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 !! **It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.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 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?Transcript and Show notesTags: 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, gastroenterology Find 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 !! **It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.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 unexpected test results on a UDS?(30:29) | PEARL 5: Throwback to “5 Pearls on Stigma in Opioid Use Disorder” episodeTranscript and Show notesTags: 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?Behind the Scenes Youtube Interview:Hospice Music TherapyShow notes & TranscriptHospice 101 Episode 1Sponsor:Imagine leveraging A.I to do pre-charting before seeing a patient. Reach out to [email protected] to integrate Glass A.I into your EMR!For more on Glass or Glass Pro, use the promo code: CoreIMTags: 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 FreedTimestamp:01:29 History of Transfusion Guidelines/Studies06:49 Pathophysiology of Anemia in heart disease10:04 Transfusion in MI Studies13:45 MINT Trial22:20 Takeaways/DiscussionTranscript and Show NotesTags: 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!Timestamps:(01:07) | Strategies for Addressing Moral Distress(09:25) | Strategies for Address Moral Injury(20:52) | ConclusionTranscript and Show notesTags: 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. Timestamps:(04:59) | Definitions(6:50) | 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) | ConsequencesTranscript and Show notesTags: 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 FreedTimestamps:(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 PressureTranscript and Show notesCardiorenal Considerations: 5 Pearls SegmentTags: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 !Timestamps:(2:44) What makes this patient different from others with similar symptoms or diagnosis?(7:28) 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 Show notes & transcriptsTags: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

What is the philosophy of hospice? (3:04)Who qualifies for hospice (6:13)Who makes up the hospice team (8:17)Who pays for hospice (17:24)What are the different levels of care (21:31)What are some limitations of the hospice medicare benefit? (31:57)Behind the Scenes Youtube Interview:Hospice Music TherapyShow notes & TranscriptSponsor: 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 FreedTags: 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.Timestamp:00:00 Introduction02:28 Pathophysiology of Colorectal Cancer & Why Screening Makes Sense06:15 General Cancer Screening – Observational Studies09:17 General Cancer Screening – Randomized Controlled Trials14:40 NordICC Trial22:36 Implications for Patient CareShow notes & TranscriptTags: 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

What causes HFpEF? (1:59)Does diastolic dysfunction imply HFpEF? (11:22)Is the BNP level helpful in HFpEF? (19:21)What scoring systems can be helpful in ruling in HFpEF? (25:06)What's the treatment for HFpEF? (32:03)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 videos on YouTubeTags: 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

How do immune checkpoint inhibitors work? (01:56)How do you organize the different immune-related adverse events (irAEs)? (07:15)Generally, when do different adverse events can present? (13:42)What makes someone more likely to develop an adverse effect? (22:20)What role does complementary & alternative medicine play in this patient population? (26:38)Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training!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

Urinalysis in a patient with AKI from purely cardiorenal syndrome? (~02:05)What is bioavailability, duration of action, and outcomes with furosemide, torsemide, and bumetanide? (~08:47)How can spot urine sodium measurements be used to assess diuretic response? (~18:08)What are the differences between thiazides (PO Metolazone vs. IV Chlorothiazide) and acetazolamide augment diuresis? (~27:35)Spaced Repetition: RAAS inhibitors or SGLT2 inhibitors as GMDT in CKD? (~35:08)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!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?Time stamps:02:05 Pearl 1 - Rhythm control11:23 Pearl 2 - Electrical cardioversion17:53 Pearl 3 - Class III antiarrhythmics and side effects26:31 Pearl 4 - Class Ic antiarrhythmics and side effects31:55 Pearl 5 - Catheter ablationTags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillation Find 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 & TranscriptTime Stamps01:47 Evolving story of asthma management03:26 Pathophysiology of asthma management06:01 Key players & terms08:56 Story of asthma through the decades17:55 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 video - Treatment of Iron DeficiencyBehind the Scenes video - IV Iron Infusion ReactionsTime stamps:02:09 | Spaced repetition from the last Gray Matters Episode05:29 | Choosing between oral and IV iron11:17 | Considerations with oral iron repletion24:02 |Considerations with IV iron repletion32:36 | 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 VideosTime stamps:03:43 Iron deficiency labs and interpretation in inflammation16:08 Heavy menstrual bleeding evaluation27:04 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

Uncover many blind spots on tube feeds!Sponsor: At Panacea Financial, every single customer gets their OWN 24/7 primary care banker who actually knows you!Youtube Interviews: Short-term enteral accessDurable enteral accessWhat is venting aka decompression?Show Notes & TranscriptTimestamp02:21 Indications for tube feeds09:36 Routes of enteral access19:20 Components of tube feeds7:03 Tube feeds complications34:50 Counseling patients before discharge and medication interactionsTags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feedsFind 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 manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship?Sponsor: Echonous, the maker of Kosmos, is redefining point-of-care ultrasound at half the price (or less) of comparable carts. Mention Core IM at the Demo to get a free A.I application of choice!Behind The Scenes videosWhen to consider a guardian?Guardianship ProcessLimitation and value of individualismShow Notes & TranscriptTimestamp04:03 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 Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship?28:30 Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred?33:27 Reflections37:06 RecapTags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case managementFind 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 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. Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & moreShow Notes & TranscriptTime Stamps02:30 Epidemiology of RSV03:46 Development of RSV vaccine05:55 Vaccine trial design12:22 ARESVI and RENOIR Trials18:18 Who should we recommend the RSV vaccine to?19:50 What don’t we know?Tags: IMCore, CoreIM, primary care, infectious disease, 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

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?Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & moreYoutube interview on key points on magnesiumYoutube interview on key points on phosphateCME : http://bit.ly/CIMCME || Show Notes & TranscriptTimestamp01:37 Pearl 1: Magnesium09:39 Pearl 2: Framework for hypomagnesemia16:53 Pearl 3: Magnesium repletion22:39 Pearl 4: Phosphorous28:36 Pearl 5: Phosphorous repletionTags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renalFind 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

Sharpen your de-escalation skills!Sponsor: GlassHealth | Get unlimited A.I queries for 1 month with promo code: COREIM !Timestamps: 02:26 Difficult Patients10:25 Mediation Toolkit17:20 Maxims of Mediation26:46 When the Conversation Still Breaks Down35:11 ConclusionTags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnoutFind 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

In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.Show Notes & Transcript01:50 Pathophysiology of Steroids and Infection03:50 Steroids in PNA Studies08:56 CAPE COD Trial14:13 Discussion of CAPE COD Trial18:36 Takeaways/DiscussionTags: IMCore, CoreIM, primary care, cardiology, 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

Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!Sponsor: Post Investment: Real Estate Syndications Show Notes & Transcript Timestamps:01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?06:31 Pearl 2: Considerations for patients with implantable devices before surgery.12:26 Pearl 3: Considerations for patients with implantable devices before MRI.14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-rayTags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacingFind 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

Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria?Sponsor: Panacea Financial Student Loan ConsultationCME : http://bit.ly/CIMCME || Show Notes & TranscriptTimestamp:00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage04:20" What's wrong with how we estimate GFR?06:50 Why is creatinine flawed as an estimator of GFR?10:52 Enter new contender...Cystatin C!16:16 Importance of the A Stage!20:21 Which patients should you measure proteinuria in?22:10 Treatments for albuminuria!24:27 Summary and ClosingTag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, 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

Check out the original interview on Youtube:Essentials on Genetic Counselor | Lynch SyndromeWho should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting!Show Notes & TranscriptTimestamp03:13 Part 1: Who should be referred to genetic counseling?11:23 Part 2: How do we set up genetic counselors for success?22:38 Part 3: Genetic counseling myth busting!Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, 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

See some of the original interviews on Youtube!What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?!CME : http://bit.ly/CIMCME || Show Notes & TranscriptWhiteboard Animation videoTimestamp01:45 Pearl 1: Evidence for potassium repletion 09:10 Pearl 2: Framework for hypokalemia17:09 Pearl 3: Repletion goals23:00 Pearl 4: Options for hypokalemia treatment29:13 Pearl 5: Frequency of lab checks and repletionTags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional educationFind 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 the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?Sponsors: Post Investment: Real Estate Syndications || Hellofresh  Show Notes & Transcript02:08 Framework for thinking about obesity03:42 History of obesity treatment06:29 Gila monsters and GLP and GIP mechanisms08:29 Story of how medications for diabetes were found to have a weight loss benefit12:50 SURMOUNT-1 trialTags: IMCore, CoreIM, primary care, cardiology, 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

With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers? Sponsors: Hellofresh | Pranay's Effective Living Formula CoursePranay's Free Masterclass (Sept 20 and 27th at 5pm PST)CME : http://bit.ly/CIMCME || Show Notes & TranscriptTimestamps01:54 Pearl 1 – Recap of GDMT and CKD09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate 20:59 Pearl 3 – Ivabradine 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT30:55 Pearl 5 – Ejection Fraction Recovery  Tags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiologyFind 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 does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?Timestamps01:00 System 1 vs. System 207:46 Cognitive Biases13:46 Case for Knowledge18:29 Other Practices to Decrease Error28:26 Conclusion CME: http://bit.ly/CIMCME || Show Notes & TranscriptThis episode is made in part of ACP’s Diagnostic Excellence curriculumTags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflectionFind 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 side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection? Timestamps02:41 Types of Immunosuppression14:31 Medication Reconciliation22:36 AKI in the Transplant Patient31:53 Infections in the Transplant Patient40:00 Transplant rejection, cancer after transplantCME: http://bit.ly/CIMCME || Show Notes & TranscriptTags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressiveFind 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

In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.Show notes & TranscriptAccess to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.Timestamps00:50 Question REVIVED addressed01:44 Revascularication in HFrEF06:32 Revascularization in stable CAD10:02 REVIVED trial12:20 Summary and takeawaysTags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicineFind 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

Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories !Listen to the original July Stories: https://bit.ly/3Y4n8jGBehind The Scenes videos on YouTubeSubscribe to our new Youtube Channel !Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedbackFind 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

BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Behind The Scenes video on YouTubeShow notes & TranscriptSubscribe to our new Youtube Channel !Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigueFind 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 between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Subscribe to our new Youtube Channel !Use this link for CME-MOC credit with ACPShow notes & TranscriptTime Stamps02:59 Types of Corticosteroids14:31 Side Effects of Steroids21:15: Prophylaxis 27:32 Steroid Weaning 33:38 Steroid Weaning Limitations Tags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndromeFind 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

In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?Show notes & TranscriptTime Stamps02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis05:35 Deep Dive 2: FFP effect on bleeding risk15:43 Deep Dive 3: Risks of FFP19:45 Deep Dive 4: Indwelling pleural catheters30:31 RecapTags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonaryFind 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 long can fatigue last for after radiation? Are all patient post radiation immunocompromised?  What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes & TranscriptWhiteboard Animation Video of Radiation PhysiologyTime Stamps02:37 Systemic Radiation Side Effects14:29 Lung Radiation Side Effects18:22 Breast Radiation Side Effects21:45 Prostate Radiation Side Effects24:54 Brain Radiation Side EffectsTags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapyFind 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 different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?Show notes & TranscriptWhiteboard Animation Video of Radiation PhysiologyTime Stamps02:04 What is radiation?03:17 How does radiation therapy work?04:50 How is today’s radiation different from the past?05:40 What role does radiation play in cancer treatment?07:48 What are the different types of radiation?15:34 How do you write a rad onc one-liner as an internist?19:59 What is palliative radiation and how/when should we use it?Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy Find 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 did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?Show notes & TranscriptTime Stamps01:12 Learning Journey05:58 Lifelong Learning11:14 Time Management16:38 Role Modeling19:59 Re-Calibrating FailureTags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time managementFind 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 does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric? Show notes, Transcript and ReferencesTime stamps00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test03:03 Hemoglobin A1c08:26 Fructosamine and Glycated Albumin10:50 Continuous Glucose Monitoring15:44 The Overlooked Issue of Insulin Resistance19:11 SummaryTags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complicationFind 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

When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?21:28 How to determine which type of device your patient has?25:10 What can a device interrogation tell you and doesn't tell you?32:13 Do all patients with bacteremia need their implantable cardiac devices taken out? 38:44 End-of-life considerations with pacemakers vs. ICDs Tags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacingFind 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 does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps03:49 Episode start07:13 Dialysis vs. kidney transplant morbidity and mortality11:44 Eligibility for kidney transplant and when to refer21:34 Pre-transplant evaluation process25:38 How long are wait times on the transplant list?36:21 What benefits of living donation? What are risks to the kidney donor?Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidneyFind 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 your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation?Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E10Show notes, Transcript and References: https://www.coreimpodcast.com/2023/03/08/trac/Time stamps2:56 Trach Components12:47 Trach Complication Management27:48 Airway Clearance34:53 Speaking Valve38:54 DecannulationTags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacyFind 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 safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care? Show notes, Transcript and References:https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/Timestamps:0:00 Hahnemann University Hospital4:36 What is a Safety Net Hospital?11:11 The Origins and Paradox of the Safety Net HospitalLinks to other episodes:A Complex Patchwork of Supplemental Payments:https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/The Future of Safety Net Hospitals & Payment Policies:https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/Tags: IM Core, CoreIM, health policy, health disparities, insurance, medicare and medicaid Find 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 does your problem representation change as we get more history in this episode? How can we use Oxaam's razor & Hickman's dictum as powerful diagnostic tools IF used properly?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/15/25438/Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Time stamps01:51 Intro07:57 Case 13:09 Differential16:15 Diagnosis22:20 Problem Representation Tags: IM Core, CoreIM, diagnostic tools, Occam's razor, Hickam's dictum, data collection, mental model, clinical reasoning, rheumatologyFind 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 approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/Time stamps04:45 What do we mean by “futility”?11:20 Definitions20:23 Ethical Analysis39:13 RecommendationsTags: IM Core, CoreIM, ATS, autonomy, justice, values, emotions, communication, medical humanities, 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

Check out original interviews on our Youtube channel!What does the duration of afib tell you about the thromboembolic risk? When do you start anticoagulation for post-op afib? What do the most recent guidelines recommend for perioperative anticoagulation management? How many devices do you know that can be useful in post-discharge cardiac monitoring in new atrial fibrillation? How can we improve our communication regarding afib management?Behind The Scenes videosGet CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps01:12 Intro03:51 Deep Dive 108:16 Deep Dive 215:25 Deep Dive 321:05 Deep Dive 427:07 Deep Dive 5Tags: IM Core, CoreIM, Devices, cardiac, risk, perioperative, stroke, surgery, anticoagulationFind 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