Core IM | Internal Medicine Podcast

“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and support their recovery. Also discover blind spots in detox and rehab centers. 🔹Transcript and Show Notes 🔹 Explore ACP’s Substance Use Disorder Education Hub for videos and an AI-powered patient simulation to practice alcohol-use conversations: https://www.coreimpodcast.com/SUDhub Alcohol Use and Chronic Health Conditions Mini Video Series 01:55 | #1: Naltrexone 12:06 | #2 Acamprosate 16:15 | #3: Topiramate 21:12 | #4: Other meds 29:31 | #5: Detox and rehab blind spots Tags: CoreIM, Medical Education, Addiction Medicine, Alcohol Withdrawal, Addiction Treatment, GLP-1, pharmacology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always obvious. We also discuss ways to work through that grief, recognize when it becomes complicated, and lean on your team for support. 🔹Transcript and Shownotes 04:12 | What is Clinician Grief? 10:02 | Types of Losses 10:22 | Loss of a close relationship with a particular patient 12:56 | Loss due to a professional's identification with the pain of family members 13:56 | Loss of one's unmet goals and expectations and one's professional self-image and role 18:47 | Loss related to one's personal system of beliefs and assumptions about life 21:30 | Past unresolved losses or anticipated future losses 23:29 | The death of the self 25:44 | Coping Tags: CoreIM, Medical Education, Clinician Wellbeing, Burnout, Secondary Traumatic Stress, Complicated Grief, Coping With Grief, Medical humanities, medical ethics Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about sphincterotomy, stents, and stone removal? Plus, how to interpret bile duct dilation without jumping straight to obstruction? 🔹Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes 02:11 | Pearl 1: Gallbladder Problems Spectrum 07:33 | Pearl 2: Choose Imaging Strategically: Start with RUQUS, Escalate as Needed 14:34 | Pearl 3: Biliary Tree Diagnostics 19:19 | Pearl 4: Invasives that are Diagnostic and Therapeutic 27:06 | Pearl 5: Stenting in ERCP Tags: CoreIM, Internal Medicine, Medical Education, Gallstones, Cholecystitis, Biliary Disease, ERCP, Biliary Imaging Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia management, from fluids and solutes to loop diuretics and identifying the underlying cause. 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here. 🔹Transcript and Shownotes 6:46 | Pearl 1: Key Principles 15:13 | Pearl 2: Fluids in hyponatremia 26: 03 | Pearl 3: Solutes in hyponatremia management 35:49 | Pearl 4: Lasix in hyponatremia management 40:05 | Pearl 5: Etiologies Tags: CoreIM, Internal Medicine, Medical Education, SIADH, Fluid Restriction, Nephrology, Hospital Medicine, Urine Osmolality Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers, Thiazides) is the preferred first-line framework, and how to personalize medication choices based on comorbidities and side effects. 🔹Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes 03:00 | Diagnosing Hypertension 04:10 | When to Start Combination Therapy Instead of Monotherapy 07:00 | Choosing First-Line Therapy Using the ACT Framework 13:23 | Why ARBs Are Often Preferred Over ACE Inhibitors 16:02 | Choosing the Right ARB: Candesartan vs Losartan 18:39 | Comparing Potency & Duration Across First-Line Antihypertensives 20:54 | Amlodipine Edema: Why It Happens and How to Fix It 23:54 | Thiazides: Practical Tips, Electrolyte Problems & Class-Killer Side Effects 29:33 | Managing Patients Who 'Can't Tolerate' Blood Pressure Medications Tags: Hypertension Management, High Blood Pressure, Primary Care, Internal Medicine, Core IM Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines! Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change statin decisions, why LDL targets are back, and when to use Lp(a), ApoB, and coronary artery calcium (CAC) testing. Discover updated risk-enhancing factors, expanded indications for non-statin therapies, and practical strategies to personalize lipid management for both primary and secondary 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here. 