REBOOT #421 Antiphospholipid Syndrome with Dr. Arielle Langer

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 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 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

1 Des 201757min

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 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 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

27 Nov 201741min

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 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 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

20 Nov 20171h 3min

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 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 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

13 Nov 201744min