Recap and review the top pearls from recent episodes #320 Palpitations and #317 Erectile Dysfunction with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Palpitations: Diagnosis, Cardiac Monitors, Treatment, Patient Counseling Erectile Dysfunction Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP Cover Art: Edison Jyang Technical Production: Pod Paste Sponsor: Pattern Get disability insurance quotes with Pattern at patternlife.com/curbsiders 

Learn from an expert panel in addiction medicine about a potpourri of fascinating topics, with updated data to guide clinical decision-making.  We picked the brains of physicians Stefan Kertesz, Ximena Levander, Kenny Morford, and Katherine Mullins to learn about the latest updates in opioid tapering (don’t do it if there isn’t a good reason!), how to define recovery in alcohol use disorder,  different options to treat methamphetamine use disorder, and Hepatitis C treatment in patients with active IV drug use.  And there’s so much more, that we’re following this with a whole series in Addiction Medicine, set to come out in early July 2022! Visit curbsiders.vcuhealth.org to claim CME credit for this episode.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro Tapering long-term opioids Perioperative buprenorphine management Defining recovery in alcohol use disorder The Fourth Wave Treatment for methamphetamine use disorder E-cigarettes for smoking cessation Disparities in substance use disorder prevalence and treatment  Advocacy opportunities Outro Credits Written and Produced by: Nora Taranto MD Hosted by: Nora Taranto MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Guests: Stefan Kertesz MD MSc; Ximena Levander MD MCR FACP; Kenneth Morford MD FASAM; Katherine Mullins MD  Show Notes, Cover Art, Infographics: Nora Taranto MD  Reviewer: Molly Heublein MD  Production team: Pod Paste Sponsor: Birch by Helix Visit birchliving.com/curb to get $200 off ALL mattresses and 2 free eco-rest pillows.  Sponsor: Blueland Visit Blueland.com/curb to get 20% off your first order. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Join us as we de-mystify the diagnosis, talk treatment strategies, parse through pharmaceutical options, and figure out follow-up in Generalized Anxiety Disorder with Dr. Dheepa Sekar (@DheepaSekarMD)! Anxiety disorders are one of the most common mental health concerns in our country and this episode will give you the tools to address it in clinic!  Claim free 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 Differential diagnosis for GAD Counseling about diagnosis Initial guidance on first-line management, apps for mindfulness Prescribing basics, SSRI and SNRI considerations Bridging with hydroxyzine and buspirone Monitoring treatment response Managing side effects Tapering medication Alternative agents, atypical antipsychotics, and benzos Take Home points, Outro Credits Producer, Scriptwriter, Show Notes, Infographic/Cover Art: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Production Team: PodPaste Guest: Dheepa Sekar MD Sponsor: Indeed Visit indeed.com/internalmedicine to claim you $75 credit now. Sponsor: Locumstory Visit Locumstory.com to learn more about locums Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors can help you.   Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Learn diagnostic and therapeutic management strategies for IBS, functional dyspepsia, and cyclic vomiting (aka disorders of gut brain interaction (DGBI))! It's like three episodes in one as we run through how to individualize evaluation and management for patients with functional dyspepsia, IBS, and cyclic vomiting. Topics: scripts for counseling patients, the pathophysiology of DGBI, which diagnostic tests are necessary, pharmacologic and nonpharmacologic options, and even hypnotherapy?! We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic) Claim free 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 Sponsor: Ten Thousand Go to tenthousand.cc/curb to receive 10% off. Sponsor: Pattern Visit patternlife.com/curbsiders to request a disability insurance quote. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

