The Curbsiders Internal Medicine Podcast: Recent Episodes

The Curbsiders Internal Medicine Podcast

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice-changing knowledge, and bad puns. Doctors Matthew Watto, Paul Williams, and friends (a national network of students, residents, and clinician-educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high-value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.

Diagnosis and Management of Obstructive Sleep Apnea Show description: Explore the interpretation of sleep studies in the diagnosis of obstructive sleep apnea. Master treatment of OSA and how to troubleshoot CPAP challenges with Dr. Aneesa Das. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact […]

Diagnosis and Management of Obstructive Sleep Apnea

Show description:
Explore the interpretation of sleep studies in the diagnosis of obstructive sleep apnea. Master treatment of OSA and how to troubleshoot CPAP challenges with Dr. Aneesa Das.

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Show Segments

Intro and guest bio
Case from Kashlak
Definitions
Sleep Testing and Interpretation
Management of OSA
Outro

Credits
* Written and produced by: Alise Burke MD * Infographic and Cover Art: Dylan Naldzin * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Aneesa Das MD

Disclosures
Dr. Das reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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We have another classic episode for you. Level up your primary prevention game. Learn when ApoB, Lp(a), and CAC actually change management, how to spot cardiometabolic risk before diabetes declares itself, and how to make smarter lipid decisions beyond the standard panel. We’re joined by Dr. Greg Katz, cardiologist and prevention expert at NYU Langone Health.

Separating Signal from Hype

Patients bring us lists. Greens powders, magnesium for everything, vitamin D “for immunity,” fish oil, creatine, curcumin… so how do we separate signals from hype without becoming the office that just says “no” to everything? In this home-grown deep dive, we build a practical, patient-centered framework for evaluating any supplement, then pressure-test it against the products patients actually take. Learn a five-question approach to any supplement, how to judge product quality in an industry the FDA does not pre-approve, and where the evidence actually lands on greens powders and multivitamins, magnesium, creatine, vitamin D, fish oil (and why cod liver oil is not the same thing), turmeric/curcumin, and glucosamine/chondroitin.

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Show Segments

Intro
Ask These Five Questions: A Framework for Any Supplement
Supplement Quality and Regulation
Greens Powders and Multivitamins
Magnesium
Creatine
Vitamin D
Fish Oil and Cod Liver Oil
Turmeric and Curcumin
Glucosamine and Chondroitin
Simplifying the Regimen
Take-Home Points

Credits* Writer and Producer, Show Notes, Cover Art, Infographic: Paul Wurtz MD. * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

Disclosures
The Curbsiders report no relevant financial disclosures.

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Caring for patients using mitragynine-derived substances

Familiarize yourself with the differences in mitragynine-derived compounds. Understand how to identify and manage kratom use disorder and withdrawal from mitragynine-derived compounds. We’re joined by Dr. Jonathan Tanawan (Profile).

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By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

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Credits

Written and Produced, with Show Notes, Infographic, and Cover Art by Zina Huxley-Reicher, MD
Hosts: Carolyn Chan, MD. MHS and Zina Huxley-Reicher, MD
Reviewer: Kento Sonoda, MD, MPH
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Jonathan Tanawan, MD

Show Segments
Intro, disclaimer, guest bio * Guest one-liner, Picks of the Week * Case from Kashlak; Definitions * Pharmacology of kratom and other mitragynine-based compounds * How to take a mitragynine-specific substance use history * Defining a use disorder * Withdrawal from kratom * Managing a use disorder with MOUD * Legal landscape and regulation * Outro

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From Pain to Gain: Diagnosis to Updated Treatment Options

Learn how to recognize fibromyalgia as a disorder of central pain processing, distinguish it from common mimics, and apply evidence-based strategies for diagnosis and management. In this episode, Dr. Daniel Clauw (University of Michigan) shares practical clinical pearls on nociplastic pain, sensory hypersensitivity, non-pharmacologic therapies, medication selection, and why opioids often fail in fibromyalgia.

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Show Segments

Intro
Rapid Fire questions
Case 1 on fibromyalgia presentation
Diagnosis and exam for fibromyalgia
Non-pharmacologic treatment recommendations
Pharmacologic treatment recommendations
Case 2 on opioids for pain management
Outro

Credits
* Written and Produced by: Zoya Surani * Show Notes, Infographic, and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dan J Clauw MD

Disclosures
Dr. Clauw reports financial disclosures with the following companies: Tonix, Axsome, Ono, Swing (Consulting Fee). The Curbsiders report no relevant financial disclosures.

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With 10+ parts to the 2025 ACLS guidelines, it’s a lot to sift through. Join us for this focused conversation on the parts that have had most practice changing updates with Dr. Jessica Nave (Emory University).

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Show Segments

Intro
Rapid Fire Questions/Picks of the Week
Case 1
Updates to narrow complex unstable tachyarrhythmias
Case 2
Stable ventricular tachycardia
Ventricular fibrillation
Refractory ventricular fibrillation
POCUS/Lines
Post Cardiac Arrest Care
Termination of Resuscitation
Outro

Credits
* Producer, Writer, Show Notes, Hosts: Monee Amin MD, Meredith Trubitt MD * Cover Art, Infographic:Caroline Coleman MD * Reviewer: Sai Achi MD, MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jessica Nave MD

Disclosures
Dr. Nave reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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We have another classic episode for you. Transform your approach to menopause care with the latest evidence and expert insights you can use tomorrow. Learn how to move beyond outdated WHI-era fears and confidently prescribe individualized, effective hormonal therapies. We’re joined by urologist and sexual medicine specialist Dr Rachel Rubin (@DrRachelRubin), who brings clarity, practicality, and a fresh perspective to this rapidly evolving field.

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Show Segments

Intro
Case
Shifting care for menopause
WHI/black box warning labels
What makes you nervous?
Local vaginal treatments
Progesterone therapy
Estrogen therapy
Testosterone therapy
Perimenopause
Outro

Credits

Producer, Writer, Show Notes, Infographic, Cover Art: Molly Heublein MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Rachel Rubin MD

Disclosures

Dr. Rachel Rubin reports financial support from Sprout Pharmaceuticals . The Curbsiders report no relevant financial disclosures.

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Confidently counsel on nutrition, as we discuss different dietary patterns and address common patient queries. We are joined by Dr. Joan Salge Blake (Boston University).

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Show Segments

Intro
Case
Ketogenic Diets
Mediterranean & DASH Diets
Fiber
Oils and Fats
Processed Foods
Paleolithic and Carnivore Diets
Food Order and Glycemic Control
Protein
Vegetarian and Vegan Diets
Intermittent Fasting and Meal Timing
Artificial Sweeteners
Outro

Credits
* Producer, Writer, Show Notes, Infographic, and Cover Art: Edison Jyang, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Joan Salge Blake, EdD, MS, RDN, LDN, FAND

Disclosures
Joan Salge Blake, EdD, MS, RDN, LDN, FAND reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Enjoy the ride as we go through a case of syncope with the Clinical Problem Solvers! Listen in awe as they break down their thought process when evaluating a patient presenting with syncope. We are joined by Reza Manesh (UCLA) and Rabih Geha (UCSF).

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Show Segments

Intro
Aliquot 1 and case discussion
Aliquot 2 and case discussion
Aliquot 3 and case discussion
Aliquot 4 and case discussion
Aliquot 5 and case discussion
Final Diagnosis
Outro

Credits
* Producers: Matthew Watto MD, FACP; Edison Jyang, MD * Clinical case writers: Youssef Saklawi, MD; Madallena Conte, MD * Show notes, infographic, and cover art: Edison Jyang, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Reza Manesh, MD; Rabih Geha, MD

Disclosures
Dr. Reza Manesh reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Become the Medetomi-Dean of Admissions

Step up your hospital addiction medicine game by learning to troubleshoot methadone dose confirmations/missed doses and understanding how medetomidine’s emergency in the drug supply is impacting patients and withdrawal management. We’re joined by Dr Maggie Lowenstein (University of Pennsylvania)

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By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

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Credits

Writer, Producer, and Show Notes: Shawn Cohen MD
Infographic and Cover Art: Zoya Surani
Hosts: Carolyn Chan, MD. MHS and Shawn Cohen MD
Reviewer: Payel Jhoom Roy MD, MSc
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Maggie Lowenstein MD MPhil MSHP

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Malignant Bowel Obstruction, VTE and Goals of Care

Master malignant bowel obstruction, cancer-associated thrombosis, and goals-of-care conversations in hospitalized patients with advanced cancer. Learn practical approaches to symptom management, anticoagulation decisions, and navigating high-stakes discussions around prognosis and hospice care. We’re joined by Dr. Jensa Morris, @JensaMorrisMD (Yale School of Medicine).

Claim free CME for this episode at curbsiders.vcuhealth.org**!

Show Segments**

Intro
Picks of the Week
Case 1: Malignant small bowel obstruction: definitions, initial management, medications, NG tubes, nutrition, and procedural options
Case 2: Cancer-associated VTE: choice of anticoagulant, treatment duration, unusual thromboses, and anticoagulation with brain metastases
Case 3: Goals of care: prognosis, performance status, palliative care, hospice and end-of-life planningTake Home Points
Outro

Credits
* Writer, producer, and show notes: Reaford Blackburn, Jr., MD * Infographic, Cover Art: Caroline Coleman, MD * Hosts: Monee Amin, MD and Meredith Trubitt, MD * Reviewer: Rahul Ganatra, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jensa Morris, MD

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Join us as we review recent articles and news featured in The DIGEST, including updated lipid guidelines, GLP1 agonists holds and procedures, the newest drug in pancreatic cancer, and discontinuing thyroid supplementation. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Nora Taranto (@norataranto), Laura Glick (@lauraglick) and Matt Watto (@doctorwatto).

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Credits

Written and Hosted by: Nora Taranto MD MSCE, Laura Glick MD, Matthew Watto MD, FACP
Cover Art: Nora Taranto MD MSCE
Reviewers: Emi Okamoto MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments* Intro and pun * Lipid Management Guidelines Overview * Emerging Treatments in Oncology * Press Release on a new KRAS Inhibitor for Pancreatic Cancer * Perioperative Considerations for GLP-1 Use * Deprescribing Levothyroxine in Older Adults

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Cut through the hype of Multi-Cancer Early Detection (MCED) tests and learn how to counsel patients on the real-world utility, false-positive risks, and the "stage shift" debate of these emerging blood assays. We are joined by world-renowned oncologist Dr. Margaret Tempero,UCSF Cancer Early Detection and Interception, to discuss whether these tests are truly ready for clinical prime time.

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Show Segments

00:00 Introduction
01:57 Current Cancer Screening Programs
06:05 Emerging Blood-Based Cancer Tests
11:55 Test Characteristics and Limitations
18:05 Practical Considerations for Patients
25:33 Direct-to-Consumer Testing/Whole Body MRIs
36:46 Navigating Positive Test Results
45:10 Anxiety and Patient Education
47:08 Future Directions in Cancer Screening
Outro

Credits
* Producer, Writer, Show Notes, Infographic, Cover Art: Molly Heublein MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD,MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Margaret Tempero, MD

Disclosures

Dr. Tempero reports the following financial relationships:
Grail (research support), Global Bio Access Fund (Advisor), Bristol Myers Squibb (Membership on Advisory Committees or Review Panels, Board Membership, etc.), Astra Zeneca (Membership on Advisory Committees or Review Panels, Board Membership, etc), Immunovia (Membership on Advisory Committees or Review Panels, Board Membership, etc.), Merck (advisory committee), Renovo Rx (advisory committee), Urogen (Advisor). Financial relationships have not ended.
The Curbsiders report no relevant financial disclosures.

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We have another classic episode for you. Don’t get caught treating high blood pressure like it is 2024. Dr. Jordy Cohen (@jordybc.bsky.social, University of Pennsylvania) guides us through the new hypertension guidelines.

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Show Segments

Intro
Case: Jeremy
Wearable devices inaccuracies
Ideal blood pressure measurement
Diagnosis and workup
Management and fixed-dose combination pills
Case: Jolene and pregnancy
Outro

Credits
* Written and Produced by: Deborah Gorth MD, PhD * Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth RD, MPH * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jordana Cohen MD, MSCE

Disclosures
Financial Relationships disclosed for Dr. Jordana Cohen: Wolters Kluwer (Royalties or Patent Beneficiary) and National Institutes of Health (Grant or research support)

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We go so that you want to go next year!

Stay current with updates in hospital medicine from SHM Converge 2026 in Nashville, TN.

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Show Segments

Intro
Picks of the Week
Heart Failure Updates
Things We Do For No Reason: Top 10
Pneumonia updates
Pharmacotherapy Updates
Severe Acute Liver Injury
Nephrology Updates
MED-TED Competition Pearls
Fevers in Oncology
Addiction Updates for the Hospitalists
Alternatives to Guardianship
Infectious disease updates
Updates in Transfusion Medicine
Sodium overcorrection/demyelinating syndrome
Total parenteral nutrition (TPN)
Perioperative hip fracture management
EKG Updates
Dermatology Updates
Home Antibiotics
Sepsis Updates
Updates in Hospital Medicine
Diabetes Inpatient Management Updates
Outro

Credits
* Producer and Writer: Monee Amin MD, Caroline Coleman MD, Meredith Trubitt MD * Show Notes: Caroline Coleman MD and Meredith Trubitt MD * Cover Art: Caroline Coleman MD * Hosts: Monee Amin, MD, Meredith Trubitt, MD * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dan Hunt MD, Kierstin Kennedy MD, Noble Maleque MD, Suchita Sata MD, Richard White MD

Disclosures
Drs. Hunt, Kennedy, Maleque, Sata and White report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Join us as we review recent practice-changing articles on left atrial appendage closure vs AC for AFib, apixaban vs rivaroxaban for VTE, intensive LDL targeting, GLP1s and substance use disorders, and more! Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Shani Herzig (@ShaniHerzig) Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

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Credits

Written and Hosted by: Rahul Ganatra MD, MPH; Shani Herzig, MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Rahul Ganatra MD, MPH
Reviewer: Emi Okamoto, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * Left atrial appendage closure vs anticoagulation in AF * Apixaban vs rivaroxaban for VTE * Intensive LDL targeting in ASCVD * GLP1s and substance use disorders * FDA approves Orforglipron * E-cigarettes and cancer * Early AM blood draws and sleep quality * Outro

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Join us as we explore practical, evidence-based strategies to help patients age with strength and confidence, and navigate the transition into retirement. We’re joined by Dr. Elizabeth Eckstrom (Oregon Health & Science University)!

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Show Segments

Intro
Case
Navigating Retirement
Staying Physically Active
Benefits of Tai Chi
Nutrition
Mobility limitations/chronic pain
Osteoporosis
Anti-aging/memory supplements
Community Resources
Outro

Credits
* Written and Produced by: Ashlee Randolph DO, Rachel Miller MD * Show Notes, infographic, cover art: Ashlee Randolph DO, Rachel Miller MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Elizabeth Eckstrom MD, MPH

Disclosures
Dr. Elizabeth Eckstrom reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

The production of this episode was supported by the Penn Geriatrics AGE-SMART Geriatric Workforce Enhancement Grant. This podcast content is solely the responsibility of the authors and does not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services.

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Gain an insider’s perspective on the techniques of pelvic floor physical therapy. Learn when to refer, what to expect and what can be gained from working with your friendly neighborhood pelvic floor PT specialist. We’re joined by our guests Dr. Nicole Schaffer and Dr. Rachel Rosvold from Uplift Pelvic Floor Physical Therapy in Horsham, PA.

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Show Segments

Intro, guest bios
Case #1 from Kashlak
Urinary incontinence in post-partum setting
Pelvic floor changes in perimenopause
Case #2 from Kashlak
Erectile dysfunction
PT for chronic prostatitis and erectile dysfunction
Constipation and fecal incontinence
Outro

Credits
* Written and Produced by: Alise Burke, MD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Nicole Schaffer PT, DPT, cert MDT and Rachel Rosvold PT, DPT. Follow them on Instagram @upliftpelvicpt

Disclosures

Dr. Nicole Schaffer and Dr. Rachel Rosvold report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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How do we help patients improve health span without letting wearables, biomarkers, and wellness trends take over the conversation? Learn how to think about CGMs in patients without diabetes, how to interpret early cardiometabolic risk beyond the A1c, how to prescribe exercise in a practical way, and how to counsel patients about sleep, wearables, and even peptides. We’re joined by Dr. Sandeep Palakadedi (Dr. “Deep”), founder and CEO of Velocity Health and author of The Ultimate Asset.

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Show Segments

Intro
CGMs, Postprandial Glucose, and Data Neurosis
Beyond Glucose: ApoB, Lp(a), and Early Cardiometabolic Risk
Body Composition, VO2 Max, and Functional Longevity
Sleep, HRV, and Wearables
Prescribing Exercise in Real Life
How to Talk to Patients About Peptides
Take-Home Points

Credits
Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD, MBA, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Sandeep Palakodeti MD, MPH

Disclosures
Dr. Palakodeti reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Sponsor: Continuing Education Company
For Curbsiders listeners, there’s a special offer: use promo code Curb30 for 30% off all online courses and webcasts. Visit CMEmeeting.org/curbsiders to learn more.

Become a master of cortisol and learn how to identify and treat a common condition in patients with adrenal tumors! Join us as we learn about mild autonomous cortisol secretion (MACS) with Dr. Irina Bancos (@irinabancos), an internationally renowned adrenal expert!

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Show Segments

Intro
Advice for listeners
Adrenal incidentaloma Definition (Case 1)
Hormonal workup for adrenal incidentalomas
Defining mild autonomous cortisol secretion (MACS)
Significance and prevalence of MACS
Diagnostic testing for MACS
Treatment options for MACS (surgery vs. comorbidity management)
Post surgical management of MACS (Case 2)
Diagnostic testing for adrenal insufficiency (AI)
Glucocorticoid withdrawal syndrome management
Deciding when patients are able to come off of steroids after AI
Outcomes after adrenalectomy in MACS
Take home points

Credits
Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Producer, writer, show notes, and CME: Mobeen Ahmad MD
Cover art and infographic: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Mobeen Ahmad MD
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Irina Bancos MD, MSc

Disclosures
Dr. Bancos has the following disclosures:* Consulting, advisory board or safety monitoring board (all fees to institution): Recordati, Corcept, Esteve, Spruce, Sparrow, Diurnal, Neurocrine, Lufordi, Adaptyx, Crinetics, Xeris, AstraZeneca, NovoNordisc, Camurus. * Research grant for investigator initiated research (to institution): Esteve, Recordati

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Metabolic Health, Advanced Lipidology, and Preventing ASCVD

Level up your primary prevention game. Learn when ApoB, Lp(a), and CAC actually change management, how to spot cardiometabolic risk before diabetes declares itself, and how to make smarter lipid decisions beyond the standard panel. We’re joined by Dr. Greg Katz, cardiologist and prevention expert at NYU Langone Health.

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Show Segments

Intro
Primary Prevention & Metabolic Syndrome (Case 1)
Beyond the Standard Lipid Panel
When to Order ApoB
How Lp(a) Changes Management (Case 2)
Using CAC/CCTA in the Gray Zone
Recognizing Early Cardiometabolic Risk
CGMs, Wearables, and Signal vs Noise (Case 3)
How to Talk to Patients About Risk
Take-Home Points

Credits
Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD, MBA, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Greg Katz MD

Disclosures
Dr. Katz reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
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code CURB at checkout.

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Sponsor: FIGS

We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.

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Join us as we review and appraise recent practice-changing articles. In this episode, we cover the latest in GLP-1s and GIP agonists for CVD, Type 2 Diabetes, and Obesity, valacyclovir to treat Alzheimer’s, weight regain patterns after medication-induced weight loss, and a deep dive into the data behind deprescribing – and behavioral science to increase deprescribing behavior. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Alex Chaitoff (@alexchaitoff), Nora Taranto (@norataranto), & Matt Watto (@doctorwatto).

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Credits

Written and Hosted by: Nora Taranto MD, MSCE; Alexander Chaitoff MD, MPH; Paul Williams, MD, FACP,, & Matthew Watto MD, FACP
Cover Art: Nora Taranto MD, MSCE
Reviewer: Sai S Achi MD, MBA, FACP
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * GLP-1 + GIPs vs GLP-1s for patients with T2DM and Obesity – SURPASS-CVOT * Weight Regain after Weight loss * VALAD – Valacyclovir in patients with early Alzheimer’s * Nudges to increase Deprescribing * Outro

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We have a classic episode for you. Conquer prediabetes and diabetes prevention! We’re joined by Dr. Scott Isaacs, who provides essential pearls on navigating screening tests for diabetes and prediabetes, identifying atypical cases of prediabetes, and individualizing management of prediabetes with lifestyle changes and medications.

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Show Segments

Intro
Case from Kashlak
Why screen for prediabetes and diabetes?
Who to screen for prediabetes and diabetes
How to screen for prediabetes and diabetes
Role of the physical exam
Explaining a diagnosis of prediabetes to patients
Atypical types of prediabetes
Management of prediabetes: lifestyle changes
Management of prediabetes: medications
Outro

Credits
* Producer, Writer, and Show Notes: Malini Gandhi MD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai Achi MD,MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Scott Isaacs MD

Disclosures
Dr. Isaacs reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Sponsor: University of Pennsylvania Graduate School of Education
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Stop getting TICK’ed off by Lyme

Master Lyme disease — from recognizing erythema migrans and avoiding unnecessary testing to managing disseminated Lyme and post-exposure prophylaxis. Learn practical, evidence-based strategies you can use in the clinic. We’re joined by Dr. Sophie Woolston MD, infectious diseases expert and clinician-educator. (MaineHealth)

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Show Segments

Intro
Case 1
Lyme Basics
Stages of Lyme
Lyme Testing and Interpretation
Coinfection
Lyme Treatment
Tick Prevention and Removal
Post-Treatment Lyme Disease Syndrome
Outro

Credits
* Written and Produced by: Beth Gasperlin MD * Show Notes, Infographics, and Cover Art by: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Gasperlin MD * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Sophie Woolston MD

Disclosures
Dr. Woolston reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
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Helping you diagnose a common cause of hypertension!

Hypertension is a growing disease globally, affecting millions of individuals and increasing the risk of heart disease and stroke. Along with the expert help of Dr. Vaidya (Brigham and Women’s Hospital), we help reimagine the approach of clinicians in terms of hypertension and help them navigate common diagnostic dilemmas! @AnandVaidya17 (Bluesky) @AnandVaidya17 (X)

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Show Segments

Introduction and Personal Interests
Advice and Wisdom in Medicine
Case 1
Defining Primary Aldosteronism
Screening for Primary Aldosteronism
How common is Primary Aldosteronism
Challenges in Diagnosis and Testing
Medication Management and Testing Protocols
Managing indeterminate cases
Aldosterone Suppression Testing and its role
Discussing treatment options with patients
Case 2
Considering genetic causes of Primary Aldosteronism
The need for AVS for lateralization
Upcoming imaging modalities for Primary Aldosteronism
Case 3
Medical Management of Primary Aldosteronism
Future Directions in Treatment

Credits
* Producer, Writer, Show Notes:Mobeen Ahmad MBBS * Infographic:Kate Grant MBChB MRCGP * Cover Art:Kate Grant MBChB MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Anand Vaidya MD, MMSc

Disclosures
Dr. Vaidya has disclosed the following:

Financial Relationships: Astra Zeneca-Consulting Fee and Corcept-Consulting Fee, relationships have not ended.

The Curbsiders report no relevant financial disclosures.

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Curbsiders listeners can get 20% off the already very moderately priced yearly subscriptions directly at sanfordguide.com. Go to sanfordguide.com and use the code, CURB at checkout.

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MedStudy Qbank - Study less. Remember more. Pass confidently. Medstudy.com/Curbsiders CURB15 for 15% off

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Join us as we review and appraise recent practice-changing articles on oral semaglutide for obesity, fish oil in ESRD, IV iron during infection, the new US Dietary Guidelines, & anticoagulation after ablation in AFib. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Josh Gilman, & Matt Watto (@doctorwatto).

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Credits

Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Joshua Gilman, MD, & Matthew Watto MD, FACP
Cover Art: Rahul Ganatra, MD MPH
Reviewer: Emi Okamoto, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * Oral Semaglutide for obesity * Fish Oil for CV risk reduction in hemodialysis patients * IV Iron for iron deficiency anemia during infection * New USA Dietary Guidelines * Anticoagulation after catheter ablation for AF * Outro

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We have another classic episode for you. Master inpatient heart failure management! Learn key tips for initiating guideline-directed medical therapy, diuretic therapy pearls, and ensuring smooth transitions of care. We are joined by Dr. Gurusher Panjrath @PanjrathG (GW School of Medicine and Health Sciences-Dr. Panjrath)

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Show Segments

Intro
Rapid Fire Questions/Picks of the Week
Case Aliquot 1
Defining Heart Failure
POCUS in Heart Failure
Timing/Indications for Echocardiography
Initiating Diuretic Therapy
Adjusting Diuretic Therapy/Drip vs Bolus
Adjunct Diuretic Therapy
Afterload Reduction
Monitoring Diuretic Response
Inpatient Sodium and Fluid Restriction
Case Aliquot 2
Classifying Heart Failure
Pharmacotherapy for HFrEF
Pharmacotherapy for HFpEF
Ischemic Evaluation
Interval Summary/Highlights
Case Aliquot 3
Considerations for Initial Care of Cardiogenic Shock
Choosing Inotrope/Vasopressor
Right Heart Catheterization
Case Aliquot 4
Discharge Medications for Heart Failure
Titration of Goal Directed Medical Therapy
Post Discharge Follow Up
Washout Period for ACEi/ARB
Cost/Barriers of ARNI
Patient Education
Take Home Points
Outro

Credits
* Writer, Producer, and Show Notes by: Reaford Blackburn, Jr., MD * Infographic & Cover Art: Caroline Coleman MD * Hosts: Monee Amin, MD and Meredith Trubitt, MD * Reviewer: Rahul Ganatra MD * Technical Production: PodPaste * Guest: Gurusher Panjrath, MD

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Sponsor: Sanford Guide
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Sponsor: Babbel
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Dr. Fleseriu schools us on managing the unexpected

Become a master of pituitary incidentalomas. Learn about the hormonal workup and management of pituitary microadenomas, macroadenomas and empty sella syndrome and when surgery may be needed. We’re joined by Dr. Maria Fleseriu, @MariaFleseriu (Oregon Health and Science University)

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Show Segments

Intro
Rapid fire questions/Picks of the Week
Case 1
Defining Pituitary Incidentalomas
What is the difference between micro adenoma, macroadenoma and functional vs non-functional adenomas
Hormonal workup of microadenoma (assessing for hypopituitarism and hormonal excess)
Decided when to reimage patients and long term follow up of microadenomas
Case 2
Hormonal workup for pituitary macroadenoma
Deciding when surgery should be considered
Discussing the role of visual field testing
Case 3
Defining empty sella syndrome
Discussing hormonal assessment of empty sella syndrome
Treatment options for hyperprolactinemia caused by empty sella syndrome
Outro

Credits
* Producer, writer, show notes, and CME: Mobeen Ahmad MD * Infographic and cover art: Kate Grant MBChb, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Maria Fleseriu

Disclosures

Dr. Fleseriu reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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We have a classic episode for you. Master male hypogonadism diagnosis and management. Discover when and how to test, how to tackle confounding conditions, and why lifestyle changes may be more effective than testosterone therapy in certain patients. We are joined by Dr. Brad Anawalt, an expert in endocrine care, to guide us through the essentials.

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Show Segments

Intro
Case 1
History and Physical
Laboratory Testing
Effect of Lifestyle on Testosterone
Case 2
Prostate and Cardiovascular risk
Treatment Options and Considerations
Secondary Causes of Hypogonadism
Case 3
Testicular Size and Klinefelter Syndrome
hCG and Clomiphene
Monitoring and Follow-Up
Take-Home Points
Outro

Credits
* Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD. * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Bradley D. Anawalt MD

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Sponsor: Locumstory
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Sponsor: MedStudy
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Sponsor: The Sanford Guide
Curbsiders listeners can get 20% off the already very moderately priced yearly subscriptions directly at sanfordguide.com. Go to sanfordguide.com and use the code, CURB at checkout.

What Dreams May Come

Breeze through your next visit for insomnia. Learn how to comfortably approach insomnia and optimize sleep. We touch on specifics such as cognitive behavioral therapy for insomnia or the effects of various sleep-related drugs/supplements, and how to taper down from them. We are joined by Ashley E. Mason, PhD (UCSF).

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Show Segments

Intro
Case
Understanding patient’s goals
Cognitive behavioral therapy for insomnia
Stimulus control
Sleep Hygiene
Time-in-bed restriction
Impact of different medications/substances on sleep
Tapering off medications
Outro

Credits
* Producer and Writer: Matthew Watto MD, FACP * Producer, Show Notes, Infographic, and Cover art: Edison Jyang, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi, MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Ashley E. Mason, PhD

Disclosures
Dr. Mason has disclosed the following:
Financial Relationships: Evolve Global, consulting fee and stock options; Oura Health, consulting fee.

The Curbsiders report no relevant financial disclosures.

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Take 15% off your first order at Wearfigs.com with the code FIGSRX.

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Sponsor: Mint Mobile
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Blood-based Biomarkers, Anti-Amyloid Therapies and Beyond

From blood-based biomarkers to anti-amyloid treatments, join us as we explore the latest in Alzheimer’s disease diagnosis and treatment with Dr. Halima Amjad. This episode will equip you to guide your patients about the latest Alzheimer’s diagnostics as well as eligibility, risks and monitoring for anti-amyloid therapies.

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Show Segments

Intro
Case
Cognitive and functional history reminders
Diagnosing Alzheimer’s Disease
Blood-based biomarkers
Anti-amyloid therapy indications, eligibility and contraindications
Patient counseling and treatment decisions
ARIA
Key takeaways
Outro

Credits
* Written and Produced by: Natalie Barrett DO, Rachel K Miller MD * Show notes, cover art and infographic: Natalie Barrett DO, Rachel K Miller MD, Leah Witt MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD, MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Halima Amjad, MD

Disclosures
Dr. Amjad reports financial relationships with Centene (Advisor) and Craniometrix (Advisor). Relationships have not ended. The Curbsiders report no relevant financial disclosures.

The production of this episode was supported by the Penn Geriatrics AGE-SMART Geriatric Workforce Enhancement Grant. This podcast content is solely the responsibility of the authors and does not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services.

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Sponsor: Sanford Guide

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Diverticulitis Simplified: Imaging, Antibiotics, Diet, and When to Call Surgery

Master diverticulitis! Learn how to distinguish uncomplicated from complicated disease, when to reach for antibiotics, and which patients need surgical consultation. We’re joined by Dr. Bob Hollis (University of Alabama at Birmingham) and Dr. Andrew Webster (Emory University).

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Show Segments
* Intro * Rapid Fire Questions * Picks of the Week * Case 1 * Defining and Classifying Diverticulosis vs Diverticulitis * History and Physical Exam * Labs and Imaging * Disposition: Admit or Discharge? * Antibiotics: Who Needs them and How to Choose * Duration of Antibiotic Therapy * Diagnostic Pitfalls and Redflags * Nutrition in the Hospitalized Patient with Diverticulitis * Case 2 * Surgery and IR Consultation * Antibiotics in Diverticular Abscess * Repeat Imaging in Undrainable Abscess * Elective Surgery in Diverticulitis * Case 3 * Diverticulitis with Perforation * Counseling Patients Undergoing Surgery * Ostomy Reversal Timing

Credits
* Writer, Producer, and Show Notes: Reaford Blackburn, Jr., MD * Infographic and Cover Art: Caroline Coleman, MD * Hosts: Monee Amin, MD and Meredith Trubitt, MD * Reviewer: Rahul Ganatra * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guests: Bob Hollis, MD and Andrew Webster, MD

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Visit CMEmeeting.org/curbsiders and use promo code Curb30 for 30% off all online courses and webcasts.
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Matt and Paul recap top pearls from a recent episode on Anticoagulation for Venous Thromboembolism with Dr. Tara Lech, PharmD. They also answer listener questions and share their picks of the week.

Picks of the week:
Paul Recommends: Death Stranding 2: On the Beach (videogame)
Matt Recommends: CJ Box novels about Joe Picket

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Show Segments
* Intro * Case: Jeremy * Wearable devices inaccuracies * Ideal blood pressure measurement * Diagnosis and workup * Management and fixed-dose combination pills * Case: Jolene and pregnancy * Outro

Credits
* Written and Produced by: Deborah Gorth MD, PhD * Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth RD, MPH * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jordana Cohen MD, MSCE

Disclosures
Financial Relationships disclosed for Dr. Jordana Cohen: Wolters Kluwer (Royalties or Patent Beneficiary) and National Institutes of Health (Grant or research support)
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Master cardiovascular disease prevention! Learn how to apply the new PREVENT risk calculator, use the CPR framework for risk reclassification, and interpret ApoB and Lp(a) in modern lipid management. We’re joined by Dr. Laurence Sperling to break down what’s new in ASCVD risk assessment and prevention.

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Show Segments
* Intro * Case 1 from Kashlak * Risk assessment framework * ApoB and Non-HDL cholesterol * Lipoprotein(a) and its importance * The PREVENT risk score and its implications * Statins and other lipid lowering therapies * The role of diet and lifestyle in lipid management * Case 2 from Kashlak * Familial Hypercholesterolemia diagnosis and management * Key takeaways * Outro

Credits
* Producer, Writer, Shownotes, Infographic, and Cover art: Ben Furman, MPH * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Laurence Sperling, MD

Disclosures
Dr. Sperling reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Transform your approach to menopause care with the latest evidence and expert insights you can use tomorrow. Learn how to move beyond outdated WHI-era fears and confidently prescribe individualized, effective hormonal therapies. We’re joined by urologist and sexual medicine specialist Dr Rachel Rubin (@DrRachelRubin), who brings clarity, practicality, and a fresh perspective to this rapidly evolving field.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case * Shifting care for menopause * WHI/black box warning labels * What makes you nervous? * Local vaginal treatments * Progesterone therapy * Estrogen therapy * Testosterone therapy * Perimenopause * Outro

Credits

Producer, Writer, Show Notes, Infographic, Cover Art: Molly Heublein MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Rachel Rubin MD

Disclosures
Dr. Rachel Rubin reports financial support from Sprout Pharmaceuticals . The Curbsiders report no relevant financial disclosures.

Sponsor: Aura Frames
For a limited time, save on the perfect gift by visiting AuraFrames.com to get $35 off Aura’s best-selling Carver Mat frames by using promo code CURB at checkout.
Sponsor: Bucksbaum-Siegler Institute

If you want to learn more about what the Bucksbaum-Siegler Institute is doing and to nominate someone for the Clinical Excellence Award visit bucksbauminstitute.uchicago.edu.

Sponsor: Mint Mobile
Shop Mint Unlimited Plans atMINTMOBILE.com/CURB.
Sponsor: Panacea Financial

Visit bit.ly/PFCURB to connect with a physician-focused banker and get your finances moving in the right direction

Join us as we review recent articles and news featured in The DIGEST #70, including PSA screening, acetaminophen and autism, COVID19 vaccines and cancer, and aspirin and anticoagulation in coronary artery disease. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), Rahul Ganatra (@rbganatra), Laura Glick (@lauraglick) and Matt Watto (@doctorwatto).

Claim free CME for this episode at curbsiders.vcuhealth.org!Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME!
Credits
* Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD MPH, Laura Glick MD, Paul Williams, MD, FACP, Adam Cifu MD, Matthew Watto MD, FACP * Cover Art: Rahul Ganatra, MD MPH * Reviewers: Rahul Ganatra MD MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP; Sai S Achi MD, MBA, FACP * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * Prostate Cancer Screening * Acetaminophen and Autism * COVID19 vaccines and cancer risk * Aspirin and anticoagulation in coronary artery disease * Outro

Sponsor: Aura Frames
For a limited time, save on the perfect gift by visiting AuraFrames.com to get $35 off Aura’s best-selling Carver Mat frames by using promo code CURB at checkout.

Sponsor: DoxGPT by Doximity
Visit doxgpt.com and see how it can simplify your clinical workflow, from patient care to paperwork.
Sponsor: Continuing Education Company
Use promo code Curb30 to get 30% off all online courses and webcasts—just for Curbsiders
Listeners. Visit CMEmeeting.org/curbsiders to learn more.

Sponsor: Freed
Use code: CURB50 to get $50 off your first month when you subscribe!

We have a classic episode for you. Update your approach to cirrhosis evaluation and management with Dr. Scott Matherly Associate Professor of Hepatology and Gastroenterology at Virginia Commonwealth University Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments […]

Dizziness can be a daunting presenting symptom. Demystify dizziness with us by breaking it down by timing and triggers, various pertinent physical maneuvers, and even an approach to chronic dizziness. We are joined by our esteemed guest Dr. David Hale (Johns Hopkins)! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | […]

Explore how GLP-1 meds can help or harm eating disorders with Dr. Laura Bridge When weight-loss meds meet eating disorders: GLP-1 drugs are reshaping medicine, but could they also be fueling disordered eating? Join Dr. Laura Bridge as we unpack the risks, red flags, and how to keep “healthy” from turning harmful. Also, how to […]

More than just mechanical! Keep older adult patients on their feet, literally! Learn to map the Age-Friendly 5Ms Framework onto multifactorial risk factor assessment and management and incorporate other evidence-based fall prevention interventions with the expertise of an interdisciplinary team. We are joined by geriatrician Alyson Michener (@AlysonMichener University of Pennsylvania) and physical therapist Suzanne […]

We have a classic episode for you.. Conquer the art of managing patients with iron deficiency anemia. We are joined by the amazing Dr. Tom DeLoughery, @Bloodman (Oregon Health & Science University). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | […]

Update your approach to the evaluation and management of IBD with Dr. Aline Charabaty (@DCharabaty). Review updates in management options, imaging modalities and preventive health recommendations. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case Initial […]

Update your approach to the evaluation and management of GERD with Dr. James Callaway. Learn when to consider ambulatory reflux monitoring and how to determine if someone has an indication for long-term PPI therapy. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | […]

In this bonus episode, Matt and Paul answer Patreon listener questions on various topics, including the role of AI in medicine, concerns about antibiotics and their impact on health, insomnia treatments, thyroid health, reflections on career burnout and more. They also share personal anecdotes and insights emphasizing the importance of continuous learning and adaptation in the medical field.

Chapters
00:00 Exploring AI in Medicine
04:50 Cultural Shifts in Music Appreciation
10:16 Navigating Medical Questions and Antibiotics
14:57 Insomnia Medications and Sleep Hygiene
19:58 Thyroid Health and Selenium
24:59 Reflections on Career and Burnout
29:55 Closing Thoughts and Gratitude

GOLD Updates, Novel Treatments, and Managing Comorbidities in COPD Care

Level up your COPD care with practical, evidence-based strategies. Learn how to confirm airflow obstruction with spirometry (and use LLN/Z-scores thoughtfully), stage patients with the A/B/E framework, and build treatment around long-acting bronchodilation—adding ICS selectively based on exacerbations and eosinophils. We’ll highlight the nonpharmacologic moves that change outcomes (smoking cessation, vaccination, pulmonary rehab, oxygen when indicated), when to reach for add-ons (azithromycin, roflumilast), how to approach chronic hypercapnia with home NIV, and what’s new (hello, ensifentrine). Pulmonologist and longtime Curbsiders member Dr. Cyrus Askin (@Askins_Razor ) returns to share real-world pearls for diagnosing, treating, and managing comorbidities in COPD.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case 1 * Diagnostic Workup * Understanding the Ratio, LLN/Z-Scores, and Equity * Symptom abd Risk Staging (A/B/E) * Case 2 * Foundational Care * Initial Inhaler Strategy * Progression & Hypercapnia: NIV & Adherence Counseling * Add-On Pharmacologic Options for Frequent Exacerbators * What’s New and Emerging * Comorbidities and When to Refer * Take-Home Points Recap * Plugs, CME, and Credits

Credits
Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Cyrus Askin MD

Sponsor - Freed
Use code: CURB50 to get $50 off your first month when you subscribe at freed.ai

Sponsor - Grammarly
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Sponsor -Locumstory
Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com

We have a classic episode for you. Preserve your sanity while treating heart failure with preserved ejection fraction. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) illuminates this confounding cardiac condition.

**Sponsors

Sponsor: FIGS
Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX**.

Sponsor: Permanente Medical Group
Discover more at northerncalifornia.permanente.org.

Sponsor: UNCOMMON GOODS
To get 15% off your next gift, go to UNCOMMONGOODS.com/curb.

Sorting out DOAC Drama in the Hospital

Is it treatment failure or not? Join us for a great conversation with Dr. Jori May (University of Alabama-Birmingham) on all the nuances around DOAC treatment failure and treatment indications for the hospitalized patient.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Rapid fire questions/Picks of the Week * Case 1 * Definitions * Missed Doses * Lab Monitoring * Medical Conditions impacting DOACs * Imaging * D-dimer Usefulness * Treatment Switching * Case 2 * LV Thrombus * Reversibility * Outro

Credits
* Producer, Writer, Show Notes, Hosts: Meredith Trubitt MD, Monee Amin MD * Infographic, Cover Art: Caroline Coleman MD * Reviewer: Rahul Ganatra MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jori May MD

Sponsor: Continuing Education Company
Curbsiders listeners: use promo codeCurb30 for 30% off all online courses and webcasts.Head to CMEmeeting.org/curbsiders to learn more
Sponsor: FIGS
We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use codeFIGSRX.

Sponsor: Quince
Go to Quince.com/curb for free shipping on your order and 365-day returns

Grow your management tools for opioid withdrawal in the hospital. Investigate how to decide between methadone and buprenorphine, additional medications to manage symptoms and how and when to use short-acting opioids for management of withdrawal. We’re joined by Ashish Thakrar, MD at the University of Pennsylvania.

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!

Show Segments
* Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak; Definitions * Symptoms of opioid withdrawal * Medications for the management of opioid withdrawal * Buprenorphine precipitated withdrawal * Starting Buprenorphine: Experiences and Strategies * Titrating Methadone: Dosage and Adjuncts * Adjunctive short-acting opioids * Emerging Trends in Drug Supply: Xylazine and Medetomidine * Outro

Credits
* Producer, Show Notes: Zina Huxley-Reicher * Infographics: Zina Huxley-Reicher MD and Zoya Surani * Hosts: Carolyn Chan, MD MHS, Zina Huxley-Reicher MD, Shawn Cohen, MD * Reviewer: Payel Jhoom Roy, MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Ashish Thakrar, MD MHSP

Sponsor: Mint Mobile
Shop plans at MINTMOBILE.com/CURB
Sponsor: Freed
Use code: CURB50 to get $50 off your first month when you subscribe!
Sponsor: FIGS
We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.

In this high-yield episode of Curbsiders Addiction Medicine, we dive deep into a practical and compassionate approach to caring for patients using methamphetamines and/or living with methamphetamine use disorder. We explore the latest pharmacologic options, harm reduction strategies, contingency management, and innovative ideas for monitoring and supporting patients. Whether you’re in primary care or other subspecialty settings, this episode is packed with pearls for every clinician with our amazing guest, Dr. Phillip Coffin, Director of the Center on Substance Use and Health in the SFDPH.

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!
Credits
* Producer/Script Writer/Show Notes: Era Kryzhanovskaya, MD * Infographic and Cover Art: Zoya Surani * Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD * Reviewer: Sarah Leyde MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Dr. Phillip Coffin

Show Segments
* Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak; Definitions * Four-tier approach to taking care of patients with methamphetamine use/use disorder * Medications for treatment * Psychosocial treatment * Harm reduction * New horizons in treatment * Outro

Sponsor: Locumstory
Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com
Sponsor: Panacea
Visit panaceafinancial.com and Panacea’s Resource Library for free student loan articles, guides, and webinars built to help you make informed decisions.

Sponsor: Grammarly
Download Grammarly for free at Grammarly.com/PODCAST

We have a classic episode for you. Dive deep into upper respiratory viral infections with Dr Amber Bird, MD (Penn). Feel confident on when to order testing, recommend symptom relieving treatments, and avoid unnecessary antibiotics.

Sponsors
Continuing Education Company
Curbsiders listeners: use promo code Curb30 for 30% off all online courses and webcasts. Head to CMEmeeting.org/curbsiders to learn more.

FIGS
Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.

Freed
Use code: CURB50 to get $50 off your first month when you subscribe at getfreed.ai

Join us as we review recent practice-changing articles on cannabidiol (CBD)-induced liver injury, IV iron for HFrEF, bedtime administration of blood pressure meds, carpal tunnel syndrome & rheumatoid arthritis , & FDA approval of finerenone for HFpEF. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Nora Taranto MD, Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Rahul Ganatra MD, MPH * Reviewer: Emi Okamoto, MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * CBD-induced liver injury * IV Iron in HFrEF * Bedtime administration of BP medications * Carpal tunnel syndrome and RA * FDA approves Finerenone for HFpEF * Outro

Sponsor: Permanente
Want to join thousands of physicians who've made TPMG their career destination? Discover more at northerncalifornia.permanente.org

Why we need to stop calling them “endemic” mycoses & more fungi fun!

Feeling muddled about endemic mycoses? We tackle the clinical presentation of diseases like histoplasmosis, blastomycosis, and coccidioidomycosis, the importance of testing, and how to diagnose fungal infections with our esteemed guest Dr. Andrej Spec, MD!

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Introduction and icebreaker, Fish Club?! 00:00 * Case 1 from Kashlak 07:27 * Diagnostic framework for dimorphic fungi 11:58 * Imaging presentations for fungal pneumonia, diagnostic schemas 18:23 * Testing options 27:48 * Treatment options 35:44 * Dimorphic Fungi Mnemonics 45:50 * Retail testing for mold 48:47 * Case 2 from Kashlak 56: 42 * Takeaways and Conclusions 1:05:19

Credits
* Producer, Writer, Show Notes: Beth “Garbs” Gasperlin MD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Gasperlin MD * Reviewer: Leah Witt Gaspard MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Andrej Spec MD

Disclosures
Dr. Spec reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: QuinceGo to Quince.com/curb for free shipping on your order and three hundred and sixty-five -day returns.

Sponsor: Continuing Education CompanySpecial offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.

Sponsor: FreedUse code: CURB50 to get $50 off your first month when you subscribe!

Dominate C. diff! Learn to distinguish colonization from infection, select first-line therapies, and counsel patients on recurrence prevention and microbiome recovery. We’re joined by IDSA past president and expert on foodborne and intestinal infections, Dr. Cindy Sears (Johns Hopkins University) for a comprehensive update on Clostridioides difficile (C. diff, Cdiff, CDAD, CDI).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Intro * 03:00 Guest bio and hobby * 04:25 Case of Charles Fleur Fontaine * 06:00 Risk factors and epidemiology * 08:00 Antibiotic hierarchy of risk * 10:00 Diagnosis, testing strategies * 14:00 Defining severity * 17:30 Treatment options * 20:00 Microbiome recovery strategies * 24:00 Probiotics and postbiotics * 27:00 Infection control counseling * 30:00 C. diff and colon cancer * 32:00 Recurrent C. diff strategies * 35:00 Why some FMT and bezlotoxumab were discontinued * 38:00 Microbiota replacement therapies * 43:00 Prophylaxis strategies * 45:00 Future therapies and ongoing research * 47:00 Audience Q&A * 52:00 Outro

Credits
* Written and Produced by: Matthew Watto, MD, FACP * Cover Art and Infographic by: * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD,MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Cynthia Sears MD

Disclosures
Dr. Sears reports no relevant financial disclosures. Dr. Williams financial relationships disclosed include a Merck grant or research support. This relationship has not ended.
Sponsor: Mint Mobile
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Sponsor: Panacea Financial
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Sponsor: FIGS
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In this special bonus episode, Dr. Linda Blustein (Bendy Bodies https://bit.ly/m/BendyBodies) addresses listener questions about Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders.

00:00 – Introduction
00:59 – Can PCPs diagnose hEDS without a geneticist?
03:19 – Limitations of the Beighton Score
05:40 – 2017 hEDS criteria & upcoming revisions
10:29 – How to find a knowledgeable provider
12:52 – SVT vs POTS in a patient with EDS family history
19:53 – How to ask your provider if they’re comfortable treating dysautonomia
22:17 – MTHFR variants and hEDS
29:23 – Celiac, gluten sensitivity & EDS
31:48 – Food allergy vs sensitivity testing
34:11 – Lipoedema and hypermobility
39:00 – LDN, Ketotifen, and Cromolyn
43:41 – Medication sensitivity in EDS/POTS/MCAS patients
45:47 – Wrap up and resources

FIGS
Get 15% off your first order at wear figs.com with the code FIGSRX

Locumstory
Locumstory.com is simply a free, unbiased educational resource about locum tenens

Grammarly
Download Grammarly for free at Grammarly.com/PODCAST

We have a classic Curbsiders episode for you. Expert guest Dr. Elliot Tapper (@ebtapper) shares his framework for approaching NAFLD/MASLD and the treatment tools he recommends including lifestyle modifications and medications.

An age-friendly approach to arthralgias.

Attack arthralgias with ease! Learn how to evaluate and manage common joint complaints in older adults. We’re joined by Dr Una Makris, @unamakris.bsky.social (UT Southwestern).

Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments
* Intro * Case 1 from Kashlak * General approach to joint pain in older adults * Diagnosing osteoarthritis * Management of osteoarthritis in older adults + Non-pharmacological interventions + Pharmacological interventions: topicals, orals, injectables + When to refer for joint replacement * Case 2 from Kashlak * Diagnosis of Late onset rheumatoid arthritis (LORA) + Differential Diagnosis and Distinguishing features + Lab work/Imaging + When to refer to rheumatology * Approach to managing LORA + The 5Ms framework + Initial treatment with glucocorticoids + Ageism as a driver of undertreatment in older adults + Treating to target * Key takeaways * Outro

Credits
* Producers, Writers and Show Notes: Joseph (Lee) Young, MD, Leah Witt, MD, Rachel Miller, MD * Cover Art and Infographic: Leah Witt, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Una Makris

DisclosuresDr. Makris reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: Heart of Care
If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts.
Sponsor: FIGS
Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX.

Here is a classic Curbsiders episode with one of our favourite guests of all time, Dr Joel Topf.

Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy.

Finerenone is FDA approved for managing CKD in patients with diabetes. *Update as of July 2025:* The non-steroidal mineralocorticoid recepter antagonist, finerenone is now FDA approved to treat heart failure with LVEF at or above 40% based on results of the FINEARTS-HF trial.

Claim CME for this episode at curbsiders.vcuhealth.org!

Heart of Care
If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts.

Quince
Go to Quince.com/curb for free shipping on your order and three hundred and sixty-five -day returns.

Combing through common dermatologic complaints in Primary Care

Hone your framework for assessing generalized and patchy hair loss and learn how to counsel patients about the hair loss advice they hear on social media. We discuss useful tests and treatments, psychosocial factors in relation to hair loss, variations in hair types and mention relevant nail conditions.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Examination of hair and nails, ethnic hair types and cultural hair styles and practices. * Lab tests- clinically useful tests, and those to avoid * Telogen Effluvium * Scaly itchy scalp, seborrheic dermatosis, psoriasis * Androgenic alopecia and age-related hair loss * Topical and oral treatments * Examining the nails, conditions related to nail polishes and prosthetics * Patchy hair loss, alopecia areata, Discoid Lupus Erythematosis * Dr Pasieka’s take home points * Outro

Credits
* Written & Produced by: Kate Grant MBChB, MRCGP * Show Notes, Infographic & Cover Art : Kate Grant MBChB, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Helena Pasieka MD MS

Disclosures
Dr. Pasieka reports no relevant financial disclosures. Dr. Pasieka’s views are her own and do not represent those of her employer or the department of defense.

The Curbsiders report no relevant financial disclosures.
Sponsor: Continuing Education Company
Curbsiders listeners get 45% off select online courses—that’s the biggest discount CEC has ever offered, and it’s exclusive to you with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

Sponsor: FIGS
Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX.

Sponsor Freed
Use code: CURB50 to get $50 off your first month when you subscribe!

Matt and Paul recap top pearls from a recent episode on Travel Medicine with Dr. Boghuma Titanji (audio version) and share their picks of the week. Below are links to the original interview & show notes.

449 Travel Medicine

Picks of the week:
Paul recommends: Clutch - Psychic Warfare; Harry Nilsson - The Point
Watto - Mr. McMahon (Netflix Docuseries)

Decode low neutrophils, recognize thalassemia without chasing iron, and sharpen your approach to bleeding disorders in primary care.

Crack the code on confusing labs. Learn from Dr. Bradley Beeler, an academic hematologist, how to recognize thalassemia without over-ordering tests, why a low neutrophil count in a healthy patient might not be a problem, and how to tackle bleeding disorders in primary care.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case 1: Duffy-null associated neutrophil count * Case 2: Bleeding disorders * Case 3: Thalassemia * Outro

Credits
Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD, MBA, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Bradley Beeler MD

Disclosures
Dr. Beeler reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: Panacea
Search The Podcast for Doctors (By Doctors) on Spotify, Apple Podcasts, or wherever you listen.
Sponsor: Locumstory
Locumstory.com is simply a free, unbiased educational resource about locum tenens.
Sponsor: Continuing Education Company
Curbsiders listeners get 45% off select online courses — that’s the biggest discount CEC has ever offered, and it’s exclusive to you with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

Master the latest approaches for treating venous thromboembolism with expert tips on direct oral anticoagulant (DOAC) selection, dosing, and duration. Learn how to tailor anticoagulation for special populations, handle treatment failures, and navigate long-distance travel risks. We’re joined by Dr. Tara Lech, PharmD, CACP (Beth Israel Lahey Health, @AnticoagPharmD, @anticoagpharmd.bsky.social‬).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case 1 from Kashlak * Choosing the right anticoagulant * Distal deep vein thrombosis management * Anticoagulation in special populations * Case 2 from Kashlak * Understanding treatment failure * Anticoagulation reversal agents * Outro

Credits
* Producer, Writer, Show Notes, Infographic, Cover Art: Ben Furman * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Tara Lech, PharmD

Disclosures
Dr. Lech reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: Grammarly
Let Grammarly take the busywork off your plate so you can focus on high-impact work. Download Grammarly for free at Grammarly.com/PODCAST.

Sponsor: Freed
CURB50 to get $50 off your first month when you subscribe at freed.ai
Sponsor: JournalFeed
Try JournalFeed free for 7 days—and get 20% off your first year with code CURB25 at journalfeed.org/curb.

Take the ache out of those joint aches!Learn about inpatient diagnosis and management of crystalline arthropathies as well as a brief conversation about those rheumatology NOS cases. We’re joined by Dr. Kimberly Trotter, MD (University of Chicago).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Rapid fire questions/Picks of the Week * Case 1 * Differential Diagnosis of arthropathy * Risk factors for Gout * Diagnostic Evaluation * Acute Treatments * Long-term Treatments * Transitions of Care for Crystalline Arthropathy * Case 2 * History and Physical Exam * Diagnostic Work up * Treatment * Outro

Credits
* Writer, Producer, Show Notes, Hosts: Meredith Trubitt MD, Monee Amin MD * Infographic, Cover Art: Caroline Coleman, MD * Reviewer: Sai Achi MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Kimberly Trotter, MD

Disclosures
Dr. Trotter reports financial relationship with GSK-Membership on Advisory Committee. The Curbsiders report no relevant financial disclosures.

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Join us as we review recent practice-changing articles on the effect of combination statin and ezetimibe in reducing myalgias, male partner treatment for BV, semaglutide for MASH/liver fibrosis, exercise and cancer risk, and cytisinicline for smoking cessation. Fill your brain hole with some delicious apps and entrees from our spring Digests! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), special guest epidemiologist Alexander Chaitoff (@alexchaitoff) and Matt Watto (@doctorwatto).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Hosted by: Nora Taranto MD; Alexander Chaitoff MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP, Alex Chaitoff MD MPH * Cover Art: Nora Taranto MD * Reviewer: Leah Witt MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * Self-collected HPV tests for cervical cancer screening * Semaglutide for MASH/Liver Fibrosis * Male Partner Treatment for BV * Statins plus ezetimibe versus high-dose statins alone for statin-associated muscle symptoms * Exercise and Colon Cancer Risk * Cytisinicline for Smoking Cessation * Outro

Disclosures
Dr. Wiliams reports financial relationship with Merck for grant or research support. Dr Chaitoff reports financial relationship with Alosa Health for Consulting. Other Curbsiders members report no relevant financial disclosures.

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Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX

Sponsor: Quince
Go to Quince.com/curb for free shipping on your order and 365 day returns.

Sponsor: Continuing Education Company
Curbsiders listeners get 45% off select online courses with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

Dive into practical, evidence-based approaches to managing pain in patients with opioid use disorder, bust common myths, and explore strategies to support patients. This episode will enhance your skills in providing holistic, patient-centered care. We’re joined by Dr. Jessica Merlin, @JessicaMerlinMD (University of Pittsburgh).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

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Credits
* Producer, Show Notes, Infographics: Carolyn Chan MD, MHS * Hosts: Carolyn Chan, MD, MHS and Shawn Cohen MD * Reviewer: Payel Jhoom Roy MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Jessica Merlin MD, PhD, MBA

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Get confident supporting your patients with infertility in primary care! We cover who needs a workup, how to evaluate both partners, and when to refer—plus tips on coding, counseling, and emotional support. Reproductive endocrinologist Dr. Brindha Bavan shares practical insights to empower PCPs on the front lines of fertility care.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case from Kashlak * Definitions of infertility * Male factor infertility evaluation + History + Semen analysis + lifestyle * Female factor infertility evaluation + Anatomical approach + Basic testing + More advanced testing * Unexplained infertility treatment * Success of infertility treatments * Financial impact/advocacy * Oocyte preservation * Outro

Credits
* Producer, Writer, Show notes, Cover Art, Infographics: Molly Heublein MD * Hosts: Molly Heublein MD, Era Kryzhanovskaya MD * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Brindha Bavan MD

Disclosures
Dr. Brindha Bavan reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Download Grammarly for free at Grammarly.com/PODCAST.
Sponsor: FIGS

We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX.

Sponsor: Panacea Financial

Learn more at PanaceaFinancial.com.

Brush up on your high-value care by exploring four Things We Do For No Reason with experts Dr. Tony Breu (@tony_breu, Harvard University) and Dr. Lenny Feldman (@DocLennyF, Johns Hopkins University). Follow along as they explore lactate-guided resuscitation in shock, beta blocker use with cocaine, holding anticoagulation in patients with fall risk, and discharge before noon.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Picks of the Week * Part 1: Things We Do for No Reason™: Using lactate as our resuscitation guide in sepsis * Part 2: Things We Do for No Reason™: Discontinuing β-blockers in patients who use cocaine * Part 3: Things We Do for No Reason™: Discontinuing anticoagulation in older patients with atrial fibrillation and a high risk of falls * Part 4: Things We Do for No Reason™: Discharge before noon * Outro

Credits
* Producers: Caroline Coleman MD, Monee Amin MD, Meredith Trubitt MD * Writers: Monee Amin MD and Meredith Trubitt MD * Show Notes, Infographic, Cover Art: Caroline Coleman, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Lenny Feldman, MD and Tony Breu, MD

Disclosures
Dr. Breu and Dr Feldman report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: FIGS
Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX
Sponsor: Freed
Usecode: CURB50 to get $50 off your first month when you subscribe at Freed.ai

Sponsor: Locumstory
Learn about locums and get insights from real-life physicians, PAs and NP sat Locumstory.com
Sponsor: Continuing Education Company
Curbsiders listeners get 45% off select online courses—that’s the biggest discount CEC has ever offered,
and it’s exclusive to you with promo code Curb45, through July 30.
You can also use Curb30 for 30% off all webcasts and on demand replay courses.
Check it all out at CMEmeeting.org/curbsiders.

Join us as we review recent practice-changing articles on the effect of vitamin D3 and omega-3 fatty acids on physical performance, gabapentin and falls, gepotidacin for uncomplicated UTI, and intermittent fasting for weight loss. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), special guest Laura Glick (@LauraRGlick) and Matt Watto (@doctorwatto).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Rahul Ganatra MD, FACP * Reviewer: Sai S Achi, MD,MBA,FACP * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * Vitamin D3 vs omega-3 fatty acids and physical performance * Gabapentin vs duloxetine and risk of falls * Gepotidacin vs nitrofurantoin for uncomplicated UTI * Intermittent fasting vs daily calorie restriction for weight loss * Outro

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This episode doesn't sugarcoat the truth about tricky diabetes management!

Wrangle wild blood sugars among older adults, pregnant individuals, and those taking corticosteroids! Join our Kashlak resident endocrinologist Dr. Jeff Colburn, as we dive into diabetic dilemmas. We will help you dodge dangerous lows and navigate tricky treatment traps in these special populations. Get the un-sugar-coated truth on managing complex diabetes cases!

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Diabetes in Older Adults (Geriatrics) + General Approach + Risks of Hypoglycemia + 4Ms Framework + Insulin Management + Oral Medications * Diabetes in Pregnancy + Preconception Counseling + Eye Health Monitoring + Insulin Therapy During Pregnancy + Postpartum Care * Steroid-Induced Hyperglycemia + General Approach + Postprandial Insulin Adjustment + NPH Insulin Usage + Initiating Insulin + Role of GLP-1RA and SGLT2-inhibitors * Take-home Points * Outro

Credits
* Producer, Writer, and Show Notes: Isabel Valdez, PA-C * Infographic and Cover Art: Zoya Surani, BA, MS * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jeff Colburn, MD

Disclosures
Dr. Jeff Colburn reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Sponsor: Continuing Education Company
Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.
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Visit Freed.ai and Usecode: CURB50 to get $50 off your first month when you subscribe.
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Go to Quince.com/curb for free shipping on your order and 365 day returns.

Join us at patreon.com/curbsiders today and save 20% on NEW Annual Memberships with promo code: UNLOCKED.

*This offer expires at 3am EST on May 15, 2025.

Matt and Paul recap top pearls from a recent episode on heart failure with reduced ejection fraction (HFrEF) and the importance of understanding the underlying causes of heart failure with Dr. Michelle Kittleson (video version). They also answer listener questions and share their picks of the week.

Chapters:
00:00 Introduction and Humor
01:41 Understanding Heart Failure
04:50 Guideline-Directed Medical Therapy
09:57 Practical Approaches to Treatment
13:58 The Importance of Medication Adherence
16:22 Dietary Considerations in Heart Failure
18:24 ED Follow-Ups and Patient Management
20:38 SGLT2 Inhibitors and Infections
25:58 Patient Counseling and Preventative Care
26:33 Picks of the Week

We’re taking a break this week, but we’ll be back next week with a brand-new episode.Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) breaks down the nuances of treating this common cardiac condition.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Introduction * 03:22 Case Presentation: Newly Diagnosed Heart Failure * 07:26 Using Physical Exam Findings to Guide Diuresis * 11:58 The Four Pillars of Guideline-Directed Medical Therapy for Heart Failure * 15:07 Optimizing Therapy and Follow-Up in Heart Failure Patients * 22:10 The Benefits of High-Intensity Initiation and Titration of Guideline-Directed Medical Therapy * 28:02 Consideration of Other Medications * 40:02 Referral to Advanced Heart Failure Specialist * 49:11 Optimizing Therapy and Follow-Up * 55:33 Conclusion and Book Recommendation

Credits
* Writer and Producer: Deborah Gorth MD, PhD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Michelle Kittleson MD, PhD

Sponsor: Mint Mobile
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Sponsor: American College of Physicians

Order ACP MKSAP today at acponline.org. Curbsiders Listeners who use promo code CORECS will receive a MKSAP gift pack with their subscription.

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Highlights and Pearls from SHM’s Annual Meeting

We recap the top pearls for the hospitalist from #SHM #Converge25 hitting updates in GI, stroke, anticoagulation, perioperative medicine, artificial intelligence, and more.

Note: There is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.

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Show Segments
* Intro * Care of the Patient Experiencing Homelessness * Updates in GI * Delirium * Adaptive Leadership * Transgender Health * Capacity Assessment * Heart Failure * Care of the Transplanted Kidney * Precipitated Withdrawal * IV contrast * Alcohol Withdrawal * MRSA Nares Swabs * Bugs, Bite, and Fever * Perioperative Medicine * Parkinson’s Disease * Stroke * Outro

Credits
* Producer, Writer, Show Notes: Meredith Trubitt MD, Monee Amin MD, Caroline Coleman MD * Cover Art: Caroline Coleman, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Rahul Ganatra, MD MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Michelle Brooks MD, Avital O’Glasser MD, Rahul Ganatra MD MPH

Disclosures
The Curbsiders report no relevant financial disclosures.
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Visit www.getfreed.ai and sse code: CURB50 to get $50 off your first month when you subscribe!
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Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com.
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Sponsor: Continuing Education Company

Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.

Conquer prediabetes and diabetes prevention! We’re joined by Dr. Scott Isaacs, who provides essential pearls on navigating screening tests for diabetes and prediabetes, identifying atypical cases of prediabetes, and individualizing management of prediabetes with lifestyle changes and medications.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case from Kashlak * Why screen for prediabetes and diabetes? * Who to screen for prediabetes and diabetes * How to screen for prediabetes and diabetes * Role of the physical exam * Explaining a diagnosis of prediabetes to patients * Atypical types of prediabetes * Management of prediabetes: lifestyle changes * Management of prediabetes: medications * Outro

Credits
* Producer, Writer, and Show Notes: Malini Gandhi MD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai Achi MD,MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Scott Isaacs MD

Disclosures
Dr. Isaacs reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
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Go to WearFIGS.com and as a Nurses Week exclusive get 20% off everything starting this Thursday May 1st thru May 7th.

Sponsor: Bombas
Enjoy worldwide shipping to over two hundred countries. Head over to Bombas.com/curb and use code curb for twenty percent off your first purchase.
Sponsor: Continuing Education Company
Visit www.CMEmeeting.org/curbsiders. Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30.

Don’t bend the knee to hypermobility! Learn how to evaluate patients for possible joint hypermobility, what associated conditions to be mindful of, and where to start with management. We’re joined by Dr. Linda Bluestein, @BluesteinLinda (https://www.hypermobilitymd.com), who shares her years of experience in treating patients with hypermobility!

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro and getting to know our guest * Case from Kashlak * Hypermobility definitions and background * Initial screening for hypermobility * Physical examination * Associated conditions and symptoms * Management principles of joint hypermobility * Outro

Credits

Writer and Producer: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Linda Bluestein, MD

Disclosures
Dr. Bluestein reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: Quince
Go to Quince.com/curb for free shipping on your order and 365 returns.
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Shop data plans at MINTMOBILE.com/CURB to get 3 months of premium wireless service from Mint Mobile for $15 a month
Sponsor: Continuing Education Company
Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.

Lead the way in depression management! We’re joined by Dr. Jessi Gold, a psychiatrist and mental health advocate, who provides essential pearls on ways to recognize the multifaceted nature of depression and similarly presenting medical conditions. We also discuss the complexities of treatment options including various medication options and therapies, and how to choose between these treatments.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case 1 from Kashlak * Medical conditions that can mimic depression * Diagnosis of depression * How to explain depression to family * Initial treatment options for depression * Case 2 from Kashlak * Suicide risk assessment * Trialing, augmenting, and tapering of medications * Pharmacogenetic testing * Alternate treatment options: TMS, ECT, ketamine, psilocybin, cannabis * Outro

Credits
* Written and Produced by: Zoya Surani * Show Notes, Infographic, and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai Achi MD,MBA,FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jessi Gold, MD

Disclosures
Dr. Gold reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Sponsor: Panacea Financial
Visit PanaceaFinancial.com to explore financial solutions designed to make your life better.
Sponsor: FIGS
Go to WearFIGS.com and use the code FIGSRX to get 15% off your first order.
Sponsor: Ezresus
Listeners of the Cribsiders get access to a 2-month free trial, letting them use 100% of the features of the app. For more information visit www.ezresus.com/curbsiders

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Visit Freed.ai and use code CURB50 to get $50 off your first month when you subscribe!

Updates in classification, evaluation, and treatment

Become dexterous with dementia management! We’re talking with Dr. Anna Chodos about cognitive domains, diagnostic criteria, patient and caregiver resources, new antibody therapies, and brain health plans!

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Rapid fire questions * The Terminology of Neurocognitive Disorders * Cognitive Domains: A Comprehensive Approach * Physical Examination Insights * Medical Workup for Dementia * Imaging and Biomarkers in Dementia Diagnosis * Referral Considerations for Dementia Patients * Understanding Dementia Stages and Prognosis * Implementing Brain Health Plans * Medications for Dementia Management * Controversies in Monoclonal Antibody Therapies * The Importance of Early Detection and Planning * Outro *

Credits
* Producers, Writers and Show Notes: Leah Witt, MD and Margaret Heller, MD * Infographic and Cover Art: Leah Witt, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Anna Chodos, MD

Disclosures
Dr. Chodos received remuneration from Novo Nordisk for participating in a task force looking at the feasibility of incorporating biomarkers for Alzheimer's disease into primary care. The financial relationship has ended. The Curbsiders report no relevant financial disclosures.

The production of this episode was supported by the Penn Geriatrics AGE-SMART Geriatric Workforce Enhancement Grant. This podcast content is solely the responsibility of the authors and does not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services.

Sponsor: Locumstory
Locumstory.com is simply a free, unbiased educational resource about locum tenens.
Sponsor: Grammarly
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Sponsor: Continuing Education Company
Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount. Whether live, online, or on-demand, Continuing Education Company makes earning CME easy and rewarding.

Join us as we review recent practice-changing articles on suzetrigine for acute pain, the risk of PAD events from SGLT2 inhibitors, the safety of very low LDL, and the benefits of restrictive vs liberal transfusion strategies in acute MI with anemia. Fill your brain hole with a delicious stack of hotcakes! Featuring Rahul Ganatra (@rbganatra), Matt Watto (@doctorwatto), and special guest Molly Brett (Paul Williams got a break and took a much-needed vacation this week!).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Molly Brett MD, and Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Leah Witt, MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, guest introduction, disclaimer * Cognitive safety of very low LDL Cholesterol * Suzetrigine for acute pain * Risk for amputation associated with SGLT2 inhibitors * Transfusion strategies in acute MI with anemia revisited * Outro

Sponsor: Freed
Visit Freed.ai and usecode: CURB50 to get $50 off your first month when you subscribe.

Sponsor: Ezeresus
Listeners of the Curbsiders podcast get access to a 2-month free trial, letting them use 100% of the features of the app. For more information visit www.ezresus.com/curbsiders
Sponsor: Bombas
Enjoy worldwide shipping to over two hundred countries. Head over to Bombas.com/curb and use code curb for 20% off your first purchase.

Sponsor: Continuing Education Company
Special offer for Curbsiders listeners: Save30% on all online courses and live webcasts with promocode CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.

Make MAUD your topira-MATE

Level up your treatment for people with alcohol use disorder. Learn about medication options beyond the first line, when they’re appropriate and not, and how to work with your patients to set goals that fit them. We’re joined by Dr Stephen Holt (Yale University School of Medicine)

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!
Credits
* Written, produced, show notes, cover art and infographics by: Shawn Cohen MD * Hosts: Carolyn Chan, MD. MHS, Shawn Cohen MD, and Paul Williams MD * Reviewer: Kento Sonoda MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Stephen Holt MD

Sponsor: Pretty Litter
Go to Prettylitter.com/curb to save twenty percent on your first order and get a free cat toy.
Sponsor: Quince
Go to Quince.com/curb for 365-day returns, plus free shipping on your order.
Sponsor: American College of Physicians Inc
Internal Medicine Board Review Courses and offered in the Greater Chicago area May 13-17 and, new for 2025, Philadelphia, July 14-18. • Enter code COURSECS25 toSave $75 dollars when registering for the Philadelphia course by 6/1. Registration is open now at acponline.org Sponsor: Ezresus
Listeners of the Curbsiders get access to a 2-month free trial, letting them use 100% of the features of the app. Go to .ezresus.com/curbsiders and use promo code Curbsiders

2024 ACC/AHA guideline update, including biomarker testing, MINS, and other consulting tips

Master perioperative medicine! Learn when to hold ACE inhibitors, how to manage OSA without delaying surgery, and why "NPO after midnight" is outdated. We’re joined by Dr. Avital O’Glasser, our Chief of Perioperative Medicine!

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case * Preoperative Assessment & Consulting Tips * Risk Calculators * Frailty * Pulmonary Considerations * Cardiovascular Meds & BP Management * NPO: Why Are We Still Doing This? * Biomarkers & Postoperative Risk * MINS * Outro

Credits

Written and produced, show notes, cover art, CME, and infographics: Paul Wurtz MD.
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Avital O’Glasser MD

Disclosures
Dr. O’Glasser reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Sponsor: EZResus
Listeners of the Cribsiders and Curbsiders podcasts get access to a 2-month free trial,letting them use 100% of the features of the
For more information, www.ezresus.com/curbsiders and Use promo code Curbsiders
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Treat Hypertension Like No Doctor Has Ever Treated Hypertension Before

Treating hypertension never gets boring. Learn about emerging therapies and how to continue to tackle this common diagnosis like a pro. Dr. Jordy Cohen (@jordybc.bsky.social) leads us through her approach to keeping the BP where it should be (University of Pennsylvania).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Introduction and Current Interests * 01:55 Understanding Hypertension * 11:59 Blood Pressure Measurement Techniques * 19:58 Treatment Goals and Guidelines for Hypertension * 30:02 Managing Resistant Hypertension and New Treatments * 36:00 Exploring GLP-1 Agonists and Blood Pressure Benefits * 39:06 Aldosterone Synthase Inhibitors: A New Hope * 42:00 Innovative Approaches: Small Interfering RNAs in Hypertension * 47:06 Renal Denervation: A Controversial Procedure * 55:01 Understanding Resistant Hypertension and Testing Protocols

Credits
* Writer and Producer: Deborah Gorth MD, PhD * Show Notes: Ben Furman and Deborah Gorth MD, PhD * Cover Art and Infographic: Deborah Gorth MD, PhD and Meryl Gorth RD, MPH * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai Achi MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jordana Cohen MD, MSCE

Disclosures
Dr. Jordana Cohen and The Curbsiders report no relevant financial disclosures.

Sponsor: Factor
Eat smart with Factor. Get started at factormeals.com/factorpodcast and use code FACTORPODCAST to get 50% off your first box plus free shipping.
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This is a special offer for Curbsiders listeners. Visit www.CMEmeeting.org/curbsiders to save 30% on all online courses and live webcasts with promo code CURB30.

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Don’t miss a beat as our guest Dr. Noble Maleque guides us through dominating narrow complex tachyarrhythmias (while keeping our own heart rates under control too). @Nobility75 (Emory University)

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Show Segments
* Intro * Case 1, part 1: Unstable narrow tachyarrhythmias * Case 1, part 2: Stable, narrow tachyarrhythmias – regular rhythm * Vagal tone: Valsalva, Modified Valsalva, or Carotid Massage? * Adenosine * 2nd line AV nodal blockade: metoprolol, diltiazem * Case 2: Stable, narrow tachyarrhythmias – irregular rhythm * AV nodal blockade * Amiodarone and diltiazem * Rapid fire questions/Picks of the Week * Outro

Credits
Please consolidate if performing multiple jobs (e.g. Written and Produced by: Cyrus Askin MD; cover art and infographic by Kate Grant)* Producer, writer, Infographic, cover art, and show notes by: Caroline Coleman, MD * Hosts: Meredith Trubitt, MD and Monee Amin, MD * Reviewer: Rahul Ganatra, MD MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Noble Maleque, MD

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Join us as we review recent articles and news featured in The DIGEST issues #59-61, including cfDNA and incidental detection of cancer in pregnancy, vitamin K2 for nocturnal leg cramps, the danger of as-needed anti-hypertensive medications in the hospital, GLP-1 agonists for alcohol use disorder, short-course (7 vs 14 days) antibiotics for bacteremia, and patient-collected HPV testing for cervical cancer screening. Fill your brain hole with a fully digestible meal! Featuring Laura Glick MD, Nora Taranto (@norataranto), Paul Williams (@paulnwilliamz), and Matt Watto (@doctorwatto).

