Tags: CoreIM, Internal Medicine, Medical Education, Eosinophilia, Hypereosinophilia, Allergy Immunology, Hematology, Pulmonology, Parasitic Infections, AtopyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Is coffee helping or harming our patients’ hearts?In this Beyond Journal Club, we unpack the CRAVE trial and use it as a lens to answer a bigger question:How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust?Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle.🔹Sponsor: Oakstone CMEUse the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show notes00:00 | Challenges of interpreting nutritional research.02:22 | Best practices for evaluating studies in nutrition. 12:35 | Delve into the CRAVE trial as an example of critically appraising nutritional investigations.26:41 | Applying this to clinical practice for your patients.Tags: IMCore, Internal Medicine, Medical Education, Epidemiology, Diet and LifestyleFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach..🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com🔹Transcript and Shownotes:02:15 | Pearl 1: Pathophysiology08:20 | Pearl 2: Diagnosis16:35 | Pearl 3: Treatment20:35 | Pearl 4: Antibiotics27:39 | Pearl 5: Wound CareTags: CoreIM, Internal Medicine, Medical Education, Diabetic Foot Infections, Osteomyelitis, Foot Ulcer, Wound CareFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter?And the classic inpatient dilemma: your heart failure patient looks better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going?🔹Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/See here for Neph Madness details See here for the POCUS region of NephMaddnessVOTE here to build your bracket!🔹Transcript and Shownotes:00:52 | What is NephMadness?02:19 | Detecting post-renal obstruction in a patient who reported normal urination11:26 | POCUS for discharge or continue diurese 17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis lineAlong the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside.If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question.Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUSFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them.• Do cholinesterase inhibitors really work?• What should clinicians know about lecanemab and donanemab before referring patients?• How much benefit should we expect and for how long?• When should you deprescribe dementia medications?🔹Sponsor: Caraway’s cookware set is a favorite for a reason.For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout.🔹Transcript and Shownotes02:27 | Deep Dive 1: How do we deliver the news of a diagnosis of dementia?09:41 | Deep Dive 2: Prescribing medications for cognitive decline29:30 | Deep Dive 3: Patient-centered management for a patient with cognitive decline35:46 | Deep Dive 4: Planning for an uncertain futureTags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI?🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com🔹Transcript & Shownotes:01:12 | Cognitive Concerns During a Routine Follow-Up03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues?15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline?31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline?Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden.🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/🔹Transcript and Shownotes:00.58 | Insulin Hx & Types06:00 | Indications for Insulin and the Burden on Patients08:26 | What is the QWINT-1 Trial?16:18 | DiscussionTags: CoreIM, Internal Medicine, Evidence-Based Medicine, Insulin Resistance, Clinical Reasoning, Hospital Medicine, Medical Education, Endocrine, EndocrinologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside, learn how clinicians should act when ethics, law, and trust collide.🔹 Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com🔹Transcript and Shownotes:03:51 | What is the difference between Privacy and Confidentiality?05:50 | Guidelines and laws10:06 | Limits/appropriate breaches (competing principles/obligations) 22:03 | Privacy vs education35:34 | ConclusionFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Baby alligators  - those betrayals of purpose , or, death by a thousand paper cuts !Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:Regulated curiosityStrategic empathySmall, well-chosen moves......and change that is big enough to matter, and small enough to win!🔹 Sponsor: Caraway’s cookware set is a favorite for a reason.For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout.🔹 Transcript & Shownotes00:00 | What are “baby alligators” in medicine?02:24 | Rifaximin & Workflow Fixes14:17 | Verbal Orders Policy18:39 | Micro Skills for Change25:12 | Key Takeaways#PhysicianBurnout #DoctorLife #HealthcareEfficiency, CoreIM, Internal Medicine, Career Development, Quality Improvement, QIFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/🔹 Transcript & Shownotes(2:56) - (13:15) | PEARL 1: Managing clots in the “unprovoked”/provoked-irreversible patient(13:21) - (18:10) | PEARL 2: Managing provoked, “reversible” clots(18:14) - (25:14) | PEARL 3: DOAC failure: time to step it up?(25:20) - (37:25) | PEARL 4: APLAS: the exception to everythingTags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.🔹 Sponsor: Oakstone CMEUse the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Shownotes(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life(10:28) | How Dr. Carol Ward Created the Horn Award and Honored Mary Horn’s Legacy(14:16) | Dr. Hilit Mechaber’s Story of Courage, Vision, and Impact Beyond the Award(17:55) | Why does the Horn Award Matter?Tags: CoreIM, Internal Medicine, Career Development Award, Mary O'Flaherty Horn Award, Clinical Care, Scholarship, Teaching, Leadership, Wellness and Care, Family ResponsibilitiesFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?🔹 Sponsor: Oakstone CMEUse the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and ShownotesTimestamp(02:58) | Host, Organism, Source: The Core Framework Behind Duration(09:02) | How Evidence Shifted Practice(11:27) | The BALANCE Trial: Short-Course vs Standard-Course Therapy(18:55) | Where does this leave us?Tags: CoreIM, Internal Medicine, Infectious disease, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical EducationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?🔹 Transcript and Shownotes(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast(05:27) | Triglycerides as a Cardiovascular Risk Marker(09:28) | Acute Management For Pancreatitis induced by Triglycerides(14:34) | Lifestyle Counseling(17:31) | Medications That Lower Triglycerides(25:29) | How to Choose the Right Triglyceride Therapy(27:56) | Genetic Causes and When to Suspect Familial DisordersTags: CoreIM, Internal Medicine, Lipidology, lipid, Cardiology, Metabolic Health, Triglycerides, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education, primary careFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score?🔹 Sponsor: Oakstone CMEUse the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes(00:00) | Volume overload vs. Venous Congestion(05:49) | Venous Congestion and AKI, mortality, possible delirium(10:10) | Measuring Venous Congestion and the Role of VEXUS(15:05) | Common Mistakes and Best Practices of VEXUS score(23:13) | Assessing Fluid Tolerance and Risks with Venous Doppler in Acute Care(25:29) | Fluid vs. Vasopressor Strategy Guided by Venous Assessment Tags: CoreIM, Internal Medicine, Critical Care, Nephrology, Cardiology, Fluid Management, POCUS, Ultrasound, Doppler, Hospital Medicine, Clinical Reasoning, Medical EducationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use?🔹 Sponsor:Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript and Show NotesTimestamps:(01:43) | Case 1: Managing Uncontrolled Diabetes in a 47-Year-Old Male(07:15) | Understanding Cost and Insurance Barriers in Diabetes Care(09:26) | Case 2: Addressing Weight Gain and Financial Stress in a 52-Year-Old Male(14:16) | Case 3: Managing Coronary Artery Disease and CKD in a 66-Year-Old Male(19:41) | Case 4: Severe Obesity and Pain Management in a 59-Year-Old Female(24:19) | Case 5: High A1C and Vascular Comorbidities in a 67-Year-Old Female (35:34) | Weighing Side Effects and Practical Use of GLP-1 and SGLT2 InhibitorsTags: CoreIM, Primary Care, Endocrinology, Diabetes Mellitus, Type 2 Diabetes, Type 1 Diabetes, Metformin, GLP-1, SGLT2, Insulin, CGM, A1C, DKA, Medical Education, Clinical Reasoning, Hospital MedicineFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care?🔹 Sponsor: Oakstone CMEUse the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps: (00:12) | Introduction and Overview of Hepatorenal Treatment (03:38) | Vasoconstrictors Focus: Terlipressin, Norepinephrine, and Midodrine (12:32) | Finding the Right Dose of Albumin and Knowing When to Stop (15:06) | Volume Management: Balancing MAP, Diuretics, and Creatinine (21:42) | Understanding the High Mortality of HRS-AKI (32:30) | Transplant, Dialysis, or Palliation CareTags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Hepatorenal Syndrome, HRS-AKI, Cirrhosis, Nephrology, Liver DiseaseFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right?🔹 Sponsor: Oakstone CMEUse the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps: (00:57) | Understanding the Pathophysiology of HRS (03:42) | How Portal Hypertension Traps the Kidneys (10:32) | Sorting the Differential of AKI in Cirrhosis Beyond HRS (18:28) | Hyponatremia and Urine Sodium in Advanced Cirrhosis (24:04) | Official Diagnosis and Evolving Criteria of HRS (29:30) | Albumin: When It Helps and When to Hold Back (34:00) | Recap and Future DirectionsTags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Nephrology, renal, hepatology, Portal Hypertension, Liver DiseaseFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Who’s really at risk for fractures, and how should we be treating them? Most fragility fractures occur in patients without osteoporosis. Should we rethink who gets treated? And could just one or two IV infusions (spread years apart) of zoledronate prevent fractures for years? Have the concerns about bisphosphonates been overblown?Find out all the nuances on this episode of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.🔹 Sponsor: Oakstone CMEUse the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps:(00:59) | Diagnosing Osteoporosis and Hidden Fracture Risk(05:38) | Evolution of Bisphosphonate Use in Osteoporosis Treatment(07:51) | Current Use of Bisphosphonates: Benefits, Risks, and Side Effects(10:31) | Exploring Non-Bisphosphonate Options for Fracture Prevention(11:44) | Teriparatide and Alternative Osteoporosis Medications(14:53) | Inside the Latest Bisphosphonate Clinical Trial(18:07) | Key Findings from the Zoledronate Fracture Prevention Study(22:38) | Public Health Impact of Fracture Prevention Strategies(24:24) | Final Takeaways and Expert Perspectives on Osteoporosis CareTags:  CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Osteoporosis, Fragility Fractures, Zoledronate, Bone HealthFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic hypotension?🔹 Sponsor: Oakstone CME’Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show Notes Timestamps (+/- 1-2 mins):(00:28) | Case Recap: Beyond Non-Pharm Strategies(03:07) | Midodrine: Timing, Testing, & Supine Hypertension(06:23) | Fludrocortisone: Benefits vs. Risks(09:01) | Droxidopa: Evidence, Side Effects, Access Issues(10:11) | Pyridostigmine & NSAIDs: Secondary Options(12:31) | Balancing Hypertension and Orthostatic Hypotension(14:29) | Functional Hypotension & Risk Stratification(18:45) | Symptomatic Patients: What to Stop, What to Continue(20:19) | Autonomic Disease: Supine & Nocturnal Hypertension(21:47) | Bed Elevation, Compression, & Non-Pharm PearlsTags: Internal Medicine, Geriatrics, Autonomic Dysfunction, Hypertension, Syncope, Falls, Patient Safety, Medical Education, physician assistant, nurse practitioner, hospitalist, primary care, neurologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Learn specific, practical ways to counsel patients on non-pharmacologic interventions. What is our goal with OH treatment? Is it the blood pressure number that matters? How do we avoid missing neurogenic causes of orthostatic hypotension (OH)? 🔹 Sponsor: Oakstone CME’Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps:(00:05) | Case Presentation: Urinary Retention → Lightheadedness(02:37) | Defining Orthostatic Hypotension & Prevalence(04:10) | Why Diagnosis Is Harder Than It Seems(06:20) | How (and When) to Measure Orthostatic Vitals(10:06) | Role of Heart Rate in Narrowing the Differential(14:41) | Rethinking Treatment Goals: Function > Numbers(17:52) | Recognizing Orthostatic Intolerance Symptoms(22:14) | Non-Pharmacologic Strategies in the HospitalTags: Primary care, Internal Medicine, Physician Assistant, Nurse Practitioner, Geriatrics, Autonomic Dysfunction, Syncope, Falls, Patient Safety, Medical EducationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks!🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio CompanionUse the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps:(02:50) | Xray vs. POCUS vs. CT for Pneumothorax Diagnosis(07:29) | Do All PTXs Need Chest Tubes?(11:55) | Explaining Pneumothorax to Patients(14:58) | Understanding the Pleural Drainage System(26:11) | Monitoring Air Leaks with the Water Seal Chamber(32:27) | Managing Persistent Air LeaksTags: CoreIM, Internal Medicine, Pulmonology, Critical Care, Medical Education, 3-Chamber Drainage System, Endobronchial Valves and PleurodesisFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

How do you work up neutropenia? When is neutropenia benign? When do neutrophils recover? How can you diagnose neutropenic fever in the first 15 minutes and start antibiotics in the first 60 minutes? Do you always add MRSA coverages? Only Pseudomonas coverage? When do you add fungal coverage?🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio CompanionUse the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show Notes Timestamps:(02:24) | Approach to Neutropenia & Duffy Null(11:38) | Dose and duration-dependent neutropenia vs. immune-mediated neutropenia(19:46) | When do neutrophils recover?(29:56) | Classifying Neutropenic Fever Syndromes(29:53) | Strategies for Managing Low-Risk Neutropenic Fever(33:02) | Antimicrobial Therapy and Duration in Febrile NeutropeniaTags: CoreIM, Internal Medicine, Oncology, Hematology, Medical Education, Physician Assistant, Nurse Practitioner, Neutropenic Fever Management, AntibioticsFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Have a good laugh and reflect deeply with these three stories that hit the feels in different ways.If you'd love to hear more stories from Dr. Maria Rosasco, check out some of her other appearances on the podcast: July Stories and Handoffs & Contingency Planning.🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio CompanionUse the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP🔹 Transcript and Show NotesTimestamps:(01:04) | Story 1: Sharing a Personal Story for Patient Care(03:42) | Story 2: Leading a Family Meeting(06:52) | Story 3: Early Days of the COVID-19 Pandemic(10:22) | What Rituals and Values Guide Your Path in MedicineTags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, HumanitiesFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What went wrong? What were the reasoning or contextual missteps that led us astray?🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025🔹 Transcript and Show NotesTimestamps:(00:02) | Case Presentation and Initial Diagnosis(02:47) | Tachycardia and Early Impressions(04:10) | Clinical Deterioration and New Clues(07:19) | Problem Representation and Reflection(21:45) | Lessons on Reasoning and Bias(26:55) | Final Takeaways and Action StepsTags: Clinical Reasoning, Internal Medicine, Diagnostic Accuracy, Hoofbeats, Cognitive Bias, Medical Education, Illness ScriptsFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Imaging Pearls | (01:12)Deciding on Thoracentesis | (04:00)Light’s Criteria and Pseudoexudates | (07:00)Pleural Fluid Studies: pH and Cell Differential | (16:56)Diagnosing and Treating Parapneumonic Effusions | (23:32)Malignant Pleural Effusions: Diagnosis and Management | (30:39)🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio CompanionUse the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP🔹 Transcript and Show NotesTags: Internal Medicine, Medical Education, Pulmonology, CoreIM, Clinical Reasoning, critical care, pulmFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Listen for some good laughs and relatable stories!In this episode, we share raw and real stories from July — from rapid responses to unexpected kindness — and reflect on the emotional weight of starting out in medicine.🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025🔹 Transcript and Show NotesPrior July Stories:July Stories 2.0 (2023)July Stories (2019)Timestamps:(00:32) | Dr. Ali Trainor's First Day as an Intern(03:00) | The Patient's Critical Condition and Emotional Response (07:12) | Dr. George Tran's First Night Shift (10:38) | Dr. Ali Trainor's Second Rotation Experience (14:01) | The Importance of Co-InternTags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, HumanitiesFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

How much do beta blockers help after a heart attack, even when the heart’s pumping well? In this episode, we revisit the origins of beta blockers in post-MI care, examine how evidence evolved, and explore the REDUCE-AMI trial, which questions whether beta blockers are still needed for all.Listen to this latest episode of Beyond Journal Club, a collaboration between Core IM and NEJM Group, where we put research into context tracing the arc of evidence, dissecting the clinical question, and exploring what the findings could mean for real-world patient care🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply!🔹 Transcript and Show NotesTimestamps:(00:48) | Background on Beta Blockers and Their Mechanism(02:41) | Historical Context of Beta Blockers in Heart Disease(04:56) | Capricorn Trial and Its Impact(07:17) | Emergence of Doubts About Beta Blockers(10:09) | Introduction to the REDUCED-AMI Trial(15:52) | Discussion on Trial Interpretation and Clinical Implications(16:18) | Comparison with Other Trials and Future DirectionsTags:  CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Cardiology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46)🔹 What are the main classes of fungi? (~11:35)🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16)🔹 How to increase the yield of blood cultures? How to interpret yeast growth in sputum/BAL and urine cultures? (~ 30:42)🔹 How is invasive fungal disease treated? (~ 35:14)📌  Sponsor: Oakstone CME’s ACP MKSAP Audio CompanionUse the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP📌 Transcript & show notesTags: CoreIM, IMCore, Infectious Disease, Hospital Medicine, Hospitalist, ICU, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, moldFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

🔹What are clinically relevant limitations of an A1c vs. a CGM (1:40)🔹What do the different parts of the ambulatory glucose profile tell you? (09:59)🔹What are common pitfalls, medications, lifestyle patterns that are important to ask your patient about when seeing them for a visit to manage blood sugar? (15:19)🔹 How can you titrate insulin based on when you see the hypoglycemia on the ambulatory glucose profile (20:00)🔹 When there is too much hyperglycemia, how do you titrate insulin when adding on GLP-1 agonists? (26:30)📌 Sponsor:  NEJM Fellowship Program, click here to learn more and/or apply!📌 Transcript & show notesTags: CoreIM, IMCore, Endocrinology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, diabetes management, insulin titrationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

🔹When is an U/S vs. CT vs. MRI helpful before consulting Interventional Radiology?🔹What factors go into an IR pre-op evaluation?🔹 When do drains go in, and when do they come out?🔹 When a patient has trouble with a drain, what are things you can do before calling IR?🔹 What does outpatient IR follow up entail, and what does a capping trial of PCN tubes entail?📌  Sponsor: Oakstone CME’s ACP MKSAP Audio CompanionUse the code "CORE30" for 30% off effective 11/1/25 through 1/31/26:  https://www.coreimpodcast.com/MKSAPTranscript & show notesTags: CoreIM, IMCore, Gastroenterology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Medical Imaging, Bleeding Assessment, Drain Management, Procedural SedationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

