Questioning Medicine27 Sep 2025

Episode 400: 408. CME Obesity and MASH

GLP1 drugs work but they likely need lifestyle modifications

No convincing evidence GLP1 cause thyroid cancer in humans BUT contraindication if family history exist

Stopping therapy usually results in weight gain

Insurance coverage for weight loss is limited and variable

Semaglutide for type 2 diabetes max dose is 2.0 mg weekly Semaglutide for weight loss has a goal dose of 2.4 mg weekly
Diagnose steatotic liver disease with imaging and 1 metabolic risk factor (or biopsy)

After diagnosis check FIB-4:
- Low risk, continue to monitor with FIB-4 every 2-3yrs
- Intermediate risk, order VCTE and consider referral if >F1
- High risk order a VCTE and referral (20% end with SLD)

2 FDA approved medications for liver fibrosis are not cheap, expect insurance push back

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Episoder(401)

Episode 439: 446. mRNA flu vaccine? Is it worth the outcome hype?

https://www.nejm.org/doi/full/10.1056/NEJMoa2516491https://www.ahajournals.org/doi/10.1161/CIR.0000000000001466

21 Okt 19min

Episode 438: 445. GLP1 CME

OMED GLP1 CME

14 Okt 39min

Episode 437: 444. Monday Morning Articles

Silvain J, et al. Discontinuation of β-blockers in stable patients with previous myocardial infarction, preserved left ventricular ejection fraction, and no heart failure: A pooled analysis of individ...

12 Okt 27min

Episode 436: 443. Fast 5 Medical Article Review

Kanwal F, et al. Clinical care pathway for the risk stratification and management of patients with metabolic dysfunction–associated steatotic liver disease. Gastroenterology 2026 Jul; 171:164. DOI: 10...

30 Sep 24min

Episode 435: 442. 7 article review

we unpack whether rivaroxaban followed by aspirin improves thromboprophylaxis after hip and knee arthroplasty, put oral GLP-1 therapy orforglipron head-to-head with dapagliflozin for type 2 diabetes, ...

10 Sep 33min

Episode 434: 441. Coronary Artery Calcium (CAC) -- Yacky Yack, the details on CAC

Does a Coronary Artery Calcium (CAC) scan still earn its place in modern cardiovascular prevention? This podcast cuts through the headlines to examine the recent research, challenge overconfident conc...

31 Aug 48min