Core IM | Internal Medicine Podcast

What’s the evidence been for the use of PPIs in mechanically ventilated patients? What do more recent studies reveal about PPIs and possible harmful side effects of aspiration pneumonia and C. difficile colitis? To find out, tune into the second season of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTimestamps:(02:13) | Define the problem / Clinically important bleeding Outcome/Risk benefit /Risk factors](05:58) | Hx and H2 antagonists(10:42) | SUP-ICU(15:12) | PEPTIC(19:30) | REVISE trial(27:28) | Deprescribing(29:06) | Outstanding questionsTranscript and Show NotesTags: CoreIM, InternalMedicine, CriticalCare, Proton Pump Inhibitors, GIbleeding, ICU, ICU bleeding, Clinical Trials, Evidence Based Medicine, Patient Centered Outcomes, DeprescribingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Why are we missing peripheral arterial disease (PAD)? How is it diagnosed using the Ankle-Brachial Index (ABI)? What treatments improve symptoms and reduce cardiovascular risks? When should revascularization be considered?** Register for 2025 Digital Education & Artificial Intelligence Conference !! **Submit your most creative and impactful AI use cases for the following categories:Reducing administrative burdenEnhancing patient careMedical education innovationOptimizing work-life balanceTranscript and Show notesBehind The Scenes YouTube InterviewTimestamps:(02:23) | PEARL 1: When to suspect PAD? Risk factors?(07:34) | PEARL 2: How to work up PAD?(16:26) | PEARL 3: Improving symptoms and quality of life (25:38) | PEARL 4: Approach to therapy: Preventing CV mortality (33:53) | PEARL 5: Deeper Dive into Antithrombotic Therapy and Anticoagulation (39:09) | PEARL 6: Who needs revascularization? Tags: CoreIM, PAD, Peripheral Arterial Disease, ABI, claudication, vascular medicine, revascularization, internal medicine, smoking cessation, lipid management, primary care, physician assistant, nurse practitioner, cilostazol. supervised exercise therapyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

How is TPN and PPN similar and how is it different? When should each be used? How does bacterial overgrowth lead to complications? Does TPN cause diarrhea?** Register for 2025 Digital Education & Artificial Intelligence Conference !! **Submit how you have been using AI to be more effective for the following categories:Reducing administrative burdenEnhancing patient careMedical education innovationOptimizing work-life balanceTranscript and Show notesBehind the Scenes Youtube InterviewTimestamps:(01:35) | PEARL 1: Basics of PN: What makes up parenteral nutrition?(06:54) | PEARL 2: Indications and Contraindications for TPN and PPN: When should I order parenteral nutrition?(13:40) | PEARL 3: Complications of parenteral nutrition: What are the common adverse effects of parenteral nutrition?(19:41) | PEARL 4: Parenteral nutrition myths: What should patients know before they start TPN?(23:56) | PEARL 5: Recap on Tube Feeds: How do we determine the amount of free water to give out patients on tube feeds?Tags: IMCore, CoreIM, parenteral nutrition, TPN, PPN, clinical nutrition, nutritional support, complications, patient safety, gastrointestinal disorders, critical care, internal medicine, fluid management, ICU, Crit Care, GI, gastroenterologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?** Register for 2025 Digital Education & Artificial Intelligence Conference !! **Submit how you have been using AI to be more effective for the following categories:Reducing administrative burdenEnhancing patient careMedical education innovationOptimizing work-life balanceTranscript and Show notesBehind The Scenes YouTube InterviewsTimestamps:(03:01) | PEARL 1: Basics to Urine Drug Screen (UDS)(08:03) | PEARL 2: Types of urine drug tests, and what are immunoassays (IA)?(18:44) | PEARL 3: What are gas chromatography/mass spectrometry (GC/MS)-based tests?(26:51) | PEARL 4: How do you address unexpected test results on a UDS?(30:29) | PEARL 5: Throwback to “5 Pearls on Stigma in Opioid Use Disorder” episodeTags: IMCore, CoreIM, primary care, urine drug screening, opioid use disorder, substance use, harm reduction, addiction medicine, clinical toxicology, patient safety, compassionate careFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What if a patient can't afford hospice? Which medications do you deprescribe when on hospice? What happens when patients who are on hospice return to the hospital or ED?Sponsor: Imagine leveraging A.I to do pre-charting before seeing a patient. Reach out to enterprise@glass.health to integrate Glass A.I into your EMR! For more on Glass or Glass Pro, Use the promo code: CoreIMBehind the Scenes Youtube InterviewShow notes & TranscriptHospice 101 Episode 1Timestamps:A hospitalized patient elects to enroll in hospice, now what?What treatments are typically covered  by hospice?What medications to continue and discontinue?Code status in hospiceApproaching the hospice patient coming back to the hospitalHospice enrollment and re-enrollment is voluntary.Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Can the MINT trial change how we treat anemia in acute MI? The largest trial of its kind compared liberal vs. restrictive transfusion strategies in patients with myocardial infarction.Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTranscript and Show NotesTimestamps:(01:29) | History of Transfusion Guidelines/Studies(06:49) | Pathophysiology of Anemia in heart disease(10:04) | Transfusion in MI Studies(13:45) | MINT Trial(22:20) | Takeaways/DiscussionTags: Tags: CoreIM, IMCore, cardiology, internal medicine, myocardial infarction, anemia, transfusion, physician assistant, nurse practitioner, pharmacist, clinical trials, MINT trial, transfusion strategies, restrictive vs. liberal transfusion, heart attackFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!Transcript and Show notesTimestamps:(01:07) | Strategies for Addressing Moral Distress(09:25) | Strategies for Address Moral Injury(20:52) | ConclusionTags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethicsFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?Sponsor: Whether you're looking to open your own practice or buy into a group, Panacea Financial understands the unique needs of physicians and offers tailored financial solutions. Transcript and Show notesTimestamps:(04:59) | Definitions(06:50) | Moral Distress(09:01) | Moral Residue(09:01) | Moral Residue(11:34) | Moral Injury(13:32) | Causes of Moral Distress and Moral Injury(18:18) | ConsequencesTags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanismFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTranscript and Show notesCardiorenal Considerations: 5 Pearls SegmentTimestamps:(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion PressureTags: IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical careFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.Sponsor: Glass Health is a platform that empower clinicians with best-in-class AI for clinical decision supportUse promo code COREIM for 1 month of free access to Glass Pro for unlimited A.I queries !Show notes & transcriptsBehind the Scenes YouTube InterviewTimestamps:(02:44) | What makes this patient different from others with similar symptoms or diagnosis?