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Show Segments
* 00:00 Introduction and Overview * 02:57 The IDENTIFY study: Non-Invasive Prenatal Testing and Cancer Detection with cfDNA * 05:54 Implications of Non-Reportable Results in Prenatal Testing * 08:51 Vitamin K2: A New Approach to Managing Nocturnal Leg Cramps * 12:07 Practicality and Future of Vitamin K2 in Clinical Practice * 23:21 The Dangers of As-Needed Antihypertensives in the hospital * 32:21 Exploring GLP-1 Agonists for Alcohol Use Disorder * 40:24 Shorter Antibiotic Courses in Sepsis * 46:09 Advancements in Patient-Collected HPV Screening for cervical cancer

Credits
* Written and Produced by: Nora Taranto MD, Laura Glick MD, Matthew Watto MD, FACP; Paul Williams MD, FACP * Show Notes: Nora Taranto MD * Cover Art: Matthew Watto MD, FACP * Hosts: Nora Taranto MD, Laura Glick MD, Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

Disclosures
The Curbsiders report no relevant financial disclosures.
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Conquer the art of managing patients with iron deficiency anemia. We are joined by the amazing Dr. Tom DeLoughery, @Bloodman (Oregon Health & Science University).

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Show Segments
* Intro * Rapid fire questions/Picks of the Week * Case * History and Physical * Laboratory Findings * Management of Iron Deficiency Anemia * Diet * Oral Supplementation * Unexplained Iron Deficiency * Case 2 * IV Iron Supplementation * IV iron reactions * Case 3 * Laboratory Follow Up Post Supplementation * When to Refer to a Hematology/Oncology specialist? * Outro

Credits
* Producer,Writer, Show Notes, Cover Art, and Infographics: Sai S Achi MD MBA FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Tom DeLoughery MD, MACP, FAWM

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Management and Ongoing Monitoring of Thyroid Neoplasms

Join us as we dive deep into the approach for thyroid nodules with our two fantastic guests, Dr. Kaniksha Desai (Stanford Medicine) and Dr. Ana Chindris (Mayo Clinic)! Learn how to stratify these nodules for cancer risk and walk alongside our patients during treatment for thyroid cancer.

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Show Segments
* Intro, guest bios * Case From Kashlak * Thyroid nodule evaluation and management * Thyroid cancer diagnosis and treatment * GLP-1s relationship to thyroid nodules and cancer * Outro

Credits
* Writer, producer, show notes, infographic, cover art: Alise Burke, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Kaniksha Desai MD and Ana Chindris MD

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Diuresing ‘til the heart's content

Master inpatient heart failure management! Learn key tips for initiating guideline-directed medical therapy, diuretic therapy pearls, and ensuring smooth transitions of care. We are joined by Dr. Gurusher Panjrath @PanjrathG (GW School of Medicine and Health Sciences-Dr. Panjrath)

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Show Segments
* Intro * Rapid Fire Questions/Picks of the Week * Case Aliquot 1 * Defining Heart Failure * POCUS in Heart Failure * Timing/Indications for Echocardiography * Initiating Diuretic Therapy * Adjusting Diuretic Therapy/Drip vs Bolus * Adjunct Diuretic Therapy * Afterload Reduction * Monitoring Diuretic Response * Inpatient Sodium and Fluid Restriction * Case Aliquot 2 * Classifying Heart Failure * Pharmacotherapy for HFrEF * Pharmacotherapy for HFpEF * Ischemic Evaluation * Interval Summary/Highlights * Case Aliquot 3 * Considerations for Initial Care of Cardiogenic Shock * Choosing Inotrope/Vasopressor * Right Heart Catheterization * Case Aliquot 4 * Discharge Medications for Heart Failure * Titration of Goal Directed Medical Therapy * Post Discharge Follow Up * Washout Period for ACEi/ARB * Cost/Barriers of ARNI * Patient Education * Take Home Points * Outro

Credits
* Writer, Producer, and Show Notes by: Reaford Blackburn, Jr., MD * Infographic & Cover Art: Caroline Coleman MD * Hosts: Monee Amin, MD and Meredith Trubitt, MD * Reviewer: Rahul Ganatra MD * Technical Production: PodPaste * Guest: Gurusher Panjrath, MD

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2024 GINA Strategy, peak expiratory flow insights, SMART therapy, and other asthma pearls that will leave you breathless

Master the art of diagnosing and managing asthma with practical, evidence-based strategies. Learn how to approach the initial interview, gain comfort with key diagnostic tools like spirometry and PEF, and optimize therapy using the latest GINA report. We’re joined by Dr. Cyrus Askin, a longtime Curbsiders member returning as our guest expert to share his insights as a pulmonologist.

X profile (formerly twitter): @Askins_Razor

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Show Segments
* Intro * Case * Topic * Rapid fire questions/Picks of the Week * Outro

Credits
Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD, MBA, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Cyrus Askin MD

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Become a mini geriatrician in our new Geriatrics series!

Geriatricize your knowledge of caring for older adults with unintentional weight loss! You’ll round out your history taking and weight gain plan by harnessing the age-friendly “5Ms”. We’re joined by Dr. Eva Szymanski (@eva_szy), expert geriatrician at Penn Medicine.

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Show Segments
* Intro * Rapid fire questions * Case * Defining Unintentional Weight Loss * Applying the Geriatric 5Ms Framework * Diagnostic Work-Up * Addressing Ageism in Medical Decisions * Defining Geriatric Syndromes * Weight Loss Treatments * Outro

Credits
* Producer: Leah Witt, MD, Rachel Miller, MD, MSEd * Writers: Abigail Schmucker, MD, Joseph Young, MD, Margaret Heller, MD, Alyson Michener, MD, Leah Witt, MD * Show Notes, Infographic and Cover Art: Leah Witt, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Molly Heublein, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Eva Szymanski, MD

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Update your approach to cirrhosis evaluation and management with Dr. Scott Matherly Associate Professor of Hepatology and Gastroenterology at Virginia Commonwealth University

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Show Segments
* Intro, disclaimer, guest bio * Case from Kashlak; Definitions * Cirrhosis Diagnosis and Initial Evaluation * Cirrhosis Physical Examination * Decompensated Cirrhosis Management * Ascites and TIPS * MELD and transplant consideration * Outro

Credits
* Written and Produced by: Elena Gibson MD * Infographic and Cover Art: Edison Jyang MD * Hosts: Paul Williams MD, FACP; Elena Gibson MD * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Scott Matherly MD

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We're taking a short winter break, but we’ll be back with new shows in time for Christmas and New Years! Can’t wait for more new episodes? Sign up for our Patreon with 15% off an annual membership at patreon.com/curbsiders (https://www.patreon.com/c/curbsiders) and get instant access to 40 plus bonus episodes!

Conquer your fear of antiphospholipid syndrome! Dr. Arielle Langer leads us through what clinical features raise suspicion for antiphospholipid syndrome, how to interpret laboratory testing, and the nuances of antiphospholipid syndrome management.

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Join us as Monee and Meredith with the rest of the hospital medicine team reflect on the past year, discussing some favorite insights gained covering a range of topics, including diabetic foot infections, sepsis, sickle cell inpatient management, syncope, psychiatry for the hospitalist, and acute coronary syndrome.

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Show Segments
* Introduction * Picks of the Year * Diabetic Foot Infections * Sepsis * Sickle Cell Inpatient Management * Psychiatry Primer * Syncope * Acute Coronary Syndrome * Reflections from the Year

Credits
* Written, Produced, and hosted by: Meredith Trubitt MD; Monee Amin MD * Script Written: Caroline Coleman, MD, RJ Blackburn, MD * Cover Art: Caroline Coleman, MD * Reviewer: Rahul Ganatra MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

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Join us as Paul and Watto reflect on the past year, discussing some favorite insights gained covering a range of topics, including dental pain management, cardiac amyloidosis, the impact of continuous glucose monitoring on diabetes care, the complexities of diagnosing primary hyperparathyroidism, hepatitis B screening and vaccination, GLP-1 agonists, travel medicine, endometriosis, rhinitis, and recurrent UTIs. Plus, we feature listener voicemails sharing their favorite episodes and why they love the Curbsiders!

No CME for this episode, but claim CME for past shows at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Introduction and Year-End Reflections * 02:59 Picks of the Year * 05:53 Dental Pain and Oral Care Insights * 10:25 Cardiac Amyloidosis * 14:33 Listener mail- diabetes * 16:33 Neck Pain * 19:08 Continuous Glucose Monitoring in Diabetes * 23:57 Hyperparathyroidism * 30:48 Hepatitis B * 34:01 Listener mail- obesity * 36:14 Travel Medicine: Malaria, Diarrhea, and Vaccination * 40:38 Endometriosis * 46:08 Rhinitis and Environmental Allergies * 49.24 Recurrent UTIs * 55:08 Reflections on Nine Years of Curbsiders

Credits
* Written, Produced, and hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP * Cover Art: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Molly Heublein MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

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We're taking a short winter break, but we’ll be back with new shows in time for Christmas and New Years! Can’t wait for more new episodes? Sign up for our Patreon with 15% off an annual membership at patreon.com/curbsiders (https://www.patreon.com/c/curbsiders) and get instant access to 40 plus bonus episodes!

Elevate your primary care management of anxiety. Become confident in counseling patients about a new anxiety diagnosis, 2nd and 3rd line medications, augmentation for anxiety treatment, and options for non-pharmacological anxiety treatment. We are joined by psychiatrist and mental health expert Dr. Jessi Gold, @drjessigold (University of Tennessee System; drjessigold.com). Check out her book, How Do You Feel?

Visit our website for detailed show notes for this episode.

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We're taking a short winter break, but we’ll be back with new shows in time for Christmas and New Years! Can’t wait for more new episodes? Sign up for our Patreon with 15% off an annual membership at patreon.com/curbsiders (https://www.patreon.com/c/curbsiders) and get instant access to 40 plus bonus episodes!

Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!

Visit our website for detailed show notes for this episode.

Claim free CME for this episode at curbsiders.vcuhealth.org**!

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We're taking a short winter break, but we’ll be back with new shows in time for Christmas and New Years! Can’t wait for more new episodes? Sign up for our Patreon with 15% off an annual membership at patreon.com/curbsiders (https://www.patreon.com/c/curbsiders) and get instant access to 40 plus bonus episodes!

Diagnosing and treating bipolar disorder is not always black-and-white. Dr. Kevin Johns teaches us how to not get tripped up on this tricky diagnosis. (The Ohio State University Wexner Medical Center)

Visit our website for detailed show notes for this episode.

Claim free CME for this episode at curbsiders.vcuhealth.org**!

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Join us as we review recent practice-changing articles on a new triple pill for hypertension, how arm position affects blood pressure, early TAVR for asymptomatic patients with severe AS, liberal versus restrictive transfusion strategy in patients with acute brain injury, and a quick overview of the 2024 ACC/AHA perioperative medicine guidelines. Fill your brain hole with a delicious stack of tofurkey cakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Jen DeSalvo (@drjendesalvo), and Matt Watto (@doctorwatto).

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Jen DeSalvo MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Rahul Ganatra MD, MPH * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * A new triple pill for hypertension * How arm position affects blood pressure * Early TAVR for asymptomatic patients with severe AS * Liberal versus restrictive transfusion strategy in patients with acute brain injury * A quick overview of the 2024 ACC/AHA perioperative medicine guidelines * Outro

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Risks/benefits in older males, when to test, fertility considerations, and more.

Master male hypogonadism diagnosis and management. Discover when and how to test, how to tackle confounding conditions, and why lifestyle changes may be more effective than testosterone therapy in certain patients. We are joined by Dr. Brad Anawalt, an expert in endocrine care, to guide us through the essentials.

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Show Segments
* Intro * Case 1 * History and Physical * Laboratory Testing * Effect of Lifestyle on Testosterone * Case 2 * Prostate and Cardiovascular risk * Treatment Options and Considerations * Secondary Causes of Hypogonadism * Case 3 * Testicular Size and Klinefelter Syndrome * hCG and Clomiphene * Monitoring and Follow-Up * Take-Home Points * Outro

Credits
* Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD. * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Bradley D. Anawalt MD

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You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
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As a special holiday offer, Whisker is offering up to $100 off Litter-Robot bundles. AND, as a special offer to listeners, you can get an additional $50 off when you go to stopscooping.com/CURB.

A Bell-Ringer of a Presentation

Is it a stroke or is it botox? No, it’s Bell’s palsy! Learn how to differentiate facial palsy from other sinister diagnoses. Join us as Dr. Jordan Amar (Assistant Professor of Clinical Neurology at USC Keck School of Medicine) gives us Bell’s palsy pointers (and a great mnemonic, if there is such a thing).

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Show Segments
Introduction * Rapid fire questions and Reflex Hammers * Case #1: Ms. Melanie * Framework for Bell's Palsy * Bell's Palsy vs Stroke: How to Differentiate * Approach to History and Physical Exam * Case #2: Mr. Lopez * Red Flags in Facial Palsy (GROWLS FACE)* * Workup: From Imaging to Labs and What Not to Do * Treatment: The Role of Steroids and Antivirals * Supportive Care, Complications and Prognosis * Take-Home Points * Outro

Credits
* Producer and Writer: Isabel Valdez, PA-C * Show Notes: Paul Wurtz MD, Ben Furman MPH MS3, Isabel Valdez, PA-C * Infographic and Cover Art: Zoya Surani, MS2 * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jordan Amar, MD

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Preserve your sanity while treating heart failure with preserved ejection fraction. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) illuminates this confounding cardiac condition.

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Show Segments
* 00:00 Introduction and Advice for Physicians * 02:24 Case Presentation * 04:16 Understanding HFpEF * 08:11 Differential Diagnosis of Dyspnea and Edema * 11:30 Diagnosing HFPEF: H2F-PEF Score and Testing * 17:07 Managing Comorbidities in HFpEF * 20:54 Non-Pharmacological Interventions: Weight Loss and Exercise * 23:16 Understanding the Challenges of HFpEF * 25:08 Medications * 30:13 Promising Results of GLP-1 Receptor Agonists * 36:38 Managing Salt and Water Intake

Credits
* Writer and Producer: Deborah Gorth MD, PhD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Michelle Kittleson MD, PhD

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Join us as we review recent articles and news featured in The DIGEST issues #56 and #57, including finerenone for heart failure, the skinny on pneumonia vaccines and the latest, PCV21, long-term oxygen therapy (the REDOX trial), and the PREVENT vs PCE cardiovascular risk equations. Fill your brain hole with a fully digestible meal! Featuring Alex Chaitoff (@alexchaitoff), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).

Note: *Update on Pneumonia Vaccine from ACIP:* After we recorded and just before we published this episode, the CDC updated its vaccine guidance to include pneumonia vaccination for all adults aged 50 years and older to receive either PCV20, PCV21, or the combination of PCV15 followed by PPSV23 one year later (CDC site accessed 24 Oct 2024).

Claim CME for this episode at curbsiders.vcu health.org!

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Credits
* Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH, Alex Chaitoff MD, MPH, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD * Reviewer: Emi Okamoto MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP

Show Segments
* Introduction + Pun * Exploring Finerenone in Heart Failure * Pneumonia Vaccines: The PCV21 Trial * Long-Term Oxygen Therapy: The REDOX Trial * Cardiovascular Risk Calculators: The PREVENT Equation

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Kittleson Rules Outpatient Heart Failure Volume 1

Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) breaks down the nuances of treating this common cardiac condition.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Introduction * 03:22 Case Presentation: Newly Diagnosed Heart Failure * 07:26 Using Physical Exam Findings to Guide Diuresis * 11:58 The Four Pillars of Guideline-Directed Medical Therapy for Heart Failure * 15:07 Optimizing Therapy and Follow-Up in Heart Failure Patients * 22:10 The Benefits of High-Intensity Initiation and Titration of Guideline-Directed Medical Therapy * 28:02 Consideration of Other Medications * 40:02 Referral to Advanced Heart Failure Specialist * 49:11 Optimizing Therapy and Follow-Up * 55:33 Conclusion and Book Recommendation

Credits
* Writer and Producer: Deborah Gorth MD, PhD * Infographic and Cover Art: Zoya Surani * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Michelle Kittleson MD, PhD

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Sponsor: Beginly Health
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Treating colds, flu, and more with Dr Amber Bird!

Dive deep into upper respiratory viral infections with Dr Amber Bird, MD (Penn). Feel confident on when to order testing, recommend symptom relieving treatments, and avoid unnecessary antibiotics.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Introduction and Setting the Agenda * 03:07 Getting to Know the Guest and Rapid Fire Questions * 05:51 Case from Kashlak: Mateo with Common Cold Symptoms * 06:12 Defining and Diagnosing the Common Cold * 09:08 Approach to History and Physical Exam * 13:23 Viral Respiratory Testing and Its Indications * 17:36 Symptomatic Treatment Options for the Common Cold * 24:25 Managing Cough and Nasal Congestion * 35:03 Home Remedies and natural products * 42:16 Prescribing Antivirals for Influenza * 46:33 Antibiotics and Counseling Patients * 52:07 Contagiousness and Risk to Family Members * 54:52 Recurring Colds and Risk Factors * 59:38 Vaccination recommendations * 01:01:23 Key Takeaways and Conclusion

Credits
* Producer: Leah Witt, MD and Molly Heublein, MD * Show Notes/CME: Molly Heublein, MD * Cover Art and Infographic: Leah Witt, MD * Hosts, writers: Leah Witt and Molly Heublein, MD * Reviewer: Fatima Syed, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Amber Bird, MD

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Transcript available via YouTube

Supplemental oxygen is ubiquitous and yet there is a tremendous amount of uncertainty related to prescription and management in the outpatient setting. Have no fear, we’ve got your back! On this episode of The Curbsiders we host special guest Susan Jacobs, RN, MS who is a bonafide, world-class expert in outpatient oxygen therapy. How to prescribe? What’s out there? What do you do when your patient travels? She joins us to tackle these questions and so much more so make sure to tune in and snag some knowledge food for that old brain hole!

Disclosures
Susan Jacobs reports no relevant financial disclosures.. The Curbsiders report no relevant financial disclosures.

Citation
Witt L, Askin C, Jacobs S, Williams PN, Watto MF. “456 Outpatient Oxygen Therapy”. The Curbsiders Internal Medicine Podcast. thecurbsiders.com/category/curbsiders-podcast Final publishing date October 07, 2024.

View full show notes at thecurbsiders.com

De-stress your approach to stress fractures (and trochanteric pain syndromes and meniscus tears)!

Follow along as the great Dr. Senter guides us through the diagnosis, workup, and treatment of an all-star lineup of sport injuries. Part 2 covers stress fractures, relative energy deficiency in sports, trochanteric pain, meniscus tears, and the ongoing quest to diagnose Paul’s mysterious hip injury.

Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME
Show Segments
* Case 1 - Hip stress fracture * Approach to hip injuries in runners * Relative Energy Deficiency in Sports (RED-S) * Imaging consideration for bone stress injuries * Surgical and treatment consideration for hip stress fractures * Osteoporosis evaluation * Case 2 - Greater trochanteric pain syndrome * Hip and trochanter anatomy * Treatment and imaging of trochanteric tendinopathies * Case 3 - Meniscus tear * Knee evaluation and physical exam * Bucket handle tears and surgical considerations * Special physical exam maneuvers * Imaging and further surgical considerations * Outro & Take Home Points

Credits
* Producer and Show Notes: Peter Wikoff MD * Writer, Infographic and Cover art: Edison Jyang MD * Reviewer: Sai S Achi MD MBA FACP * Hosts and Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Carlin Senter MD

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You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Produced by: Fatima Syed, MD, MSc * Infographic and Cover Art: Zoya Surani, MD * Show Notes: Fatima Syed, MD, MSc * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi, MD, MBA, FACP * Showrunners: Matthew Watto MD, FACP and Paul Williams MD, FACP * Technical Production: Pod Paste * Guest: Joel Topf, MD

Sponsor: Mint Mobile
To get this new customer offer and your new 3-month premium wireless plan for just 15 bucks a month, go to mintmobile.com/CURB.
Sponsor: ClinicalKey AI
ClinicalKey AI is an award-winning solution that combines trusted, evidence-based clinical content with conversational search powered by generative AI. To unlock the power of AI in clinical decision-making with ClinicalKey AI, visit Elsevier.health/AI”
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You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Follow along as the great Dr. Senter guides us through the diagnosis, workup, and treatment of an all-star lineup of sport injuries. Part 1 covers concussions, femoroacetabular impingement (FAI), and the ongoing quest to diagnose Paul’s mysterious hip injury.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
00:00 Introduction
08:43 Case 1 - Concussion
9:39 Approach and Workup of Concussions
18:08 Treatment of Concussions (Return to Activity)
24:10 Consideration of Head Imaging
33:20 Case 2 - Hip Pain (FAI)
34:15 Hip Anatomy and Differential Diagnosis
38:41 Hip Physical Exam
45:41 Hip Imaging
47:28 Treatment of FAI
Outro & Take Home Points

Credits
* Producer and Show Notes: Peter Wikoff MD * Writer, Infographic and Cover art: Edison Jyang MD * Reviewer: Sai S Achi MD MBA FACP * Hosts and Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Carlin Senter MD

Sponsor: ClinicalKey AI
ClinicalKey AI is an award-winning solution that combines trusted, evidence-based clinical content with conversational search powered by generative AI. To unlock the power of AI in clinical decision-making with ClinicalKey AI, visit Elsevier.health/AI
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

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Get up to 60% off your Babbel subscription - but only for our listeners at Babbel.com/CURB.

Expand your NAFLD/MASLD knowledge!

Expert guest Dr. Elliot Tapper (@ebtapper) shares his framework for approaching NAFLD/MASLD and the treatment tools he recommends including lifestyle modifications and medications.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Rapid Fire Segment * Case 1 Part 1 * NAFLD/MASLD terminology and differential diagnoses * PEth testing * Diagnostic tools for NAFLD/MASLD: Fib4 Score * Imaging * When to Refer to a Hepatologist? * Treatment options * Lifestyle modifications * Role of GLP-1 agonists * Role of new FDA approved medications * Outro

Credits
* Producer: Sai S Achi, MD, MBA, FACP; Matthew Watto MD, FACP * Writer, Show Notes, Cover Art, and Infographics: Sai S Achi, MD MBA, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Elliot Tapper MD

Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: The University of Vaginia
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Quit playing games with my heart

Yet another beat no to skip here with part 2 of our conversation with cardiologist Dr. Sanjeev Francis (@, Maine Medical Center)for acute coronary syndrome. Learn about the warranty on stress tests, initial management of ACS and how to deal with those pesky elevated troponins from patients with sepsis.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Start Part 1 * Intro * Rapid fire questions/Picks of the Week * Case 1 * History and Physical * ECGs * Definitions * Risk Stratification Tools * Non-invasive Testing Options * End Part 1 * Start Part 2 * Case 2 * Warranty on Non-invasive Testing * Invasive Management of non ST elevation ACS * Medical Management of non ST elevation ACS * Case 3 * Myocardial Injury Definitions * Diagnostics to Consider for Myocardial Injury * Transitions of Care * Outro * End Part 2

Credits
* Producer, Writer, Show Notes, Hosts: Meredith Trubitt, MD, MPH, Monee Amin MD * Infographic, Cover Art: Caroline Coleman, MD * Reviewer: Rahul Ganatra, MD, MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Sanjeev Francis, MD

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Sponsor: Freed

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If you’re ready to join the thousands of doctors who have declared independence from traditional banks, visit panaceafinancial.com today.

Quit playing games with my heart

Don’t skip a beat and join us in part 1 of our conversation with cardiologist Dr. Sanjeev Francis (@, Maine Medical Center)for acute coronary syndrome. First up, the basics on physical exam, how to interpret high-sensitivity troponin and how to think through the spectrum of acute coronary syndrome.

Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments
* Start Part 1 * Intro * Rapid fire questions/Picks of the Week * Case 1 * History and Physical * ECGs * Definitions * Risk Stratification Tools * Non-invasive Testing Options * End Part 1 * Start Part 2 * Case 2 * Warranty on Non-invasive Testing * Invasive Management of non ST elevation ACS * Medical Management of non ST elevation ACS * Case 3 * Myocardial Injury Definitions * Diagnostics to Consider for Myocardial Injury * Transitions of Care * Outro * End Part 2

Credits
* Producer, Writer, Show Notes, Hosts: Meredith Trubitt, MD, MPH, Monee Amin MD * Infographic, Cover Art: Caroline Coleman, MD * Reviewer: Rahul Ganatra, MD, MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Sanjeev Francis, MD

Sponsor: Mint Mobile
To get your new 3-month premium wireless plan for just 15 bucks a month, go to mintmobile.com/CURB.
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You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off your first month.

Sponsor: American College of Physicians
Preorder ACP MKSAP to receive discounted pricing plus free MKSAP 19 premium content you can use now at acponline.org/acpmksap

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.

Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more.

Claim CME for this episode at curbsiders.vcuhealth.org!Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Show Segments
* Intro, disclaimer, guest bios * Guest one-liners, Introduction to Nephmadness 2022 * Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine * Definition and pathophysiology of cardiorenal syndrome * Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome * Case #2 from Kashlak: the creatinine bump with diuresis * Approach to the creatinine bump with diuresis * Tips for the volume exam * Interpreting cardiac biomarkers in patients with chronic kidney disease * Case #3 from Kashlak: diuretic resistance * Maximizing loop diuretic efficacy * Sequential nephron blockade * Use of hypertonic saline * Outro

Credits
* Producer, Writer, Show Notes, Infographics: Malini Gandhi * Cover Art: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD, FACP * Executive Producer: Beth Garbitelli * Showrunner: Matthew Watto MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD

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AKI Tips and Tricks from Joel Topf MD, Kashlak’s Chief of Nephrology

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

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Credits
* Written (including CME questions) and Produced by: Cyrus Askin, MD * Infographic by: Cyrus Askin, MD * Cover Art: Kate Grant MBChb, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: Joel Topf, MD

Time Stamps
00:00 Sponsors - VCU Health CE and Pediatrics On Call podcast by APP * 00:30 Intro, disclaimer, guest bio * 03:00 Guest one-liner, Picks of the Week: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); * 08:45 Sponsor - Pediatrics On Call podcast by APP * 09:15 Definition of acute kidney injury (AKI) and fundamentals * 11:00 Cardiorenal syndrome * 12:24 Schema for AKI * 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities * 21:22 AKI in the otherwise-healthy patient; * 32:20 Rhabdomyolysis 38:21 Vancomycin * 41:43 Acute interstitial nephritis (AIN) * 44:52 Contrast induced nephropathy (CIN) * 50:37 Gadolinium in AKI and/or CKD * 52:53 Timing of dialysis * 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; * 62:01 Is Ultrasound necessary in AKI * 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology * 68:45** Outro and Sponsor - VCU Health CE

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Your swell guide to the swollen leg

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.

We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.

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Show Segments
Intro, disclaimer * Picks of the Week * The case of Lynn Fedema * Pathophysiology of edema * Differential diagnosis of chronic edema * Chronic edema work-up * Management of chronic edema * Calvin Fedema and acute edema * Evaluation of acute edema * Outro

Credits
* Written and produced by: Paul Williams, MD, FACP * Infographic and Cover Art: Matthew Watto, MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli * Reviewer: Emi Okamoto, MD * Executive Producer: Beth Garbitelli * Showrunner: Matthew Watto, MD, FACP * Editor: Clair Morgan of nodderly.com

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We're taking a short summer break, but we'll be back at the end of August with brand new episodes.

This is an unlocked episode from our Curbsiders Patreon. You can sign up at Patreon.com/curbsiders.

We're taking a short summer break, but we'll be back at the end of August with brand new episodes.

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.

Claim CME for this episode at curbsiders.vcuhealth.org!

Credits
● Writer: Matthew Watto, MD, FACP
● Producers: Matthew Watto, MD, FACP and Malini Gandhi
● Show Notes, Infographic, and Cover Art: Malini Gandhi
● Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Reviewer: Emi Okamoto MD
● Executive Producer: Beth Garbitelli
● Showrunner: Matthew Watto MD, FACP
● Editor: Clair Morgan of nodderly.com
● Guest: Jordy Cohen MD

Show Segments
● Intro, disclaimer, guest bio
● Guest one-liner, Picks of the Week*
● Case from Kashlak: New diagnosis of hypertension
● How to make a diagnosis of hypertension
● When to start anti-hypertensive medication
● Initial blood pressure regimen
● Case from Kashlak: White coat hypertension
● Case from Kashlak: Hypertension in chronic kidney disease
● ACEis and ARBs in chronic kidney disease
● Diuretics in chronic kidney disease
● Case from Kashlak: Refractory hypertension
● History and initial workup for refractory hypertension
● Treatment of primary hyperaldosteronism
● Outro

OTP yea you know me

Make methadone a part of your practice. Learn how the methadone system in the US works and how you can play an active role in improving care for people with opioid use disorder treated with methadone. We’re joined by Dr. Ruth Potee @DrRuthPotee (website) and Dr. David Frank @highway_dave

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

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Show Segments
* Intro, disclaimer, guest bio * 5:00 Guest one-liner * 10:25 Case from Kashlak; Definitions * 11:19 Methadone pharmacology and evidence * 17:08 What an OTP feels like * 20:25 OTP intake * 24:45 Talking through methadone with a patient * 28:15 Personal impact of methadone * 30:20 Requirements at an OTP * 33:43 What your patient needs to access an OTP * 37:25 The line * 39:06 Dosing/Take homes * 44:48 Loss of take homes * 48:39 How to interact with an OTP as a PCP * 52:50 Methadone at STRs * 57:03 How to clinicians use their voice to improve things * 1:00:45 Take home points * 1:03:00 Plugs * 1:04:24 Outro

Credits
* Producer, Writer, Show Notes, Infographic, Cover Art: Shawn Cohen MD * Hosts: Carolyn Chan, MD. MHS and Shawn Cohen MD * Reviewer: Payel Jhoom Roy MD, MSc * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Ruth Potee MD, David Frank PhD

Get your patients ready to globetrot with our fantastic review of Travel Medicine with the esteemed Dr. Boghuma Titanji (@Boghuma)! We cover malaria, anti-malarial chemoprophylaxis, basics of treatment and management of traveler’s diarrhea, yellow fever, and vaccination guidance!

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Case 1 - Defining travel medicine * How to approach a travel clinic visit * Malaria basics, transmission and burden * Chemoprophylaxis for malaria * Basic guidance for mosquito avoidance and travel * Harm reduction, pregnancy and STI prevention, PrEP and doxyPEP * Case 2 - Traveler’s diarrhea * Food safety * When to treat traveler’s diarrhea * Case 3 - Yellow fever vaccine * General vaccination guidance * Take home points * Outro

Credits
* Producer, Writer, Show Notes & Graphics: Beth Garbitelli MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD * Reviewer:Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Boghuma Titanji MD, MSc., DTM&H, PhD

Sponsor: Babbel
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In this episode of The Curbsiders Podcast, the team delves into the recently updated breast cancer screening recommendations from the U.S. Preventive Services Task Force (USPSTF) with Dr. Wanda Nicholson (@wnicholsonobgyn), an expert in preventive medicine, diversity, equity and inclusion, and women's health and the Chair of the Task Force. Join us as we review the newest screening mammography recommendations, evidence for earlier screening for all women, the challenge of dense breast findings, and more. Importantly, we discuss disparities in breast cancer outcomes and the need to better understand and address them.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro and Guest Background * Case * Updated Breast Cancer Screening Recommendations * Rationale for screening age * Considerations for findings of dense breasts * Balancing benefits and harms * Racial disparities * Research Gaps * Outro

Credits

Producer, writer, show notes, infographic, and cover art: Fatima Syed MD
Hosts: Paul Williams MD, FACP and Fatima Syed MD
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Wanda Nicholson MD, MBA, MPH

Elevate your rhinitis management!

Learn from expert allergist Dr. Olajumoke Fadugba about rhinitis and environmental allergies. You’ll review how to distinguish between allergic and non-allergic rhinitis, and how to decode the drugstore allergy aisle for your patients!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments* Intro * Rapid Fire Questions * Case Part 1 * Allergic vs Non-Allergic Rhinitis * The Rhinitis History and Physical * Allergy skin testing * The Pathophysiology of Allergies * Oral, intranasal and ocular treatments * Case Part 2 * Allergy immunotherapy * Chronic sinusitis * Sinus rinses * Climate Change and Allergies * Outro

Credits* Producer: Leah Witt, MD & Matthew Watto MD * Writer, Show Notes, Infographic, and Cover Art: Leah Witt, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi, MD MBA * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Olajumoke Fadugba MD

Sponsor: Sponsor: Freed
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Anxious about psychiatry on the wards? Don’t be! Join us with guest Dr. Aaron Gluth (Emory University) as we learn about the role the hospitalist plays in managing co-morbid psychiatry conditions on the wards.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Rapid fire questions/picks of the week * Case * Pertinent history * Physical Exam including Mental Status Exam * Role of the multidisciplinary team * Work-up for reversible causes * Agitation management * Framework for capacity and challenging ethical scenarios * Mortality gap * Transitions of Care * Outro

Credits
* Producer, Writer, Show Notes, Hosts: Meredith Trubitt MD MPH, Monee Amin MD * Infographic and Cover Art: Caroline Coleman, MD * Reviewer: Rahul Ganatra, MD MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Aaron Gluth

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Join us as we review recent practice-changing articles on preventive PCI, andexanet alfa for ICH, aspirin for fatty liver, naltrexone in cirrhosis, pivmecillinam for UTI, cefepime vs pip-tazo, MDRO decolonization, microplastics and MACE, and more! Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Rahul Ganatra MD, MPH; Emi Okamoto MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * Preventive PCI * Andexanet alfa for ICH * Aspirin for MASLD * Naltrexone for AUD in cirrhosis * Pivmecillinam for UTI * MDRO decolonization * Cefepime vs pip/tazo * Microplastics * Pax-NO-vid * Outro

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Recorded LIVE! At Johns Hopkins Internal Medicine Grand Rounds

Step up your anemia game as we explore the causes and diagnostic approach for macrocytic anemia, what to do with a reticulocyte count, the differential diagnosis for hemolytic anemia, the significance of the direct antiglobulin test, and diagnosis and management pearls for autoimmune hemolytic anemia (AIHA) and myelodysplastic syndrome (MDS). Plus, common questions and concerns regarding folate supplementation and the use of bone marrow biopsies. We’re joined by hematologist and pun enthusiast Dr. Rakhi Naik MD, MHS, @redcell_doc @hopkinsheme.

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Show Segments
* 00:00 Intro and Guest intro * 05:53 Case 1: Elise - Macrocytic Anemia * 14:59 Case 2: Jane - Hemolytic Anemia * 23:24 Testing for Underlying Causes of Autoimmune Hemolytic Anemia * 24:40 Association of Autoimmune Hemolytic Anemia with Lymphomas * 25:10 Autoimmune Hemolytic Anemia: Diagnosis and Treatment * 26:06 Management Approach for Autoimmune Hemolytic Anemia * 27:30 Considerations for Outpatient Treatment of Autoimmune Hemolytic Anemia * 28:18 Clotting Risk in Autoimmune Hemolytic Anemia * 29:20 Treatment Options for Autoimmune Hemolytic Anemia * 30:42 Long-Term Prognosis and Recurrence of Autoimmune Hemolytic Anemia * 33:32 Diagnostic Challenges in Myelodysplastic Syndrome * 35:00 Considerations for Folate Supplementation * 36:24 Factors to Consider in the Management of Myelodysplastic Syndrome * 39:30 When to Perform a Bone Marrow Biopsy in Myelodysplastic Syndrome * 41:25 Shared Decision-Making in the Treatment of Myelodysplastic Syndrome

Credits
* Writer and Producer: Matthew Watto MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art and Infographic: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed MD, MSc * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Rakhi P. Naik MD, MHS

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Don’t just sit on that borderline calcium! Learn how to approach hypercalcemia and work up primary hyperparathyroidism. In this episode, we learn who goes to surgery, how to work them up, and some variants of typical primary hyperparathyroidism. We’re joined by Dr. Lindsay Kuo @lindsaykuo (Temple University Hospital)

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Show Segments
* 00:00 Intro * 03:31 Understanding Primary Hyperparathyroidism * 09:03 Handling Mistakes and Complications in Surgery * 11:44 Case Discussion: Hypercalcemia and Elevated PTH Levels * 22:41 Symptoms of Primary Hyperparathyroidism * 25:06 The Role of Vitamin D in Primary Hyperparathyroidism * 28:07 Testing Considerations for Parathyroid Hormone (PTH) Levels * 46:02 Considerations for Parathyroid Carcinoma * 49:19 Parathyroid Imaging in Primary Hyperparathyroidism * 52:23 The Surgical Procedure for Primary Hyperparathyroidism * 57:45 Intraoperative Parathyroid Hormone Monitoring * 01:00:15 Post-Operative Monitoring for Hypocalcemia * 01:04:38 Normocalcemic Primary Hypoparathyroidism and Normohormonal Primary Hyperparathyroidism

Credits

Written and produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Lindsay Kuo, MD

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Don’t pass up on passing out!

Stand up to syncope as Dr. Dan Dressler (Emory University) guides us to confidently manage cases! We review a framework for understanding different types of syncope, and strategies for determining which low-risk patients can be safely discharged, and appropriate next steps to work up those high-risk and in-between cases.

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Show Segments
* Intro * Picks of the Week * Case 1: Tamara * What is syncope? * Categorizing Syncope * Initial workup * Risk scores * Pulmonary embolism * Case 2: Travis * Cardiac evaluation * Take-home points * Outro

Credits
* Producer, Script and Show Notes: Emi Okamoto MD * Infographic and Cover Art: Caroline Coleman MD * Hosts: Monee Amin MD and Meredith Trubitt MD * Reviewer: Rahul Ganatra MD, MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Daniel D. Dressler, MD, MSc, MHM, FACP

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More clinical pearls from ACP #IM2024, including emerging infectious diseases in the US (malaria, dengue, super gonorrhea, and a resurgence of syphilis), new C. diff treatments, coagulopathy and cirrhosis, fatty liver disease, HFpEF, peripheral arterial disease, Lp(a) and ApoB, CAR T-cells for autoimmune disease, SGLT2i for gout, and hematology updates. Paul and Watto are joined by Drs. Nora Taranto, Beth Garbitelli, and of course Chris “The Chiu Man” Chiu.

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Show Segments
* 00:00 Tropical Diseases: Resurgence of Malaria and Dengue Fever * 03:44 Infectious Diseases: Syphilis Rates and New Treatments for C. diff * 08:28 Coagulopathy and Cirrhosis: Managing Hemostasis and Portal Vein Thrombosis * 11:34 Fatty Liver Disease: Risk Stratification and Treatment * 14:59 Cardiology Updates: Cardiovascular Kidney Metabolic Syndrome * 31:03 New Medications for Hypertension * 32:54 Renal Denervation and Hypertension * 33:51 Lp(a) Drugs and Their Potential * 36:01 Peripheral Arterial Disease and Claudication * 38:10 SGLT2 Inhibitors and Gout * 41:50 APO-B and LDL Cholesterol * 42:45 Secondary Hypogonadism and Head and Neck Radiation * 45:30 VEXAS: A Genetic Autoimmune Condition * 49:08 Obesity-Induced Leukocytosis * 52:49 CAR T-Cell Therapy in Rheumatologic Diseases

Credits* Producers/Writers/Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD, Chris Chiu MD, Beth Garbitelli MD * CME, Cover Art: Beth Garbitelli MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Nora Taranto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

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More clinical pearls from ACP #IM2024, including emerging infectious diseases in the US (malaria, dengue, super gonorrhea, and a resurgence of syphilis), new C. diff treatments, coagulopathy and cirrhosis, fatty liver disease, HFpEF, peripheral arterial disease, Lp(a) and ApoB, CAR T-cells for autoimmune disease, SGLT2i for gout, and hematology updates. Paul and Watto are joined by Drs. Nora Taranto, Beth Garbitelli, and of course Chris “The Chiu Man” Chiu.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* 00:00 Tropical Diseases: Resurgence of Malaria and Dengue Fever * 03:44 Infectious Diseases: Syphilis Rates and New Treatments for C. diff * 08:28 Coagulopathy and Cirrhosis: Managing Hemostasis and Portal Vein Thrombosis * 11:34 Fatty Liver Disease: Risk Stratification and Treatment * 14:59 Cardiology Updates: Cardiovascular Kidney Metabolic Syndrome * 31:03 New Medications for Hypertension * 32:54 Renal Denervation and Hypertension * 33:51 Lp(a) Drugs and Their Potential * 36:01 Peripheral Arterial Disease and Claudication * 38:10 SGLT2 Inhibitors and Gout * 41:50 APO-B and LDL Cholesterol * 42:45 Secondary Hypogonadism and Head and Neck Radiation * 45:30 VEXAS: A Genetic Autoimmune Condition * 49:08 Obesity-Induced Leukocytosis * 52:49 CAR T-Cell Therapy in Rheumatologic Diseases

Credits* Producers/Writers/Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD, Chris Chiu MD, Beth Garbitelli MD * CME, Cover Art: Beth Garbitelli MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Nora Taranto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

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Become a pro in Hepatitis B! Dr. Arthur Kim teaches us how to approach Hepatitis B screening and vaccination in primary care, provides pearls on counseling patients with chronic Hepatitis B infection, and summarizes considerations for Hepatitis B antiviral treatment and monitoring.

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Show Segments
* Intro * Case from Kashlak * Hepatitis B screening - who should be screened? * Hepatitis B screening - interpreting test results * Hepatitis B vaccination * Stages of Chronic HBV infection * Counseling patients with chronic HBV about preventing transmission and protecting liver health * Treatment of chronic HBV infection * Screening for hepatocellular carcinoma * Outro

Credits
* Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Arthur Kim MD

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Repair and replace your old approach to shoulder pain! We cover shoulder anatomy, explain the continuum of impingement syndrome (from bursitis to tendonitis to rotator cuff tears to cuff tear arthropathy), how to take a good shoulder history, perform a high-yield physical exam, when to refer, and when to get an MRI. Plus, how to differentiate glenohumeral joint arthritis from frozen shoulder, and how to diagnose AC joint pathology. We’re joined by everyone’s favorite orthopedic surgeon, inventor, and renaissance man, Dr. Ted Parks.

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Show Segments
* 00:00 Intro * 05:38 Shoulder Anatomy * 14:47 Continuum of Impingement Syndrome * 33:41 When to order an MRI * 36:28 Glenohumeral joint arthritis vs frozen shoulder * 51:50 AC joint arthritis * 62:25 Outro

Credits
* Written and Produced by: Matthew Watto MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art and Infographic: Beth Garbitelli MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Ted Parks MD

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We went to it so you don’t have to

We recap the top pearls for the hospitalist from #SHM #Converge24 covering discussions on heart failure, gastrointestinal bleeds, sepsis, updates in critical care, updates in hospital medicine, oncologic emergencies, pneumonia, COPD, transitions of care, vulnerable populations, AI, and more!

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Show Segments
* Intro * Picks of the Week * Heart Failure * Patients with Disabilities * POCUS on Inpatient Service * GI Updates * High Value Delivery of Medical Education * Molecular Testing for Infectious Diseases * Interhospital Transfers * Artificial intelligence in Inpatient Care * Care of the Incarcerated Patient * Periop Updates * Oncologic Emergencies--Neutropenic Fever * Oral vs IV Antibiotics * Updates in Hospital Medicine * Updates in Critical Care & Guidelines in Hospital Medicine * Post Acute Care * Things We Do For No Reason ™ * Iron Deficiency Anemia * Updates in Community Acquired Pneumonia * Updates in Palliative Care * Outro

Credits
* Written, produced and show notes by: Monee Amin MD, Caroline Coleman MD, Meredith Trubitt MD * Cover Art: Caroline Coleman MD * Hosts: Monee Amin MD, Meredith Trubitt MD * Reviewer: Rahul Ganatra, MD, MPH * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guests: Harika Gorti MD, Sneha Neurgaonkar MD

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We cover angina, COPD-asthma overlap, home oxygen, colon cancer screening, cancer survivorship, tobacco cessation, e-cigarettes, step counts for health, new drugs, the RSV vaccine, addiction medicine, interstitial lung disease, APOL1-mediated kidney disease, testosterone therapy, antimicrobial resistance, office-based allergy testing and more! The Curbsiders review highlights, clinical pearls, and practice-changing updates from the American College of Physician Internal Medicine Meeting #IM2024!

No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!

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Show Segments
* Intro * ACP Pearls * Outro

Credits

Producers: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD
Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer:Matthew Watto MD FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

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Energize your education on endometriosis! Learn common clinical presentations, optimal diagnostic imaging tests, and how to counsel patient on treatment options. We are joined by Dr. Adela Cope (Mayo Clinic) and Dr. Isabel Green @isabelgreenMD (Mayo Clinic).

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Show Segments
* 00:00 Intro * 03:00 Guest Introduction * 06:45 Topic * 07:30 Endo Definition & Symptoms * 14:40 Endo phenotypes * 21:30 Differential Diagnoses to Consider * 25:47 Making a Diagnosis * 31:00 Imaging to consider * 37:40 Endo Hormonal Treatment Optiosn * 48:30 Monitoring Treatment * 52:20 When to Refer * 57:30 Surgical Treatment * 1:09:20 Pain Management * 1:13:30 Take Homes * 1:19:00 Outro

Credits
* Producer, Show notes, Infographics: Carolyn Chan, MD, MHS * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi, MD, MBA * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Adela Cope and Dr. Isabel Green

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A real pain in the neck (Get it?! We have fun.)

Protect your neck! Learn how to evaluate a patient with neck pain, and differentiate between mechanical neck pain, radiculopathy, and myelopathy. You’ll learn who should be reassured, who should see a surgeon, and what nonoperative options are available. We’re joined by Dr. Anthony Mikula @anthony_mikula from Mayo Clinic.

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Show Segments
* 00:00 Introduction * 06:14 Anatomy and Pain Generators * 09:58 Approach to Neck Pain * 22:57 Differentiating Radiculopathy from Non-Specific Neck Pain * 24:05 Management of Mechanical Neck Pain * 27:36 Indications for Imaging * 29:21 Terminology and Explanation of Spondylosis, Spondylolisthesis, and Spondylolysis * 30:48 Diffuse Idiopathic Skeletal Hyperostosis (DISH) * 32:23 Imaging Terminology and Plain Films * 36:19 Pathophysiology of Cervical Radiculopathy * 38:34 Physical Examination for Cervical Radiculopathy * 44:54 Diagnostic Work-up for Radiculopathy * 51:53 Interventions for Cervical Radiculopathy * 53:53 Considerations for Surgery * 57:49 Recognizing Cervical Myelopathy * 01:00:17 Natural History of Myelopathy * 01:02:25 Referral and Treatment for Myelopathy * 01:09:28 Summary and Takeaways

Credits
* Written and Produced by: Paul Williams, MD, FACP * Show Notes: Paul Williams, MD, FACP * Infographic and Cover Art: Paul Williams, MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Anthony Mikula, MD

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It’s NOT Always a UTI!

Sounds like another UTI but it could be more than that! Time to explore the entire pelvic floor and see what more you can treat. School’s in session with the Bladder Teacher, Kellen Choi, DO from the University of Louisville @KellenChoi

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Show Segments
* Intro * Rapid fire questions/Picks of the Week * Case #1 and Definitions * Bowel habits * Water intake * Case #2 * Vaginal Estrogen * Non-antibiotic prophylaxis * Antibiotic in prophylaxis * Pelvic Floor Physical Therapy * Take-home points * Outro

Credits
* Producer, Writer & Show Notes: Isabel Valdez, PA * Infographic & Covert Art: Edison Jyang * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Kellen Choi DO, FAOCS

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Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!

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Show Segments
* 00:00 Introduction and Diabetes Puns * 01:00 Introduction of Guest and Topic * 09:12 Qualifications and Eligibility for CGMs * 11:32 Types of CGMs and Sensor Placement * 24:47 Interpreting CGM Data and Alarms * 34:30 Troubleshooting Patterns and Adjustments * 35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses * 36:15 The Rule of 15 and Addressing Hypoglycemia * 37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia * 38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin * 39:51 Managing Exercise-Induced Hypoglycemia * 41:43 Preventing Exercise-Induced Hypoglycemia with Snacks * 43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas * 45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin * 46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia * 51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin * 56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin * 57:44 Addressing Adherence and Medication Barriers * 59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management * 01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap * 01:05:49 Considering Patient Adherence and Barriers to Treatment

Credits
* Writer and Producer: Matthew Watto MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art and Infographic: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jeff Colburn MD

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Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Rahul Ganatra MD, MPH * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Introduction and disclaimer * E-cigarettes for smoking cessation * Gabapentinoids and COPD exacerbations * Topical lidocaine for neck pain * Association between specific antibiotics and C. diff infection * Shortage of GLP-1 agonists and “dosing by clicks”

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Show description:
Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter!

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Show Segments
* Intro, disclaimer * A case of pericarditis * Diagnosing pericarditis * The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis * Etiologies of pericarditis and initial testing recommendations * Treatment of acute uncomplicated pericarditis * Using colchicine to prevent recurrent pericarditis * Patient counseling after diagnosing pericarditis * A case of myocarditis * Interpreting elevated troponin levels * Distinguishing between myocardial infarction and myocardial injury * Diagnostic testing for suspected myocarditis * When to pursue cardiac MRI and endomyocardial biopsy * The spectrum of myocarditis presentations * Fulminant myocarditis * Common etiologies of myocarditis * Immune checkpoint inhibitor myocarditis * Myocarditis from mRNA vaccines and from SARS-CoV-2 infection * Management of patients with myocarditis * Activity restrictions for patients with myocarditis * Outro

Credits
* Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP * Guest: Vivek Kulkarni, MD, FACC * Producer, Script, and Show Notes: Adam Barelski, MD * Infographics and Cover Art: Edison Jyang * Reviewer: Leah Witt, MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

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This episode has been Unlocked from patreon.com/curbsiders!

Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM#SGIM23 in Denver, Colorado This audio episode is only available on Patreon!

Below are links to the original interview & show notes.

405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips

Picks of the week:* Paul recommends: Blue Eye Samurai (Netflix) * Matt recommends: Live, Die, Repeat aka Edge of Tomorrow (film)

Show Segments
00:00 Introduction and Happy New Year
02:22 Overview of Obesity Medicine
04:13 Challenges in Weight Maintenance
06:07 Prevention of Obesity
08:04 Barriers to Obesity Care
09:29 Setting Realistic Weight Loss Goals
10:24 Counseling Patients on Weight Loss
11:45 Measuring Waist Circumference
12:44 Telemedicine and Tracking Apps
13:41 Psychological Considerations in Obesity Medicine
15:05 Low-Carb Diets
21:04 Managing Side Effects of GLP-1 Agonists
23:54 New Medication for Obesity
24:52 Prolia and Forteo for Osteoporosis
26:18 Statins and Lab Testing
29:30 Annual Labs and Urine Testing
32:37 Picks of the Week
35:02 Outro

Join our Patreon today and save 16% on an annual membership at patreon.com/curbsiders. Kashlak Admitting Privileges comes with ad-free episodes, access to the Kashlak Vault, which contains PDF files and graphics from over 400 Curbsiders shows, access to our private Discord group, plus twice monthly bonus episodes like this one!

Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It’s NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl!

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Show Segments
Time stamps refer to the ad-free version* 00:00 Introduction and Guest Bio * 07:46 Case Presentation * 08:42 Initial Approach to CKD Management * 09:10 Metabolic Acidosis in CKD * 13:30 Consequences of Metabolic Acidosis * 22:28 Administration of Bicarbonate * 23:54 Alternative Options for Bicarbonate Repletion * 24:47 Citrate and Bicarbonate * 26:02 Sodium Bicarbonate for CKD * 30:19 Dietary Modifications * 33:35 Renal Diet * 38:20 Counseling CKD Patients * 41:39 Veverimer and Other Treatments * 44:36 Mistakes and Pitfalls * 46:55 Conclusion

Credits
* Writer and Producer: Matthew Watto MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art and Infographic: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Timothy Yau MD

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Elevate your primary care management of anxiety. Become confident in counseling patients about a new anxiety diagnosis, 2nd and 3rd line medications, augmentation for anxiety treatment, and options for non-pharmacological anxiety treatment. We are joined by psychiatrist and mental health expert Dr. Jessi Gold, @drjessigold (University of Tennessee System; drjessigold.com).

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Show Segments
* Intro * Case from Kashlak * Diagnosing anxiety * Explaining anxiety to patients * Non-pharmacological management of anxiety * Pharmacological management of anxiety * 2nd and 3rd line treatments * Cannabis and anxiety * Outro

Credits
* Writer, Producer, Show Notes, Infographic, Cover Art: Edison Jyang * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai Achi MD, MBA * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jessi Gold MD

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Join us as we review recent articles and news featured in The DIGEST #48, #49, and #50 including thromboprophylaxis for patients receiving chemotherapy, eosinophil count to guide steroids in COPD exacerbations, anticoagulation in subclinical atrial fibrillation, the new genetic testing recommendations for patients with breast cancer, and at-home STI testing–not to mention trial names galore. Fill your brain hole with a fully digestible meal! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).

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Credits
* Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Nora Taranto MD * Reviewer: Emi Okamoto MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* 00:00 Introduction + Pun * 06:06 Target TP Trial: Thromboprophylaxis in Cancer Patients * 13:07 Steroids for COPD Exacerbations * 25:25 Anticoagulation in Subclinical Atrial Fibrillation * 34:01 Genetic Testing in Breast Cancer * 43:38 Home STI Testing

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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The clinical picture of an underrecognized disease

Amyloidosis demystified. Learn the clinical clues that suggest possible amyloidosis and how to order the correct tests to diagnose this disease. We are joined by Dr. Michelle Kittleson who shows us the ropes of treating fibril accumulation, @MKittlesonMD (Cedars Sinai).

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Show Segments
* Introduction * Case Presentation: Mr. Smith * Differential Diagnosis of Heart Failure with Preserved Ejection Fraction * Understanding Amyloidosis * Clinical Clues and Red Flags for Amyloidosis * Physical Examination Findings * Workup for Amyloidosis * Treatment Options * AL Amyloidosis and Hematologist's Role * ATTR Amyloidosis and Cardiologist's Role * Other Therapies for TTR Amyloidosis * Therapy on the Horizon * Cost and Access to Tafamidis * Alternative Therapies and Supplements * Monitoring and Side Effects of Tafamidis * Symptomatic Management and Anticoagulation * Take Home Points

Credits
* Written and Produced by; Deborah Gorth, MD, PhD * Infographic and Cover Art: Meryl Gorth, RD, MPH and Deborah Gorth, MD, PhD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S. Achi MD MBA * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Michelle Kittleson, MD, PhD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Join us as Sandhya Pruthi, MD talks us through basics of breast cancer, specifically how to share a new diagnosis with a patient, the spectrum of disease from favorable to more aggressive, and the basics of what to expect with initial treatment. Feel more confident sharing a new diagnosis of breast cancer and supporting your patients through this journey.

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Show Segments
00:00 Introduction
02:18 Getting to Know Dr Sandhya Pruthi
09:49 Picks of the Week
12:35 Case 1: Diagnosis and Treatment of ductal carcinoma in situ (DCIS)
21:24 Risk Stratification and Active Surveillance for DCIS
23:43 Genetic Testing Recommendations
28:08 Case 2: Evaluation and Diagnosis of a Breast Lump
39:14 Invasive Ductal Carcinoma
47:49 Initial Management of invasive ductal carcinoma (IDC)
48:19 Preoperative Discussion and MRI
49:19 Lumpectomy and Sentinel Lymph Node Biopsy
50:16 Radiation and Hormonal Adjuvant Therapy
51:46 Considerations for Chemotherapy
55:51 Signs of Late Recurrence or Metastasis
58:20 Screening Guidelines and Age
01:02:25 Importance of Breast Self-Awareness
Credits
* Written and produced, Show Notes: Molly Heublein MD * Infographic and Cover Art: Edison Jyang * Hosts: Molly Heublein MD, Era Kryzhanovskaya MD * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Sandhya Pruthi MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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Get rid of those clots around anticoagulation and antiplatelet management

Join us for a review of the perioperative risk assessment of bleeding and clotting and how to manage each patient’s own antithrombotics. We are joined by Dr. Poorvi Hardman from Ohio State University.

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Show Segments
* Intro * Rapid Fire Questions/Picks of the Week * Case 1 * Risk stratification of thromboembolism and bleeding * Review of types of surgeries and risk associated with surgical intervention * Utilizing scoring systems to aid decision making * Bridging * Considerations for VKAs, DOACs * Pitfalls to bridging * Case 2 * Aspirin Management * P2Y12 Management * Consultants * Outro

Credits
* Written, produced and show notes by: Jaimie Patel MD * Infographic and Cover Art by: Caroline Coleman MD * Hosts: Monee Amin MD; Meredith Trubitt MD * Reviewer: Fatima Syed MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Poorvi Hardman MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
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Sponsor: Pathway
Improve your clinical decision-making process and enhance patient care. Download the Pathway app today by visiting pathway.md

The Curbsiders and Cribsiders are back with a very special Med-Peds collaboration on RSV immunizations! Dr. Buddy Creech, Pediatric Infectious Disease at Vanderbilt, walks us through these breakthrough “vaccines" for both adults and kids. He teaches us about their mechanisms of action, eligibility criteria, and why it’s been so challenging to find doses this season. Get ready for your next shot of fun!

Join us as we review recent practice-changing articles on transfusion thresholds in acute MI, COVID-19 rebound after treatment with ritonavir-boosted nirmatrelvir (PaxlovidTM), the prevalence of iron deficiency, as well as the debut of our new “corrections and omissions” section, in which we cover important knowledge updates on oral iron dosing and correcting serum calcium. And, find out why oral phenylephrine does not work and what you should prescribe instead for upper respiratory symptoms. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

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Credits
* Written, Produced, and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Rahul Ganatra MD, MPH * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* 00:00 Introduction and Calcium Puns * 03:11 Iron Deficiency and Iron Supplementation * 12:20 Corrected Calcium * 18:09 Virologic Rebound after nirmatrelvir/ritonavir (Paxlovid™) * 32:09 Phenylephrine and its Ineffectiveness * 37:00 Restrictive vs. Liberal Transfusion Strategy in MI (MINT trial) * 49:20 Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice. Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction. Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.

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Show Segments
00:00 Introduction and Overview
09:13 Diagnosing Dental Pain and Examination Techniques
18:44 Treatment Options for Dental Pain
29:34 Complications and Emergencies in Dental Care
32:36 Post-operative Care and General Dental Advice
40:35 Dry Mouth and Treatment Options
44:05 Gingivitis
49:39 Temporomandibular Joint (TMJ) Dysfunction
55:43 Medications and Dental Side Effects
56:12 Anticoagulants and Dental Procedures
01:00:55 Endocarditis Prophylaxis
01:03:15 Joint Replacements and Antibiotic Prophylaxis
01:04:10 Oral Health in Patients with Opioid Use Disorder
Credits
* Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Molly Heublein MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Lisa Simon MD, DMD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
Sponsor: Grammarly
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Sponsor: Factor
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Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Learn practical tips for the inpatient management of patients with sickle cell disease and vaso-occlusive crisis from guest, Dr. Yoo Mee Shin (Emory). We cover acute pain management including adjuvant therapies, IV fluids, oxygen therapy, the management of acute chest syndrome, and when to perform simple vs exchange transfusions. Key takeaways include the importance of early triage and analgesia, addressing misconceptions about opioid use disorder in patients with sickle cell disease, and recognizing complications of vaso-occlusive crises.

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Show Segments
* 00:00 Intro * 01:27 Getting to know our guest * 07:48 Case Presentation and Initial Management of Sickle Cell Disease (SCD) * 13:46 Misconceptions about opioid use disorder and sickle cell * 17:02 Management of Acute Pain in Sickle Cell Disease * 25:46 Adjuvant therapy for pain * 29:04 Transition to outpatient care * 32:46 General admission orders for sickle cell * 38:44 Management of Acute Chest Syndrome * 42:01 Simple vs exchange transfusion * 47:08 Transfusion in preoperative and pregnant patients * 48:03 Transitions and follow-up care * 49:35 Key takeaways and Outro

Credits
* Written and Produced by: Matthew Watto MD, FACP * Cover Art & Infographic: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Yoo Mee Shin MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Conquer your fear of antiphospholipid syndrome! Dr. Arielle Langer leads us through what clinical features raise suspicion for antiphospholipid syndrome, how to interpret laboratory testing, and the nuances of antiphospholipid syndrome management.

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Show Segments
* Intro * Case from Kashlak * What is antiphospholipid syndrome? * Clinical features that raise suspicion for antiphospholipid syndrome * Laboratory testing and diagnosis of antiphospholipid syndrome * Management of antiphospholipid syndrome: initial treatment * Management of antiphospholipid syndrome: managing recurrent thrombosis * Return to Case: Pregnancy in patients with a history of thrombotic APLS * Obstetric APLS * Final questions * Outro

Credits
* Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Arielle Langer MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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Discover DGBI! Learn its pathophysiology, evaluation and individualized treatments so you can leave the fear of managing DGBI behind. We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic)

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
Intro, disclaimer, guest bio * Guest one-liner, Picks of the Week * Case from Kashlak; Definitions (6:20) * Definition of Disorders of the Gut-Brain Interaction (7:30-11:00) * Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments (24:30-36:00) * Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00) * Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11) * Take home points * Outro

Credits
* Producer: Elena Gibson MD * Writer:Andréa Perdigão, Elena Gibson * Show Notes and Infographics: Andréa Perdigão * Cover Art: Kate Grant * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Associate Editor: Leah Witt * Showrunner: Matthew Watto MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: Dr. Xiao Jing (Iris) Wang MD

Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders.

Our team needed a break so we did not make CME for this episode.
Show Segments
Time Stamps are for Patreon (Ad-Free) Version* 00:00 Introduction and Overview * 09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms * 14:20 Understanding Hemochromatosis * 19:24 Evaluation and Management of Hematuria * 25:00 Updates in Diabetes Management * 29:35 Xylazine Overdose and Withdrawal * 35:35 Primary Aldosteronism * 39:36 Resistant Hypertension * 44:12 Delirium and its Implications * 46:29 The Acorn trial and AKI risk * 49:47 HIV trial: Reprieve * 51:11 Updates in hospital medicine * 56:00 Kratom and its implications * 59:11 RSV vaccines and their effectiveness * 01:05:38 Reflections and Gratitude

Credits
* Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP * Cover Art: Matthew Watto MD, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

Sponsor - Glass Health

Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.

Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.

You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.

Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI.

You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS

Glass, like a clinical reference text or podcast, should never replace clinician judgment.

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry. Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).

Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry. Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).

Show Segments
* Intro, disclaimer, guest bio * Dr. Pallais One-Liner * Case from Kashlak * Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin * Causes of hypercalcemia * How Lithium works! * Testing for Hypercalcemia: Get that PTH, and that phos * Symptoms of Hypercalcemia, and Questions on History * Indications for Surgery for Parathyroidectomy * Management of Hypercalcemia and Hypercalcemic Emergency * Outro

Credits
* Producer, Writer, Infographic, Cover Art: Nora Taranto MD * Hosts: Matthew Watto MD, FACP; Nora Taranto MD * Reviewer: Yan Emily Yuan MD, MSc * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Carl Pallais MD, MPH

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Sponsor - Glass HealthGlass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.

Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context. You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.

Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI. You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS.

Glass, like a clinical reference text or podcast, should never replace clinician judgment.

Sponsor - PatternAt Pattern, we give you a quick, simple way to compare and buy disability insurance. Busy doctors shouldn't have to worry about whether or not they are getting the best rates and discounts. Trying to research all your options and make the right decision while in training can make the process even more overwhelming. That’s why thousands of doctors trust Pattern to help them compare and understand the disability insurance they are buying.
We do this in three simple steps: First off, request your quotes online at patternlife.com/curbsiders. Second, compare your options and ask questions. And third, secure your policy!
So check disability insurance off your list today! Be confident that you have the right policy so that your income is protected. With huge discounts for doctors in training, now is truly the best time to request your disability insurance quotes with Pattern at patternlife.com/curbsiders.

We’re taking a short break, but we’ll be back in two week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 17 of them available to feed your brain hole! Yummy!Time Stamps*
Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.

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Time Stamps
Note: Time Stamps refer to ad free version

Intro, disclaimer, guest bio - 00:00
Picks of the Week - 3:10
Case from Kashlak - 6:30
Nephrotic syndrome definition- 12:30
Proteinuria evaluation - 15:04
Additional lab testing - 27:08; 40:09
Types of Nephrotic syndrome - 30:15
Mechanism of nephrotic syndrome edema - 33:08
Management of nephrotic syndrome - 44:07
Second Kashlak Case- Glomerulonephritis - 55:05
Treatment of glomerulonephritis - 65:05
Outro and post-credits scene - 73:20

Credits
* Producer, writer, infographic, cover art: Elena Gibson MD * Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) * Guest: Joel Topf MD

Sponsor - Pattern Life
Request your quotes online at patternlife.com/curbsiders

A shock to the system

Join us for an infectious conversation about sepsis as we learn about the recognition and initial management of sepsis on the wards. We are joined by Dr. Mohleen Kang (@KangMohleen, Emory University).

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Rapid fire questions/Picks of the Week * Case * Managing rapid response logistics * Sepsis Scoring Systems * Diagnostic Work-up for Sepsis * Access * Antibiotic Management * Fluids * Pressors * Supportive Measures for Sepsis * Outro

Credits
* Producers, Writers, and Hosts: Meredith Trubitt, MD and Monee Amin, MD * Show Notes: Meredith Trubitt, MD * Infographic and Cover Art: Sean Evans or Caroline Coleman * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Mohleen Kang, MD, MSc

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Join us as we review recent articles and news featured in The DIGEST #45 and #46, including semaglutide in HFpEF and obesity (STEP HFpEF), TCAs for irritable bowel syndrome (ATLANTIS), clopidogrel versus aspirin as long-term secondary prevention after PCI (HOST-EXAM), statins in HIV (REPRIEVE), weight changes and diet, and heavy metal exposure in cannabis users. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).

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Credits
* Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewers: Nora Taranto MD; Paul Williams, MD, FACP; Matthew Watto MD, FACP; Sai Achi, MD MBA * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * STEP HFpEF: semaglutide for HFpEF in obesity * TCAs for IBS * HOST-EXAM and post-PCI clopidogrel versus aspirin after DAPT * REPRIEVE and pitavastatin in HIV * Starchy vegetables and weight changes * Cannabis and heavy metal content * Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Become a pro on pre-exposure prophylaxis!

Review the updated 2023 United States Preventive Task Force (USPSTF) guidelines on PrEP for HIV Prevention with Dr. John Wong.

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Show Segments
* Intro * What is PrEP? * USPSTF PrEP for HIV Prophylaxis recommendations * Defining Increased Risk for HIV * Counseling pearls * Types of PrEP, considerations about choice of PrEP * Talking about Safer Sex practices, HIV and STI screening on PrEP * Recap; outro

Credits

Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD
Hosts: Paul Williams MD, FACP, Beth Garbitelli MD
Reviewer:Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: John Wong MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

“I collect spores, molds and fungus” - Dr. Egon SpenglerDr. Ilan Schwartz MD PhD (@GermHunterMD) teaches us that we should always at least consider fungi in the differential diagnosis of unexplained sepsis, especially in patients with impaired immune systems or complex medical or surgical histories, and walks us through an approach to antifungals. Be sure to check out the Mycoses Study Group Education & Research Consortium (@MSG_ERC), an organization of clinicians who are dedicated to advancing diagnostics and treatment of fungal disease (where Dr. Schwartz serves on the board of directors!) Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME
Show Segments
* Intro * Rapid fire questions, get to know our guest * Intentionally vague case; When should we be worried about fungal infection? * Overnight emergencies: Candidiasis and mucormycosis * Starting empiric anti-fungals * Testing basics: direct versus indirect * Fungemia, fungal endocarditis * Resistant candida; candida auris * Pneumocystis jiroveci pneumonia * Outro

Credits
* Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Ilan Schwartz MD, PhD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Diagnosing and treating bipolar disorder is not always black-and-white. Dr. Kevin Johns teaches us how to not get tripped up on this tricky diagnosis. (The Ohio State University Wexner Medical Center)

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Show Segments
* Intro * Case * Screening for mania * History for diagnosing bipolar disorder * Definition * Mimickers * Treatment * Outro

Credits
* Written and Produced by: Deborah Gorth MD, PhD * Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth MPH, RD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deborah Gorth MD, PhD * Reviewer: Molly Heublein MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Kevin Johns MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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We’re taking a short break, but we’ll be back next week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 15 of them available to feed your brain hole! Yummy!Tighten up your glute-n facts!

Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and understand diagnostic testing, management and proper follow-up for patients.

Claim free CME for this episode at curbsiders.vcuhealth.org!Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments
* Intro, disclaimer, guest bio * Guest one-liner, Picks of the Week * Case from Kashlak; Definitions * Workup for a typical celiac patient * Nonclassical features of CD * When to do a small bowel biopsy * Management of CD * Considerations for atypical celiac patient and differentials * Non-celiac gluten sensitivity * Outro

Credits

Production and Script: Matthew Watto MD, FACP
Production, Show Notes and Infographics: Edison Jyang
Cover Art: Kate Grant MBChB, MRCGP, DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Amy Oxentenko MD, FACG

Birch Living
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Join us as we review recent practice-changing articles on VKAs vs DOACs in frail adults with atrial fibrillation, RSV vaccine for adults over 60, how much does blood pressure cuff size matter, cotton fever in people who inject drugs, new bloating and belching guidelines, and does pip-tazo cause more AKI than cefepime. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

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Credits
* Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Sai Achi, MD * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Show Segments
* Intro, disclaimer * VKAs vs DOACs in frail adults with atrial fibrillation, * RSV vaccine for adults over 60, * how much does blood pressure cuff size matter? * cotton fever in people who inject drugs, * new bloating and belching guidelines, * does pip-tazo cause more AKI than cefepime? * Outro

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Common Ear Complaints, Tips and (Keratin) Pearls in Primary Care

Get an earful from ENT expert Dr. Angela Peng about how to approach common ear concerns, basic ear exam skills, safely clearing earwax and more!

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Show Segments
* Intro with great pun! * Rapid fire questions/Picks of the Week * Case #1: Inner ear complaint * Ear Exam 101 * Eustachian Tube Dysfunction * Cholesteatoma * Case #2: Outer ear complaint * Malignant otitis externa * Open tympanic membrane treatments * Cerumen impaction * Itchy Ears * Outro

Credits
* Producer, Writer, Show Notes, Cover Art and Infographics: Isabel Valdez, PA-C * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Angela Peng, MD

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
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Keep saving lives by prescribing methadone and buprenorphine. Learn how initiations of each have changed in the era of high-potency synthetic opioids (HPSOs) like fentanyl and how to continue to provide person-centered care to people with opioid use disorder. We’re joined by Dr Melissa Weimer, @DrMelissaWeimer (Yale University). This episode is in honor of National Addiction Treatment Week (treataddictionsavelives.org).

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

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Credits
* Producers: Shawn Cohen MD, Kenneth Morford MD * Writer: Carolyn Chan MD MHS * Show Notes: Shawn Cohen MD * Infographic and Cover Art: Kenneth Morford MD * Hosts: Carolyn Chan MD. MHS Shawn Cohen MD, Natalie Stahl MD, Kenneth Morford MD * Reviewer: Kento Sonoda MD * Showrunner: Carolyn Chan, MD, MHS * Technical Production: PodPaste * Guest: Melissa Weimer DO MCR

Show Segments
* Intro, disclaimer, guest bio 00:00 * Guest one-liner 05:02 * National Addiction Treatment Week 06:00 * Case from Kashlak; Definitions 08:30 * Starting methadone 11:01 * Common methadone pitfalls 15:00 * Buprenorphine precipitated opioid withdrawal 23:50 * High-dose buprenorphine 32:20 * Treating buprenorphine precipitated withdrawal 36:50 * Low-dose buprenorphine 41:50 * Maintenance dose of buprenorphine 48:15 * ER buprenorphine 49:00 * Take home points 53:31

Semaglutide can’t fix everything…

Recommend lifestyle interventions for weight management with Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center and Interim Chief of Division of General Internal Medicine at Duke (@DrWillYancy). Learn about the ketogenic diet, lower carbohydrate diets, and exercise, and their impacts on your patients.

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Credits
* Producer and writer: Fatima Syed, MD, MSc, FACP * Show Notes, Infographic, and Cover Art: Fatima Syed, MD, MSc, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Will Yancy, MD

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Full Transcript available HERE

Show description:
Feel confident diagnosing adrenal insufficiency. Learn how to accurately interpret a stimulation test, differentiate primary from secondary adrenal insufficiency, and teach patients about preventing an adrenal crisis with Dr. Atil Kargi (UNC School of Medicine)

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Show Segments
* Intro * Case 1 * Case 2 * Topic * Outro

Credits
* Written and Produced by: Elena Gibson, MD * Infographic and Cover Art: Edison Jyang * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi, MD MBA * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Atil Kargi, MD

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Full transcript available HERE

A Guide to Seeing Them and Stopping Them in Their Tracks
Bea step ahead of diabetic foot infections! Learn who really needs that MRI, when to call your vascular colleagues, and when you really need that pseudomonas and anaerobic coverage. We are joined by Dr. Andrew Webster, infectious disease physician and antimicrobial stewardship director at the Atlanta VA. Emory Division of Infectious Diseases

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Show Segments
* Intro * Picks of the Week * Case * Definitions * Risk Stratifications * Diagnostic Work-up * Vascular evaluations * Treatment * Outro

Credits
* Writer, producer and show Notes: Reaford Blackburn, Jr., MD * Cover Art and Infographic: Monee Amin, MD * Hosts: Monee Amin, MD and Meredith Trubitt, MD * Reviewer: Sai Achi, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Andrew Webster

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Full transcript available HERE

Master hormonal and nonhormonal therapies for menopausal symptoms including vasomotor symptoms (VMS). We’re joined by Dr. Monica Christmas, @drmonicaxmas (UChicago Medicine).

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Show Segments
* Intro * Nonpharmacologic management of vasomotor symptoms (VMS) * Non-hormonal therapy for menopause * Taking a history for menopausal symptoms, VMS * Hormone therapy (HT) risk assessment, counseling * Prescribing Hormone therapy * Troubleshooting hormone therapy * Premature menopause and primary ovarian insufficiency * Discontinuation of hormone therapy * Outro

Credits
* Written and Produced by: Matthew Watto MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art and Infographic: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Molly Heublein MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Monica Christmas MD

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Full transcript available HERE.

Definitions, 4Ms & Inhaler Pro Tips

Level up COPD management in older adults. Start with learning the latest in COPD diagnosis and classification, then stay for the mind-blowing inhaler misuse & cost discussion. We’re joined by a dynamic (and interprofessional) duo: Dr. Leah Witt (@leahjwitt) and Dr. Amber Lanae Martirosov, PharmD (@AmberMartirosov).

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Show Segments* Intro * Rapid Fire Questions * Case Part 1 * COPD Definition * COPD alphabet soup: ABE * Case Part 2 * Geriatric 4Ms & COPD * Inhaler Use & Cost * Outro

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Full transcript available HERE

Join us as we review recent articles and news featured in The DIGEST #43 and #44, including bempedoic acid to lower cardiovascular risk, Alpha-Gal Syndrome, tick bites and meat allergy, orforglipron an oral GLP1 agonist for weight loss, zuranolone for postpartum depression, DOACs for VTE of malignancy, monoclonal antibodies (mAbs) for Dementia, cytisinicline for smoking cessation, and two kiwis a day for constipation. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).