🔹Transcript and Shownotes: 01:17 | Highlight #1 & #2: CPR and PREVENT Score 03:14 | Highlight #3: Updated ASCVD Risk Categories Using the PREVENT Score 05:30 | Highlight #4: LDL Targets Are Back 07:20 | Highlight #5: High-Risk Conditions That Bypass the PREVENT Score 08:41 | Highlight #6: Lp(a) Screening for Everyone 11:51 | Highlight #7: When to Use ApoB Testing 13:16 | Highlight #8: Reproductive Risk Factors 15:29 | Highlight #9: Using CAC to Guide Statin Therapy 19:09 | Highlight #10: Non-Statin Therapies Tags: CoreIM, Internal Medicine, Medical Education, Cholesterol, Statins, LDL, ASCVD, Preventive Cardiology, LpA, ApoB, CAC, ACC2026, Cardiology, PrimaryCare Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we finally entering an era where we can meaningfully treat MASH? In this Beyond Journal Club episode, we unpack the evolving language of steatotic liver disease and take a close look at two major trials: MAESTRO-NASH studying resmetirom, the first FDA-approved liver-directed therapy for MASH, and ESSENCE, evaluating semaglutide in biopsy-confirmed disease. Along the way, we explore what these biopsy-based histologic endpoints really mean, why placebo responses were surprisingly high, and whether improvements in steatohepatitis and fibrosis will ultimately translate into better clinical outcomes for patients. This episode is for clinicians trying to understand where the field is headed, which patients deserve closer attention, and how metabolic liver disease is increasingly becoming part of everyday primary care and hospital medicine. 🔹Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes: 01:57 | Understanding MASLD as a Systemic Disease 05:45 | MASLD vs MASH vs Met-ALD: Spectrum Steatotic Liver Disease 08:55 | How to Screen for Fibrosis (FIB-4 & FibroScan) 16:15 | Lifestyle Treatment & Weight Loss Targets 19:00 | ESSENCE Trial: Semaglutide for MASH 21:58 | MAESTRO-NASH Trial: Resmetirom 27:27 | Future Treatments for MASH 30:51 | Key Takeaways for Clinicians Tags: CoreIM, Internal Medicine, Medical Education, Hepatology, Fatty Liver Disease, Metabolic Dysfunction Associated Steatohepatitis, Nonalcoholic Fatty Liver Disease, Liver Fibrosis Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability, antihypertensive selection, and strategies to prevent intradialytic complications while optimizing long-term outcomes. 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here. 🔹Transcript and Shownotes: 02: 19 | Pearl 1: Blood Pressure Targets 09: 40 | Pearl 2: Timing Medications and Dialyzability 15: 31 | Pearl 3 - Pharmacologic Management Nuances in Dialysis Patients 22: 57 | Putting It All Together: The Medication Hierarchy Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, ESRD, End-Stage Kidney Disease, Hypertension, Kidney Health, Dry Weight, Volume Overload Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis, why ESKD patients have unique physiology, and how volume overload, not just hypertension, drives many complications. Learn practical pearls on dry weight, sodium restriction, diuretics, and the strategies that can reduce hospitalizations and improve patient outcomes. 🔹Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes: 02:49 | Pearl 1: Foundations of Dialysis 09:21 | Pearl 2: Distinct Physiology 11:42 | Pearl 3: Why is fluid management so important? 19:43 | Pearl 4: Fluid Management Pro-tips 25:31 | Pearl 5: Diuretics in Patients with Residual Kidney Function Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, Dialysis, End-stage kidney disease, Hypertension, Kidney Health, Dry Weight, Volume Overload Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between algorithms, uncertainty, and human judgment in modern medical care. 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here. 🔹Transcript and Shownotes: 02:51 | Broad workup for reversible causes and other etiologies of AFib that may occur post-op 05:10 | Considerations for management of post-op atrial fibrillation 13:00 | Stroke risk in atrial fibrillation 20:49 | Outpatient management of atrial fibrillation 25:54 | The role of AI in medical decision-making Tags: CoreIM, Internal Medicine, Medical Education, Atrial Fibrillation, Cardiology, Open Evidence Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but hopefully less than before. 🔹Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes: 04:40 | Emergency Medical Kit (EMK) Standard Contents 08:50 | Role of Ground-Based Medical Support & Flight Diversion Decision-Making 19:35 | Interpreting Hypoxia at Altitude 22:06 | In-Flight Liability 23:35 | Common Chief Concerns & Useful Additional Medications 24:53 | How to Be Resourceful in an Austere Environment Tags: CoreIM, Internal Medicine, Medical Education, In-flight Care, Medical Emergencies, Clinical Reasoning, Seizure Management, Hypoxia, Airway Management, Cardiac Emergency, Syncope, Respiratory Distress Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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