We recap the top pearls from ACP #IM2022 including important drug interactions/intolerance (acetaminophen, tramadol, ticagrelor, nirmatrelvir-ritonavir), perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS), recognizing PMR, when to initiate urate-lowering therapy in gout, glucocorticoid-induced osteoporosis, food as medicine, dietary potassium, OSA, nocturia, telemedicine and health equity, a new obesity medicine paradigm, advances in HIV/PrEP, and rethinking atrial fibrillation!  Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro Tapering long-term opioids Physician Wellbeing Common drug interactions (acetaminophen, ticagrelor, tramadol, Nirmatrelvir-ritonavir) Perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS) Nocturia and OSA Food as Medicine Rheumatology (how to diagnose PMR, when to initiate ULT for gout and steroid-induced osteoporosis) Avi’s pearls on (diversity, telemedicine, telehealth, burnout) Obesity medicine (a new paradigm and a new medication) HIV in primary care (PrEP, long-acting injectable antiviral therapy) Atrial fibrillation Outro Credits Written, Produced, and Hosted by: Nora Taranto MD; Molly Heublein MD; Chris Chiu MD, FACP, FAAP; Avital O’Glasser MD, FACP; Alan Dow MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP Cover Art: Chris Chiu MD, FACP, FAAP Production team: Pod Paste Sponsor: Indeed Visit indeed.com/internalmedicine to claim you $75 credit now. Sponsor: Locumstory Visit Locumstory.com to learn more about locums

Join Dr. Nathan Erdmann (@NerdmannID, University of Alabama Birmingham) as he walks us through inpatient covid management from antivirals, immune modulators and anticoagulation.  Claim free 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 Outpatient vs ER therapeutic options Considerations for labs to risk stratify  Antivirals Immunomodulators Anticoagulation Empiric Antibiotics Transitions of Care Take Home Points Outro Credits Producer: Monee Amin, MD Writers: Monee Amin, MD and Meredith Trubitt, MD Show Notes: Meredith Trubitt, MD Infographic and Cover Art: Monee Amin, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Rahul Ganatra, MD Showrunner: Matthew Watto MD, FACP Production Team: PodPaste Guest: Nathan Erdmann, MD Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors can help you.   Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

More inpatient diabetes! In this part 2 of 2, we cover diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro  DKA and HHS - introduction and therapy overview Insulin drips, closing the gap and transitioning to a subcutaneous regimen Euglycemic DKA Pumps and glucose monitors Final take home points Outro Credits Producer: Adam Barelski MD, Cyrus Askin MD Writer: Adam Barelski MD Show Notes:  Cyrus Askin MD Infographic: Edison Jyang Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Adam Barelski MD Technical Production: Pod Paste Showrunner: Matthew Watto MD, FACP Content Editor: Emi Okamoto MD  Guest & Content Reviewer: David Lieb MD, FACE, FACP CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Sponsor: Bambee Visit bambee.com/curb for a free HR audit of your business. Sponsor: Grammarly Visit grammarly.com/curb for 20% off when you sign up

Dominate inpatient diabetes! In this part 1 of 2, we discuss how to handle oral hypoglycemics, how to choose an initial insulin regimen, the use of correction scale insulin monotherapy, how to titrate insulin, how to use NPH for steroid-induced hyperglycemia (check out this Twitter thread on safe dosing), and how to reconcile diabetes meds at discharge! Stay tuned for part 2 (drops Wed April 27th) covering diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro #1, disclaimer, guest bio Guest one-liner, Picks of the Week* Inpatient diabetes - a bird’s eye view and the goal(s) of therapy Management of outpatient diabetes medications Inpatient insulin - options and dosing Correctional insulin (“sliding scale”) A word on the “Diabetic Diet” Steroids and hyperglycemia Discharge pearls for the patient with diabetes Outro #1 Credits Producer: Adam Barelski MD, Cyrus Askin MD Writer: Adam Barelski MD Show Notes:  Cyrus Askin MD Infographic: Edison Jyang Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Adam Barelski MD Technical Production: Pod Paste Showrunner: Matthew Watto MD, FACP Content Editor: Emi Okamoto MD  Guest & Content Reviewer: David Lieb MD, FACE, FACP Sponsor: Bambee Visit bambee.com/curb for a free HR audit of your business. Sponsor: Grammarly Visit grammarly.com/curb for 20% off when you sign up CME Partner: VCU Health CE The Curbsiders partner with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

DeLiver on the promise of elimination with Dr. Christian Ramers Let’s deLiver on the promise of hepatitis C elimination! Dr. Christian Ramers @cramersmd brings hepatitis C diagnosis, care, and cure into the primary care clinic with a simplified algorithm for workup and treatment. Claim free 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 Who should we screen? Patient Workup  Preparing for treatment Treating hepatitis C Opportunities for integration of care Outro Credits Producer, writer, co-host: Emi Okamoto MD, FACP Show Notes, infographic, cover art: Lyan Chang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Christian Ramers MD, MPH, FIDSA Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. Sponsor: MedMastery Visit www.medmastery.com/curbsiders for a 15% lifetime discount! Sponsor: Birch Matresses Visit birchliving.com/curb to claim your $200 off any Birch Mattress plus two free pillows Sponsor: Indeed Visit Indeed.com/internalmedicine and get a $75 credit to sponsor your first job CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Update Description