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Credits

Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewers: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

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Show Segments

Intro, disclaimer
Bempedoic Acid for CV risk reduction
DOACs to prevent recurrent VTE of malignancy
Cytisinicline for smoking cessation
Alpha-Gal Syndrome, tick bites, and meat allergy
Zuranolone for postpartum depression
Orforglipron, an oral GLP1 agonist, for weight management
mAbs for Alzheimer’s dementia
Kiwis to prevent constipation
Outro

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!

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Credits

Written and Produced by: Elena Gibson MD
Cover Art and Infographic: Kate Grant MD; Elena Gibson MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Elliot Tapper MD

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Definitions of liver enzymes, liver function tests
Patterns of acute liver injury
Drug-induced liver injury
Isolated alkaline phosphatase elevation
Isolated total bilirubin elevation
Livery Injury During Pregnancy
Acute liver failure
Outro

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.

Free CME for this episode at curbsiders.vcuhealth.org

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Credits

Writer: Matthew Watto, MD, FACP
Producers: Matthew Watto, MD, FACP and Malini Gandhi
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Jordy Cohen MD

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak: New diagnosis of hypertension
How to make a diagnosis of hypertension
When to start anti-hypertensive medication
Initial blood pressure regimen
Case from Kashlak: White coat hypertension
Case from Kashlak: Hypertension in chronic kidney disease
ACEis and ARBs in chronic kidney disease
Diuretics in chronic kidney disease
Case from Kashlak: Refractory hypertension
History and initial workup for refractory hypertension
Treatment of primary hyperaldosteronism
Outro

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We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Not only that, we’ve been thinking about obesity the wrong way for decades. Join us with Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital as we reframe our approach to this disease and learn tips on prescribing older, but still very effective, medications used to treat obesity.

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Credits

Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C
Show Notes, Infographics: Maddison McLellan
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Monee Amin, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Fatima Cody Stanford, MD

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.Get 55% off your Babbel subscription at Babbel.com/curb. Rules and restrictions apply.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner by Dr. Fatima Cody Stanford
Case from Kashlak
Guidelines for treatment
Getting the history and discussing weight goals
The Care Team: Dietician, Behavioral Specialist, Provider
Medications: Phentermine, Topiramate, Bupropion, Naltrexone
Obesity treatment in pregnancy
Referring to bariatric surgery
Take home points
Outro

Your swell guide to the swollen leg

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.

Credits

Written and produced by: Paul Williams, MD, FACP
Infographic and Cover Art: Matthew Watto, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto, MD, FACP
Editor: Clair Morgan of nodderly.com

Show Segments

Intro, disclaimer
Picks of the Week*
The case of Lynn Fedema
Pathophysiology of edema
Differential diagnosis of chronic edema
Chronic edema work-up
Management of chronic edema
Calvin Fedema and acute edema
Evaluation of acute edema
Outro

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We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy!

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm.

Free CME for this episode atcurbsiders.vcuhealth.org

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Credits

● Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD

● Show Notes, Infographic and Cover Art: Caroline Coleman, MD

● Reviewer: Emi Okamoto, MD

● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP

● Technical Production: PodPaste

● Guest: Sara Markley Webster, MD

Sponsor: GrammarlyGo to grammarly.com/GO to download and learn more about GrammarlyGO.

Sponsor: LocumstoryGet a comprehensive view of locums and decides if its right for you at locumstory.com

Sponsor: Birch LivingBirch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you use code BIRCHPARTNER20!

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

● Intro, disclaimer, guest bio

● Guest one-liner, Picks of the Week*

● Case 1 from Kashlak

● Adrenal crisis identification, workup and management

● Case 2 from Kashlak

● Myxedema identification, workup and management

● Case 3 from Kashlak

● Thyroid storm identification, workup and management

● Outro

Full transcript available HERE

Ready for more knee pain? You’ve already memorized episode #98, so join us as Ted Parks to returns to teach us even more about common causes of knee pain (anterior knee pain, patellofemoral pain, knee bursitis, pain after knee replacement) and what to do about them!

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Credits

Producer: Paul Williams, MD, FACP
Writer: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD, MSc
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Edward (Ted) Parks, MD

Sponsor: Pathway

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Full transcript available HERE

Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM #SGIM23 in Denver, Colorado

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Show Segments

Intro
Barriers to treating medicine in primary care
Patient counseling and obesity pathophysiology
Motivational Interviewing
Telemedicine for obesity
Tools and tips for a weight loss program
Medications for Obesity
GLP1 agonist prescribing tips
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
In-studio Technical Production: Chris Chiu MD, FACP, FAAP
Technical Production: PodPaste
Guest: Kimberly Anne Gudzune MD, MPH

When there’s blood in the water…

Work-up hematuria with confidence. Learn what you should be worrying about, what tests are worth considering, and how to figure out if this is a job for a urologist or nephrologist.

Claim free CME for this episode at https://curbsiders.vcuhealth.org!

Credits

Producer and writer: Paul Williams, MD, FACP

Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP

Reviewer: Emi Okamoto, MD

Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Technical Production: PodPaste

Guest: Derek Fine, MD

Join us as we review recent practice-changing articles on ketamine vs ECT for refractory depression, nonhormone treatment (fezolinetant) for menopause, metformin for long COVID, new breast cancer screening draft recommendations, and a primer on kratom.

Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

Go to https://thecurbsiders.com for more info

Become a Kashlak Memorial Hospital member and support us by joining our Patreon

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Put on your Primary Care Cat-Hat

We are thrilled to be back to kick off season 2! Carolyn Chan, MD (@CarolynAChan) soon to be at the University of Cincinnati, Shawn Cohen MD (@ShawnCohen_MD) at Yale University, Kenneth Morford MD at Yale University, and Natalie Stahl MD (@NanouTheNomad) at Greater Lawrence Family Health Center are back and on this episode, they answer burning questions submitted by listeners. We cover topics such as targeted naltrexone, increasing buprenorphine doses, treating kratom dependence, and so much more!

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By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

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Credits

Producer, Show Notes: Kenneth Morford, MD
Infographic and Cover Art: Carolyn Chan, MD, MHS
Hosts: Carolyn Chan MD, MHS, Shawn Cohen MD, Kenneth Morford MD, Natalie Stahl MD, MPH
Reviewer: Payel Jhoom Roy, MD
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste

Dominate naughty CAUTIs. Learn how to define them, which studies to order, and how to treat and prevent these pesky infections. We’re joined by Dr. Laila Woc-Colburn, @DocWoc71 (Emory University).

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Credits

Please consolidate if performing multiple jobs (e.g. Written and Produced by: Cyrus Askin MD; cover art and infographic by Kate Grant)
Producer and Writer:: Noble Maleque MD
Show Notes: Caroline Coleman MD & Noble Maleque MD
Cover Art and Infographic: Caroline Coleoman MD & Sean Evans MD
Hosts: Monee Amin MD & Meredith Trubitt MD
Reviewer: Sai S Achi, MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Laila Woc-Colburn MD

Guests Dr. Sue Farrell, Harvard University and Dr. Caroline Okorie, Stanford University, discuss careers as clinician educators. They share their own roadmap for advancement in academic medicine while reflecting on the concept of ikigai. We review tips for success for academic clinicians across the spectrum- how to create your strategic plan, think about advancement, and integrate scholarship into your work.

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thecurbsidersteach@gmail.com

Credits

Script, Guest Selection: Frances Ue MD MPH
Infographic, Cover Art: Megan Connor MD
Hosts: Frances Ue MD MPH, Era Kryzhanovskaya MD, Molly Heublein MD
Show Notes/CME: Molly Heublein MD
Editor: (audio materials) Podpaste; Frances Ue MD MPH, Era Kryzhanovskaya MD (written materials)
Guests: Sue Farrell MD EdM, Caroline Okorie MD MPH

Show Credits

Intro, disclaimer, guest bio
Guest one-liner/ Best piece of advice
Case #1 from Kashlak Memorial Hospital
Learning from senior faculty vs mid-level
Ce vs cE
Tips to building your early career
Ikigai/ Roadmap to becoming a CE
What our guests wish they knew from the beginning
You don’t always have to say yes
Mid-Career Educator
ACGME CE Milestones
Strategic Plan
Dr Okorie’s Personal Path
What she has learned through this process
Advancement/Promotion
Bias and Equity in Promotion
Scholarship
Take Home Points
Outro

We are far too classy for a “Rocky Mountain High” joke.

Live from SGIM 2023 in Aurora, Colorado! We talk to a panel of Addiction Medicine specialists who recap their outstanding talk on all of the exciting developments in treating addiction. We review major policy changes, trends in drug overdose, outpatient screening for alcohol use, and all of the ways we might be using psychedelics to treat addiction. We are joined by Stefan Kertesz, MD @StefanKertesz (University of Alabama at Birmingham), Ximena Levander, MD, MCR, FACP @XimenaLevander (OHSU), Kenneth L. Morford MD, FASAM (Yale), and Katherine Mullins, MD, AAHIV @_kmullins_ (NYU Langone).

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Credits

Producer: Carolyn Chan, MD and Paul Williams, MD, FACP
Writer: Carolyn Chan, MD and Paul Williams, MD, FACP
Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP
Hosts: Carolyn Chan, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guests: Stefan Kertesz, MD, MSc; Ximena A. Levander, MD, MCR, FACP; Kenneth L. Morford, MD, FASAM; Katherine Mullins, MD, AAHIV

Master the prescription of antiplatelets and anticoagulation for coronary artery disease and afib (atrial fibrillation). We discuss why, when, and how long to prescribe aspirin, clopidogrel, ticagrelor, prasugrel, and/or anticoagulation for primary, secondary, and “primary and a half” prevention including the definition and discussion of mono, dual, and triple therapy for patients with coronary disease who need anticoagulation for atrial fibrillation. We’re joined by preventive cardiologist, Dr. Donald Lloyd-Jones MD, ScM (@dmljmd from NMCardioVasc)! This episode was recorded in person at ACP’s (@ACPIMPhysicians) Internal Medicine Meeting 2023 #im2023 in San Diego.

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Show Segments

Intro
Getting to know our guest
Definition mono, dual, triple therapy, DAPT
Post-PCI for NSTEMI with existing afib
Stable CAD with new Afib
CABG with New Afib
Prior stent with New Afib
Antiplatelet therapy after Acute Coronary Syndrome
Primary Prevention
Primary “and a half” Prevention
Life’s Essential 8
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art & Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed MD, MSc
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Donal Lloyd-Jones MD, ScM

The ANA, anti-CCP, RF, and beyond!

We all have ‘rheum’ to grow when it comes to making sense of autoantibodies and common markers. We talk through the nuances with rheumatologist Dr. Matthew B. Carroll (biography here!). Our interview covers physical exam tips for inflammatory arthritis, basic interpretation of rheumatologic testing, and what to do with the dreaded ‘vaguely positive’ speckled ANA!

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Show Segments

Intro
Case 1
History clues
Physical exam pearls; what does synovitis look like?
Interpreting mixed labs
Rheumatoid Factor tips
Role for imaging
Importance of early diagnosis
New testing modalities
Case 2
Oh no– a vaguely positive ANA!
ANA testing basics
Outro

Credits * Showrunners, Hosts, Producers and Writers: Matthew Watto MD, FACP; Paul Williams MD, FACP * Show Notes, Infographic, Cover Art: Beth Garbitelli MD * Reviewer: Emi Okamoto MD * Technical Production: PodPaste * Guest: Matthew B. Carroll MD

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Learn to bust through inpatient cirrhosis management! The basics of ascites, HRS, portal vein thrombosis and hepatic encephalopathy management are all here. We’re joined by Dr. Suchita Sata (@suchitasata) (Duke University).

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Show Segments

Intro
Austin Picks of the week
Case
Ascites
Portal Vein Thrombosis
AKI/HRS
SBP
Diuretic Management
Albumin
Case
HRS treatment
GIB Management
Hepatic Encephalopathy Management
Palliative Care
Outro

Credits

Producer, Writer: Monee Amin MD, Meredith Trubitt MD
Show Notes, Cover Art: Monee Amin MD
Infographic: Caroline Coleman MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Suchita Sata MD

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Full Transcript available HERE

Don’t be scared of insulin or hypoglycemia anymore! Our Kashlak Friend of the Pod Dr. Jeff Colburn gives us all the essentials you’ll need in your fanny pack for navigating the ups and downs of insulin in type 2 diabetes.

Claim free CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME
Show Segments
* Intro * Rapid fire questions/Picks of the Week * Case #1: Starting insulin * Types of basal insulin: glargine, detemir, NPH, 70/30 NPH/regular * Glucose monitoring while on insulin * Glucose targets when taking insulin * Overbasalization * Adding additional agents to basal insulin * Case #2: Deescalating insulin * Insulin use in the geriatric population * Hypoglycemia Rule of 15 * Glucagon how-to * Outro

Credits
* Producer, Writer, Show Notes, Infographic and Cover Art: Isabel Valdez, PA-C * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jeff Colburn, MD

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Don’t miss this rapid-fire recap of our top pearls from #SGIM23 in Aurora, Colorado, including obesity medicine, GLP1 agonists, trauma-informed care, an update on hormone therapy for vasomotor symptoms of menopause, treating low sexual desire in women, dementia diagnosis and treatment, chronic pain and buprenorphine, complex persistent opioid dependence, chlorthalidone vs hydrochlorothiazide, the timing of blood pressure medication, how to prescribe CPAP or auto-PAP, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk), Chris Chiu (@cjchiu), Carolyn Chan (@CarolynAChanMD, Curbsiders Addiction Medicine), and Era Kryzhanovskaya (@EraKryzhMD, Curbsiders TEACH).

No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Recap, Top Pearls Part 1 * Recap, Top Pearls Part 2 * Outro

Credits
* Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Carolyn Chan MD; Era Kryzhanovskaya MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Technical Production: PodPaste
Sponsor: Pattern
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There might be a lot to swallow, but you will master an initial approach to dysphagia in this episode. Review the types of dysphagia, common etiologies, initial evaluations and treatment plans. We are joined by Dr. Diana Snyder @DianaSnyderMD (Mayo Clinic)

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Show Segments
* Intro & Picks of the Week * Case * Dysphagia definitions * Oropharyngeal vs esophageal dysphagia * Associated symptoms and alarm signs * Outro

Credits
* Producer, Writer & Show Notes: Elena Gibson MD * Show Notes: Elena Gibson MD * Cover Art & Infographic: Kate Grant MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Diana Snyder MD

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Full transcript available HERE

Don’t miss this rapid fire recap of our top pearls from ACP #IM2023 in San Diego including hypertension, hypogonadism, frailty, afib, sleep medicine, in-flight emergencies, nephroprotective meds, order of antibiotics for pneumonia in the hospital, genitourinary syndrome of menopause, pickle juice for leg cramps, bristol stool scale and hepatic encephalopathy, coronary calcium, tirzepatide, cystatin c, functional dyspepsia, hair and nails, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk) and Chris Chiu (@cjchiu) of The Cribsiders Podcast.

No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org!

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME
Show Segments
* Intro * Recap, Top Pearls Part 1 * Recap, Top Pearls Part 2 * Outro

Credits
* Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

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Join us for this Hotcakes style episode as we talk through impactful literature for the hospitalist with Dr. Heather Nye (UCSF) and Dr. Rahul Ganatra (@rbganatra, Harvard University) who presented the Clinical Updates in Hospital Medicine at SHM #Converge23.

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Show Segments
* Intro, disclaimer * Rapid fire questions/Picks of the Week * EMPULSE * ADVOR * STRONG-HF * CRISTAL * Perioperative Gabapentin * Waterfall * Midline catheters vs PICC lines * What’s in a Name? * Outro

Credits
* Producer, Writer, Show Notes: Monee Amin MD; Rahul Ganatra, MD; Meredith Trubitt MD; * Cover Art: Monee Amin MD * Hosts: Monee Amin MD; Meredith Trubitt MD * Reviewer: Fatima Syed MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Rahul Ganatra and Dr. Heather Nye

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Dominate opioid and xylazine (aka tranq) withdrawal in the hospital with expert insights from Dr. Joseph D’Orazio (@dorazepam) recorded LIVE! at Pennsylvania Hospital Grand Rounds in Philadephia, PA. Xylazine, an alpha-2 adrenergic agonist, has emerged as a frequent contaminant in the opioid supply with a distinct withdrawal syndrome. You’ll learn to manage this common withdrawal syndrome while also addressing acute pain complaints and opioid withdrawal.

Sorry, no CME for this episode, but check out CME for past episodes at curbsiders.vcuhealth.org.

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Show Segments
* Intro * Xylazine basics * Management of xylazine withdrawal * Opioid withdrawal and acute pain * Outpatient considerations for xylazine * Audience questions * Outro

Credits
* Writer and Producer: Matthew Watto MD, FACP * Infographic and Cover Art: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Joseph D’Orazio MD

Master the nuances of the hypercoagulable work-up! Our expert discussant, Dr. Jean Connors, leads us through when to send testing for thrombophilia and how to interpret the results.

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Show Segments
* Intro * Case from Kashlak: DVT after a trip to Singapore * History-taking in a patient with a venous thromboembolism (VTE) * Risk factors for VTE * Who to test for thrombophilia, and how this testing influences management * Thrombophilia panel: what to order * When to send thrombophilia testing * Case from Kashlak: potential obstetric antiphospholipid syndrome * Antiphospholipid syndrome: diagnosis * Antiphospholipid syndrome: management * Outro

Credits
* Producers and Writers: Malini Gandhi and Nora Taranto MD * Show Notes, Infographics, and Cover Art: Malini Gandhi * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Jean Connors MD

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Hypertension FAQ Round #2 Dr. Jordy Cohen Strikes Back

Tackle resistant hypertension. Learn when it is pseudo resistant hypertension, and how to treat this pesky condition when it is true resistant hypertension. Dr. Jordy Cohen (@jordy_bc) leads us through her approach to keeping the BP where it should be (University of Pennsylvania).

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Show Segments
* Intro * Case * Hypertension definition * Mechanisms of hypertension * Vascular stiffness and aging * Antihypertensive agents * Anxiety and hypertension * Escalating blood pressure management * Resistant hypertension * Ruling out pseudo resistant hypertension * Substance induced pseudo resistant hypertension * Pick of the Week * Outro

Credits
* Written and Produced by: Deborah Gorth MD, PhD * Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Sai S Achi MD, MBA * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jordy Cohen MD, MSCE

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We recap the top pearls for the hospitalist from #SHM #Converge2023 covering discussions on syncope, heart failure, COPD, pneumonia, sickle cell pain management, nausea and dyspnea, complex pain management issues, delirium, geriatrics updates, severe infections from injection drug use, electrolyte management, perioperative anemia and anticoagulation, and GI updates.

Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.

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Show Segments
* Intro * Picks of the Week * Syncope * Heart Failure * Nausea and Dyspnea * COPD and Pneumonia * Sickle Cell Pain Management * Pain Management for the Hospitalist * Delirium * Geriatrics Updates * Electrolyte Management * Perioperative Anticoagulation * Perioperative Anemia * Severe Infections from Injection Drug Use * GI updates * Outro

Credits
* Written, Produced and Hosted by: Christina Sensabaugh MD, Meredith Trubitt MD, and Monee Amin MD * Cover Art: Monee Amin MD * Show Notes: Meredith Trubitt MD, Monee Amin MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste

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LIVE! Updates in HIV management at Hershey

Highly active, high-yield points on HIV management in Primary Care! We are joined by Infectious Disease specialist Dr. Jonathan J. “JJ” Nunez MD (of Penn State Health - Hershey) to review basics of management, important comorbidities, and new horizons in HIV care.

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments
* Intro * Establishing HIV Care, Initial History Taking * Privacy and HIV * Physical Exam Tips for HIV * Weight gain, managing cardiometabolic risks * Initial labs, tracking viral load * Undetectable = Untransmissible * Sexual history considerations, PEP, PrEP, * Anal paps, cervical cancer screening * Long-Acting HIV Medications * Take-home points * Outro

Credits
* Producer, Writers: Paul Williams MD, FACP, Beth Garbitelli MD * Show Notes, Infographic, Cover Art: Beth Garbitelli MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: J.J. Nunez MD

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Drop the pounds and the sugar with new guidelines

New rules to manage diabetes means using new tools. Leverage GLP-1 RA and SGLT2-i to drop with pounds and the sugars with the expert insight from our guest, Dr. Marie McDonnell.

Claim free CME for this episode at curbsiders.vcuhealth.orgPatreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments
* Puns and Intro. * Disclaimer and Guest bio * Case from Kashlak * Labs to distinguish type 1 from type 2 diabetes * Selecting initial therapy: Focus on weight loss and glucose control * HbA1c goals * Yeast infections and SGLT2-i * Using sulfonylureas and extended release metformin * Pancreatitis and GLP-1 RA * Cancer and GLP-1 RA * Semaglutide tips * Tirzepatide, how it works and benefits * Take home points * Outro

Credits
* Producer: Matthew Watto, MD and Isabel Valdez, PA * Writer: Matthew Watto, MD * Show Notes, Cover Art and Infographics: Isabel Valdez, PA * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed, MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Marie E. McDonnell, MD

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We demystify primary aldosteronism, MRAs (mineralocorticoid receptor antagonists), non-steroidal MRAs, and how to recognize and treat renovascular hypertension with nephrologist/hypertension expert, Dr. Matt Luther (@DrJMLuther) as part of the NephMadness PodCrawl 2023. Fill out a bracket for NephMadness and check out all eight NephMadness PodCrawl participants at NephMadness.com/podcrawl (list below) and the MRA region write-up by Micah Schub (@AcidBassMD). The Curbsiders gets the skinny on mineralocorticoid receptor antagonists * Core IM will be covering Kidney Transplant in their classic Five Pearl format * The CardioNerds will be covering the effect of Heart Failure Devices on Kidney Health * Freely Filtered will try to understand thrombotic microangiopathy * ISN Global Kidney Care goes deep on IgA nephropathy * The Cribsiders look at transitions, first the Pediatrics to Adult nephrology transition and then from living to death with palliative nephrology * Fellow on Call will be covering Onconephrology * And finally, The Nephron Segment looks at Transgender Health and CKD*

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Show Segments
* Intro * Diagnosis and Management of Primary Aldosteronism (PA) * MRAs vs non-steroidal MRAs (mineralocorticoid receptor antagonists) * NephMadness MRA region picks * Renovascular Hypertension * Outro

Credits
* Writer and Producer: Matthew Watto MD * Show Notes: Matthew Watto MD * Cover Art & Infographic: Matthew Watto MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: J. Matthew Luther MD

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We’ve got the hard-hitting questions and must-know answers on all things TIA and stroke from neurology expert, Dr. Karima Benameur (Emory University). Topics: TIA and stroke supportive management, indicated workup, and anticoagulation and antiplatelet management pearls for the hospitalist.

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Show Segments
Intro, disclaimer, guest bio * Case 1 from Kashlak; Definitions * Initial stroke triage, imaging, and assessing for interventions * Supportive care for stroke * Managing patients already on antiplatelet or anticoagulant therapy * Inpatient stroke workup * Dual antiplatelet therapy * Case 2 from Kashlak; Definitions * TIA workup and management * Transitions of care: “the invisible deficits” * Brain health and nutrition * Guest questions and Picks of the Week * Outro

Credits
* Written, Produced, Infographic and Cover Art, Show Notes: Caroline Coleman MD * Hosts: Monee Amin MD; Meredith Trubitt MD, MPH; Caroline Coleman MD * Reviewer: Molly Heublein MD * Executive Producer: Karly Loy * Showrunner: Matthew Watto MD, FACP * Editor: Pod Paste * Guest: Karima Benameur MD

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Full transcript available HERE

Stay up-to-date with advances in chronic kidney disease (CKD)! Join our esteemed Chief of Nephrology at Kashlak Memorial Hospital, Dr. Joel Topf, as he leads us through the latest on SGLT2 inhibitors, finerenone, potassium binders, and treatment of CKD-associated metabolic acidosis.

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Show Segments
* Intro, disclaimer, guest bio * Case from Kashlak * SGLT2i: when to initiate * SGLT2i: adverse effects * Finerenone * Potassium binders * Treatment of CKD-associated metabolic acidosis * Outro

Credits
* Writer, Producer, Show Notes, Infographics, and Cover Art: Malini Gandhi * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Dr. Joel Topf MD

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Join us as we review recent practice-changing articles on loop diuretics for heart failure exacerbation (torsemide vs furosemide), time-restricted eating vs small frequent meals for weight loss, how sedentary breaks from sitting effect blood glucose & blood pressure, early FMT for C. diff, and a brief rant on medications for obesity. Fill your brain hole with a delicious stack of hotcakes! Featuring Nora Taranto (@norataranto, The DIGEST), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

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Show Segments
* Intro, disclaimer * Loop diuretics (torsemide vs furosemide) for heart failure exacerbation * Time-restricted eating vs small frequent meals for weight loss * Sedentary breaks for lowering blood glucose and blood pressure * Early fecal microbiota transplant (FMT) for C. diff infection * Outro

Credits
* Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP * Cover Art: Matthew Watto MD, FACP * Reviewer: Rahul Ganatra MD, MPH * Technical Production: Pod Paste * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Full transcript available HERE

With Dr Holly Wong Cummings

Listen in as we talk through abnormal uterine bleeding (AUB) with our esteemed guest Holly Wong Cummings, MD. We review the PALM-COEIN framework for AUB diagnosis and discuss options for acute and chronic treatment of AUB. We can get bleeding under control! Many of the treatments including progesterone only pills, combined oral contraceptives, and tranexamic acid are medications we in primary care should feel confident prescribing to our patients.

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Show Segments
* Intro, disclaimer, guest bio * Case from Kashlak * Normal Menstrual Cycle * Nomenclature for AUB- PALM COEIN * History and Physical Exam * Laboratory and radiologic evaluation * Structural causes for bleeding/interpreting the ultrasound * Acute treatment of AUB * When to refer to ED * Chronic treatment for AUB * When to refer to gyn * Take home points * Outro

Credits
* Producer, Writer, Show Notes: Molly Heublein MD * Infographic: Edison Jyang * Cover Art: Sarah Phoebe Roberts * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD * Reviewer: Sai S Achi MD, MBA * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Holly Wong Cummings MD

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Join Drs. Amin and Trubitt as they go rogue and LIVE! from Southern Hospital Medicine to discuss Things We Do For No ReasonTM in the hospital that impact the patient experience. They cover NPO at midnight, fluid restriction, VTE chemoprophylaxis and routine vital signs via the hospital course of one poor, unfortunate soul.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org

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Show Segments
* Intro * NPO at midnight * Fluid restriction * VTE chemoprophylaxis * Frequency of vital sign monitoring * Outro

Credits
* Written and Produced by: Monee Amin MD and Meredith Trubitt MD * Cover art and presentation graphics: Caroline Coleman, MD * Show Notes: Monee Amin MD and Meredith Trubitt MD * Hosts: Monee Amin, MD and Meredith Trubitt MD * Technical Production: PodPaste * Showrunner: Matthew Watto MD, FACP

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Full Transcript available HERE

Recognize when to consider the diagnosis of hemochromatosis and how to recognize common mimics of an elevated ferritin level. We’re joined by Dr. Elliot Tapper,@ebtapper on twitter (University of Michigan)

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Show Segments
* Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak; Definitions * Initial evaluation of Hemochromatosis * Etiology of elevated ferritin in liver disease * Potential mimics of hemochromatosis * Diagnosis of hemochromatosis * Evaluation of hepatic fibrosis in hemochromatosis * Manifestations & complications of hemochromatosis * Outro

Credits
* Producer & Writer:: Elena Gibson MD * Infographic & Cover Art:Edison Jyang * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Elliot Tapper

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With Dr Steven Rauch

Demystify hearing loss, identify who will benefit from hearing aids and learn to evaluate hearing complaints in primary care including an overview of tinnitus and how to recognize and treat Meniere’s disease with guest expert, Dr. Steven Rauch (Harvard University).
Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Case from Kashlak;
Definitions, etiology and risk factors for hearing loss
Initial workup for hearing loss
What is an audiogram and what does it show
Hearing loss red flags
How to manage hearing loss
Tinnitus: what can help patients
Diagnose, distinguish and treat Meniere’s disease
Outro

Credits
* Script and Show Notes written by, Produced by: Kate Grant MBChB, MRCGP and Andréa Perdigão * Infographic and Cover Art: Kate Grant MBChB, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Molly Heublein MD * Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Steve Rauch MD

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Pro Tips & Practical Insights from Dr. Jim O’Brien

Are acute COPD exacerbations taking the wind out of YOUR sails? Join us as we navigate the stormy waters that can be AECOPD with our guest expert, Dr. Jim O’Brien from National Jewish Health Center.

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Show Segments
Intro, disclaimer, guest bio * What is a COPD * Case from Kashlak - Natalie Harrison * Knee jerk reaction: Determining level of illness & disposition * Initial work-up considerations * What’s in your differential? * The second-order assessment - shuffling the differential, honing in on the patient * AECOPD: Triggers & Pathophysiology * Treatment Pearls I: Steroids * Treatment Pearls II: Antibiotics * Treatment Pearls III: Bronchodilators * Treatment Pearls IV: Oxygen Therapy * Preparing for discharge * Take home points * Lightning Round! Getting to know Dr. O’Brien & Picks of the Week * Outro

Credits
* Writer & Producer: Cyrus Askin MD * Show Notes, Infographic & Cover Art: Cyrus Askin MD * Hosts: Meredith Trubitt MD, Monee Amin MD & Cyrus Askin MD * Reviewer: Sai Achi, MD MBA * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Jim O’Brien MD

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Subscription.

Conquer your fear of adrenal incidentalomas! We’re joined by Dr. William Young, who teaches us pearls for evaluating imaging characteristics of adrenal incidentalomas, tips for assessing and managing functioning adenomas, approaches to follow-up and surgical considerations, and more.

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Show Segments
* Intro, disclaimer, guest bio * Case #1 from Kashlak; Definitions * Discussing adrenal incidentalomas with patients * Imaging characteristics of adrenal incidentalomas * Evaluation of hormonal hypersecretion - overview * Subclinical Cushing’s syndrome * Pheochromocytoma * Surgical considerations based on nodule size and imaging phenotype * Follow-up imaging * Case#2 from Kashlak * Primary hyperaldosteronism - work-up and management * Bilateral adrenal nodules * Guest Picks of the Week * Outro

Credits
* Producer, Writer, Show Notes, Infographic, and Cover Art: Malini Gandhi * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Leah Witt MD * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: William Young MD

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We have better tools for prevention, but let’s talk!

Should we be offering hormone therapy for primary prevention in postmenopausal patients? Dr. Carol Mangione (UCLA) talks us through the potential benefits and harms, and explains how this can be a jumping off point for important conversations about preventive care.

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Credits
* Producers, Hosts: Elena Gibson MD and Paul Williams MD, FACP * Writer, Infographic, and Cover Art: Elena Gibson MD * Show notes: Paul Williams MD, FACP * Reviewer: Molly Heublein MD * Production team: Podpaste * Guest: Carol Mangione MD

In this episode you will learn to master delirium in the hospital! We discuss preventing, recognizing, and managing this common and dangerous condition. We are joined by delirium expert and President of the American Delirium Society, Dr. Esther Oh @EstherOh_MDPhD (Johns Hopkins University)

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Show Segments
Intro, disclaimer, guest bio * Guest one-liner, Picks of the Week * Case 1 from Kashlak: hypoactive delirium * Definition of delirium * Delirium vs. encephalopathy vs. dementia * Delirium assessment tools * Prevention of delirium * Discharging patients with delirium * Case 2 from Kashlak: hyperactive delirium * Antipsychotics * Working up etiologies of delirium * Treatment/management pitfalls * Outro

Credits
* Produced, Script, Show Notes: Adam Barelski MD * Infographic & Cover Art: Edison Jyang; Sarah Phoebe Roberts * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Adam Barelski MD * Reviewer: Molly Heublein MD * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Esther Oh MD, PhD

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Full transcript HERE

Don’t get distracted, pay attention to the details, and manage ADHD in your patients!

Dr. Kevin Simon, @DrKMSimon (Boston Children’s Hospital) shows us how to stay focused and diagnose and manage attention deficit hyperactivity disorder (ADHD) in your patients. Learn how to make the right diagnosis, choose an appropriate medication, and modify therapy.

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Show Segments
* Intro, disclaimer, guest bio * Case from Kashlak; Definitions and diagnosis of ADHD * Stimulant medications for ADHD * Non-stimulant medications for ADHD * Mitigating diversion of medications for ADHD * Managing ADHD in patients with substance use disorder * Lightning round and picks of the week * Outro

Credits
* Written and Produced by: Paul Williams, MD, FACP * Show Notes: Paul Williams, MD, FACP * Infographic and Cover Art: Paul Williams, MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Fatima Syed, MD * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Kevin Simon, MD

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Full Transcript HERE

Celebrate the holiday season with top pearls on constipation, palpitations, hypertension, meds for obesity, cardiorenal syndrome, hepatitis C, staging the liver, vitamin supplementation and more! Plus, Watto and Paul share their reflections on seven years of podcasting, give their picks of the year, and tease upcoming episodes for 2023!

Note No CME for this episode but visit curbsiders.vcuhealth.org to claim credit for shows from 2022!

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Show Segments
* Intro, disclaimer, * Reflections on 2022 * Constipation, * Palpitations, * Hypertension, * Obesity medications, * Cardiorenal syndrome, * Hepatitis C, * Vitamin supplementation * Picks of the Year * Outro

Credits
* Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art design: Matthew Watto MD, FACP * Technical Production: Pod Paste

Full transcript HERE

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm.
Free CME for this episode atcurbsiders.vcuhealth.org

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Show Segments
● Intro, disclaimer, guest bio
● Guest one-liner, Picks of the Week
● Case 1 from Kashlak
● Adrenal crisis identification, workup and management
● Case 2 from Kashlak
● Myxedema identification, workup and management
● Case 3 from Kashlak
● Thyroid storm identification, workup and management
● Outro
Credits*
● Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD
● Show Notes, Infographic and Cover Art: Caroline Coleman, MD
● Reviewer: Emi Okamoto, MD
● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Technical Production: PodPaste
● Guest: Sara Markley Webster, MD

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Navigating guidelines, parsing through the PSA, Survivorship, & More!

Become a pro when addressing prostate cancer! We tackle the nuances surrounding screening for this all-to-common cancer and discuss important considerations in survivorship with our guest Dr. Petar Bajic (Twitter: @PBajicMD, Instagram: @the.sexdoc) of Cleveland Clinic! You’re IN for a good time listening to this episode!

Claim free CME for this episode at curbsiders.vcuhealth.org!Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME!
Show Segments
● Intro, disclaimer, guest bio
● Guest one-liner
● Case from Kashlak
● Epidemiology of Prostate Cancer
● Screening Basics
● What is the PSA?
● Next Steps After Elevated PSA
● Thresholds and techniques for biopsy
● Free PSA, Other testing modalities, Prostate MRI
● Active Surveillance Nuts and Bolts
● Survivorship
● Take home points, Outro

Credits
● Producer,Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli MD
● Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD
● Reviewer: Sai S Achi, MD MBA
● Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP
● Technical Production: PodPaste
● Guest: Dr. Petar Bajic MD

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Sponsor: Pattern Life
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Full Transcript HERE

Master the ins-and-outs of Parkinson’s Disease! We’re joined by Dr. Albert Hung, who teaches us pearls for the initial history and physical exam in a patient with undiagnosed Parkinson’s, a framework for management of early and advanced motor symptoms, tips for treating autonomic symptoms and cognitive / psychiatric features, and more.

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Show Segments
* Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak * Initial history in a patient with undiagnosed Parkinson’s * “Pre-motor” symptoms of Parkinson’s disease * Physical exam in Parkinson’s disease * Drug-induced Parkinsonism * “Red flags” suggesting atypical parkinsonian syndromes * Role of imaging in diagnosis * Typical discussion with patient at initial diagnosis * Initial management of motor symptoms * Management of autonomic symptoms * Management of advanced motor symptoms * Management of cognitive and psychiatric symptoms * Outro

Credits
* Producer, Writer, Show Notes, and Infographic: Malini Gandhi * Cover Art: Kate Grant * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD * Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP * Technical Production: PodPaste * Guest: Albert Hung MD, PhD

Recap and review the top pearls from recent episodes #339 Hand and Wrist Pain, #348 Foot and Ankle Pain, and #351 Myopathy and Myositis with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #339, #348 and #351!

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Show Segments

Intro, disclaimer, guest bio
Hand and Wrist pain: CMC joint arthritis, tenosynovitis, carpal tunnel syndrome, trigger finger
Foot and Ankle pain: Ankle sprains, Achilles tendon injuries, Posterior tibial tendon dysfunction
Myopathy and Myositis pearls
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

A Rational Approach: Who to Image, How to Treat, and More!

Back pain is one of the most common concerns our patients bring to us in the outpatient setting. It’s a lot more complicated than rest, ice, and NSAIDs! Fortunately, we have pain expert, strength coach, and academic internist Dr. Austin Baraki (Austin Baraki, MD (@AustinBaraki) / Twitter) to help us develop a comprehensive, patient centered approach to help our patients manage their pain and lead healthier lives. Take control of your patients’ back pain!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak
Introduction to Back Pain
Eliciting the Patient’s Story
Risk Stratification, Intro to Red Flags, and and the STarT Back Tool
The Importance of Language and Patient-Centered Outcomes
A Deeper Dive into Red Flags
Setting Expectations for Care
Therapeutics for Back Pain - Does anything work?
The Exercise Prescription

Credits

Producers: Isabel Valdez, PA-C & Cyrus Askin, MD
Writer, Cover Art and Infographics: Isabel Valdez, PA-C
Show Notes: Cyrus Askin, MD
Hosts: Matthew Watto MD, FACP; Isabel Valdez, PA-C
Reviewer: Molly Heublein, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Austin Baraki, MD

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Join us as we review recent practice-changing articles addressing the questions: Do weekend warriors experience a mortality benefit from exercise? Is an aggressive fluid strategy superior to a moderate strategy in acute pancreatitis? Does an invite for colonoscopy decrease colon cancer-related mortality? Did the benefits of intensive blood pressure control continue after the SPRINT trial ended? Fill your plate with a stack of hot tofurkey cakes! Featuring Drs. Era Kryzhanovskaya (@erakryzhmd), Nora Taranto (@norataranto), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer
Do weekend warriors experience a mortality benefit?
Should you choose aggressive or moderate fluid resuscitation for acute pancreatitis?
Does an invite for screening colonoscopy reduce colon cancer and CRC-related mortality?
Did benefits from the SPRINT trial persist in observational follow up?
Outro

Credits

Written and Hosted by: Era Kryzhanovskaya, MD, Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste

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With Carolyn Chan MD and Shawn Cohen MD

Conquer acute pain in the hospitalized patient with opioid use disorder! It’s challenging to treat opioid withdrawal and acute pain simultaneously. This episode features clinical pearls on prescribing methadone, buprenorphine, low-dose buprenorphine initiation, and how to incorporate opioids as part of multimodal pain treatment responsibly. We’re joined by The Curbsiders Addiction Medicine Podcast hosts, Drs. Carolyn Chan (@carolynachan) and Shawn Cohen (@shawncohen)!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Acute pain in the patient on buprenorphine maintenance
Acute pain in the patient on methadone maintenance
Acute pain in the patient with opioid withdrawal
Standard buprenorphine initiation
Methadone initiation
Low dose buprenorphine initiation
Take-home points
Outro

Credits

Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP
Reviewer: Fatima Syed MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Carolyn Chan MD and Shawn Cohen MD

Sponsor: ExpressVPN

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Sponsor: Southern California Permanente Medical Group

Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684.

Full transcript HERE

We’ve Come a Long Way From Ether

Learn how an anesthesiologist approaches perioperative medicine from how to choose the right type of anesthesia (general anesthesia vs regional anesthesia vs MAC), to preoperative risk assessment, and how to avoid anesthesia related complications. Our guest, anesthesiologist, Dr. Angela Selzer (Denver, CO) helps us explore high yield pearls regarding the practice of anesthesiology to empower the internal medicine clinician to deliver team-based, perioperative care.

Claim Free CE credit for this episode through VCU Health CE atcurbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Introduction to anesthesiology
Introduction to regional anesthesiology
Walk through what an anesthesiologist does in the operating room
Ambulatory surgery center exclusions
Approach to preop assessments
“Will it change management?” applied to anesthesiologists
ASA Classes
Anesthesia complications
Take Home Points; Outro; Bonus clip

Credits

Written and Produced by: Edison Jyang; Avital O’Glasser MD, FACP, SFHM
Cover Art: Sarah Phoebe Roberts, MPH
Infographic: Avital O’Glasser MD, FACP, SFHM; Edison Jyang
Show Notes: Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Avital O’Glasser MD, FACP, SFHM
Technical Production: Pod Paste
Reviewer: Sai S Achi, MD MBA
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Angela Selzer, MD

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Full transcript HERE

We ran the numbers, and it’s still important!

Should patients be screened for syphilis? If so, which ones? Dr. Katrina Donahue (USPSTF) talks us through this re-affirmation of the USPSTF syphilis screening guideline, including who might be high risk and how to screen them.

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Credits

Producers: Elena Gibson, MD and Paul Williams MD, FACP
Writer: Elena Gibson, MD
Show notes: Paul Williams MD, FACP
Infographic and Cover Art: Elena Gibson, MD
Hosts: Paul Williams MD, FACP and Elena Gibson MD
Production team: Podpaste
Guest: Katrina Donahue MD

Full Transcript HERE

Optimize and update your approach to atrial fibrillation (afib) as we discuss early rhythm control, antiarrhythmic drugs, TTE/cardioversion, afib ablation, new onset afib in the hospitalized patient, and left atrial appendage closure. Plus, we try to answer, Does afib burden matter? Our guest is cardiologist-electrophysiologist, Hugh Calkins MD, @hughcalkinsMD, Professor of Cardiology at Johns Hopkins, @hopkinsheart.

Sorry, but we won’t be offering CME for this episode. You can claim CME for past episodes at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak; Definitions
An approach to new-onset afib in the office
Rhythm control
Lifestyle modification is a pillar of afib treatment
Indications for hospitalization in afib
More on rhythm control and when to pursue afib ablation
Rhythm control in heart failure
New onset afib in the hospitalized patient
Does afib burden matter?
Left atrial appendage closure
Watto and Paul recap what we’ve learned
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover art and Infographic by:
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Hugh Calkins MD

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Full transcript HERE

Recap and review the top pearls from recent episodes #341 Migraine Headaches Update and #350 Acute Hypoxemia with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #341 and #350!

Show Segments

Intro, disclaimer, guest bio
Migraine Headaches Update
An approach to Hypoxemia
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

Lipids Update 2022: Cardiovascular Risk Reduction and New Medications on the Horizon with Erin Michos, MD

Show description:

Ready to take the next step in management of your patient with hyperlipidemia? Dr. Erin Michos (@erinmichos) returns to give us a lesson in Advanced Lipidology. She updates us on what new medications we can use for those difficult to treat lipids and what medications are on the horizon.

Unfortunately, this episode will not be available for CME. You can claim free CME for other episodes at curbsiders.vcuhealth.org!

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Show Segments

Intro, Getting to know Dr. Erin Michos, Pick of the Week
Patient Case, Digging into ASCVD Risk
Coronary artery calcium scoring - why it’s important
What are “Risk Enhancing Factors”?
Biomarker testing, what is the significance of Lip a and how can we use it to drive management?
Introduction to PCSK9 inhibitors
More than just statins - other LDL-lowering medications
siRNAs, ASOs - Pelacarsen and more
Apollo Trial regarding Pelacarsen
Importance of Family History
What to do if maxed out on a statin or statin intolerance - Ezetimibe, PCSK9 inhibitors, MAB therapies, and more
Bempedoic Acid discussion
Medication side effects
Homozygous FH - approach to treatment, ANGPTL3 inhibitors
Triglycerides discussion, icosapent ethyl, the REDUCE-IT trial
Wrap-up and Take home points, Outtro

Credits

Producer and written by: Christopher Chiu MD, FACP, FAAP
Show Notes: James Antaki MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChB, DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Erin Michos MD, MHS

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Full transcript HERE

The treatment your patients need but may not be getting!

Take a bite out of our latest episode featuring guest expert Dr. Michelle McMacken (@DrMcMacken) and learn how you can help your patients effectively and sustainably reap the health benefits of improved nutrition. Discover the enormous evidence base for nutritional recommendations, develop scripts to engage patients, and update your CVD, T2DM, and hyperlipidemia treatment plans to meaningfully incorporate nutrition. Get your truffle-hunting outfit on, it’s time to go foraging for some tasty knowledge food!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, favorite advice
Case from Kashlak; definitions
“Evidence-based nutrition” vs plant-based diet
Unifying the guidelines for patient care
Treating the skeptical patient
Tailoring recommendations to patients’ needs
Treating the motivated patient
Host questions
Outro

Credits

Written and Produced by: Deep Shah MD
Show Notes: Sarah Phoebe Roberts, Deep Shah MD
Infographic and Cover Art: Lyan Chang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deep Shah MD
Reviewers: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Michelle McMacken MD, FACP, DipABLM

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Super foods handout

Full transcript HERE

Master the latest knowledge on the ongoing monkeypox outbreak with Dr. Boghuma Titanji (@Boghuma)! Learn how to recognize monkeypox in the clinic, how to test for monkeypox, how to approach management (including options for antiviral agents), and more.

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak
History of monkeypox - past and current outbreaks
Transmission of monkeypox
Risk factors for monkeypox
Clinical presentation of monkeypox
Testing for monkeypox
Management of monkeypox: supportive care and antivirals
Monkeypox in patients with HIV
Monkeypox in pregnancy
Monkeypox vaccines
Outro

Credits

Producer and Writer: Paul Williams MD, FACP
Show Notes: Malini Gandhi
Infographic: Sarah Phoebe Roberts
Cover Art: Kate Grant MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Boghuma Titanji MD

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From Cord Compression to Tumor Lysis Syndrome

Do you freak out over oncologic emergencies like cord compression or tumor lysis syndrome? Join Dr. Aditi Singh (University of Pennsylvania, Abramson Cancer Center, @AditiSinghMD) for this comprehensive conversation on six commonly encountered oncologic emergencies we see in the hospital!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Cord Compression
SVC Syndrome
Malignant Obstruction
Tumor Lysis Syndrome
Blast Crisis
Outro

Credits

Producer, Writer, Hosts: Meredith Trubitt, MD MPH; Monee Amin, MD
Infographic and Cover Art: Caroline Coleman
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Aditi Singh, MD

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Find out if ultra-short course (two days) antibiotics work for pneumonia, if acetazolamide improves diuretic efficiency in acute decompensated heart failure, should we prescribe psilocybin (magic mushrooms) to treat alcohol use disorder, and if removal of asymptomatic kidney stones decreases the incidence of future events! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto) catch up on recent practice-changing articles and guidelines!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer
Ultra-short Antibiotics for Pneumonia,
Acetazolamide for acute heart failure exacerbations,
Psilocybin for AUD,
Asymptomatic Kidney Stone Removal
Outro

Credits

Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste

Brush up on your COPD skills and learn some new tips for diagnosis and management of this common respiratory condition from our expert Dr. Antonio Anzueto (University of Texas San Antonio).

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Epidemiology
Diagnosis
Workup
Characterization of disease
Treatment
Outro

Credits

Writer and Producer: Cyrus Askin, MD
Show Notes: Deborah Gorth MD, PhD
Infographic: Kate Grant MD
Cover Art: Kate Grant MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Antonio Anzueto, MD

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Brush up on your COPD skills and learn some new tips for diagnosis and management of this common respiratory condition from our expert Dr. Antonio Anzueto (University of Texas San Antonio).

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Epidemiology
Diagnosis
Workup
Characterization of disease
Treatment
Outro

Credits

Writer and Producer: Cyrus Askin, MD
Show Notes: Deborah Gorth MD, PhD
Infographic: Kate Grant MD
Cover Art: Kate Grant MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Antonio Anzueto, MD

Sponsor: Wild Grain

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Upper and Lower GI Bleed Diagnosis and Management

Handle the gush of upper and lower GI bleeds with ease thanks to Dr. Tanvi Dhere (@DhereMdEmory)! Learn diagnosis, initial management as well as post-procedure management including when to resume anticoagulation and antithrombotic therapy.

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak;
Upper GI bleed
Labs, Stool Studies
Initial Management of GI bleed
Endoscopy
Post-procedure management
Lower GI bleed
Colonoscopy
Imaging/Interventional Radiology
Outro

Credits

Producers and Writers: Meredith Trubitt MD, MPH; Monee Amin MD
Show Notes: Monee Amin, MD
Infographics and Cover Art: Caroline Coleman, MD
Hosts: Meredith Trubitt MD, MPH; Monee Amin MD
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Tanvi Dhere, MD

Sponsor: Birch

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Full Transcript HERE

Upper and Lower GI Bleed Diagnosis and Management

Handle the gush of upper and lower GI bleeds with ease thanks to Dr. Tanvi Dhere (@DhereMdEmory)! Learn diagnosis, initial management as well as post-procedure management including when to resume anticoagulation and antithrombotic therapy.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak;
Upper GI bleed
Labs, Stool Studies
Initial Management of GI bleed
Endoscopy
Post-procedure management
Lower GI bleed
Colonoscopy
Imaging/Interventional Radiology
Outro

Credits

Producers and Writers: Meredith Trubitt MD, MPH; Monee Amin MD
Show Notes: Monee Amin, MD
Infographics and Cover Art: Caroline Coleman, MD
Hosts: Meredith Trubitt MD, MPH; Monee Amin MD
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Tanvi Dhere, MD

Sponsor: Birch

Birch is giving $400 off all mattresses and 2 free eco-resy pillows at BirchLiving.com/curb Sponsor: BetterHelp

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Sponsor: Medmastery

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Full Transcript HERE

We’re back with another women in medicine episode– this time Shreya and Leah interview their she-ro Dr. Kemi Doll, career coach extraordinaire to women of color in academic medicine. She is breaking down the biggest challenges she’s seen her clients face and how to tackle them!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Dr. Doll’s journey into coaching women of color in academic medicine
Top 5 challenges faced by women of color in academic medicine
Solutions to the challenges
Outro

Credits

Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD
Infographic and Cover Art: Shreya Trivedi, MD
Show Notes: Leah Witt, MD
Hosts: Leah Witt, MD, Shreya Trivedi, MD and Matthew Watto MD, FACP
Associate Editor: Emi Okamoto, MD
Showrunners: Leah Witt, MD and Shreya Trivedi, MD
Technical Production: PodPaste
Guest: Kemi Doll, MD

Polyps, polypectomy & surveillance with Dr. Jennifer Maranki

Learn how to recommend a good bowel prep, read colonoscopy reports, and review recommended polyp surveillance with Dr. Jennifer Maranki, @jenmarankimd (Penn State Health)

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; definitions
Polyp definitions and categories
Bowel prep & colonoscopy quality
Colorectal polyp surveillance
Potential complications
When to consider polyposis syndromes
Outro

Credits

Producer & Writer: Elena Gibson MD
Show Notes: Elena Gibson MD
Infographic & Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Jennifer Maranki MD

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Polyps, polypectomy & surveillance with Dr. Jennifer Maranki

Learn how to recommend a good bowel prep, read colonoscopy reports, and review recommended polyp surveillance with Dr. Jennifer Maranki, @jenmarankimd (Penn State Health)

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; definitions
Polyp definitions and categories
Bowel prep & colonoscopy quality
Colorectal polyp surveillance
Potential complications
When to consider polyposis syndromes
Outro

Credits

Producer & Writer: Elena Gibson MD
Show Notes: Elena Gibson MD
Infographic & Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Jennifer Maranki MD

Sponsor: ExpressVPNSecure your online Activity and get three months free by visiting ExpressVPN.com/curb

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A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here.

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Show Segments

Intro, Getting to know our guest
Clinical Case
Why can’t patients describe their dizziness?
Classifying dizziness
The 3 vestibular syndrome buckets defined
Episodic vestibular syndrome differential diagnosis
Acute vestibular syndrome differential diagnosis
Chronic vestibular syndrome differential diagnosis
Challenges of medical history taking
Approach to the acute vestibular syndrome/HINTS
How to evaluate nystagmus
How to perform the head impulse test (aka head thrust)
How to perform “test of skew” (alternate cover testing)
Recap of HINTS exam and discussion of MRI
Signs and symptoms of cerebellar stroke
Use of Dix-Hallpike for episodic vertigo
What happens when you choose the wrong test
Continuous versus triggered dizziness, or vertigo
Meclizine use in BPPV
How to cure horizontal canal BPPV
Treatment for vestibular neuritis
Treatment for Meniere’s disease
Who benefits from vestibular rehab/exercises
Dizziness and giddiness
Take home points
Outro

Credits

Produced and Written by: Cyrus Askin MD
Show Notes: Matthew Watto MD
Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: David Newman-Toker MD, PhD

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A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | ask@gmail.com | Free CME!

Show Segments

Intro, Getting to know our guest
Clinical Case
Why can’t patients describe their dizziness?
Classifying dizziness
The 3 vestibular syndrome buckets defined
Episodic vestibular syndrome differential diagnosis
Acute vestibular syndrome differential diagnosis
Chronic vestibular syndrome differential diagnosis
Challenges of medical history taking
Approach to the acute vestibular syndrome/HINTS
How to evaluate nystagmus
How to perform the head impulse test (aka head thrust)
How to perform “test of skew” (alternate cover testing)
Recap of HINTS exam and discussion of MRI
Signs and symptoms of cerebellar stroke
Use of Dix-Hallpike for episodic vertigo
What happens when you choose the wrong test
Continuous versus triggered dizziness, or vertigo
Meclizine use in BPPV
How to cure horizontal canal BPPV
Treatment for vestibular neuritis
Treatment for Meniere’s disease
Who benefits from vestibular rehab/exercises
Dizziness and giddiness
Take home points
Outro

Credits

Produced and Written by: Cyrus Askin MD
Show Notes: Matthew Watto MD
Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: David Newman-Toker MD, PhD

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Recap and review the top pearls from recent episodes #322 H. Pylori and #324 Obesity Medicine FAQ with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #322 and #324!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
H. pylori
Obesity Medicine FAQ
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

Recap and review the top pearls from recent episodes #322 H. Pylori and #324 Obesity Medicine FAQ with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #322 and #324!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
H. pylori
Obesity Medicine FAQ
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Full transcript HERE

On this Curbsiders classic, we discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)! This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! Original show notes here.

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
How to approach antibiotics
Choosing antibiotics / Framework
Dr. Shah’s favorite antibiotics
Pneumonia
Diabetic Foot Infections
Take-home points
Outro

Credits

Produced and Written by: Nora Taranto MD
Infographic, Cover Art, Show Notes: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com
Reviewer: Victor Kovac MD
Guest: Adi Shah MBBS

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On this Curbsiders classic, we discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)! This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! Original show notes here.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | ask@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
How to approach antibiotics
Choosing antibiotics / Framework
Dr. Shah’s favorite antibiotics
Pneumonia
Diabetic Foot Infections
Take-home points
Outro

Credits

Produced and Written by: Nora Taranto MD
Infographic, Cover Art, Show Notes: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com
Reviewer: Victor Kovac MD
Guest: Adi Shah MBBS

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The Thrill of Victory and the Agony of the Feet

Don’t fear foot pain! Learn how to evaluate the painful foot and ankle, what needs imaging, and who needs rehab. We are joined by Dr. Joan Ritter (Walter Reed National Military Medical Center) for a special live Curbsiders episode!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Relevant anatomy
Ankle sprains
Achilles tendon rupture and tendonitis
Plantar fasciitis
Posterior tibial tendon dysfunction
Midfoot pain
Morton’s neuroma
Audience questions
Outro

Credits

Writer and Producer: Paul Williams MD, FACP
Show Notes and Infographic: Paul WIlliamsMD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Joan Ritter MD

Sponsor: Birch Living

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The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Diagnosing & Managing Acute Hypoxemia with Nick Mark MD

Quick! Your patient is desaturating! Have no fear, for in this installment of our Rapid Response series we have recruited pulmonologist/intensivist extraordinaire, the great Dr. Nick Mark of ICU One Pager, to share with us all the pitfalls and pearls we need to have under our collective belt when it comes to understanding, managing, and considering the etiologies of acute hypoxemia!

Free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Definitions
How does a pulse oximeter work?
Clinical approach to hypoxemia
The SIX causes of hypoxemia
Delivering supplemental oxygen

Credits

Written and Produced by: Cyrus Askin MD & Edison Jyang MS4
Infographic and Cover Art: Edison Jyang MS4
Show Notes: Cyrus Askin, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste

Guest: Nick Mark MD

Sponsor: Indeed

Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Offer good for a limited time.

Sponsor: Betterhelp

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Sponsor: Ten Thousand

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Sponsor: Medmastery

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Diagnosing & Managing Acute Hypoxemia with Nick Mark MD

Quick! Your patient is desaturating! Have no fear, for in this installment of our Rapid Response series we have recruited pulmonologist/intensivist extraordinaire, the great Dr. Nick Mark of ICU One Pager, to share with us all the pitfalls and pearls we need to have under our collective belt when it comes to understanding, managing, and considering the etiologies of acute hypoxemia!

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Definitions
How does a pulse oximeter work?
Clinical approach to hypoxemia
The SIX causes of hypoxemia
Delivering supplemental oxygen

Credits

Written and Produced by: Cyrus Askin MD & Edison Jyang MS4
Infographic and Cover Art: Edison Jyang MS4
Show Notes: Cyrus Askin, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste

Guest: Nick Mark MD

Sponsor: Indeed

Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Offer good for a limited time.

Sponsor: Betterhelp

Listeners get 10% off their first monmouth at BetterHelp.com/Curb

Sponsor: Ten Thousand

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Sponsor: Medmastery

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Find out how tirzepatide might revolutionize weight loss, pharmacogenomics might improve antidepressant prescribing, seasonal edema affects Google searches, and whether nirmatrelvir/ritonavir helps standard-risk patients with COVID-19, and patient-centered recommendations for inpatient care from SHM/Choosing Wisely! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, Picks of the Week
Case from Kashlak; Definitions
Tirzepatide for weight loss
Pharmacogenomics for personalized antidepressants
Seasonal Edema
Nirmatrelvir/ritonavir for standard-risk COVID-19
Hospital Medicine Choosing Wisely recommendations
Outro

Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste

Sponsor: Medmastery

Visit medmastery.com/curbsiders to claim a discount on any subscription.

Sponsor: Green Chef

Go to GreenChef.com/curb135 and use curb135 to get $135 off across 5 boxes and your first box shipped free.

Sponsor: South California Permanente Medical Group

Visit scpmgphysiciancareers.com or call (866) 449-1684 to apply to join SCPMG as an Outpatient Internal Medicine Physician.

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Find out how tirzepatide might revolutionize weight loss, pharmacogenomics might improve antidepressant prescribing, seasonal edema affects Google searches, and whether nirmatrelvir/ritonavir helps standard-risk patients with COVID-19, and patient-centered recommendations for inpatient care from SHM/Choosing Wisely! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, Picks of the Week
Case from Kashlak; Definitions
Tirzepatide for weight loss
Pharmacogenomics for personalized antidepressants
Seasonal Edema
Nirmatrelvir/ritonavir for standard-risk COVID-19
Hospital Medicine Choosing Wisely recommendations
Outro

Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatral MD, MPH
Technical Production: Pod Paste

Sponsor: Medmastery

Visit medmastery.com/curbsiders to claim a discount on any subscription.

Sponsor: Green Chef

Go to GreenChef.com/curb135 and use curb135 to get $135 off across 5 boxes and your first box shipped free.

Sponsor: South California Permanente Medical Group

Visit scpmgphysiciancareers.com or call (866) 449-1684 to apply to join SCPMG as an Outpatient Internal Medicine Physician.

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Learn to recognize myositis and myopathy (aka the idiopathic inflammatory myopathies), perform the appropriate initial testing, whether or not statins and exercise are safe to continue, and how to partner with our subspecialist colleagues to treat these patients in primary care. Recorded LIVE at Johns Hopkins, we’re joined by Dr. Lisa Christopher-Stine, @DrLisaCS of @HopkinsMedicine, a rheumatologist and leading expert on myositis and myopathy!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
History and Exam
Workup for suspected myositis
Cancer screening
Safety of statin use and exercise
Our role in primary care
Audience Questions
Outro

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Andréa Perdigão
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Technical Production: Pod Paste

Guest: Lisa Christopher-Stine MD, MPH

Sponsor: Grammarly

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Sponsor: Betterhelp

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Sponsor: Wildgrain

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

USPSTF Update with Dr. John Wong

Review the updated 2022 United States Preventive Task Force (USPSTF) guidelines on aspirin use to prevent cardiovascular disease (CVD) with Dr. John Wong.

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Credits

Producer & Writer: Elena Gibson MD
Show Notes: Elena Gibson MD
Cover Art & Infographic: Elena Gibson MD
Hosts: Paul Williams MD, FACP; Elena Gibson MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: John Wong, MD

Sponsor: Medmastery

Visit medmastery.com/curbsiders to receive a discount.

Full Transcript HERE

USPSTF Update with Dr. John Wong

Review the updated 2022 United States Preventive Task Force (USPSTF) guidelines on aspirin use to prevent cardiovascular disease (CVD) with Dr. John Wong.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer & Writer: Elena Gibson MD
Show Notes: Elena Gibson MD
Cover Art & Infographic: Elena Gibson MD
Hosts: Paul Williams MD, FACP; Elena Gibson MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: John Wong, MD

Sponsor: Medmastery

Visit medmastery.com/curbsiders to receive a discount.

Full Transcript HERE

There’s nothing that gets a hospitalist more anxious and excited at the same time than a case of suspected meningitis. In this episode, we learn that if the thought crosses our mind, a lumbar puncture is almost certainly indicated. Our guest, Dr. Payal Patel, helps us with the balancing act that is diagnosing and managing meningitis!

Free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; history and physical
Initial workup for meningitis
Treatment choices and duration
Transitions of Care

Credits

Written and Produced by: Monee Amin MD, Meredith Trubitt MD, MPH
Infographic and Cover Art: Caroline Coleman, MD
Show Notes: Monee Amin, MD
Hosts: Matthew Watto MD, FACP; Monee amin,, MD
Reviewer: Rahul Ganatra, MD MPH
Executive Producer: Karly Loy
Showrunner: Matthew Watto MD, FACP
Editor: podpaste
Guest: Payal Patel, MD

Sponsor: Indeed

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Sponsor: Birch

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Sponsor: Green Chef

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Can vitamins prevent CVD and cancer? We kind of don’t have the answer!

Is vitamin and mineral supplementation safe? Effective? Listen as our esteemed guest Dr. Michael Barry talks to us about the new United States Preventive Services Task Force recommendation regarding the role of vitamin and mineral supplementation in preventing cardiovascular disease and cancer.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers: Paul Williams MD, FACP and Elena Gibson, MD
Writer: Paul Williams MD, FACP
Show notes: Paul Williams MD, FACP
Infographic and Cover Art: Elena Gibson, MD
Hosts: Paul Williams MD, FACP and Elena Gibson MD
Production team: Podpaste
Guest: Michael Barry MD

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow-up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! Get the original show notes here!

Prior lipid episodes:

37 Lipids, PCSK9, and ezetimibe: Lower is better.

10 Cholesterol, lipids, statins, fish oil. Become a Master Lipidologist.

Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org!

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Show Segments

Intro
Getting to know Dr. Erin Michos
Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel
Digging into ASCVD Risk Calculator
Who should get 10 year ASCVD Risk assessment and what are the categories?
How Dr. Michos discusses healthy lifestyle and “Primordial Prevention”
What are “Risk Enhancing Factors”?
Who should get biomarker testing vs CAC scoring?
How Dr. Michos discusses statin therapy with her patients
How to address risks of side effects
Primary vs Secondary Prevention
“What should my cholesterol be?”
How often to follow-up labs?
Differences between stain intensity
How to manage side effects
PCSK9 inhibitor discussion
Aspirin, Fibrates and Icosapent Ethyl
High Risk vs Stable ASCVD
Take home points and the future
Outro

Credits

Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli MD
Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA
Infographic: Beth “Garbs” Garbitelli MD
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP
Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Erin Michos MD MHS

Sponsor: Better Help

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The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing

Make It Stick: The Science of Successful Learning

Trick Mirror: Reflections on Self-Delusion

Catch and Kill: Lies, Spies, and a Conspiracy to Protect Predators

Tidying Up with Marie Kondo: The Book Collection: The Life-Changing Magic of Tidying Up and Spark Joy

Recognize multiple sclerosis in the clinic, learn how to diagnose it, and partner with your neurology colleagues to help care for these patients. Dr. Annette Okai expertly walks us through multiple sclerosis (North Texas Institute of Neurology & Headache).

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak
Patient presentation
Physical exam
Labs and imaging
Pathophysiology
Treatment
Recognizing and treating relapses
Outro

Credits

Written and Produced by: Deborah Gorth MD, PhD
Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth
Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Annette Okai MD

Sponsor: Panacea Financial

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Sponsor: Ten Thousand

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Sponsor: Indeed

Visit Indeed.com/internalmedicine to start hiring now. Business only pay for quality applications matching the sponsored job description.

Sponsor: Medmastery

Go to medmastery.com/curbsiders and use curbsiders15 to claim a 15% lifetime discount on any subscription.

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Supercharge your knowledge on using methadone for the treatment of opioid use disorder! We discuss treatment goals, and how to start or continue methadone in the hospital. We’re joined by guest Dr Ruth Potee, addiction medicine physician, full-scope family medicine doc, feminist, and expert composter. She inspires us to be strong advocates for our patients.

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio 0:46
Guest one-liner 3:23
Case from Kashlak 5:00
Methadone for OUD 5:47
Methadone Dosing 16:35
72 hour Rule 25:35
What is a methadone clinic 31:00
Methadone Checklist 35:44
QTc Prolongation and Methadone 39:15
Confirming Methadone Dose 43:17
Managing Missed Methadone doses: 45:20
Outro 50:40

Credits

Producer, Writer: Kenneth Morford, MD
Show Notes, Infographic, Cover Art: Zina Huxley-Reicher, MD
Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD; Kenneth Morford, MD
Reviewer: Shawn Cohen MD
Showrunner: Carolyn Chan, MD
Technical Production: Castos
Guest: Dr. Ruth Potee

The Curbsiders Addiction Medicine are proud to partner with The American College of Addiction Medicine (ACAAM) to bring you this mini-series. ACAAM is the proud home for academic addiction medicine faculty and trainees and is dedicated to training and supporting the next generation of academic addiction medicine leaders. Visit their website at acaam.org to learn more about their organization.

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn. Get the original show notes here!

Prior diabetes episodes:

330 & #331 Inpatient Diabetes with Dr. Dave Lieb

309 USPSTF Quick Update: Prediabetes & Type 2 Diabetes Screening

296 Diabetes FAQ with Dr. Jeff Colburn

243 Diabetes Triple Distilled

168 Diabetes Update with Jeff Colburn MD

96: Diabetes: A1C targets & ACP guidelines controversy

51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction

Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro
Rapid fire questions
Definitions and classification of diabetes
DKA in type 2 diabetes?
Pathophysiology of DKA
Severe hyperglycemia mislabeled as DKA
Which type 2 diabetics get DKA?
The cardinal issue is dehydration
Starvation ketosis vs DKA vs other
How to handle severe hyperglycemia in outpatients
Sick day management in type 1 diabetes
Initial testing for diagnosis of DKA
Subcutaneous or IV insulin for DKA
Initial evaluation and management in ER
Fluids and electrolyte management
SGLT2 inhibitors and euglycemic DKA

Credits

Writer, Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Stuart Brigham MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Jeffrey Colburn MD, FACP, FACE

Sponsor: Better Help

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Sponsor: Panacea Financial

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Recap and review the top pearls from recent episodes #321 Hypertension FAQ and #326 Cardiorenal Syndrome (NephMadness 2022) with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #321, and #326!

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Show Segments

Intro, disclaimer, guest bio
Hypertension FAQ
Cardiorenal syndrome
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
TFTC Cover Art design: Edison Jyang
Technical Production: Pod Paste

Sponsor: Grammarly

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Sponsor: Pattern

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Full Transcript HERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

With great power comes great immunogenicity. Learn about the ins and outs of immunotherapy–its indications, its power, and its adverse effects–in this episode with Dr. Christian Cable, hematologist/oncologist and medical educator extraordinaire. We learn a riveting history of immunotherapy and about how checkpoint inhibitors work, as well as the best practices for identifying downstream effects of checkpoint inhibitors and their immune system activation (it’s all about the -Itis!).

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro
What is Immunotherapy?
A History Lesson
Immune Checkpoint Inhibitors (ICIs)
Immune Related Adverse Events (irAEs)
Endocrine complications of checkpoint inhibitors
Rheumatologic complications of checkpoint inhibitors
Considerations before starting checkpoint inhibitors (and what labs to check)
Diagnosing and Managing irAEs
Common post-irAE questions
New Kids on the Block: CAR-T
Take Home Points

Credits

Written and Produced by: Nora Taranto MD
Hosted by: Molly Heublein MD; Nora Taranto MD; Paul Williams MD, FACP
Guests: Christian Cable MD
Show Notes: Nora Taranto MD
Cover Art: Andrea Perdigão
Infographics: Andrea Perdigão
Reviewer: Emi Okamoto MD, FACP
Production team: Pod Paste

Sponsor: Southern California Permanente Medical Group

Learn more or apply at scpmgphysiciancareers.com

Sponsor: Locumstory

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Full transcriptHERE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit

Dr. Kevin Weber @KwebMD (Ohio State University Wexner Medical School) takes the pain out of headache management! Have the confidence to prescribe new CGRP-antagonists and ditans for migraine prevention and acute relief. We also dive deep into when to order imaging and alternatives like infusions and devices.

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak Definitions
Imaging for headaches
Labs
Headache types
Acute Migraine Treatment
Ditans
Anti-cgrp medications
Prophylactic Migraine Treatment
CGRP antagonists
Devices
Take home points
Outro

Credits

Producer, writer, and show notes: Isabel Valdez PA-C
Infographic: Edison Jyang
Cover Art: Chris Chiu MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Chris Chiu MD
Reviewer: Molly Heublein MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Guest: Dr. Kevin Weber

Sponsor: Better Help

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Sponsor: Birch Living

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Sponsor: Indeed

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Sponsor: Locumstory

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The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Help your patients navigate gallbladder disease, including asymptomatic stones, incidental polyps, and uncomplicated cholecystitis. Dr. Rahul Pannala (@RahulPannala) talks us through how to diagnose biliary colic, what imaging to order, and what to anticipate for potential post-cholecystectomy complications (eg persistent pain or diarrhea). Feel confident in sending the right patients for cholecystectomy!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak; Definitions
Typical biliary pain
Imaging for cholelithiasis
Treatment for symptomatic gallstones
Post-cholecystectomy diarrhea and pain
Inpatient management of cholecystitis
Advanced imaging- HIDA scans and MRCP
Incidental gallbladder findings
Outro

Credits

Producer, Writer, Show Notes: Molly Heublein, MD
Infographic/Cover Art: Lyan Chang
Hosts: Molly Heublein, MD, Nora Taranto, MD; Paul Williams MD, FACP
Associate Editor: Leah Witt, MD
Showrunner: Matthew Watto MD, FACP
Technical Production: PodPaste
Audio Engineer for this live episode: Chris Chiu, MD
Guest: Rahul Pannala, MD

Sponsor: Ten Thousand

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Sponsor: Blueland

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Sponsor: Locumstory

Visit Locumstory.com to find out more about locum tenens.

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Join us as Curbsiders favorite Dr. Ted Parks gives us a hand with the diagnosis and management of common causes of hand and wrist pain.

Claim free CME for this episode atcurbsiders.vcuhealth.org!Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Anatomy review: the thumb is the short one
Pathophysiology of De Quervain’s tenosynovitis
Physical examination for thumb pain
Management of DeQuervain’s and CMC arthritis
Pathophysiology of trigger finger
Management of trigger finger
Pathophysiology of carpal tunnel syndrome
Physical examination for carpal tunnel syndrome
Carpal tunnel syndrome management
Outro

Credits

Writer and Producer: Paul Williams, MD
Infographic and Cover Art: Paul Williams, MD
Hosts: Paul Williams MD and Molly Heublein, MD
Editor: Emi Okamoto, MD (written materials)
Guest: Ted Parks, MD

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It’s high time we revisit the benefits and harms

Master the ins-and-outs of medical cannabis! Dr. Julia Arnsten (@DrArnsten) will lead us through the initial evaluation of a patient interested in medical cannabis, summarize the state of evidence for the benefits and harms, lay out a schema for dosing and formulations, provide pearls on how to counsel patients, and more!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Definitions and terminology
A brief history of medical cannabis
Case from Kashlak
History to obtain for a patient interested in medical cannabis
Medical cannabis dosing and formulations
Conditions for which the evidence supports considering medical cannabis
Risks of medical cannabis
Disparities in access to medical cannabis
Does medical cannabis reduce opioid use?
Outro

Credits

Producer and Writer: Matthew Watto MD, FACP
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Associate Editor: Leah Witt MD
Showrunner: Matthew Watto MD, FACP
Production Team: PodPaste
Guest: Julia Arnsten MD, MPH

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The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Recap and review the top pearls from recent episodes #320 Palpitations and #317 Erectile Dysfunction with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

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Show Segments

Intro, disclaimer, guest bio
Palpitations: Diagnosis, Cardiac Monitors, Treatment, Patient Counseling
Erectile Dysfunction
Outro

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Edison Jyang
Technical Production: Pod Paste

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Learn from an expert panel in addiction medicine about a potpourri of fascinating topics, with updated data to guide clinical decision-making. We picked the brains of physicians Stefan Kertesz, Ximena Levander, Kenny Morford, and Katherine Mullins to learn about the latest updates in opioid tapering (don’t do it if there isn’t a good reason!), how to define recovery in alcohol use disorder, different options to treat methamphetamine use disorder, and Hepatitis C treatment in patients with active IV drug use. And there’s so much more, that we’re following this with a whole series in Addiction Medicine, set to come out in early July 2022!

Visit curbsiders.vcuhealth.org to claim CME credit for this episode.

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Show Segments

Intro
Tapering long-term opioids
Perioperative buprenorphine management
Defining recovery in alcohol use disorder
The Fourth Wave
Treatment for methamphetamine use disorder
E-cigarettes for smoking cessation
Disparities in substance use disorder prevalence and treatment
Advocacy opportunities
Outro

Credits

Written and Produced by: Nora Taranto MD
Hosted by: Nora Taranto MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Guests: Stefan Kertesz MD MSc; Ximena Levander MD MCR FACP; Kenneth Morford MD FASAM; Katherine Mullins MD
Show Notes, Cover Art, Infographics: Nora Taranto MD
Reviewer: Molly Heublein MD
Production team: Pod Paste

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Join us as we de-mystify the diagnosis, talk treatment strategies, parse through pharmaceutical options, and figure out follow-up in Generalized Anxiety Disorder with Dr. Dheepa Sekar (@DheepaSekarMD)! Anxiety disorders are one of the most common mental health concerns in our country and this episode will give you the tools to address it in clinic!

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Differential diagnosis for GAD
Counseling about diagnosis
Initial guidance on first-line management, apps for mindfulness
Prescribing basics, SSRI and SNRI considerations
Bridging with hydroxyzine and buspirone
Monitoring treatment response
Managing side effects
Tapering medication
Alternative agents, atypical antipsychotics, and benzos
Take Home points, Outro

Credits

Producer, Scriptwriter, Show Notes, Infographic/Cover Art: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto MD
Showrunner: Matthew Watto MD, FACP
Production Team: PodPaste
Guest: Dheepa Sekar MD

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Learn diagnostic and therapeutic management strategies for IBS, functional dyspepsia, and cyclic vomiting (aka disorders of gut brain interaction (DGBI))! It's like three episodes in one as we run through how to individualize evaluation and management for patients with functional dyspepsia, IBS, and cyclic vomiting. Topics: scripts for counseling patients, the pathophysiology of DGBI, which diagnostic tests are necessary, pharmacologic and nonpharmacologic options, and even hypnotherapy?! We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic)

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions (6:20)
Definition of Disorders of the Gut-Brain Interaction (7:30-11:00)
Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments (24:30-36:00)
Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00)
Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11)
Take home points
Outro

Credits * Producer: Elena Gibson MD * Writer:Andréa Perdigão, Elena Gibson * Show Notes and Infographics: Andréa Perdigão * Cover Art: Kate Grant * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Associate Editor: Leah Witt * Showrunner: Matthew Watto MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: Dr. Xiao Jing (Iris) Wang MD

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Sponsor: Pattern

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

We recap the top pearls from ACP #IM2022 including important drug interactions/intolerance (acetaminophen, tramadol, ticagrelor, nirmatrelvir-ritonavir), perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS), recognizing PMR, when to initiate urate-lowering therapy in gout, glucocorticoid-induced osteoporosis, food as medicine, dietary potassium, OSA, nocturia, telemedicine and health equity, a new obesity medicine paradigm, advances in HIV/PrEP, and rethinking atrial fibrillation!

Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.

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Show Segments * Intro * Tapering long-term opioids * Physician Wellbeing * Common drug interactions (acetaminophen, ticagrelor, tramadol, Nirmatrelvir-ritonavir) * Perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS) * Nocturia and OSA * Food as Medicine * Rheumatology (how to diagnose PMR, when to initiate ULT for gout and steroid-induced osteoporosis) * Avi’s pearls on (diversity, telemedicine, telehealth, burnout) * Obesity medicine (a new paradigm and a new medication) * HIV in primary care (PrEP, long-acting injectable antiviral therapy) * Atrial fibrillation * Outro

Credits * Written, Produced, and Hosted by: Nora Taranto MD; Molly Heublein MD; Chris Chiu MD, FACP, FAAP; Avital O’Glasser MD, FACP; Alan Dow MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP * Show Notes: Matthew Watto MD, FACP * Cover Art: Chris Chiu MD, FACP, FAAP * Production team: Pod Paste

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Join Dr. Nathan Erdmann (@NerdmannID, University of Alabama Birmingham) as he walks us through inpatient covid management from antivirals, immune modulators and anticoagulation.

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Outpatient vs ER therapeutic options
Considerations for labs to risk stratify
Antivirals
Immunomodulators
Anticoagulation
Empiric Antibiotics
Transitions of Care
Take Home Points
Outro

Credits

Producer: Monee Amin, MD
Writers: Monee Amin, MD and Meredith Trubitt, MD
Show Notes: Meredith Trubitt, MD
Infographic and Cover Art: Monee Amin, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Rahul Ganatra, MD
Showrunner: Matthew Watto MD, FACP
Production Team: PodPaste
Guest: Nathan Erdmann, MD

Sponsor: Panacea Financial

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

More inpatient diabetes! In this part 2 of 2, we cover diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School. Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

Intro
DKA and HHS - introduction and therapy overview
Insulin drips, closing the gap and transitioning to a subcutaneous regimen
Euglycemic DKA
Pumps and glucose monitors
Final take home points
Outro

Credits

Producer: Adam Barelski MD, Cyrus Askin MD
Writer: Adam Barelski MD
Show Notes: Cyrus Askin MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Adam Barelski MD
Technical Production: Pod Paste
Showrunner: Matthew Watto MD, FACP
Content Editor: Emi Okamoto MD
Guest & Content Reviewer: David Lieb MD, FACE, FACP

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

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Dominate inpatient diabetes! In this part 1 of 2, we discuss how to handle oral hypoglycemics, how to choose an initial insulin regimen, the use of correction scale insulin monotherapy, how to titrate insulin, how to use NPH for steroid-induced hyperglycemia (check out this Twitter thread on safe dosing), and how to reconcile diabetes meds at discharge!

Stay tuned for part 2 (drops Wed April 27th) covering diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip!

Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.

Claim free CME for this episode at curbsiders.vcuhealth.org!Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Show Segments

Intro #1, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Inpatient diabetes - a bird’s eye view and the goal(s) of therapy
Management of outpatient diabetes medications
Inpatient insulin - options and dosing
Correctional insulin (“sliding scale”)
A word on the “Diabetic Diet”
Steroids and hyperglycemia
Discharge pearls for the patient with diabetes
Outro #1

Credits

Producer: Adam Barelski MD, Cyrus Askin MD
Writer: Adam Barelski MD
Show Notes: Cyrus Askin MD
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Adam Barelski MD
Technical Production: Pod Paste
Showrunner: Matthew Watto MD, FACP
Content Editor: Emi Okamoto MD
Guest & Content Reviewer: David Lieb MD, FACE, FACP

Sponsor: Bambee

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CME Partner: VCU Health CEThe Curbsiders partner with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

DeLiver on the promise of elimination with Dr. Christian Ramers

Let’s deLiver on the promise of hepatitis C elimination! Dr. Christian Ramers @cramersmd brings hepatitis C diagnosis, care, and cure into the primary care clinic with a simplified algorithm for workup and treatment.

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Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Who should we screen?
Patient Workup
Preparing for treatment
Treating hepatitis C
Opportunities for integration of care
Outro

Credits

Producer, writer, co-host: Emi Okamoto MD, FACP
Show Notes, infographic, cover art: Lyan Chang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Christian Ramers MD, MPH, FIDSA

Sponsor: BetterHelp

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Sponsor: MedMastery

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Update Description

Fill up with delicious practice-changing knowledge food from #SGIM22 as The Curbsiders team discusses breast cancer survivorship, sexual dysfunction, How climate change will affect health, Are PT consults necessary in the hospital?, Do we need antibiotics for aspiration events?, bias in note writing, Are plant-based meats a healthy?, complications after breast implantation, how to get breast reduction approved, doxycycline for chlamydia, the metronidazole and alcohol myth, pearls for clinician-educators, telehealth, TEACHIM.org, CGMs help lower a1c, PT for rotator cuff disease, Is it safe to taper antidepressants? and how to treat methamphetamine use disorder!

Note: There is no CME for this episode, but claim CME for prior episodes at curbsiders.vcuhealth.org!

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Credits

Written and Hosted by: Nora Taranto MD, Beth Garbitelli (about to be an MD!), Era Kryzhanovskaya MD, Justin Berk MD, MPH, MBA, Shreya Trivedi MD, Chris Chiu MD, Paul Williams MD, Matthew Watto MD
Show Notes and Cover Art: Matthew Watto MD, FACP
Showrunner: Matthew Watto MD, FACP
Technical Production: Pod Paste

Show Segments * Intro * A few ambulatory teaching models include the One Minute Preceptor, SNAPS (summarize, narrow, analyze, probe, plan, and select), PIPP (precepting in the presence of the patient) [see Community Preceptor Toolbox] * Ikigai is a Japanese term indicating a motivational force or reason for living. It is associated with decreased mortality [Tanno, 2009]. Explore your ikigai here (PositivePsychology.com). * Listening to podcasts while driving does not affect knowledge retention (Gottleib et al. 2021) * Treatment of Hot flashes: Avoid paroxetine, fluoxetine, and sertraline in breast cancers survivors taking tamoxifen. Instead use venlafaxine (or another SNRI), citalopram, or escitalopram. Gabapentin given at bedtime is also an option. (Clinical Update 2019: Tamoxifen and Antidepressants) * Distress in patients with cancer can be measured using the NCCN screening tool [NCCN Distress Thermometer] * Don’t forget to ask for a Cancer Survivorship Plan from oncology [CDC Cancer Survivorship Care Plans] * Ask about sexual dysfunction in cancer survivors. * How will climate change impact our patient’s health? NIH framework; CH2OPD2 environmental screening tool [CH2OPD2 ]; and the 15 steps of climate communication. * Use the AM-PAC score cutoff of >18 to avoid a PT consult in hospitalized patients (Martinez 2021). * Early antibiotics after an aspiration event do not improve outcomes (Aga 2021). * Biased language is more common in notes about Black patients (Beach 2021). Be thoughtful about what you write and role model good behavior. * While plant-based meats are more eco-friendly than animal-sourced meats, they are heavily processed foods (van Vliet 2021) and may have high sodium. * Silicone breast implant rupture can be insidious. Guidelines recommend screening with MRI after 6 years, then every 2-3 years (FDA 2020, More FDA info) (Note: FDA’s most recent guidance also recommends ultrasound as an alternative screening method, so always check with the patient's insurance about which modality will be covered) * Document a trial of NSAIDs, physical therapy, attempted weight loss, and supportive bra usage before breast reduction surgery for macromastia. * Doxycycline is now first line for chlamydia rather than azithromycin [STI Treatment Guidelines Update], BUT the most effective treatment is the one your patient will take! * Metronidazole does not cause a disulfiram-like reaction and is no longer recommended by the guidelines [STI Treatment Guidelines Update] * More clinician-educator pearls from Era: Don’t be afraid to brand yourself! Network with like-minded individuals (e.g. interest groups). * BST mode: bite-sized teaching pearls can help reduce extrinsic load and improve retention [Manning, 2021] * A guided discussion based on Scrubs episodes can improve resident wellness [Holtzclaw 2021] * Chris recaps some posters (click links to see them on Twitter!): Telehealth disparities and tech equity (poster 1, poster 2); TeachIM.org (poster) * Continuous glucose monitors can help lower a1c in patients on basal insulin [Martens 2021] * A single session of PT improved shoulder pain. The benefits of steroid injections were limited to 8 weeks in the GRASP trial [Hopewell 2021] * There is a high risk of recurrence after tapering antidepressants [Lewis 2021] * Methamphetamine use disorder can be treated with IM naltrexone every 3 weeks, plus oral bupropion 450 mg daily [Trivedi 2021]. Limitations include cost and co-use of opioids. * Outro

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We need a few days to process the highlights from #SGIM22 in Orlando, FL. We'll be dropping a DELUXE recap and highlights episode this Friday April 15, 2022 covering Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more!

Learn what you really need to diagnose pancreatitis, when to use imaging sources and what is most important in management! Rapidly treating Acute Pancreatitis might change its course! We’re joined by Dr. Kaveh Sharzehi @sharzehi of Oregon Health & Science University (@OHSUNews).

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Show Segments * Intro, disclaimer, guest bio * Guest one-liner * Case from Kashlak * Risk factors for severe course * Use of Scoring Systems * Requirements to make the diagnosis * Rational use of imaging * Initial management: fluids, analgesia, and nutrition * When to use antibiotics * When to perform cholecystectomy * Most common complications and interventions * How to follow up in the outpatient setting

Credits * Producer & Scriptwriters: Monee Amin MD and Meredith Trubitt MD * Show Notes & Infographics: Andréa Perdigão * Cover Art: Monee Amin MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Molly Heublein MD * Executive Producer: Beth Garbitelli * Showrunner: Matthew Watto MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: Kaveh Sharzehi MD, MS

Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. Sponsor: MedMastery Visit www.medmastery.com/curbsiders for a 15% lifetime discount!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic…even when you inject your own thumb?! Original show notes here.

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Credits * Producer, infographic, and cover art: Emi Okamoto MD * Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, Emi Okamoto MD * Editor: Matthew Watto MD, FACP * Guest: Olajumoke Fadugba MD * Special thanks to Sarah Phoebe Roberts MPH for booking!

Show Segments * Intro and disclaimer * Guest one-liner, book recommendation, advice to fellows and trainees * Case of anaphylaxis with mucocutaneous and GI symptoms * Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin) * Vancomycin and non-IgE mediated reactions * Common presentations of anaphylaxis and the three diagnostic criteria * Biphasic reactions and predicting severity * Counseling patients on the use of epinephrine * Stuart’s thumb question * Adjuvant medications: antihistamines and corticosteroids * Are there any contraindications to epinephrine use? * Use of tryptase levels when the diagnosis of anaphylaxis is uncertain * Outro

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Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here.

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Credits

Written and produced by: Justin Berk MD, Nora Taranto MD
Infographic by: Alex M @nephroguy
Host: Matthew Watto MD
Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials)
Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD

Show Segments * NephMadness Kidney Pun Contest * Disclaimer * Intro, guest one-liners * Case of acute kidney injury in a patient with cirrhosis * Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium) * History and physical in cirrhosis and AKI * Fluid choice * Diuretic therapy in cirrhosis and volume overload * Is a Renal Ultrasound useful in AKI? * Recap: the initial approach to AKI in cirrhosis * Therapeutic trials when volume status is uncertain * Hepatorenal physiology revisited * Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine * Type 1 versus type 2 hepatorenal syndrome * Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?! * Diagnostic criteria or HRS * NephMadness matchups including bile cast nephropathy * Outro

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We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more!

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Credits * Written and produced by: Justin Berk MD * NephMadness Pain Region: Samantha Gelfand MD * NephMadness Pun Contest produced by: Hannah R Abrams * Cover art by: Kate Grant MBChB, Dip GUMed * Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD * Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes) * Guests: Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

Show Segments * Kidney Pun * Disclaimer, intro and guest bios * Guest one-liners * Clinical Case and Pain Management Disclaimer * Modalities for pain meds in ckd * Opioids for pain and their metabolites * Dave Juurlink reframes the question, “what is our real goal with pain management?” * Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD * Communicating meds that are contraindicated or relatively contraindicated in CKD * Buprenorphine * What about the WHO Pain Ladder for CKD? * Should we use more cannabinoids? Ketamine? * Dave Juurlink rants on Tramadol * NSAIDS and CKD * Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?! * Estimating eGFR in CKD and AKI. Which equation is best? * How would each of our experts treat this patient with CKD and knee pain * Outro

Sponsors: * Birch by Helix birchliving.com/curb for $200 off all mattresses and 2 free eco-rest pillows * BetterHelp betterhelp.com/curb for 10% of your first month * Indeed indeed.com/internalmedicine for a $75 sponsored job credit * Squarespace squarespace.com/curb offer code: CURB to save 10%

Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more. This episode is part of our first ever NephMadness Pod Crawl, so check out the other podcasts, and fill out your NephMadness 2022 brackets!

Credits * Producer, Writer, Show Notes, Infographics: Malini Gandhi * Cover Art: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Reviewer: Emi Okamoto MD, FACP * Executive Producer: Beth Garbitelli * Showrunner: Matthew Watto MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD

Claim free CME for this episode at* curbsiders.vcuhealth.org*! Available within 24 hours of release.

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Show Segments * Intro, disclaimer, guest bios * Guest one-liners, Introduction to Nephmadness 2022 * Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine * Definition and pathophysiology of cardiorenal syndrome * Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome * Case #2 from Kashlak: the creatinine bump with diuresis * Approach to the creatinine bump with diuresis * Tips for the volume exam * Interpreting cardiac biomarkers in patients with chronic kidney disease * Case #3 from Kashlak: diuretic resistance * Maximizing loop diuretic efficacy * Sequential nephron blockade * Use of hypertonic saline * Outro

NephMadness 2022 Pod Crawl * Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast * Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders * Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com * Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/ * Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered * Twitter: @thecurbsiders @TheCribsiders @NephJC_Podcast @drs_washington @upmynursinggame @medmyths

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New registrants will receive 6 months of access to the course recordings. Visit acponline.org/imbr2022 to register or learn more.

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CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Find out whether balanced solutions beat saline in the ICU (fluid wars revisited), how sleep affects weight loss and calorie intake, whether or not Vitamin D can prevent autoimmune disease, new guidelines for pneumonia and hepatitis B (HBV) vaccination, and the utility of ultrasound to measure JVP! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Reviewer: Matthew Watto, MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Green Chef

Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!

Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: Panacea Financial

Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.

Sponsor: Indeed

Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, picks of the week
Fluid wars: balance solution vs saline
Sleep and energy intake, weight loss
Vitamin D to prevent autoimmune disease
New ACIP guidelines for Pneumonia and Hepatitis B (HBV) vaccines
Ultrasound for JVP
Outro

Resuscitate your inner nephrology nerd with a bolus of kidney themed podcast episodes in the first annual NephMadness Pod Crawl featuring topics like cardiorenal syndrome, hemodialysis, chronic kidney disease (CKD), neonatal AKI, and inequalities in nephrology! The pod crawl starts Monday March 14, 2022 with The Curbsiders Cardiorenal episode and continues all week! See the schedule below, check out the other podcasts in the pod crawl, and fill out your brackets for NephMadness 2022 #nephmadness #NephPodCrawl Pod Crawl Release schedule: Mon 3/14: The Curbsiders - Cardiorenal Syndrome. Listen on Apple or Spotify. Website: https://thecurbsiders.com

Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders

Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com

Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/

Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered

Learn how to prescribe affordable, effective medications for obesity medicine! We discuss metformin, naltrexone, bupropion, phentermine, topiramate, GLP1 agonists, and how to counsel patients about the available weight loss modalities. Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital helps reframe our approach as she walks through these Obesity Medicine FAQs. Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long!

Claim free CME for this episode at curbsiders.vcuhealth.org!

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Credits

Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C
Show Notes, Infographics: Maddison McLellan
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Monee Amin, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Fatima Cody Stanford, MD

Sponsor: ACP

Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount: use code IM22CURB. Visit annualmeeting.acponline.org to learn more.

Sponsor: Grammarly

Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB

Sponsor: MedMastery

Listers are eligible for a lifetime 15% off discount on subscription if you go to https://www.medmastery.com/curbsiders!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner by Dr. Fatima Cody Stanford
Case from Kashlak
Guidelines for treatment
Getting the history and discussing weight goals
The Care Team: Dietician, Behavioral Specialist, Provider
Medications: Phentermine, Topiramate, Bupropion, Naltrexone
Obesity treatment in pregnancy
Referring to bariatric surgery
Take home points
Outro

We recap the top pearls on pelvic pain, constipation, and Long COVID. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for shows #311, #314, and #315atcurbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Birch

Birch is giving 200 dollars off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb

Sponsor: Blueland

Right now, you can get 20% off your first order when you go to Blueland.com/CURB

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Pelvic Pain
Constipation
Long COVID
Outro

Say hi and bye to H. pylori infections! We review the basics of H. pylori screening, refresh your memory on testing basics, discuss treatment strategies, and talk through eradication testing with gastroenterologist Dr. George Saffouri (@gbsaff). A special thanks to our listener Ana Maria Keilhauer Varona (@KeilhauerMa) of @UFMedu who pitched this episode. Her hard work formed the basis for our script!

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Credits

Pitch Writer and Initial Script: Ana Maria Keilhauer Varona
Producer, Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli
Script Co-Writer: Elena Gibson, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: George Saffouri, MD

Sponsor: Panacea Financial

Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.

Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: SquareSpace

Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain.

Sponsor: Indeed

Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, pitch contest winner, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Conceptualizing gastritis vs. dyspepsia
When to screen for h.pylori
Gastric cancer and h.pylori infection
Cultural competency in screening
Other indications for h.pylori testing, ITP and h.pylori
How to test
Treatment modalities
Eradication testing, persistent infection

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Writer: Matthew Watto, MD, FACP
Producers: Matthew Watto, MD, FACP and Malini Gandhi
Show Notes, Infographic, and Cover Art: Malini Gandhi
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Jordy Cohen MD

Sponsor: Provider Solutions & Development

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org /curbsiders

Sponsor: Southern California Permanente Medical Group

Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684.

Sponsor: Stamps.com

Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Just go to Stamps.com, click the microphone at the top of the page, and enter code CURB.

Sponsor: SquareSpace

Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain.

Sponsor: Green Chef

Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak: New diagnosis of hypertension
How to make a diagnosis of hypertension
When to start anti-hypertensive medication
Initial blood pressure regimen
Case from Kashlak: White coat hypertension
Case from Kashlak: Hypertension in chronic kidney disease
ACEis and ARBs in chronic kidney disease
Diuretics in chronic kidney disease
Case from Kashlak: Refractory hypertension
History and initial workup for refractory hypertension
Treatment of primary hyperaldosteronism
Outro

When should you fold or Holt onto your cards for palpitations? Learn about properly characterizing a patient’s palpitations, red flag symptoms, when to grab an echocardiogram and/or heart monitoring, and when certain “benign” ECG findings can be concerning. We’re joined by the director of cardiac electrophysiology at Temple University Hospital, Dr. Joshua Cooper (@narrowQRS) for this episode chock full of cardiac pearls to make your heart skip a beat.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, Show Notes, Infographic, and Cover Art: Edison Jyang
Producer: Paul Williams MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Molly Heublein MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Joshua Cooper MD

Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: Panacea Financial

Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.

Sponsor:Imperfect Foods

Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.

Sponsor: Indeed

Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Defining what the patient means by palpitations
Common causes and misdiagnoses
Red flag symptoms
Exposures and medications to consider
Sinus tachycardia
Workup for palpitations
Monitors
Script for a negative workup
Premature ventricular contractions
Outro

Fill up your plate with a fresh stack of 2022 hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto help catch us up recent practice-changing articles and guidelines including patient-directed interventions in atrial fibrillation, the utilization of chlorthalidone in advanced CKD, and updates on outpatient COVID treatment.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH, Matthew Watto, MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Grammarly

Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB

Sponsor: Green Chef

Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping!

Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB

Sponsor: Provider Solutions & Development

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org /curbsiders

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org

Show Segments

Intro, disclaimer
Picks of the week, Listener Email
I-STOP Afib
Chlorthalidone in CKD
Outpatient COVID Treatment Update
Outro

Master urinary tract symptoms! Paul and Matt recap, review, and update past episodes on BPH and urinary incontinence so you’ll be able to confidently manage lower urinary tract symptoms (LUTS) in primary care. Topics: categorizing urinary incontinence, lifestyle modifications for LUTS, nonpharmacologic & pharmacologic therapies for urinary incontinence and BPH, plus when to refer to surgery.

Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographic by: Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: M3 Global Research

To join M3 Global Research’s panel, go to M3research.info/curbsiders! Complete registration before Feb 28, 2022 for a $10 welcome bonus!

Sponsor: Indeed

Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows!

Show Segments * Intro, disclaimer, guest bio * Urinary incontinence diagnosis, management * BPH diagnosis, management * Outro

Listen as our expert guest Dr. Ashley Winter @AshleyGWinter (Northwest Kaiser Permanente, Portland, OR) helps us explore the spectrum of erectile dysfunction management for the internist and primary care clinician. This episode will empower you to provide evidence based, patient-centered care to erectile dysfunction while maintaining an astute and holistic diagnostic approach. We also explore treatment and patient counseling techniques.

Claim Free CE credit for this episode through VCU Health CE athttp://curbsiders.vcuhealth.org/

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Hannah R. Abrams, MD
Infographic and Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Show Notes: Hannah R. Abrams, MD; Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Hannah R. Abrams, MD
Reviewer: Molly Heublein, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Ashley Winter, MD

Sponsor: Masterworks

Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders

Sponsor: ACP

For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content.

Sponsor: SquareSpace

Go to squarespace.com/curb to save 10% off your first purchase of

a website or domain! Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Defining ED
Additional history, exam, and labs
How to talk about ED
Addressing ED for transgender and nonbinary patients
Treatment of ED
Advanced therapies and referral
Take Home Points; Outro; Bonus clip

We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and produced by: Paul Williams, MD, FACP * Infographic and Cover Art: Matthew Watto, MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli * Reviewer: Emi Okamoto, MD * Executive Producer: Beth Garbitelli * Showrunner: Matthew Watto, MD, FACP * Editor: Clair Morgan of nodderly.com

Sponsor: Stamps.com

Sign up with promo code CURBfor a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts.

Sponsor: BetterHelp

Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: Imperfect Foods

Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.

Sponsor: ACP

Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments * Intro, disclaimer * Picks of the Week* * The case of Lynn Fedema * Pathophysiology of edema * Differential diagnosis of chronic edema * Chronic edema work-up * Management of chronic edema * Calvin Fedema and acute edema * Evaluation of acute edema * Outro

Explore the actively evolving clinical landscape of Long COVID as we discuss epidemiology, pathogenesis, manifestations, and patient-centered management options including the role of a dedicated Long COVID clinic. Listen as our expert guest Dr. Monica Verduzco-Gutierrez @MVGutierrezMD (Long School of Medicine at UT Health, San Antonio) helps us navigate this rapidly emerging syndrome. This episode will empower you to provide evidence based, patient-centered care for this challenging facet of the ongoing COVID-19 pandemic. We explore the manifestations including fatigue, dyspnea, psychiatric symptoms, and other neurologic effects. We also examine the emergence of dedicated Long COVID clinics and the imperative of interdisciplinary care.

Update: The original version of this episode contained a brief, but incorrect characterization of mast cell disorders that was subsequently removed after feedback from our allergy/immunology colleagues. We apologize for this inconvenience and thank our colleagues for their peer review.

Claim Free CE credit for this episode through VCU Health CE athttp://curbsiders.vcuhealth.org/

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Avital O’Glasser MD, FACP, SFHM
Infographic: Edison Jyang
Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Show Notes: Avital O’Glasser MD, FACP, SFHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, SFHM
Reviewer: Hannah Abrams, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Monica Verduzco-Gutierrez, MD

Sponsor: Blueland

Right now, you can get 20% off your first order when you go to Blueland.com/CURB

Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program.

Sponsor: Indeed

Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case 1 from Kashlak
Definition of Long COVID or post-COVID symptoms
Pathogenesis of Long COVID
Illness script for mast cell activation
Epidemiology and risk factors for Long COVID
Interdisciplinary care for Long COVID
Illness script for POTS-like phenotype in Long COVID
Illness script for chronic fatigue syndrome/myalgic encephalomyelitis in Long COVID
Management of fatigue and post-exertional malaise (PEM)
Case 2 from Kashlak
Neuropsychiatric manifestations of Long COVID
Anosmia and smell training
Role of the patient voice and community in Long COVID
Disability assessments and management
Take Home Points; Outro; Bonus clip

Move smoothly through constipation evaluation and management. Learn how to evaluate for the various etiologies of constipation including pelvic floor dysfunction, IBS-C and more with our esteemed guest Dr. Xiao Jing (Iris) Wang @IrisWangMD!

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, Show Notes, Infographic & Cover Art: Elena Gibson MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Xiao Jing (Iris) Wang MD

Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content. Sponsor: SquareSpace https://www.squarespace.com Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Show Segments (Note: timestamps are without ads) * Intro, disclaimer, guest bio * Guest one-liner, Picks of the Week* (6:00) * Case from Kashlak; Definitions (11:00) * Physiology of a bowel movement (10:00) * Definitions (16:00) * Bowel Habit Review of Systems (17:00) * Rectal Exam (33:00) * Initial Constipation Evaluation * Common categories of constipation (43:40) * Additional evaluation of Constipation (52:00) * Treatment options (1:10:00) * Outro

We recap the top pearls from 2021, including celiac disease, kidney stones, SGLT2 inhibitors for weight loss & HFpEF, smoking cessation, buprenorphine for acute pain, metabolic alkalosis, nephrotic syndrome, bronchiectasis, obesity hypoventilation syndrome, acute diarrhea, osteoporosis, and diabetes. Plus, Paul and Watto express their gratitude to The Curbsiders family and look forward to 2022. Finally, it’s our annual recap extravaganza 2021 with guest host Chris “the Chiu Man” Chiu (@cjchiu), providing a rapid review of previous Curbsiders episodes for your spaced learning. Special thanks to the whole Curbsiders team and our listeners for an incredible six years of podcasting!

Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes.

Click here for full show notes

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Christopher Chiu MD, FACP FAAP
Cover Art: Beth Garbitelli
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro
Garbs’ picks: Pelvic pain, smoking cessation
Addiction medicine pearls: Nicotine use disorder; Acute pain in OUD
Nephrology: Kidney stones, nephrotic syndrome, metabolic alkalosis
Cardiology: Peripheral arterial disease (PAD), SGLT2 inhibitors for HFpEF
Pulmonology: Bronchiectasis, OHS
Gastroenterology: Celiac disease, Liver test abnormalities
Bariatric Medicine: Semaglutide for weight loss; bariatric surgery
Endocrinology: Osteoporosis; Diabetes FAQ
Outro

Master endocarditis! Don’t feel thwarted by a positive set of blood cultures. We’re joined by Dr. David Serota (@serotavirus) for a comprehensive discussion of the pathophysiology of infective endocarditis, frameworks for work-up and diagnosis, the TTE vs. TEE debate, indications for valve surgery, antibiotic tips, harm reduction strategies, and more!

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Writer and Producer: Adam Barelski MD * Show Notes: Beth Garbitelli; Adam Barelski MD * Infographic: Adam Barelski MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Adam Barelski MD * Reviewer: Meredith Trubitt, MD * Executive Producer, Cover Art: Beth Garbitelli * Showrunner: Matthew Watto MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: David Serota MD

Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB.

Sponsor: Southern California Permanente Medical Group Want to make a difference in a community that appreciates your passion and expertise? Then join SCPMG as an Outpatient Internal Medicine Physician. Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684. Sponsor: P3 P3 is a revenue cycle management provider that takes over your workload for claim submissions, and denial management. P3 is offering a 10% discount on all invoices for a limited time period. Visit www.p3care.com/curb and avail your offer today!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
What to do with positive blood cultures
Initial workup for endocarditis
How to diagnose endocarditis
When to get a TTE and a TEE
Indications for valve surgery
Antibiotic tips
Oral vs IV antibiotics
Treatment considerations for patients who inject drugs
Take-home points
Outro

Pelvic pain is not just a gyn issue! As a PCP, you can feel confident doing an initial workup and starting treatment for pelvic pain. Dr. Lamvu shares a great framework to narrow down your diagnosis and provides amazing resources for those who work in an under-resourced center. We’ll walk you through what to focus on in the history, a trauma-informed physical exam, and the first-line treatments. Feel confident with your ability to help your chronic pelvic pain patients.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Writers/Producer: Molly Heublein, MD
Infographic: Edison Jyang
Cover Art: Kate Grant, MBChB MRCGP DipGUMed
Hosts: Beth Garbitelli, Molly Heublein, MD
Reviewer: Emi Okamoto, MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Georgine Lamvu, MD MPH

Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: Locumstory Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine. Locumstory is your source for all things locum tenens! Check out their website, locumstory.com, for resources, FAQs, and more!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest introduction and recommendations
Picks of the Week
Case from Kashlak
Persistent Pelvic Pain Definitions
Differential diagnosis/organ system approach
History
Physical Exam
Trauma informed Care
First line Treatments
Resources for patient education and to build speciality team
Summary and take home points
Outro

Listen in as expert Dr Calvin Chou (UCSF) leads us through concrete tips to optimize your feedback dialogue with learners. We cover the importance of creating a relationship built on mutual goals of getting to our personal best, helping learners form SMART goals, the ARTful approach to a feedback conversation, ways to minimize bias, and you even get to hear Era role play!

This brand new weekly Curbsiders' mini-series, TEACH, is available on its own feed (Apple, Spotify) with new episodes every Tuesday.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Credits * Infographic: Andrew Delaat * Hosts, producers, writers: Era Kryzhanovskaya, MD; Molly Heublein, MD * Audio Editor: Clair Morgan of nodderly.com * Guest: Calvin Chou, MD

Sponsor: MasterworksMasterworks uses data and technology to determine investment-grade works of art. Then they securitize them and allow anyone to invest in artwork at an affordable entry point. While making great art is difficult, investing in it is easier than ever. Go to masterworks.art/curbsiders to get started.

CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments: * Intro, disclaimer, guest bio * Guest one-liner * Picks of the Week * Case from Kashlak * Definition of Feedback * Creating a relationship to give feedback * Helping learners set goals * ARTful approach * Giving feedback on hearsay * Reducing bias * Accepting feedback up the hierarchy * Outro

Don’t sweat inpatient hypertension any longer. Who needs guidelines when Dr. Noble Maleque (@nobility75, Emory University, Division of Hospital Medicine) explains the spectrum of hypertensive disorders in the inpatient setting, and an approach for thinking about treatment.

Claim free CME for this episode atcurbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Production, Script, Infographic, and Cover Art: Monee Amin, MD, Meredith Trubitt, MD MPH
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Monee Amin, MD, Meredith Trubitt, MD MPH
Reviewer: Adam Barelski MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Noble Maleque MD

Sponsor: Panacea Financial

Join the growing number of doctors nationwide that expect more from their bank and have switched to Panacea Financial. Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Panacea Financial is a division of Primis, Member FDIC Sponsor: Ten Thousand

Ten Thousand is offering our listeners 15% off your purchase! Go to tenthousand.cc and enter code CURB to receive 15% off your purchase!.

Sponsor: Locumstory

Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine. Locumstory is your source for all things locum tenens! Check out their website, locumstory.com, for resources, FAQs, and more!

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Definitions
Case from Kashlak
Elevated blood pressure / hypertensive urgency
Contributing factors to elevated blood pressure in the hospital
Hypertensive urgency—to treat or not to treat
Transitions of care and case against intensification of treatment
Case from Kashlak
Hypertensive emergency diagnosis and treatment
Secondary Hypertension
Outro

Curbsiders Teach is THE internal medicine podcast for all things medical education. We use expert interviews to inspire the next generation of medical educators by providing listeners with teaching pearls, practice-changing knowledge, and a learning objective-based dosing of Edutainment (medical education, made entertaining).

This weekly mini-series will air every Tuesday starting December 14th, 2021 on our website or wherever you get your podcasts!

Subscribe on Apple Podcasts

Subscribe on Spotify

We are so excited to bring you this new series in the Curbsiders Family focusing on medical education. Molly Heublein, MD and Era Kryzhanovskaya, MD are your new hosts for the Curbsiders Teach- they are Clinician Educators with a passion for teaching.

Whether you precept students, teach small groups, are involved in curricular design, or give CME lectures, we think you’ll find valuable skills. We have the pleasure of interviewing a variety of amazing experts in topics ranging from bedside teaching, feedback conversations, learner mental health, and time-based competencies in medical education. We can’t wait to share their expertise with you!

Subscribe on Apple Podcasts

Subscribe on Spotify

Send questions or suggestions to thecurbsidersteach@gmail.com

Sweeten your day with a review of the updated 2021 USPSTF Prediabetes and Type 2 Diabetes screening guidelines with expert guest Dr. Chien-Wen Tseng! We review the new screening recommendations, assess different testing modalities, talk through screening intervals, and emphasize other risk factors that impact screening!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Paul Williams MD & Elena Gibson MD
Cover Art: Beth Garbitelli
Hosts: Paul Williams MD, FACP; Elena Gibson MD
Reviewer: USPSTF Team
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Chien-Wen Tseng MD

Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb

Sponsor: GreenChef The #1 Meal Kit for Eating Well! Go to GreenChef.com/curb10 and use the code curb10 to get 10 Free Meals including free shipping!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps*

*Note: Time Stamps refer to ad free version. * Intro, disclaimer, guest bio: 0:33 * Guest one-liner: 3:30 * Picks of the Week: Sneaky pick at 3:00! Guest pick: 4:45 * Case from Kashlak of Mr. Sugar: 5:30 * Screening recommendations: 6:00 * Testing modalities: 10:00 * Possible harms of screening: 15:50 * Screening intervals: 18:00 * Prediabetes screening: 20:45 * Other risk factors that impact screening: 26:30 * Recap: 34:15 * Outro: 36:25

@Kidney_Boy returns to school us on metabolic alkalosis and hypokalemia! What do diuretics, hyperaldosteronism, black licorice, and milk-alkali have in common? Our Chief of Nephrology, Dr. Joel Topf, talks through the pathophysiology of metabolic alkalosis, the utility of urine chloride and pH measurements, why normal saline is sometimes better than balanced solutions, when to reach for acetazolamide, and more! Urine for a good time ; )

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Matthew Watto MD, FACP
Show Notes, CME, Infographic and Cover Art by: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Reviewer: Emi Okamoto MD
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com
Guest: Joel Topf MD

Sponsor: ACPJoin the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

Sponsor: Grammarly Take the stress out of getting the words right with Grammarly. Our listeners get 20% off Grammarly Premium at grammarly.com/CURB

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Case of Al Kaline - metabolic alkalosis from vomiting
Pathophysiology of metabolic alkalosis
Case of Mike Arbonate - hypokalemic, metabolic alkalosis from aggressive IV diuresis and therapies to mitigate
Case of Fracture Franny - milk-alkali syndrome
Case of Hyper Al - metabolic alkalosis from excess mineralocorticoid receptor activation
Outro

Fill up your plate with some spooky tofurkey cakes! Drs. Rahul Ganatra (@rbganatra) and Nora Taranto (@norataranto) help catch us up recent practice-changing articles and guidelines including EMPEROR-Reduced (SGLT2 inhibitors for HFpEF), the 2021 CHEST VTE guidelines update, whether or not antibiotics are needed for diverticulitis, and what treatments are most effective for rotator cuff disease!

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art: Beth Garbitelli
Hosts: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Executive Producer: Beth Garbitelli
Showrunner: Matthew Watto MD, FACP
Editor: Clair Morgan of nodderly.com

Sponsor: Birch by Helix

Birch is giving $200 off ALL mattresses and two free eco-rest pillows at BirchLiving.com/curb

Sponsor: BetterHelp

Get 10% off your first month at betterhelp.com/curb

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer,
Picks of the Week
EMPEROR-Reduced (SGLT2 inhibitors for HFpEF)
GRASP trial for rotator cuff disease (physiotherapy and steroid injections)
DINAMO trial (no antibiotics for outpatients with uncomplicated diverticulitis)
2021 CHEST VTE Guidelines Update
Outro

Take a deep breath and inhale high-yield knowledge molecules about the perplexing conditions known as bronchiectasis and NTM (nontuberculous mycobacteria)! Learn the pitfalls and pearls of diagnosis and management from one of the world’s experts, the great Dr. PJ McShane from UT Health - East Texas!

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Writers/Producers: Cyrus Askin MD; Leah Witt MD
Infographic & Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD
Reviewer: PJ McShane MD
Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com
Guest: PJ McShane MD

Sponsor: Ten Thousand.Ten Thousand is offering our listeners 15% off your next purchase! Go to https://www.tenthousand.cc and enter code: CURB to receive 15% off your purchase at checkout!

Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest introduction and recommendations
Case from Kashlak - Part I: The Basics
- What is bronchiectasis, how do we define it?
- Symptoms and history
- Why does it matter?
- What should you ask, how do you work this up?
- A brief discussion on antibiotics
Case from Kashlak - Part II: Getting into the Management
- Airway Clearance
Case from Kashlak - Part III: The Sputum (Plot) Thickens
- What is a bronchiectasis exacerbation?
- Pitfall and pearls regarding exacerbation management
Case from Kashlak - Part IV: The Sputum (Plot) Thickens Even Further!
- Non-tuberculous Mycobacterial Infections - the basics
- Triple Drug Therapy for MAC
- The new kid on the block: Liposomal Inhaled Amikacin for refractory MAC
Summary and take home points from Dr. McShane
Outro

What to expect when you’re taking care of a patient who’s expecting! This fantastic episode will help you work through preconception counseling with ease, assess and treat non-obstetrical acute concerns in pregnant patients, and help you conceptualize best practices for postpartum care. We are joined by expert guest Dr. Xiaolei Chen.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Show Notes by: Shelagh Browne
Cover Art and Infographic: Edison Jyang
Reviewer: Molly Heublein MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Xiaolei Chen MD

Sponsor: GreenChef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping!GreenChef.com/curb125

Sponsor: Need to hire? You need Indeed. Get started RIGHT NOW with a $75SPONSORED JOB CREDIT to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer valid through December 31st. Terms and conditions apply.

Sponsor: Provider Solutions & Development

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

Show Segments

Intro
Picks of the week
Preconception counseling
Lifestyle: caffeine, alcohol, exercise
Preconception medications
Management of acute complaints during pregnancy
Go-to medications for acute complaints during pregnancy
Chronic diseases during pregnancy
Postpartum management
Breastfeeding recommendations
Take-home points
Outro

Who gets a COVID booster? Can we mix and match COVID vaccines? What are monoclonal antibodies and when should we use them? What is molnupiravir and does it work? Shots for kids? Ready yourself to answer these questions and more with our guest, Dr. Monica Gandhi @MonicaGandhi9.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer and Writer: Isabel Valdez PA, Molly Heublein MD
Infographic: Edison Jyang
Cover Art: Edison Jyang, Isabel Valdez, PA
Hosts: Molly Heublein MD, Chris Chui MD, Isabel Valdez PA
Reviewer: Emi Okamoto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Monica Gandhi MD

Sponsor: The American College of Physicians

Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

Sponsor: Provider Solutions & Development

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Covid Boosters
Pfizer data
Moderna Data
DNA vaccines
Pediatric Vaccines
Monoclonal Antibodies
Molnupiravir
Dr Gandhi’s crystal ball
Outro

Explore burnout and gender-based differences in well-being with our esteemed guests Drs. Clif Knight, Tammy Lin, and Kim Templeton. We discuss workarounds for leading our way to wellness.

Dr. Clif Knight is a family physician and Senior Vice President for Education at the American Academy of Family Physicians (AAFP) with extensive leadership and expertise in well-being.

Dr. Tammy Lin is an internal medicine specialist and a Voluntary Assistant Clinical Professor at the University of California, San Diego Health Sciences. We originally met her as a member of the Wellness through Equity and Leadership (WEL) Program and she started a podcast called "The DEI Shift" (pronounced The "Day" Shift), which focuses on diversity, equity, and inclusion within the medical field. Dr. Knight and Dr. Lin participated in the 2019-2020 WEL program-- six different specialty organizations came together to think about the core tenets of equity, well-being and leadership and how you really can’t have one without the other.

Dr. Kim Templeton is Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City. Her research focuses on women physicians and the inclusion of sex and gender medicine in medical education.

No CME for this episode, but claim CME for past episodes at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD
Infographic: Leah Witt, MD
Cover Art: Kate Grant MBChB MRCGP DipGUMed
Hosts: Matthew Watto MD, FACP; Leah Witt, MD, Shreya Trivedi, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Clif Knight, MD, Tammy Lin, MD, Kim Templeton, MD

Sponsor: Grammarly

Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB

Sponsor: The American College of Physicians

Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.

Sponsor: Panacea Financial

Learn about their $1,000 giveaway at panaceafinancial.com/curb. Panacea Financial is a division of Primis member FDIC.

Sponsor: Provider Solutions & Development

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments

Intro, disclaimer, guest bios
Burnout & Wellness
The Case: Dr. Elizabeth Blackwell & her friend in primary care
The Part-Time Discussion
Outro

Fine-tune your approach to liver tests! It’s LFTs Triple Distilled! Paul and Matt channel the wisdom of hepatologist, Dr. Elliot Tapper (@ebtapper) to cover hepatocellular vs cholestatic vs mixed patterns, which tests to order, which ones to skip, how to handle isolated alkaline phosphatase elevation, mild, chronic ALT elevation, and even how to interpret liver test abnormalities in pregnancy.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #293 at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographic by: Elena Gibson
Cover Art: Matthew Watto MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com

Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb

Sponsor: Locumstory

Visit Locumstory.com to see if a locum tenens assignment is right for you.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Hepatocellular pattern
Cholestatic pattern
Chronic ALT elevation
Isolated Alkaline phosphatase elevation
Liver test abnormalities in pregnancy
Outro

Join us for this rapid fire review of systems featuring our top pearls and articles LIVE! from the TriService ACP conference. Matt and Paul serve up their favorite practice changing knowledge food on antibiotics, MRSA, hair loss, dementia, seizures, diabetes, medications for hypertension, foods for constipation, diverticulitis, colon cancer screening, colon polyps, chronic sinusitis, chronic cough, treatment of uterine bleeding, and more!

No CME for this episode, but check out curbsiders.vcuhealth.org for past CME offerings!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Sawyer Watto
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb.

Sponsor: ACP’s National Internal Medicine Day

Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer
ID: Shorter is better; MRSA swabs; Antibiotics for diverticulitis
Endo: Prediabetes in older adults,
MSK: Knee OA, orthopedic surgery
Derm: Alopecia
Neuro: Seizures, dementia quick typing
Cardio: Coffee and arrhythmias; Hypertension management, ACEi vs ARBs
Respiratory: Chronic cough and sinusitis
GI: CRC screening, foods for constipation
GU: treatment of uterine bleeding
Addiction Medicine: smoking cessation, buprenorphine
Outro

Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and understand diagnostic testing, management and proper follow-up for patients.

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Production and Script: Matthew Watto MD, FACP * Production, Show Notes and Infographics: Edison Jyang * Cover Art: Kate Grant MBChB, MRCGP, DipGUMed * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli * Reviewer: Emi Okamoto MD * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Amy Oxentenko MD, FACG

Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay.

Sponsor: Grammarly

Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week
Case from Kashlak; Definitions
Workup for a typical celiac patient
Nonclassical features of CD
When to do a small bowel biopsy
Management of CD
Considerations for atypical celiac patient and differentials
Non-celiac gluten sensitivity
Outro

Links 1. Crucial Conversations (book) 2. Gluten-free flour (flour) 3. Pie crust recipe (recipe) 4. What Remains of Edith Finch (game) 5. Doughboys (podcast)

Crucial Conversations: Tools for Talking When Stakes Are High, Second Edition

What Remains of Edith Finch - Nintendo Switch [Digital Code]

King Arthur, Measure for Measure Flour, Certified Gluten-Free, Non-GMO Project Verified, Certified Kosher, Non-Dairy, 1 Pound, Packaging May Vary

Confidently manage acute pain in the hospital! In this episode listeners will learn how to develop a multimodal analgesia plan for acute pain in the hospital, as well as how to safely initiate and discharge a patient on opioids. We’re joined by Dr. Melissa Weimer @DrMelissaWeimer (Yale School of Medicine).

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer and Writer: Carolyn Chan, MD
Script: Carolyn Chan, MD, Avi O’Glasser, MD
Cover Art and Infographic: Edison Jyang
Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD
Reviewer: Emi Okamoto, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Melissa Weimer DO

Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay.

Sponsor: Green Chef

Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

01:39 Intro, disclaimer, guest bio
03:20 Guest one-liner, Picks of the Week
09:18 Case from Kashlak; Definitions
11:00 Assessing Acute Pain
12:12 Types of Pain
15:08 Initiating Opioids
22:32 Counseling on Opioid Exit Strategy
25:26 Opioid Dependence vs. Opioid Use Disorder
29:50 Post-Op Pain Management
31:00 Other cool stuff
37:00 PCA
41:00 Opioid Taper
46:50 Acute Pain and Opioid Use Disorder
58:00 Methadone Titration
1:04:00 Outro

Do kidney stones have you saying “this too shall pass?” Our guest Dr. David S. Goldfarb, MD, FASN, FNKF, FACP can help! In this episode he takes us through risk factors as well as treatment and prevention for urinary stone disease.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Paul Williams MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
Show Notes by: Shelagh Browne, Kate GrantMBChB MRCGP DipGUMed,
Cover Art and Infographic: Kate Grant MBChB MRCGP DipGUMed
Reviewer: Molly Heublein, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: David Goldfarb MD, FSN, FNKF, FACP

Sponsor: ACP’s National Internal Medicine Day 2021 acponline.org/NIMD21

Sponsor: Indeed indeed.com/internalmedicine

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

Show Segments

Guest book recommendation and advice
Common risk factors for urinary stone disease
Differential diagnosis of kidney stones
Symptomatology of kidney stones
Types of stones
Urine pH
Role of physical exam
Role of imaging
STONE score
Labs to order
Management of urinary stone disease
Prevention of urinary stones and approach to lifestyle/diet changes
Outro

We recap the top pearls on CRC Screening, Common Skin Complaints, and Antibiotic Pearls. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #283, #284, and #285 at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Beth Garbitelli, and Nora Taranto
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: ACP acponline.org/telemedicine201

Sponsor: Ten Thousand tenthousand.cc code = CURB

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
CRC Screening
Antibiotic Pearls
Derm Pearls (Common Skin Complaints)
Outro

Stumped by diabetes care? Hungry for tips on diagnosis and management? We’ve got you covered with this high-yield Diabetes FAQ covering type 1 and type 2 diabetes. We’re joined by Dr. Jeff Colburn, a board-certified endocrinologist and clinician educator in San Antonio, Texas as we review initial diagnosis, interrogate insulin resistance versus insulin deficiency, delve into down-titrating insulin, discuss ‘tricky diabetes,’ and talk through dietary approaches!

Claim free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers and Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Writer: Matthew Watto MD, FACP
Show Notes, Infographic & Cover Art: Beth Garbitelli
Reviewer: Molly Heublein MD
Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com
Guest: Jeff Colburn, MD

Sponsor: BetterHelp betterhelp.com/curb

Sponsor: Birch by Helixbirchliving.com/curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak
Initial Presentation of Diabetes
Type 1 or Type 2
Initial Labs, Managing new diagnosis
Using GLP-1 agonists, SGLT-2 inhibitors
How to down titrate insulin
Diabetes in geriatrics
Diets for diabetes management
Outro

Advance your care planning with tips from our esteemed guest, Dr. Rebecca Sudore, @prepareforcare (UCSF). She helps us up our ACP game by defining advance care planning, and giving clear examples of how it can be incorporated into a busy primary care practice. It’s her life’s mission is to improve advance care planning and medical decision-making for culturally and ethnically diverse older adults. She is the creator of an interactive ACP website called PREPARE For Your Care, (after this episode, we are sure you’ll be sending patients there for advance care planning!)

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written by: Leah Witt, MD
Produced by: Leah Witt, MD & Molly Heublein, MD
Reviewer: Lingsheng Li, MD
Infographic and Cover Art: Leah Witt, MD
Hosts:Matthew Watto MD, FACP; Paul Williams MD, FACP, Leah Witt, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Rebecca Sudore, MD

Sponsor: Grammarly grammarly.com/curb

Get 20% off Grammarly Premium by signing up at grammarly.com/curb

Sponsor: Green Chef greenchef.com/curb100

Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!”

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week
Case from Kashlak Part 1: General ACP
Defining Advance Care Planning
Case from Kashlak Part 1: Dementia & ACP
Surrogate decision-makers
POLST
Outro

Join us as we take a six-minute walk through the definition, presenting symptoms, and diagnosis of pulmonary hypertension with our esteemed guest Dr. Estefania Oliveros, @EstefaniaOS (Temple University). She helps us get on the right side of hypertension on the right side of the heart!

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Writer and producer: Deborah Gorth MD, PhD
Infographic and Cover Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Estefania Oliveros MD

Sponsor: Indeed indeed.com/internalmedicine

Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.

Sponsor: The American College of Physicians Telemedicine 201

ACP invites you to attend its free 4-part webinar series, Telemedicine 201. Episode one, “Video Visits Beyond the Simple Cases,” is on September 28th. Register today at acponline.org/telemedicine201.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Case from Kashlak
Definitions
Discussion of testing for pulmonary hypertension
CTEPH diagnosis and management
Rundown of therapies for pulmonary hypertension
Outro

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!

Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Elena Gibson MD
Cover Art and Infographic: Kate Grant MD; Elena Gibson MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
Guest: Elliot Tapper MD

Sponsor: BetterHelp betterhelp.com/curb

Sponsor: Panacea Financial panaceafinancial.com

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Definitions of liver enzymes, liver function tests
Patterns of acute liver injury
Drug-induced liver injury
Isolated alkaline phosphatase elevation
Isolated total bilirubin elevation
Livery Injury During Pregnancy
Acute liver failure
Outro

Enjoy this rapid clinical overview of heart failure based on Episode #230 Kittleson Rules Acute Heart Failure Featuring Dr. Michelle Kittleson @MKittlesonMD (Cedars Sinai)!

This triple distilled episode is not available for CME, but claim CME for #230 Kittleson Rules Acute Heart Failure at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Locumstorylocumstory.com

Visit Locumstory.com to see if a locum tenens assignment is right for you.

Show Segments

Intro, disclaimer, guest bio
The History, Failure mnemonic
CHF exam
CHF Labs, Swan (RHC)
Management of ADHF
Outro

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea? Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement. Enjoy this Curbsiders classic and stay tuned this Wednesday, September 1, 2021 for a brand new CHF Triple Distilled episode.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits * Written and Produced by: Deborah Gorth ScM * Cover Art and Infographic by: Edison Jyang * Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP * Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com * Guest: Michelle Kittleson MD, PhD

Sponsor: Ten Thousand tenthousand.cc

Head to tenthousand.cc and enter our code CURB at checkout to save 15%.

Sponsor: BetterHelp betterhelp.com/curb

Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb

Time Stamps*

Time Stamps refer to ad-free version * 00:00 Intro, disclaimer, guest bio * 02:40 Guest one-liner; Picks of the Week * 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic) * 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction? * 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?! * 28:36 Labs to trend during an ADHF admission * 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes * 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2? * 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB) * 56:05 Who needs a right heart cath? * 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care * 64:04 SGLT2i in heart failure * 68:15 Take home points and outro

Enjoy this rapid clinical overview of CBC abnormalities based on Episode #167 LIVE! Common CBC Abnormalities Featuring Dr. Mary Kwok! Production & graphics by our very own and very talented Dr. Matt Watto! Unfortunately, this episode is not available for CME : (

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Show Segments * Intro, disclaimer, guest bio * Approaching a mildly abnormal CBC, red flags * Build the diff,Fy(a-b-) phenotype * Physical exam and advanced testing * Polycythemia vera * Thrombocytopenia * Outro

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 25, 2021 for a brand new CBC Abnormalities Triple Distilled episode.

Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits * Written, Produced and Edited by: Matthew Watto MD, FACP * Cover Art and Infographic by: Matthew Watto MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Guest: Mary Kwok MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB.

Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: Birch by Helix birchliving.com/curb

Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

Time Stamps*

Time Stamps refer to ad-free version * 00:00 Intro; Paul shame’s the audience; Guest bio * 03:17 Guest one-liner, book recommendation –Emperor of All Maladies (book) by Siddhartha Mukherjee, When Breath Becomes Air (book) by Paul Kalanithi; Career advice -set goals for whatever you’re learning. * 08:43 Picks of the week: John Wick 3 (film); The Movies That Made Me (podcast) by Joe Dante; The Tim Ferriss Podcast with Julie Rice of Soul Cycle; Infinity Chamber (film) by Travis Milloy * 11:50 A case of asymptomatic leukocytosis; Red flags; Repeat the CBC until it’s normal * 17:30 The peripheral smear; Leukemoid reaction * 20:00 The physical exam; When to send flow cytometry? * 22:18 A case of lymphopenia; benign ethnic neutropenia; What to look for in the history * 27:10 A case of erythrocytosis; Checking EPO levels; JAK2 mutation; Differential Diagnosis; Therapeutic Phlebotomy; Physical findings of Polycythemia Vera * 36:53 A case of thrombocytopenia; Lab workup; Differential diagnosis; Pathophysiology; Culprit meds * 45:35 Advice for internists * 46:36 Take Home Points * 47:46 Dr. Kwok’s disclaimer * 48:10* Outro and post credit scene

The Emperor Of All Maladies (Thorndike Press Large Print Biography)

When Breath Becomes Air

None

None

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #164 with Neurologist Dr. Chris Favilla!

This mini episode is not available for CME, but episode #164 on Stroke and TIA is available for CME credit through the ACP!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Ten Thousand tenthousand.cc

Head to tenthousand.cc and enter our code CURB at checkout to save 15%.

Show Segments

Intro, disclaimer, guest bio
Afib prevention
Workup for afib
Treatment of afib
Updates on ablation, Left atrial appendage occlusion
Outro

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 18, 2021 for a brand new Stroke and TIA Triple Distilled episode.

Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences. Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders

Credits

Producers: Molly Heublein MD; Matthew Watto MD, FACP
Writer (including CME questions): Molly Heublein MD
Cover Art: Bryan Brown MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto, MD; Matthew Watto MD, FACP
Guest: Chris Favilla, MD

Sponsor: Indeed indeed.com/internalmedicine

Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.

Sponsor: Qalo qalo.com/curb

Head to qalo.com/curbto get 20% off your purchase today.

Time Stamps*

Time Stamps refer to ad-free version * 00:00 Intro, disclaimer, guest bio, and a bad pun * 04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch, * 07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter * 08:40 A case of TIA; definition of TIA * 12:14 Stroke territories * 14:24 New definition of TIA * 16:00 Differentiation from complex migraine * 19:17 Risk stratifying TIA and ABCD2 score * 22:00 A bit on tPA * 24:01 Workup for TIA; workup for amaurosis fugax * 25:36 CNS imaging studies after stroke or TIA; Choice of imaging study * 33:15 HINTS exam for posterior circulation stroke * 34:48 Is an echo necessary? Bubble study for PFO? * 38:32 Duration of afib monitoring * 40:24 Echo reports: what to look for in patient with stroke or TIA; “soft markers” * 41:55 Blood testing after Stroke and TIA (lipid panel, HbA1C; +/- RPR, coags, CBC) * 43:50 Folic acid; Sparkle trial: high dose atorvastatin versus placebo for secondary prevention * 47:00 Incidental finding: multiple patchy infiltrates in a patient without stroke or TIA; Is it significant? * 48:50 Aspirin therapy after TIA; Dosage adjustment based on weight? * 51:10 A case of stroke; TOAST trial and classification of acute stroke; ESUS; aortic arch atheromas * 55:58 Large artery strokes (hypoperfusion, acute thrombosis, artery to artery embolization) * 57:15 Antiplatelets after stroke and TIA; DAPT and duration of therapy * 62:57 Antidiabetic drugs and stroke * 63:40 Lightning round: CHA2DS2VASc score and women; how much afib is significant?; 66:32 Are all DOACs created equal?; 68:20 Regaining function after a stroke; 69:47 Silent infarcts on imaging * 71:54 Resources for stroke: Decision making in neurology textbook * 73:28 Outro

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #159 with Cardiologist Dr. James Furgerson; Plus, updates on ablation and left atrial appendage occlusion!

This episode is not available for CME, but episode #159 on Atrial Fibrillation is available for CME credit through the ACP!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: FIGS wearfigs.com

Head to wearfigs.com and enter our code CURB at checkout to save 15%.

ASN Loan Mitigation Pilot Program: asn-online.org/lmpp

The American Society of Nephrology’s Loan Mitigation Pilot Program (LMPP) aims to decrease the loan burden of those entering the field of nephrology, while also increasing interest in the specialty. Year 1 of the program will center on individuals historically underrepresented in medicine. Visit ASN-online.org/lmpp or email grants@asn-online.org

Show Segments

Intro, disclaimer, guest bio
Afib prevention
Workup for afib
Treatment of afib
Updates on ablation, Left atrial appendage occlusion
Outro

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 11, 2021 for a brand new Afib Triple Distilled version.Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up – This episode is going to send your heart racing! You might even skip a beat!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Writer and Producer: Cyrus Askin MD * Infographic: Cyrus Askin MD * Cover Art: Cyrus Askin MD * Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD * Editors: Matthew Watto MD * Guest: James Furgerson MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 100 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: Panacea Financial panaceafinancial.com

Visit panaceafinancial.com today to open your account and join a bank built with you in mind.

*Time Stamps

Note: Time stamps refer to ad-free version * 00:00 Intro, disclaimer and guest bio * 03:45 Guest one liner, a bit on physician well-being and some other randomness * 08:15 A case of palpitations; risk factors for atrial fibrillation * 12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters? * 15:08 Case summary and next steps in initial work up * 18:48 Counseling patient about atrial fibrillation and its consequences * 21:40 Ischemic heart disease and atrial fibrillation * 24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation * 25:25 Rate versus rhythm control; AFFIRM trial * 30:50 Strict versus lenient rate control; RACE trial * 33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy * 36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials * 40:40 When to refer to cardiology and electrophysiology * 42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation * 45:22 DOACs in CKD and some other nuances in choice of agent * 52:27 Bleeding and anticoagulation * 58:38 Cardioversion for atrial fibrillation (initial versus delayed) * 63:32 Anticoagulation before and after cardioversion * 67:48 Lifestyles measures for atrial fibrillation * 70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism * 74:12 Aspirin monotherapy is not appropriate for atrial fibrillation * 76:42 Take home points * 78:50* Outro

We’ve got a neutropenic fever and the only cure is...more cowbell? LIVE! It’s neutropenic fever (aka febrile neutropenia) deconstructed with infectious diseases expert, Dr. Susan Seo (Memorial Sloan Kettering Cancer Center). Topics: identifying low vs high risk patients, initial labs & imaging, empiric antibiotic therapy, when to add antifungals, de-escalation, and the G-CSF controversy.

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Writer and Producer: Matthew Watto MD, FACP
Infographic: Edison Jyang
Cover Art: Kate Grant MBChb, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Matthew Watto MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Susan Seo MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: BetterHelp betterhelp.com/curb

Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb

Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org**.

Show Segments**

Intro, disclaimer, guest bio
Guest one-liner, Picks of the Week*
Case from Kashlak; Definitions
Initial workup for neutropenic fever
Low risk neutropenic fever
High risk neutropenic fever
When to add antifungal coverage, G-CSF
Audience questions
Outro

We recap the top pearls on angina, Stable CAD, Heavy Menstrual Bleeding, and Hypercalcemia. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #279, #280, and #281.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Beth Garbitelli, Avital O’Glasser, and Nora Taranto
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Amercian College of Physicians acponline.org/100curb

ACP’s all-new CME 100 video package is now available at acponline.org/100CURB Use code 100CURB.

Sponsor: The Jordan Harbinger Show jordanharbinger.com/subscribe

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Intro, disclaimer
Angina and Stable CAD
Heavy Menstrual Bleeding and Anticoagulation in Menstruating patients
Hypercalcemia and primary hyperparathyroidism
Outro

Shaken by a shortage of shingles savvy? Vexed by varicella-zoster imposters? Perplexed by post-herpetic neuralgia? Get ready to sharpen your expertise in varicella vaccines, learn how to tell a zoster from a zebra, and administer infection interventions with an eye towards prevention. We are joined today by special guest and returning Curbsiders expert, Dr. Boghuma Kabisen Titanji MD, M.Sc., DTM&H, PhD. (@Boghuma on Twitter!). Unfortunately, CE credit is NOT YET available for this episode : (

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Sarah Phoebe Roberts, MPH
Show Notes by: Sarah Phoebe Roberts MPH, Kate GrantMBChB MRCGP DipGUMed
Cover Art: Kate Grant MBChB MRCGP DipGUMed
Infographic: Sarah Phoebe Roberts
Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH
Reviewer: Paul Williams MD, FACP
Editor: Kate Grant MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Dr. Boghuma Titanji, MD, M.Sc., DTM&H, PhD

Sponsor: BetterHelp betterhelp.com/curb

Special offer for listeners: get 10% off your first month at betterhelp.com/curb

Sponsor: Grammarly grammarly.com/curb

Get 20% off Grammarly Premium by signing up at Grammarly.com/curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

Show Segments

Intro, disclaimer
Guest bio and one-liner
First Kashlak case: Diagnosis of varicella-zoster virus (VZV, aka shingles)
Mimics and atypical presentations
Treatment for uncomplicated shingles cases
Second Kashlak case: Post-herpetic neuralgia (PHN)
PHN treatment options
Management of complicated shingles cases
VZV prophylaxis and infection control
Third Kashlak case: Immunization guidelines for older adults
VZV vaccine efficacy, live attenuated vs. recombinant vaccine
Varicella (chickenpox) vaccine guidelines
Final pearls and Outro

Walk with us through common skin complaints in primary care, focusing on the trunk and extremities. Our favorite skinternist, Dr. Helena Pasieka (Chief of Dermatology at Kashlak) schools us on tinea versicolor, the fluff test, treatment of skin tags, how to work up and manage generalized pruritus, venous insufficiency, and how to get ready for sandal season in the face of onychomycosis. #dermismedicine!

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers: Maddie “Mad Dog” Morgan, Edison Jyang
Infographic and Cover Art: Edison Jyang
Writer: Beth Garbs Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD, FACP
Editor: Emi Okamoto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Dr. Helena Pasieka

Sponsor: Qalo qalo.com/curb

Listeners get 20% off at qalo.com/curb (Promo code: CURB20)

Sponsor: Green Chef GreenChef.com/curb100

Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!

Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsidersStart the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Tinea (pityriasis) versicolor and the fluff test, bumps, and lesions
Generalized Pruritus: clinical features, work-up and supportive care
Lower Extremity Venous Insufficiency and Lipodermatosclerosis
Onychomycosis
Take-Home Points
Outro

This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! We discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and so much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, Script and Show Notes: Nora Taranto MD
Infographic, Cover Art, Show Notes: Beth Garbitelli
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com
Reviewer: Victor Kovac MD
Guest: Adi Shah MBBS

Sponsor: Panacea Financial panaceafinancial.com

Panacea Financial is a division of Primis, member FDIC

Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
How to approach antibiotics
Choosing antibiotics / Framework
Dr. Shah’s favorite antibiotics
Pneumonia
Diabetic Foot Infections
Take-home points
Outro

Review the 2021 USPSTF Guidelines on Colorectal Cancer (CRC) screening with our guest, Dr. Michael Barry (vice-chair of the U.S. Preventive Services Task Force). Topics include a breakdown of testing modalities (stool tests versus direct visualization), screening ages, what to do for patients older than 75, and more!

Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Elena Gibson MD
Cover Art and Infographic: Elena Gibson MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Matthew Watto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Michael Barry MD

Sponsor: Indeed indeed.com/internalmedicine

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Benefits of CRC screening
How to choose a testing modality
Testing in adults over 75 years old
Health disparities in CRC screening
Outro

We recap the top pearls from our SGIM & ACP 2021 highlight shows (including gabapentin for pain, LGBTQ and Women’s health pearls, CCBs and edema, MRSA swabs, IPMNs, DILI, and more!) plus recent interviews on bariatric surgery and osteoporosis. It’s Tales from the Curbside! (TFTC #6), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #275 Bariatric Surgery and #277 Bone Up on Osteoporosis.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Sarah Roberts, Edison Jyang, and Isabel Valdez
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Qalo qalo.com/curb

Head to qalo.com/curb to get 20% off.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer
LGBTQ health, Gabapentin, Care of the Muslim Patient, MRSA swabs
IPMNs, DILI, CCB and Prescribing Cascades
Bariatric Surgery
Osteoporosis
Outro

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium, and what to do when that regulation goes awry. Not to mention that, at the end of the day, PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).

Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer, Writer, Infographic, Cover Art: Nora Taranto MD
Hosts: Matthew Watto MD, FACP; Nora Taranto MD
Reviewer: Yan Emily Yuan MD, MSc
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Carl Pallais MD, MPH

Sponsor: Grammarly Grammarly.com/CURB

Sponsor: Native NativeDeo.com/curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

Show Segments

Intro, disclaimer, guest bio
Dr. Pallais One-Liner
Case from Kashlak
Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin
Causes of hypercalcemia
How Lithium works!
Testing for Hypercalcemia: Get that PTH, and that phos
Symptoms of Hypercalcemia, and Questions on History
Indications for Surgery for Parathyroidectomy
Management of Hypercalcemia and Hypercalcemic Emergency
Outro

Explore the intersection of hematology and women’s health as we discuss heavy menstrual bleeding (HMB), gynecologic risks of therapeutic anticoagulation, and prescribing contraception in the setting of venous thromboembolic disease. Wondering how to expand your women’s health knowledge as an internist? Listen as our insightful guest Dr. Bethany Samuelson Bannow @bsamuelson_md (Oregon Health & Science University) helps us navigate the intersections between non-malignant hematology and menstrual health. This episode will empower you to tackle the stigma and overcome knowledge gaps with regard to abnormal menstrual bleeding, as well as learn treatment, and management pearls. We also explore the intersection between therapeutic anticoagulation, heavy menstrual bleeding, and thromboembolic disease of different contraceptive options. Finally, we face the themes of overcoming sexism, and even misogyny, in women’s health head-on throughout this episode. After all, half the population has a uterus.

Claim Free CE credit for this episode through VCU Health CE athttp://curbsiders.vcuhealth.org/

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Avital O’Glasser MD, FACP, FHM
Infographic: Avital O’Glasser MD, FACP, FHM
Cover Art : Kate Grant MBChB MRCGP DipGUMed
Show Notes: Kate Grant MBChB MRCGP DipGUMed, Maddie Morgan, and Avital O’Glasser MD, FACP, FHM
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM
Reviewer: Carolyn Chan, MD
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
Guest: Bethany Samuelson Bannow, MD

Sponsor: Birch by Helixbirchliving.com/curb

Sponsor: Green ChefGreenChef.com/curb100

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case 1 from Kashlak
Definitions related to menstrual health
Quantifying/defining heavy menstrual bleeding
Overcoming stigma of asking about menstrual history/health
Clinical evaluation/management of the patient with heavy menstrual bleeding
Case 2 from Kashlak
Risk of heavy menstrual bleeding (HMB) in the setting of therapeutic anticoagulation
Hormonal and nonhormonal therapy options for HMB while anticoagulated
Contraception options for someone who develops VTE
Case 3 from Kashlak
Counseling about VTE risk of different contraception options
Take Home Points; Outro; Bonus clip

Learn how to dominate stable angina. Coronary artery disease with stable angina is a different beast than acute coronary syndrome. We deconstruct it’s pathophysiology, diagnosis, and management with Drs. Dan Ambinder and Rick Ferraro. Topics: When to order coronary CT vs Stress testing; An approach to non-obstructive coronary disease; What treatments are life prolonging; Medical therapy vs Stenting; An approach to antianginal therapy; and how to partner with each patient. Listen as we dive deep into the recent literature and recommendations to dominate stable angina.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Molly Heublein, MD
Writer: Molly Heublein, MD, Michael Sternberg MD
Show Notes: Molly Heublein, MD, Beth Garbitelli
Infographic, Cover Art: Beth Garbitelli
Hosts: Molly Heublein, MD; Paul Williams MD, FACP
Editor: (written materials); Cyrus Askin MD, Clair Morgan of nodderly.com
Guest: Daniel Ambinder, MD; Rick Ferraro, MD

Sponsor: Panacea Financial panaceafinancial.com

Panacea Financial a nationwide digital bank built for doctors by doctors. Panacea offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com. Panacea Financial is a division of Primis, member FDIC

Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders

Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders.

Sponsor: Audible Audible.com/curb

New members can always try Audible Plus free for 30 days. Visit Audible.com/curb or text curb to 500-500.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week*
Case from Kashlak
Definitions of stable angina, unstable angina
INOCA
Assessing risk
Treatment - life prolonging vs symptom relief
Diagnosis- stress testing vs anatomical studies
Angioplasty/stenting- ISCHEMIA trial
Take home points
Outro

Delve into the neuro Ddx with expert diagnosticians the @CPSolvers, Drs. Reza Manesh (@DrRxEdu) and Rabih Geha (@rabihmgeha). Play along as they solve a neurology mystery case, and give us a tour of the neuraxis.

No CME for this episode, but claim it for past episodes at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Matthew Watto MD, FACP
Writer (case): Daniel Minter MD (@dminter89)
Show Notes: Matthew Watto, MD, FACP
Cover Art: Sawyer Watto
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guests: Reza Manesh MD and Rabih Geha MD

Sponsor: Panacea Financial panaceafinancial.com

Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Weakness and Falls
Localization on the neuraxis
NM junction
Lung Mass
Cognitive Autopsy
Outro

Bone up on osteoporosis in primary care! Don’t let osteoporosis sneak up on your patients with a vertebral fracture or a hip fracture! Make no bones about your osteoporosis knowledge, from knowing when to screen your patients to selecting a treatment that matches your patient’s lifestyle. Join us as we discuss these topics and more with osteoporosis expert and internal medicine physician, Dr. Carolyn Crandall (UCLA).

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Isabel Valdez, PA-C
Show Notes: Isabel Valdez, PA-C
Infographic: Isabel Valdez, PA-C
Cover Art: Kate Grant MD
Hosts: Isabel Valdez, PA-C; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD FACP and Leah Witt, MD (written materials); Clair Morgan of nodderly.com
Guest: Carolyn Crandall MD

Sponsor: Indeed indeed.com/internalmedicine

Get started RIGHT NOW with a FREE $75 SPONSORED JOB CREDIT to upgrade your job post at indeed.com/internalmedicine. Offer valid through JUNE 30TH. Terms and conditions apply.

Sponsor: Native NativeDeo.com/curb

Stay fresh, stay clean with Native by going to NativeDeo.com/curb, or use promo code curb at checkout, and get 20% off your first order!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Picks of the Week
First Case from Kashlak
Definitions of Osteoporosis and Low Bone Density (formerly Osteopenia)
Patient Counseling on Treatment Side Effects
Frequency of Testing
Dental Clearance
CKD and Osteoporosis Treatment
Prevention
Vitamin D and Calcium
Take-home Points and Outro

Recap the top pearls from recent shows on Chronic Diarrhea, Dementia, OHS, and MSK (Shoulder, Hip, and Knee).. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #267 Chronic Diarrhea, #268 Dementia, and #269 OHS, and #274 MSK Triple Distilled.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Elena Gibson, Emi Okamoto, Cyrus Askin, and Matt Watto
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Grammarly Grammarly.com/CURB

Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB

Sponsor: Audible Audible.com/curb

New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer
Chronic Diarrhea,
Dementia,
OHS,
MSK: Shoulder, Hip, Knee
Outro

What if we told you there was a powerful tool that could help promote significant weight loss, correct uncontrolled diabetes, improve quality of life, and even improve patient mortality? What if we told you it was offered less than 1% of the time to patients who qualify for it? Listen as our esteemed guest Dr. Vivan Sanchez (Boston University) talks us through the patient selection, preoperative workup, and postoperative considerations for bariatric surgery, and how it might benefit your patients.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Paul Williams MD, FACP
Infographic: Edison Jyang
Cover Art: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein, MD; Clair Morgan of nodderly.com
Guest: Vivian Sanchez, MD

Sponsor: GeriPal GeriPal.org

Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

Sponsor: Green Chef GreenChef.com/90curb

Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Show Segments * Intro, disclaimer, guest bio * Guest one-liner * Picks of the Week * Case from Kashlak * Criteria for bariatric surgery * Benefits of bariatric surgery * Presurgical workup * Postoperative management * Complications * Outro

Dominate MSK complaints in primary care! A packed recap from our past musculoskeletal episodes, triple distilled to what you need to know. Learn some buckets to consider when addressing knee pain, just how simple hip complaints are, when to urgently refer shoulder problems, and easy exam maneuvers to differentiate elbow pain. Use our simple framework to help with the top diagnoses walking into your primary care clinic.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Molly Heublein, MD
Show Notes by: Molly Heublein, MD
Cover Art and Infographics: Matthew Watto
Hosts: Stuart Brigham MD; Molly Heublein, MD Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD, FACP; Clair Morgan of nodderly.com (audio)

Sponsor: GeriPal GeriPal.org

Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

Sponsor: Birch by Helix birchliving.com/curb

Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer
Case from Kashlak- general orthopedic complaints
Yellow flags
Case from Kashlak Knee
4 buckets of knee pain
Ligamentous injury
Meniscus
Patellofemoral
Knee exam
Knee Imaging
Osteoarthritis treatment
Case from Kashlak: hip
Three steps to hip diagnosis
Case from Kashlak: Shoulder
Case from kashlak: elbow
Take-home points

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: primary care management of anxiety and depression, insomnia, medical marijuana, venous thromboembolism, COVID-19 and coagulopathy, syncope, diverticulitis, aspirin, and delirium!

Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Paul Williams MD, FACP; Chris Chiu MD FACP; Sarah Roberts MPH, Beth “Garbs” Garbitelli
Show Notes by: Beth Garbitelli
Cover Art: Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial panaceafinancial.com

Panacea Financial offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com today to open your account and join a bank built with you in mind.

Panacea Financial is a division of Primis, member FDIC

Sponsor: GeriPal GeriPal.org

Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

CME Partner: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Top Pearls on: * Primary care management of anxiety and depression * Insomnia * Medical Marijuana * Venous Thromboembolism * COVID-19 and Coagulopathy * Syncope * Diverticulitis * Aspirin * Delirium

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: Heart Failure, Hypertension, IV vs PO antibiotics, Hepatology, Kiwifruit for constipation, Perioperative Sleep Apnea, Thyroid, Bariatric Surgery, Neurology, Super Gonorrhea, and more!

Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Deborah Gorth; Paul Williams MD, FACP; Matthew Watto MD FACP; Avital O’Glasser MD, FACP; Molly Heublein MD
Show Notes by: Matthew Watto MD
Cover Art: Beth Garbitelli
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial panaceafinancial.com

Sponsor: GeriPal GeriPal.org

Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Show Segments

Heart Failure
Oral vs IV antibiotics for osteomyelitis, bacteremia, and endocarditis
Inpatient Blood Pressure Management
Perioperative sleep apnea
Thyroid pearls (pregnancy and weekly dosing)
Bariatric Surgery pearls
GI disorders (Cdiff, constipation, diverticulitis)
Super Gonorrhea; Sunscreen!
Outro

Recap our top pearls from recent shows on peripheral arterial disease (PAD), Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea. It’s Tales from the Curbside (TFTC)!, our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #260 PAD, #263 Iron CKD, and #266 Acute Diarrhea. CME is not available for #261-262 Abdominal Pain

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Beth Garbitelli and Edison Jyang
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: BetterHelp betterhelp.com/Curb

This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.com/Curb.

Sponsor: Indeed Indeed.com/INTERNALMEDICINE

Get a $75 credit at Indeed.com/INTERNALMEDICINE. Offer valid through JUNE 30TH. Terms and conditions apply.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer
Peripheral Arterial Disease (Dx and Management)
Abdominal Pain and the Abdominal Exam
Iron deficiency and Anemia in CKD
Acute Diarrhea
Outro

It’s SGIM 2021, #SGIM21! LGBTQ health, updates in primary care for patients of all ages, caring for the Muslim patient, periop pearls, MRSA in your nose, and more! It’s the most wonderful time of the year for internists: SGIM and ACP, all in one month! We’re here to help you make the most out of these action-packed virtual events, starting with our SGIM 2021 conference highlights. We hope you enjoy this grab-bag of clinical pearls, from LGBTQ healthcare to periop medicine to primary care, reproductive health, and beyond. Stay tuned for our upcoming ACP IMM2021 recaps for even more knowledge food!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced, and Hosted by: Sarah Phoebe Roberts MPH; Becca Raymond-Kolker, Paul Williams MD, FACP; Chris Chiu MD, FACP, FAAP; Matthew Watto MD FACP
Show Notes by: Sarah Phoebe Roberts MPH
Cover Art and Infographic: Sarah Phoebe Roberts MPH
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: The American College of Physicians

Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov

Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process.

Sponsor: Audible Audible.com/curb

New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org. **Show Segments

Top Pearls on:** * LGBTQ health * Gynecological health * Reproductive medicine * Primary Care * Hospital Medicine * Perioperative Medicine * Caring for the Muslim patient * Young adult medicine pearls (including COVID19; and Down Syndrome) * Reflections on SGIM 2021 and Outro

Does obesity hypoventilation syndrome (OHS) give you respiratory distress? Are you baffled by bilevel? The wait is over! Learn all the ins and outs about OHS from Dr. Aneesa Das, @AneesaDas, a sleep specialist and pulmonologist at The Ohio State University! You’ll learn tips and tricks regarding the diagnosis and management of OHS, the important role PCPs can play, and why on earth we’re discussing the didgeridoo!

Free CME for this episode at curbsiders.vcuhealth.org!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Cyrus Askin, MD * Infographic: Cyrus Askin, MD * Cover Art: Kate Grant MBChb, MRCGP * Hosts: Cyrus Askin, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD * Reviewer: Leah Witt, MD * Editor: Matthew Watto, MD (written materials); Clair Morgan of nodderly.com * Guest: Aneesa Das, MD

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: Birch by Helix birchliving.com/curb

Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov

Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org. Show Segments * Intro, disclaimer, guest bio * Guest one-liner * Picks of the Week * Case from Kashlak * Basic risk factors for OHS and red flags * That pathophysiologic trifecta * Physical Exam & History - OHS * Surveys and specific testing * Labs and other tests (PFTs, Echo, and more) * OSA, OHS, and Central Sleep Apnea * Treating OSA: CPAP vs Bilevel * The importance of weight loss * Keys for inpatient management * Perioperative considerations * Take-home points * Outro

Dust off your dementia playbook and re-evaluate your approach as Dr. Josh Uy walks us through this common (yet perplexing) condition. Dr. Uy (@joshuy) is the geriatric fellowship director at University of Pennsylvania in addition to a nursing home director and shares his skills in simplifying dementia screening, management, and treatment. Set your chairs up for the “triad visit” and prepare to ‘stew in the milieu’ of dementia!

Free CME for this episode at curbsiders.vcuhealth.org!

Credits * Producer, cover art, infographic: Emi Okamoto MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com * Guest: Josh Uy MD

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: Green Chef GreenChef.com/90curb

Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org. Show Segments * Intro, disclaimer, guest bio * Guest one-liner and picks of the Week* * Case from Kashlak * Definitions of dementia and cognitive impairment * Subtyping dementia * Cases to refer and basic laboratory testing * Potential imaging * Management of dementia * Take-home points, Outro

Flow with us through Diarrhea Disemboweled Part 2 as Dr. Xiao Jing (Iris) Wang @IrisWangMD walks us through the differential diagnosis and initial evaluation of chronic diarrhea.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Elena Gibson MD
Writer: Elena Gibson MD, Beth Garbitelli
Cover Art: Kate Grant, MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written); Clair Morgan of nodderly.com (audio)
Guest: Xiao Jing (Iris) Wang MD

Sponsor: Express VPN ExpressVPN.com/curb

Protect your online activity TODAY with the VPN rated #1 by CNET and Wired. Visit our exclusive linkExpressVPN.com/curband you can get an extra 3 months FREE on a one-year package!

CME Partner: VCU Health CEThe Curbsiders partner with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Show Segments

Intro, disclaimer, guest bio
Case from Kashlak
Osmotic diarrhea & stool osmotic gap
Causes of osmotic Diarrhea
Algorithm for evaluating diarrhea workup
Testing workup for chronic diarrhea
Endoscopic evaluation indications
Disorders of the Gut-Brain Axis

Flow with us through Diarrhea Disemboweled Part 1 as Dr. Xiao Jing (Iris) Wang @IrisWangMD walks us through the evaluation and management of acute diarrhea.

NOTE: CME will not Go LIVE until Wed 4/7/21 for both #266 and #267. Then, claim 2 hours credit in one shot!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer: Elena Gibson MD * Writer: Elena Gibson MD, Beth Garbitelli * Cover Art: Kate Grant, MD * Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matt Watto MD (written); Clair Morgan of nodderly.com (audio) * Guest: Xiao Jing (Iris) Wang MD

Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.

Sponsor: BetterHelp betterhelp.com/Curb

This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.com/Curb.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Show Segments * Intro, disclaimer, guest bio * Picks of the Week * Case from Kashlak * Definitions * Small bowel vs. Large bowel pathology * Red flags * Microbiologic evaluation of acute diarrhea * Non-Culture based testing panels * Supportive Management * Post infectious diarrhea * Oral Rehydration Solution * Take-Home points and Outro

Recap our top pearls from recent shows on hypertension, sarcoidosis, and seizure. It’s Tales from the Curbside (TFTC)!, our monthly series providing a rapid review of recent Curbsiders episodes.

Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #254, #256, and #257.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Beth Garbitelli and Edison Jyang
Cover Art: Edison Jyang
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Show Segments * Intro, disclaimer * Hypertension pearls * Sarcoidosis pearls * Seizures pearls * Outro

Fresh hotcakes! Practice-changing articles that you need to know: semaglutide for weight loss; metronidazole plus a fluoroquinolone versus amoxicillin/clavulanic acid for uncomplicated diverticulitis; and the perioperative risks of COVID19. We’re joined by Dr. Adnan Khan (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced and hosted by: Rahul Ganatra MD, MPH; Adnan Khan MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Matthew Watto MD, FACP
Editor: Rahul Ganatra MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial panaceafinancial.com

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com. Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: ACP’s MKSAP 19 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at check out.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

Show Segments

Intro, disclaimer
Pick of the week: Dark (Netflix TV series)
Preventive Medicine Updates
Semaglutide for weight loss
Amox-clav vs FQ-metronidazole for Diverticulitis
Perioperative COVID19 infection and timing of surgery
Rahul’s take-home points
Outro

Dominant iron deficiency and anemia of CKD! We discuss how to interpret iron studies, when and how to start treatment with PO vs. IV iron, and ESAs vs. the new HIF-PHIs! Iron deficiency in chronic kidney disease is common but frequently overlooked in primary care. This episode features Kashlak Memorial’s own Chief of Nephrology, Dr. Joel Topf (@kidney_boy), joined by NephMadness experts, Dr. Matthew Spark (@Nephro_Sparks), and Dr. Pascale Khairallah (@Khairallah_P)! Our guests lay out an easy-to-follow framework for primary care and give us some inside information to #Nephmadness! Read the Anemia Region scouting report.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Writer, Producer: Stuart Brigham, MD * Cover Art: Kate Grant MBChB, MRCGP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Joel Topf MD, Matt Sparks MD, Pascale Khairallah MD

Sponsor: Grammarly Grammarly.com/CURB

Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB

Sponsor: Green Chef GreenChef.com/90curb

Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping!

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Segments

Intro, disclaimer, guest bio
Case from Kashlak
Approaching CKD in Primary Care
Iron and anemia labs in CKD
Ferritin Goals in CKD
Oral Replacement of Iron in CKD
IV Replacement of Iron in CKD
Discussing treatment option for Anemia of CKD
Basic information on HIF Stabilizers/ PHIs in CKD
Take-home points and Outro

In this part 2 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of the DX: Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com

Guest: Andrew Olson MD

Sponsor: Birch by Helix birchliving.com/curb

Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

In this part 1 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of DX: the Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com

Guest: Andrew Olson MD

Sponsor: Panacea Financial panaceafinancial.com

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: BetterHelp betterhelp.com/Curb

This podcast is sponsored by BetterHelp and Curbsiders listeners get 10% off their first month at betterhelp.com/Curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

A painless walk through the diagnosis and management of peripheral artery disease (PAD). PAD is one of those diagnoses that you know about, but maybe don’t feel comfortable diagnosing and managing. Listen as our esteemed guest Dr. Vladimir Lakhter @VladLakhter (Temple Health) talks us through its diagnosis and management. Dr. Lakhter gives us a straightforward framework for categorizing and triaging peripheral artery disease and talks us through the important components of medical management and who benefits from revascularization.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and produced by: Jake Kieserman and Paul Williams MD, FACP * Infographic: Edison Jyang * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com * Guest: Vladimir Lakhter, DO

Sponsor: Indeed INDEED.COM/INTERNALMEDICINE

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Time Stamps*

*Note: Time Stamps refer to ad-free version. * Intro, disclaimer, guest bio- 00:33 * Guest one-liner- 3:25 * Dr. Lakhter book recommendations- 5:36 * Case from Kashlak- 8:35 * Definition and background for PAD- 10:25 * Classification schema for PAD- 12:45 * The physical examination- 21:05 * ABIs and PVR in the diagnosis of PAD- 33:50 * Exercise program for PAD- 46:08 * Medication therapy- 52:05 * Revascularization- 62:50 * Outro- 68:45

Let's recap our favorite addiction medicine pearls! We cover the treatment of alcohol use disorder, opioid use disorder and discuss strategies surrounding the management of long-term opioid therapy. Please share your favorite addiction medicine pearls with us that we may have forgotten in the comments or by tagging us on Twitter @thecurbsiders.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producers: Carolyn Chan MD; Nora Taranto MD
Infographics: Hannah R Abrams; Justin Berk MD, MPH, MBA; Carolyn Chan MD; Nora Taranto MD
Writer and Cover Art: Carolyn Chan, MD
Hosts: Carolyn Chan MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Justin Berk MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea FinancialThis episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial, you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea is also excited to announce their “Match Day Giveaway.” $500 will be awarded to five medical students entering the match in 2021. Entry is free, and students can enter the giveaway on their website until March 31, 2021. Winners will be selected randomly on April 1st, 2021. No purchase necessary for entry. Go to panaceafinancial.com/matchday today to learn more. Panacea Financial, a Division of Sonabank, Member FDIC

Partner: The Cribsiders Pediatric Medicine Podcast

A Pediatric Podcast here to feed pediatric knowledge food to your adult-sized brain hole & provide weight-based dosings of fun. New episodes drop every other Wednesday! https://thecribsiders.com/

CME Partner: VCU Health CEThe Curbsiders partner with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org to claim credit.

Time Stamps

Intro, disclaimer 00:00
Alcohol Use disorder (inpatient and outpatient management) 03:50
Sponsor -Panacea Finanicial 24:00
Partner -The Cribsiders Pediatric Medicine Podcast
Chronic Pain and Opioid Therapy (prescribing buprenorphine; microdosing) 25:30
Benzo Tapers 46:11
Outro

Recap our top pearls from recent shows on nephrotic syndrome vs nephritic syndrome, smoking cessation and updates in preventive medicine. Tales from the Curbside (TFTC) is a monthly series providing a rapid review of recent Curbsiders episodes.

Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #250, #251 and #252.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Infographics by: Elena Gibson MD, Beth Garbitelli and Carolyn Chan MD
Cover Art: Matthew Watto MD
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea FinancialThis episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: Grammary grammarly.com/curb

Seize control of your differential for epilepsy! This week, we review the basics of seizure work-up and management with our esteemed guest Dr. Sara Dawit @DrSaraDawit a board-certified neurologist who is an Assistant Professor of Neurology and Neurophysiology Fellow at The Mayo Clinic, Scottsdale Campus. Dr. Dawit takes us through rapid response to witnessed seizure, how to approach first-time seizures and adult-onset seizure disorders, gives us some facts about non-epileptic seizure disorders, and describes how to approach medication management in epilepsy!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Paul Williams MD, Beth Garbitelli
Writer and Infographics: Beth Garbitelli
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Sara Dawit MD

Sponsor: ACP’s MKSAPMKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout.

Sponsor: Green Chef GreenChef.com/90curb

Sponsor: Indeed Indeed.com/INTERNALMEDICINE

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

This grand overview of granulomas will leave you comfortable tackling an often breathtaking disease, sarcoidosis. Listen as our esteemed guests Dr. Mary Beth Scholand (University of Utah) and Dr. Jonathan Boltax (University of Utah) rheum-inate on sarcoidosis. We discuss the pathophysiology, diagnosis, and treatment of this disease, role of the primary care clinician and why sarcoidosis in the chart reminds Paul of Shakespeare.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Producer: Cyrus Askin MD and Deborah Gorth
Writer: Deborah Gorth
Infographic and Cover art: Edison Jyang
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
Guest: Drs. Mary Beth Scholand & Jonathan Boltax

Sponsor: ACP’s MKSAP MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout.

Sponsor: birch by HelixVisit birchliving.com/curb

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Time Stamps

00:00 Intro, disclaimer, guest bio, Awful(ly good?) Pun
03:42 Guest one-liners
06:28 Sponsor - ACP’s MKSAP19
07:40 Case from Kashlak
08:40 Explaining sarcoidosis
12:19 Possible drivers of sarcoidosis
13:30 Taking a sarcoidosis history
17:26 Suggestions for catching sarcoidosis
21:44 Sponsor - birchliving.com/curb
23:52 Sarcoidosis physical exam, Diagnosis
33:00 Lofgren’s and Heerfordt’s syndromes; Imaging for sarcoidosis
40:44 Initiating therapy for sarcoidosis; Prognosis; the Treatment team
51:23 Primary care considerations for sarcoidosis
54:55 Diagnosing and treating a sarcoidosis exacerbation
61:20 Take home points and outro

Fresh hotcakes! Practice changing articles that you need to know: low dose colchicine for stable CAD; colchicine vs naproxen for acute gout flares; and physical therapy vs glucocorticoid injection for chronic Knee osteoarthritis. We’re joined by Michael Sternberg (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Hosts: Rahul Ganatra MD, MPH; Michael Sternberg MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: ACP’s MKSAP18MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org .

Time Stamps

Intro, disclaimer
01:45 Fun animal fact; Picks of the Week*
06:33 PT vs steroid injection for chronic knee OA
21:00 Colchicine for stable CAD
33:00 Low dose colchicine vs naproxen for acute gout flares

Listen as our esteemed guest Dr. Wanpen Vongpatanasin, @DrWanpen (UT Southwestern) discusses the nitty-gritty of blood pressure monitoring and hypertension treatment. We review the thresholds for HTN diagnosis and how to accurately measure blood pressure levels at home and in the office. Dr Vongpatanasin shares the latest guideline recommendations for first line pharmaceutical therapies as well as her pearls about how to treat special populations.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Produced by: Deborah Gorth and Isabel Valdez, PA
Written by: Deborah Gorth
Infographic and Cover Art: Edison Jyang
Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; Paul Williams, MD, FACP
Editor: Molly Heublein, MD (written materials); Clair Morgan of nodderly.com
Guest: Wanpen Vongpatanasin, MD

Sponsor: ACP’s MKSAP18MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021.

Sponsor: Provider Solutions and DevelopmentProvider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Time Stamps

00:00 Sponsors, Intro, disclaimer, guest bio 03:20 Guest one-liner 05:50 Sponsor - ACP’s MKSAP 18

07:05 Case from Kashlak; Defining hypertension and treatment thresholds 10:43 Measuring blood pressure (at home, in the office, validatebp.org) 16:46 Wrist BP cuff 19:50 Home monitoring and ambulatory BP monitoring; What time to take BP medication 31:23 Sponsor - Provider Solutions and Development

32:10 Approach to treatment; Combo pills; How to titrate meds 42:20 Treating resistant hypertension; hyperaldosteronism; Isolated systolic hypertension 52:04 Take home points and Outro

Answer all your burning questions (and your patients’ burning questions) about the different COVID-19 vaccines currently authorized in the US. Infectious diseases / HIV expert, Dr Monica Gandhi @MonicaGandhi9 (UCSF) joins us to cover: the Pfizer-BioNTech and Moderna novel mRNA vaccine mechanisms, trial data, and practicalities of who should receive them. We discuss data around the Oxford-AstraZeneca adenovirus vaccine, which is authorized in the UK and India, and may be available in the US later this year. Feel confident recommending COVID-19 vaccines to your patients!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and Produced by: Molly Heublein, MD
Cover Art: Chris Chiu, MD, FACP, FAAP
Infographic: Tima Karginov
Hosts: Chris Chiu, MD, FACP, FAAP; Molly Heublein, MD; Paul Williams, MD, FACP
Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Monica Gandhi, MD, MPH

Sponsor: Panacea FinancialThis episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Time Stamps

Intro, disclaimer, guest bio - 00:00
Guest one-liner, book recommendation - 3:40
Authorized vaccines in the US - 8:30
AstraZeneca vaccine mechanism- 9:26
mRNA vaccine mechanism - 10:30
Vaccine distribution issues (cold chain) - 16:05
mRNA safety - 18:24
mRNA vaccine efficacy/data from phase 3 trials - 19:40
How did we get this so quickly - 23:40
Vaccine impact on asymptomatic infection - 26:18
AstraZeneca trials - 28:20
Pregnancy - 35:10
Anaphylaxis - 37:10
Prior COVID-19 infection - 39:07
Side effects - 42:05
Pediatric patients - 45:12
Phases of role outs in the US -46:50
Herd immunity - 48:16
Thoughts of how to make this happen - 52:45
Preexisting conditions - 53:40
How long will immunity last - 57:15
Mutant strains - 58:25
Future of mRNA vaccines - 1:00:30
Take home points and Outro - 1:02:12

Get all the details on varenicline, nicotine replacement therapy, and integrating psychosocial interventions into a comprehensive smoking cessation treatment plan! Smoking cigarettes is the leading cause of preventable death worldwide. Listen as our esteemed guest Dr. Steve Baldassarri (Yale) provides us expert pearls to help our patients quit smoking.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits

Written and produced by: Carolyn Chan, MD
Infographic: Edison Jyang
Cover Art: Kate Grant
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin, MD (written materials); Clair Morgan of nodderly.com
Guest: Steve Baldassarri MD MHS

Sponsor: The American College of PhysiciansJoin us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org. (Prices shown online at registration pages reflect Discounted Rates.)

Register now—Early Bird savings end January 31st!

Sponsor: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Time Stamps*

Note:* Time Stamps refer to ad free version. * 03:02 Intro, disclaimer, guest bio * 04:35 Guest one-liner * 09:50 Tobacco Use Disorder - Chronic Disease * 11:08 Case from Kashlak * 11:56 Obtaining a history * 13:39 Motivations for Smoking Cessation * 15:29 Factors associated with challenges in smoking cessation: * 21:40 Gradual Tapers vs Cold Turkey * 25:18 Nicotine Replacement 32:40 * 28:57 Pharmacotherapy - “Controller” Medications * 31:05 Pharmacotherapy - Short Acting Medications * 33:20 Dosing Medications * 38:35 Varenicline * 39:00 Nicotine gum dosing * 44:40 Duration of therapy * 48:08 Bupropion * 49:05 Behavioral Interventions * 55:24 Vaping and electronic cigarettes * 57:03 Vaping for smoking cessation * 01:02:35 EVALI * 01:05:49** Outro

What the USPSTF?! It’s time for some preventive medicine updates on: screening for unhealthy drug use, cervical cancer, hepatitis C and draft recs for colorectal cancer; plus how to interpret USPSTF screening recs. Dr. Amber-Nicole Bird @ABirdMD (Penn Medicine) refreshes our love for preventive medicine, with updates on the newest recommendations. She reviews how to appropriately interpret and adopt guidelines for our patients, being cognizant of the source. We shine light on the mechanism of USPSTF, including how their guidelines differ from others, so we can understand the value and context when utilizing the guidance in the clinic.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Produced and Written by: David Madick MD; Peter Wikoff MD; Paul Williams MD, FACP * Infographic: Beth Garbitelli * Cover Art: Chris Chiu MD * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto, MD (Show notes); Clair Morgan of nodderly.com * Guest: Amber-Nicole Bird, MD

Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st!

Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer, writer, infographic, cover art: Elena Gibson MD * Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) * Guest: Joel Topf MD

Sponsor: The American College of Physicians

Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.

“Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB.

Register now—Early Bird savings end January 31st!

Sponsor: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Recap the top pearls from recent shows on vulvovaginitis, cellulitis and bites, MGUS and the SPEP. Tales from the Curbside (TFTC) is pilot project providing a rapid review of recent Curbsiders episodes. Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #244, #246 and #247.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Infographics by: Kate Grant MBChb, MRCGP, Beth Garbitelli and Nora Taranto MD * Cover Art: Matthew Watto * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: The American College of Physicians

Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.

“Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB.

Register now—Early Bird savings end January 31st!

Time Stamps Note: Time Stamps refer to ad free versions.

00:00 Intro, disclaimer, guest bio
02:35 Vulvovaginitis
05:35 Cellulitis and Bites
09:45 SPEP it Up
15:15 Outro

Our team shares the top pearls of 2020 in our annual recap extravaganza featuring guest host, Chris “The Chiu Man” Chiu @cjchiu. Check out the video version at YouTube. Topics: hypothyroidism, women in medicine, hypothermia, diuretics, heart failure, AKI, lipids, post-op fever, refugee health, SGLT2 inhibitors, euglycemic DKA, UTIs, bat bites, rabies, ILD, statins in NAFLD, framework for hair loss, and more! Plus: Our picks of the year and the Curbsiders gift guide! Note: This episode is not available for CME but #208 through #247 are available for CME/MOC at curbsiders.vcuhealth.org for free!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer: Chris Chiu MD, FACP, FAAP * Written by: The Curbsiders Team * Show Notes: Matthew Watto MD, FACP * Cover Art: Chris Chiu MD, FACP, FAAP * Hosts: Chris Chiu MD, FACP, FAAP, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

On this episode, Dr. Jorge Castillo (Harvard, Dana Farber) walks us through some immunology basics, teaches us the limitations of the SPEP, plus some additional tests that complement it (think Immunofixation), shares his clinical gestalt about when to suspect MGUS, Myeloma, Waldenstrom’s, and Amyloidosis--and finally, how to talk to patients about them. If you, like Stuart, have ever wondered what on earth to do with that pesky free light chain ratio or the SPEP that so often gets inboxed to you without explanation, then fear not, Dr Castillo has your back!

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by Nora Taranto MD * Infographics by Nora Taranto MD * Cover Art by Kate Grant MBChB, MRCGP * Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, FACP, Nora Taranto MD * Editor: Matthew Watto MD, FACP ; Clair Morgan of nodderly.com * Reviewer: Jooho Chung MD, PhD * Guest: Jorge Castillo MD

Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

Sponsor: VCU Health CE

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your account!

Master common skin and soft tissues infections: cellulitis, abscesses, human and animal bites with returning guest, infectious diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED).

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written (including CME) and Produced by: Matthew Watto MD, FACP * Cover Art and Infographic by: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto (written materials); Clair Morgan of nodderly.com * Guest: Boghuma Titanji MD, M.Sc., DTM&H, PhD

Sponsor: Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org.

Time Stamps Note: Time Stamps refer to ad free version.

00:00 Intro, disclaimer, guest bio
02:00 Picks of the Week
06:00 Definitions, Initial Approach to cellulitis
10:35 Nonpurulent cellulitis; antibiotic choice 18:10 Fish handler’s disease
24:30 Recurrent cellulitis
31:30 Purulent cellulitis and MRSA; Antibiotic choice; Step down therapy
47:33 Abscesses; Adjuvant antibiotics; Packing Wounds
53:30 Decolonization for recurrent MRSA infections
56:30 Human Bites (clenched fist injury); Dog bites and Cat bites
67:10 Take home points and Outro

Diagnosis, Management, and Social Implications of Attention Deficit Hyperactivity Disorder.

Ever gotten overwhelmed by all the categories of ADHD, or interpreting the scores on a Vanderbilt form? Join us with Dr. Sarah Vinson, a triple-boarded clinician in adult psychiatry, child psychiatry, and pediatrics who helps us optimize a diagnosis and management process for ADHD. What other conditions can masquerade as ADHD? Which type of stimulant should you use? Listen to find out more! Show notes at: https://thecurbsiders.com/cribsiders/13 Subscribe at: Apple , Google, Spotify

Credits * Writer, Producer, Infographic: Angela Zhang * Cover Art: Chris Chiu * Hosts: Justin Berk, Chris Chiu * Editor:Justin Berk; Clair Morgan of nodderly.com * Guest(s): Dr. Sarah Y. Vinson

Time Stamps * 5:30 Diagnosis of ADHD * 6:53 Considering a differential diagnosis of ADHD * 8:43 Categories of ADHD * 15:02 Ancillary Supports * 18:27 Consequences of Misdiagnosis * 19:53 Parent Counseling * 22:08 Behavioral Interventions Treatment * 25:56 Gender Differences in ADHD * 28:00 Anaphylaxis Promo * 28:39 Alternative Treatments * 30:54 Pharmacotherapy for ADHD * 37:29 Side Effects of Medical Treatments * 44:33 Monitoring Progress * 46:19 Treating concurrent mood disorders * 49:21 ADHD in Young Adults * 55:29 ADHD and Race * 1:08:13 Future of ADHD

Learn about the latest in COVID-19: Do masks prevent infection?, SARS-CoV-2 home testing, vaccine advice, and how to prevent and treat VTE in COVID-19. Join us as our tzar-of-clinical-appraisal Curbsider/internist/epidemiologist Rahul Ganatra MD MPH (@rbganatra) talks us through the controversial DANMASK-19 trial, plus Watto reports back on his conversation with Dr Parth Rali @parthrali (Temple Lung Center) who helped write the CHEST anticoagulation guidelines for COVID-19.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer: Deb Gorth ScM * Show Notes, Cover Art, and CME by: Deb Gorth ScM and Matthew Watto MD * Written by: Matthew Watto MD, Paul Williams MD, and Rahul Ganatra MD MPH * Hosts: Rahul Ganatra MD MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Time Stamps * 00:00 Intro, disclaimer, Picks of the week* and Vaccines * 08:00 DANMASK-19 * 25:00 Anticoagulation in COVID-19 * 35:06 COVID-19 home PCR testing * Outro

Everything you need to know about vulvovaginitis: candidiasis, bacterial vaginosis, and Genitourinary Syndrome of Menopause. Join us on the journey of a lifetime as we learn all about diagnosing, treating and managing vulvovaginal conditions in patients of all ages. Plus, a bit on how to recognize and treat lichen sclerosus. Our brilliant guest for this episode is Dr. Monica Christmas (@drmonicaxmas on Twitter), who is a self-described yoga enthusiast, avid reader, wannabe artist and gynecologist. Dr. Christmas is currently an Assistant Professor at the University of Chicago in the section of Minimally Invasive Gynecologic Surgery where she is the director of the Menopause Program. Monica specializes in gynecologic surgery, abnormal uterine bleeding and menopause management with an interest in sexual dysfunction. Her focus is on helping women live healthy, vibrant, happy lives.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Produced by: Kate Grant MD; Sarah Phoebe Roberts MPH * Written by: Kate Grant MD * Show Notes by: Sarah Phoebe Roberts MPH, Kate Grant MD * Cover Art and Infographic: Kate Grant MD * Hosts: Kate Grant MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Dr. Monica Christmas, MD

Sponsor: ACP’s I Raise the Rates

Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

Sponsor: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Listen in as we recap four of our favorite diabetes episodes to bring you the pearls you need to stay up to date on type 2 diabetes management in the clinic. We cover pitfalls of A1c testing, guidelines for A1C targets, when and how to use the newer medications SGLT-2 inhibitors and GLP-1 agonists. We wrap up with a discussion of managing DM2 in patients with kidney disease and in which patients to consider de-intensifying treatment. Feel confident managing diabetes with the latest data in 2020!

Listeners can claim 4 HOURS of Free CE credit for this episode through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits

Written and Produced by: Molly Heublein, MD
Infographic and Cover Art: Isabel Valdez, PA
Show Notes: Isabel Valdez, PA; Molly Heublein, MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein, MD
Editors: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com

Sponsors: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps

0:00 Intro,

2:45 Pitfalls of A1c testing,

7:00 Diabetes goals/A1c guidelines; Macrovascular vs Microvascular benefits,

16:20 Choosing between SGLT2 inhibitors vs GLP1 agonists,

19:10 Stuart rants on insulin for symptomatic hyperglycemia,

22:32 Start your patient on an SGLT2i and counsel them about potential adverse events,

30:30 GLP-1 agonists,

36:50 Deintensification; Diabetes Treatment in CKD,

Tags Diabetes, hypoglycemia, SGLT2 inhibitors, GLP-1 agonist, metformin, CKD, primary care, assistant, doctor, education, family, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, physician, resident, student

Explore the essentials of Wilderness Medicine and prepare yourself for austere environments as we discuss Altitude Sickness, Frostbite, Animal Bites, Thermoregulation, Wound Care and the proper way to apply a tourniquet.

Thinking about outdoor escapes and vacations now more than ever? Listen as our esteemed guest Dr. Thomas DeLoughery @Bloodman (Oregon Health & Science University) takes us through the fascinating, and at times chilling, world of Wilderness Medicine. This episode will empower you to explore the great outdoors as safely as possible. We discuss the breadth of wilderness medicine, multiple unique clinical entities encountered in austere environments, and practical ways to protect yourself and others on your adventures. This episode is truly wild!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written, Produced, and Infographic by: Avital O’Glasser MD, FACP, FHM * Show Notes: Deborah Gorth ScM and Avital O’Glasser MD, FACP, FHM * Cover Art: Kate Grant, MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: Thomas DeLoughery MD, MACP, FAWM

Sponsors: Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ * Sponsor - VCU Health CE curbsiders.vcuhealth.org * 00:00 Intro, disclaimer, guest bio * 03:45 Guest one-liner, advice and Picks of the Week* * 08:10 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ * 09:00 Case of mountaineering; What is Wilderness Medicine? * 12:05 What’s in your first aid kit? * 21:36 Altitude sickness: acute mountain sickness, high altitude cerebral edema and High altitude pulmonary edema * 31:25 Hypothermia * 39:36 Frostbite * 47:25 Hyperthermia: Heat exhaustion and Heat stroke; How much water should you drink? * 51:55 Bat bites and rabies * 58:20 Snake bites * 66:03 Wound care and tourniquets * 75:40 Take Home Points; Outro; Bonus clip * Sponsor - VCU Health CE curbsiders.vcuhealth.org

Links* 1. De Gaulle by Julian Jackson 2. Command and Control by Eric Schlosser 3. Auerbach's Wilderness Medicine, 2-Volume Set 4. Whatever book Paul said he was reading, sounds nerdy (The First Law Trilogy) 5. Wilderness Medicine Society 6. Stop The Bleed: Home 7. Into Thin Air: A Personal Account of the Mt. Everest Disaster by Jon Krakauer 8. National Outdoor Leadership School 9. Advanced Wilderness Life Support 10. Inside the ER at Mt. Everest 11. Annapurna by Maurice Herzog 12. K2, The Savage Mountain: The Classic True Story Of Disaster And Survival On The World's Second-Highest Mountain– by Charles Houston and Robert Bates

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will learn the basics of wilderness medicine and how to approach a few common conditions.

Learning objectives After listening to this episode listeners will…

Appreciate Wilderness Medicine as a medicine subspeciality and understand why or how someone might pursue this clinical focus area
Recognize signs and symptoms of high altitude sickness
Develop an approach to treating animal bites and injuries
Learn high yield tips for administering first aid in the wilderness including field hemostasis

Disclosures Dr DeLoughery reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation O’Glasser AY, Gorth D, Deloughery T, Williams PN, Watto MF. “#242 Wilderness Medicine: Prfor Disaster”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date November 16, 2020.

Tags Wilderness Medicine, Travel medicine, first aid, first aid kit, altitude sickness, acute mountain sickness, high altitude cerebral edema, high altitude pulmonary edema, acetazolamide, dexamethasone, hypothermia, frostbite, frostnip, heat exposure, heat exhaustion, heat syncope, hyperthermia, hyponatremia, animal bites, bats, rabies, snakes, antivenom, wound care, tourniquet, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

De Gaulle

K2 THE SAVAGE MOUNTAIN: THE CLASSIC TRUE

Command and Control: Nuclear Weapons, the Damascus Accident, and the Illusion of Safety (ALA Notable Books for Adults)

Auerbach's Wilderness Medicine, 2-Volume Set

Into Thin Air: A Personal Account of the Mount Everest Disaster

Blade Itself

Annapurna: The First Conquest Of An 8,000-Meter Peak

Rejoice! as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward. Listeners can claim free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). We hope you enjoy learning from this episode as much as we enjoyed producing it!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written (including CME questions) and Produced by: Cyrus Askin MD * Infographic by: Cyrus Askin MD * Cover Art: Kate Grant MBChb, MRCGP * Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Paul Williams MD, FACP * Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com * Guest: Brad Hayward MD

Sponsors: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - Panacea Financial panaceafinancial.comSponsor - VCU Health CE curbsiders.vcuhealth.org * 00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week* * 06:23 Sponsor - Panacea Financial panaceafinancial.com * 07:30 Case of Post Infectious Cough; Basic definitions for cough * Important aspects of the history * Empiric therapies for post-viral cough * 22:50 Case of idiopathic chronic cough; Physical exam * 29:20 Basic testing and empiric therapy for the common causes of chronic cough * 41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds * 54:28 Take home message; Outro * Sponsor - VCU Health CE curbsiders.vcuhealth.org

Links * 90 Day Fiancé (show) * Below Deck Mediterranean (show) * Mastering Communication with Seriously Ill Patients* by Anthony Back, Robert Arnold & James Tulsky (book)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will develop a pragmatic approach to evaluating subacute and chronic cough in adult patients.

Learning objectives After listening to this episode listeners will be able to…

... define sub-acute vs chronic cough
... build a repertoire of history questions geared towards identifying the etiology of cough in a patient
... build a toolbox of diagnostic studies / tests that can be used in the evaluation of cough
... marry history, physical and diagnostic studies into a coherent approach to diagnosing subacute and chronic cough through a tiered/logical approach
... understand empiric therapies for cough that may have an advantageous risk-reward profile, even in the absence of diagnosis
... educate patients on common causes for subacute cough and chronic cough, as well as how to appropriately set expectations regarding symptoms severity and duration

Disclosures Dr. Hayward reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Askin CA, Hayward B, Williams PN, Brigham SK, Okamoto E, Watto MF. “241: Chronic Cough”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date: November 9, 2020.

Tags Cough, dyspnea, asthma, COPD, eosinophil, IL-5, allergy, ENT, allergist, pulmonary, pulmonologist, PFT, spirometry, post-nasal drip, GERD, reflux, eczema, rash, atopy, mucus, bronchiectasis, lung, antihistamine, CT, X-Ray, smoking, vaping, birds, dust, cockroaches, steroids, ICS, inhaled, gabapentin, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope

Returning guest expert Dr Ted Parks helps us get the elbow straight with a simple approach to common causes of elbow pain for primary care. Listen as he guides Stuart through physical exam techniques (or watch them on YouTube) for epicondylitis and learn what the bursa is there for anyways. Find out what fracture you can treat in your office, why you shouldn’t stab straight into the olecranon bursa and when elbow pain should be referred. Feel confident when your patient comes in with elbow pain!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Molly Heublein, MD * Cover Art and Infographic: Edison Jyang * Hosts: Stuart Brigham MD, Matthew Watto MD, FACP; Molly Heublein, MD * Editor: Emi Okamoto, MD (written materials); Clair Morgan of Nodderly.com (audio/video) * Guest: Ted Parks, MD

Sponsors Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ * Sponsor - VCU Health CE curbsiders.vcuhealth.org * 00:00 Intro, disclaimer, guest bio * 04:00 Picks of the Week* * Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ * 09:50 Medial and lateral epicondylitis case, Elbow anatomy * 13:00 Pathophysiology of epicondylitis, Epicondylitis exam, Epicondylitis treatment * 34:11 Olecranon bursitis, Bursitis diagnosis and aspiration * 46:12 Radial head fracture diagnosis, Radial head fracture treatment * 55:30 Cubital tunnel nerve entrapment * 57:45 Platelet rich plasma * 60:39 Take home points, Plug and Outro * 64:00 Bonus Pick of the Week * Sponsor - VCU Health CE curbsiders.vcuhealth.org

Goals Listeners will have a working differential of elbow complaints that commonly present in primary care, and understand how to diagnose these and initiate treatment.

Learning objectives After listening to this episode listeners will...

Perform an exam for medial and lateral epicondylitis.
Describe treatment options for medial and lateral epicondylitis
Identify when further evaluation for clinical olecranon bursitis beyond clinical exam is needed
Explain how radial head fractures differ from most other fractures, and why casting or surgery is generally not needed.

Links* 1. Molly’s Pick: The Warmth of Other Suns (book) by Isabel Wilkerson 2. Stuart’s Pick: The Fringe (TV show), JJ Abrams 3. Practical Office Orthopedics (textbook) by Ted Parks, MD

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

References 1. Johnson GW, Cadwallader K, Scheffel SB, Epperly TD. Treatment of lateral epicondylitis. Am Fam Physician. 2007 Sep 15;76(6):843-8. PMID: 17910298. 2. Simental-Mendía M, et al. Clinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials. Clin Rheumatol. 2020 Aug;39(8):2255-2265. doi: 10.1007/s10067-020-05000-y. Epub 2020 Feb 26. PMID: 32103373. 3. Parks, Ted. Practical Office Orthopedics. McGraw-Hill Education / Medical; 1st Edition (December 29, 2017). 4. Khodaee M. Common Superficial Bursitis. Am Fam Physician. 2017 Feb 15;95(4):224-231. PMID: 28290630. 5. Liow RY, Cregan A, Nanda R, Montgomery RJ. Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols. Injury. 2002 Nov;33(9):801-6. doi: 10.1016/s0020-1383(02)00164-x. PMID: 12379391. 6. Boone S, Gelberman RH, Calfee RP. The Management of Cubital Tunnel Syndrome. J Hand Surg Am. 2015 Sep;40(9):1897-904; quiz 1904. doi: 10.1016/j.jhsa.2015.03.011. Epub 2015 Aug 1. PMID: 26243318.

Tags Elbow, orthopedics, olecranon bursitis, bursa, aspiration, septic joint, medial epicondylitis, lateral epicondylitis, radial head fracture, PRP, platelet rich plasma, humerus, olecranon, radius, tendonitis, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Disclosures Dr Parks reports is the author of Practical Office Orthopedics (McGraw-Hill 2017) . The Curbsiders report no relevant financial disclosures.

Citation Heublein M, Parks T, Jyang E, Brigham SK, Okamoto E, Watto MF. “#240 Elbow Pain: Straighten it out. A dabble into elbow care with Dr Ted Parks”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list November 02, 2020.

The Warmth of Other Suns: The Epic Story of America's Great Migration

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Practical Office Orthopedics

A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL).

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli * Cover Art: Kate Grant MBChb, MRCGP * Infographic by: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio) * Guest: Dink Jardine, MD

Sponsors: National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor – National Internal Medicine Day, The American College of Physicians * Sponsor - VCU Health Continuing Education * 00:30 Intro, disclaimer, guest bio * 03:00 Guest one-liner, Favorite failure, Pick of the Week*: Still Life by Louise Penny * Sponsor – National Internal Medicine Day, The American College of Physicians * 09:30 Case 1 - Acute Viral Rhinosinusitis * 10:40 Rhinosinusitis vs. Sinusitis * 14:20 Physical exam in rhinosinusitis * 20:40 Counseling patients about viral vs. bacterial infection * 22:56 Sinus regimen/nasal irrigation - “Is there a sinus toilet” * 27:10 Intranasal fluticasone and other intranasal medications * 29:40 Rhinitis medicamentosa * 30:40 Nasal spray positioning * 33:50 Case 1 - Double Sickening * 37:40 Worst case scenarios from rhinosinusitis * 40:40 Antibiotic treatment for bacterial rhinosinusitis * 43:20 Failed improvement on antibiotics? Second-line options * 49:30 Case 2 - Chronic rhinosinusitis * 52:28 Etiology of chronic rhinosinusitis * 53:33 Making a diagnosis of chronic rhinosinusitis * 55:25 Treating chronic rhinosinusitis * 58:40 Vasomotor rhinitis * 60:40 Sinus irrigation counseling and tips (YouTube) * 65:30 Case 3 - Allergic Rhinitis * 70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis * 73:51 Take-home points

Links* 1. Still Life: A Chief Inspector Gamache Novel by Louise Penny, Chief Inspector Gamache series 2. “Dr. Adappa and Dr. Palmer teach you How to do Nasal Irrigation” https://www.youtube.com/watch?v=Br928VfiC1M

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals Listeners will develop an approach to the diagnosis and management of rhinosinusitis.

Learning objectives After listening to this episode listeners will...

Classify rhinosinusitis, including acute, chronic, bacterial, and viral.
Discuss the microbiology and pathophysiology underpinning rhinitis and sinusitis.
Differentiate the presentation and management of acute bacterial and acute viral rhinosinusitis.
Develop an approach to the diagnosis and management of allergic rhinosinusitis.
Recognize and manage patients with non-allergic rhinitis.
Discuss the role of antibiotic therapy and surgery in the management of rhinosinusitis.

Disclosures Dr. Jardine reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Williams PN, Garbitelli B, Jardine D, Heublein M, Watto MF.. “#239 Sinusitis: It’s not that tricky.” The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 26, 2020.

Tags sinus, sinusitis, rhinitis, acute bacterial, rhinosinusitis, bacterial, viral, virus, nose, chronic sinusitis, ENT, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Still Life (A Chief Inspector Gamache Novel)

DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates.

Listeners can claim 2 hours of Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Matthew Watto MD, FACP * Cover Art by: Matthew Watto MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * 00:00 Intro, disclaimer * 01:40 Making the diagnosis of VTE * 09:07 Triage and risk stratify Pulmonary Embolism * 14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE * 21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight, advanced CKD and in antiphospholipid syndrome * 28:22 IVC filters * 30:20 Outro

Links Check out the full show notes from previous Curbsiders’ shows covering VTE.

Dr Oren Friedman #92 Pulmonary Embolism for the Internist
Dr Michael Streiff #154 DVT and PE Master Class

Goals Listeners will feel confident in the diagnosis and management of VTE

Learning objectives After listening to this episode listeners will...

Diagnose (VTE) DVT and PE using imaging, risk scores and clinical gestalt
Risk stratify patients with pulmonary embolism
Choose the appropriate initial anticoagulant for VTE
Decide duration of anticoagulation for VTE
Recall real risks and questionable benefits of IVC filters in DVT / PE
Determine need for cancer or thrombophilia workup in unprovoked DVT / PE

Disclosures The Curbsiders report no relevant financial disclosures.

Citation Watto MF, Williams PN, Brigham SK, Watto MF. “#238 DVT / PE Triple Distilled”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 22, 2020.

Tags Pulmonary embolism, vte, dvt, pe, heparin, anticoagulation, right ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC filter, TPA, echocardiogram, CT scan, bleed, clot, deep, vein, thrombosis, DOAC, NOAC, anticoagulation, d-dimer, Wells, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Fun, fluorescein, and fundoscopy unite as our esteemed guest, Dr. Nisha Chadha @iEducatorMD (Mount Sinai School of Medicine) brings us ophthalmology for primary care! Dr. Chadha is a medical educator and the content creator of the med-ed simulation website 20/20 Sim. She teaches us the 3-vital signs of ophthalmology, how to recognize common diabetic eye diseases, how to explain diabetic retinopathy to our patients, how to optimize a patient for cataract surgery and so much more. This episode is truly vision-ary!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written, Produced, and Infographic by: Carolyn Chan, MD * Cover Art: Kate Grant * Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD * Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com * Guest: Dr. Nisha Chadha

Sponsors: National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor – National Internal Medicine Day, The American College of Physicians * Sponsor – VCU Health Continuing Education * 00:30 Intro, disclaimer, guest bio * 03:21 Guest one-liner, Carolyn’s Pick of the Week * 09:05 Picks of the Week* * 10:13 Case from Kashlak, 3 - Vital Signs of Ophthalmology * 17:09 Ocular complications of diabetes * 20:22 Screening for diabetic retinopathy; Reports and Abbreviations * 26:07 Counseling Patients: The eye is a camera; Clinical symptoms of ocular complications * 32:07 Fluorescein Stain; Treatment Options for Diabetic Eye Disease: NPDR, PDR, VH, and RD * 41:16 Eye Vitamins for Macular Edema * 43:35 Cataracts * 47:22 Missing Glaucoma Drops * 50:50 Periop Optimization for Cataract Surgery, Anticoagulation and Other Medical Management * 58:14 Take Home Points, Plug: 20/20 Sim; Outro * Sponsor – VCU Health Continuing Education

Links* 1. Mindset: The New Psychology of Success by Carol S. Dwek 2. Crackdown Podcast 3. 20/20 Sim Site

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will discuss screening, counseling, and management of common ocular diseases seen within primary care. Learning objectives After listening to this episode listeners will…

Define and assess the three vital signs of ophthalmology.
List ocular complications of diabetes.
Counsel a patient on a new diagnosis of diabetic retinopathy.
Describe treatments for diabetic retinopathy.
Define proliferative retinopathy, non-proliferative retinopathy, and macular edema.
Compose a perioperative medication management plan for cataract surgery

Disclosures Dr. Chadha reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Chan C., Chadha N., Okamoto E., Watto MF. “#237 Ophthalmology for Primary Care”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date October 19, 2020.

Tags Eye, ophthalmology, ophtho, optometry, glaucoma, diabetes, diabetic retinopathy, macular edema, cataracts, cataract surgery, perioperative management, physical exam, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Mindset: The New Psychology of Success

Learn which exam maneuvers are worthwhile and which ones are worthless in your approach to shortness of breath. In our evidence based series on the physical exam, we discuss the approach to the dyspneic patient with Dr. Brian Garibaldi (Hopkins, SBM), associate professor of pulmonary and critical care medicine at Johns Hopkins, and co-president of the Society of Bedside Medicine. We discuss the physical exam’s effect on our differential diagnosis, maneuvers that are commonly taught, and some simple tests with great data that may go overlooked. Be prepared, this episode may take your breath away!

Credits * Written and Produced by: Justin Berk, MD, MPH, MBA and Sam Masur, MD * Infographic: Sam Masur, MD, Beth Garbitelli * Cover Art: Beth Garbitelli * Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; and Paul Williams, MD, FACP * Editor:Justin Berk MD; Clair Morgan of nodderly.com * Guest(s): Brian Garibaldi, MD

Sponsors: National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor – National Internal Medicine Day, The American College of Physicians * Sponsor – VCU Health Continuing Education * 00:00 Intro, disclaimer, guest bio * Sponsor – National Internal Medicine Day, The American College of Physicians * 03:47 Introduction to evidence-based exam, pre-test probability, and likelihood ratios * 05:29 Case from Kashlak Memorial * 06:51 Dr. Garibaldi’s initial maneuvers for the dyspneic patient * 11:33 Recapping the exam maneuvers * 14:05 Likelihood ratios for common maneuvers * 18:25 Over 6/Under 6 maneuvers * 25:30 Recap of Dr. Garibaldi’s go-to maneuvers * 28:19 Role of labs and diagnostic imaging * 31:03 Role of point-of-care ultrasound (POCUS) * 34:10 Friday at 5pm * 36:31 Take home points * 39:25 Outro * Sponsor – VCU Health Continuing Education

Links* 1. Stanford 25: Teaching and promoting bedside exam skills to students, residents and healthcare professionals both in person and online 2. The 5 Minute Moment at the Society of Bedside Medicine 3. The POCUS Atlas: Evidence Based Point of Care Ultrasound

Goal Listeners will feel confident how to optimally use the physical exam to guide clinical decision-making in patients presenting with dyspnea.

Learning objectives After listening to this episode listeners will…

Describe the effectiveness of the exam when it comes to aiding diagnosis in a patient with dyspnea
Identify specific exam maneuvers that can aid clinical decision-making
Identify exam maneuvers that may not offer more information compared to imaging such as POCUS

Disclosures This episode was made with assistance from the Society of Bedside Medicine and funding from the New York Academy Medicine. Dr Garibaldi reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Masur S, Garibaldi BT, Watto M, Williams P, Brigham S, Berk J. #236 Physical Exam Series: Approach to Shortness of Breath. The Curbsiders Internal Medicine Podcast. https:/www.thecurbsiders.com/episode-list. Original Air Date October 12, 2020.

References 1. Mochizuki K et al. Importance of respiratory rate for the prediction of clinical deterioration after emergency department discharge: a single-center, case-control study. Acute Med Surg. Nov 2016. doi:10.1002/ams2.252 2. Sarkar M et al. Physical signs in patients with chronic obstructive pulmonary disease. Lung India. 2019. doi:10.4103/lungindia.lungindia_145_18 3. Fagan TJ. Letter: Nomogram for Bayes theorem. N Engl J Med. 1975;293(5):257. doi:10.1056/NEJM197507312930513 4. Simel, David, et al. Rational Clinical Examination, McGraw-Hill Professional Publishing, 2009. ProQuest Ebook Central 5. McGee, Steven. Evidence-based physical diagnosis [4th edition] Elsevier, 2018. Clinical Key 6. Benbassat, J., Baumal, R. Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?. J GEN INTERN MED 25, 865–872 (2010). https://doi.org/10.1007/s11606-010-1327-8 7. Al Deeb M et al. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-852. doi:10.1111/acem.12435 8. Yousefifard et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emerg (Tehran). 2016;4(1):1-10. 9. Martindale et al. Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016;23(3):223-242. doi:10.1111/acem.12878 10. Caldentey et al. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure). JACC Heart Fail 2014.. doi:10.1016/j.jchf.2013.10.004

Tags Physical exam, dyspnea, shortness of breath, auscultation, PMI, percussion, heart failure, wheeze, POCUS, COPD, JVD, hepatojugular reflux, observation, asymmetry, Brian Garibaldi, practice, pallor, lung, heart, hands.

Time for spooky cakes with a side of candy corn. We discuss Dapagliflozin (SGLT2i) for CKD, Turmeric for knee pain and Honey for URTI (cough) on this halloween themed hotcakes with Rahul Ganatra MD, MPH @rbganatra

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (Note: CME for this episode won’t be available until 10/12/20. We apologize for the inconvenience).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer: Sarah Phoebe Roberts * Written by: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH * Cover Art: Matthew Watto MD, FACP * Hosts: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * 00:00 Sponsor – National Internal Medicine Day, The American College of Physicians * 00:25 Sponsor – VCU Health Continuing Education * 00:40 Intro, disclaimer, Picks of the Week * 07:38 Sponsor – National Internal Medicine Day, The American College of Physicians * 08:40 Dapa-CKD * 20:00 Turmeric for Knee Osteoarthritis * 32:10 Honey for URTI and Cough * 46:32 Shout out to @votehealth2020 and PatientVoting.com * 48:25 Outro * Sponsor – VCU Health Continuing Education

Links* 1. Candy Corn (autumn mix) and (classic) 2. Paul’s Halloween movie marathon: Cabin in the Woods, The Descent, The Witch, Ghostbusters

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will review and perform critical appraisal of recent articles with the potential to change internal medicine practice

Learning objectives After listening to this episode listeners will…

Review the potential benefits of dapagliflozin for prevent of CKD progression and death
Evaluate the utility of turmeric for osteoarthritis with inflammatory synovitis
Discuss the efficacy of honey for the treatment of acute upper respiratory tract infection and persistent post-infectious cough

Disclosures The Curbsiders report no relevant financial disclosures.

Citation Watto M, Ganatra R, Williams PN, Brigham SK, Roberts SP. “235 Spooky Cakes”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 5, 2020.

Tags Dapagliflozin, slgt2i, sglt2 inhibitors, ckd, turmeric, curcumin, knee osteoarthritis, knee pain, synovitis, honey, urti, respiratory tract infection, cough, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

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Brach's Classic Candy Corn, 11 oz bag

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Brach's Autumn Mix, 11 oz

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Master your breast cancer screening spiel, cultivate your approach to the breast mass, and empower your patients with empathetic shared decision-making (which we know you’re all already fabulous at)! On this fantastic episode, we are joined by Dr. Nancy Keating @NancyKeatingMD, policy wonk and primary care doc extraordinaire at Brigham and Women’s Hospital. This episode is rife with drama, as the ACS butts heads with the USPTF and the ACR, and you have to figure out what’s right for the patient by talking with them--almost as exciting as that moment on Grey’s when Izzie cuts the...anyway, I won’t ruin a key plot point in the most excellent medical show of all time, all in a day’s work, here at The Curbsiders. Enjoy!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer and Writer: Nora Taranto MD * Show Notes: Nora Taranto MD, Isabel Valdez PA * Infographic: Nora Taranto MD * Cover Art: Kate Grant, MD * Hosts: Stuart Brigham MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Reviewer: Arielle Medford MD * Guest: Nancy Keating MD, MPH

Sponsors Provider Solutions & Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. * Sponsor - VCU Health Continuing Education * 00:30 Intro & Guest Bio * 03:27 Guest one-liner * 05:27 Best Advice for Women in Medicine * 07:34 Picks of the Week * Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. * 10:00 Case 1: Brenda Cantwell and Breast Lump DDx * 13:39 Clinical Breast Exam vs Self Breast Exam * 17:26 Practical Tips for the Clinical Breast Exam * 21:50 Imaging to Evaluate the Breast Lump * 26:36 Demystifying BIRADS * 28:36 Epidemiology Potpourri * 33:02 Breast Pain without a Mass * 34:30 Case 2: Mammie Gram and Breast Screening * 46:03 Average Risk vs High Risk Screening * 47:18 Breast Risk Prediction Tools * 48:51 Breast Density * 53:16 Imaging Modalities * 61:28 Shared Decision Making in Screening * 68:04 Case 3: Ms Britta Lumpworth and When to Stop Screening Mammograms * 74:42 Take Home Points and Outro * Sponsor - VCU Health Continuing Education

Links 1. Evicted: Poverty and Profit in the American City by Matthew Desmond 2. Run The List podcast 3. ACOG Practice Bulletin 179, 2017 4. Elmore et al, Ten Year Risk of False Positive Screening Mammograms and Clinical Breast Examinations, N Engl J Med, 1998. 5. Thomas, et al, Randomized trial of breast self-exam in Shanghai: final results. JNCI, 2002. 6. Semagliazov et al, Results of a prospective randomized investigation [Russia] to evaluate the significance of self-examination for the early detection of breast cancer, Vopr Onkol, 2003. 7. Fuller, M. S., Lee, C. I., & Elmore, J. G. Breast cancer screening: an evidence-based update. The Medical clinics of North America, 2015. 8. Chan et al, False-negative rate of combined mammography and ultrasound for women with palpable breast masses. Breast Cancer Res Treat, 2015. 9. ACS Recommendations for the Early Detection of Breast Cancer, 2020. 10. USPTF Breast Cancer Screening Recommendations, 2016. 11. Henderson et al, Breast Examination Techniques, 2020. 12. Kolb et al. Comparison of the performance of screening mammography, physical exam, and breast ultrasound and evaluation of factors that influence them: an analysis of 27.825 patient evaluations, Radiology, 2002. 13. Mammogram Interpretation, Chapter 2. Radiology Key.Com. 14. Flobbe et al, The Additional Diagnostic Value of Ultrasonography in the Diagnosis of Breast Cancer. Arch Intern Med, 2003. 15. ACS Understanding Mammogram Readings, 2019. 16. Bittner, Guide to mammography reports: BIRADS terminology, Am Fam Physician, 2010. 17. Seer cancer statistics review, 1975-2017. 2020. 18. Anders CK et al, Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes?. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011 19. ACS How Common is Breast Cancer? 20. SEER Lifetime Risk (%) of Dying from Cancer by Site and Race/Ethnicity: Females, Total US, 2014-2016 21. Garcia et al, Cardiovascular disease in women: clinical perspectives, Circ res, 2017. 22. Cancer Statistics Center: Breast Statistics. 23. Independent UK Panel on Breast Cancer Screening, The Benefits and harms of breast cancer screening: an independent review, Lancet, 2012. 24. CDC Breast Cancer Screening Guidelines 2020 25. ACS Breast Cancer Screening Guidelines, 2015 26. USPTF Breast Cancer Screening Recommendations, 2016. 27. ACR Breast Cancer Screening Update, 2018. 28. Canadian Task Force Breast Cancer Screening Recommendations 29. UK-NHS Breast Cancer Screening Recommendations 30. Biller-Andorno et al. Perspective: Abolishing Mammography Screening Programs? A View from the Swiss Medical Board, N Eng J Med, 2014. 31. Nelson et al, Effectiveness of Breast Cancer Screening: Systematic Review and Meta-analysis to Update the 2009 US PTF Recommendation, Ann Intern Med, 2016. 32. Miller et al, Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial, BMJ, 2014. 33. Breast Cancer Risk Assessment Tool (NCI) 34. BCSC Breast Cancer Risk Assessment Tool 35. Health Decision/University of Wisconsin Decision Tool 36. Harding Center for Risk Literacy Fact Box 37. Keating et al, Breast Cancer Screening in 2018: Time for Shared Decision Making, Jama Insights, 2018.* 38. ePrognosis life expectancy calculator

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will learn how to evaluate a breast lump in the primary care clinic, what the guidelines recommend for asymptomatic breast cancer screening, and how to engage a patient in shared-decision making given the data available on mammograms.

Learning objectives After listening to this episode listeners will…

Triage and evaluate the Breast Lump
Perform breast cancer risk assessment
Recall the Guideline Recommendations for Breast Cancer Screening and how they vary
Engage patients in conversation about b...

Evicted: Poverty and Profit in the American City

Listen to our medical education heroes, Dr. Abby Spencer, @abbyCCim (Cleveland Clinic), and Dr. Alia Chisty, @aliachisty (Penn State Health), school us on how to give effective and meaningful feedback! Topics include: the ADAPT framework, how to give difficult feedback, keywords and phrases when giving feedback, how to avoid gender and racial bias when giving feedback, giving feedback to your peers and how to solicit effective feedback as a team leader.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by Paul Williams MD, FACP * Cover Art: Paul Williams, MD, FACP * Infographic: Edison Jyang * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guests: Abby Spencer MD and Alia Chisty MD

Sponsors Provider Solutions & Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. * Sponsor - VCU Health Continuing Education * 00:30 Intro, disclaimer, guest bio, pun * 04:00 Guest one-liners, Picks of the Week* (see links below) * 10:25 Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. * 11:00 Case from Kashlak, Feedback definitions * 15:00 Addressing perceived barriers to feedback * 31:45 ADAPT model of feedback * 38:10 Addressing potentially gendered feedback; * 42:45 Giving feedback to those who lack insight * 48:29 Feedback and racial bias * 52:25 Giving peer feedback * 58:10 Tips for soliciting feedback as a supervisor * 69:05 Does giving difficult feedback mean people won’t like you? * 75:10 Take home points and Outro * Sponsor - VCU Health Continuing Education

Links* 1. Radical Candor (book) 2. Host (film) 3. Percy Jackson & The Olympians: The Lightning Thief movie 4. Hamilton on Disney Plus 5. Her (film)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will demonstrate effective techniques to deliver and solicit meaningful feedback.

Learning objectives After listening to this episode listeners will…

Discuss the definitions and terms used to discuss feedback.
Deliver effective feedback that is concordant with the learning goals of their trainees.
Address potential perceived barriers to feedback.
Utilize the ADAPT framework to partner with their learners and develop shared goals.
Develop strategies to mitigate against using gender- or racially-biased narrative language.
Deliver feedback to learners with limited insight by leveraging the impact of perception on achieving goals.
Solicit effective and meaningful feedback despite being in a position of authority

Disclosures Drs. Spencer and Chisty report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Williams PN, Spencer A, Chisty A, Brigham SK, Jyang E, Watto MF. “#233 Giving effective feedback with Abby Spencer and Alia Chisty”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 21, 2020.

References 1. Ende J. Feedback in Clinical Medical Education. JAMA. 1983. . [https://pubmed.ncbi.nlm.nih.gov/6876333/] 2. Brown B. 2018. Dare to Lead. Random House. 3. Stone D and Heen S. 2014. Thanks for the Feedback. Penguin Books. 4. Scott K. 2019. Radical Candor. St. Martin’s Press. 5. Fainstad T et al. Feedback can be less stressful: Medical trainee perceptions of using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) framework. Cureus. 2018. [https://pubmed.ncbi.nlm.nih.gov/30906679/] 6. Rojek AE et al. Differences in narrative language in evaluations of medical students by gender and under-represented minority status. J Gen Int Med. 2019. [https://pubmed.ncbi.nlm.nih.gov/30993609/] 7. Mueller AS et al. Gender differences in attending physicians’ feedback to residents. JGME. 2017. [https://pubmed.ncbi.nlm.nih.gov/29075375/] 8. Ross, DA et al. Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations. PLoS ONE. 2017. [https://pubmed.ncbi.nlm.nih.gov/28792940/]

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Radical Candor: Be a Kick-Ass Boss Without Losing Your Humanity (Revised, Updated)

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Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP, * Cover Art and Infographic by: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli * Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com * Guest: Helena Pasieka MD, MS

Sponsors Provider Solutions & Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. * Sponsor - VCU Health Continuing Education * 00:30 Intro, disclaimer, guest bio * 04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt * Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders * 08:30 Case 1: Alopecia * 12:05 Assessing scalp for inflammatory changes and follicular drop-out * 13:10 Central Centrifugal Cicatricial Alopecia (CCCA) * 14:00 Alopecia/hair loss non-scarring subtypes * 25:00 Alopecia Treatments * 28:55 Case 2: Psoriasis vs. Seborrheic Dermatitis * 31:45 Looking for psoriatic plaques * 32:11 Seborrheic dermatitis hallmarks * 35:19 Treatment for Seborrheic Dermatitis * 42:10 Case 3: Rosacea vs. Acne * 50:40 Differentiating rosacea rash from SLE * 52:40 Rosacea management & treatment * 55:00 Identifying rosacea in Black skin * 56:50 Acne management & treatment * 59:10 Retinoid dermatitis * 1:00:30 Maskne * 1:02:29 Antibiotics for acne * 1:03:38 Retinoids and pregnancy * 1:04:09 Doxycycline for rosacea * 1:06:15 Take home points * Sponsor - VCU Health Continuing Education

Links* 1. Hamilton and Alexander Hamilton by Ron Chernow, 2. Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance) 3. The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt 4. Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones) 5. Brown Skin Matters on Twitter and Instagram 6. Skin of Color Society 7. American Academy of Dermatology 8. Society for Dermatology Hospitalists 9. Black Skin Directory Learning Journal 10. Mind the Gap (2020) by Malone Mukwende 11. Ethnic Dermatology: Principles and Practice (2013) 12. Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012) 13. An Atlas of African Dermatology (2001)

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic.

Learning objectives After listening to this episode listeners will...

Recognize and treat common skin complaints of the scalp and face in primary care.
Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care.
Be able to differentiate non-scarring versus scarring hair loss on physical exam.
Comprehend nuances in total body presentations of psoriasis as a means to differentiate from seborrheic dermatitis.
Review when referral to dermatology for hair loss or skin changes of the face/scalp is necessary.
Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.

Disclosures Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Pasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.

Hamilton (Original Broadway Cast Recording) [Explicit]

Alexander Hamilton

Ethnic Dermatology: Principles and Practice

Neutrogena Sensitive Skin Mineral Sunscreen Lotion with Broad Spectrum SPF 60+ & Zinc Oxide, Water-Resistant, Hypoallergenic, Fragrance- & Oil-Free Gentle Sunscreen Formula, 3 fl. oz

An Atlas of African Dermatology

The Food Lab: Better Home Cooking Through Science

Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Original episode written and produced by: Matthew Watto MD, FACP * Show Notes and CME questions by: Deb Gorth ScM * Cover Art and Infographic by: Edison Jyang * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Molly Heublein (written materials); Matthew Watto MD (audio) * Guest: Joel Topf MD

Sponsors POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team.

Interview season is in full swing and they’re actively accepting applications. Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information. You can apply for fellowship using the eusfellowships.com portal.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * 00:00 Intro * 03:30 Guest interview * 07:15 Pick of the week w/Dr. Topf * 16:20 Clinical case of hyponatremia * 17:48 False hyponatremia normal osmolality * 19:34 False hyponatremia high osmolality * 20:36 Understanding why osmolality matters * 23:28 Workup false hyponatremia * 24:45 Recap of discussion so far * 25:40 ADH dependent vs independent hyponatremia * 27:00 Psychogenic polydipsia * 289:15 Renal failure and hyponatremia * 30:03 Tea and toast, and Beer Drinker’s potomania * 35:22 ADH dependent hyponatremia * 38:15 Volume versus osmolality * 40:00 Volume status exam * 45:14 Additional testing with urine lytes and uric acid * 47:30 Treatment for SIADH * 52:42 Discussion of the vaptans * 58:21 Additional testing in SIADH * 62:50 When to admit patient for hyponatremia * 63:59 Clinical case of hyponatremia complications * 68:56 Fluids and rate of correction * 73:36 DDAVP clamp * 76:30 Moderate hyponatremia * 78:35 Diuretic dosing DOES matter! * 81:59 Loop diuretics for SIADH * 84:25 Take home points * 87:25 Outro

Links* 1. Dr. Joel Topf’s Textbook 2. Dr. Joel Topf’s Blog 3. Dungeons and Dragons 4. Tartine (cookbook) by Elizabeth M. Prueitt 5. I Hate You, Don’t Leave Me by Hall Strauss 6. Intentional Parenting by Sissy Goff 7. Mindset by Carol Dweck 8. Nintendo Switch 9. 8.0 Bit Techno- The Curbsiders Theme Song by Stuart Kent Brigham 10. Ure-Na 11. European Society of Endocrinology Clinical Practice Guidelines. 12. Don’t miss Dr. Topf on twitter aka @kidney_boy.

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goal Listeners will recall the pathophysiology of hyponatremia and develop a systematized approach to identifying the type and cause of hyponatremia, as well as how to safely manage hyponatremia.

Learning objectives After listening to this episode listeners will…

Differentiate true and false hyponatremia
Recall the pathophysiology of true and false hyponatremia
Interpret blood and urine tests to identify the cause of hyponatremia
Recall the limitations of the volume status exam
List ADH dependent causes of hyponatremia
List ADH independent causes of hyponatremia
Explain the pathophysiology of beer drinker’s potomania and “tea and toast” hyponatremia
Use uric acid to differentiate SIADH from other causes of hyponatremia
Basic therapy for SIADH
Recall safe rates of correction for hyponatremia

Disclosures Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures.

Citation Topf J, Gorth DJ, Williams PN, Brigham SK, Heublein M, Jyang E, Watto MF. “REBOOT #48 Hyponatremia Deconstructed”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date: July 17, 2017; Updated September 7, 2020.

Mindset: The New Psychology of Success

The Fluid, Electrolyte And Acid-base Companion

I Hate You--Don't Leave Me: Understanding the Borderline Personality

Intentional Parenting: Autopilot Is for Planes

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Tartine Bread

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot!

NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively.

Credits * Written and Produced by: Shannon Snellgrove * Infographic: Shannon Snellgrove * Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders) * Hosts: Justin Berk MD and Christopher Chiu MD * Editor:Justin Berk MD; Clair Morgan of nodderly.com * Guest(s): Hussein Abdullatif MD

Sponsors POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team.

Interview season is in full swing and we’re actively accepting applications. Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information. You can apply for fellowship using the eusfellowships.com portal.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Diagnosis of T1DM 6:50 * Presentation of T1DM 10:10 * Explaining T1DM to a parent 12:00 * Genetic Predisposition to Diabetes 15:20 * T1DM Antibodies 17:10 * Initial work-up for concomitant autoimmune disease 21:10 * Atypical Presentation of T1DM 22:44 * Treatment of T1DM 29:10 * Dietary Modifications in T1DM 33:10 * Checking blood sugars 39:50 * Honeymoon Period 42:25 * Hypoglycemia 44:00 * Sports, Sickness, Alcohol and Glucose levels 48:25 * Periop glucose management 51:10 * Long-term complications of T1DM 53:50 * Closed Loop System and Future Treatments 56:10

Goal Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes.

Learning objectives After listening to this episode listeners will…

Identify the signs and symptoms of type 1 diabetes
Practice appropriate work-up in the diagnosis of type 1 diabetes
Manage type 1 diabetes with evidence-based therapies
Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts
Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes)

Disclosures Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures.

Citation Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (link goes live on 9/2/2020)

Are U Talkin’ UTIs Re: Me? Infectious Diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED) schools us on the diagnosis and management of urinary tract infections: updated definitions of complicated and uncomplicated UTI, pitfalls of the urinalysis, first line antibiotics, duration of therapy and which agents to use for complicated UTI. This episode is liquid gold!

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Matthew Watto MD, FACP * Cover Art and Infographic by: Edison Jyang * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com * Guest: Boghuma Kabisen Titanji MD, PhD

Sponsor - VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

Time Stamps * Sponsor - VCU Health Continuing Education * 00:30 Intro, disclaimer, guest bio * 02:50 Guest one-liner, Picks of the Week*: Urban gardening, Behave (book) by Robert Sapolsky * 08:54 Defining UTI; Framework for UTI * 16:35 Case 1 - Cath Foley; Acute uncomplicated cystitis; Interpreting the Urinalysis * 28:00 Women with recurrent UTIs * 38:55 Case 2 - UTI in a man * 47:15 Treatment of complicated infections; Duration of therapy * 52:27 Case 3 - Catheter associated UTI; MRSA UTI * 61:25 Duration of therapy for bacteremia from UTI * 64:40 Take home points, plugs and outro * Sponsor - VCU Health Continuing Education

Links* 1. Behave (book) by Robert Sapolsky 2. Boghuma’s blog theiddoc.net 3. Boghuma’s TED Talk 4. Emory’s ID fellowship program

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

Goals Listeners will appropriately recognize, diagnose and treat the various presentations of urinary tract infection.

Learning objectives After listening to this episode listeners will...

Define UTI and feel confident making the diagnosis of UTI based on lab tests, history and exam findings
Differentiate between complicated and uncomplicated UTI
Recognize how UTI may presents differently in differ groups (paraplegic, chronic foley catheter, men and women)
Choose the appropriate antibiotic and duration with an eye towards antibiotic stewardship
Determine an approach to the patient with recurrent UTIs, including who may benefit from long term antibiotic prophylaxis.

Disclosures Dr Titanji reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

Citation Titanji BK, Williams PN, Watto MF. “#231 U Talkin’ UTIs Re: Me”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 24, 2020.

Behave: The Biology of Humans at Our Best and Worst

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea? Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Deborah Gorth ScM * Cover Art and Infographic by: Edison Jyang * Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP * Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com * Guest: Michelle Kittleson MD, PhD

Sponsor - VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Time Stamps * 00:00 Intro * 02:40 Guest one-liner; Picks of the Week * 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic) * 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction? * 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?! * 28:36 Labs to trend during an ADHF admission * 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes * 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2? * 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB) * 56:05 Who needs a right heart cath? * 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care * 64:04 SGLT2i in heart failure * 68:15 Take home points and outro

Join us for an extra-hot summer episode featuring our critical appraisal expert, Rahul Ganatra MD, MPH @rbganatra. Prepare to marvel as he breaks down his recent tweetorial on the RECOVERY trial of dexamethasone for COVID-19; to gasp as Paul Williams updates us on statins and ASCVD prevention and to be enthralled by the dulcet tones of Matt Watto explaining the latest research on DAPT vs. monotherapy with ticagrelor. Bonus: a new hotcakes rating scale has arrived!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer: Sarah Phoebe Roberts * Show Notes by: Sarah Phoebe Roberts * Writer: Rahul Ganatra MD, Sarah Phoebe Roberts, Matthew Watto MD, Paul Williams MD * Cover Art: Matthew Watto MD * Hosts: Rahul Ganatra MD, Matthew Watto MD, Paul Williams MD * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Time Stamps * 00:00 Intro * 02:15 Picks of the Week * 06:15 New Hotcakes rating scale * 09:20 RECOVERY trial * 17:30 Rapid home-testing for COVID * 20:15 Statins and ASCVD prevention * 32:30 Ticagrelor monotherapy after ACS * 41:30 Outro

Picks of the week 1. Paul: U Talkin' Talking Heads 2 My Talking Head podcast 2. Sarah: New hotcakes scale! 3. Rahul: Chromeo’s new Quarantine Casanova album 4. Watto: 30 Rock season 1, episode 3 “Blind Date”

Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire!

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Credits * Written and Produced by: Tima Karginov and Matthew Watto MD, FACP * Infographic by: Tima Karginov * Cover Art: Kate Grant MBChb, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: Eve Bloomgarden MD

Sponsors: Pediatrics On Call podcast by the American Academy of Pediatrics If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here.

VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Time Stamps * 00:00 Intro * 03:15 Guest one-liner, favorite failure, Picks of the Week * 08:50 Sponsor * 10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs * 14:20 Case from Kashlak, Symptoms of Hyperthyroidism * 25:00 Grave’s eye disease: exam, therapy and counseling * 32:35 Thyroid exam and ultrasound * 38:55 Thyroid Stimulating Immunoglobulin * 41:00 Biotin * 44:30 Thyroid Scintigraphy * 49:00 Causes of Thyrotoxicosis * 52:00 Treatment & Adherence to antithyroid medication (methimazole) * 56:20 Beta Blockers in thyrotoxicosis * 64:50 Subclinical Hyperthyroidism * 67:00* Take Home Points, Outro

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year!