(07:28) | Does your covering team have the tools to follow up on tasks and information they need for success? (16:06) | Is the handoff updated? (18:26) | What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients? (22:41) | What are we still uncertain about? (25:30) | Closing thoughts Tags: IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalistFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedBehind the Scenes Youtube InterviewShow notes & TranscriptTimestamps:(03:04) | What is the philosophy of hospice?(06:13) | Who qualifies for hospice?(08:17) | Who makes up the hospice team?(17:24) | Who pays for hospice?(21:31) | What are the different levels of care?(31:57) | What are some limitations of the hospice medicare benefit?Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention.Book by Dr. Adaira Landry, Dr. Resa E. Lewiss:MicroSkills: Small Actions, Big ImpactShow notes & TranscriptTags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Does colonoscopy prevent colon cancer, and does it save lives? There has never been a randomized controlled trial on screening colonoscopies before NordICC trial, even though it is a guideline based recommendation for everyone over 45! How did this come to be? What do we tell our patients who are on the fence about undergoing screening colonoscopy? To find out, tune into the sixth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Sponsor: At Panacea Financial, you get a personal banker and a competitive high-yield savings account. Learn why its the #1 rated bank on Trustpilot.Show notes & TranscriptTimestamp:(00:00) | Introduction(02:28) |Pathophysiology of Colorectal Cancer & Why Screening Makes Sense(06:15) | General Cancer Screening – Observational Studies(09:17) | General Cancer Screening – Randomized Controlled Trials(14:40) | NordICC Trial(22:36) | Implications for Patient CareTags: IMCore, CoreIM, primary care, gastroenterology, nurse practitioner, pharmacist, physician assistant, sigmoidoscopy, per protocol analysis and intention to treat analysisFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedBehind The Scenes YouTube InterviewsTranscript and Show NotesTimestamps:(01:59) | What causes HFpEF?(11:22) | Does diastolic dysfunction imply HFpEF?(19:21) | Is the BNP level helpful in HFpEF?(25:06) | What scoring systems can be helpful in ruling in HFpEF?(32:03) | What's the treatment for HFpEF?Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, heart failure with preserved ejection fractionFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training!Behind the Scenes YouTube InterviewTranscript and Show NotesTimestamps: (01:56) | How do immune checkpoint inhibitors work?(07:15) | How do you organize the different immune-related adverse events (irAEs)?(13:42) | Generally, when do different adverse events can present?(22:20) | What makes someone more likely to develop an adverse effect?(26:38) | What role does complementary & alternative medicine play in this patient population?Tags: Side effects, oncology, cancer, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, pharmacologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedGet CME-MOC credit with ACP!Transcript and Show NotesTimestamps: (02:05) | Urinalysis in a patient with AKI from purely cardiorenal syndrome?(08:47) | What is bioavailability, duration of action, and outcomes with furosemide, torsemide, and bumetanide?(18:08) | How can spot urine sodium measurements be used to assess diuretic response?(27:35) | What are the differences between thiazides (PO Metolazone vs. IV Chlorothiazide) and acetazolamide augment diuresis?(35:08) | Spaced Repetition: RAAS inhibitors or SGLT2 inhibitors as GMDT in CKD?Tags: nephrology, cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, diuretic resistanceFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What are the benefits of early rhythm control versus rate control alone? When is electrical cardioversion used and what information can it tell us? What side effects for amiodarone, dofetilide, and sotalol, propafenone and flecainide? When should catheter ablation be considered in patients with atrial fibrillation?Behind the Scenes YouTube InterviewTranscript and Show NotesTime stamps:(02:05) | Pearl 1 - Rhythm control(11:23) | Pearl 2 - Electrical cardioversion(17:53) | Pearl 3 - Class III antiarrhythmics and side effects(26:31) | Pearl 4 - Class Ic antiarrhythmics and side effects(31:55) | Pearl 5 - Catheter ablationTags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care.Show Notes & TranscriptTimestamps:(01:47) | Evolving story of asthma management(03:26) | Pathophysiology of asthma management(06:01) | Key players & terms(08:56) | Story of asthma through the decades(17:55) | MANDALA TrialTags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalersFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula?  What is a Fishbane reaction? And how is it different from anaphylaxis?Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training!Behind the Scenes YouTube InterviewTranscript and Show NotesTime stamps:(02:09) | Spaced repetition from the last Gray Matters Episode(05:29) | Choosing between oral and IV iron(11:17) | Considerations with oral iron repletion(24:02) |Considerations with IV iron repletion(32:36) | Complications and side effects of IV ironTags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history?Sponsor: Freed is an AI scribe that listens, prepares your notes, and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedBehind The Scenes YouTube VideosTranscript and Show NotesTime stamps:(03:43) | Iron deficiency labs and interpretation in inflammation(16:08) | Heavy menstrual bleeding evaluation(27:04) | When should a premenopausal woman with iron deficiency have endoscopy?(35:15) | RecapTags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosisFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy