The Curbsiders Internal Medicine Podcast

Join us as we review recent practice-changing articles on transfusion thresholds in acute MI, COVID-19 rebound after treatment with ritonavir-boosted nirmatrelvir (PaxlovidTM), the prevalence of iron deficiency, as well as the debut of our new “corrections and omissions” section, in which we cover important knowledge updates on oral iron dosing and correcting serum calcium. And, find out why oral phenylephrine does not work and what you should prescribe instead for upper respiratory symptoms. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written, Produced, and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments 00:00 Introduction and Calcium Puns 03:11 Iron Deficiency and Iron Supplementation 12:20 Corrected Calcium 18:09 Virologic Rebound after nirmatrelvir/ritonavir (Paxlovid™) 32:09 Phenylephrine and its Ineffectiveness 37:00 Restrictive vs. Liberal Transfusion Strategy in MI (MINT trial) 49:20 Outro 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: Rocket Money Cancel unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Netsuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance for 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.

29 Jan 202456min

Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice.  Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction.  Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.  Claim CME for this episode at curbsiders.vcu health.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction and Overview 09:13 Diagnosing Dental Pain and Examination Techniques 18:44 Treatment Options for Dental Pain 29:34 Complications and Emergencies in Dental Care 32:36 Post-operative Care and General Dental Advice 40:35 Dry Mouth and Treatment Options 44:05 Gingivitis 49:39 Temporomandibular Joint (TMJ) Dysfunction 55:43 Medications and Dental Side Effects 56:12 Anticoagulants and Dental Procedures 01:00:55 Endocarditis Prophylaxis 01:03:15 Joint Replacements and Antibiotic Prophylaxis 01:04:10 Oral Health in Patients with Opioid Use Disorder Credits Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Lisa Simon MD, DMD 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: Grammarly Go to grammarly.com/PODCAST to download for FREE today. Sponsor: Factor Head to FactorMeals.com/curb50 and use code curb50 to get 50% off.  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.

22 Jan 20241h 15min

Learn practical tips for the inpatient management of patients with sickle cell disease and vaso-occlusive crisis from guest, Dr. Yoo Mee Shin (Emory). We cover acute pain management including adjuvant therapies, IV fluids, oxygen therapy, the management of acute chest syndrome, and when to perform simple vs exchange transfusions. Key takeaways include the importance of early triage and analgesia, addressing misconceptions about opioid use disorder in patients with sickle cell disease, and recognizing complications of vaso-occlusive crises. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Intro 01:27 Getting to know our guest 07:48 Case Presentation and Initial Management of Sickle Cell Disease (SCD) 13:46 Misconceptions about opioid use disorder and sickle cell 17:02 Management of Acute Pain in Sickle Cell Disease 25:46 Adjuvant therapy for pain 29:04 Transition to outpatient care 32:46 General admission orders for sickle cell 38:44 Management of Acute Chest Syndrome 42:01 Simple vs exchange transfusion 47:08 Transfusion in preoperative and pregnant patients 48:03 Transitions and follow-up care 49:35 Key takeaways and Outro Credits Written and Produced by:  Matthew Watto MD, FACP Cover Art & 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: Yoo Mee Shin 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: Green Chef Go to greenchef.com/60curb and use code 60curb to get 60% off, plus 20% off your next two months. Sponsor: NetSuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance -absolutely free, at NetSuite.com/CURBSIDERS

15 Jan 202457min

Conquer your fear of antiphospholipid syndrome! Dr. Arielle Langer leads us through what clinical features raise suspicion for antiphospholipid syndrome, how to interpret laboratory testing, and the nuances of antiphospholipid syndrome management. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak What is antiphospholipid syndrome? Clinical features that raise suspicion for antiphospholipid syndrome Laboratory testing and diagnosis of antiphospholipid syndrome Management of antiphospholipid syndrome: initial treatment Management of antiphospholipid syndrome: managing recurrent thrombosis Return to Case: Pregnancy in patients with a history of thrombotic APLS Obstetric APLS Final questions Outro Credits Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Arielle Langer 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: Rocket Money Cancel your unwanted subscriptions by going to RocketMoney.com/CURB. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Green Chef Get sixty percent off Green Chef, plus twenty percent off your next two months, with code 60curb at GREENCHEF.com/60curb.