Credits * Producers & Writers: Edward Corty, Nicholas Lee MD * Infographic: Nicholas Lee MD * Cover Art: Chris Chiu MD * Hosts: Justin Berk MD, Chris Chiu MD, Edward Corty * Editor:Justin Berk MD; Chris Chiu MD * Guest(s): Joshua Sharfstein MD

Sponsors: Pediatrics On Call

Sponsor: VCU Health Continuing Education - to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org or cribsiders.vcuhealth.org

Time Stamps * Introduction 1:00 * How to answer “What do you think about school openings?” 11:30 * Risk Assessment of School Re-openings 14:40 * Evidence of Transmission among Children 17:10 * What Other Countries Have Done 19:40 * Community Threshold for Re-Opening and Using Protocols 20:30 * The Reasons to Cohort 22:45 * How to Address Scenarios 24:20 * Health Disparities and Return to School 27:00 * Existing Inequities and Children’s Sacrifice of Education 29:00 * “Opting Out” of School Return and Feeling Safe 31:30 * How Can Governments Help Support the Return 35:50 * Guidance to give as PCP 37:50 * School Alternatives / Innovations to Going Back 40:10 * The Difference Between Equity and Equality 42:50 * Testing in Schools 43:45 * Resources to Follow For More Information 46:00 * Take-Away Points 47:10 * Optimism 48:25 * Picks of the Week 53:50

Swim through the sea of acronyms as Dr Scott Matherly (@liverprof) helps us become a little less baffled by the thought of NAFLD. We discuss the initial diagnosis of fatty liver disease, indications for additional evaluation with imaging and/or biopsy, and potential treatment options. With a quarter of the world affected, it’s crucial to understand the various forms of disease and how to counsel patients about this all-too-common condition!

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Credits * Written and Produced by: Elena Gibson MD * Infographic and Cover Art: Elena Gibson MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com * Guest: Scott Matherly MD

Sponsor: Pediatrics On Call

Sponsor: VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps * 00:00 Intro * 03:15 Guest one-liner; Picks of the Week* : * 08:15 Sponsor * 08:50 Case from Kashlak part 1; What is hepatic steatosis? * 11:43 NAFLD acronyms and definitions * 18:20 Alcohol and Fatty Liver * 23:15 Initial Evaluation of NAFLD * 35:12 Dr Matherly’s piel to patients with fatty * 41:11 NASH/Fibrosis Risk Assessment * 48:54 Outcomes in NASH with Fibrosis * 51:20 Statins are safe in liver disease * 56:15 Treatment Options (surgery, Vitamin E, Pioglitazone, SLGT2 inhibitors and GLP1 agonists; Coffee?!) * 71:42 Take home points and Outro

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.

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Credits * Written (including CME questions) and Produced by: Cyrus Askin, MD * Infographic by: Cyrus Askin, MD * Cover Art: Kate Grant MBChb, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: Joel Topf, MD

Sponsor: Pediatrics On Call

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps * 00:00 Intro * 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); * 08:45 Sponsor * 09:15 Definition of acute kidney injury (AKI) and fundamentals * 11:00 Cardiorenal syndrome * 12:24 Schema for AKI * 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities * 21:22 AKI in the otherwise-healthy patient; * 32:20 Rhabdomyolysis 38:21 Vancomycin * 41:43 Acute interstitial nephritis (AIN) * 44:52 Contrast induced nephropathy (CIN) * 50:37 Gadolinium in AKI and/or CKD * 52:53 Timing of dialysis * 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; * 62:01 Is Ultrasound necessary in AKI * 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology

Listen as our expert guests, Kelly Graham, MD, MPH (@KellyGrahamMD) and Lekshmi Santhosh, MD MAEd (@LekshmiMD), detail the professional and personal challenges faced by women in medicine during the COVID-19 pandemic.

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Credits * Produced by: Leah Witt MD & Shreya Trivedi MD * Written by: Molly Heublein MD, Isabel Valdez PA-C, Leah Witt MD & Shreya Trivedi MD * Infographic & Cover Art: Edison Jyang * Hosts: Leah Witt MD & Shreya Trivedi MD, Justin Berk MD, MPH, MBA * Editor: Molly Heublein MD and Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guests: Kelly Graham, MD, MPH; Lekshmi Santhosh, MD MAEd

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Episode Breakdown * Intro, disclaimer * Introduction and bio for Kelly Graham, MD, MPH * Introduction and bio for Lekshmi Santhosh, MD MAEd * One-liner for Kelly Graham, MD, MPH * One-liner for Lekshmi Santhosh, MD MAEd * Gender Awakening Moments * Picks of the Week* * Case from Kashlak * Difficulty with lack of childcare while working * Hippocratic Oath paradox * Dr. Santhosh’s 3 Ps * Motherhood penalty-fatherhood bonus * Two Pandemics, One Response * Breadwinner-homemaker bias * Female physician burnout * Minority Tax * Silver Linings * Take home points and Outro

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter. In this episode we talk to addiction medicine expert, Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Topics include: the management of polysubstance withdrawal, approaching acute pain management for a person with opioid use disorder, and inpatient harm reduction strategies. After this episode listeners will gain new tools to help them best care for hospitalized patients with substance use disorders.

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Credits * Writers and Producers: Carolyn Chan MD, Deb Gorth, and Nora Taranto MD * Cover Art and Infographics by: Carolyn Chan, MD * Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Carolyn Chan MD * Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com * Guest: Dr. Melissa Weimer

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps * Intro, disclaimer, guest bio : 00:00 * Guest one-liner: 03:00 * Picks of the Week*: 08:20 * Case from Kashlak: 10:30 * Urine Toxicology Screens 11:30 * Discussing Urine Toxicology Screens with Patients 13:20 * Management of Polysubstance Withdrawal 16:16 * Tapering Benzodiazepines 19:56 * Acute Pain Management and Opioid Use Disorder 30:35 * Active Drug Use in the Hospital 38:52 * Harm Reduction 40:00 * Discharges - Planned 43:43 * Perioperative Buprenorphine and Methadone: 46:50 * QT Prolongation and Methadone - 52:53 * Outro 56:21

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas. Show notes: https:/www.thecribsiders.com/.

Credits * Writer, Producer, Infographic, CME Questions: Clara Mao * Cover Art: Christopher Chiu MD * Hosts: Justin Berk MD, Christopher Chiu MD, and Matthew Watto MD * Editor: Justin Berk MD; Clair Morgan of nodderly.com * Guest: Whittney Warren DO

Time Stamps * Intro / Disclaimer 0:00 * Guest bio 2:25 * Guest one-liner, picks of the week 3:15 * Explaining CF to patients, life expectancy 7:00 * Types of CF mutations and phenotypes 11:50 * Presentation of CF in older patients 15:20 * Screening and diagnosis 16:40 * PFTs and airway clearance 25:20 * Nutrition and the “CF diet” 29:10 * CF exacerbations and antibiotic selection 32:25 * Extrapulmonary manifestations 39:35 * Transition of care for CF adolescents (alcohol, exercise, sex) 43:50 * CFTR modulator therapy 51:35 * Lung transplantation 54:45

Goal Listeners will develop a systematic approach towards long-term management and acute exacerbations of cystic fibrosis.

Learning objectives After listening to this episode listeners will…

Explain the pathophysiology underlying cystic fibrosis.
Identify maintenance therapies that optimize pulmonary function and nutritional status in patients with cystic fibrosis.
Choose evidence-based practices in the management of cystic fibrosis-associated pulmonary exacerbations.

This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening. Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits * Written and Produced by: Rahul Ganatra MD, MPHl Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD * Show Notes and CME questions by: Deborah J. Gorth ScM * Cover Art: Deborah J. Gorth ScM * Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Utibe Essien MD, MPH

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps * 00:00 Intro, disclaimer, guest bio * 02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Netflix; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page! * 07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19 * 26:10 Dexamethasone for COVID-19 * 28:55 Hormonal therapy for depression * 38:16 Probiotics * 45:00 Outro

Listen as our esteemed guest Dr. Utibe Essien @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings.

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Credits * Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD * Cover Art: Hannah Abrams MD * Infographic: Beth Garbitelli * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD * Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com * Guest: Utibe Essien MD

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps * 00:00 Intro, disclaimer, guest bio * 02:40 Guest one-liner, Picks of the Week: Just Mercy * 09:20 Statement from the show; Importance of discussing racism in medicine * 14:11 Definitions * 18:06 Identifying how racism manifests in the clinical setting * 37:46 Ideas for advocacy * 49:50* Take points and Outro

Throw out your down pillows and join The Curbsiders for this lively discussion on interstitial lung disease. While the hundreds of interstitial lung disease types make this topic a bit overwhelming, breathe easy knowing that pulmonologist, Dr. Erin Narewski @erinnarewski (Temple), can boil things down to an easy to approach framework in less time than it takes to complete a few 6-minute walk tests. In this episode, we walk through the classification, relevant patient history, workup, and management of interstitial lung disease.

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Credits * Written and Produced by: Paul Williams, MD, FACP; Nicole Kus, David Madnick, and Peter Wikoff * Infographic and Cover Art: Edison Jyang * Show Notes: Deborah Gorth * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Paul Williams MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: Erin Narewski DO, FCCP

Sponsor: ACP membership acponline.org/member

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps * 0:00 Intro * 03:14 Guest one-liner, career advice, favorite failure, Picks of the Week*: The Strain, FX Horror TV Show; One Hundred Years of Solitude (book) by Gabriel Garcia Marquez; Hypoallergenic pillows; Peanut butter whiskey * 10:02 Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT * 11:00 Case from Kashlak, Definitions * 16:40 Buckets of ILD * 32:06 Discussion of testing ILD: Labs and Imaging * 44:20 Imaging findings in ILD * 49:44 Basic Management of ILD * 61:00 Take home points and Outro

The Strain 1-4: The Complete Series

One Hundred Years of Solitude

We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing.

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Credits * Written and Produced by: Emi Okamoto MD * Cover Art: Kate Grant MBChb, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Karen DeSalvo MD, MPH, MSc

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account!

Time Stamps * Intro, disclaimer, guest bio 0:44 * Dr Desalvo’s one-liner 3:34 * Picks of the Week- The Great Influenza book by John M Barry 5:01 * Dr Desalvo’s advice and past experience 6:10 * Case from Kashlak 10:30 * What about the evidence for social determinants? 13:40 * What to do about this in the clinic, and is it worth screening? 16:06 * Approaching as a team and with the community 19:40 * How do we affect the upstream, before the downstream consequences? 22:40 * NAM recommendations and framework 26:00 * The role of technology 30:00 * What are Social Determinants of Health (SDOH), and who they affect 34:00 * Start paying attention to SDOH 37:00 * Outro 38:49*

The Great Influenza: The Story of the Deadliest Pandemic in History

Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever.

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Credits * Written: Hannah Abrams MD, Avital O’Glasser MD * Produced by, Infographic and Cover Art by: Hannah Abrams MD * Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com * Guest: Avital O’Glasser MD

Sponsor: ACP - acponline.org/member

Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps * 00:00 Intro * 02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students * 09:28 Sponsor * 10:17 Kashlak case; How to collaborate with our surgical colleagues * 13:45 Questions to ask at the time of transfer * 23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea * 44:25 Co-managing Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis * 57:55 Outro

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Hedwig And The Angry Inch (Original Cast Recording)

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment, modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255.

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Credits * Producer/Writer/Graphics: Beth Garbitelli * Co-Producer: Paul Williams MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli * Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com * Guest: Megan Gerber MD, MPH, FACP

Sponsor: ACP - Visit acponline.org/member

Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!

Time Stamps * Intro, disclaimer, guest bio (0:00 - 3:15) * Guest one-liner (3:30) * Kashlak Cases (13:45) * Epidemiology of trauma (15:18) * Trauma and #MeToo (18:10) * Defining Trauma-Informed Care (TIC) (19:00) * Integrating TIC into primary care (22:48) * Screening in TIC (25:00) * Containment and retraumatization (29:00) * Inquiring about trauma (30:45) * Recap and Office Visit Mechanics (35:30) * Building the Relationship (38:00) * Common Inquiry Mishaps (38:52) * TIC Physical Exam (40:20) * Resources for Patients (44:30) * Office Environment (48:00) * Provider Burnout (50:00) * TIC in Covid-19 (52:30) * Take-home Points (56:20)

Trauma-Informed Healthcare Approaches: A Guide for Primary Care

Introducing our friends, The Curious Clinicians:

Why do human bodies work how they do? Why do medications work, or not work? Do you miss digging into the “why” behind what we do every day? Join Hannah Abrams (@hannarabrams), Tony (@tony_breu), and Avi (@AvrahamCooperMD) in the Curious Clinicians podcast as they delve into these questions & more, starting with episode 1: Why does fingernail clubbing happen in so many different diseases? https://curiousclinicians.com/

Check out their website and subscribe on your favorite podcast player.

Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross!

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Credits * Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD * Cover Art: Deborah J. Gorth ScM * Hosts: Matthew Watto MD, Rahul Ganatra MD MPH, Emi Okamoto MD, and Sarah P. Roberts MPH * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors: ACP and VCU Health CE Time Stamps * 00:00 Sponsors * 00:30 Intro, disclaimer * 02:40 Fomites, groceries and killer rats * 08:22 Sponsor * 09:22 ACTT-1 trial of remdesivir * 18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon * 33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests? * 44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics * 50:30 Outro

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!). Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by Nora Taranto MD * Infographics by Nora Taranto MD * Cover Art by Kate Grant MBChB, MRCGP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD * Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com * Guest: Stefan Kertesz MD

Sponsor: VCU Health CE

Time Stamps * 00:00 Intro, disclaimer, guest bio * 3:17 Guest one-liner * 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/ * 10:07 Case from Kashlak * 10:56 Language: How to ask where a patient lives? * 13:25 Terminology: Persons Experiencing Homelessness: * 14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors * 20:44 How to start the visit, and how to establish trust early on? * 27:40 Why is the mortality rate higher? * 35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C * 54:15 COVID and homeless healthcare * 57:00 Care Models * 62:30 Take Home Points and Outro

On Becoming a Healer: The Journey from Patient Care to Caring about Your Patients

Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist.

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Credits * Written and Produced by: Justin Berk, MD MPH MBA * Infographic and Cover Art: Beth Garbitelli * Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com * Guest: Douglas Paauw, MD

Sponsor: VCU Health CE

Time Stamps * 00:00 Intro, disclaimer, guest bio * 02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories! * 06:15 Medical Myth Definitions * 10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol * 19:09 Expired Medications; Military Stockpiling Study * 24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap * 31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%) * 41:07 Epinephrine in extremity; RCT of Epi in Extremities * Study showing Experts use it; Podiatry journal * 48:39 Take home points and Outro

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Being Mortal: Medicine and What Matters in the End

Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again!

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Credits * Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD * Cover Art: Beth Garbitelli * Hosts: Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD , Sarah P. Roberts MPH, * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE

Time Stamps * 00:00 Intro * 02:10 Fun animal facts: Llama antibodies * 09:10 Remdesivir RCT by Wang et al * 12:40 Power and Sample Size * 16:32 Baseline Characteristics, Results and Author’s conclusions * 19:15 Rahul’s conclusions: How chance and bias affected the results * 24:00 Right censoring; Viral load and timing of antivirals * 30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial * 33:53 Are patients really having fewer strokes and heart attacks? * 38:20 Awake proning * 43:30 Paul teaches us not to use the term “happy hypoxemic” * 45:00 CIDRAP viewpoint on future waves and exit strategies * 50:22 Outro

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams * Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: Nina Mingioni MD, FACP

Sponsor: VCU Health CE

Time Stamps * 00:00 Intro, disclaimer, guest bio and a bad pun * 03:00 Guest one-liner * 07:10 Case from Kashlak, Defining fatigue; Taking a general history * 11:36 Most common causes of fatigue and how to elicit them from the history * 20:39 Physical exam for fatigue; Medications that cause fatigue; * 25:25 Exam findings and LRs for anemia; Sleep apnea * 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme * 47:55 Spiel to the patient when no answer is found * 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis * 55:09 Take home points and Outro

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal! Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!).

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME

Credits * Written and Produced by Nora Taranto MD * Infographic and Cover Art by: Nora Taranto MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Joji Suzuki MD

Sponsor: VCU Health CE

Time Stamps * 00:00 Intro, disclaimer, guest bio * 02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film) * 08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk * 17:32 Outpatient Versus Inpatient Treatment * 25:27 Gabapentin for alcohol withdrawal * 27:10 Indicators for ICU level Care * 31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs * 36:55 And which benzo? * 39:47 A Natural History of Withdrawal * 44:10 Banana Bags and Thiamine Deficiency * 48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing * 56:36 Outro and Bonus clip

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Why We Do What We Do: Understanding Self-Motivation

In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!

Credits * Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD * Writer: Emi Okamoto MD, Rahul Ganatra MD MPH, * Cover Art: Chris Chiu MD * Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsors: Apollohct.com and VCU Health CE

Time Stamps * 00:30 Intro, disclaimer * 02:30 Picks of the Week * 6:36 Remdesivir trial rundown * 21:52 Thrombosis in COVID-19 * 29:50 Asymptomatic/Presymptomatic transmission * 41:42 Quick takes * 49:00 Outro

It’s NephMadness! Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from the Freely Filtered Podcast led by Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist. Topics: indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME

Credits * Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew * Infographic: Cyrus Askin MD * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

Sponsor: VCU Health CE

Time Stamps * 00:00 Announcement, Intro to Freely Filtered and NephMadness * 04:00 Case of advanced CKD; Who/when to refer for transplant * 12:05 Benefits of renal transplant * 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors * 20:40 Medications after transplant; Drug-drug interactions * 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness * 32:07 Calcineurin inhibitor levels * 36:42 Prophylaxis for long term complications * 40:21 Allograft rejection; BAMF criteria * 50:40 Cardiovascular risk; Statins * 56:11 Malignancy after kidney transplant * 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy * 72:23 Outro

LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Matthew Watto MD, FACP * Infographic: Michelle Brooks MD * Cover Art: Matthew Watto MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Clair Morgan of nodderly.com * Guest: Michelle Brooks MD

Sponsor: VCU Health CE

Time Stamps * 00:00 Guest one liner, favorite failure, career advice, * 08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series) * 11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles * 23:04 Negative aspects of social media * 26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer * 37:14 Pros and Cons of #medtwitter * 42:02 Tweetorials * 44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media * 51:34 Outro

Teaching Naked: How Moving Technology Out of Your College Classroom Will Improve Student Learning

Crucial Conversations: Tools for Talking When Stakes Are High, Second Edition

The Culture Code: The Secrets of Highly Successful Groups

Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Written and Produced by: Elena Gibson MD * Cover art and Infographic by: Dr Kate Grant MBChb MRCGP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com * Guest: Susan Mandel MD, MPH

Sponsor: VCU Health CE

Time Stamps * 00:00 Intro, disclaimer, guest bio * 02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice * 09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms * 13:20 When to Test for Hypothyroidism * 17:43 Biotin interaction * 19:49 Which thyroid tests should we order? * 26:15 Subclinical hypothyroidism * 29:00 Etiology/Types of hypothyroidism * 33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam * 37:10 Levothyroxine replacement time of administration * 42:10 TSH goal * 46:00 Levothyroxine manufacturers * 48:33 Dosing in older adults * 50:27 T3 treatment * 56:52 Pregnancy * 59:42 Dose adjustments * 61:43 Estrogen and thyroid binding protein * 63:33 Who needs a referral? * 65:40 Plugs, Outro

Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and produced by: Matthew Watto MD * Cover art and Infographic by Matthew Watto MD * Hosts: Matthew Watto MD and Paul Williams MD * Editor: Clair Morgan of Nodderly.com

Time Stamps * 00:00 Announcement, Intro, Disclaimer * 02:53 Our top podcasting pearls * 07:01 Find your niche * 09:46 Logistics * 13:25 Business, finances and legal matters * 14:40 Equipment * 21:48 Recording and editing * 24:56 Website, web and media hosting * 28:53 How to setup and record your podcast * 35:08 Editing software * 35:58 Search engine optimization * 37:45 Post-processing * 39:49 Take home points and outro

Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management in these challenging times. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD * Show Notes: Cyrus Askin MD * Infographic: Elena Gibson, MD * Cover Art: Dr. Kate Grant MBChB DipGUMed * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com * Guest: COL Kevin Chung, MD, FACP

Sponsors: McGraw Hill

Time Stamps * 00:00 Intro * 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice * 07:40 Sponsor * 08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs * 16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation * 23:40 Proning patients for hypoxemia * 29:15 ARDS basics: diagnostic criteria, Brief Recap * 33:22 Mechanical ventilation: Initial settings, following the blood gas * 40:55 Peak and plateau pressure, Lung compliance and Troubleshooting a high pressures * 51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs * 62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19 * 68:10 Take home points; Plugs; Outro

Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston). Plus, @Paulnwilliamz and @cjchiu give us some telehealth along with the usual antics. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written, Produced, Hosted by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP * Cover Art and Show Notes by: Matthew Watto MD, FACP * Editor: Matthew Watto MD * Guest: Rahul Ganatra MD

Time Stamps * 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week * 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site * 11:50 Telehealth best practices * 16:42 Convalescent plasma and Serology * 21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report) * 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality * 25:30 Critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial * 49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)

Get under the hood of SGLT2 inhibitors! Listen as our guests Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf give us a tour through the NephMadness 2020 SGLT2i region! How do these promising drugs work, and what evidence is there for using them in non-diabetic kidney disease or kidney transplant patients. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Hannah R. Abrams * Cover Art and Infographic by: Hannah R. Abrams * Hosts: Hannah R Abrams, Matthew Watto MD, FACP * Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) * Guests: Harish Seethapathy MD; Matthew Sparks MD; Joel Topf MD

Sponsor: McGraw Hill

Time Stamps * 00:00 Sponsor * 00:26 Intro, disclaimer, guest bio * 02:57 Guest one-liner and Picks of the Week*: Michael Pollan audiobook on Coffee and Caffeine Addiction * 03:52 SGLT2i definition, background, and why we now consider CV endpoints in diabetes * 11:16 Sponsor * 12:00 Tubuloglomerular feedback; Balloon analogy * 17:40 Other mechanisms for SGLT2i * 23:05 Back to the case; Risks from SGLT2i; Counseling and Monitoring * 34:18 SGLT2i for non-diabetic kidney disease; Possible mechanisms: Joel’s caution against early adoption * 41:42 SGLT2 inhibitors in kidney transplant * 45:20 Take home points and picks for the SGLT2 inhibitor region * 49:50 Outro

Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running.

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Paul Williams MD, FACP * Cover art and Show notes by: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Kat Zechar MD and Amreet Sidhu MD

Time Stamps * 00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020. * 01:22 Intro, disclaimer and guest bios * 03:38 Guest one-liners, Picks of the week * 09:30 Why you might need an online meded curriculum * 16:33 Overview of Amreet and Kat’s online curriculum * 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment * 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org) * 46:35 Time commitment * 50:55 Take home points and Outro

LIVE! from Mayo Clinic, a practical approach to lymphadenopathy with Carrie Thompson MD @cathompsonmd (Hematology Oncology, Mayo Clinic). Dr. Thompson provides her simplified approach to the history, differential diagnosis, high yield lab testing, imaging, how to counsel patients with adenopathy and tips on when, where and how to biopsy!

The Curbsiders are insanely grateful to the Mayo Clinic Internal Medicine Residency Chief Residents @mayomn_imres (@JasonEckmannMD @SamiRyanMD @BHuffmanMD @CourtHarrisMD) and their amazing program director @AmyOxentenkoMD for an amazing trip to Rochester!

Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Carrie Thompson MD and Matthew Watto MD, FACP * Infographic: Matthew Watto MD, FACP * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Carrie Thompson MD

Time Stamps * 00:00 Announcement: We’re looking for Medical Student members. Send applications to thecurbsiders@gmail.com by April 10, 2020. * 01:20 Intro, guest bio, one-liner, career advice; Pick of the week*: In Shock by Rana Awdish * 07: 00 Lymphatic system * 09:19 Differential diagnosis for lymphadenopathy * 11:38 Taking a history (ALL AGES mnemonic), Red Flags * 19:15 Physical exam for lymphadenopathy * 22:30 Which labs to order; Flow cytometry * 26:05 Imaging * 28:30 Counseling patients with LAD * 31:10 Biopsy: How to choose type and location * 37:35 Take Home Points * 39:00 Audience Questions * 42:25 Outro

In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

Listen as the pioneers of the COVID pandemic share their experiences taking care of some of the first COVID patients in the US. Our guests have a broad range of expertise and experiences. This episode features hospitalist Dr. Francisco Alvarez (University of California at San Francisco, @fnalvarez), Infectious Disease fellow Dr. Karolina Maciag (University of Washington, @KMaciag), Critical Care and Pulmonology Fellow Dr. David Furfaro (Columbia University, @david_furfaro

) and intensivist and founder of onepagericu.com, Dr. Nick Mark (Seattle, WA).Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced: Justin Berk MD MPH MBA * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Justin Berk MD MPH MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Dr. Francisco Alvarez, Dr. Karolina Maciag, Dr. Dave Furfaro, Dr. Nick Mark

Sponsors: Cayuga

Time Stamps * 00:00 Intro * 04:28 Francisco: Process leading up to first case * 07:42 Karolina: The perspective of the consultant- calm in the storm * 11:40 (Karolina) Seattle Flu Study as early warning * 16:00 Dave: ICU patients * 20:30 Nick: making decisions with a moving target * 25:05 Sponsor * 25:53 Francisco: data available on Twitter * 28:00 Francisco: the role of generalist during the COVID pandemic * 31:15 Karolina: on vulnerable populations during pandemic * 38:26 Dave/Nick: how generalists should be preparing themselves * 45:16 Avoiding aerosolized procedures / nebulizers * 47:46 What was the big surprises * 54:20 How do you address the anxiety * 60:12 Plugs * 64:20 Outro

Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral!Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP * Cover Art and Infographic by: Beth Garbitelli * Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Paul Sax MD

Sponsor: Cayuga

Time Stamps * 00:00 Intro * 04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza * 07:00 Rahul highlights areas of caution interpreting COVID cases studies * 12:35 Sponsor * 13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms * 18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity * 21:15 Who merits testing for COVID-19 * 23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine * 25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital * 30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible? * 32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine * 36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces? * 40:20 Do exposed HCWs without symptoms require quarantine? * 41:30 Personal Protective equipment (PPE) * 45:00 COVID-19 in pregnancy * 47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.) * 50:45 Where should you get your COVID-19 information? * 52:30 Closing remarks and outro

NephMadness 2020 is here! Listen as Dr. Ryann Sohaney (@ryannsohaney), Dr. Deborah Clegg and Dr. Joel Topf (@kidney_boy) discuss this year’s first Nephmadness topic, Hyperkalemia in CKD. They will (1) review the use of potassium binders for management of hyperkalemia in CKD (2) identify the potential health benefits of dietary potassium and challenge the use of low-potassium diets in CKD, and (3) describe how exercise influences serum potassium and consider exercise recommendations in CKD.

Check out the regions and fill out your brackets for NephMadness 2020 here! Sign-up as a part of The Curbsiders team!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Elena Gibson MD * Infographic: Caitlyn Vlasschaert MD * Cover Art: Elena Gibson MD * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan Nodderly.com (audio) * Guest: Ryann Sohaney, MD; Deborah Clegg, PhD; Joel Topf, MD

Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit AccessMedicine to learn more:http://bit.ly/MHCurbsiders.

Time Stamps * 00:00

Polycystic ovary syndrome (PCOS) is more common than we think! Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Molly Heublein, MD * Cover Art and Infographic: Kate Grant MBChB DipGUMed * Hosts: Matthew Watto MD, FACP; Molly Heublein, MD * Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) * Guest: Katherine Sherif, MD

Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit AccessMedicine to learn more:http://bit.ly/MHCurbsiders.

Primary Care Physician Opportunity in beautiful Ithaca, NY! Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/.

Time Stamps * 00:00 Sponsors - AccessMedicine.com (McGraw-Hill)

Join us as we demystify the world of pulmonary nodules & lung cancer screening. During this episode, Dr. Denitza Blagev (@mybetterdoctor) makes her triumphant return to The Curbsiders to help us tackle this topic. She is currently the Medical Director for Quality/Specialty-Based Care at Intermountain Healthcare and a Pulmonary & Critical Care physician. We learn to take command of the recommendations for lung cancer screening, disambiguate the terms used by pulmonologists and radiologists, and appreciate some of the nuances of lung cancer screening all with the hope of making YOU a better primary care physician!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Cyrus Askin MD & Leah Witt, MD * Infographic: Leah Witt, MD * Cover Art: Dr. Kate Grant MBChB DipGUMed * CME/MOC: Cyrus Askin, MD * Hosts: Cyrus Askin MD; Leah Witt, Matthew Watto MD, FACP; Paul Williams MD, FACP * Editors: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) * Guest: Denitza Blagev, MD

Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps * 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders * 00:15 Intro, disclaimer, guest bio * 02:15 Guest one-liner;

Develop your approach to refugee health in the primary care setting. We discuss important considerations for primary care of the refugee patient with Dr. Tanuja Devaraj (Penn State), an internist with expertise in migration health. We review barriers to primary care, how to take a migration history, and common health concerns that occur in this patient population. We also discuss strategies for screening for trauma and mental health issues, which are common among patients who have gone through migration.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Producer: Paul Williams MD, FACP * Writer: Tanuja Devaraj MD and Paul Williams MD, FACP * Infographic: Emi Okamoto MD * Cover Art: Paul Williams MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) * Guest: Tanuja Devaraj MD

Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps * 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders * 00:15 Intro, disclaimer, guest bio * 02:08 Guest one-liner, book recommendations, career advice * 07:12 Picks of the Week*:

Discover common practices that persist in the hospital wards despite no proven benefit! We review how potassium replacement goals should not drive you bananas, extra oxygen should not give you comfort, and how you should maybe calm down with antipsychotics for delirium. Join returning guests: high-value care specialist Dr. Lenny Feldman (@DocLennyF, Johns Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 3 of “Things We Do for No ReasonTM.

SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Burton H. Shen MD, Justin Berk, MD MPH MBA * Infographic: * Cover Art: * Hosts: Justin Berk MD MPH MBA; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FaCP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) * Guest: Lenny Feldman MD, Tony Breu MD

Sponsors The Society of Hospital Medicine Hospital Medicine 2020 (HM20) is the Society of Hospital Medicine’s Annual Conference April 15th through the 18th in sunny San Diego. Don’t miss the largest hospital medicine meeting. Register now at https://shmannualconference.org/ and use the code CURBSIDERS to receive a $50 discount.

Primary Care Internal Medicine of Ithaca

Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder. Your patients need you!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Carolyn Chan, MD * Cover Art and Infographic: Carolyn Chan, MD * Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) * Guest: Marlene Martin, MD

Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Time Stamps * 00:00 Sponsor -ACP’s MKSAP 18

Join us as we discuss how to approach “The Struggling Learner” with Dr. Melissa McNeil (@missydoc0128), Professor Medicine and Associate Chief of General Internal Medicine at the University of Pittsburgh Medical Center (UPMC), recorded LIVE in Pittsburgh, PA! In this episode, we discuss how to approach the struggling learner, highlighting the 5-Step process discussed in a recent article co-written by Dr. McNeil (Merriam 2019). This episode is not intended to give educators a roadmap for how to develop and implement a corrective action plan, but was put together to provide a common toolset on how to approach a struggling learner. As such, the topics discussed can be applied to all kinds of learners that struggle, not just in medicine. However, the techniques discussed involve a common framework routinely taught in medical education (assessment, diagnosis, and referral) and, therefore, is communicated using this shared language.

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Stuart Brigham MD * Infographic: Matthew Watto MD, FACP * Cover Art: Stuart Brigham MD * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham, MD * Editor: Stuart Brigham MD (written materials); Clair Morgan at Nodderly.com * Guest: Melissa McNeil MD, MACP * Special thanks to Dr. William Kelly, FACP, FCCP

Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Kidney Boy Returns! Compare the types of dialysis, learn how nephrologists approach medication management in ESRD, and avoid the most common mistakes non-nephrologists make in patients on dialysis! Kashlak Chief of Nephrology Dr. Joel Topf, @kidney_boy, walks us through what you need to know to take care of a patient on dialysis and gives us an idea of how nephrologists think through mineral bone disease (calcium, phosphorus and vitamin D), anemia, iron repletion, and hypertension. We answer all your questions about co-managing patients on dialysis!

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Producer: Hannah R. Abrams * Written and produced by: Hannah R. Abrams * Cover Art and Infographic by: Hannah R. Abrams * Hosts: Hannah R. Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials), Clair Morgan of Nodderly.com (audio) * Guest: Joel Topf MD

Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps * 00:00 Sponsor -ACP’s Internal Medicine Meeting 2020 * 00:15 Intro, disclaimer, guest bio * 01:45 Guest one-liner, Picks of the Week*: KidneyCon, CATS (film) * 06:00 Sponsor -ACP’s Internal Medicine Meeting 2020 * 06:50 Case of Anne Yuric; Assessing risk of progression to dialysis; Candidacy for dialysis and renal

Trailer for season 9 of The Curbsiders! Plus, our friends from NephJC and the Freely Filtered Podcast will be at KIDNEYcon 2020! It features 6 amazing hands on workshops and lots of celebrities from #NephTwitter. The deadline for travel grants is approaching (See below).

What: KIDNEYcon 2020 (www.kidneycon.org)

When: April 16-19, 2020 Where: Little Rock, Arkansas

Who Should Attend: Internal Medicine Residents, Pediatric Residents, Adult and Pediatric Nephrology Fellows, Attending Nephrologists

Travel Grants: Available for Adult and Pediatric Residents and Nephrology Fellows (Deadline to apply: February 1st )

Click HERE to Register in January 2020

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Rate our infographics! Tell us what you think in this brief survey.

Credits * Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli * Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA * Infographic: Beth “Garbs” Garbitelli * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP * Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) * Guest: Erin Michos MD MHS

Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Time Stamps * 00:00:00 Intro * 00:01:52 Getting to know Dr. Erin Michos * 00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and

Tidying Up with Marie Kondo: The Book Collection: The Life-Changing Magic of Tidying Up and Spark Joy

A Curbsiders classic with a fresh intro by Hannah Abrams @hannahRabrams (soon to be MD)! Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis. Get deeper into potassium physiology with a FREE pdf copy of Joel’s book The Fluid Electrolyte and Acid Base Companion here.

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits * Written, edited and produced by: Matthew Watto MD, FACP * Intro: Hannah R Abrams * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD * Infographic and Cover Art: Matthew Watto MD, FACP * Guest: Joel Topf MD

Time Stamps * 00:00 Sponsor -ACP’s IM Meeting 2020 in LA * 00:28 Disclaimer, intro and guest bio * 03:00 Guest one-liner * Picks of the week* —Peloton indoor bike;

Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic!

Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that.

The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line.

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at doctorpoorman@gmail.com, or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need.

New episodes return January 20, 2020! Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits * Written and produced by: Nora Taranto MD, Shreya Trivedi MD * Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD * Edited by: Matthew Watto MD * Guest: Elisabeth Po

Recap extravaganza 2019 featuring top pearls from our staff’s favorite episodes of 2019 and voicemails from Kashlak faculty, Dr. Avital O’Glasser (@aoglasser), Dr. Kimberly Manning (@gradydoctor), Dr. Renee Dversdal (@DrSonosRD) and The Curbsiders team. Topics include: HFpEF, the PARAGON-HF trial, Buprenorphine, Opioid Use Disorder, Cirrhosis, Coagulopathy, SBP, Hyperkalemia treatment, Multimorbidity, and how to think about NNT. Plus, the team shares a bunch of other favorite moments and random pearls!

Upcoming shows: The next two weeks will feature REBOOT episodes with fresh intros from The Curbsiders team. Season 9 starts January 20, 2020 with a Lipid Update from Cardiologist Dr. Erin Michos (@ErinMichos)

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Produced by: Sarah Phoebe Roberts MPH and Chris Chiu MD, FACP, FAAP * Writer: Sarah Phoebe Roberts MPH * Infographic: Sarah Phoebe Roberts MPH * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Chris Chiu MD, FACP, FAAP; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Chris Chiu MD, FACP, FAAP (audio), Matthew Watto MD, FACP (show notes)

Time Stamps * 00:00 Intro and disclaimer * 04:25 Picks of the year*: The Expanse (TV show) -Chiu Man’s pick;

The Expanse Seasons 1-3

Team up with the authors of the JAMA Medicine series on Medical Overuse, Dr. Dan Morgan @dr_dmorgan (University of Maryland) and Dr. Deborah Korenstein @DKorenstein (Memorial Sloan Kettering). We discuss procalcitonin (again!), the dangers of incidentalomas, risks of chest CT for lung cancer screening, the easiest place to get antibiotics for a viral infection, and why not to treat subclinical hypothyroidism despite guidelines. Trying to find ways to shed the fat off of some common medical practices? Look no further.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Justin Berk, MD MPH MBA * Infographic: Justin Berk, MD MPH MBA * Cover Art: Matthew Watto MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Molly Heublein MD, Matthew Watto MD, FACP, Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) * Guest: Daniel Morgan MD, Deborah Korenstein MD, FACP

Time Stamps * 00:00 Intro, disclaimer, guest bios * 04:45 Guest one-liners * Picks of the Week*: The Fifth Season is part of

The Fifth Season (The Broken Earth, 1)

Delve into the diagnosis and management of GERD and dyspepsia with Dr. Amy Oxentenko (@AmyOxentenkoMD), Gastroenterologist and the Internal Medicine Residency Program Director, Associate Chair for the Department of Internal Medicine, and Professor of Medicine at Mayo Clinic in Rochester, MN. Our discussion features a review of the standard presentations of GERD and dyspepsia, alarm symptoms and who needs referral for endoscopy or other specialized testing (pH, impedance testing, screening for Barrett’s esophagus). Additionally, we comprehensively cover proton pump inhibitor (PPI) therapy including: choice of agent, dose, frequency, how taper, how to counsel patients about risk, what labs should be monitored and the use of adjuvant therapies like H2 blockers, antacids and even carafate. After this episode, you will be flexing on reflux!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli * CME Questions: Beth Garbitelli, Matthew Watto MD, FACP * Infographic: Beth Garbitelli * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP (written materials); Clair Morgan at Nodderly.com * Guest: Amy Oxentenko MD

Time Stamps * 00:00 Intro, disclaimer, guest bio * 02:47 Guest one-liner, Picks of the Week*: Reality TV Shows: Survivor and

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How to initiate buprenorphine like a pro. Treating people with Opioid Use Disorder can be the most rewarding part of your practice! Get comfortable with counseling and pharmacotherapy for OUD with tips from Dr. Michael Fingerhood, Associate Professor of Medicine at Public Health at Johns Hopkins. We review building a therapeutic relationship with people with substance use disorders, the differences between the three FDA-approved medications for opioid use disorder (buprenorphine, methadone and extended-release naltrexone), and the nitty-gritty of prescribing buprenorphine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Justin Berk, MD MPH MBA, Joseph “Seffy” Muller MD * Infographic: Hannah R Abrams and Justin Berk MD, MPH, MBA * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Justin Berk, MD MPH MBA * Editor: Matt Watto MD, FACP (written materials), Clair Morgan at Nodderly.com (audio) * Guest: Michael Fingerhood MD

Time Stamps * 00:00: Introduction * 04:40: Guest introduction & questions (great stories about addiction) * Picks of the Week*: Papillon (film) and Papillon (book) per Dr. Fingerhood;

Papillon (P.S.)

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Make some gains with Drs. Feigenbaum (@Jordan_theCoach) & Baraki (@AustinBaraki) of Barbell Medicine as we delve into the topic of sarcopenia! Together we’ll learn what exactly is sarcopenia, how it is diagnosed, and explore approaches to both management and counseling including: exercise prescriptions, recommendations for protein intake, and even how to treat patients with multiple comorbidities.

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Cyrus Askin MD * Infographic: Cyrus Askin MD, Hannah Abrams * Cover Art: Dr. Kate Grant MBChB DipGUMed * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editors: Matthew Watto MD, FACP; Clair Morgan of Nodderly.com * Guests: Jordan Feigenbaum MD; Austin Baraki MD

Check Out our friends at Barbell Medicine! Learn more about Barbell Medicine through their website at www.barbellmedicine.com or their YouTube channel - Barbell Medicine. They also have their own Podcast, The Barbell Medicine Podcast and can be found on Instagram: @barbell_medicine, Twitter via @BarbellMedicine.

Drs. Feigenbaum and Baraki can

“Guidelines” galore! From Community-Acquired Pneumonia to asthma to...red meat? While you may be listening to this around Thanksgiving, we actually recorded on October 30th‒the best and spookiest time of the year. To really set the mood I wanted to include some terrible skeleton puns, but the ones I found weren’t humerus. What we do have for you are some tasty knowledge treats, courtesy of our ghosts‒oops, I mean our HOSTS‒Chris, Matt, Stuart and Paul. Join us as we review the most terrifyingly relevant research findings and creepiest clinical pearls!

Today also marks the debut of our newest Hotcakes team member, the frighteningly talented Dr. Rahul Ganatra. Rahul will now be our resident statistician/study design expert, and will use his research skulls‒no wait, SKILLS‒to provide even more insight into the practice-changing findings we love to highlight for you.

ACP members can claim CME-MOC at CME credit https://www.acponline.org/curbsiders. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits * Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD * Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD * Statistics Expert: Rahul Ganatra MD * Editors: Christopher Chiu MD (audio/text), Emi Okamoto MD (text) * Cover-Art: Sarah Phoebe Roberts MPH * Music: Stuart Brigham MD

Time stamps

00:00 Introduction/Disclaimer
03:18 Getting to know Dr. Rahul Gantra
05:35 Community-Acquired Pneumonia Guidelines
15:13 Sarah explains Hotcakes ratings
16:45 A new Asthma Strategy
17:26 Chris forgets what LABA stands for
27:37 Stuart makes a joke
29:00 A lot of meat talk
37:22 Rahul’s Napkin Calculations
51:40 Honorable Mentions
52:42 Take-away Points & Outtro

Meet Rahul:

Rahul Ganatra is a Medical Attending and Director of Continuing Medical Education for the Medical Service at the VA Boston Healthcare System. He fell in love with clinical epidemiology and public health while taking night classes for his MPH during medical school. and we

Score some great insights and clinical pearls from Dr. Christine Won on the incredibly important topic of sleep medicine during this live recording at CHEST! On this episode we’ll tackle why we sleep, how to treat insomnia, the “Z-drugs” and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Cyrus Askin MD, Matthew Watto MD, FACP * Infographic: Matthew Watto MD, FACP * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP; Emi Okamoto MD * Guest: Christine Won, MD MSc

Sponsor The American College of Chest Physicians

Time Stamps * 00:00 Intro, disclaimer, guest bio * 06:10 Guest one-liner * 10:15 Picks of the Week*: Become Your Child’s Sleep Coach (book) by Lynelle Schneeberg; * Sleep in Art: How artists portrayed sleep and dreams in the last 7000 years (book) by Meir Kryger; The Toxic Avenger (film);

Become Your Child's Sleep Coach: The Bedtime Doctor's 5-Step Guide, Ages 3-10

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Sleep in Art: How artists portrayed sleep and dreams in the last 7000 years

We want to live longer… and healthier too! Dr Peter Attia, a physician focusing on the applied science of longevity, walks us through lifespan and healthspan, exploring tactics aimed at extending both. Listeners will challenge the conventional approach to primary care and explore tactics to optimize exercise, nutrition, and health, including counseling on different dietary patterns, fasting, exercise, emotional well-being and how to prepare for the Centenarian Olympics!

Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com

Credits * Written and Produced by: Matthew Watto MD, FACP and Elena Gibson MD * Cover Art and Infographic: Elena Gibson MD * Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Emi Okamoto MD * Audio Editor: Clair Morgan of Nodderly * Guest: Peter Attia MD

Time Stamps * 00:00 Intro, disclaimer, guest bio * 04:22 Guest one-liner, Career Advice, Picks of the Week * 14:30 Case: A couple seeking maximize longevity; Defining longevity, healthspan, lifespan and the 4 types of death * 19:30 Lifespan, the longevity curve and the long tail * 23:50 Peter’s approach to shepherding patients toward longevity; Exploring motivations * 32:06 Back to our couple: What exercises should they perform * 42:09 Peter’s advice on nutrition; the standard American diet; Intermittent fasting; Dietary Restriction * 51:20 Periodic fasting and water only fasting * 54:33 Genetics and longevity * 56:40* Metformin;

This podcast covers several concrete steps that residents can do or program directors can suggest to help residents transition to assuming the role of PGY3. A year is a long time, but requires a strategic approach to ensure that residents get the most out of it. It’s our latest offering from ACP’s IMpower series for residents featuring our friends from Walter Reed IM Residency: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray).

If you are a PGY3 you should: LEAD like someone’s life depends on it!

Credits * Written and Produced by: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD * Infographics: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD * Cover Art: Matthew Watto MD, FACP * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP * Guests: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray)

Sponsor - ACP IMpower: Catalyzing your professional future Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.

Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

Time Stamps * 00:00 Sponsor, disclaimers, intro, guest bios * 05:10 Guest one-liners * 07:43 Precocious Passion for teaching * 09:30 Picks of the Week*: High Life (film);

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Learn how to approach the geriatric patient with multimorbidity and how to parse through and prioritize a mile-long problem list with Dr Josh Uy, master geriatrician at the University of Pennsylvania. We review different approaches to a clinic visit with a patient who takes fifteen daily medications with just as many chief complaints, all in a thirty minute (or less!) appointment time. We discuss what the term “multimorbidity” even means, how to ask about patient preferences and use them to inform the treatment plan, and what the evidence has to say about adjusting treatment goals of common conditions for individual patients. (Spoiler alert: It all depends on the patient, comorbid conditions and goals!)

Full show notes https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Producer: Nora Taranto MD * Writer: Nora Taranto MD, Leah Witt MD * Infographic: Leah Witt MD * Cover Art: Nora Taranto MD * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Leah Witt MD, Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP; Clair Morgan * Guest: Josh Uy MD

Time Stamps * 00:00 Pun, Intro, disclaimer, guest bio * 04:30 Guest one-liner; Career advice; * Picks of the Week*: Unbroken (book), Down Dog Yoga (app); Check out Dimash’s music on YouTube; Off Your Rocker (TV show); Finishing Well to the Glory of God (book) * 12:30

Finishing Well to the Glory of God: Strategies from a Christian Physician

Unbroken: A World War II Story of Survival, Resilience, and Redemption

CHEST 2019 Recap Part 2 featuring random pearls and highlights from #CHEST2019 in New Orleans including: tips for addressing futile end-of-life care, bleeding in the ICU, DOAC reversal agents, use of procalcitonin and monocyte distribution width to identify sepsis, vitamin C for sepsis treatment, small particles and lung cancer risk, augmented reality/virtual learning, and tech as a teaching tool. Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written, produced, and co-hosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP * Edited by: Matthew Watto MD, FACP * Special Guests: Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Chidinma Chima-Melton MD, FCCP (@LABritishLady), Kim Fabyan MD (@kfabsMD)

Time Stamps * 00:00 Pun, Disclaimer, Intro * 03:58 Dr Erin Narewski on end of life conversations * 13:30 Bleeding in the ICU * 15:40 DOACs and reversal agents * 18:40 Dr Chidinma Chima-Melton on ICU visiting hours * 22:50 Vitamin C use in the ICU, Stuart’s Vitamin C rant * 29:22 Monocyte distribution width for identifying patients with sepsis * 30:55 Sarah Phoebe Roberts on Procalcitonin and CRP for sepsis * 39:36 Dr Nina on technolo

Recap of random pearls and highlights from #CHEST2019 including: A pop quiz on inhaler use, interstitial lung disease, pulmonary fibrosis (IPF), limitations of supplemental oxygen, lung cancer screening, imposter syndrome, and is it safe to use beta blockers in COPD.

Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written, produced, and cohosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP * Edited by: Matthew Watto MD, FACP * Special Guests: Leah Witt MD (@leahJwitt); Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Hassan Bencheqroun MD, FCCP (@drBcalifornia); Chidinma Chima-Melton MD, FCCP (@LABritishLady)

Time Stamps * 00:00 Intro, disclaimer * 05:20 Dr Leah Witt @leahwitt (UCSF) quizzes us on inhalers. * 09:55 Dr Leah Witt on ILD in geriatric patients * 13:09 Dr Erin Narewski @erinnarewski (Temple) on supplement oxygen. * 15:07 Dr Erin Narewski discusses the brand new BLOCK trial. * 18:11 Dr Chidinma Chima-Melton

Catch up on the latest guidelines and insights on tuberculosis with help from Dr. Laila Woc-Colburn, @docwoc71 (Baylor)! We cover new recommendations for screening health care workers, treatment of both latent and active TB, and best practices for counseling patients throughout the process. Listen to find out more… And say goodbye to the annual PPD?

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full notes https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written and Produced by: Hannah R. Abrams * Cover Art and Infographic by: Hannah R. Abrams * Hosts: Hannah R. Abrams; Matthew Watto MD, FACP * Editors: Matthew Watto MD, FACP; Emi Okamoto MD * Guest: Laila Woc-Colburn, MD, FACP

Partners Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans! We’ll be doing two live interviews on stage, plus recording two rec

ACR osteoarthritis guidelines author, Dr. Tuhina Neogi (Boston University; @tuhinaneogi) schools us on all things OA, including new understandings of pathophysiology, diagnosis, when to order imaging and labs, and an overview of pharmacologic and nonpharmacologic therapies. Plus, get answers to your questions from Twitter on CBD, turmeric, glucosamine, chondroitin, NSAIDS, intra-articular steroid and hyaluronic acid injections, tai chi, and more!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written (including CME questions) and Produced by: Beth Garbitelli and Matthew Watto MD, FACP * Cover Art and Infographic by: Beth Garbitelli * Hosts: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP * Guest: Tuhina Neogi MD, PhD

Partners Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

Dominate the most common in-flight emergencies with tools and tips from this classic Curbsiders episode. Our guest, Angelica Zen MD, (formerly an IM Chief Resident at UCLA), recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane. Original air date November 21, 2016.

Full show notes https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written, produced and edited by: Matthew Watto MD, FACP * Cover Art by: Matthew Watto MD, FACP * Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Matthew Watto MD, FACP * Guest: Angelica Zen MD

Partners Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. * Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans! * We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Time Stamps * 0

Tools, tips and tactics to survive intern year from Alex Glaser MD (PENN) and Saumil Chudgar MD @saumilchudgar (Duke). It’s our latest offering from ACP’s IMpower series for residents!

The transition from medical student to intern is one of the world’s most notorious times in a career, and tales of woe from intern year have even permeated into TV shows and movies. Ultimately, while the transition seems daunting with multiple challenges, it should not be feared. Many physicians look back fondly on this early time in their training, and life-long friendships often develop among an intern class. This is a time of major growth, and unease about intern year should be met with excitement for the career that is yet to come!

For meeting notes, a discussion guide and facilitators guide visit https://www.acponline.org/impower. 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 thecurbsiders@gmail.com.

Credits

Written and Produced by: Alex Glaser MD
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD; Matthew Watto MD, FACP
Guests: Alex Glaser MD, Saumil Chudgar MD

Sponsor - ACP IMpower: Catalyzing your professional future

Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.

Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

We dive deep into the relationship between HPV and cervical cancer and identify when and how to screen women with tips from Dr. Karen Smith-McCune (UCSF), Professor in the Department of Obstetrics and Gynecology! We review common cytology findings, screening guidelines, and basic indications for HPV vaccination.

Full show notes at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Producer: Molly Heublein MD
Writer: Elena Gibson MD and Molly Heublein MD
Infographic: Beth Garbitelli MS2
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Molly Heublein MD; Matthew Watto MD, FACP
Editor: Emi Okamoto MD; Matthew Watto MD, FACP
Guest: Karen K. Smith-McCune MD, PhD

Sponsors

Win a prize! Help ACP Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud.

Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019!

What makes you proud to practice internal medicine or one of the I.M. subspecialties?
What recent patient experience made you proud to be an internist or subspecialist?
How is internal medicine unique from other subspecialties?

See us at the CHEST 2019 Annual Meeting in New Orleans!

We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Dominate perioperative medication management with tips from Kashlak’s newly minted Chief of Perioperative Medicine, @aoglasser, Avital O’Glasser MD, FACP, FHM (OHSU). We cover perioperative anticoagulation, why “bridging is dead”, aspirin, dual antiplatelet therapy, DMARDS, diabetic medications, buprenorphine, and much more! Be sure to check out Dr. O’Glasser’s previous episode #135 Perioperative Medicine: Assess and Optimize Risk to get a full overview of perioperative medicine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written and Produced by: Avital O’Glasser MD, FACP, FHM and Matthew Watto MD, FACP * CME Questions: Matthew Watto MD, FACP * Infographic: Matthew Watto MD, FACP * Cover Art: Kate Grant MBChB DipGUMed * Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD, FACP * Guest: Avital O’Glasser MD, FACP, FHM

Time Stamps * 00:00 Intro, disclaimer, guest bio * 03:20 Guest one-liner * 04:46 Picks of the Week*: A Moment of Lift (book) by Melinda Gates; Crawl (film); Rich Roll (podcast) episodes w/

The Moment of Lift: How Empowering Women Changes the World

None

Dr Kimberly Manning joins to discuss imposter syndrome, how vacations affect health, and an update on the pneumonia vaccine, PCV13. Plus, hot takes on the dangers of vaping, and using procalcitonin and CRP to determine need for antibiotics.

Howdy, gentle listeners! It’s that special time of year when the school doors reopen, classrooms are awash in ‘new pencil’ smell, and FOAMed fans grab their trays and head to the cafeteria for some tasty knowledge food. Rest assured your Curbsiders friends have saved you a seat at the lunch table for this very special September 2019 episode!

Today we are joined by Dr. Kimberly Manning MD, FACP, FAAP, who is an Associate Professor of Medicine at Emory University School of Medicine. Dr. Manning authors a blog (“Reflections of a Grady Doctor”) that was named in 2010 by ‘O’ The Oprah Magazine as one of “four top medical blogs you should read.” She can also be found on Twitter, @gradydoctor. Thanks for listening!

Full show notes at https://thecurbsiders.com/episode-list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD, FACP, FAAP
Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH, Paul Williams MD, FACP; and Christopher Chiu MD, FACP, FAAP
Editor: Christopher Chiu MD, FACP, FAAP; Emi Okamoto MD
Cover-Art: Christopher Chiu MD, FACP, FAAP
Guest: Kimberly Manning MD, FACP, FAAP

Recognize the importance of cost-of-care conversations and identify resources to facilitate these discussions with help from Gwen Darien, executive vice president at the National Patient Advocate Foundation, and Dr. Jessica Dine, Associate Professor and Chief of the division of Pulmonology and Critical Care at Perelman School of Medicine. We review barriers to cost-of-care conversations and identify tools to help make these conversations a part of routine care discussions.

Full show notes at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and Produced by: Elena Gibson, MD
Infographic and Cover Art: Elena Gibson, MD
Hosts: Elena Gibson MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Gwen Darien and Jessica Dine MD

Partners and Grant Support

The American College of Physicians. Check out this supplement to the Annals of Internal Medicine from May 2019 on Fostering Productive Health Care Cost Conversations https://annals.org/aim/issue/937992

The Robert Wood Johnson Foundation https://www.rwjf.org provided grant support for this episode.

Diagnose and treat lupus in primary care with tips from rheumatologist, Beth Jonas MD, FACR (UNC). We discuss the history and exam findings in lupus, initial lab workup, the dreaded ANA, who needs expanded lab testing, lifestyle factors in lupus, vaccinations, the basics of treatment...and Jethro Tull?!

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Written and Produced: Kate Grant MBChB DipGUMed; Matthew Watto MD, FACP
Infographic: Matthew Watto MD, FACP
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: Beth Jonas MD, FACR

Solve hypernatremia with tips and tactics from Dr. Joel Topf, MD (@kidney_boy), our Kashlak Chief of Nephrology. We review the diagnostic workup for hypernatremia, polydipsia and polyuria, review the pathophysiology of diabetes insipidus, and how to differentiate between nephrogenic and central DI. Plus, we walk through how to treat hypernatremia in the acute setting and Dr. Topf shares clinical pearls on why hypernatremia is the opposite of hyponatremia… It’s easy!

Full show notes at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written by Hannah R. Abrams and Joel Topf MD
Producer: Hannah R. Abrams
Cover Art and infographic by: Hannah R. Abrams
Hosts: Hannah R. Abrams; Stuart Brigham MD; Matthew Watto MD, FACP
Editors: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Joel Topf MD

Check out Dr. Topf’s podcast!

The NephJC podcast, Freely Filtered, discusses the latest NephJC topic every two weeks. Subscribe here or on iTunes.

Search and secure your first job after residency. Dr. Alia Chisty (Penn State) returns to school us on surviving the PGY3 and beyond, part of ACP’s IMpower series. Topics: finding mentors, how to plan ahead as an intern and PGY2, master the interview day, avoid common pitfalls and confidently enter your early career. We’re joined by Curbsider and recent graduate Justin Berk MD, MPH, MBA who shares his experiences from the job trail.

Flip the classroom!

For meeting notes, a discussion guide and facilitators guide visit visit IMpower: Catalyzing your professional future.

Credits

Written and Produced by: Paul Williams MD, FACP and Alia Chisty MD, MS
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guests: Alia Chisty MD, MS; Justin Berk MD, MPH, MBA

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 thecurbsiders@gmail.com.

Sponsor

Join The American College of Physicians today! Resident members get exclusive access to IMpower: Catalyzing your professional future.

Step up your diabetes game! We answer your questions from #MedTwitter with help from returning guest, Jeff Colburn MD, FACP, FACE (USU) Topics include: the pitfalls of A1C testing, the A1C target controversy, lifestyle interventions, continuous glucose monitoring, pathophysiology of T2DM, use of SGLT2 inhibitors, GLP1 agonists, and how to initiate and titrate insulin therapy. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Writer (including CME Questions) and Producer: Matthew Watto MD, FACP
Cover Art and Infographic: Bryan Brown MD
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Jeff Colburn MD, FACP, FACE

Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia.

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Written, Produced and Edited by: Matthew Watto MD, FACP
Cover Art and Infographic by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Guest: Mary Kwok MD

Join us for this roundtable discussion of advocacy in healthcare and a rundown of hot topics: coding and billing, the Affordable Care Act, universal healthcare, gender equity, women’s health, gun violence and more! Returning guest, Dr. Robert McLean (@rmmclean84), current president of the American College of Physicians, helps us answer questions like, What is advocacy in healthcare? What are the issues that are impacting your profession? What can your medical home do for you? He’s been heavily involved in advocacy throughout his career including testifying before Congress. Guest hosts Drs. Fatima Syed MD, MSc and Deep Shah MD, MSc join!

Full show notes available at https://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 thecurbsiders@gmail.com.

Credits

Written and Produced by: Fatima Syed, MD, MSc; Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Fatima Syed, MD, MSc; Deep Shah, MD, MSc
Editor: Matthew Watto MD, FACP
Guest: Robert McLean MD, FACP

Discover more common practices that persist in the hospital wards despite no proven benefit! We review how hospitals prescribe a “crapload” of docusate which only clogs up the medication list, how unnecessary echocardiograms are ordered enough times to make your head spin, and how basal insulin needs to slide back into your inpatient diabetes management instead of correctional insulin monotherapy. Join high-value care specialist Dr. Lenny Feldman (@DocLennyF, Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 2 of “Things We Do For No Reason™.”

SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Written and Produced by: Justin Berk, MD MPH MBA, Matthew Watto MD
Infographic: Justin Berk MD MPH MBA
Cover Art: Matthew Watto MD
Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD
Editor: Matthew Watto MD, Emi Okamoto MD
Guest: Lenny Feldman MD, Tony Breu MD

Sponsor

The Society of Hospital Medicine / Journal of Hospital Medicine - Things We Do For No Reason™series. Check out all the Things We Do For No ReasonTM articles here: Master Index of TWDFNR articles .

Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at www.acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine.

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 thecurbsiders@gmail.com.

Credits * Written by: Christopher Chiu MD, FACP and Renee Dversdal MD, FACP * Produced and CME questions by: Christopher Chiu MD, FACP * Edited by: Matthew Watto MD, FACP * Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Christopher Chiu MD, FACP * Guest Expert: Renee Dversdal MD, FACP

Special thanks to our POCUS friends! ACP We can speak first hand that the following courses are amazing POCUS learning experiences! Sign up today

Point-of-Care Ultrasound: Foundational Skills for Internists

November 7-8, 2019 and November 9-10, 2019 (same 2-day course repeated back to back)
Crowne Plaza O’Hare Hotel and Conference Center, Rosemont, IL
Registration is now open at acponline.org/pocus

Point-of-Care Ultrasound: Foundational Skills for Internists

April 21-22, 2020 (during Internal Medicine Meeting 2020)
Los Angeles Convention Center
Registration will open at the end of September

Point-of-Care Ultrasound: Advanced Skills for Outpatient Practice

April 22, 2020 (during Internal

Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences. Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Producers: Molly Heublein MD; Matthew Watto MD, FACP
Writer (including CME questions): Molly Heublein MD
Cover Art: Bryan Brown MD
Hosts: Stuart Bringham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto, MD; Matthew Watto MD, FACP
Guest: Chris Favilla, MD

Summary

The sun is shining, the cakes are hot, and the takes are even hotter. Welcome to our July 2019 Hotcakes episode! Join us as our beloved hosts Chris, Matt, Stuart and Paul share some of the latest practice-changing knowledge, news and research in medical science. Today’s discussion covers studies on the use of IV iron supplementation for heart failure, aspirin as VTE prophylaxis after arthroplasty, and the relationship between physician burnout and ability to address patients’ social determinants of health. Honorable mentions include a throwback to the life-changing magic of Pokémon GO.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Editor: Christopher Chiu MD, Emi Okamoto MD
Cover-Art: Matthew Watto MD

Dr. Reshma Jagsi (TIME’S UP Healthcare; UMichigan) schools us on sexual harassment and describes the systemic and cultural changes that need to happen to effect real change. She unpacks the definition of sexual harassment, describes the state of the #MeToo and TIME’s UP movements across the science and medicine fields and highlights how we all can recognize/respond to harassment.

This is the third episode of our Women in Medicine series. Last August, you heard us talk to Dr. Vinny Arora about the paucity of women in leadership positions, finding sponsors for career advancement, and being bold about career decisions. In December, we spoke to Dr. Susan Hingle about work-life integration. Her advice? Stop worrying about what other people think, acknowledge that being a doctor is hard, especially for women due to disproportionate out-of-work responsibilities, and define a beautiful life that is individualized to you.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Leah Witt MD, Shreya Trivedi MD, Nora Taranto MD, Sarah P. Roberts MPH.
Editor: Matthew Watto MD
Hosts: Shreya Trivedi MD, Chris Chiu MD, Leah Witt MD
Guest: Reshma Jagsi MD, DPhil
Special thanks to: Hannah Abrams MS4, Beth Garbitelli MS2, and Molly Heublein MD

Tackle rashes with wisdom from Kashlak’s resident Skinternist (or Internist-Externist) Dr. Helena Pasieka (MedStar, Georgetown), board certified in both Internal Medicine and Dermatology. She offers “a rash approach to rashes” including: initial triage, ‘inside job’ vs ‘outside job’, differential diagnosis, a review of common culprits, basic management techniques, and how to determine if the reaction is life-threatening. Plus, Dr Pasieka teaches us how to handle family and friends asking, “Can you take a look at this rash?”.

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Written and Produced: Beth Garbitelli MS2
Infographic and Cover Art: Beth Garbitelli MS2
Hosts: Stuart Bringham MD, Matthew Watto MD, Paul Williams MD
Editor: Matthew Watto MD
Guest: Helena Pasieka MD

Confession: we have been holding out on you. Specifically, we’ve been sitting on a special episode of Hotcakes and Hot Takes that we recorded this March, with featured guest Armand Gottlieb, MD of the online publication The Scope. But here it is! We hope you’ll enjoy our discussion of topics like the ever-controversial e-cigarettes for smoking cessation question, outcomes related to antibiotic treatment of UTIs among elderly adults, and the role of sacubitril-valsartan for acute decompensated heart failure in inpatient settings (the PIONEER-HF study). Special guest is Dr. Armand Gottlieb @ArmandGottlieb, who was a third year internal medicine resident at Columbia University Medical Center in New York City at the time of recording. He is a co-Editor of the The Scope, a free and brief weekly roundup of the most recent and relevant medical literature.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Guest Presenter and Content Planning: Armand Gottlieb, MD
Editor: Christopher Chiu MD
Cover-Art: Christopher Chiu MD

Pick of the Week

The SCOPE. The week’s best in evidence-based medicine, written in plain language and delivered to your inbox. Sign-up for weekly emails or download the app.

Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up - This episode is going to send your heart racing! You might even skip a beat! Full notes at https://thecurbsiders.com.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

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 thecurbsiders@gmail.com.

Credits

Writer and Producer: Cyrus Askin MD
Infographic: Cyrus Askin MD
Cover Art: Cyrus Askin MD
Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD
Editors: Matthew Watto MD
Guest: James Furgerson MD

Expand your knowledge about how--and how well--we manage the health of incarcerated patients in the United States, with the expert knowledge of correctional health experts Drs. Aaron Fox @adfoxmd, Jon Giftos @JonGiftosMD, and Emily Wang @ewang422. Correctional medicine is a black box for many providers who do not work in prison and jail settings. But it’s ever more relevant to primary care physicians everywhere, with increasing rates of incarceration the last decade. In this episode, recorded live at SGIM 2019 #SGIM19, Dr. Fox, Dr. Giftos, and Dr. Wang talk us through the variability of the correctional healthcare systems throughout the country, the challenges to health for patients both while incarcerated and in the transition after release, and some essential nuts and bolts for providers about how to provide better care to this vulnerable population.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Justin Berk MD MPH MBA, Nora Taranto MD
Cover Image: Beth Garbitelli MS2
Infographic: Beth Garbitelli MS2
Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MPH MBA
Edited by: Matthew Watto MD
Guests: Aaron Fox MD, Jon Giftos MD, Emily Wang MD MAS

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Bring back Bedside Rounds with tips from a master clinician educator, Jeff Wiese MD MACP (Tulane). How to accomplish teaching in the hospital is not on the curriculum for most folks in medical school or residency. This can feel especially daunting as you move from resident to attending. We address strategies to assess, monitor, teach, and coach the medical learners under your leadership with teaching wizard and coach extraordinaire, Dr. Jeff Wiese, recipient of over 50 teaching awards! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the release date).

Full show notes available at http://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits * Written and Produced by: Matthew Watto MD FACP and Beth Garbitelli MS1 (almost MS2!) * CME questions by: Matthew Watto MD FACP * Hosts: Stuart Brigham MD, Paul Williams MD FACP, Matthew Watto MD FACP * Images and infographics: Beth Garbitelli MS1 * Edited by: Matthew Watto MD FACP, Emi Okamoto MD * Guest: Jeff Wiese MD MACP

Time Stamps * 00:00 Intro, disclaimer, guest bio * 03:28 Guest one-liner, love of Aaron Sorkin, book recommendations * 10:52 Setting goals and expectations on day one * 23:52 Preparing the resident for autonomy and assessing their place on the scale of supervision to autonomy * 28:18 How to prepare for rounds as an attending to set yourself up for efficiency and success; The cardinal rule for being an attending * 33:50 How long does it take determine a resident’s readiness for autonomy; Give your colleagues an “educational signout” * 38:31 How to handle a request for card flipping; Prodiving a rationale for bedside rounds * 43:54 The three Ds of Rounding; Should there be a fourth D * 4

Rethink how you’re diagnosing and managing chronic pain with high-yield tips from pain experts and primary care doctors Soraya Azari MD @azarimugs (UCSF), and Phoebe Cushman MD, MS (UMass Memorial). Because let’s face it, managing chronic pain can be very difficult. Expand your toolbox for management-- including the importance of activity, empowering your patient, risk stratification for patients prior to opioid initiation, how to identify opioid use disorder, and how to taper opioids. Plus, updates on recent practice changing articles in chronic pain.

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MD
Hosts: Nora Taranto MD, Paul Williams MD, Matthew Watto MD
Edited by: Emi Okamoto MD, Matthew Watto MD
Guests: Soraya Azari MD; Phoebe Cushman MD, MS

Sponsor

This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Build your knowledge base to improve primary care for LGBT patients! This episode is chock full of clinical pearls and updates for LGBT health from SGIM presenters, Dr. Jenny Siegel (Boston University) and Dr. Megan McNamara (Louis Stokes Cleveland VAMC). They define common gender identity terms and provide tips on how to take a sexual history. You’ll develop an approach to the unique clinical concerns of LGBT patients and learn how to phrase medical information in a gender neutral framework. This is a must listen episode for all health care providers!

Full show notes at https://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 thecurbsiders@gmail.com.

Credits

Written and Produced by: Carolyn Chan MD Graphics: Hannah Abrams Hosts: Carolyn Chan MD, Paul Williams MD, Matthew Watto MD Guest: Megan McNamara MD, Jenny Siegel MD

Sponsor This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

What do Judas Priest, surfing, and clots have in common? They are the passionate interests of expert Dr. Michael Streiff who guides us through the diagnosis and management of DVT and PE aka venous thromboembolism (VTE). By the end of the episode you will know how to catch a clot very Wells! We dive deep into the treatment options, literature, and some unique cases. ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by (including CME questions): Justin Berk MD, MPH, MBA
Cover art by: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Edited by: Matthew Watto, MD, FACP
Guest: Michael Streiff MD

Expand your idea of ischemic heart disease to include non-obstructive patterns, which as our guest, Dr Noel Bairey Merz, a clinical investigative cardiologist whose multiple roles include Director of the Barbra Streisand Women’s Heart Center and the Preventive Cardiac Center at the Smidt Cedars-Sinai Heart Institute, shares with us, is incredibly common, especially in women. Learn to recognize these women and treat according to guidelines, preventing unnecessary IHD mortality in our female (and some male) patients. We review a variety of non-obstructive pathologies and the best techniques to evaluate them.

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 thecurbsiders@gmail.com.

Credits

Written and produced by: Shreya Trivedi MD, Molly Heublein MD
Hosts: Paul Williams MD, FACP; Shreya Trivedi MD; Molly Heublein MD
Edited by: Matthew Watto MD, FACP; Emi Okamoto MD
Graphics by: Hannah Abrams
Guest: Dr. C Noel Bairey Merz MD, FACC, FAHA

Curbsiders' Schwag!

We’ve got the perfect father’s day gift for every internal medicine nerd. The Curbsiders have opened our own online shop. Get your Curbsiders t-shirts, hoodies, stickers, and coffee mugs. Help support the show and gain instant bragging rights. Note: All purchases come with admitting privileges at Kashlak Memorial Hospital!

Dare to lead. Master the transition to PGY2 with tips from expert educator Abby Spencer MD, MS, FACP, IM Residency Program Director and Vice Chair for Education for the Medicine Institute at Cleveland Clinic and Shreya Trivedi MD, GIM Fellow at NYU School of Medicine. Topics include: how to run work rounds, preparing your team for attendings rounds, how to teach on the fly, finding your leadership style, and what to read during residency. This is the first of three episodes that we’re co-developing with the American College of Physicians for their Resident Transitions Series.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Shreya Trivedi MD
Graphics and Show Notes by: Hannah R Abrams
Hosts: Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP; Shreya Trivedi MD
Guest: Abby Spencer MD, MS, FACP

Sponsor

The Resident Transitions Series is brought to you by The American College of Physicians with support from its Council of Resident/Fellow Members. Visit acponline.org/resident to learn more about the benefits of Resident/Fellow Membership and join our proud internal medicine community today!

Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic...even when you inject your own thumb?! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Full show notes available at https://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 thecurbsiders@gmail.com.

Credits

Writer (interview, show notes & CME questions) and cover art: Emi Okamoto MD
Infographic by: Emi Okamoto MD
Hosts: Matthew Watto MD, FACP; Stuart Brigham MD
Editors: Matthew Watto MD, FACP
Guest: Olajumoke Fadugba MD
Special thanks to Sarah Phoebe Roberts MPH for booking!

HFpEF (heart failure with preserved ejection fraction) with master cardiologist, Dr Clyde Yancy MD, Chief of Cardiology and Professor of Medicine (Cardiology) and Medical Social Sciences, Northwestern, Feinberg School of Medicine. Topics include: pathophysiology, HFpEF phenotypes, how to interpret a borderline ejection fraction, evidence based therapies, diuretics, and future directions (pulmonary artery monitors, intra-atrial shunts, ARNI compounds), and more!

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 thecurbsiders@gmail.com.

Credits

Written and produced by: Paul Williams MD, FACP; Sarah Phoebe Roberts MPH
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD
Show Notes: Justin Berk MD, MPH, MBA; and Beth Garbitelli MS1
Infographics: Beth Garbitelli MS1
Editor: Matthew Watto MD, FACP
Guest: Clyde Yancy MD, MSc, MACC, FAHA, MACP, FHFSA

Recap of random pearls and highlights from SGIM19 Day 2 including: methadone and buprenorphine, perioperative buprenorphine, medical cannabis, HPV vaccination, young adult medicine, academic promotions, long term sequelae of childhood kidney disease, stage 1 hypertension, some great free resources in addiction medicine, and more! Special thanks to the Society for General Internal Medicine for their hospitality.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Nora Taranto MS4 (soon to be MD!)
Edited by: Matthew Watto MD

Recap of random pearls and highlights from SGIM19 Day 1 including: Kidney stone treatment (roller coasters, sex and tamsulosin), aspirin, SGLT2 inhibitors to reduce kidney events, oral antibiotics for endocarditis, preferred physician attire, sexual harassment, writing letters of recommendation, triple therapy for COPD, DAPT for stroke, and more! Special thanks to the Society for General Internal Medicine for their hospitality.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Abby Spencer MD, MS, Nora Taranto MS4 (soon to be MD!)
Edited by: Matthew Watto MD
Special Guest: Abby Spencer MD, MS

Identify and treat the most common causes of hip pain in the outpatient setting with returning guest, Dr Ted Parks. A large majority of hip pain in the office setting will be due to one of three conditions (hip osteoarthritis, greater trochanteric pain syndrome, and lumbo-sacral back pain). Learn to easily identify these conditions, how to initiate conservative treatment, and more about hip replacements. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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 thecurbsiders@gmail.com.

Credits Written and produced by: Molly Heublein MD, Nora Taranto MS4 CME questions by: Molly Heublein MD, Nora Taranto MS4 Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein MD Edited by: Matthew Watto MD, Emi Okamoto MD Guest Presenter: Ted Parks MD

Electric cars, virtual reality, nanotechnology, and now… telemedicine? We chat with Dr. Ana María López MD, FACP about the future of telehealth, how to implement it in your practice, and the challenges you might face in doing so. Dr. López is immediate past president of the American College of Physicians (ACP) as well as Vice Chair of Medical Oncology and Chief of New Jersey Division Sidney Kimmel Cancer Center of Thomas Jefferson University. Her main areas of professional interest and expertise include cancer prevention and equity, integrative oncology, implementation of innovations in health care including telemedicine, and women’s health. We learned immensely from our talk with her and we hope you will, too! ACP members can claim free CME & MOC credit at https://acponline.org/curbsiders. Download Dr Brigham’s telehealth cheat sheet as a PDF at http://thecurbsiders.com/podcast.

Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and produced by: Hannah Abrams, Stuart Brigham MD Cohosts: Matt Watto MD, Stuart Brigham MD, Paul Williams MD, Hannah Abrams Guest: Ana María López MD

This week we narrow in on the enlarging prostate and decipher the common issue of benign prostatic hyperplasia with Adam C. Reese MD, Associate Professor of Urology at the Lewis Katz School of Medicine at Temple University and Chief of Urologic Oncology at Temple University Hospital. Learn how to interpret the symptom profile for patients presenting with common urinary issues, what to feel for in the digital rectal exam, how to treat BPH, and when to refer.

ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

See you at SGIM 2019!

Find us in our red Curbsider’s t-shirts handing out Curbsiders and Kashlak stickers/patches at SGIM 2019 in Washington DC! We’ll be recording full length shows and daily recaps!

Credits

Written and produced by: Paul Williams MD

Hosts: Paul Williams MD, Matthew Watto MD

Images and infographics: Elena Gibson, Beth Garbitelli

Show Notes: Elena Gibson, Beth Garbitelli

Edited by: Matthew Watto MD, Chris Chiu MD

Guest: Adam Reese MD

Time Stamps

00:00 SGIM announcement

00:30 Disclaimer, intro and guest bio

03:20 Guest one liner, book recommendation, favorite failure and surgical M&M

10:56 Case of benign prostatic hyperplasia, defining terms and obstructive/voiding versus storage/irritative symptoms

16:11 IPSS score and evaluating symptoms

22:10 Digital rectal exam. Will this give any useful information?

26:55 Taking a history about BPH and some lifestyle modifications

29:20 Lab studies for urinary tract symptoms and interpreting PSA and free PSA

36:20 Initial therapy for BPH and managing patient expectations, alpha blocker side effects

39:25 Choice of agent and monitoring symptoms on therapy

42:25 Nonpharmacologic management of bladder complaints

45:10 Who and when to refer to urology

47:33 Counseling about use of 5 alpha reductase inhibitors, their side effects and is there a risk for high grade cancer?

52:35 Phosphodiesterase inhibitors for BPH symptoms

53:50 Urethral milking. NOT prostate milking

54:55 Desmopressin for nocturia

56:20 Take home points

59:03 Prostate volume and PSA

61:10 Outro

Full show notes available at http://thecurbsiders.com/episode-list.

Random pearls from ACP #IM2019 Day 3. The Curbsiders crew is joined by Dr Alan Dow of VCU to discuss highlights from ACP’s Internal Medicine Meeting in Philadelphia including: sleep deprivation, the glymphatics system, inflammatory back pain, heart failure, dermatology pearls, a new definition for pulmonary hypertension and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

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 thecurbsiders@gmail.com.

#IM2019 Curbsiders Crew

Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
Director of operations: Chris Chiu MD
Twitter: Cyrus Askin MD, Hannah Abrams MS3
Instagram: Beth Garbitelli MS1
Facebook: Chris Chiu MD
Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4
Marketing: Jen Watto

Random pearls from ACP #IM2019 Day 2. The Curbsiders crew is joined by Dr Alia Chisty (future PD at Penn State Hershey) at ACP’s Internal Medicine Meeting in Philadelphia to discuss highlights including: baloxavir a new drug for flu, stress testing and coronary CT angiography pearls, celiac disease, H. pylori pearls, and a bunch of random pearls from infectious diseases, palliative care and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

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 thecurbsiders@gmail.com.

#IM2019 Curbsiders Crew

Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
Director of operations: Chris Chiu MD
Twitter: Cyrus Askin MD, Hannah Abrams MS3
Instagram: Beth Garbitelli MS1
Facebook: Chris Chiu MD
Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4
Marketing: Jen Watto

Random pearls from #IM2019 Day 1. The Curbsiders crew is joined by Kashlak’s POCUS Chief, Renee Dversdal MD at ACP’s Internal Medicine Meeting in Philadelphia to discuss day 1 highlights inlcuding: POCUS, lyme rash, back pain, syphilis, women’s health, patient handoffs, the flip-flop fungal sign a ton of cardiology pearls (ie diuretics, paracentesis for CHF, beta blockers, LBBB, when is it safe to have intercourse after an MI?) and more!

"Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders

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 thecurbsiders@gmail.com.

#IM2019 Curbsiders Crew

Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD
Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD
Director of operations: Chris Chiu MD
Twitter: Cyrus Askin MD, Hannah Abrams MS3
Instagram: Beth Garbitelli MS1
Facebook: Chris Chiu MD
Off-air producer: Sarah Phoebe Roberts MPH
Marketing: Jen Watto

Join(t) us in learning about rheumatoid arthritis care for the internist with Robert McLean MD, rheumatologist, Associate Clinical Professor at Yale, and President Elect of the ACP! We discuss the complexity of rheumatoid arthritis, how to differentiate from other arthritic conditions, and how to have a patient-centered framework for the evaluation and treatment of affected patients. ACP members can claim CME-MOC credit at on ACP's site..

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 thecurbsiders@gmail.com.

Credits

Writer (Interview & CME questions): Cyrus Askin MD

Show Notes and Infographic by: Elena Gibson MS4

Hosts: Matthew Watto MD, Stuart Brigham MD

Editors: Matthew Watto MD, Emi Okamoto MD

Guest: Robert McLean MD

Pain management in patients with chronic kidney disease (CKD) often goes something like this: NSAIDs are evil, acetaminophen hardly works, opioids are dangerous, and all the rest (tramadol, gabapentinoids, antidepressants) are messy. But, we tackle the complexities of pain management in patients with chronic kidney disease in this special @NephMadness 2019 episode that, on a scale of 1-10, will leave you feeling very relieved in addressing pain.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Earn CME and read about each region in NephMadness 2019 at AJKD blog.

Credits

Written and produced by: Justin Berk MD, Samantha Gelfand MD
NephMadness Pun Contest produced by: Hannah R Abrams MS3
Cover art by: Kate Grant MBChB, Dip GUMed
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto MD, Emi Okamoto MD
Guests: Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

Does your sympathetic nervous system get activated when you notice acute kidney injury in patients with cirrhosis? Ever wonder how to really diagnose hepatorenal syndrome (HRS)? Think you have the bile-acid-stones to start diuretics on a patient requiring pressor support for kidney failure? You have come to the right place! Listen to @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) tackle the complex pathophysiology and treatment of hepatorenal syndrome in this NephMadness 2019 special episode!

Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Earn CME and read about each region at AJKD blog.

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Justin Berk MD, Nora Taranto MS4

Infographic by: Alex M @nephroguy

Hosts: Matthew Watto MD

Edited by: Matthew Watto MD, Emi Okamoto MD

Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Some precocious policy wonks take a deep dive into the evolving trends and future directions for our primary care workforce. Experts, Dr. Fatima Syed and Dr. Deep Shah return to school us on Physician Supply and Demand, the Access Gap, role of NPs and PAs, Retail Clinics, and Managed Care Clinics. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Catch up on our previous discussions with Dr. Syed and Dr. Shah: Episode #62: Pod Save Health Care: The Curbsiders Foray into health policy and Episode #120 Health Policy, Patients, Payments, Paperwork for more context. We also did an overview of health care policy essentials with Dr. Sue Bornstein in Episode #64: Stuff You Should Know About Health Policy

Full show notes available at http://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Fatima Syed MD, MSc; Deep Shah MD, MSc

CME questions by: Chris Chiu MD, Beth Garbitelli MS1,

Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD,

Images and infographics: Beth Garbitelli MS1

Edited by: Matthew Watto MD, Chris Chiu MD

Guest: Fatima Syed MD, MSc, Deep Shah MD, MSc

Inpatient hypertension is tricky. What’s the best way to answer those overnight nursing phone calls for elevated blood pressures? What’s the role of treating hypertensive urgency in the hospital? Plus, Our nephrology experts put a new issue on the generalist’s radar: are ACE-inhibitors dangerous to give (or hold) during an operation? This NephMadness 2019 episode, features special guests Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) to better understand the role of anti-hypertensives in the inpatient setting and keep your blood pressure down on those overnight calls.

Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders!

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Justin Berk MD, MPH, MBA; Pascale Khairallah MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto, MD

Guest: Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

The battle over the superiority of resuscitation fluids is coming to a boil. Enter the Fluid Wars. Are Lactated Ringers superior to normal saline? Will LR increase a patient’s lactate? What about albumin? The Curbsiders quench the thirst for knowledge by turning to masters Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) for guidance in this special @NephMadness episode that will get your feet wet with the complicated world of fluid resuscitation.

Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders!

Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday.

Credits

Written and produced by: Justin Berk MD, Pascale Khairallah MD

NephMadness Pun Contest produced by: Hannah R Abrams MS3

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD

Cirrhosis TIPS for the decompensated cirrhotic & acute on chronic liver failure from expert hepatologist and keto-practitioner Scott Matherly MD, @liverprof and chief hepatologist at @KashlakHospital. We walk through acute management of variceal bleeds, when to suspect SBP in decompensated cirrhosis (all the time, it turns out), how much fluid to remove in paracentesis, and some definitions about what decompensated cirrhosis and acute on chronic liver failure really mean.

Take our pretest on cirrhosis!

Full show notes available at http://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4, Matthew Watto MD

Pretest by: Cyrus Askin MD

Hosts: Matthew Watto MD, Paul Williams MD,

Images and infographics: Hannah Abrams MS3

Edited by: Matthew Watto MD

Guest: Scott Matherly MD

Sponsor

Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Listen to our first ever discussion with @kidney_boy, Joel Topf MD. It’s a classic episode with a fresh intro as we prepare for @NephMadness 2019 with our friends from Twitter and @AJKDonline

Dominate leg cramps, diuretic therapy, and resistant hypertension with tips from @kidney_boy, Joel Topf MD @kidney_boy, Chief of Nephrology Kashlak Memorial Hospital, co-creator @NephMadness. We start with basic renal physiology and build up to the treatment of resistant hypertension.

Corrections: Dr Topf posted the following corrections on his blog PBfluids.com 3/22/2017 “I enjoyed the experience immensely, but in an hour of talking off the cuff I made some embarrassing mistakes:

In describing water reabsorption I said it occured in the cortical collecting duct rather than the medullary collecting duct.

In describing my cure for cramps I tell the story of Gitelman’s and say it is like congenital loop diuretics rather than congenital thiazide diuretics

I mucked up the story about the MRFIT story and how it allowed a head to head comparison of HCTZ and chlorthalidone. I really oversold what happened.”

Full show notes at https://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written by: Matthew Watto MD

Produced by: Stuart Brigham MD and Matthew Watto MD

Cohosts: Stuart Brigham MD and Matthew Watto MD

Guest: Joel Topf MD

Sponsor Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 201

Demystify chronic wound care management with high yield pearls from wound care expert Dr. Elizabeth (Foy) White-Chu. She takes us through a simple yet thorough approach to manage complex chronic wounds. We discuss everything from selecting a dressing, to pain management, and what kind of water should you really use when cleansing a wound. Answers to all of these burning questions and more await you, so don’t waste anymore time! Press play and let Dr. White-Chu take you on a journey through evidence based practices for the management of chronic wounds. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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 thecurbsiders@gmail.com.

Credits

Written by: Carolyn Chan MD

CME questions by: Justin Berk MD

Produced by: Matthew Watto MD

Hosts: Matthew Watto MD, Paul Williams MD, Carolyn Chan MD

Guest: Dr. Elizabeth (Foy) White-Chu

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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 thecurbsiders@gmail.com.

Credits

Written and produced by: Molly Heublein, MD

CME questions by: Molly Heublein, MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein, MD

Edited by: Matthew Watto MD

Guest Presenter: Patrick Finley, PharmD BCPP

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Join us at the forefront as we talk genetic testing in primary care with Dr Dallas Read, esteemed gynecologist and the only medical geneticist at Tufts Medical Center. Topics include: what internists should be comfortable testing for in the office, how and when to refer for screening, what tests to order, how to interpret test results, how to handle direct-to-consumer results or requests, and so much more! For years, the medical community has been talking about the immense potential for genetic testing to guide diagnosis and treatment. But has it realized its full potential? The answer to that seems to be a resounding no at the moment--but the days of ubiquitous genetic testing to identify disease and disease risk may not be so far off after all. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

Coming to you from the Curbsiders, we hope you’ll enjoy this latest episode about the genes you wear, whether you want to put them on or not. Genes, Genes, they’re (maybe) good for your heart. But do patients want to know if they are, or if they aren’t?

Full show notes available at http://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4
CME questions by: Nora Taranto MS4
Hosts: Stuart Brigham MD, Matthew Watto MD, Nora Taranto MS4
Images and infographics: Beth Garbitelli MS1
Edited by: Matthew Watto MD, Chris Chiu MD
Guest: Dr. Dallas Reed MD

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich, Assistant Professor of Medicine and co-director of the Inflammatory Bowel Disease Program at Temple University Hospital. In this episode, we learn about the initial work-up, general principles of management, and important primary care considerations for Crohn’s disease and ulcerative colitis (ie endoscopic surveillance, immunizations, bone health/osteoporosis, and more!).

Full show notes available at https://thecurbsiders.com/episode-list. 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 thecurbsiders@gmail.com.

Credits

Written and produced by: Paul Williams MD
Edited by: Matthew Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Adam Ehrlich MD

Sponsor

Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis.

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 thecurbsiders@gmail.com.

Sponsor

Join us at ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there!

Credits

Written and produced by: Matthew Watto, MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Infographic: Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Dr Joel Topf MD

Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sickle Cell Center for Adults at Johns Hopkins joins!

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 thecurbsiders@gmail.com.

Sponsor ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA. We'll see you there!

Credits Written (including CME questions) and produced by: Justin Berk MD, Martha Brucato MD PhD, Beth Garbitelli MS1

Hosts: Paul Williams MD, Justin Berk MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Sophie Lanzkron MD MHS

Time Stamps * 00:00 Announcements, intro * 02:30 A quick refresher on hemoglobinopathy * 03:45 Guest bio * 05:03 Guest one-liner, movie recommendation, career advice, picks of the week * 10:53 ACP Internal Medicine Meeting 2019 (ad read) * 12:33 Clinical case; defining sickle cell; pathophysiology * 16:23 Different types of hemoglobinopathy genotypes and phenotypes * 20:20 Preventive care for sickle cell disease * 22:56 Taking a history at the initial visit in patient with sickle disease * 26:40 Life expectancy in SCD * 28:30 Hydroxyurea * 30:40 Chronic red blood cell transfusion therapy; complications; monitoring * 37:07 Silent cerebral infarcts and mild cognitive impairment in SCD * 40:10 Chronic pain management; opioid use disorder in sickle cell disease * 46:00 Acute pain crisis management; PCAs vs bolus therapy * 54:08 Reticulocyte count in sickle cell disease * 55:40 Itching, opioids and naloxone? * 58:10 Red blood cell transfusion threshold in sickle cell disease (anemia) * 60:03 Acute fever in SCD * 61:48 Acute chest syndrome * 66:45 Transition from pediatrics to adult medicine in sickle cell * 68:00 Incentive spirometry to prevent acute chest syndrome * 68:45 Take home points * 70:00 Outro

Optimize perioperative risk and dominate perioperative medicine. Topics include surgical risk calculators, preoperative labs, stress testing, use of BNP and troponins, postoperative MI, cardiac and pulmonary risk stratification, and more! We’re joined by perioperative medicine expert, Avital O’Glasser MD, Associate Professor of Medicine at Oregon Health & Science University and Assistant Program Director for Scholarship and Social Media. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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 thecurbsiders@gmail.com.

Credits Written and produced by: Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Matthew Watto MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Avital O’Glasser MD

Time Stamps * 00:00 Disclaimer, intro and guest bio * 04:20 Guest one-liner, book and movie recommendations, career advice * 11:20 ACP Internal Medicine Meeting 2019 details * 14:02 Patient with coronary artery calcifications going for elective hip surgery and wants "clearance" * 20:50 Functional capacity * 25:00 Preoperative stress testing and coronary revascularization * 31:55 Canadian guidelines, BNP and troponin testing * 36:30 The METS trial and predicting perioperative cardiac events and mortality * 40:44 Preoperative testing (labs, imaging, urine studies) * 50:24 Choosing your perioperative cardiac and surgical risk calculator (RCRI, MICA, ACS-NSQIP) * 59:50 Communicating risk to patient and their surgeon * 61:30 Pulmonary risk assessment and complications * 70:35 Perioperative use of opioids * 75:30 Who needs an echocardiogram prior to surgery? * 79:00 Canceling a patient's surgery * 82:55 Take home points * 83:45 Outro

“Urinary tract infections” (UTIs) are overdiagnosed. Antibiotics are overprescribed. UTIs are inappropriately blamed for geriatric syndromes (eg delirium) despite little supporting evidence. Our guest, Tom Finucane MD, Emeritus Professor of Medicine at Johns Hopkins makes us question everything. Topics: How can we diagnose “UTI”? Who needs treatment? Do urinary tract symptoms matter? Does malodorous urine correlate with infection? Who’s at risk for pyelonephritis and sepsis? Don’t miss this paradigm changing episode. And stop using the term “urinary tract infection” unless it’s prefaced by air quotes!

Sponsor: Join ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there!

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 thecurbsiders@gmail.com.

Credits

Written and produced by: Matthew Watto MD

Hosts: Matthew Watto MD, Paul Williams MD

Edited by: Matthew Watto MD

Guest: Tom Finucane MD, MACP

Time Stamps * 00:00 Disclaimer, intro and guest bio * 04:00 Guest one liner, book recommendation, career advice * 08:22 The “medical ignorome” * 13:40 ACP Internal Medicine Meeting 2019 details * 16:20 Case of malodorous urine; Urine is NOT sterile; Defining terms * 25:14 Stop saying UTI unless using air quotes * 28:34 What symptoms or history matters in evaluation for “UTI”? And can we predict who will become systemically ill? * 34:47 Voltaire and when treatment is warranted for “urinary tract infections” * 37:15 Delirium in an older adult with possible UTI, how to work it up, and who warrants antibiotics * 51:55 Take home points * 53:38 Outro

Take a trip down memory lane with top clinical pearls and favorite moments from The Curbsiders in 2018.

Welcome to our 2018 Recap Extravaganza! Since last year, the Curbsiders team has grown substantially and the podcast has undergone several exciting developments. These include our collaboration with ACP that allows us to provide CME and MOC credit for select episodes, our new partnership with Human Dx as featured in our Kashlak Morning Reports, and the launch of our Women in Medicine series. For our 2017 year-end show, we had listeners vote for their favorite episodes from the past year. This year, we're changing it up a bit and have invited our Curbsider colleagues to share their picks for pearliest pearls and most illuminating episodes of 2018. We hope you’ll enjoy hearing the team’s highlights, and we’ll be back in 2019 with fresh content. Note: No CME-MOC credit for this episode, but stay tuned in 2019 for eligible episodes.

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 thecurbsiders@gmail.com.

Credits Written and produced by: Chris Chiu MD and Sarah Phoebe Roberts, MPH

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Chris Chiu MD

Edited by: Chris Chiu MD

Time Stamps * 00:00 Disclaimer, Intro * 06:39 Clinical Reasoning Pearls * 12:35 Pulmonary Hypertension Pearls * 15:52 Women In Medicine Pearls * 20:40 Iron Deficiency Pearls * 24:52 Tick-Borne Illness Pearls * 28:00 STI Pearls * 31:00 Physical Exam Pearls * 32:51 “Things we do for no reason” Pearls * 36:16 Host Picks * 42:38 Paul Wraps-up the Year * 43:38 Outro and Curbsider Team sign-offs

Master the diagnosis and management of Genital Herpes with tips from expert, Robert Bettiker MD . Topics include: the natural history, diagnosis & screening guidelines for genital herpes; cold sores; options for primary and recurrent episodes including prophylaxis; and consideration of specific populations including symptomatic and asymptomatic patients, pregnancy and MSM (men who have sex with men). We also discuss partner notification and treatment.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Kate Grant MBChB DipGUMed, Matthew Watto MD

Images by: Kate Grant MBChB DipGUMed

Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD

Guest: Robert Bettiker MD

Time Stamps * 00:00 Disclaimer, guest bio, intro * 01:50 Guest one liner, memorable teaching moment and a few failures * 10:50 Intro to herpes * 12:25 Case 1: Genital herpes in a married man * 15:42 Overview of testing options * 18:50 Marital counseling in Herpes * 22:18 Prophylaxis in serodiscordant partners and asymptomatic shedding * 25:08 Case 2: Severe outbreak of genital herpes in a young woman * 31:50 Case 3: Young male with recent exposure to herpes * 38:45 Herpes 1 (HSV1) versus Herpes 2 (HSV2) * 44:12 Case 4: Herpes in pregnancy * 50:45 Do topical agents work for herpes * 55:05 Take home points * 56:10 Outro * 57:52 Stuart shares a PUN!

Sharpen your diagnostic schema for abdominal pain and eosinophilia with this mystery case http://hdx.org/Rxg (click link to follow along). Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx attempts to solve this challenging case with the help of The Curbsiders.

Use this link http://hdx.org/Rxg to follow along with the case on the Human Dx app and check out more Global Morning Report cases.

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 thecurbsiders@gmail.com.

Credits Written and produced by: Hannah R Abrams

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes.

Time Stamps * 00:00 Announcement, disclaimer, intro, guest bio * 01:20 Picks of the week * 05:42 How Reza fell in love with clinical reasoning * 08:58 Case of 50 yo male with abdominal pain * 21:14 Some unexpected findings * 43:00 Case conclusion/answer, cognitive autopsy and Reza’s take home points * 48:35 Outro

Hone your diagnostic skills with this mystery case of cough and dyspnea http://hdx.org/pdp (click link to follow along). The Curbsiders deconstruct the case and discuss their diagnostic schemas for these common problems with the help of returning guest, Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx.

Use this link http://hdx.org/pdp to follow along with the case on the Human Dx app or website and check out more Global Morning Report cases.

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 thecurbsiders@gmail.com.

Credits Written and produced by: Hannah R Abrams

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes.

Time Stamps * 00:00 Announcement, disclaimer, intro, guest bio * 03:13 When and how to practice clinical reasoning * 05:53 Creating diagnostic schemas and Clinical Problem Solvers Podcast * 09:40 A bit on Human Dx and the show format * 12:00 Case of a 40 yo male with a cough * 23:22 Some insights from Reza on “signal versus noise” * 37:10 Case conclusion/answer, cognitive autopsy and Reza’s take home points * 45:36 Outro

Create a successful partnership and career withs tips from Wonder Woman, Sue Hingle MD of ACP.

Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro tip: stop worrying about what others think!). Dr. Hingle is Professor in the Department of Internal Medicine and Vice Chair of Education and Faculty Development and Associate Internal Medicine Residency Program Director at Southern Illinois University. She is also the Immediate Past Chair of the Board of Regents of the American College of Physicians (ACP). She has served at the ACP in a variety of ways, including as a member of the ACP Women’s Task Force. Her clinical expertise is in women’s health, health promotion, and disease prevention. Enjoy the episode!

ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4, Shreya Trivedi MD, Leah Witt MD, Sarah P. Roberts MPH.

CME Questions by: Shreya Trivedi MD

Editors: Matthew Watto MD and Chris Chiu MD

Hosts: Shreya Trivedi MD, Paul Williams MD, Leah Witt MD

Guest: Susan Hingle MD

Time Stamps

00:00 Disclaimer, intro and guest bio
02:52 Guest one liner, WIM Moment of awakening, advice for her younger self
07:45 Picks of the week
10:30 Physician with family and caregiver responsibility; How to plan for personal and professional goals
18:20 What to look for in a partner, how to work with them to achieve work life fit, and non-traditional roles
28:35 Advice on family planning
31:40 Residency programs and life events
32:55 Should you go part-time?
39:43 Work life balance? Or work life fit? And some examples/tips for success
49:54 Take home points
50:45 Outro

Dr Elisabeth Poorman MD joins us to discuss the natural history of physician depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line. The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat).

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available either via email, private msg on FB or twitter (@DrPoorman), or any of us on twitter. We are happy to talk and see that you get support you need.

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 thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4, Shreya Trivedi MD

Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Elisabeth Poorman, MD

Aspirin’ to figure out if ASA can help prevent a heart attack? Interpreting all the new trials doesn’t have to cause chest pain! Join Dr. Ambarish Pandey from UT Southwestern as he helps The Curbsiders ASCEND the mountains of the latest studies to ARRIVE at some well-informed conclusions on the role of aspirin in primary prevention for cardiac events. The team also discusses secondary prevention, aspirin and dual (or triple) antiplatelet therapy, and whether it’s okay to stop giving aspirin to older adults without known CAD (Spoiler alert: it’s okay). ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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 thecurbsiders@gmail.com.

Credits Written and produced by: Justin Berk MD, Matthew Watto MD

CME questions by: Justin Berk MD

Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD

Edited by: Matthew Watto MD and Chris Chiu MD

Guest: Dr. Ambarish Pandey MD

Time Stamps * 00:00 Disclaimer, intro and guest bio * 04:15 Guest one liner, book recommendation, career and research advice * 11:07 Case of aspirin for primary prevention, aspirin’s public persona, and nocebo effects of statins * 21:40 ARRIVE and ASCEND trials * 28:14 Aspree trial * 32:38 Coronary artery calcium; aspirin use for secondary prevention * 37:42 Dual antiplatelet therapy and the DAPT score * 41:25 Should we continue aspirin when a patient also needs a DOAC? * 46:14 Should we continue DAPT in a patient who needs a DOAC (or warfarin)? * 49:40 Deprescribing aspirin for primary prevention in older adults? * 50:51 Closing remarks * 52:33 Outro

Tony Breu MD joins us for some hotcakes, and “cold cakes” including: how aspirin and zodiac sign affect the treatment of acute MI, a recent study on how exercise is probably still good for you, the recently announced REDUCE-IT trial, and the evidence (or lack thereof) for the treatment of hypertensive urgency. Welcome to another edition of Hotcakes and Hot Takes, where we discuss the most interesting articles and news that we have been reading. Special guest is the prolific Dr. Tony Breu (@tony_breu) who is an Assistant Professor of Medicine at Harvard Medical School and a Hospitalist and Director of Internal Medicine Resident Education at the VA Boston Healthcare System. He is known for his series on "Things We Do For No Reason” as well as his thought-provoking “Tweetorials” online. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST on day of release).

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD

CME Questions: Christopher Chiu MD

Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD

Guest Presenter and Content Planning: Anthony Breu MD

Editor: Christopher Chiu MD

Cover-Art: Christopher Chiu MD

Time stamps * 00:00 Disclaimer, intro, guest bio * 05:53 Discussion on Tweetorials * 08:00 Cold Cake: ISIS-2 and the treatment of acute MI with aspirin * 14:04 ISIS-2 and zodiac subgroup analysis * 16:19 What is the relationship between cardiorespiratory fitness on mortality? * 24:40 Discussion of the REDUCE-IT study * 33:00 Cold Cake: VA Cooperative study and the evidence for treating essential hypertension * 36:42 TWDFNR and the treatment of hypertensive urgency * 46:36 Wrap-up and outro

Master the diagnosis and management of common STIs (sexually transmitted infections) with tips from expert, Dana Dunne MD, Associate Professor of Medicine in Infectious Diseases at Yale. Topics include: the stages and many presentations of syphilis, syphilis treatment and counseling, the natural history, diagnosis, and screening guidelines for gonorrhea and chlamydia, treatment options in the age of growing resistance, and a discussion of partner notification and treatment.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and produced by: Bryan Brown MD

Hosts: Bryan Brown MD, Paul Williams MD, Matthew Watto MD

Guest: Dana Dunne MD

Special thanks to Kate Grant MBChB, Dip GUMed for her contribution of knowledge and artwork.

Time Stamps * 00:00 Announcement, disclaimer, intro and guest bio * 04:29 Guest onliner, book recommendation, advice for learners/teacher, and picks of the week * 11:00 A case of syphilis, clinical manifestations and discussion of the stages * 26:05 Testing for syphilis * 39:05 Mandatory reporting and partner tracing * 42:40 Counseling patients with syphilis * 44:44 A case of gonorrhea and chlamydia, clinical manifestations, screening guidelines * 52:30 How to counsel patients to obtain samples from urethra, rectum, vagina, oropharynx; Mycoplasma genitalium * 59:40 CDC treatment guidelines, Super gonorrhea, test of cure, and treatment of partners * 72:35 Take home points * 74:30 Outro

Practice solving diagnostic puzzles with The Curbsiders and Internist / Diagnostician, Reza Manesh MD, Assistant Program Director for Clinical Reasoning of the Osler Medical Training Program at Johns Hopkins! Solve along with us at these links: Case 1 http://hdx.org/I2B and Case 2 http://hdx.org/uM2. Topics include: clinical reasoning terminology, how to use cases to practice diagnostic reasoning, how to build a diagnostic schema, and how to conduct your own cognitive autopsy.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and Produced by: Hannah Abrams

Hosts: Hannah Abrams, Paul Williams MD, Stuart Brigham MD, Matthew Watto MD

Guest: Reza Manesh MD

Special thanks to: Doctors Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing cases

Time Stamps * 00:00 Disclaimer, intro and guest bio * 04:02 Guest one liner, book recommendation, favorite failure, advice for learners * 11:27 Human Dx Project and Global Morning Report * 15:35 Diagnostic terminology * 21:25 Case #1, Reza solves * 33:40 Diagnostic autopsy and teaching points for case #1 * 38:00 Case #2, The Curbsiders solve * 57:30 Diagnostic autopsy and teaching points for case #2 * 61:33 Take home points and a plug * 64:30 Outro

Check out this audio treasure map to find the hidden curriculum and learn how it can change your practice. Learn how positive teaching spans not just the classroom or bedside but, how we simply talk about patients. Sanjay Desai MD, coauthor of ACP’s Position Paper on Hidden Curriculum and Internal Medicine program director at Johns Hopkins guides us through several cases that illustrate how our institutional norms can shape the practice of medicine...for better or worse. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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 thecurbsiders@gmail.com.

Credits Written and produced by: Sanjay Desai MD; Justin Berk MD, MPH, MBA; Matthew Watto MD

CME questions by: Justin Berk MD

Editors: Chris Chiu MD & Matthew Watto MD

Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD

Guest: Sanjay Desai MD

Time Stamps * 00:00 Disclaimer, Intro and guest bio * 04:00 Guest one liner, book recommendations, career advice * 10:50 Intro to the hidden curriculum and ACP’s three recommendations * 22:00 Case #1: A patient with schizophrenia * 32:10 Case #2: The iPatient * 38:07 Case #3: Attending forgets to wash their hands * 41:10 Case #4: A dying patient’s primary care doctor saves the day * 46:26 Case #5: A case of violating duty hours * 60:10 Take home points * 62:00 Outro

Shoulder pain made simple. Develop your confidence and skills with tips from sports medicine specialist Dr. Carlin Senter MD. We discuss her simplified approach to the basic shoulder exam, including when and how to do special tests, high yield exam maneuvers, when to refer shoulder pain patients to orthopedic surgery, and who can be managed conservatively.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and produced by: Molly Heublein MD and Nora Taranto MS4

Editor: Matthew Watto MD

Hosts: Molly Heublein, MD, Paul Williams MD, Matthew Watto MD

Guest: Carlin Senter, MD

Time Stamps * 00:00 Disclaimer, intro, and guest bio * 03:15 Guest one liner, book recommendation, career advice, and some picks of the week * 13:20 Clinical case of shoulder pain; helpful historical features * 18:54 Differentiating referred pain from c-spine pathology from shoulder pathology * 21:00 A framework for shoulder pain, HIP-ROT, and using ROM to generate a differential * 27:40 Frozen shoulder aka adhesive capsulitis * 31:57 Glenohumeral joint arthritis * 33:52 Rotator cuff disease * 40:53 Specific testing for rotator cuff tears * 51:45 Impingement syndrome versus bursitis * 56:25 Counseling patient with shoulder pain or injury * 59:03 Steroid injections, topical therapy, and AC joint arthritis * 65:18 When to refer to surgery and some take home points

The sleep apnea episode that won’t put you to sleep. Become a sleep apnea guru with incredible insights from Barbara Phillips MD, MSPH, FCCP an expert in pulmonary medicine, critical care and sleep medicine who is also a past president of CHEST! We discuss high-yield topics in the world of obstructive sleep apnea including: home sleep studies vs in-lab polysomnography, the importance of oxygen saturation (the T90 and ODI) when interpreting sleep study results, tricks to improve CPAP adherence, and alternatives therapies for obstructive sleep apnea. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and produced by: Cyrus Askin MD

CME questions by: Cyrus Askin MD

Editor: Chris Chiu MD & Matthew Watto MD

Hosts: Cyrus Askin MD & Matthew Watto MD

Guest: Barbara Phillips, MD

Cover-Art & Infographic - Beth Garbitelli, MS1

Time Stamps * 00:00 Disclaimer, intro, guest bio * 03:00 Guest one liner, book recommendation, advice for trainees * 08:10 Clinical case of sleep apnea, some basic stats, and key predictors of sleep apnea * 12:38 Barriers to diagnosis and treatment of OSA * 15:23 Discussion of T90, hypoxemia and sleep fragmentation * 17:05 How to read a sleep study report * 21:55 Home sleep apnea testing * 24:15 What are the consequences of sleep apnea * 28:30 What is the efficacy of cpap for lowering blood pressure and mortality * 31:45 Counseling a patient who is new to cpap * 33:45 Choice of mask * 40:10 Do alternatives to cpap work? e.g. surgery, mandibular advancement devices * 44:17 Modafinil and z-drugs * 47:15 Driver’s license issues in sleep apnea * 48:35 Future of sleep medicine and take home points

We delve into advanced management of headaches, including novel therapies, migraines with aura, migraines in complicated patients, and headaches of short duration with Dr. Rebecca Burch, a headache medicine specialist at the John R. Graham Headache Center at Brigham and Women’s Hospital.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and produced by: Paul Williams MD

Edited by: Matthew Watto MD

Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD

Guest: Rebecca Burch MD

Time Stamps * 00:00 Disclaimer, intro and guest bio * 03:28 Guest one-liner, movie and podcast recommendations, favorite failure and picks of the week from The Curbsiders * 10:38 Clinical case of migraines; diagnosis and classification * 14:12 Does medication overuse headache exist? * 16:16 Chronic daily headache; Conversion from episodic to chronic and vice versa * 21:43 Approaches to medication overuse headache * 25:54 Case 2: migraine with aura and other types of migraine (retinal, hemiplegic, etc.) * 32:09 Pathophysiology of migraine; how triptans work; How should aura effect management? * 38:44 Migraine cocktails * 41:15 Comorbid mood disorders; Use of psych meds and triptans * 45:08 Migraines and oral contraceptives * 48:42 Botulinum toxin and new CGRP therapies * 53:36 What does success look like in migraine therapy? * 55:32 Nonpharmacologic management * 60:45 Case 3: headaches of short duration * 66:36 Headache red flags; Imaging for headaches; pathophysiology of high and low pressure headaches * 72:00 Idiopathic intracranial hypertension * 75:25 Take home points * 77:00 Outro

HIV care for the internist with author and HIV expert, Michael Saag MD, Professor of Infectious Diseases at University of Alabama and founder of the 1917 Clinic. We discuss the specifics of screening & diagnostic testing in HIV, monitoring CD4 counts and viral loads, first line antiretroviral therapy, harm reduction, and how to provide excellent HIV care in your primary care clinic.

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 thecurbsiders@gmail.com.

Credits Written & Produced by: Elena Gibson MS4, Justin Berk MD MBA MPH

Artwork by: Elena Gibson MS4

Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MBA MPH

Editor: Matthew Watto MD

Guest: Michael Saag MD

Time Stamps * 00:00 Disclaimer, intro, and guest bio * 04:35 Getting to know our guest, a movie recommendation, and words of wisdom * 08:48 Clinical case, HIV screening, in-depth discussion of HIV testing & diagnosis * 15:56 New diagnosis of HIV, counseling after diagnosis, confirmation, follow-up testing, the second visit * 24:20 Treatment - what to start and when; some basic comments on therapy * 30:05 Primary care after diagnosis, vaccines, cancer screening, cardiovascular disease prevention * 34:35 Monitoring CD4 counts and viral load; interpreting CD4 count; time course of response for CD4 and viral load * 42:02 Harm reduction counseling; addressing medication non-adherence * 47:40 PCP prophylaxis * 49:43 The 1917 Clinic, Ryan White Clinics, and linking patients to care * 53:10 Take home points * 55:40 Plugs * 57:45 Will a cure or vaccine for HIV emerge? * 59:16 Outro

Join us in this roundtable discussion of patients before paperwork, administrative burden, the new CMS payment model proposal, and a bit on health insurance with cohost, Fatima Syed MD MSc and guest, Deep Shah MD MSc. Doctors Syed and Shah are both early career physicians with masters degrees in comparative social policy from Oxford University and are active members of the American College of Physicians. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits Written and produced by: Fatima Syed MD MSc and Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Fatima Syed MD MSc, Matthew Watto MD

Guest: Deep Shah MD MSc

Time Stamps * 00:00 Disclaimer, intro, and guest bios * 02:18 Guest one liners, book recommendations, picks of the week * 11:00 Administrative burden * 16:00 Will the documentation problem get better? Suggestions for improvement * 25:11 Why do CMS rules spread to the private insurance sector? * 29:30 What innovations might reduce administrative burden? * 32:40 The Affordable Care Act, health insurance, price transparency * 40:20 Take home points * 43:20 Outro

Nutrition pearls from integrative cardiologist, Steven Devries MD, Associate Professor of Medicine, Northwestern Feinberg School of Medicine, Executive Director of The Gaples Institute. Clinicians receive little formal nutritional training in medical school and residency. It’s time to fill that gap! We discuss the strength of the literature supporting dietary interventions for cardiovascular health and review practical tips to help patients achieve healthy eating patterns. Patients need to hear from us that nutrition matters!

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 thecurbsiders@gmail.com.

Credits

Written & Produced by: Molly Heublein MD

Hosts: Matthew Watto MD, Paul Williams MD, Molly Heublein MD

Guest: Stephen Devries MD

Editor: Matthew Watto MD

Special thanks to Elena Gibson MS4 for writing our show notes

Houston, we have a female sexual dysfunction problem. Female sexual problems, which can affect women of all ages, are underdiagnosed and undertreated--in part because clinicians are not the best at asking about sex in primary care visits. In the course of this episode, learn about how to have that sex talk you’ve (maybe) been avoiding, what to ask when working up sexual problems in women, and find the words to talk to patients about sex. Today, we’re lucky to have the female sexual health expert of experts, Dr. Stacy Lindau, MD, MA, Professor of Obstetrics and Gynecology and Medicine-Geriatrics at the University of Chicago Medicine, on the show to teach us the best “sex talk” language, the differential for female sexual problems, and explore therapies. Sadly, there’s no sildenafil-like magic bullet, but a multidisciplinary team can make real impact on female sexual problems. Don’t forget to check out http://womanlab.org

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Nora Taranto MS4

Hosts: Leah Witt MD and Matthew Watto MD

Infographic: Leah Witt MD

Editor: Matthew Watto MD

Guest: Stacy Lindau MD

Time Stamps

00:00 Disclaimer
00:35 Intro and guest bio
03:30 Guest one liner, book recommendations, favorite failure, career advice and picks of the week
12:57 Clinical Case of female sexual dysfunction and some definitions
15:08 Are sexual problems a normal part of aging?; How to take a sexual history; Etiology of sexual dysfunction; “Diagnostic sex”; Red flags
27:54 Medications that contribute to sexual dysfunction
31:00 Labs
34:45 Treatment: pelvic PT, medications, counseling, flibanserin, herbal supplements
49:05 Screening for female sexual problems
51:58 Take home points; WomanLab.org
55:19 Outro

Summary Conquer Clostridium difficile (Clostridioides difficile) with this “spore-tacular” episode featuring infectious diseases expert, Dr. Curtis Donskey, Professor at Case Western Reserve University and clinician at the Louis Stokes VA Hospital. We discuss the updates in the 2017 IDSA C. difficile guidelines plus a bunch of random pearls. If you have ever laid awake at night wondering how many pills are needed for a fecal transplant, then this is the episode for you! We discuss why metronidazole was dropped as the first line therapy for Clostridium difficile infection (CDI) along with other hot topics such as two-step testing, loperamide use, which antibiotics are the least likely to cause CDI, and more. Do not miss this episode!

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 thecurbsiders@gmail.com.

Credits

Written by: Carolyn Chan MD

Produced by: Matthew Watto MD

Hosts: Carolyn Chan MD, Matthew Watto MD, Paul Williams MD

Editor: Matthew Watto MD

Guest: Curtis Donskey, MD

Geriatric psychiatry returns. We tackle sleep problems and behavioral disturbances in patients with dementia with returning guest, and Geriatric Psychiatrist Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: pharmacologic and nonpharmacologic management of insomnia; treating agitation and irritability; medical management of psychotic symptoms and paranoia; ethical concerns about the treatment of challenging behaviors in dementia; and the shortage of geriatricians and geriatric psychiatrists.

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 thecurbsiders@gmail.com.

Credits Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps * 00:00 Intro and guest bio * 01:55 Case of sleep disturbance in a patient with dementia; medications for sleep disturbances; nonpharmacologic strategies for sleep * 11:32 Irritability and agitation versus paranoia, or psychotic symptoms; benzodiazepines in older adults * 15:40 Antipsychotic medications, the black box warning and ethical concerns * 23:50 Geriatricians, geriatric psychiatrists in short supply; Behavioral interventions * 28:16 Outro

Tags psychiatry, psych, geri, geriatrics, dementia, paranoia, psychosis, sleep, insomnia, agitation, antipsychotics, atypical, black, box, warning, adverse, zolpidem, benzodiazepine, side, effects, therapy, mirtazapine, gabapentin, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Summary Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and titrate medications, and how long to continue therapy. Stay tuned for part two of our discussion with Dr Popeo on managing sleep and behavioral problems in older adult patients with dementia.

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 thecurbsiders@gmail.com.

Credits Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD

Artwork by: Kate Grant MD

Hosts: Jordana Kozupsky NP, Matthew Watto MD

Editor: Matthew Watto MD

Guest: Dennis Popeo, MD

Time Stamps

00:00 A question for you, the listeners
01:12 Disclaimer, intro and guest bio
05:00 Getting to know our guest, recommendations for reading, and career advice
14:13 Case of geriatric depression; effective history taking; recognizing associated symptoms; depression scales
19:03 Suicide in older adults; firearm safety
24:26 Choice of therapy; Pharmacologic agents; Counseling patients and managing expectations; Dose titration and tracking symptoms
34:41 Augmenting therapy versus cross-titration to another agent; When is it okay to stop an antidepressant
40:50 Take home points
44:40 Outro

Tags: psychiatry, psych, geri, geriatrics, depression, mdd, sleep, insomnia, appetite, agitation, suicide, SSRIs, side, effects, therapy, diagnosis, serotonin, mirtazapine, bupropion, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Kick up the quality of your care with tips and tactics from Caitlin Clancy MD, coauthor of ACP’s High Value Care Curriculum. We learn to define quality and value in healthcare; the most common barriers to high value care; use of probability and likelihood ratios to boost clinical reasoning and combat diagnostic uncertainty; some useful tools to estimate cost; sources of healthcare waste; and some general pearls on how the healthcare system works...or doesn’t. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

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 thecurbsiders@gmail.com.

Credits:

Written & Produced by: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Caitlin Clancy MD

Time Stamps * 00:00 Disclaimer, intro and guest bio * 03:50 Guest one-liner, some discussion on non traditional paths, and picks of the week * 12:10 Case 1: Defining value, cost, quality; sources of healthcare waste; and how to avoid the waste of daily labs * 23:00 Case 2: An uninsured patient who needs major surgery; costs for uninsured versus insured patients * 28:35 Do insured patients have better outcomes? * 31:15 How to determine cost and “fair market price” * 36:29 Case 3: Clinical case of suspected heart failure * 45:45 Case 4: Clinical case of patient requesting antibiotics; barriers to high value care and how to overcome them * 57:05 Outro

Tags: high, value, care, quality, cost, diagnostic, uncertainty, likelihood, ratio, testing, treatment, consumer, acp, college, american, insured, uninsured, bill, charge, reimbursement,

Master the management of gout with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. Topics include: how to initiate and titrate urate lowering therapy, guidelines controversy over uric acid targets, colchicine & NSAIDS for anti-inflammatory prophylaxis, uricosuric agents, febuxostat, HLA B5801, use of uric acid levels in the acute setting and more random gout facts.

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 thecurbsiders@gmail.com.

Credits:

Written and produced by: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Tuhina Neogi MD, PhD

Time Stamps

00:00 Intro and guest bio
01:30 Allopurinol initiation and titration
07:10 Uricosuric therapy
09:10 Controversy over uric acid targets for gout
17:40 Parachutes and randomized controlled trials
19:15 Colchicine or NSAIDS for prophylaxis
23:20 Who needs febuxostat?
26:20 When to refer for gout, HLA B5801, and checking uric acid levels in the acute setting
33:29 Take home points
36:15 Outro

Tags: allopurinol, uric, urate, acid, level, therapy, management, gout, flare, crystal, arthritis, titration, probenecid, febuxostat, target, acr, acp, guidelines, nsaids, colchicine, hla b5801, septic, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Crystalize your knowledge of gout and stop flares in their tracks with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. On this first of two gout episodes we learn to diagnose gout with or without arthrocentesis, how to treat flares, and how to counsel patients about gout, which apparently involves fire fighting and bathtubs. Don’t miss next week’s episode on urate lowering therapy, gout guidelines controversy, and answers to your gout questions from social media.

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 thecurbsiders@gmail.com.

Credits:

Written and produced by: Matthew Watto MD
Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD
Guest: Tuhina Neogi MD, PhD

Time Stamps

00:00 Disclaimer, intro
01:40 Guest bio
03:20 Guest one liner, music recommendations, advice for researchers, and some comments on failure
09:15 Clinical diagnosis of gout
12:15 Is taking a diet history useful?
14:30 Classification criteria for gout
17:35 MSK ultrasound and Physical exam findings in gout
21:06 Arthrocentesis and MSU crystals
24:45 A recap of how to make the diagnosis of gout
26:50 The bathtub analogy and how to counsel a patient with a new diagnosis of gout
30:55 Pathophysiology of gout
34:55 Treatment for acute gout flares (steroids, colchicine, NSAIDS. And topical NSAIDS?)
45:30 Outro

Tags: gout, crystal, colchicine, steroids, nsaids, joint, flare, acute, chronic, urate, uric, acid, arthritis, acr, exam, diagnosis, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Dr. Neda Frayha (@nedafrayha) of Primary Care RAP (Hippo Education) joins us this month for our thoughts and analysis of some recent (and not so recent) journal articles that interested us this month. Our articles spanned topics that include at cancer survival among patients pursuing treatment with complementary medicine, the effect of body weight on effectiveness of preventive aspirin dosing, strategies to promote physician leadership, respiratory symptoms in those with marijuana use and MRSA risk among patients with penicillin allergies. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

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

Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

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

Time stamps:

00:00 Disclaimer, intro, guest bio
05:05 Do patients using complementary medicine for cancer therapy have worse outcomes?
13:11 Does low dose aspirin work for primary prevention of major adverse cardiac events?
19:16 Do physicians make better leaders?
24:55 Does marijuana cause respiratory symptoms?
30:40 Does penicillin allergy confer increased risk for C Diff and MRSA infection?
38:40 Wrap-up and outro

Tags: aspirin, cardiac risk, mortality, cancer, complementary, alternative, conventional, therapy, marijuana, cannabis, respiratory, symptoms, leader,

Get schooled on driver’s safety for older adults by expert, Alice Pomidor MD, Professor of Geriatrics at Florida State University. Whether or not older adults can continue to drive is a huge problem faced by for primary care clinicians, and will remain one until driverless cars become ubiquitous. Topics covered include: how to take a driving history, red flags, physical exam, cognitive exam, and vision assessment for driver’s safety, resources, when to refer, alternate means of transportation, and the legal repercussions of reporting...or not reporting.

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 thecurbsiders@gmail.com.

Credits:

Written and produced by: Matthew Watto MD and Elizabeth Garbitelli MD Candidate 2022
Editor: Matthew Watto MD
Cover Image by: Kate Grant MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Alice Pomidor MD

Time Stamps

00:00 Disclaimer
00:35 Intro and guest bio
03:10 Guest onliner, book recommendations, and career advice
10:43 Clinical case, and the 5 Rs of clinicians responsibility
19:15 Taking a history from older adult drivers
26:28 The clinical exam for driver’s safety (cognition, vision, and MSK tests)
37:24 How can we avoid patient anger towards clinician and family members?
41:10 When and where to refer for driving evaluation
47:00 Alternative transportation
52:00 What to do if someone refuses or forgets to stop driving
59:45 Reporting requirements and legal ramifications
69:15 Take home points
72:00 Outro

Tags: driving, elderly, geriatrics, dementia, treatment, prevention, cognition, seniors, drivers, safety, crash, motor, vehicle, car, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Things We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound and urine electrolytes in acute kidney injury (AKI), folate deficiency and anemia work-up, prealbumin and malnutrition, blood transfusions, shellfish and contrast allergies, monitoring after switch from IV or oral antibiotics, and “against medical advice” discharges.

Don't forget to check out Clinicwiki.orga free, online resource for teaching ambulatory medicine.

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 thecurbsiders@gmail.com.

Credits:

Written and produced by: Justin Berk MD, MPH, MBA
Editor: Matthew Watto, MD
Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD, FACP
Guest: Lenny Feldman MD, FACP

Time Stamps

00:00 Announcements
00:38 Disclaimer, intro, and guest bio
03:53 Guest one liner, some recommendations, and advice
08:35 Defining high value care and things we do for no reason (TWDFNR)
12:40 Why do clinicians order useless testing?
14:58 Urine electrolytes for acute kidney injury
20:30 Renal ultrasound for acute kidney injury
25:54 Stop ordering folate for anemia workup
31:47 How many units should I transfuse?
34:40 Prealbumin and albumin for malnourishment.
43:24 Iodine, shellfish and contrast allergy
50:28 Patient leaving against medical advice
56:45 Switching from IV to oral antibiotics
63:27 Dr Feldman’s plugs
65:36 Outro

Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine.

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 thecurbsiders@gmail.com.

Credits:

Written by: Christopher Chiu MD and Renee Dversdal MD
Produced and CME questions by: Christopher Chiu MD
Edited by: Matthew “Mike” Watto MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Christopher Chiu MD
Guest Expert: Renee Dversdal MD

Tags: point-of-care, acp, impocus, ultrasound, bedside, POCUS, CLUE, exam, training, lifestyle, management, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

“Women in medicine, be bold.” Medical World, powerful women are here to stay. Dr. Vineet (Vinny) Arora, Professor of Medicine at University of Chicago, an exemplary Woman in Medicine and Leadership, shares snippets of her own story, valuable career advice to folks at all levels of training, and fascinating data about the gender disparities that exist in training, promotion, and pay. We hope you’ll learn from this episode, whether you have faced or anticipate facing these struggles as a Woman in Medicine or as a member of another marginalized group, or whether you’re an ally and want to learn more about the issue.

Women are entering medical school now more than ever, and are learning to provide the best possible care to patients (didn’t you see that patients of female physicians have significantly lower mortality rates than patients of male physicians? (Tsugawa et al., 2016)). The modern medical woman wants to teach, mentor, and lead--and be fairly evaluated, and promoted. That’s where We In Medicine (both women and men) have some work to do. Because gender disparities (and other disparities hinging on identity) do exist.

N.b. This episode is our inaugural in what we hope will be a Women in Medicine series for the Curbsiders. We have many more topics with which we’d like to engage, from career trajectory to imposter syndrome to sexual harassment to balancing career and personal lives (as inequity is not only at work (Khullar. Being a Doctor is Hard. It’s Harder for Women. NYT 2017)), to conversations about race, gender, and LGBTQ identity in medicine. We’re passionate, at The Curbsiders, about all these topics, and we want to dive deep into how to make Medicine a more welcoming and ceiling-less place for all. We can’t wait to bring this series to you, not to mention to bring some more fabulous female experts on air.

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 thecurbsiders@gmail.com.

Credits:

Written and produced by: Leah Witt MD, Shreya P. Trivedi MD, Nora Taranto AB, Sarah Phoebe Roberts MPH, Molly Heublein MD, Beth Garbitelli, Hannah R Abrams,
Images by: Beth Garbitelli and Hannah Abrams
Editor: Matthew Watto MD
Hosts: Leah Witt MD, Shreya P. Trivedi MD, Matthew Watto MD
Guest: Vineet Arora MD

Short on time but hungry for knowledge? Curbsiders’ Journal Club gives you the speedy article analysis you crave. We provide brief summaries of recent research and news items in the field of internal medicine, so you can save time and stay on top of the literature. On this episode, we were joined by Kashlak Memorial’s very own Chair of Medicine, Dr. Robert Centor AKA @medrants on Twitter or “Uncle Bob” to the Curbsider Crew. This month’s topics include: estimating atherosclerotic cardiovascular disease risk, whether CT pulmonary angiography (CTPA) effectively rules out pulmonary embolism, discharging low risk patients with pulmonary embolism from the ED, metformin and risk of acidosis in patients with CKD, treating opioid use disorder after a nonfatal overdose, Canagliflozin and renal protection in type 2 diabetes, screening for diabetes among patients below age 40, and the association between nose-picking and staphylococcus. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date).

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!

Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Credits:

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

Lyme disease and tick-borne illness deconstructed by Infectious Diseases expert, Paul E. Sax MD, of episode 78 fame. Oh, Summer Nights. The time for romance between Danny Zuko and good girl Sandy, the time to sit in the backyard around the bonfire, the time for sunset hikes in the woods and mountains…..and don’t forget, it’s also the time for those pesky woodland ticks who’ll go for a ride on you and maybe suck your blood (gross!). Dr. Sax takes us through the essentials of tick-borne illness, with a focus on Lyme Disease: diagnosing it, treating it, identifying possible co-infections, and managing Post-Lyme residual symptoms.

Our (And Dr. Sax’s) Disclaimer about this episode, and the shownotes: Tick-borne illness is a very serious problem in public health in the US, but management is quite a controversial issue. We’ve done our best with this episode to stay as evidence-based as possible. Moreover, given the limited time we have on air, we have tried to focus on what we think is most clinically relevant.

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 thecurbsiders@gmail.com.

Credits:

Written by: Shreya P. Trivedi MD, Nora Taranto AB
Produced by: Shreya P. Trivedi MD, Nora Taranto AB
Editor: Matthew Watto MD
Images by: Hannah R. Abrams
Hosts: Shreya P. Trivedi MD, Matthew Watto MD, Paul Williams MD
Guest: Paul E. Sax MD

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 thecurbsiders@gmail.com.

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

Expert diagnostician, Dr. Gurpreet Dhaliwal, again joins The Curbsiders to dive deeper into the topic of clinical expertise. Topics include, and are mainly focused on, Dr. Dhaliwal’s “training regimen:” feedback, simulation, quizzing, learning from consultants, and how to read the medical literature as a clinician. While we found this episode to be incredibly useful (and entertaining to record), don’t let our bias sway your opinion! In fact, just listen to the episode and listen for practical advise on how to improve your own clinical acumen.

Dr Brigham’s comment: Be forewarned, much of what we talk about is seemingly common sense, but, upon listening to the episode many times, I realize that we have, over time, overly complicated the fundamentals of expertise. I’m just as guilty as the next physician.

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 thecurbsiders@gmail.com.

Credits

Written and produced by: Stuart Brigham MD
Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD
Guest: Gurpreet Dhaliwal MD
Images by: Beth Garbitelli
Edited by: Matthew Watto MD

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.

Credits:

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 thecurbsiders@gmail.com.

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

Cirrhosis. Finally. Take your liver game to the next level with tips from @liverprof, Scott Matherly MD, Assistant Professor of Medicine at Virginia Commonwealth University. Topics include: exam findings in cirrhosis, interpreting liver function tests, incidental cirrhosis on imaging, fatty liver disease, steatohepatitis, hep c, shear wave elastography, screening for varices and hepatocellular carcinoma, pathophysiology, and lifestyle measures for initial management. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date).

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 thecurbsiders@gmail.com.

Credits:

Written by: Cyrus Askin MD
CME questions by: Cyrus Askin MD
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

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 thecurbsiders@gmail.com.

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

Knee pain is easy with practical tips from Orthopedist, medical educator, car-builder, and inventor extraordinaire Dr. Ted Parks. He teaches us the four buckets of knee pain, how to perform a 30-second knee exam, choose a knee brace, order x-rays, and the red flags to look for in a history and physical that should have you shouting for your closest neighborhood orthopedic surgeon. This episode is brought to you in partnership with the American College of Physicians. ACP members can claim free CME-MOC credit at acponline.org/curbsiders. Check out our video of the Parks-Approved 30-second knee exam!

Credits:

Written by: Nora Taranto BA, Matthew Watto MD
Produced by: Chris Chiu MD and Nora Taranto BA
Edited by: Matthew Watto MD.
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD.
Guest: Ted Parks MD.

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 thecurbsiders@gmail.com.

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 thecurbsiders@gmail.com. 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

Get schooled on hemoglobin a1c targets in type 2 diabetes mellitus by American College of Physicians guidelines coauthor, Devan Kansagara MD MCR, Associate Professor of Medicine, Oregon Health Sciences University. We summarize outcomes from the landmark diabetes trials (ACCORD, ADVANCE, VADT, UKPDS 33 & 34), how a1c targets effect microvascular and macrovascular events, estimating life expectancy, and how to personalize diabetes control for your patients. We’re proud to announce our new partnership with the ACP to provide free CME credit and MOC points on select episodes of The Curbsiders. ACP members can visit acponline.org to redeem free CME/MOC credit.

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

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 thecurbsiders@gmail.com.

Credits:

Written, produced, and edited by: Matthew Watto MD.
Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD.
Guest: Devan Kansagara MD, MCR

Time Stamps

00:00 Announcement
00:48 Disclaimer and intro
03:11 Getting to know our guest: one liner, book recommendation, mentorship
06:50 How and why did ACP write their guidance statement on diabetes, A1C targets
09:18 Landmark trials in type 2 diabetes
11:36 Does tight control prevent micro or macrovascular complications
13:20 Trials of newer agents like SGLT2i, GLP-1 and DPP4i
14:33 How do ACP’s guidelines differ from other published guidelines
17:20 Quick recap of landmark trial findings
22:24 Personalizing glycemic control
24:30 Controversy over an A1C goal of 7-8%
28:05 Clinical inertia
30:26 Legacy effect and metabolic memory
34:00 Deintensifying therapy
38:29 Life expectancy and comorbid conditions
43:15 Performance measures in diabetes
44:42 Take-home points
46:30 The Curbsiders recap and give some closing remarks
49:13 Outro

Separate the wheat from the chaff when it comes to food allergy, food intolerance, and celiac disease. Featuring renowned gastroenterologist and current president of the American Gastroenterological Association, Dr. Sheila Crowe MD FRCPC FACP FACG AGAF, we discuss how to differentiate a food allergy from an intolerance, what diagnostic testing is appropriate, and why fructans might be the real culprit in patients with ‘gluten sensitivity’.

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 thecurbsiders@gmail.com.

Credits: * Written by: Sarah P. Roberts, MPH * Guest: Sheila Crowe, MD * Hosts: Matthew Watto, MD; Stuart Brigham, MD; Paul Williams, MD * Producers: Sarah P. Roberts, MPH and Chris Chiu, MD * Editor: Matthew Watto, MD

Time Stamps:

00:00 Disclaimer
03:35 Getting to know our guest, book recs, and career advice
10:35 Clinical case
11:40 Defining allergy, intolerance
14:05 Food intolerance and FODMAP
18:02 Taking a history in patient with potential food allergy vs intolerance
21:34 Dermatitis herpetiformis, gluten ataxia, and extraintestinal manifestations of celiac
26:12 Diagnosing celiac disease
30:53 Next steps if celiac testing is negative; lactose, fructose intolerance, IBS
33:48 Non-celiac gluten sensitivity (NCGS)
37:48 Study of NCGS
40:41 Olmesartan and drug-induced enteropathy
43:38 Dieticians, dietary recs, elimination diets
48:10 “Voodoo” testing
52:36 Counseling patients on diet
54:35 Take home points
55:50 Outro

A random serving of knowledge food for your brain hole with returning guest, Dr. Alan Dow, Professor of Internal Medicine at Virginia Commonwealth University School of Medicine. Our final live recap show from ACP 2018 covering: human microbiome, copper deficiency, POTS syndrome, substances of abuse, drugs for delirium and how to be more like Leonardo Da Vinci. Please let us know what you liked, didn’t like and how we can make the show better.

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

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

Time stamps:

00:00 Disclaimer
01:30 Guest bio
03:19 Getting to know our guest, podcast, and book recommendations
08:55 Human microbiome
11:05 A case of anemia and neuropathy
13:30 Physiology and treatment of POTS syndrome
17:00 Novel substances of abuse
20:17 Benzodiazepines for delirium
24:00 Leonardo Da Vinci versus the modern physician
27:18 Outro

Tags: microbiome, transplant, bupropion, gabapentin, pregabalin, copper, POTS, substance, use, disorder, leonardo, da, vinci, acp, journal, article, literature, news, media, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

A fast moving recap of hot topics and clinical pearls live from Internal Medicine’s largest national conference, ACP 2018 in New Orleans! Dr. Nina Mingioni, Clinical Associate Professor and director of Undergraduate Medical Education in Internal Medicine at Thomas Jefferson University Hospital serves up some knowledge food for our brain holes. Topics: the athlete as a patient, sports physicals, food as medicine, medical marijuana (cannabis), and more! Listeners, please let us know what you liked, didn’t like and how we could make this better. YouTube video of this episode available here: ACP 2018 Recap with Nina Mingioni.

You can 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 thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Time stamps:

00:00 Music and disclaimer
02:48 Getting to know our guest
06:07 The athlete as a patient
10:20 Relative energy deficiency in sports
12:00 Drug interactions
15:51 Food as medicine
21:56 Marijuana
30:24 Outro

Credits:

Written by: Nina Mingioni MD, Hannah Abrams. Producer/videographer: Chris Chiu MD. Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD. Editor: Matthew Watto MD

Tags: food, microbiome, marijuana, athlete, ekg, ecg, physical, sports, training, energy, relative, deficiency, cannabinoid, entourage, effect, cannabidiol, thc, cannabis, acp, 2018, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz

Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD

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 thecurbsiders@gmail.com.

Time Stamps

5:10 - Start of Interview / Introduction
10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology
16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”)
23:30 - Other ways to risk-stratify (Other CT findings, clot burden)
28:45 - What does a low-risk patient look like?
30:35 - When to consider treatment modalities other than general anticoagulation
35:12 - Anticoagulation treatment options
36:38 - Next step intensive interventions after anticoagulation
42:00 - Evidence behind catheter-directed lysis
44:05 - IVC Filter discussion
47:22 - Discharge criteria for PE
50:00 - Incidental PEs
52:40 - Interdisciplinary PERT Team

Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

Random clinical pearls from day 2 of ACP 2018 live in New Orleans. Topics include: Perioperative medicine, DOACs, anticoagulation, reversal agents, ACP statements on hidden curriculum, physician well being and burnout, modeling behavior, dermatology pearls, rashes, venous stasis ulcers, pentoxifylline, biotin and Grave's disease, dermatology pearls, Stuart's tips on sports doping, and how chocolate milk improves recovery time. Doctors Chris Chiu and Chris Thrash join us to discuss their favorite teaching points from today's sessions.

Cochrane Review on Venous Ulcers https://bit.ly/2JdQAMu

Joinour 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 thecurbsiders@gmail.com.

The Curbsiders share random clinical pearls from day 1 of ACP 2018 live in New Orleans. Topics covered include: breast density and cancer risk, patients before paperwork, diverticulitis, social determinants of health, migraine prevention, PrEP and thunderclap headaches. Doctors Chris Chiu and Chris Thrash join us on air to discuss their favorite teaching points from today's sessions.

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 thecurbsiders@gmail.com.

Keep up-to-date with this fast moving discussion of recent journal articles and thought-provoking headlines in medicine. Welcome to the first-ever Curbsiders journal club covering landmark articles from March to April 2018, plus rapid fire hot takes and the unveiling of our new hotcake based rating system. Please let us know what you liked, didn’t like and how we can make this better next month. Topics: Resident work hours, saline versus balanced IV fluids, barber shops and hypertension, coffee causes cancer, Twitter based medicine, clonidine versus spironolactone, opioids versus nonopioids and aromatherapy for nausea!

Written by: Chris J Chiu, MD; Producer: Sarah Phoebe Roberts MPH; Edited by: Matthew Watto, MD

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 thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.

Time stamps:

00:00 Disclaimer
00:35 Host intros, featuring special guest and correspondent Chris Chiu, MD
01:30 Introducing a new Curbsiders segment!
03:20 First article: Duty-Hour Flexibility Trial
08:55 Second article: Trial of Blood-Pressure Reduction in Black Barbershops
14:27 Third article: SALT-ED Trial
20:00 Hot takes—intro
20:36 Hot take #1, Dr. Milton Packer and Twitter-based medicine
24:07 Hot take #2, Coffee and cancer risk
26:24 Hot take #3 Aromatherapy for nausea
28:10 Hot take #4 Opiates vs. non-opiates for chronic pain
29:00 Hot take #5, Surgeon general’s statement on naloxone
29:46 Hot take #6, Spironolactone vs clonidine for resistant HTN
31:54 Outro & announcements

Become an expert diagnostician like Dr Gurpreet Dhaliwal, Professor of Medicine at UCSF. Join us for this deep dive into clinical reasoning and how doctors think! Topics include: how to improve your own clinical reasoning and diagnostic skills, how to teach these skills, and the initial steps to building your own expertise/mastery in clinical medicine! Dr. Osler once admonished his students to build experiential wisdom and follow-up with their clinical cases (clear cases, doubtful cases, and mistakes), but to do so, one must “...learn to play the game fair, no self-deception, no shrinking from the truth; mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.” Test yo’ self: Take our quiz here

Written and produced by: Stuart Brigham, MD; Images by Hannah Abrams; Edited by: Matthew Watto, MD

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 thecurbsiders@gmail.com.

Revolutionize your approach to the red eye in pr-eye-mary care! Dr. Glaucomflecken (of GomerBlog/Twitter--fame) teaches us to recognize and manage common eye complaints. You’ll develop an approach to diagnosing and treating your patient with the dreaded red eye. We answer: What presentations should have us running down the hallway for that prized ophtho consult? What on earth does glaucomflecken stand for? Which eye drops are best? What is an eye dentist? Plus, answers to your twitter questions, and so much more! By the end of this episode, you’ll be sure to say “Eye Understand!” Self Assessment Questions: Take the ophtho self-assessment!

Donate at FirstDescents.org to support young cancer survivors like Dr. Glaucomflecken!

Written and produced by: Nora Taranto AB, Carolyn Chan MD; Original art by: Bryan Brown, MD. Edited by: Matthew Watto, MD.

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 thecurbsiders@gmail.com.

Dominate acid-base disturbances with the wisdom of @kidney_boy aka Joel Topf, MD, Chief of Nephrology at Kashlak Memorial Hospital. Master his 5 key steps for interpreting acid-base disorders and decode any ABG, VBG, and BMP to find the primary disorder, and any other disorders tucked away in the ABG! Plus: Henderson-Hasselbach and pH simplified; the anion gap, should your correct it?; choice of IV fluid; osmolar gaps, methanol, ethylene glycol, isopropyl alcohol; and how metabolic disorders are like a boy band. Be sure to follow along the Dr. Topf’s brilliant acid-base powerpoint.

Written and produced by Joel Topf MD, Shreya Trivedi MD, Xavi Jimenez MD; Images by Hannah Abrams; Edited by Matthew Watto MD

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 thecurbsiders@gmail.com.

Want to look cool like a toxicology consultant, sipping coffee on rounds? Ever check a patient for armpit sweat? Learn the secrets of tox from the titans of toxicology podcasting, The Dantastic Mr. Tox & Howard (AKA Dr. Dan Rusyniak and Dr. Howard Greller), as they loquaciously dish on all things tox. Topics include: how to approach the patient with an unknown overdose, are toxidromes clinically useful, clues on physical exam, is GI decontamination still recommended, and why they hate bupropion and tramadol. We recommend cautious ingestion of fluids while listening because this was a seriously funny episode. Try our Self Assessment Questions Toxicology 101 Quiz.

Written and produced by: Christopher Chiu, MD; Graphics by: Beth Garbitelli; Edited by: Matthew Watto, MD

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 thecurbsiders@gmail.com.

Take a deep breath and tune in to this week’s episode full of COPD diagnosis and management pearls, with expert Dr. Denitza Blagev, a pulmonologist, intensivist, and Medical Director for Quality, Speciality Care at Intermountain Healthcare in Utah with a particular interest in physician wellness and issues related to women in medicine. We cover: history taking, interpreting PFTs, patient counseling, inhalers and medications, exacerbations, antibiotics, steroids, and who needs BIPAP...so basically everything you ever wanted to know about chronic obstructive pulmonary disease. Take our self assessment here.

Sponsored by @nephmadness. Registration opens March 15th at AJKDblog.org

Written and produced by: Leah Witt, MD, Cyrus Askin, MD. Edited by Matthew Watto, MD

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 thecurbsiders@gmail.com.

Contraception simplified with clinical pearls from reproductive health and family planning experts, Dr Angeline Ti, and Dr Moira Rashid. We cover it all including: the menstrual cycle, mechanism of action for various methods of birth control, hormonal versus nonhormonal contraceptives (e.g. intrauterine devices, patches, pills, rings, implants), patient counseling, and lots of resources to make your job easier. Women’s health correspondent, Dr Molly Heublein returns as cohost. Take our self-assessment quiz!

Written by: Molly Heublein, MD, Beth Garbitelli and Sarah Roberts, MPH. Edited by Matt Watto, MD

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

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Abolish anemia, and iron deficiency w/tips on IV iron therapy from real life iron man, Michael Auerbach, MD, FACP, Clinical Professor of Medicine Georgetown University School of Medicine. Topics include oral versus IV iron therapy, safety of IV iron, ferritin cutoffs, and how to diagnosis/ treat iron deficiency in patients with chronic inflammation, chronic kidney disease, pregnancy, heart failure, and more! Take our Self Assessment Test Here.

Images by Beth Garbitelli; Written and produced by Justin Berk, MD and Matthew Watto, MD.

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 thecurbsiders@gmail.com.

Get the latest on valvular heart disease: TAVR vs SAVR, choice of valve type, rheumatic heart disease, antibiotic prophylaxis for endocarditis, who needs an echocardiogram, and anticoagulation goals with tips from cardiologist, Dr Eli Gelfand, Section Chief of General Cardiology at Beth Israel Deaconess Medical Center in Boston and an Assistant Professor of Medicine at Harvard Medical School. Correspondent Dr Kate Grant joins us for this conversation w/Dr Gelfand about his common sense approach to the evaluation and management of valvular heart disease.

Written by Kate Grate, MD and Matthew Watto, MD.

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 thecurbsiders@gmail.com.

Challenge your beliefs on the efficacy of pervasive treatments used in dementia with expert Eric Widera, MD, Professor and clinician-educator in the Division of Geriatrics at the University of California-San Francisco. We explore the use of cholinesterase inhibitors, antipsychotics for behavior disturbances, feeding tubes, medications and supplements used for weight gain (inspired by Choosing Wisely and the American Geriatric Society’s “Ten Things Clinicians and Patients Should Question”). Plus, we introduce our new correspondent, Dr. Leah Witt, Geriatrics Fellow at UCSF.

Written and produced by: Jordana Kozupsky, NP, Nora Taranto, MS3, Leah Witt, MD; Edited by: Matthew Watto, MD

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 thecurbsiders@gmail.com.

Self Assessment Questions Take the quiz now!

Time Stamps

00:00 Disclaimer
00:37 Guys set up the show
02:00 Dr Widera’s bio
03:15 Getting to know our guests
13:10 Picks of the week
16:40 Clinical case: new diagnosis of dementia
17:40 Discussing dementia with patients and caregivers
23:42 Cholinesterase inhibitors
27:35 Stopping cholinesterase inhibitors
33:35 Follow up to therapy
36:05 Dealing with behavior disturbances
39:15 DICE approach
44:17 Risks of antipsychotic medications
48:00 Use of benzos or sedative hypnotics
49:45 Melatonin for delirium or sleep
52:00 Mirtazapine
53:54 Clinical case: patient with dementia not eating
54:40 Feeding tubes
59:40 Dysphagia and NPO orders
62:04 Misinformation on malnutrition and girth creep
65:10 Thickened liquid challenge
70:25 Appetite stimulants
72:38 Megestrol
73:54 Take home points from Dr Widera
79:17 Outro

Tags: dementia, donepezil, cholinesterase, inhibitor, antipsychotic, behavior, disturbance, agitation, benzodiazepine, supplement, feeding, tube, restraints, thickened, liquids, geriatric, choosing, wisely, american, society, ags, assistant, care, doct

Boost treatment efficacy and amplify the “doctor as a placebo” phenomenon with tips from placebo expert (and ex-cartoonist), Mark W. Green, MD, Director of Headache/Pain Medicine and Professor of Neurology, Anesthesiology, and Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai. Topics include: What’s that pesky sugar pill actually doing to us? Why do we get a boost from taking medicines that have no active compounds within them? How does placebo work? How can it be leveraged? What does it mean for study design/blinding? And what’s with its pesky dark twin--the nocebo effect? “Enjoy this, our only placebo-controlled episode” (Thanks, Stuart!).

Written and produced by: Molly Heublein, MD and Nora Taranto MS3; Edited by: Matthew Watto, MD

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

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Pulmonary hypertension deconstructed with clinical pearls from cardiologist, John J. Ryan MD, FACC, FAHA, director of University of Utah Pulmonary Hypertension Center. We discuss classification, diagnosis/differentiation, initial workup, additional testing, echo findings, how to counsel patients with pulmonary hypertension, and why cows never get ankle edema!

Written and produced by: Jordana Kozupsky, NP and Matthew Watto, MD

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

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Time Stamps:

00:00 Disclaimer
01:30 Introducing our new Correspondent Jordy
03:05 Listener feedback
04:40 Guest bio
06:25 Getting to know Dr Ryan
09:33 Picks of the week
15:20 Clinical case
16:35 How to explain pulmonary hypertension to a patient
18:12 Groupings of pulmonary HTN
21:20 Taking a history. Ask these questions.
23:30 Physical exam
25:45 Initial testing
27:40 Overnight pulse oximetry
29:00 Echo findings in pulmonary HTN
31:30 Transpulmonary gradient
33:33 What is a normal pulmonary artery pressure
35:15 Accuracy of PA pressure estimate by echo
39:04 Mechanism of shortness of breath in PH
40:10 Should you hold PAH meds in a hypotensive patient?
41:55 Therapy for PH and follow up
46:28 Who to refer
47:40 PAH risk factors
52:09 Mortality in PH
58:22 Take Home Points & Outro

Differentiate, diagnose, and treat the various forms of dermatitis and stop the ‘itch that rashes’ with this in-depth, myth-busting episode of “The Dermsiders” with Dr. Kalman Watsky Clinical Professor of Dermatology at Yale Medical School. Topics include: how to differentiate between and diagnosis various forms of dermatitis, topical therapies, common pitfalls, patch testing, and more! Special thanks to Bryan Brown and Beth Garbitelli who wrote and produced this episode and the show notes!

