Core Internal Medicine via following series: 5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do? Gray Matters || Management Reasoning Hoofbeats || Dissecting clinical reasoning At the Bedside || Explore everyday challenges
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This podcast delves into a post-operative atrial fibrillation case, contrasting an AI's straightforward recommendations with a cardiologist's nuanced approach. It discusses the critical role of human judgment in integrating incomplete evidence, understanding individual patient contexts, and considering factors beyond pure data, such as rehabilitation needs and moral considerations. The episode ultimately argues that while AI can assist, professional medical judgment remains indispensable for truly patient-centered care.
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 CME Use the code "CORE325" for 25% off: https://www....
The episode provides practical insights into peripheral eosinophilia, covering definitions, thresholds, and risks of organ damage. It explores common causes like atopy, medications, and parasitic infections, emphasizing the importance of thorough patient history. Additionally, it delves into the nuanced role of steroids and the diagnostic challenge of malignancy in eosinophilia, offering guidance for management in both stable and critically ill patients.
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 CME Use the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show...
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...
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 sh...
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 f...
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 D...
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 & Types 06:00 | Indications for Insulin and the Burden on P...
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 clin...
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 curiosity Strategic empathy Small, 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 & Shownotes 00:00...
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 & Shownote...
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 CME Use 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 Stor...
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 CME Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Shownotes Timestamp (02:58) | Host, Organism, Source: The Core Framework Behind Duration (09:...
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 (1...
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 CME Use 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, mo...
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 Notes Timestamps: (01:43) | Case 1: Managing Uncontrolled Diabetes in a 47-Year-Old Male (07:15) | Understanding Cost and In...
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 CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript & Show Notes Timestamps: (00:12) | Introduction and Overview of Hepatorenal Treatment (03:38) | Vasoconstricto...
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 CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript & Show Notes Timestamps: (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:...
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 CME Use the...
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:...
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 Notes Timestamps: (00:05) | Case Presentation: Urinary Retention → Lightheadedness (02:37) | Defini...
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 Companion Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP 🔹 Transcript & Show Notes Timestamps: (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:...
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 Companion Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP 🔹 Transcript & Show Notes Timestamps: (02:2...
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 Companion Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show Notes Timestamps: (01:04) | Story 1: Sharing a Pe...
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 Notes Timestamps: (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 Steps Tags: Cli...
Core IM's July Stories 3.0 features intern tales of the intense emotional challenges faced when starting medicine. Dr. Ali Trainor recounts a terrifying rapid response and imposter syndrome on her first day, while Dr. George Tran shares a surprising encounter with a patient from his past during a night shift. The episode emphasizes navigating tough situations, overcoming self-doubt, and the crucial support found among co-interns and colleagues.
This episode delves into the history of beta blocker use after myocardial infarction, from early landmark trials like BHAT and Capricorn that established them as standard therapy, to the modern era of advanced treatments and emerging doubts. It thoroughly reviews the REDUCE-AMI trial, which found no benefit for beta blockers in post-MI patients with preserved ejection fraction, challenging long-held medical dogma. The discussion covers the trial's implications, contrasting it with other studies like ABYSS, and emphasizes the need for individualized patient care and adapting quality metrics as evidence evolves.
🔹 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 Companion Use the code "CORE30" for 30% off effectiv...