Fill up with delicious practice-changing knowledge food from #SGIM22 as The Curbsiders team discusses breast cancer survivorship, sexual dysfunction, How climate change will affect health, Are PT consults necessary in the hospital?, Do we need antibiotics for aspiration events?, bias in note writing, Are plant-based meats a healthy?, complications after breast implantation, how to get breast reduction approved, doxycycline for chlamydia, the metronidazole and alcohol myth, pearls for clinician-educators, telehealth, TEACHIM.org, CGMs help lower a1c, PT for rotator cuff disease, Is it safe to taper antidepressants? and how to treat methamphetamine use disorder!  Note: There is no CME for this episode, but claim CME for prior episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Hosted by: Nora Taranto MD, Beth Garbitelli (about to be an MD!), Era Kryzhanovskaya MD, Justin Berk MD, MPH, MBA, Shreya Trivedi MD, Chris Chiu MD, Paul Williams MD, Matthew Watto MD Show Notes and Cover Art: Matthew Watto MD, FACP Showrunner: Matthew Watto MD, FACP Technical Production: Pod Paste Show Segments Intro A few ambulatory teaching models include the One Minute Preceptor, SNAPS (summarize, narrow, analyze, probe, plan, and select), PIPP (precepting in the presence of the patient) [see Community Preceptor Toolbox] Ikigai is a Japanese term indicating a motivational force or reason for living. It is associated with decreased mortality [Tanno, 2009]. Explore your ikigai here (PositivePsychology.com). Listening to podcasts while driving does not affect knowledge retention (Gottleib et al. 2021) Treatment of Hot flashes: Avoid paroxetine, fluoxetine, and sertraline in breast cancers survivors taking tamoxifen. Instead use venlafaxine (or another SNRI), citalopram, or escitalopram. Gabapentin given at bedtime is also an option.  (Clinical Update 2019: Tamoxifen and Antidepressants) Distress in patients with cancer can be measured using the NCCN screening tool [NCCN Distress Thermometer] Don’t forget to ask for a Cancer Survivorship Plan from oncology [CDC Cancer Survivorship Care Plans] Ask about sexual dysfunction in cancer survivors. How will climate change impact our patient’s health? NIH framework; CH2OPD2 environmental screening tool [CH2OPD2 ]; and the 15 steps of climate communication. Use the AM-PAC score cutoff of >18 to avoid a PT consult in hospitalized patients (Martinez 2021).  Early antibiotics after an aspiration event do not improve outcomes (Aga 2021).  Biased language is more common in notes about Black patients (Beach 2021). Be thoughtful about what you write and role model good behavior. While plant-based meats are more eco-friendly than animal-sourced meats, they are heavily processed foods (van Vliet 2021) and may have high sodium. Silicone breast implant rupture can be insidious. Guidelines recommend screening with MRI after 6 years, then every 2-3 years (FDA 2020, More FDA info) (Note: FDA’s most recent guidance also recommends ultrasound as an alternative screening method, so always check with the patient's insurance about which modality will be covered) Document a trial of NSAIDs, physical therapy, attempted weight loss, and supportive bra usage before breast reduction surgery for macromastia.  Doxycycline is now first line for chlamydia rather than azithromycin [STI Treatment Guidelines Update], BUT the most effective treatment is the one your patient will take! Metronidazole does not cause a disulfiram-like reaction and is no longer recommended by the guidelines [STI Treatment Guidelines Update] More clinician-educator pearls from Era: Don’t be afraid to brand yourself! Network with like-minded individuals (e.g. interest groups).  BST mode: bite-sized teaching pearls can help reduce extrinsic load and improve retention [Manning, 2021] A guided discussion based on Scrubs episodes can improve resident wellness [Holtzclaw 2021] Chris recaps some posters (click links to see them on Twitter!): Telehealth disparities and tech equity (poster 1, poster 2); TeachIM.org (poster) Continuous glucose monitors can help lower a1c in patients on basal insulin [Martens 2021] A single session of PT improved shoulder pain. The benefits of steroid injections were limited to 8 weeks in the GRASP trial [Hopewell 2021] There is a high risk of recurrence after tapering antidepressants [Lewis 2021] Methamphetamine use disorder can be treated with IM naltrexone every 3 weeks, plus oral bupropion 450 mg daily [Trivedi 2021]. Limitations include cost and co-use of opioids.  Outro Sponsor: Masterworks Get started at masterworks.art/curbsiders.   Sponsor: Ten Thousand Get 15% off at tenthousand.cc/curb Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Blueland Get 20% off your first order at blueland.com/curb 

We need a few days to process the highlights from #SGIM22 in Orlando, FL. We'll be dropping a DELUXE recap and highlights episode this Friday April 15, 2022 covering Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more!

Learn what you really need to diagnose pancreatitis, when to use imaging sources and what is most important in management! Rapidly treating Acute Pancreatitis might change its course! We’re joined by Dr. Kaveh Sharzehi @sharzehi of Oregon Health & Science University (@OHSUNews). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Risk factors for severe course Use of Scoring Systems  Requirements to make the diagnosis  Rational use of imaging  Initial management: fluids, analgesia, and nutrition When to use antibiotics  When to perform cholecystectomy  Most common complications and interventions  How to follow up in the outpatient setting  Credits Producer & Scriptwriters: Monee Amin MD and Meredith Trubitt MD Show Notes & Infographics: Andréa Perdigão  Cover Art: Monee Amin MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Kaveh Sharzehi MD, MS Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. Sponsor: MedMastery Visit www.medmastery.com/curbsiders for a 15% lifetime discount! CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic…even when you inject your own thumb?! Original show notes here. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer, infographic, and cover art: Emi Okamoto MD Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, Emi Okamoto MD Editor: Matthew Watto MD, FACP Guest: Olajumoke Fadugba MD Special thanks to Sarah Phoebe Roberts MPH for booking! Show Segments Intro and disclaimer Guest one-liner, book recommendation, advice to fellows and trainees Case of anaphylaxis with mucocutaneous and GI symptoms Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin) Vancomycin and non-IgE mediated reactions Common presentations of anaphylaxis and the three diagnostic criteria Biphasic reactions and predicting severity Counseling patients on the use of epinephrine Stuart’s thumb question Adjuvant medications: antihistamines and corticosteroids Are there any contraindications to epinephrine use? Use of tryptase levels when the diagnosis of anaphylaxis is uncertain Outro Sponsor Medmastery - Visit www.medmastery.com/curbsiders for a 15% lifetime discount! 

Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and produced by: Justin Berk MD, Nora Taranto MD Infographic by: Alex M @nephroguy Host: Matthew Watto MD Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials) Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD Show Segments NephMadness Kidney Pun Contest Disclaimer Intro, guest one-liners Case of acute kidney injury in a patient with cirrhosis Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium) History and physical in cirrhosis and AKI Fluid choice Diuretic therapy in cirrhosis and volume overload Is a Renal Ultrasound useful in AKI? Recap: the initial approach to AKI in cirrhosis Therapeutic trials when volume status is uncertain Hepatorenal physiology revisited Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine Type 1 versus type 2 hepatorenal syndrome Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?! Diagnostic criteria or HRS NephMadness matchups including bile cast nephropathy Outro Sponsors  Grammarly. Visit grammarly.com/curb for 20% off. Panacea Financial. Visit panaceafinancial.com a bank for doctors, by doctors.

We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and produced by: Justin Berk MD NephMadness Pain Region: Samantha Gelfand MD NephMadness Pun Contest produced by: Hannah R Abrams Cover art by: Kate Grant MBChB, Dip GUMed Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes) Guests:  Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD Show Segments Kidney Pun Disclaimer, intro and guest bios Guest one-liners Clinical Case and Pain Management Disclaimer Modalities for pain meds in ckd Opioids for pain and their metabolites Dave Juurlink reframes the question, “what is our real goal with pain management?” Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD Communicating meds that are contraindicated or relatively contraindicated in CKD Buprenorphine What about the WHO Pain Ladder for CKD? Should we use more cannabinoids? Ketamine? Dave Juurlink rants on Tramadol NSAIDS and CKD Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?! Estimating eGFR in CKD and AKI. Which equation is best? How would each of our experts treat this patient with CKD and knee pain Outro Sponsors:  Birch by Helix birchliving.com/curb for $200 off all mattresses and 2 free eco-rest pillows BetterHelp betterhelp.com/curb for 10% of your first month Indeed indeed.com/internalmedicine for a $75 sponsored job credit  Squarespace squarespace.com/curb offer code: CURB to save 10%

Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more. This episode is part of our first ever NephMadness Pod Crawl, so check out the other podcasts, and fill out your NephMadness 2022 brackets! Credits Producer, Writer, Show Notes, Infographics: Malini Gandhi Cover Art:  Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD *Claim free CME for this episode at curbsiders.vcuhealth.org! *Available within 24 hours of release. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bios Guest one-liners, Introduction to Nephmadness 2022 Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine Definition and pathophysiology of cardiorenal syndrome Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome Case #2 from Kashlak: the creatinine bump with diuresis Approach to the creatinine bump with diuresis Tips for the volume exam Interpreting cardiac biomarkers in patients with chronic kidney disease Case #3 from Kashlak: diuretic resistance Maximizing loop diuretic efficacy Sequential nephron blockade Use of hypertonic saline Outro NephMadness 2022 Pod Crawl Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast  Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/ Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered  Twitter: @thecurbsiders @TheCribsiders @NephJC_Podcast @drs_washington @upmynursinggame @medmyths Sponsor: ACP’s Internal Medicine Board Review The Greater Chicago course, beginning on May 23rd  through May 27th     or Washington, D.C., on July 11th through July 15th New registrants will receive 6 months of access to the course recordings. Visit acponline.org/imbr2022 to register or learn more. Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain. Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders  CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

Find out whether balanced solutions beat saline in the ICU (fluid wars revisited), how sleep affects weight loss and calorie intake, whether or not Vitamin D can prevent autoimmune disease, new guidelines for pneumonia and hepatitis B (HBV) vaccination, and the utility of ultrasound to measure JVP! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Reviewer: Matthew Watto, MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, picks of the week Fluid wars: balance solution vs saline Sleep and energy intake, weight loss Vitamin D to prevent autoimmune disease New ACIP guidelines for Pneumonia and Hepatitis B (HBV) vaccines Ultrasound for JVP Outro

Resuscitate your inner nephrology nerd with a bolus of kidney themed podcast episodes in the first annual NephMadness Pod Crawl featuring topics like cardiorenal syndrome, hemodialysis, chronic kidney disease (CKD), neonatal AKI, and inequalities in nephrology! The pod crawl starts Monday March 14, 2022 with The Curbsiders Cardiorenal episode and continues all week! See the schedule below, check out the other podcasts in the pod crawl, and fill out your brackets for NephMadness 2022 #nephmadness #NephPodCrawl Pod Crawl Release schedule: Mon 3/14: The Curbsiders - Cardiorenal Syndrome. Listen on Apple or Spotify. Website: https://thecurbsiders.com Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast  Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/ Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered 

Learn how to prescribe affordable, effective medications for obesity medicine! We discuss metformin, naltrexone, bupropion, phentermine, topiramate, GLP1 agonists, and how to counsel patients about the available weight loss modalities. Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital helps reframe our approach as she walks through these Obesity Medicine FAQs. Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C Show Notes, Infographics: Maddison McLellan Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Monee Amin, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Fatima Cody Stanford, MD  Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount: use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  Sponsor: Grammarly Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB Sponsor: MedMastery Listers are eligible for a lifetime 15% off discount on subscription if you go to https://www.medmastery.com/curbsiders! CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner by Dr. Fatima Cody Stanford Case from Kashlak  Guidelines for treatment  Getting the history and discussing weight goals The Care Team:  Dietician, Behavioral Specialist, Provider Medications: Phentermine, Topiramate, Bupropion, Naltrexone Obesity treatment in pregnancy Referring to bariatric surgery Take home points Outro

We recap the top pearls on pelvic pain, constipation, and Long COVID. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for shows #311, #314, and #315 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP   Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Birch Birch is giving 200 dollars off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb   Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Pelvic Pain Constipation Long COVID Outro