🔹 High-yield reversible causes of constipation? (02:26)🔹 Which type of fiber is more helpful? And is more hydration really better? And bulk-forming laxatives (9:03)🔹 Osmotic vs Stimulant Laxatives (15:06)🔹 Suppositories and enemas? (25:39)🔹Best practices with opioid induced constipation (34:05)📌  Sponsor: Freed is an AI scribe that listens and writes your note in learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed📌 Earn CME credit with ACP for this episode! CME-MOC credit 📌 Transcript and Show NotesTags: CoreIM, IMCore, Gastroenterology, GI Pharmacology, Digestive Health, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Laxatives, Stool Softeners, Senna, Bisacodyl, Polyethylene Glycol, Bowel Regimen, Magnesium Citrate, LactuloseFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

How good are we at preventing HIV? How do efficacy and effectiveness differ? We journey from oral pre-exposure prophylaxis (PrEP) to long-acting injectables, and then to the PURPOSE trials, which look at the use of long-acting lenacapavir as PrEP — a potential game-changer in the field of HIV.Listen to this latest episode of Beyond Journal Club, a collaboration between CoreIM and NEJM Group, where we put research into context, telling the story of how we arrived at the current standard of care, appreciating the clinical question of the trial at hand, and interpreting what the findings may mean for these patients.🔹 Sponsor:  NEJM Fellowship Program, click here to learn more and/or apply!🔹 Transcript and Show NotesTimestamps:(02:25) | HIV PrEP Daily Truvada and Descovy (07:48) | On-Demand Prep(13:25) | Purpose Trials(20:56) | Discussion of Effectiveness to Efficacy Tags:  CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, HIV Prevention, Infectious Disease Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What does Lipoprotein(a) tell us that a standard lipid panel doesn’t? Should we be testing everyone for it? Dive into the genetics, clinical implications, and evolving management strategies for Lp(a). Learn how to interpret results, counsel patients, and navigate topics with limited data like aspirin and PCSK9 inhibitors in treatment.🔹 Sponsor: Freed is an AI scribe that listens and writes your note in learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed🔹 Transcript and Show NotesTimestamps:(02:17) | Pearl 1: What makes Lp(a) unique? How does it raise ASCVD risk?(10:32) | Pearl 2: Who should be tested for Lp(a)? When and why?(16:54) | Pearl 3: Understanding and interpreting Lp(a) levels(24:04) | Pearl 4: How does an elevated Lp(a) affect management?(37:05)| Pearl 5: The role of aspirin and PCSK9 inhibitors in Lp(a)Tags: CoreIM, Internal Medicine, Primary Care, Preventive Cardiology, Atherosclerosis, Lipid Management, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical StudentFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

A new way to think of clots beyond provoked vs. unprovoked: Learn all about how important it is to think about reversibility! What patient states affect the inherited thrombophilia testing? Learn the nuances and practical approaches!🔹 Sponsor: Freed is an AI scribe that listens and writes your note in learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.Transcript and Show NotesTimestamps:(02:07) | Pearl 1: Reframing Provoked vs. Unprovoked to Reversibility(09:12) | Pearl 2: How can Virchow's Triad help us categorize the etiology of a clot?(17:01) | Pearl 3: What factors affect anti-thrombin III, Protein C and Protein S deficiency(28:50) | Pearl 4: Is the Factor V Leiden or Prothrombin Gene Mutation as important as the family history?(38:41) | Pearl 5: Spaced Repetition of Learning PointsTags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What is the impact of microplastics on human health? How can we use observational data to support the argument that microplastics may lead to poor health outcomes?Join us as we tackle these questions and discuss the APAChE study on microplastics and cardiovascular disease on this episode of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.🔹 Transcript and Show Notes🔹 Behind The Scenes YouTube VideoThis episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.Timestamps:(02:24) | Introduction to Plastic's Key Players(07:59) | Bradhill/Observational Work(10:33) | APAChE Study Deep Dive(18:03) | Discussion📢 Special Thanks:🎙️ Audio Editing: Jerome Reyes📊 Graphics: Dr. Jimin HwangTags:CoreIM, Environmental Health, Medical Education, IMCore, Public Health, Clinical Pearls, Physician, Medical Student, Nurse Practitioner, EpidemiologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What is the last sense to go? How can music create connection, ease anxiety, and help process emotions at the end of life? Join Dr. Jafar Al-Mondhiry, Dr. Harry Han, and music therapist Bryanna Tobin as they explore the power of music therapy in hospice care, sharing moving stories and clinical insights.🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.🔹 Transcript and Show NotesTimestamps:(00: 39) | 1st: What is Music Therapy in Hospice?(07:59) | 2nd: A Powerful Story(14:19) | 3rd: Challenges in the Field of Music TherapyTags:  IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Incidental fibrosis on CT —what now? What does prone imaging tell you? Is it fibrosis, aspiration, or atelectasis? And once you diagnose ILD, does the “alphabet soup” really matter for treatment? Antifibrotics vs. immunosuppression?Plus, how do we bridge the gap when social barriers make care unsafe?🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.Transcript and Show NotesTimestamps:(01:26) | Deep Dive 1(06:38) | Deep Dive 2(12:37) | Deep Dive 3(21:13) | Deep Dive 4(28:06) | Deep Dive 5Tags: CoreIM, Internal Medicine, Pulmonology, Clinical Pearls, Medical Education, IMCore, Radiology, Hospitalist, Physician Assistant, Nurse Practitioner, Medical Student, interstitial lung diseaseFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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!Sponsor: Freed is an AI scribe that listens and writes your note in learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.Behind The Scenes Youtube Interview with Dr. Vincent Rajkumar Transcript and Show NotesTimestamps:(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 medicineFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 NotesICIs & IrAEs 101 EpisodeBehind The Scenes videoSponsor:Interested in integrating Glass AI into your EMR? Reach out to [email protected] code "COREIM" for one month free access of AI queries through Glass Pro.Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!Get CME-MOC credit with ACP!Timestamps:(03:14) | Pearl 1(13:34) | Pearl 2(24:42) | Pearl 3(30:34) | Pearl 4(35:21) | Pearl 5Tags: CoreIM, Internal Medicine, ClinicalPearls, Skin Toxicity, Medical Education, IMCore, oncology, hospitalist, physician assistant, nurse practitioner, medical studentFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

YouTube VideosAnion Gap Metabolic Acidosis: https://youtu.be/oE0lygmMANMInhaler Delivery Systems: https://youtu.be/yYPdjClm9BgIron Deficiency in Pregnancy https://youtu.be/xTzYSXUbLscSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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 TeachingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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.Sponsor: Freed is an AI scribe that listens and writes your note in learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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 questionsTranscript and Show NotesTags: CoreIM, InternalMedicine, CriticalCare, Proton Pump Inhibitors, GIbleeding, ICU, ICU bleeding, Clinical Trials, Evidence Based Medicine, Patient Centered Outcomes, DeprescribingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 notesBehind The Scenes YouTube InterviewSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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 therapyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 notesBehind the Scenes Youtube InterviewSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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, gastroenterologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 notesBehind The Scenes YouTube InterviewsSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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” episodeTags: IMCore, CoreIM, primary care, urine drug screening, opioid use disorder, substance use, harm reduction, addiction medicine, clinical toxicology, patient safety, compassionate careFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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?Sponsor: Imagine leveraging A.I to do pre-charting before seeing a patient. Reach out to [email protected] to integrate Glass A.I into your EMR! For more on Glass or Glass Pro, Use the promo code: CoreIMBehind the Scenes Youtube InterviewShow notes & TranscriptHospice 101 Episode 1Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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 hospiceApproaching the hospice patient coming back to the hospitalHospice enrollment and re-enrollment is voluntary.Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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.Sponsor: Freed is an AI scribe that listens and writes your note in learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTranscript and Show NotesSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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/DiscussionTags: 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 attackFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!Transcript and Show notesSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!Timestamps:(01:07) | Strategies for Addressing Moral Distress(09:25) | Strategies for Address Moral Injury(20:52) | ConclusionTags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethicsFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?Sponsor: Whether you're looking to open your own practice or buy into a group, Panacea Financial understands the unique needs of physicians and offers tailored financial solutions. Transcript and Show notesSubscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!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) | ConsequencesTags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanismFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out FIGS: https://wearfigs.com* Click for 15% off Premium Starter Kit at Branch Basics: https://branchbasics.com/COREIMAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy