The Curbsiders Internal Medicine Podcast

In this bonus episode, Matt and Paul answer Patreon listener questions  on  various topics, including the role of AI in medicine, concerns about antibiotics and their impact on health, insomnia treatments, thyroid health, reflections on career burnout and more. They also share personal anecdotes and insights emphasizing the importance of continuous learning and adaptation in the medical field. Chapters 00:00 Exploring AI in Medicine 04:50 Cultural Shifts in Music Appreciation 10:16 Navigating Medical Questions and Antibiotics 14:57 Insomnia Medications and Sleep Hygiene 19:58 Thyroid Health and Selenium 24:59 Reflections on Career and Burnout 29:55 Closing Thoughts and Gratitude

GOLD Updates, Novel Treatments, and Managing Comorbidities in COPD Care Level up your COPD care with practical, evidence-based strategies. Learn how to confirm airflow obstruction with spirometry (and use LLN/Z-scores thoughtfully), stage patients with the A/B/E framework, and build treatment around long-acting bronchodilation—adding ICS selectively based on exacerbations and eosinophils. We’ll highlight the nonpharmacologic moves that change outcomes (smoking cessation, vaccination, pulmonary rehab, oxygen when indicated), when to reach for add-ons (azithromycin, roflumilast), how to approach chronic hypercapnia with home NIV, and what’s new (hello, ensifentrine). Pulmonologist and longtime Curbsiders member Dr. Cyrus Askin (@Askins_Razor ) returns to share real-world pearls for diagnosing, treating, and managing comorbidities in COPD. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 Diagnostic Workup Understanding the Ratio, LLN/Z-Scores, and Equity Symptom abd Risk Staging (A/B/E) Case 2 Foundational Care  Initial Inhaler Strategy  Progression & Hypercapnia: NIV & Adherence Counseling Add-On Pharmacologic Options for Frequent Exacerbators What’s New and Emerging Comorbidities and When to Refer  Take-Home Points Recap Plugs, CME, and Credits Credits Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD. 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: Cyrus Askin MD   Sponsor - Freed Use code: CURB50 to get $50 off your first month when you subscribe at freed.ai Sponsor - Grammarly Sign up for FREE and experience how Grammarly can elevate your professional writing from start to finish. Visit Grammarly.com/podcast Sponsor -Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com

We have a classic episode for you. Preserve your sanity while treating heart failure with preserved ejection fraction.  Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) illuminates this confounding cardiac condition. Sponsors Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX. Sponsor: Permanente Medical Group Discover more at northerncalifornia.permanente.org. Sponsor: UNCOMMON GOODS To get 15% off your next gift, go to UNCOMMONGOODS.com/curb.

Sorting out DOAC Drama in the Hospital Is it treatment failure or not? Join us for a great conversation with Dr. Jori May (University of Alabama-Birmingham) on all the nuances around DOAC treatment failure and treatment indications for the hospitalized patient.  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  Definitions Missed Doses Lab Monitoring  Medical Conditions impacting DOACs Imaging D-dimer Usefulness  Treatment Switching Case 2  LV Thrombus Reversibility  Outro Credits Producer, Writer, Show Notes, Hosts: Meredith Trubitt MD, Monee Amin MD  Infographic, Cover Art: Caroline Coleman MD Reviewer: Rahul Ganatra MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jori May MD Sponsor: Continuing Education Company Curbsiders listeners: use promo codeCurb30 for 30% off all online courses and webcasts.Head to CMEmeeting.org/curbsiders to learn more Sponsor: FIGS We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use codeFIGSRX. Sponsor: Quince Go to Quince.com/curb for free shipping on your order and 365-day returns

Grow your management tools for opioid withdrawal in the hospital. Investigate how to decide between methadone and buprenorphine, additional medications to manage symptoms and how and when to use short-acting opioids for management of withdrawal. We’re joined by Ashish Thakrar, MD at the University of Pennsylvania.  Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Symptoms of opioid withdrawal Medications for the management of opioid withdrawal Buprenorphine precipitated withdrawal Starting Buprenorphine: Experiences and Strategies  Titrating Methadone: Dosage and Adjuncts Adjunctive short-acting opioids Emerging Trends in Drug Supply: Xylazine and Medetomidine Outro  Credits Producer, Show Notes: Zina Huxley-Reicher Infographics: Zina Huxley-Reicher MD and Zoya Surani Hosts: Carolyn Chan, MD MHS, Zina Huxley-Reicher MD, Shawn Cohen, MD Reviewer: Payel Jhoom Roy, MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Ashish Thakrar, MD MHSP Sponsor: Mint Mobile  Shop plans at MINTMOBILE.com/CURB Sponsor: Freed Use code: CURB50 to get $50 off your first month when you subscribe! Sponsor: FIGS  We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.

In this high-yield episode of Curbsiders Addiction Medicine, we dive deep into a practical and compassionate approach to caring for patients using methamphetamines and/or living with methamphetamine use disorder. We explore the latest pharmacologic options, harm reduction strategies, contingency management, and innovative ideas for monitoring and supporting patients. Whether you’re in primary care or other subspecialty settings, this episode is packed with pearls for every clinician with our amazing guest, Dr. Phillip Coffin, Director of the Center on Substance Use and Health in the SFDPH.  Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME! Credits Producer/Script Writer/Show Notes: Era Kryzhanovskaya, MD Infographic and Cover Art: Zoya Surani Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD Reviewer: Sarah Leyde MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Dr. Phillip Coffin Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Four-tier approach to taking care of patients with methamphetamine use/use disorder Medications for treatment Psychosocial treatment Harm reduction New horizons in treatment  Outro Sponsor: Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com Sponsor: Panacea Visit panaceafinancial.com and Panacea’s Resource Library for free student loan articles, guides, and webinars built to help you make informed decisions. Sponsor: Grammarly  Download Grammarly for free at Grammarly.com/PODCAST

We have a classic episode for you. Dive deep into upper respiratory viral infections with Dr Amber Bird, MD (Penn).  Feel confident on when to order testing, recommend symptom relieving treatments, and avoid unnecessary antibiotics. Sponsors Continuing Education Company Curbsiders listeners: use promo code Curb30 for 30% off all online courses and webcasts. Head to CMEmeeting.org/curbsiders to learn more. FIGS Curbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX. Freed Use code: CURB50 to get $50 off your first month when you subscribe at getfreed.ai

Join us as we review recent practice-changing articles on cannabidiol (CBD)-induced liver injury, IV iron for HFrEF, bedtime administration of blood pressure meds, carpal tunnel syndrome & rheumatoid arthritis , & FDA approval of finerenone for HFpEF. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Hosted by: Rahul Ganatra MD, MPH; Nora Taranto MD, Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Rahul Ganatra MD, MPH Reviewer: Emi Okamoto, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer CBD-induced liver injury IV Iron in HFrEF Bedtime administration of BP medications Carpal tunnel syndrome and RA FDA approves Finerenone for HFpEF Outro Sponsor: Permanente Want to join thousands of physicians who've made TPMG their career destination? Discover more at northerncalifornia.permanente.org

Why we need to stop calling them “endemic” mycoses & more fungi fun! Feeling muddled about endemic mycoses? We tackle the clinical presentation of diseases like histoplasmosis, blastomycosis, and coccidioidomycosis, the importance of testing, and how to diagnose fungal infections  with our esteemed guest Dr. Andrej Spec, MD! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Introduction and icebreaker,  Fish Club?!  00:00 Case 1 from Kashlak 07:27 Diagnostic framework for dimorphic fungi 11:58 Imaging presentations for fungal pneumonia, diagnostic schemas 18:23 Testing options 27:48 Treatment options 35:44 Dimorphic Fungi Mnemonics 45:50 Retail testing for mold 48:47 Case 2 from Kashlak 56: 42 Takeaways and Conclusions 1:05:19 Credits Producer, Writer, Show Notes:  Beth “Garbs” Gasperlin MD Infographic and Cover Art: Zoya Surani Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP,  Beth Gasperlin MD   Reviewer: Leah Witt Gaspard MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Andrej Spec MD Disclosures Dr. Spec reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: Quince Go to Quince.com/curb for free shipping on your order and three hundred and sixty-five -day returns. Sponsor: Continuing Education Company  Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount. Sponsor: Freed Use code: CURB50 to get $50 off your first month when you subscribe!

Dominate C. diff! Learn to distinguish colonization from infection, select first-line therapies, and counsel patients on recurrence prevention and microbiome recovery. We’re joined by IDSA past president and expert on foodborne and intestinal infections, Dr. Cindy Sears (Johns Hopkins University) for a comprehensive update on Clostridioides difficile (C. diff, Cdiff, CDAD, CDI). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Intro 03:00 Guest bio and hobby 04:25 Case of Charles Fleur Fontaine 06:00 Risk factors and epidemiology 08:00 Antibiotic hierarchy of risk 10:00 Diagnosis, testing strategies 14:00 Defining severity 17:30 Treatment options 20:00 Microbiome recovery strategies 24:00 Probiotics and postbiotics 27:00 Infection control counseling 30:00 C. diff and colon cancer 32:00 Recurrent C. diff strategies 35:00 Why some FMT and bezlotoxumab were discontinued 38:00 Microbiota replacement therapies 43:00 Prophylaxis strategies 45:00 Future therapies and ongoing research 47:00 Audience Q&A 52:00 Outro Credits Written and Produced by: Matthew Watto, MD, FACP  Cover Art and Infographic by: Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi MD,MBA,FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Cynthia Sears MD Disclosures Dr. Sears reports no relevant financial disclosures. Dr. Williams financial relationships disclosed include a Merck grant or research support. This relationship has not ended. Sponsor: Mint Mobile  This year, skip breaking a sweat AND breaking the bank. Get this new customer offer and your 3-month Unlimited wireless plan for just 15 bucks a month at mintmobile.com/CURB  Sponsor: Panacea Financial Let Panacea Financial take the financial stress off your plate,so you can get back to doing what matters most. Visit panaceafinancial.com  Sponsor: FIGS Get15% off your first order at wearfigs.com with the code FIGSRX