Written by: Bryan Brown, MD and Beth Garbitelli
Edited by: Matthew Watto, MD
Infographics by: Bryan Brown, MD
Cover image by: Beth Garbitelli

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

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It's a potpourri of Infectious Diseases with tips from expert, Dr Paul Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women's Hospital, and Professor of Medicine at Harvard Medical School. We discuss the man flu, the flu vaccine, travel medicine, malaria, lyme disease, post lyme syndrome, chronic lyme, shingles, cellulitis, abscesses, antibiotics, c diff, antibiotic associated diarrhea, the dangers of fluoroquinolones, why doxycycline is awesome, and more! Told you it was a potpourri. Dr Shreya Trivedi joins Matt and Paul as guest host.

Show Notes, MCQ by Shreya Trivedi, MD
Edited by Matthew Watto, MD
Infographics and cover image by Matthew Watto, MD

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

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Time Stamps:

00:00 Announcement
01:38 Intro
03:46 Picks of the Week
06:47 Guest bio
08:47 Getting to know our guest
15:40 Flu vaccination
19:54 Barriers to the flu vaccine
23:34 Can you give the flu vaccine to an ill patient
24:14 Man flu
26:27 Travel Medicine
30:35 Tick bites
33:49 Lyme serologies
35:38 Lyme prophylaxis
37:37 Chronic lyme disease and post lyme syndrome
38:55 Penicillin and antibiotic allergies
41:48 Fluoroquinolones and adverse reactions
45:24 Should antibiotics be given after an I&D of an abscess
49:34 Antibiotic associated diarrhea, C diff
52:10 Probiotics, stool transplantation, and C diff
54:50 Shingles, recurrent zoster, complications, and the new subunit vaccine
61:45 Using salad tongs at a buffet
63:04 Take home points
64:26 Outro

Tags:

ID, infectious, diseases, disease, flu, influenza, lyme, doxycycline, cdiff, antibiotics, infection, cellulitis, abscess, vaccine, zoster, shingles, malaria, travel, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes.

Time Stamps

00:00 The setup
02:15 Disclaimer
03:32 Picks of the Week
08:13 Getting to know Dr Forciea
13:35 Broad overview and a clinical case of geriatric hypertension
14:45 Brief history on BP targets
18:05 How do you measure a blood pressure? What type of monitors are available?
22:13 How to standardize BP in the office?
23:55 Ambulatory BP monitoring
24:55 Home blood pressure monitoring
26:11 Standing blood pressure readings and orthostatic hypotension
27:53 How guidelines are written
30:51 Evaluating evidence quality and strength of recommendation
32:35 Timeline and process for guideline generation
34:27 How to read guidelines with a “critical eye”
36:15 Return to our case of uncontrolled hypertension
38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults
40:33 Counsel patients on BP targets
42:25 Low diastolic blood pressure
45:35 SPRINT and the ACP BP guidelines
48:58 Take home points from Dr Forciea
50:07 HTN targets and pay for performance in clinical practice
51:45 Curbsiders recap the ACP guidelines
53:45 Matt and Paul recap the AHA guidelines
54:47 AHA definitions of hypertension
56:15 Diagnosing hypertension and how to measure a blood pressure
60:35 Choosing a blood pressure monitor and HBPM
62:29 Blood pressure goals in ACC guidelines
66:08 Non-pharmacologic measures
69:15 Will we follow these new strict targets?
72:45 Outro

Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resid

Conquer community acquired pneumonia and avoid misdiagnosis with tips from Dr. Robert Centor, Professor Emeritus University of Alabama and newly appointed Chair of Medicine at Kashlak Memorial Hospital. We discuss diagnosis, misdiagnosis, procalcitonin, steroids for severe pneumonia, pneumonia severity index versus CURB-65, and how to determine antibiotic choice and duration. Special thanks to Correspondents Neela Bhajandas (cohost), Justin Berk and Bryan Brown who all contributed several articles, resources, and questions to prep for this show. Cover image by Dr Kate Grant paintscientific.com.

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

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Join us for this recap of the key clinical pearls and favorite fan voted episodes from 2017 including: lipids, asthma, diuretics, hyponatremia, CKD, vertigo, and dizziness. Plus, Picks of the Year, exciting announcements for 2018, and Paul reveals that he has a wife! Matt, and Paul are joined by Curbsiders Correspondent, Dr. Chris Chiu, who wrote and produced this episode. Stuart was out with the Man Flu. My apologies to Dr. Bryan Brown whose name I forgot to shout-out when listing our Correspondents. Thanks to Kate Grant for her beautiful cover image.

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

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Time Stamps

00:00 Intro
01:18 Getting to know Chris Chiu introduction
03:07 Picks of the week and
06:10 Picks of the year and discussion of vancomycin and pip-tazo causing AKI
11:41 Recap of Scott Weingart and EM vs IM episode
17:45 Discussion of Lipids, PCSK9, CAC, CCTA
27:10 Asthma pearls recapped
32:43 Dizziness and vertigo recapped
38:40 Diuretics, diuretic resistance, and secondary hypertension diagnosis and treatment
44:35 Diuretic dosing
46:25 Hyponatremia, volume status, solute loads and SIADH
50:08 CKD, when to refer, and an argument about low protein diets
54:25 Matt, Paul, and Chris reflect on important lessons learned from 2017
59:32 Listener questions and comments
63:35 Wrap-up, and shout outs
66:22 Announcements for 2018
67:25 Outro

Tags: hyponatremia, salt, kidney, ckd, asthma, vancomycin, zosyn, injury, weingart, emcrit, emergency, lipids, pcsk9, statin, dizziness, vertigo, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Combat opioid use disorder and the opioid epidemic as we review common clinical scenarios with addiction medicine specialists, Dr. Stefan Kertesz, University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton,Virginia. We need all hands on deck, and that means you! Learn the basics of opioid use disorder treatment as Dr. Manhapra gives us the scoop on “bup, bup, bup” (buphrenophine), and Dr. Kertesz primes us on opioid related health care policy and reminds us that “We can all do something about the opioid crisis”. Plus, Stuart and Paul express some concerns about how to approach these patients. Do not miss this episode filled with clinical pearls, policy, and joy! Special thanks to writers and producers, Dr. Carolyn Chan and Elena Gibson (MD Candidate, MS4), for their hard work on both of our addiction medicine episodes.

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

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Take the pain out of pain management with clinical pearls from addiction medicine specialists Dr. Stefan Kertesz at the University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton, Virginia. They walk us through an approach to pain management in persons with a history of opioid use disorder (OUD), discuss treatment options for OUD, plus hot tips on how to interpret guidelines surrounding opioids, and more! What are you waiting for? Hit the play button! Special thanks to Elena Gibson, MD and Carolyn Chan, MD

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

Credits * Producer: Elena Gibson and Carolyn Chan * Writer: Carolyn Chan * Infographic: Elena Gibson * Cover Art: Elena Gibson * Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP * Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com * Guest: Dr. Stefan Kertez and Dr. Ajay Manhapra

Time Stamps * 00:00 Intro * 01:58 Host picks of the week * 04:10: Intro to the episode * 04:35: Guest Bios * 12:32: Case from Kashlak Memorial * 13:40 Define substance dependence, substance use, unhealthy use * 17:42 Where to go next conversation about pain control * 17:54: Assessing risk of relapse * 19:35 Screening Tools * 20:10 Risk factors for developing OUD when initiating opioids. * 25:10: CDC Guidelines length of prescription and risk of substance use disorder (7) * 27:00: Defining optimal length of opioid after common surgical procedures (6) * 30:30: Long term use of opioids * 33:50: OUD treatment options * 37:30: Duration of buprenorphine/naloxone treatment, tapering risks (8) * 38:50: POATs: Prescription opioids (9) * 40:05 Social support and mental health services for SUD treatment * 41:10 Risk of abstinence and adverse outcomes * 42:35 Protracted withdrawal * 43:35: Editorial BMJ Golden Month of Opioid use disorder (10) * 44:00 Overdose risk in patients on long term opioids * 44:40 Op-Ed on the Hill (11) * 45:40 Example of protracted withdrawal syndrome * 47:40 Reducing Harms: Naloxone, who to prescribe to? * 50:30 Take home points * 53:40 Outro

Trans patients need excellent primary care and you can provide it with expert tips from endocrinologists, Dr Vin Tangpricha, Professor of Medicine at Emory University School of Medicine, and Dr Jeffrey Colburn, Assistant Professor of Medicine at Uniformed Services University. Learn practical tips in caring for transgender patients including: defining terms like gender dysphoria, gender nonconformity, transgender; use of pronouns; patient counseling; fertility concerns; initiating and monitoring hormonal therapy; surgical options; and how to help trans patients navigate the complexities of gender affirming therapy.

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

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Knock the wind out of asthma with tips from Dr Denitza Blagev, a pulmonologist and intensivist who currently serves as Director for the Schmidt Chest Clinic at Intermountain Medical Center in Murray, Utah. We simplify the approach to diagnosis, spirometry, patient counseling, choice of agent, stepwise therapy, and de-escalation...plus, a little myth busting. Special thanks to Dr Cyrus Askin for writing and producing this episode and to Dr Bryan Brown for his wonderful infographics.

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

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Dr Kevin Pho, founder KevinMD.com “Social Media’s Leading Physician Voice" schools Matt, Paul and Stuart on a potpourri of topics including physician advocacy, the dangers and benefits of social media, the pros and cons of electronic health records, health policy, health advocacy and lastly primary care and the integration of advanced practice providers/clinicians. Special thanks to Dr Chris Chiu who helped produce the show and write our show notes.

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

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Time Stamps:

00:00 Intro
00:54 Picks of the week
06:58 Getting to know our guest
10:30 Why physicians need to understand health policy
11:21 Best advice Dr Poh has received in his career and why variety is important to avoid burnout
13:45 Advice to young physicians about to start using social media
16:40 Why are physicians afraid of social media
18:54 Risks of social media
21:20 Discussion of “Twitter bates” aka debates
23:20 Physician advocacy and social media
26:18 The next big health care debate...is it a right?
31:03 Why electronic health records are so painful to use?
34:49 How can charting be worked into clinic workflow?
37:50 Conspiracy theories on EHRs
39:11 Advanced practice providers/clinicians
46:40 Primary care shortage
50:16 Growth of medical administrators and how to take back control as physicians
52:38 Advice on how to break into medical writing
54:08 Paul ends the show with some wisdom and steals the show
55:59 Outro

Tags: kevinmd, advocacy, policy, health, care, ehr, chart, advanced, practice, clinician, physician, meded, foamed, social, media, twitter, kevin, pho, nurse, practitioner, medicine, internal, family, primary, education, internist, hospitalist

Making all your nephrology dreams come true with part 2 of our interview with @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Flush away your bad prescribing habits when it comes to nephrotoxic drugs in this fast paced run down of the medications which must stay on or off Santa’s naughty-list, backed up with a sack full of memorable research studies. Special thanks to Annie Medina, Justin Berk and Kate Grant for writing/producing this show and to physician artist, Kate Grant for her lovely/hilarious artwork (more at paintscientific.com).

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

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Time Stamps

00:00 Intro
03:00 Which medications should we exercise caution over in CKD?
03:31 Bactrim (Trimethoprim+Sulfamethoxazole)
07:00 NSAIDS
08:29 NSAIDS and the ‘Precision’ Trial NEJM 2016 looking at cardiovascular safety
12:50 The Male Physician Study JAMA 2001
13:50 Discussion about Nurses Health Study and use of analgesia, and CKD
15:15 Acute Interstitial Nephritis, Beta Lactam Antibiotics, and the risk of Acute kidney injury +/- CKD with Proton Pump Inhibitors
18:20 Advice for co-prescribing NSAIDS,ACE inhibitors and diuretics
20:39 Creatinine levels and ACE/ARB prescribing. How High can you go?
24:55 Facebook question from listener: measures to reduce proteinuria in hypertensive patients
27:20 Empagliflozin and renal protection in diabetic patients
32:00 Contrast Induced Nephropathy, the AMACING trial 2016.
38:00 Take Home Points
39:57 Outro

Tags: chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, medications, pharmacology, bactrim, nsaid

Steady your hand and annihilate tremor with tips from Neurologist, and Movement Disorder specialist, Andres Deik, MD, Assistant Professor of Clinical Neurology at Kashlak Memorial Hospital (we can’t tell you where he really works: ) We teach you to differentiate benign causes of tremor from Parkinson’s disease with simple history and physical exam skills, plus nonpharmacologic and pharmacologic therapies for tremor. Special thanks to Beth Garbitelli and Chris Thrash who wrote and produced this episode and the show notes!

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

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Time Stamps

00:00 Intro and disclaimer
01:08 Listener feedback - Paul is not fired.
02:09 Picks of the week.
05:35 Dr. Deik intro
07:19 Icebreaker questions
12:20 Wikipedia definition
13:02 Classifying tremor
14:33 Postural tremor vs. reemerging rest tremor
15:48 Important history questions
17:58 Medications that can induce tremor
21:39 Physical exam techniques
27:30 Exam characteristics between typical PD tremor and ET
28:36 History components to distinguish between PD and ET
34:10 Misdiagnosis of Parkinson’s
36:54 Imaging workup
39:03 Case from Dr Deik
41:33 Nonpharmacologic management
44:18 Pharmacologic management
49:06 Dosing propranolol
51:07 Distinguishing between physiologic tremor and pathologic tremor’
54:06 Website recommendations
55:50 Handwriting
59:14 Take home points
61:34 Outro

Tags: tremor, essential, postural, neurology, Parkinsons, disease, beta, blockers, primidone, movement, disorders, antidepressants, occupational, therapy, rest, intention

Take control of chronic kidney disease with tools, and tips from @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Learn which equation is best for eGFR, how to counsel patients about progression/prognosis, how to monitor patients in CKD, and who needs a referral to Nephrology. Special thanks to Annie Medina, and Justin Berk for writing/producing this show and to physician-artist, Kate Grant for her lovely and hilarious artwork (more at paintscientific.com).

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

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Time Stamps

00:00 Intro
03:13 Pick of the weeks
08:49 Clinical Case
09:36 How to explain CKD to patients
12:16 Loss of GFR with age
13:22 Which equation should be used to estimate GFR
18:05 Creatinine clearance from 24 hour urine collection
22:25 Initial workup upon diagnosis of CKD
25:40 Interpreting tests for proteinuria
26:52 Staging and prognosis in CKD
32:00 Completing the initial workup for CKD
33:52 Who needs a referral to nephrology?
35:53 What labs to check in CKD and a discussion of secondary hyperparathyroidism
40:32 Take home points
42:30 Outro

Tags: chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, prognosis, monitoring, iron, pth, proteinuria, hypertension, nephropathy, diabetes, albumin, protein, anemia, hyperparathyroidism, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine, medical, primary, physician, resident, student

Hiding from Hep C? Dive in with experts Dr. Gina Simoncini, MD, MPH Associate Professor of Clinical Medicine at Temple University Hospital, & Dr. David Koren, PharmD, BCPS, AAHIVP, board-certified pharmacotherapy specialist and infectious diseases clinical pharmacist at Temple University Hospital. They walk us through a simplified approach on whom to screen, how to start antiviral therapy, what to follow up on, and how to navigate insurance waters along the way. Special thanks to Sarah Roberts and Jordana Kozupsky who wrote and produced this episode and the show notes!

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

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Time Stamps * 00:00 Intro * 01:00 Guest bios * 03:00 Getting to know our guests * 05:35 Picks of the week * 10:05 Clinical case * 10:54 Diagnosing HCV * 12:00 ASCEND study * 13:14 Restrictions on HCV treatment * 15:17 Ordering and interpreting pre-treatment tests * 19:30 Prescribing medication * 22:00 Genotyping and drug resistance * 24:10 Patient counseling * 25:49 Understanding drug classes * 27:33 Drug interactions * 30:06 Multidisciplinary approach to treatment * 33:01 Follow-up * 36:47 Reinfection/cure rates * 39:35 Patient counseling revisited * 41:25 Side effects of treatment * 42:53 Screening * 44:02 Take home points

Tags: hepatitis, virus, hcv, direct-acting, antiviral, therapy, management, primary, care, liver, ultrasound, fibrosis, cirrhosis, side, effects, monitoring, hcc, hiv, infectious, disease, assistant, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine,

Fighting with Emergency Medicine colleagues is stupid. Learn how EM doctors think and avoid the petty infighting with tips from Dr. Scott Weingart, MD FCCM FUCEM DipHTFU, host of the EMCrit podcast, Clinical Associate Professor and Chief, Division of Emergency Critical Care at Stony Brook Hospital, NY. We discuss decision making, how to avoid anchoring bias, the devil of the gaps, why the elderly always get admitted, how to build relationships with the ED, and Scott’s pet peeves.

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

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Time Stamps 00:00 Intro 01:10 Picks of the week 05:28 Guest bio 07:00 Getting to know our guest 12:00 Do EM and IM docs hate each other? 14:04 Where conflicts arise. 17:05 System 1 versus system 2 thinking 20:19 When the patient doesn’t match the story 23:55 Why does every 85 year old get admitted? 26:05 Transitions of care: form ED to medical ward 32:08 Is face-to-face signoff only needed for sick patients? 36:28 The devil in the gaps 41:03 Scott’s beer recommendation 42:17 BP cutoff for discharge home 43:44 Scott’s biggest pet peeve with primary care 45:04 How to make friends and collaborate with your EM colleagues 47:14 Take home points 50:35 Outro

Tags: emergency, department, room, em, ed, im, conflict, devil, gaps, post-test, probability, illness, serious, system, one, bias, heuristic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Get schooled on medical homes, payer reform, and what the future might look like for primary care with Dr. Sue Bornstein, MD, FACP and Executive Director of the Texas Medical Home Initiative and Chair of the Health and Public Policy Committee at the ACP.

Dr Alex Lane of Cooper University Hospital joins Matt as cohost!

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

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Time Stamps

00:00 Intro

02:42 Guest CV and background

04:42 Getting to know our guest

10:40 Helpful resources for learning health policy

12:10 Who are the major players/influencers in health care and how do their interests align

15:02 Defining “medical home”

18:45 Where did the idea for a “medical home” originate

22:33 How does medical home affect cost

29:45 Payer reform and the quality payment program (QPP)

33:06 Recap and defining terms

37:18 How will the QPP be implemented?

41:04 Repeal and replace

43:37 Cuts in funding for safety net hospitals that care for the poorest, sickest patients

46:59 Take home points

48:55 Outro

Tags: medicare, medicaid, health, care, policy, spending, quality, improvement, advanced, payment, macra, mips, qpp, apm, medical, home, pcmh, affairs, super, utilizer, texas, physician, doctor, assistant, nurse, practitioner, foamed, meded

Expand your consciousness around medical cannabis (aka marijuana) with expert Dr Donald Abrams, Chief of the Hematology-Oncology Division at San Francisco General Hospital and a Professor of Clinical Medicine at the University of California San Francisco. We explain the cannabinoid system, THC, CBD aka cannabidiol, limitations surrounding cannabis research, current and future medical uses for medical cannabis (marijuana), and potential conditions it may benefit. We take a deep dive on the potential harms of medical cannabis and how to counsel patients on safe use. Plus, the return past guest and new correspondent, Dr Molly Heublein, Assistant Professor of Medicine from UCSF.

Thanks to Dr Molly Heublein for writing and producing this episode and it’s show notes!

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

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Clinical case from Kashlak Memorial: MM is a 62 yo woman with a history of osteoarthritis and breast cancer, now on an aromatase inhibitor. She struggles with aching and stiffness in her hands, shoulders, knees, and hips. A friend suggested she try medical marijuana. She wants her provider’s opinion on if this is safe and effective.

Time Stamps

00:00 Intro

01:30 Picks of the week

03:40 Guest bio

05:11 Getting to know our guest

11:03 Clinical case

11:40 Limitations for cannabis research

12:59 Discussion of THC and cannabidiol

14:50 Smoking versus ingesting cannabis products

16:40 Recap of cannabinoid mechanism of action

18:30 Cannabis and cannabinoid products available

20:20 Synthetic THC (dronabinol)

21:46 How “recommending” cannabis and dispensaries work

25:46 Conditions that respond to medical cannabis

29:15 Potential harms of medical cannabis

34:51 Future directions of cannabinoid medicine research

37:24 Cannabis induced hyperemesis syndrome

39:00 Possible lung cancer risk

40:12 Take home points

42:54 The Curbsiders recap and share their views on the medical cannabis controversy

49:40 Outro

Remedy your ignorance as we review some basics of health care policy with Dr. Fatima Syed, Chair of the Council of Residents and Fellows for the American College of Physicians. Dr. Syed is early career physician whose work is already affecting health policy at a national level. You can do it too and we’ll teach you where to start along with defining basic, but poorly understood concepts like The Affordable Care Act, universal health care, single payer health care, MACRA, MIPS, and how “quality” is really measured. Don’t miss this part one in our health care policy for beginners series.

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

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Time Stamps

00:00 Intro

03:20 Getting to know our guest

07:23 How to get involved in a professional organization

09:37 Resources to learn health policy

14:06 The Affordable Care Act and ObamaCare

17:56 What is MACRA, MIPS and how do they affect physicians?

23:09 Nationalized health care in the US versus other countries

25:33 Universal and “single payer” health care defined

27:00 How is quality health care defined? Why is the US rated so poorly?

32:53 Recap and summary of what we’ve learned

34:09 Dr. Syed’s take home points

35:36 Outro

Tags: policy, healthcare, macra, mips, aca, affordable, care, act, health, acp, advocacy, quality, payments, reimbursement, kaiser, commonwealth, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Keep your cool in the face of inflammation, and make the path to vasculitis diagnosis less tortuous with Dr. Rebecca Sharim, Rheumatologist and Assistant Professor of Medicine at Temple University. In this episode, we go with the flow from large vessel to small vessel vasculitides, and then learn how to make the diagnosis and management of Giant Cell Arteritis (GCA) and polymyalgia rheumatica (PMR) less of a headache. Correspondent, Dr. Bryan Brown cohosts!

Special thanks to Dr. Bryan Brown for writing our show notes, and creating figures for our handouts.

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 thecurbsiders@gmail.com.

Case from Kashlak Memorial: A 75 year-old woman with a PMHx of hypertension presents to the ED with three days of worsening left sided headache, now with left sided vision loss during a Norwegian folk festival. On review of systems, she also endorses a week of soreness of her shoulders and hips. This has never happened to her before.

Time Stamps

00:00 Intro

03:07 Picks of the week

09:13 Getting to know our guest

15:00 Clinical case of vasculitis

15:59 Defining and classifying vasculitis

20:55 Workup for suspected vasculitis

23:17 How to explain GCA to a patient

25:08 Typical symptoms of vasculitis

28:00 Chewing gum test

29:34 Interpreting ESR

32:54 Basic exam and lab workup for vasculitis

35:23 Headache and suspicion for GCA/temporal arteritis

38:10 Is a temporal artery biopsy still mandatory?

39:20 Polymyalgia rheumatica

40:59 Steps to take when GCA/temporal arteritis suspected in clinic

43:55 PCP prophylaxis with high dose steroids

46:30 DMARDs and steroid sparing agents

48:12 Imaging studies to aid in diagnosis of GCA

50:50 Complications of long term steroid therapy

52:31 Take home points

53:26 Outro

Tags: giant, cell, arteritis, gca, vasculitis, steroids, temporal, biopsy, artery, esr, pmr, polymyalgia, rheumatica, vessel, headache, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

How to individualize learning for yourself, and your learners with tips from Dr. Philip A. Masters, editor-in-chief of MKSAP and IM Essentials, Vice President of Membership/International Programs at the American College of Physicians (ACP) and an Adjunct Professor of Medicine at the University of Pennsylvania School of Medicine. Dr. Masters schools us on work life balance, how to recognize and diagnose struggling learners, what resources to use, teaching exercises, and how to generate a study plan.

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 thecurbsiders@gmail.com.

Time Stamps

00:00 Intro

01:50 Listener feedback

04:18 Announcements

04:58 Picks of the Week

10:37 Guest bio and credentials

12:36 Getting to know our guest

18:05 Wellness and work life balance

22:55 How medical education has changed

28:55 Choosing resources as a learner

38:00 Case of a struggling learner

41:50 Learners with knowledge deficits and the role of the clinician (non-professional educator)

47:56 Resources to improve your skills as a medical educator

51:01 Take home points

Tags: study, resources, MKSAP, acp, learner, educator, academic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, primary, physician, resident, student

Solidify your approach to back pain and sciatica with Dr. Chris Miles, Assistant Professor, Family & Community Medicine and Associate Director, Sports Medicine program, Wake Forest Baptist Medical Center. He schools us on red/yellow flags, physical exam maneuvers, when to order imaging, and practical tools and tips for evidence-based management! Correspondent Dr. Shreya Trivedi cohosts!

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 thecurbsiders@gmail.com.

Case from Kashlak Memorial: 53 yo M construction worker with a BMI of 29 and PMhx of DM2, HTN, depression presenting with right low back pain. He can't remember any trauma or injury. Denies radiation, no bowel or bladder dysfunction, saddle anesthesia, weakness

Case from Kashlak Memorial: 48 yo F nurse who has had intermittent back pain for years presented with acute flare after helping lift a patient. The pain similar to previous episodes but more severe and also radiates to her left foot. She has tried naproxen and exercises/mindful stress reduction for months without improvement. It is unbearable for her to work.

Time Stamps

00:00 Intro

02:14 Listener feedback

03:44 Announcements

05:14 Picks of the week

08:20 Millenial learners

10:40 Topic intro and guest bio

12:06 Getting to know our guest

17:30 Clinical case of back pain

20:18 How to hand sensory deficits

21:51 Red and yellow flag symptoms

25:44 How to approach patient with yellow flag symptoms

28:00 Physical exam for back pain

30:00 Special testing: Trendelenburg, Slump test, and Straight leg raise

35:48 Classifying types of back pain and a quick recap of teaching points so far

39:28 How to manage patient expectations

40:42 Treatment of non-radicular back pain

46:33 Home exercises and YouTube training

49:31 When to follow up after initial treatment trial

51:35 The patient with severe acute pain

53:33 Some pearls on muscle relaxants

55:22 Clinical case and how to treat radicular pain

59:40 Invasive treatment of back pain

65:04 Back pain treatments that don’t work

Summary:

Get a-HEAD of concussions (aka traumatic brain injuries) with tools, tips, and tricks from The Concussion Guy, Dr. Evan Ratner, Medical Director of Gridiron Heroes. Learn to recognize concussions/traumatic brain injury, what questions to ask, physical exam maneuvers, and how to counsel patients and families on safe return-to-learn/play.

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 thecurbsiders@gmail.com.

Case from Kashlak Memorial: 29F with no significant PMH presents to primary care office less than 24 hours after she accidentally struck her head on the metal of her car door. She experienced temporary altered consciousness lasting about one hour along with a headache. No nausea, vomiting, speech, or vision changes. She rested at home last night, but didn’t feel up to reading, or watching TV. She drove herself to your office today.

Time Stamps

00:00 Intro

02:33 Listener feedback

05:35 Picks of the week

12:15 Getting to know our guest

19:41 Defining and classifying concussion

23:00 What questions to ask your patient

26:34 Physical exam for patient with concussion

28:50 Use of neurocognitive testing in concussion

30:45 Specifics of testing eye movements and balance

35:00 Who needs imaging?

41:51 Recap of what we’ve learned so far

43:40 Can you let someone with a concussion go to sleep?

47:08 Return-to-learn protocol

50:30 Return-to-play protocol

52:30 Post-concussive syndrome

53:55 Medications for post-concussive symptoms

58:58 Second impact syndrome

64:40 Counseling the patient with multiple concussions

67:08 Take home points

69:09 The Curbsiders recap their favorite teaching points

71:30 Outro

Tags: concussion, post, concussive, syndrome, tbi, traumatic, brain, injury, return, play, school, cognitive, rest, treatment, diagnosis, assistant, care, education, doctor, family, foam,

Improve your prescribing practices with tips from The Curbsiders as Matt, Stuart and Paul “Pwilliams” discuss safe prescribing in frail, older adults with diabetes, chronic kidney disease, hypertension, and/or dementia in this part two episode on polypharmacy and deprescribing.

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 thecurbsiders@gmail.com.

Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, diabetes, hypertension, kidney, chronic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Avoid common pitfalls, recognize prescribing cascades, and deprescribe like a champ with tips from Clinical Pharmacist, Dr. Sean M. Jeffery, Clinical Professor of Pharmacy at the University of Connecticut School of Pharmacy, and Chair of the Polypharmacy Special Interest Group for the American Geriatrics society. We discuss how to create better medication lists, tools and tips for deprescribing, how to counsel patients on polypharmacy, and safe use of medication in the elderly.

Special thanks to the American Geriatrics Society for setting up this interview.

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 thecurbsiders@gmail.com.

Time Stamps

00:00 Intro

01:12 Listener feedback

01:56 Picks of the week

06:28 Topic intro and guest bio

07:49 Getting to know our guest

13:05 Defining polypharmacy and related terms

16:30 Clinical Case of polypharmacy

20:34 Making better medication lists

25:01 Clinical Case from Kashlak Memorial

28:40 Beers Criteria

35:41 Statins in frail, elderly patients

38:00 Treating insomnia in the elderly

44:15 Dosing of meds in patients with CKD

45:50 Tool for analysis of drug-drug interactions

48:10 Take home points from Dr. Jeffery

50:00 Outro

Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Enhance your skills in the identification and management of eating disorders with clinical pearls from Dr. Rosalind Kaplan, Clinical Associate Professor of Medicine at Thomas Jefferson University and a Primary Care Physician in Jefferson Women's Primary Care. We learn who to screen for eating disorders, what questions to ask, criteria for diagnosis, common complications, and how to manage them. This is a must listen if you’re like us and don’t know much about eating disorders specified and not otherwise specified.

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 thecurbsiders@gmail.com.

Case from Kashlak Memorial Hospital: 24yo F medical student with history of anxiety, weight loss, and restricting food senior year of high school. She regained weight with psychotherapy. Now she is a medical student who is over exercising, and abusing laxatives. She passes out one day after class and is referred to you at Kashlak.

Time Stamps:

00:00 Intro

01:19 Listener feedback

02:43 Picks of the week

06:50 Topic intro and guest bio

09:10 Getting to know our guest

15:18 Clinical case

20:15 Broad overview of eating disorders

26:40 Eating disorder not otherwise specified

29:19 Underreporting and under diagnosis in men

30:25 Who to screen and how to do it

34:33 Questionnaires: SCOFF, ESP, and Binge Eating Disorder Inventory

38:42 Initial lab workup for eating disorders

42:38 Bone density screening, treatment

45:41 Back to the case: Initial patient counseling

49:22 Medical therapy

52:20 Can we use bupropion?

54:02 What’s the role for primary care?

58:14 Hyponatremia in eating disorders

60:34 Complications of purging

66:25 How to be an ally for your patient

69:12 Treatment for binge eating

72:51 Take home points

74:30 Outro

Tags: anorexia, nervosa, bulimia, eating, disorder, weight, loss, binge, binging, purge, electrolytes, not, otherwise, specified, ideal, body, image, treatment, screening, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Don’t miss life threatening upper respiratory infections, and stop underusing antibiotics with tools and tips from our wonderful guests: Dr. Robert Centor, Professor of Medicine at University of Alabama, known for developing the Centor Criteria for pharyngitis, and his excellent blog and Twitter feed @medrants; and Dr. Alexandra Lane, Assistant Professor of Medicine, and Director of the Resident Clinic at Cooper University Hospital. We cover red flag signs in upper respiratory tract infections, diagnostic testing, physical exam maneuvers, antibiotic therapy, and symptom management. Plus, we’ll teach you have to counsel patients about upper respiratory infections and recommend some great learning resources.

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 thecurbsiders@gmail.com.

Case from Kashlak Memorial Hospital: 39 yo F with obesity, HTN, fibromyalgia who presents with 3 days of chills, subjective fevers, sinus pressure/congestion, post-nasal drip, and cough with some green/yellow mucus. She says, “I get this every year and it only goes away with antibiotics. They usually give me a z-pack”.

Tags: upper, respiratory, infections, cough, cold, nasal, pharyngitis, bronchitis, rhinosinusitis, sinusitis, decongestant, spray, symptoms, management, pneumonia, pertussis, influenza, antibiotics, overuse, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Get control of urinary incontinence with tips from Internist and Women’s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you’re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder.

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 thecurbsiders@gmail.com.

Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else.

Time Stamps

00:00 Intro

01:06 Listener feedback

02:43 Announcements

03:43 Picks of the week

09:07 Getting to know our guest

14:27 Case of urinary incontinence (UI)

15:30 Epidemiology of UI

16:34 Screening for UI

17:30 The 3IQ Questionnaire

18:44 Additional testing in UI

21:23 Classifying UI

24:00 Nonpharmacologic therapy for UI

32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy

34:50 Case continued. Changing medications

37:42 Mirabegron as an alternative to anticholinergics

40:18 More options for stress UI management

41:40 Next line therapies for urge UI, overactive bladder

44:38 Surgery for stress urinary incontinence

45:50 Botox therapy for urge UI, overactive bladder

48:30 Do we need any more fancy diagnostic tests?

50:30 Take home points

55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds

56:40 Outro

Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, educ

Master the anemia algorithm, and take a deep dive on iron deficiency, anemia of chronic kidney disease, anemia of chronic inflammation, causes of macrocytic anemia and more in this discussion with international expert, Dr. David P. Steensma, Senior Physician from Dana Farber Institute, and Associate Professor of Medicine at Harvard Medical School.

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

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Cases from Kashlak Memorial:

62 yo M with diabetes and CKD with asymptomatic Hgb 10, MCV 90, and Cr. 1.9?
72 yo F with HTN with asymptomatic Hgb of 11, MCV 85 and Cr. 0.6.
72 yo F with breast cancer in remission after lumpectomy, adjuvant chemo, and XRT treated 6 years ago presents with fatigue and some dyspnea on exertion. Hgb 9.6, MCV 102.

Time Stamps

00:00 Intro

01:18 Listener feedback

04:05 Announcement: We’re looking for on air correspondents to join The Curbsiders

05:05 Picks of the week

11:12 Getting to know our guest

17:50 Case #1 Normocytic anemia

19:15 Defining anemia (WHO criteria)

21:10 Epidemiology of anemia

23:45 Normocytic anemia

25:55 Erythropoietin for diagnosis and treatment

28:22 Anemia of CKD or chronic inflammation?

31:37 Discussion of ferritin and soluble transferrin receptor

33:47 Case #1 Conclusion

35:45 Hemoglobin targets in CKD

36:53 Case #2 Microcytic anemia

37:43 Correct reticulocyte count and reticulocyte index

40:45 Deciding on dose and route for iron repletion

43:44 Does vitamin C improve iron absorption?

45:27 Case #3 Macrocytic anemia

46:54 Vitamin B12 deficiency

51:54 Medication related B12 deficiency

52:35 Myelodysplastic syndrome

55:00 Side effects of common MDS treatments

56:18 Take home points

57:35 The Curbsiders post game analysis

64:16 Outro

Tags: anemia, hemoglobin, i

Get cozy with these new drugs for diabetes. Don’t be scared, they won’t bite. On this episode, we interview Endocrinologist and current president of AACE, Dr. Jonathan D. Leffert, MD, FACP, FACE, ECNU about how to utilize the myriad of new diabetes drugs on the marketplace including SGLT2 inhibitors, DPP4 inhibitors, GLP1 agonists, and new ultra long acting insulins. Plus, we’ll teach you how to choose between agents, common side effects, A1C goals, and the cardiovascular benefits of these newer agents.

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

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Case: Case from Kashlak Memorial Hospital: 49 yo M with HTN, BMI 29, hyperlipidemia, family history of premature CAD (dad age 45yo), and DM2 with A1C increase from 6.4% to 9% while on metformin monotherapy.

Time Stamps

00:00 Intro

04:33 Getting to know our guest

09:50 Clinical case of diabetes

12:40 Latent autoimmune diabetes

15:16 Life expectancy and A1C goal

16:47 Anemia’s effect on A1C

18:40 Back to our case, choice of agent

20:57 Lifestyle changes effect on A1C

22:55 Starting an SGLT2 inhibitor, what to look for

26:45 SGLT2 inhibitor use in patient already on diuretic

27:53 Discussion of CV risk reduction and newer DM meds

33:27 Euglycemic DKA

34:30 Choice of agent GLP1 vs SGLT2

37:10 Use of DPP4 inhibitors

38:55 Back to the case

39:37 Degludec, long acting insulin

41:34 Clinical case conclusion

43:03 Take home points

45:15 Outro

Tags: diabetes, medications, glucose, insulin, oral, therapy, drug, hypoglycemia, a1c, blood, cardiac, risk, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Master this practical approach to reading the medical literature (No statistics needed!) with expert tips from Dr. Christine Laine, Editor in Chief, Annals of Internal Medicine, and Dr. Darren Taichman, Executive Deputy Editor, Annals of Internal Medicine*. They teach us what we should be reading, and detail their thought processes as they appraise an article. Topics covered include: Is 3 minute critical appraisal possible? What’s the deal with P-values? What are common sources of bias? How does the approach differ with clinical trials versus observational studies versus meta-analyses?

*Minimal statistics needed ; )

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

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Time Stamps

00:00 Intro

01:13 Listener comment on Entresto

02:50 Picks of the week

09:36 Getting to know our guests

14:00 How to stay up on the medical literature

17:15 Three minute critical appraisal

19:15 Step 1: Assess the outcome being studied

20:50 Statistical versus clinical significance

22:33 Evaluating composite endpoints

24:47 Statistical power

28:58 Evaluating for bias

34:40 Recap of what we’ve learned so far

36:33 Is PICO useful?

39:01 Observational studies and bias

41:09 Evaluating a meta-analysis

46:05 Take home points

50:35 The Curbsiders recap the episode

53:02 Outro

Tags: literature, appraisal, meta, analysis, analyze, critical, read, medical, journal, study, randomized, observational, systematic, review, clinical, trial, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab.

Special thanks to Dr. Cyrus Askin who found our expert, wrote the questions for this episode, and acted as our cohost.

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

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Case: A 45-year-old man presents to the emergency department because of continuous dizziness, nausea, vomiting and unsteady gait that began 18 hours earlier.

Step up your salt game. We deconstruct hyponatremia with expert tips from our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer. Topics include: true versus false hyponatremia, SIADH, tea and toast/beer potomania, safe rates of sodium correction, fluid restriction, salt tablets, IV fluid choice, DDAVP clamps, and more.

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

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Case: 85yo F with anxiety, asthma, HTN (on a CCB), hypothyroidism with TSH of 3 on therapy. Sodium was 128 from previous values 134-137 mg/dL. She is more fatigued than usual.

Time Stamps

00:00 Intro

03:00 Guest interview

06:45 Pick of the week w/Dr. Topf

15:50 Clinical case of hyponatremia

17:18 False hyponatremia normal osmolality

19:04 False hyponatremia high osmolality

20:06 Understanding why osmolality matters

22:58 Workup false hyponatremia

24:15 Recap of discussion so far

25:10 ADH dependent vs independent hyponatremia

26:30 Psychogenic polydipsia

28:45 Renal failure and hyponatremia

29:33 Tea and toast, and Beer Drinker’s potomania

34:42 ADH dependent hyponatremia

37:45 Volume versus osmolality

39:30 Volume status exam

44:44 Additional testing with urine lytes and uric acid

47:00 Treatment for SIADH

52:12 Discussion of the vaptans

57:51 Additional testing in SIADH

62:20 When to admit patient for hyponatremia

63:29 Clinical case of hyponatremia complications

68:26 Fluids and rate of correction

73:06 DDAVP clamp

76:00 Moderate hyponatremia

78:05 Diuretic dosing DOES matter!

81:29 Loop diuretics for SIADH

83:55 Take home points

86:55 Outro

Solidify your knowledge of osteoporosis and osteopenia in this discussion with Endocrinologists and osteoporosis guideline authors, Dr. Rachel Pessah-Pollack, and Dr. Dan Hurley from the American Association of Clinical Endocrinologists (AACE). Learn when to start therapy after an acute hip fracture, how to use bone turnover markers to assess fracture risk, more on how to dose calcium and vitamin D, and finally, we discuss the new American College of Physicians (ACP) guidelines and how they differ from the AACE guidelines on osteoporosis.

For a more basic talk on osteoporosis check out episode #18 w/Dr. Pauline Camacho.

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

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Time Stamps

00:00 Intro

03:00 Picks of the week

07:31 Guest and topic intro

10:25 Rapid fire questions

14:45 Clinical Case and defining osteoporosis

17:00 FRAX score

20:35 Secondary evaluation for cause of bone loss

20:54 Bone turnover markers (telopeptides)

23:17 Alkaline phosphatase

26:30 Calcium and Vit D

29:35 Recap of teaching points so far

31:25 Antiresorptive versus anabolic therapy

32:40 Aromatase inhibitors increase fracture risk

34:28 When to start therapy after fracture

35:44 Mechanism of action recombinant PTH

41:38 Vitamin D assay and dosing

46:53 Calcium intake, and formulations

49:45 Take home points

50:54 Recap and discussion of AACE vs ACP guidelines by The Curbsiders

59:42 Outro

Tags: bone, osteoporosis, anabolic, osteopenia, vitamin D, calcium, fracture, density, AACE, guidelines, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Master the evaluation of acute and chronic chest pain with coronary CT angiography (CCTA). We deconstruct this game changing technology w/experts from the Society for Cardiovascular Computed Tomography (SCCT), Dr. Todd Villines and Dr. Ahmad Slim. We’ve got answers on what to do when a patient with chest pain has a prior CAC score of zero, and/or a CCTA with non-obstructive disease. Plus: how to select, prepare, and counsel patients; how to interpret reports; choosing between myocardial perfusion study and CCTA, and more!

Special thanks to Dr. Emilio Fentanes from SCCT for setting up this interview.

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

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Case: 45 yo F active duty Colonel with chronic chest pain syndrome despite negative conventional stress test and CAC score of zero.

Time Stamps

00:00 Intro

04:00 Rapid fire questions

08:23 Book recommendations

10:14 Defining terms CCTA vs CAC

12:47 Script for counseling patient about CCTA

14:34 Prep for CCTA

16:40 Why is CCTA controversial?

19:37 Patient selection for CCTA both acute and chronic

25:20 Chronic chest pain and CCTA

27:58 CAC and CCTA in high risk occupations

33:25 Clinical case

36:10 Acute chest pain in patient w/CAC score zero

39:18 Acute chest pain in patient w/CAC score zero and previous CCTA w/non-obstructive CAD

41:22 How to read a CCTA report

45:48 CCTA versus conventional testing and risk MI, death

49:18 Use of CCTA in outpatients

52:16 Plaque characteristics and risk ACS

55:51 CCTA w/non-obstructive disease in patients with acute chest pain

58:14 When is myocardial perfusion scanning better?

61:00 Listener question on small vessel disease

62:09 Take home points

65:00 Curbsiders recap

69:33 Outro

Update your management of heart failure (HF) with expert tips from Cardiologist Dr. Eric Adler, Associate Professor of Medicine and Director of Cardiac Transplant and Mechanical Circulatory Support at UC San Diego. We cover how to use BNP, a simple way to examine jugular venous distention, medical therapy for heart failure, the PARADIGM-HF trial, and how to use sacubitril/valsartan (Entresto).

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

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Time Stamps

00:00 Intro

04:25 Rapid fire questions

06:00 Palliative care and heart failure

08:40 Book recommendation

10:20 Advice for teachers and learners

12:27 Clinical case of HF

13:38 Classification and staging of HF

17:07 Discussion of BNP

19:35 How to perform neck vein exam for JVD

21:20 BNP for prognosis

23:00 BNP at hospital discharge

26:36 Factors that affect BNP

27:25 Initial patient counseling

32:35 Exercise in HF

34:00 Additional testing at time of diagnosis

36:28 Initial medical therapy

38:30 Discussion of diuretics and dosing

42:50 Aldosterone antagonists

44:30 PARADIGM-HF and entresto

51:27 Medications to avoid in HF

54:14 Digoxin

57:30 Dr. Adler’s take home points

59:11 Stuart questions dosing conventions

60:48 Outro

Tags: arni, assistant, care, diuretics, doctor, education, failure, family, foam, foamed, health, heart, hospitalist, hospital, internal, internist, neprilysin, nurse, management, medicine, medical, physician, practitioner, primary, resident, sacubitril, student

Master the safe and effective use of obesity medications with Endocrinologist, Dr. Karl Nadolsky (co-author of 2016 AACE Obesity guidelines), Director of the Diabetes, Obesity & Metabolic Institute at Walter Reed National Military Medical Center. We get under the hood of each FDA approved obesity medication plus some of our normal hijinks. Check out episode #23 for a more general overview of obesity.

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

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Time Stamps

00:00 Intro

03:12 Picks of the week

08:44 Rapid fire questions

13:00 Counsel patients about obesity

14:40 Pathophysiology of obesity

18:00 Case

22:46 Phentermine/topiramate (Qsymia)

26:20 Bupropion/naltrexone (Contrave)

29:18 Liraglutide (Saxenda)

34:32 Orlistat (Alli, Xenical)

37:35 Cost issues

40:18 Lifelong medical therapy for obesity

42:44 Dr. Nadolsky’s take home points

44:45 The Curbsiders recap and discuss their experience with obesity medications

52:28 Outro

Tags: assistant, care, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, obesity, pharmacotherapy, weight loss, safety, side effects, orlistat, alli, naltrexone, bupropion, contrave, phentermine, topiramate, qsymia, lorcaserin, belviq, FDA

Load up on clinical pearls for your practice in this wide ranging discussion with expert clinician educator, Dr. Jon M. Sweet, Associate Professor of Medicine from Virginia Tech Carilion School of Medicine. Topics include cellulitis, tinea infections, dermatologic emergencies, smoking cessation, heart failure, hormone replacement therapy, iron supplementation, and vocal cord dysfunction. Plus, Stuart gives Paul a new nickname! Special thanks to the Dr. Patrick Alguire and Dr. Darilyn Moyer from the American College of Physicians for setting up this episode.

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

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Time Stamps

00:00 Intro

02:12 Picks of the week

05:10 Guest intro

07:13 Rapid fire questions

15:25 Tinea infections

18:22 Misdiagnosis of cellulitis

23:53 AGEP (Dermatology)

29:03 DRESS syndrome (Dermatology)

35:28 Smoking cessation

36:55 Back pain, acetaminophen and acupuncture

41:42 Hot flashes and hormone therapy

43:05 Iron supplementation

49:55 Heart failure and sacubitril/valsartan

53:33 Vocal cord dysfunction

56:50 Response from Stuart and Paul

62:20 Outro

Tags: AGEP, ARNI, assistant, back pain, care, cellulitis, cessation, dermatology, DRESS, doctor, education family, foam, foamed, health, heart failure, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, smoking, student, tobacco, vocal cord dysfunction

Diagnose, prevent, and treat diabetic foot ulcers and infections like international expert, Dr. Andrew Boulton, Professor of Medicine at the University of Manchester (England). From how to perform a proper foot exam, to foot care, to ulcers and infections we cover the essentials for your practice.

For full show notes visit http://thecurbsiders.com/podcast

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Tags: assistant, care, diabetes, diabetic, doctor, education, family, foam, foamed, foot, health, hospitalist, hospital, infection, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, ulcer

Prevent HIV infections with pre-exposure prophylaxis (PrEP), and learn to perform appropriate screening for sexually transmitted infections with tips from expert, Dr. Gina Simoncini, Associate Professor of Medicine at Temple University Hospital. Learn how to implement PrEP in your practice, plus tips on vegetable gardens, fellowships, and where to get the best samosas, in this wide ranging discussion.

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

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Time Stamps

00:00 Intro

04:50 Rapid fire questions

16:23 Defining preexposure prophylaxis

18:50 Who benefits from PrEP

21:43 Case discussion

23:45 PrEP during pregnancy, breastfeeding

24:45 Baseline testing and STI screening before PrEP use

28:15 Counseling on adherence, side effects

31:25 Adverse effects of PrEP

34:00 Monitoring patients on PrEP

36:46 Collaborative practice

37:30 Discussion of high risk behaviors on PrEP

39:30 Does PrEP promote viral resistance?

41:51 Insurance reimbursement for PrEP

42:50 Take home points

44:24 Outro

Tags: assistant, care, doctor, education, emtricitabine, family, foam, foamed, health, HIV, hospitalist, hospital, infection, internal, internist, nurse, meded, medicine, medical, physician, practitioner, primary, prophylaxis, resident, sti, student, tenofovir

Learn “weird” endocrine stuff! How to approach vague complaints like fatigue and weight gain. Reverse T3 syndrome, Wilson’s T3 syndrome, and adrenal fatigue; Do they exist? Learn how to help the challenging patient who is convinced they have an endocrine disorder in this discussion recorded live from AACE 2017 with Dr. Michael T. McDermott, Professor of Medicine, University of Colorado Denver School of Medicine.

For full show notes visit http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

05:36 Guest intro

07:50 Definition of “pseudo” endocrine

10:02 Case introduction

13:39 “Reverse T3 Syndrome”, the thyroid and fatigue

20:45 Growth hormone

25:10 Fatigue, and where to start

33:00 Adrenal fatigue

38:00 Lab testing

39:34 Take home points

42:12 Stuart on the thyroid and reverse T3

45:30 Paul’s approach to multisystem complaints

51:12 Outro

Tags: adrenal, assistant, care, doctor, education, endocrine, family, fatigue, foam, foamed, growth, health, hormone, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, thyroid, t3

Expert tips on the diagnosis and management of secondary hypertension in this conversation with Dr. Richard Auchus MD, PhD, Professor of Pharmacology and Internal Medicine & Director of the Diabetes, Endocrinology, & Metabolism Fellowship Program at the University of Michigan. Topics include: primary hyperaldosteronism, use of spironolactone, Cushing’s syndrome, pheochromocytoma, and which tests to utilize.

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

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Tags: assistant, care, cushing's, doctor, education, endocrine, family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nurse, medicine, medical, pheochromocytoma, physician, practitioner, primary, resident, resistant, spironolactone, student

Recognize and manage end of life symptoms with competence and confidence. In this extensive discussion with Dr. Brooke Worster, Assistant Professor of Medicine at Sydney Kimmel Medical College and Medical Director, of the Palliative Care Service at Thomas Jefferson University Hospitals we discuss scripts for having difficult conversations, managing patient/family expectations, what comes in the hospice “E” kit, terminal delirium, the “death rattle”, air hunger, and more.

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

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Time Stamps

00:00 Intro

03:10 Rapid fire questions

08:33 Defining hospice and palliative care

11:28 Case discussion

21:28 Gunderson, MI and Respecting Choices

24:25 How to counsel patients about home hospice?

37:10 Hospice “E” kit and how to use it

42:09 Air hunger, terminal delirium, death rattle, and Cheyne Stokes breathing

52:48 What is the PCM’s role while patient is on hospice?

58:19 Cancer survivorship and palliative care

60:33 Take home points

62:20 Outro

Tags: assistant, care, doctor, end, education, family, foam, foamed, health, hospice, hospitalist, hospital, internal, internist, life, nurse, medicine, medical, palliative, physician, practitioner, primary, resident, student, symptom

Learn the latest in lipid lowering therapy in this extensive discussion with Dr. Paul S. Jellinger, MD, MACE, Professor of Medicine at the University of Miami and Chair of the writing committee for the American Association of Clinical Endocrinologists (AACE) 2017 Guidelines for the Management of Dyslipidemia and Prevention of Cardiovascular Disease (CVD). Topics include ezetimibe, PCSK9, FOURIER trial, statin myopathy, CoQ10, fish oil, fibrates and more. For a more basic discussion of dyslipidemia check out episode #10.

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

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Time Stamps

00:00 Intro

03:10 Rapid fire questions

08:15 Dyslipidemia defined

10:26 Classifying dyslipidemia

13:21 Diagnosing Familial Hypercholesterolemia

17:48 A difficult lipid case discussed

22:40 Lp (a), Apo B and LDL particle concentration

28:40 What labs to order

31:31 ACC/AHA versus other risk scores

38:21 IMPROVE-IT

41:35 Non-statin medications discussed

45:05 Hypertriglyceridemia fibrates and fish oil

48:25 How often to check the lipid panel

49:58 Statin Myopathy and CoQ10

54:17 FOURIER, PCSK9 and very low LDLs

59:43 Extreme risk category discussed

62:34 Is plaque regression possible?

64:12 Take home points

67:08 Outro

Tags: assistant, care, cholesterol, doctor, education family, fish oil, foam, foamed, health, hospitalist, hospital, internal, internist, ldl, lipid, medicine, medical, myopathy, nurse, pcsk9, physician, practitioner, primary, statin, resident, student

A recap and highlights from ACP 2017, Internal Medicine's largest national conference, with Dr. Alan Dow MD, MSHA, FACP, Professor of Medicine from Virginia Commonwealth University. We discuss iron supplementations, shellfish allergies and IV contrast, proton pump inhibitors, and more!

For full show notes visit http://thecurbsiders.com/podcast.

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Tags: acp, allergy, assistant, care, contrast, doctor, education, family, foam, foamed, health, hepcidin, hospitalist, hospital, internal, internist, iron, nurse, medicine, medical, physician, ppi, practitioner, primary, resident, shellfish, student

Master the management of major depressive disorder (MDD) with clinical pearls from Dr. Marius Marcel Commodore, Associate Professor of Clinical Medicine and Psychiatry from Temple University Hospital. We cover diagnosis, patient counseling, choice of agent, dose titration, augmentation...and DJ names?

For full show notes visit http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

02:08 Rapid fire questions

11:04 Initial diagnosis and screening

13:06 Tools for diagnosis discussed

17:07 Shared decision making in choice of agent

19:40 Monitoring and follow up

21:51 Choice and comparison of agents

27:38 Augmentation and the STAR-D study

31:03 Quick recap

33:52 Cognitive behavior therapy

40:58 Medication titration and duration of therapy

45:18 Bipolar disorder screening

47:38 Screening for suicidality

49:58 Difficulty getting patients into specialty care

53:38 Mood disorders in health care providers

58:31 Listener Questions

60:48 Take home points

64:10 Outro

Tags: antidepressant, assistant, care, depression, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, mood, physician, practitioner, primary, psychiatry, ssri, snri, resident, student

An approach to super utilizers, and difficult patients with Dr. Alex Lane, Assistant Professor of Medicine at Cooper University Hospital. In this wide ranging discussion we cover books, learning, super utilizers, hot spotting, and how to approach difficult patients.

For full show notes visit http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro

02:04 Getting to know you

06:12 Best advice

07:13 Alex’s tips on keep up with EBM

11:22 Something about Alex we won’t forget

13:06 Listener Mail

15:00 Super Utilizers defined

17:00 Hot spotting defined

24:55 ACE score discussed

30:15 Team based approach to care

33:16 Getting involved in your community

36:18 Outro

Tags: assistant, care, difficult, doctor, education family, foam, foamed, health, hot, hospitalist, hospital, internal, internist, nurse, medicine, medical, patient, physician, practitioner, primary, resident, spotting, student, super, utilizer

Dominate the diagnosis and management of dementia with tips from international expert Dr. Stephen Dekosky, Professor of Neurology, and deputy director of the McKnight Brain Institute at the University of Florida. Filled with clinical pearls, we cover everything from basic testing to advanced imaging modalities, as well as current and future therapies for dementia. This episode is a must listen. Big thanks to the American Academy of Neurology for setting up this interview.

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

Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Time Stamps

00:00 Intro

02:20 Rapid fire questions

04:40 Defining dementia

08:40 Choosing a clinical test for dementia

17:20 Diagnostic labs

19:00 Genetic and CSF testing

25:46 Advanced brain imaging

28:18 Preclinical Alzheimer’s disease (AD)

32:17 Routine CNS imaging

36:18 Initiating medical therapy

39:35 Differentiating MCI and dementia

41:45 Vascular Dementia

44:10 CSF testing for AD

45:15 Vitamins, supplements, and foods as treatment or prevention

50:56 Mental exercise for AD prevention

52:36 Anticholinergic, benzos and dementia

54:46 Future directions

57:55 Outro

Tags: Alzheimers, assistant, care, education, dementia, disease, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, neurology, nurse, medicine, medical, mri, pet, primary, physician, resident, student, vascular

Dominate syncope with tools, tips, and tricks from The Curbsiders. No guest on this episode, just doctors Watto, Brigham, and Williams deconstructing the frustrating topic of syncope to provide listeners with some shiny clinical pearls and practice changing knowledge.

For full show notes visit http://thecurbsiders.com/podcast

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Tags: assistant, cardiology, care, doctor, education, epilepsy, family, foam, foamed, guideline, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, presyncope, primary, resident, student, syncope

Dominate leg cramps, diuretic therapy, and resistant hypertension. Our guest, Dr. Joel Topf, is a clinical nephrologist, pioneer in the use of social media for medical education, and Assistant Clinical Professor at Oakland University William Beaumont School of Medicine, best known for his blog, Precious Bodily Fluids, and hilarious/informative Twitter feed @kidney_boy. We start with basic renal physiology and build up to the treatment of resistant hypertension.

For full show notes visit http://thecurbsiders.com/podcast.

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Tags: assistant, care, diuretics, doctor, education family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nephrology, nurse, media, medicine, medical, physician, physiology, practitioner, primary, social, renal, resident, resistant, student

Dominate the treatment of menopause with tips from expert, Dr. Amy Tremper, Assistant Professor of Obstetrics and Gynecology at the University of Michigan Medical School. We discuss hormone replacement therapy, the Women’s Health Initiative, bio-identical hormones...and game shows?!

For full show notes visit http://thecurbsiders.com/podcast.

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Tags: assistant, care, doctor, education family, foam, foamed, health, hormone, hospitalist, hospital, hot flashes, internal, internist, nurse, medicine, medical, menopause, physician, practitioner, primary, replacement, resident, student, therapy

Stop the madness! Diagnose and treat neuropathy like expert guest, Dr. Grace Kimbaris, Assistant Professor of Clinical Neurology from University of Pennsylvania. We cover the basics along with some random pearls on fluoroquinolones, small fiber neuropathy, alpha lipoic acid, and more!

For full show notes visit http://thecurbsiders.com/podcast.

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Tags: assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medical, medicine, nerve, neuropathy, primary, physician, resident, student

Individualize cardiovascular risk, and optimize risk reduction using cardiac CT with coronary artery calcium (CAC) scoring. Our expert guests from The Society for Cardiovascular Computed Tomography (SCCT), Dr. Harvey Hecht, Professor of Medicine from Mount Sinai, and Dr. Matthew Budoff, Professor of Medicine from UCLA, school us on the use of this powerful tool. Special thanks to Dr. Emilio Fentanes from the SCCT for setting up this interview.

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Get full show notes at http://thecurbsiders.com/category/podcast

Tags/keywords: artery, assistant, cac, calcium, care, cardiovascular, coronary, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Diagnose and treat irritable bowel syndrome (IBS) like master clinician, Dr. Brooks Cash of the American College of Gastroenterology. This condition frustrates clinicians and patients alike, but we’ll give you the tools to conquer IBS. Now with our theme song included!

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Get full show notes at http://thecurbsiders.com/category/podcast

Tags: assistant, bowel, care, doctor, education, family, foam, foamed, gastroenterology, health, hospitalist, hospital, internal, internist, irritable, nurse, medicine, medical, primary, physician, resident, student, syndrome

Anticipate, and dominate the side effects of radiation therapy. On this episode we interview Dr. John J. Cuaron, Radiation Oncologist from Memorial Sloan Kettering Cancer Center in New York to better understand, “What’s the deal with radiation oncology?”.

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Get full show notes at http://thecurbsiders.com/category/podcast

Tags: assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn.

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Get full show notes at http://thecurbsiders.com/category/podcast

Tags: assistant, care, diabetes, dka, doctor, endocrinology, family, health, hospitalist, hospital, hyperglycemia, internal, internist, ketoacidosis, nurse, medicine, medical, primary, physician, student, resident

More tools, tips, and tricks so you can master obesity in clinic. On this first roundtable episode, The Curbsiders give their take on the management of obesity, and offer their own practice changing tips. Also, Paul announces his goal to watch 365 movies in 365 days, and the guys give more great book, movie, and TV recommendations.

Got feedback? Email thecurbsiders@gmail.com

Picks of the week

Matt’s pick - Never Eat Alone by Keith Ferrazzi
Paul’s pick - Sing Street (film)
Stuart’s pick - Lemony Snicket's: A series of unfortunate events

Clinical pearls (from Recap and response OR Brief topic review)

Obesity is a DISEASE. Not a lifestyle choice.
Percent weight loss by intervention
- Diet and lifestyle 5-10%
- Medications >10%
- Bariatric surgery >30%
Utilize specialist referral to gain resources e.g. dietician, and psychologist through bariatric surgery referral
Put faith in your patients ability to change and they will hold themselves accountable

Coding tips

If BMI >35 then code “morbid obesity” to increase medical decision making
Code “BMI” in addition “Morbid obesity”
Be sure to code comorbid conditions e.g. hypertension, diabetes, hyperlipidemia, OSA

Time Stamps

00:00 Intro

01:29 Picks of the week

06:07 Recap and responses to our obesity interview with Dr. Garvey

08:55 Mechanisms of obesity

10:15 Discussion of relapse rates, weight gain

11:23 Percent weight loss per therapy

14:35 Treating obesity on a budget

18:51 Coding tips

20:43 Diet, lifestyle counseling and how to leverage resources

26:38 Closing remarks

28:40 Outro

Disclosures:

The Curbsiders report no relevant financial disclosures, but as always hope to have lots of them in the future.

Never Eat Alone, Expanded and Updated: And Other Secrets to Success, One Relationship at a Time

None

Obesity is of epidemic proportions in the United States and, unfortunately, many physicians are ill-equipped to tackle this disease. In this episode, we talk with Dr. Timothy Garvey, MD, FACE, one of the world’s leading experts in obesity research. We asked the American Association of Clinical Endocrinology to recommend an obesity expert and they gave us the best!

Got feedback? Email thecurbsiders@gmail.com

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview national and international experts to bring you clinical pearls and practice changing knowledge. Doctors Matthew Watto, Stuart Brigham, and Paul Williams deliver some knowledge food for your brain hole.

Comments or questions? Email thecurbsiders@gmail.com

Summary:

Consolidate your knowledge and reinforce the learning you’ve done with us in 2016. Enjoy this holiday helping of knowledge food for your brain hole. The guys offer their best of recommendations for 2016 and recap key teaching points from the past year so you have the tools to dominate 2017.

Recommend a guest or topic and give feedback at thecurbsiders@gmail.com

Clinical Pearls:

SPRINT trial debate

Bias effects results seen in this trial. e.g. stopped early
Blood pressure (BP) control may have been overestimated based on how BP was measured leading to increased CV events (Stuart’s view).
BP measurements in trial likely reflected out of office BP so results are useful (Paul’s view).
Lower BP is probably safe, even in the elderly so be reluctant to back off on meds.

HTN Urgency

Verify BP reading and measurement technique
Evaluate for pain, anxiety, volume overload, nonadherence, or noncompliance
Treat high BP with long term goals in mind (i.e. go up on chronic/long-acting meds)

Anticoagulation

Avoid warfarin in patients with gastric bypass or Crohn’s with ileitis.
Use SPARC tool to visually demonstrate risks and benefits of anticoagulation in Afib.
Physicians commonly underestimate benefit of anticoagulation in older sicker patients and overestimate risk of bleeding.

Fibromyalgia and chronic pain

Recognize the constellation of fatigue, memory problems, sleep disturbance, and multifocal pain as fibromyalgia.
Use the 2011 American College of Rheumatology criteria for diagnosis. No tender point exam required!
Nonpharmacologic therapies and education are most effective (see video links below).
Chronic painful conditions like rheumatoid arthritis, or lupus can lead to fibromyalgia.

Functional Medicine

At least 80% of your food should be whole foods.
Use the Dirty Dozen and Clean 15 to guide organic food choices.
Knowledge of pathophysiology and biochemistry can be used to treat disease e.g. treating small intestinal bacterial overgrowth can fix iron deficiency and indirectly treat iron deficiency.

Lipids

Lowering LDL is key. Some s

Summary:

Advance your career and expertly navigate the job hunt with guidance from Dr. Alia Chisty of Temple University Hospital. Highlights include Dr. Chisty offering up her personal email address for mentorship and Dr. Watto announcing our first contest. This episode is full of wisdom to enhance your career whether you're gainfully employed or looking for your first job.

Clinical Pearls:

Meet with your mentors at the start of the process. They can:
1. Help clarify your goals
2. Activate your network
Look for jobs 9 months in advance.
An ideal job: incorporates your interests, skills, and values.
Leverage your network (friends, mentors, program director) to identify available opportunities
Email your cover letter (typically an email) and CV to the division chair or section chief
1. Craft your elevator pitch.
2. Do your homework.
3. Explain how you will add value.
When interviewing:
Give yourself credit! Highlight experiences in your CV (e.g. conference attendance, lectures given, etc.)
Have someone review and proofread your CV.
If an employer makes a promise, then have it included in your contract. Don’t just take their word!
Have a lawyer review your contract.

Goal: Listeners will learn to craft a systematized approach to finding their perfect job.

Learning objectives:

By the end of this podcast listeners will:

Recognize timeline for applications and finding or switching jobs.
Design an effective CV and cover letter.
Recognize the importance and utility of mentors in the application process

Disclosures:

Dr. Chisty reports no relevant financial disclosures.

Time Stamps

0:20 Intro

03:40 Rapid fire questions

07:10 When to start looking for jobs

09:22 How to narrow your focus

11:33 Too many choices may be worse

13:05 Asking yourself the right questions

14:40 Quick recap of what we

Summary:

On this episode we’ll teach you to dominate hypertensive urgency and severe hypertension (HTN) in the clinic, the ER, or on the hospital wards. The Curbsiders offer you this delicious serving of knowledge food so you can manage high blood pressure (BP) without making the same egregious errors that we made during our more formative years.

Of note, The Curbsiders are guestless for this episode. Guestless? Is that a word? Our guest for this episode was supposed to be Dr. Wallace Johnson, a Cardiologist, and expert on HTN from the University of Maryland. He did a fantastic job, but, unfortunately, technical difficulties caused us to lose any useable audio. Our sincerest gratitude and deepest apologies to Dr. Johnson. Nevertheless, we pressed on and used one of our own, the illustrious Dr. Paul Williams, as our expert guest.

Clinical Pearls:

Hypertensive crisis is divided into hypertensive emergency and hypertensive urgency.
- “Emergency” needs IV therapy NOW
- “Urgency” needs increased oral therapy over next 24-72 hours
History, physical exam, and familiarity with the patient are key for triage (e.g. verify BP readings, assess compliance, etc.)
Severe HTN and hypertensive urgency can often be treated in the outpatient setting
IV agents are not indicated outside of true hypertensive emergency (i.e. objective end organ damage)
We recommend increasing dose or frequency of existing BP meds as 1st line (better long-term solution)
Intermittent dosing of oral labetalol, clonidine, and captopril can be considered as 2nd line (short-term solution)
Rule out uncontrolled pain, volume overload, alcohol withdrawal, illicit drug, and missed medications as cause of severe HTN
Evidence from observational studies suggests that headaches are NOT caused by HTN
Untreated severe HTN was historically fatal in months to years prior to development of antihypertensives

Goal: Listeners will become proficient in the appraisal of severe hypertension/ hypertensive urgency and employ safe and practical management strategies.

Learning objectives:

By the end of this podcast listeners will:

Confidently triage patients with severe hypertension and provide appropriate disposition in a variety of settings
Employ a safe and common sense approach to the treatment of severe hypertension in the clinic, the ER, or on the wards
Be familiar with pharmacologic management of severe hypertension in a variety of settings
Recognize the common causes of severe blood pressure elevation in the inpatient setting

Does the thought of responding to an in-flight emergency ruin your air travel? Then tune in because on this episode, Angelica Zen, MD, Chief Resident of Internal Medicine at UCLA, recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane.

On this episode, we got served! Endocrinologist, Dr. Pauline Camacho, current president of AACE and Professor of Medicine at Loyola University Chicago makes it rain clinical pearls as she schools us on the use of calcium, Vitamin D, bisphosphonate therapy and drug holidays. This is a must listen for anyone treating osteoporosis. Make sure to check out the new 2016 AACE guidelines, which include infographics for patients and their easy to use algorithm.

Dr. Robert Centor’s Knowledge Food, Part 2! On this episode of The Curbsiders, we continue our discussion with the legendary Dr. Centor, focusing on pharyngitis and the highly entertaining origin of the Centor Criteria. Not only do we learn how to dominate pharyngitis, but we also uncover one of Dr. Watto’s knowledge deficits - Lemierre’s Syndrome. (He owes us a two minute talk on Lemierre’s Syndrome in case you’re wondering. I know I am.)

Summary:

Dr. Robert Centor’s Knowledge Food, Part 1. This Halloween, the “Curse of Knowledge” is REAL! So you think you can teach? This master clinician educator, known for “Centor’s Criteria,” schools us the most common errors made by medical educators and how to improve learner retention. While we only scratch the surface, Season 1’s arguably penultimate episode should NOT be missed. After all, how else are you going to learn about Pretty Pimpin’? Stay tuned for Part Duex when we briefly review Pharyngitis and Dr. Watto finally learns about Lemierre’s Syndrome! As always, you’re welcome.

Stop feeling helpless in the face of vague complaints like fatigue, digestive problems, mood swings, inability to lose weight, etc. Learn to treat any chronic disease without writing more prescriptions. Heal yourself and your patients with the power of food. Join us for the return of Functional Medicine physician, Dr. Yousef Elyaman, as he schools us on elimination diets, phytonutrients, liver detoxification, going “paleo” and more. This is a deluxe episode so we’ve included a time key below. You’re welcome.

Learn to treat non cancer pain in the elderly. Managing persistent pain in the elderly can be...painful. On this episode Matt and Paul interview Dr. Marissa Galicia-Castillo, a Professor of Geriatrics from Eastern Virginia Medical School board certified in Internal Medicine, Geriatrics, Hospice/Palliative Medicine. Are we being too stingy with opioid prescriptions? How do you assess and treat pain in patients with advanced dementia? We’ve got your answers.

Fifty four percent of physicians report at least one symptom of burnout. On this episode Dr. Philip Kroth an Internist and Chief of Clinical Informatics from the University of New Mexico schools us on how electronic health records (EHR) relate to burnout and tips to promote physician wellness. Miss this episode and you might get burned...out. I refuse to apologize for that pun. Enjoy!

Do complaints of insomnia stress you out? Well, never fear. In this episode our guest is Dr. Karl Doghramji, Professor of Psychiatry, Neurology and Medicine and the Medical Director of the Sleep Disorders Center at Thomas Jefferson University Hospital in Philadelphia. With his help we deconstruct the “dread pirate” insomnia (as I call it) so you can dominate it in your daily practice.

In this episode our guest is Dr. Robert Dickson a Pulmonologist from the University of Michigan who studies the respiratory microbiome. We discuss how the lung microbiome differs in health, chronic illness and acute disease states like pneumonia, sepsis and ARDS. The lung microbiome has the ability to predict frequency of exacerbations and even severity and progression of certain lung diseases. We’ll explore all of this plus Dr. Dickson’s new paper published last month in Nature Microbiology, which had the surprise of finding gut bacteria in the lungs during critical illness. Please enjoy this wide ranging discussion

We explore everything you’ll ever want to know about cholesterol and lipids. Are statins still king when it comes to cholesterol lowering? Should we be rushing to use PCSK9 inhibitors? Should we throw away older drugs like fibrates? Are nonpharmacologic therapies like niacin and fish oil worthwhile? Our guest is Master Lipidologist, Dr. Peter Howard Jones from Baylor College of Medicine and the National Lipid Association. My guest host is Dr. Paul Williams, Clinician Educator extraordinaire from Philadelphia.

Treat C. diff, choose the correct antibiotic regimen, and identify who needs fecal transplant as we “curbside” Gastroenterologist, Dr. Adam Ehrlich from Temple University Hospital. On the show, we cover the ins-and-outs of procuring, preparing and performing transplants as well as future directions in this burgeoning field e.g. IBD, obesity, metabolic syndrome and more.

Take Home Points:

Clostridium difficile infection is the only indication for which FMT is allowed by the FDA without special authorization
FMT is VERY effective in these C difficile patients compared to standard of care (approximately 90% cure vs 30%)
We are just beginning to understand the role of the microbiome in human health, and I anticipate many changes in the years ahead where modifying the microbiome will be used to help treat a number of diseases.

Links from the Show:

Recommended reading...

NEJM Journal Watch for Gastroenterology - register here

Review on novel uses for fecal transplantation

Rossen NG, et al. Fecal microbiota transplantation as novel therapy in gastroenterology: A systematic review. World J Gastroenterol. 2015 May 7;21(17):5359-71. doi: 10.3748/wjg.v21.i17.5359.

Randomized controlled trial of fresh vs frozen fecal transplantation

Fresh vs Frozen Fecal Microbiota Transplant for C diff Recurrent C difficile infection. JAMA 2016

Review on mechanisms for gut microbiota on metabolic syndromes

Qian LL, et al. Effect of the Gut Microbiota on Obesity and Its Underlying Mechanisms: an Update. Biomed Environ Sci. 2015 Nov;28(11):839-47. doi: 10.3967/bes2015.117.

In this episode Dr. Yousef Elyaman from the Institute of Functional Medicine schools us on how the biochemistry and pathophysiology we’ve forgotten from medical school can be used to cure illness. FODMAP diet and Antibiotics to cure restless legs syndrome? Melatonin to treat gastroesophageal reflux disease? This is just a little taste of the knowledge food served up on this introduction to Functional Medicine.

This episode, part 2 of our last episode, is a must listen if you’ve ever felt helpless in the face of fibromyalgia and chronic pain. Keep listening for part 2 of our “curbside” with expert clinician and prominent researcher Dr. Daniel Clauw, from the University of Michigan’s Chronic Pain and Fatigue Research Center. The show is chock full of clinical pearls for the mastery of chronic pain syndromes.

This episode, part 1 of 2, is a must listen if you’ve ever felt helpless in the face of fibromyalgia and chronic pain. Listen as we “curbside” expert clinician and prominent researcher Dr. Daniel Clauw, from the University of Michigan’s Chronic Pain and Fatigue Research Center. The show is chock full of clinical pearls for the mastery of chronic pain syndromes.

In this episode we “curbside” SoCal Cardiologist, Dr. Neel Patel. If you’re like us and confused by the smorgasbord of cardiac imaging and stress testing then this show is a must listen. Whether you’re in the clinic or on call for Internal Medicine, Dr. Patel has your answers on coronary artery calcium scoring, coronary CT scans and all types of stress testing.

If headache patients strike fear in your heart, then this is the episode for you. In this episode The Curbsiders interview Internist and Headache Specialist Dr. Glen D. Solomon to deconstruct the topics of migraine and chronic tension type headaches. Dr. Solomon is currently a Professor and Chair of the Department of Internal Medicine at Wright State University and a former director of the Headache Medicine Fellowship at the Cleveland Clinic. Join them as they discuss the approach to diagnosis and management of chronic headaches.

In this part 1 of 2 episode on the non-Vitamin K oral anticoagulants, The Curbsiders discuss these novel medications and other changes associated with the updated 2016 CHEST guidelines for anticoagulation.

In this interview, Matt speaks with Dr. Paul Williams about the SPRINT Trial of Intensive blood pressure control and how it is likely to change clinical practice. Tony and Stuart discuss their own take-home points from the trial. Discussion of ARBs you've never heard of and the holy grail of blood pressure cuffs ensues.

Tags: assistant, blood, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nurse, medicine, medical, pressure, primary, physician, resident, student

In this inaugural episode, join the Curbsiders as they tackle the hot topic of male hypogonadism and low testosterone by curbsiding Endocrinologist Dr. Jeff Colburn, a leading clinician and educator in San Antonio, Texas

Tags: androgen, andropause, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, hypogonadism, internal, internist, libido, low T, medical, medicine, nurse, primary, physician, resident, student, testosterone