Is coffee helping or harming our patients’ hearts? In this Beyond Journal Club, we unpack the CRAVE trial and use it as a lens to answer a bigger question: How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust? Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle. 🔹Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show notes 00:00 | Challenges of interpreting nutritional research. 02:22 | Best practices for evaluating studies in nutrition. 12:35 | Delve into the CRAVE trial as an example of critically appraising nutritional investigations. 26:41 | Applying this to clinical practice for your patients. Tags: IMCore, Internal Medicine, Medical Education, Epidemiology, Diet and Lifestyle Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach. .🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com 🔹Transcript and Shownotes: 02:15 | Pearl 1: Pathophysiology 08:20 | Pearl 2: Diagnosis 16:35 | Pearl 3: Treatment 20:35 | Pearl 4: Antibiotics 27:39 | Pearl 5: Wound Care Tags: CoreIM, Internal Medicine, Medical Education, Diabetic Foot Infections, Osteomyelitis, Foot Ulcer, Wound Care Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded? A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI? A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter? And the classic inpatient dilemma: your heart failure patient looks better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going? 🔹Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/ See here for Neph Madness details See here for the POCUS region of NephMaddness VOTE here to build your bracket! 🔹Transcript and Shownotes: 00:52 | What is NephMadness? 02:19 | Detecting post-renal obstruction in a patient who reported normal urination 11:26 | POCUS for discharge or continue diurese 17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound 23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis line Along the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside. If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question. Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUS Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them. • Do cholinesterase inhibitors really work? • What should clinicians know about lecanemab and donanemab before referring patients? • How much benefit should we expect and for how long? • When should you deprescribe dementia medications? 🔹Sponsor: Caraway’s cookware set is a favorite for a reason. For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout. 🔹Transcript and Shownotes 02:27 | Deep Dive 1: How do we deliver the news of a diagnosis of dementia? 09:41 | Deep Dive 2: Prescribing medications for cognitive decline 29:30 | Deep Dive 3: Patient-centered management for a patient with cognitive decline 35:46 | Deep Dive 4: Planning for an uncertain future Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI? 🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com 🔹Transcript & Shownotes: 01:12 | Cognitive Concerns During a Routine Follow-Up 03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues? 15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline? 31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline? Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden. 🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/ 🔹Transcript and Shownotes: 00.58 | Insulin Hx & Types 06:00 | Indications for Insulin and the Burden on Patients 08:26 | What is the QWINT-1 Trial? 16:18 | Discussion Tags: CoreIM, Internal Medicine, Evidence-Based Medicine, Insulin Resistance, Clinical Reasoning, Hospital Medicine, Medical Education, Endocrine, Endocrinology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside, learn how clinicians should act when ethics, law, and trust collide. 🔹 Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com 🔹Transcript and Shownotes: 03:51 | What is the difference between Privacy and Confidentiality? 05:50 | Guidelines and laws 10:06 | Limits/appropriate breaches (competing principles/obligations) 22:03 | Privacy vs education 35:34 | Conclusion Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Baby alligators - those betrayals of purpose , or, death by a thousand paper cuts ! Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with: Regulated curiosity Strategic empathy Small, well-chosen moves... ...and change that is big enough to matter, and small enough to win! 🔹 Sponsor: Caraway’s cookware set is a favorite for a reason. For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout. 🔹 Transcript & Shownotes 00:00 | What are “baby alligators” in medicine? 02:24 | Rifaximin & Workflow Fixes 14:17 | Verbal Orders Policy 18:39 | Micro Skills for Change 25:12 | Key Takeaways #PhysicianBurnout #DoctorLife #HealthcareEfficiency, CoreIM, Internal Medicine, Career Development, Quality Improvement, QI Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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

