The Curbsiders Internal Medicine Podcast

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!

13 Mar 202437min

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! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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 Sponsor: Rocket Money  Cancel your unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Freed You can try Freed for free right now by going to freed.ai And listeners of Curbsiders can use code CURB 50 for $50 off their first month.

11 Mar 202453min

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).  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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 Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts. 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: Allbirds   Visit Allbirds.com and use code CURB for a free pair of socks with a purchase of $48 or more.

4 Mar 20241h 32min

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).  Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! 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. Sponsor: Factor Head to FactorMeals.com/curb50 and use code curb50 to get 50% off.  Sponsor: NetSuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance - absolutely free, at NetSuite.com/CURBSIDERS. 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.

26 Feb 202455min

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).  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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. Sponsor: Panacea  Visit panaceafinancial.com today to open your free account. Sponsor: Grammarly  Make a bigger impact at work with Grammarly. Sign up and download for FREE at grammarly.com/PODCAST Sponsor: Rocket Money  Stop wasting money on things you don’t use. Cancel your unwanted subscriptions by going to RocketMoney.com/CURB.

19 Feb 20241h 8min

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. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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. Sponsor: Freed You can try Freed for free right now by going to freed.ai Listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Babbel Get 50% off at Babbel.com/CURB Sponsor: NetSuite Get your own KPI Checklist at NetSuite.com/CURBSIDERS

12 Feb 202458min

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.  Claim 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 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. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Pathway Improve your clinical decision-making process and enhance patient care. Download the Pathway app today by visiting pathway.md

5 Feb 20241h 1min

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!

31 Jan 202449min