In this special bonus episode, Dr. Linda Blustein (Bendy Bodies https://bit.ly/m/BendyBodies) addresses listener questions about Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders. 00:00 – Introduction 00:59 – Can PCPs diagnose hEDS without a geneticist? 03:19 – Limitations of the Beighton Score 05:40 – 2017 hEDS criteria & upcoming revisions 10:29 – How to find a knowledgeable provider 12:52 – SVT vs POTS in a patient with EDS family history 19:53 – How to ask your provider if they’re comfortable treating dysautonomia 22:17 – MTHFR variants and hEDS 29:23 – Celiac, gluten sensitivity & EDS 31:48 – Food allergy vs sensitivity testing 34:11 – Lipoedema and hypermobility 39:00 – LDN, Ketotifen, and Cromolyn 43:41 – Medication sensitivity in EDS/POTS/MCAS patients 45:47 – Wrap up and resources ​FIGS Get 15% off your first order at wear figs.com with the code FIGSRX Locumstory ​Locumstory.com is simply a free, unbiased educational resource about locum tenens Grammarly Download Grammarly for free at Grammarly.com/PODCAST

We have a classic Curbsiders episode for you. Expert guest Dr. Elliot Tapper (@ebtapper) shares his framework for approaching NAFLD/MASLD and the treatment tools he recommends including lifestyle modifications and medications. 

An age-friendly approach to arthralgias. Attack arthralgias with ease! Learn how to evaluate and manage common joint complaints in older adults. We’re joined by Dr Una Makris, @unamakris.bsky.social (UT Southwestern). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 from Kashlak General approach to joint pain in older adults Diagnosing osteoarthritis Management of osteoarthritis in older adults Non-pharmacological interventions Pharmacological interventions: topicals, orals, injectables When to refer for joint replacement Case 2 from Kashlak Diagnosis of Late onset rheumatoid arthritis (LORA) Differential Diagnosis and Distinguishing features Lab work/Imaging When to refer to rheumatology Approach to managing LORA The 5Ms framework Initial treatment with glucocorticoids Ageism as a driver of undertreatment in older adults Treating to target Key takeaways  Outro  Credits Producers, Writers and Show Notes: Joseph (Lee) Young, MD, Leah Witt, MD, Rachel Miller, MD Cover Art and Infographic: Leah Witt, MD 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: Dr. Una Makris Disclosures Dr. Makris reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Sponsor: Heart of Care If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts. Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX. 

Here is a classic Curbsiders episode with one of our favourite guests of all time, Dr Joel Topf. Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy.  Finerenone is FDA approved for managing CKD in patients with diabetes. **Update as of July 2025: The non-steroidal mineralocorticoid recepter antagonist, finerenone is now FDA approved to treat heart failure with LVEF at or above 40% based on results of the FINEARTS-HF trial. ** Claim CME for this episode at curbsiders.vcuhealth.org! Heart of Care If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts. Quince Go to Quince.com/curb for free shipping on your order and three hundred and sixty-five -day returns.

Combing through common dermatologic complaints in Primary Care Hone your framework for assessing generalized and patchy hair loss and learn how to counsel patients about the hair loss advice they hear on social media. We discuss useful tests and treatments, psychosocial factors in relation to hair loss, variations in hair types and mention relevant nail conditions.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Examination of hair and nails, ethnic hair types and cultural hair styles and practices. Lab tests- clinically useful tests, and those to avoid Telogen Effluvium Scaly itchy scalp, seborrheic dermatosis, psoriasis Androgenic alopecia and age-related hair loss Topical and oral treatments Examining the nails, conditions related to nail polishes and prosthetics Patchy hair loss, alopecia areata, Discoid Lupus Erythematosis Dr Pasieka’s take home points Outro Credits Written & Produced by: Kate Grant MBChB, MRCGP Show Notes, Infographic & Cover Art : Kate Grant MBChB, MRCGP  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Helena Pasieka MD MS Disclosures Dr. Pasieka reports no relevant financial disclosures. Dr. Pasieka’s views are her own and do not represent those of her employer or the department of defense.  The Curbsiders report no relevant financial disclosures.  Sponsor: Continuing Education Company  Curbsiders listeners get 45% off select online courses—that’s the biggest discount CEC has ever offered, and it’s exclusive to you with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.  Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX. Sponsor Freed Use code: CURB50 to get $50 off your first month when you subscribe!