8 Jan 20241h 20min

Discover DGBI! Learn its pathophysiology, evaluation and individualized treatments so you can leave the fear of managing DGBI behind. We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic) Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions (6:20)  Definition of Disorders of the Gut-Brain Interaction (7:30-11:00) Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments  (24:30-36:00) Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00) Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11) Take home points Outro Credits Producer: Elena Gibson MD Writer:Andréa Perdigão, Elena Gibson Show Notes and Infographics: Andréa Perdigão Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Xiao Jing (Iris) Wang MD

1 Jan 20241h 37min

Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders. Our team needed a break so we did not make CME for this episode.  Show Segments Time Stamps are for Patreon (Ad-Free) Version 00:00 Introduction and Overview 09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms 14:20 Understanding Hemochromatosis 19:24 Evaluation and Management of Hematuria 25:00 Updates in Diabetes Management 29:35 Xylazine Overdose and Withdrawal 35:35 Primary Aldosteronism 39:36 Resistant Hypertension 44:12 Delirium and its Implications 46:29 The Acorn trial and AKI risk 49:47 HIV trial: Reprieve 51:11 Updates in hospital medicine 56:00 Kratom and its implications 59:11 RSV vaccines and their effectiveness 01:05:38 Reflections and Gratitude Credits Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art: Matthew Watto MD, FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste 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 - Glass Health Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.  Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.  You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.  Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI.  You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS  Glass, like a clinical reference text or podcast, should never replace clinician judgment.

25 Des 20231h 16min

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry.  Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).   Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry.  Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).  Show Segments Intro, disclaimer, guest bio Dr. Pallais One-Liner Case from Kashlak Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin Causes of hypercalcemia How Lithium works!  Testing for Hypercalcemia: Get that PTH, and that phos  Symptoms of Hypercalcemia, and Questions on History  Indications for Surgery for Parathyroidectomy  Management of Hypercalcemia and Hypercalcemic Emergency  Outro Credits Producer, Writer, Infographic, Cover Art: Nora Taranto MD  Hosts: Matthew Watto MD, FACP; Nora Taranto MD   Reviewer: Yan Emily Yuan MD, MSc Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Carl Pallais MD, MPH  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Sponsor - Glass Health Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.  Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.  You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.  Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI. You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS. Glass, like a clinical reference text or podcast, should never replace clinician judgment.  Sponsor - PatternAt Pattern, we give you a quick, simple way to compare and buy disability insurance. Busy doctors shouldn't have to worry about whether or not they are getting the best rates and discounts. Trying to research all your options and make the right decision while in training can make the process even more overwhelming. That’s why thousands of doctors trust Pattern to help them compare and understand the disability insurance they are buying.  We do this in three simple steps: First off, request your quotes online at patternlife.com/curbsiders. Second, compare your options and ask questions. And third, secure your policy! So check disability insurance off your list today! Be confident that you have the right policy so that your income is protected. With huge discounts for doctors in training, now is truly the best time to request your disability insurance quotes with Pattern at patternlife.com/curbsiders.

18 Des 20231h 26min

We’re taking a short break, but we’ll be back in two week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 17 of them available to feed your brain hole! Yummy! Time Stamps* Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! | Transcript Time Stamps* *Note: Time Stamps refer to ad free version Intro, disclaimer, guest bio - 00:00 Picks of the Week - 3:10 Case from Kashlak - 6:30 Nephrotic syndrome definition- 12:30 Proteinuria evaluation - 15:04 Additional lab testing - 27:08; 40:09 Types of Nephrotic syndrome - 30:15 Mechanism of nephrotic syndrome edema - 33:08 Management of nephrotic syndrome - 44:07 Second Kashlak Case- Glomerulonephritis - 55:05 Treatment of glomerulonephritis - 65:05 Outro and post-credits scene - 73:20 Credits Producer, writer, infographic, cover art: Elena Gibson MD Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) Guest: Joel Topf MD Sponsor - Pattern Life  Request your quotes online at patternlife.com/curbsiders

11 Des 20231h 16min