#500: COPD Update with Cyrus Askin

#500: COPD Update with Cyrus Askin

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

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#483: Diabetic Dilemmas in Older Adults, Pregnancy and Corticosteroid Use with Jeff Colburn, MD

#483: Diabetic Dilemmas in Older Adults, Pregnancy and Corticosteroid Use with Jeff Colburn, MD

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! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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.  Sponsor: Freed Visit Freed.ai and Usecode: CURB50 to get $50 off your first month when you subscribe.  Sponsor: Quince Go to Quince.com/curb for free shipping on your order and 365 day returns.

19 Touko 1h 19min

UNLOCKED #43 Exclusive! HFrEF (TFTC audio)

UNLOCKED #43 Exclusive! HFrEF (TFTC audio)

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

14 Touko 30min

REBOOT #458 Heart Failure with Reduced Ejection Fraction - Kittleson Rules Outpatient Heart Failure Volume 1

REBOOT #458 Heart Failure with Reduced Ejection Fraction - Kittleson Rules Outpatient Heart Failure Volume 1

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! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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  Get your summer savings and shop premium wireless plans at MINTMOBILE. com/CURB. 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. Sponsor: Panacea Legal Learn more and schedule your free consultation at Panacea.Legal.

12 Touko 1h 3min

#482 Recap from SHM #Converge25

#482 Recap from SHM #Converge25

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. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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.  Sponsor: Freed Visit www.getfreed.ai and sse code: CURB50 to get $50 off your first month when you subscribe! Sponsor: Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com. Sponsor: Grammarly  Download Grammarly for free at Grammarly.com/PODCAST. 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.

5 Touko 1h 29min

#481 Prediabetes and Diabetes Prevention with Dr. Scott Isaacs

#481 Prediabetes and Diabetes Prevention with Dr. Scott Isaacs

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! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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.  Sponsor: FIGS 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.

28 Huhti 1h 33min

#480 Hypermobility with Dr. Linda Bluestein

#480 Hypermobility with Dr. Linda Bluestein

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! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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.  Sponsor: Mint Mobile 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.

21 Huhti 1h 24min

#479 Managing Treatment-Resistant Depression featuring Dr. Jessi Gold

#479 Managing Treatment-Resistant Depression featuring Dr. Jessi Gold

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! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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 Sponsor: Freed Visit Freed.ai and use code CURB50 to get $50 off your first month when you subscribe!

14 Huhti 1h 34min

#478 Dementia 2.0 with Anna Chodos

#478 Dementia 2.0 with Anna Chodos

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! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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  Download Grammarly for free at Grammarly.com/PODCAST 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.

7 Huhti 1h 30min

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