Core IM | Internal Medicine Podcast

Imaging Pearls | (01:12)Deciding on Thoracentesis | (04:00)Light’s Criteria and Pseudoexudates | (07:00)Pleural Fluid Studies: pH and Cell Differential | (16:56)Diagnosing and Treating Parapneumonic Effusions | (23:32)Malignant Pleural Effusions: Diagnosis and Management | (30:39)

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🔹 Transcript and Show Notes

Tags: Internal Medicine, Medical Education, Pulmonology, CoreIM, Clinical Reasoning, critical care, pulm

Listen for some good laughs and relatable stories!

In this episode, we share raw and real stories from July — from rapid responses to unexpected kindness — and reflect on the emotional weight of starting out in medicine.

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🔹 Transcript and Show Notes

Prior July Stories:

July Stories 2.0 (2023)

July Stories (2019)

Timestamps:

(00:32) | Dr. Ali Trainor's First Day as an Intern

(03:00) | The Patient's Critical Condition and Emotional Response 

(07:12) | Dr. George Tran's First...

How much do beta blockers help after a heart attack, even when the heart’s pumping well? In this episode, we revisit the origins of beta blockers in post-MI care, examine how evidence evolved, and explore the REDUCE-AMI trial, which questions whether beta blockers are still needed for all.

Listen to this latest episode of Beyond Journal Club, a collaboration between Core IM and NEJM Group, where we put research into context tracing the arc of evidence, dissecting the clinical question, and exploring what the findings could mean for real-world patient care

🔹 Sponso...

🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46)

🔹 What are the main classes of fungi? (~11:35)

🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16)

🔹 How to increase the yield of blood cultures? How to interpret yeast growth in sputum/BAL and urine cultures? (~ 30:42)

🔹 How is invasive fungal disease treated? (~ 35:14)

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📌 Transcript & show notes

Tags: CoreIM, IMCore, In...

🔹What are clinically relevant limitations of an A1c vs. a CGM (1:40)

🔹What do the different parts of the ambulatory glucose profile tell you? (09:59)

🔹What are common pitfalls, medications, lifestyle patterns that are important to ask your patient about when seeing them for a visit to manage blood sugar? (15:19)

🔹 How can you titrate insulin based on when you see the hypoglycemia on the ambulatory glucose profile (20:00)

🔹 When there is too much hyperglycemia, how do you titrate insulin when adding on GLP-1 agonists? (26:30)

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🔹When is an U/S vs. CT vs. MRI helpful before consulting Interventional Radiology?

🔹What factors go into an IR pre-op evaluation?

🔹 When do drains go in, and when do they come out?

🔹 When a patient has trouble with a drain, what are things you can do before calling IR?

🔹 What does outpatient IR follow up entail, and what does a capping trial of PCN tubes entail?

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🔹 High-yield reversible causes of constipation? (02:26)

🔹 Which type of fiber is more helpful? And is more hydration really better? And bulk-forming laxatives (9:03)

🔹 Osmotic vs Stimulant Laxatives (15:06)

🔹 Suppositories and enemas? (25:39)

🔹Best practices with opioid induced constipation (34:05)

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📌 Transcript and Show Notes

Tags: CoreIM, IMCore, Gastroenterology, GI Pharmacology, D...

How good are we at preventing HIV? How do efficacy and effectiveness differ? We journey from oral pre-exposure prophylaxis (PrEP) to long-acting injectables, and then to the PURPOSE trials, which look at the use of long-acting lenacapavir as PrEP — a potential game-changer in the field of HIV.

Listen to this latest episode of Beyond Journal Club, a collaboration between CoreIM and NEJM Group, where we put research into context, telling the story of how we arrived at the current standard of care, appreciating the clinical question of the trial at hand, and interpreting what the findings may me...

What does Lipoprotein(a) tell us that a standard lipid panel doesn’t? Should we be testing everyone for it? Dive into the genetics, clinical implications, and evolving management strategies for Lp(a). Learn how to interpret results, counsel patients, and navigate topics with limited data like aspirin and PCSK9 inhibitors in treatment.

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🔹 Transcript and Show Notes

Timestamps:

(02:17) | Pearl 1: What makes Lp(a) unique? How does it raise...

A new way to think of clots beyond provoked vs. unprovoked: Learn all about how important it is to think about reversibility! What patient states affect the inherited thrombophilia testing? Learn the nuances and practical approaches!

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🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.

Transcript and Show Notes

Timestamps:

What is the impact of microplastics on human health? How can we use observational data to support the argument that microplastics may lead to poor health outcomes?

Join us as we tackle these questions and discuss the APAChE study on microplastics and cardiovascular disease on this episode of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.

🔹 Transcript and Show Notes

🔹 Behind The Scenes YouTube Video

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What is the last sense to go? How can music create connection, ease anxiety, and help process emotions at the end of life? Join Dr. Jafar Al-Mondhiry, Dr. Harry Han, and music therapist Bryanna Tobin as they explore the power of music therapy in hospice care, sharing moving stories and clinical insights.

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🔹 Transcript and Show Notes

Timestamps:

(00: 39) | 1st: What is Music Therapy in Hospice?

(07:59...

Incidental fibrosis on CT —what now? What does prone imaging tell you? Is it fibrosis, aspiration, or atelectasis? And once you diagnose ILD, does the “alphabet soup” really matter for treatment? Antifibrotics vs. immunosuppression?

Plus, how do we bridge the gap when social barriers make care unsafe?

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Transcript and Show Notes

Timestamps:

(01:26) | Deep Dive 1

(06:38) | Deep Dive 2

(12:37) | Deep Dive 3

(21:13...

SPEP vs. UPEP? What does it tell you and not tell you? What is the role for immunofixation and free light chains in diagnosis? Learn about paraneoplastic antibodies with MGCS and its renal, neurologic, and dermatologic manifestations!

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🔹 This episode is also sponsored by Factor! Get fresh, ready-made meals delivered to your door. Use the code factorpodcast for a special discount at factor75.com.

Behind The Scenes Youtube Intervie...

How do you differentiate immune checkpoint inhibitor-related adverse events aka IrAEs from other conditions like infection? Join as we go through pneumonitis, colitis, dermatitis and endocrinopathies due to immune checkpoint inhibitor toxicity!

Transcript and Show Notes

ICIs & IrAEs 101 Episode

Behind The Scenes video

Sponsor:

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more...

YouTube Videos

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

01:27 | Anion Gap Metabolic Acidosis (Dr. Nick Villano)

02:52 | Inhaler Delivery Systems (Dr. Allie Sheridan)

04:44 | IDA in Pregnancy (Dr. Michael Auerbach)

Tags:IMCore, Medical Education, IDA, hospitalist medicine, hospitalist, primary care, nurse practitioner, chalktalks, hematology, asthma, COPD, pregnancy care, Medical Podcast, Clinical...

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.

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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?

Transcript and Show notes

Behind The Scenes YouTube Interview

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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) | ...

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?

Transcript and Show notes

Behind the Scenes Youtube Interview

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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 effe...

Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?

Transcript and Show notes

Behind The Scenes YouTube Interviews

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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 unexpect...

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: CoreIM

Behind the Scenes Youtube Interview

Show notes & Transcript

Hospice 101 Episode 1

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard...

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.

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Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(01:29) | History of Transfusion Guidelines/Studies

(06:49) | Pathophysiology of Anemia in heart disease

(10:04...

Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!

Transcript and Show notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(01:07) | Strategies for Addressing Moral Distress

(09:25) | Strategies for Address Moral Injury

(20:52) | Conclusion

Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethics

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 notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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...

Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”

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Transcript and Show notes

Cardiorenal Considerations: 5 Pearls Segment

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Timestamps:

(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension

(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output

(26:34...

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 support

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Show notes & transcripts

Behind the Scenes YouTube Interview

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(02:44) | What makes this pa...

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Behind the Scenes Youtube Interview

Show notes & Transcript

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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 li...

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 Impact

Show notes & Transcript

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Tags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistant

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. 

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Behind The Scenes YouTube Interviews

Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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?

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Behind the Scenes YouTube Interview

Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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 & alternati...

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Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Timestamps:

(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 re...

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 Interview

Transcript and Show Notes

Subscribe to Core IM’s YouTube Channel for more behind the scenes, whiteboard animations and more!

Time stamps:

(02:05) | Pearl 1 - Rhythm control

(11:23) | Pearl 2 - Electrical cardioversion

(17:53) | Pearl 3 - Class III antiar...

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 & Transcript

Timestamps:

(01:47) | Evolving story of asthma management

(03:26) | Pathophysiology of asthma management

(06:01) | Key players & terms

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?

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Behind the Scenes YouTube Interview

Transcript and Show Notes

Time stamps:

(02:09) | Spaced repetition from the last Gray Matters Episode

(05:29) | Choosing between oral and IV iron

...

What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history?

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Behind The Scenes YouTube Videos

Transcript and Show Notes

Time 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?

...

Uncover many blind spots on tube feeds!

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Behind the Scenes Youtube Interviews: 

Show Notes & Transcript

Timestamps:

(02:21) | Indications for tube feeds

(09:36) | Routes of enteral access

(19:20) | Components of tube feeds

(27:03) | Tube feeds complications

(34:50) | Counseling patients before discharge and medication interactions

Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, in...

How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship?

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Behind The Scenes YouTube Interview

Show Notes & Transcript

Timestamps:

(04:03) | Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult?

(11:55) | D...

How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.

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Show Notes & Transcript

Time Stamps:

(02:30) | Epidemiology of RSV

(03:46) | Development of RSV vaccine

...

When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement?

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Youtube interview on key points on magnesium

Youtube interview on key points on phosphate

CME : http://bit.ly/CIMCME || Show Notes & Transcript

Timestamps:

(01:37) | Pearl 1: Magnesium

(09:39) | Pearl 2: Framework for hypomagnesemia

(16:53) | Pearl 3: Magnesium repletion

(22:39) | Pea...