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

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

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

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

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

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

HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right? 🔹 Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 Transcript & Show Notes Timestamps: (00:57) | Understanding the Pathophysiology of HRS (03:42) | How Portal Hypertension Traps the Kidneys (10:32) | Sorting the Differential of AKI in Cirrhosis Beyond HRS (18:28) | Hyponatremia and Urine Sodium in Advanced Cirrhosis (24:04) | Official Diagnosis and Evolving Criteria of HRS (29:30) | Albumin: When It Helps and When to Hold Back (34:00) | Recap and Future Directions Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Nephrology, renal, hepatology, Portal Hypertension, Liver Disease Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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

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

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

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

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

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

What went wrong? What were the reasoning or contextual missteps that led us astray? 🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025 🔹 Transcript and Show Notes Timestamps: (00:02) | Case Presentation and Initial Diagnosis (02:47) | Tachycardia and Early Impressions (04:10) | Clinical Deterioration and New Clues (07:19) | Problem Representation and Reflection (21:45) | Lessons on Reasoning and Bias (26:55) | Final Takeaways and Action Steps Tags: Clinical Reasoning, Internal Medicine, Diagnostic Accuracy, Hoofbeats, Cognitive Bias, Medical Education, Illness Scripts Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Imaging Pearls | (01:12) Deciding on Thoracentesis | (04:00) Light’s Criteria and Pseudoexudates | (07:00) Pleural Fluid Studies: pH and Cell Differential | (16:56) Diagnosing and Treating Parapneumonic Effusions | (23:32) Malignant Pleural Effusions: Diagnosis and Management | (30:39) 🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP 🔹 Transcript and Show Notes Tags: Internal Medicine, Medical Education, Pulmonology, CoreIM, Clinical Reasoning, critical care, pulm Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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

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

🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46) 🔹 What are the main classes of fungi? (~11:35) 🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16) 🔹 How to increase the yield of blood cultures? How to interpret yeast growth in sputum/BAL and urine cultures? (~ 30:42) 🔹 How is invasive fungal disease treated? (~ 35:14) 📌 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP 📌 Transcript & show notes Tags: CoreIM, IMCore, Infectious Disease, Hospital Medicine, Hospitalist, ICU, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, mold Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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

🔹When is an U/S vs. CT vs. MRI helpful before consulting Interventional Radiology? 🔹What factors go into an IR pre-op evaluation? 🔹 When do drains go in, and when do they come out? 🔹 When a patient has trouble with a drain, what are things you can do before calling IR? 🔹 What does outpatient IR follow up entail, and what does a capping trial of PCN tubes entail? 📌 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion Use the code "CORE30" for 30% off effective 11/1/25 through 1/31/26: https://www.coreimpodcast.com/MKSAP Transcript & show notes Tags: CoreIM, IMCore, Gastroenterology, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Medical Imaging, Bleeding Assessment, Drain Management, Procedural Sedation Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

🔹 High-yield reversible causes of constipation? (02:26) 🔹 Which type of fiber is more helpful? And is more hydration really better? And bulk-forming laxatives (9:03) 🔹 Osmotic vs Stimulant Laxatives (15:06) 🔹 Suppositories and enemas? (25:39) 🔹Best practices with opioid induced constipation (34:05) 📌 Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed 📌 Earn CME credit with ACP for this episode! CME-MOC credit 📌 Transcript and Show Notes Tags: CoreIM, IMCore, Gastroenterology, GI Pharmacology, Digestive Health, Primary Care, Medical Education, Physician Assistant, Nurse Practitioner, Medical Student, Laxatives, Stool Softeners, Senna, Bisacodyl, Polyethylene Glycol, Bowel Regimen, Magnesium Citrate, Lactulose Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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

What does Lipoprotein(a) tell us that a standard lipid panel doesn’t? Should we be testing everyone for it? Dive into the genetics, clinical implications, and evolving management strategies for Lp(a). Learn how to interpret results, counsel patients, and navigate topics with limited data like aspirin and PCSK9 inhibitors in treatment. 🔹 Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed 🔹 Transcript and Show Notes Timestamps: (02:17) | Pearl 1: What makes Lp(a) unique? How does it raise ASCVD risk? (10:32) | Pearl 2: Who should be tested for Lp(a)? When and why? (16:54) | Pearl 3: Understanding and interpreting Lp(a) levels (24:04) | Pearl 4: How does an elevated Lp(a) affect management? (37:05)| Pearl 5: The role of aspirin and PCSK9 inhibitors in Lp(a) Tags: CoreIM, Internal Medicine, Primary Care, Preventive Cardiology, Atherosclerosis, Lipid Management, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

A new way to think of clots beyond provoked vs. unprovoked: Learn all about how important it is to think about reversibility! What patient states affect the inherited thrombophilia testing? Learn the nuances and practical approaches! 🔹 Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed 🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com. Transcript and Show Notes Timestamps: (02:07) | Pearl 1: Reframing Provoked vs. Unprovoked to Reversibility (09:12) | Pearl 2: How can Virchow's Triad help us categorize the etiology of a clot? (17:01) | Pearl 3: What factors affect anti-thrombin III, Protein C and Protein S deficiency (28:50) | Pearl 4: Is the Factor V Leiden or Prothrombin Gene Mutation as important as the family history? (38:41) | Pearl 5: Spaced Repetition of Learning Points Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Check out Eko: https://ekohealth.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy