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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 

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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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 | [email protected] | 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

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 | [email protected] | 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 | [email protected] | 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

Say hi and bye to H. pylori infections! We review the basics of H. pylori screening, refresh your memory on testing basics, discuss treatment strategies, and talk through eradication testing with gastroenterologist Dr. George Saffouri (@gbsaff).  A special thanks to our listener Ana Maria Keilhauer Varona (@KeilhauerMa) of @UFMedu who pitched this episode. Her hard work formed the basis for our script!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Pitch Writer and Initial Script: Ana Maria Keilhauer Varona  Producer, Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli Script Co-Writer: Elena Gibson, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: George Saffouri, MD 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: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb 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: 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, disclaimer, pitch contest winner, guest bio Guest one-liner, Picks of the Week  Case from Kashlak; Conceptualizing gastritis vs. dyspepsia When to screen for h.pylori Gastric cancer and h.pylori infection Cultural competency in screening Other indications for h.pylori testing, ITP and h.pylori How to test Treatment modalities Eradication testing, persistent infection

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer: Matthew Watto, MD, FACP Producers: Matthew Watto, MD, FACP and Malini Gandhi Show Notes, Infographic, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Jordy Cohen MD Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org /curbsiders Sponsor: Southern California Permanente Medical Group Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684. Sponsor: Stamps.com Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Just go to Stamps.com, click the microphone at the top of the page, and enter code CURB.  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! 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, Picks of the Week* Case from Kashlak: New diagnosis of hypertension How to make a diagnosis of hypertension When to start anti-hypertensive medication Initial blood pressure regimen Case from Kashlak: White coat hypertension Case from Kashlak: Hypertension in chronic kidney disease ACEis and ARBs in chronic kidney disease Diuretics in chronic kidney disease Case from Kashlak: Refractory hypertension History and initial workup for refractory hypertension Treatment of primary hyperaldosteronism Outro

When should you fold or Holt onto your cards for palpitations?  Learn about properly characterizing a patient’s palpitations, red flag symptoms, when to grab an echocardiogram and/or heart monitoring, and when certain “benign” ECG findings can be concerning.  We’re joined by the director of cardiac electrophysiology at Temple University Hospital, Dr. Joshua Cooper (@narrowQRS) for this episode chock full of cardiac pearls to make your heart skip a beat.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Show Notes, Infographic, and Cover Art: Edison Jyang Producer: Paul Williams MD, FACP 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: Joshua Cooper MD 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: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB. 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, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Defining what the patient means by palpitations Common causes and misdiagnoses Red flag symptoms Exposures and medications to consider Sinus tachycardia Workup for palpitations Monitors Script for a negative workup Premature ventricular contractions Outro

Fill up your plate with a fresh stack of 2022 hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto help catch us up recent practice-changing articles and guidelines including patient-directed interventions in atrial fibrillation, the utilization of chlorthalidone in advanced CKD, and updates on outpatient COVID treatment.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH, Matthew Watto, MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Grammarly Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org /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 Show Segments Intro, disclaimer Picks of the week, Listener Email I-STOP Afib Chlorthalidone in CKD Outpatient COVID Treatment Update Outro

Master urinary tract symptoms! Paul and Matt recap, review, and update past episodes on BPH and urinary incontinence so you’ll be able to confidently manage lower urinary tract symptoms (LUTS) in primary care. Topics: categorizing urinary incontinence, lifestyle modifications for LUTS, nonpharmacologic & pharmacologic therapies for urinary incontinence and BPH, plus when to refer to surgery.  Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographic by: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: M3 Global Research To join M3 Global Research’s panel, go to M3research.info/curbsiders! Complete registration before Feb 28, 2022 for a $10 welcome bonus! 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. There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows! Show Segments Intro, disclaimer, guest bio Urinary incontinence diagnosis, management BPH diagnosis, management Outro

Listen as our expert guest Dr. Ashley Winter @AshleyGWinter (Northwest Kaiser Permanente, Portland, OR) helps us explore the spectrum of erectile dysfunction management for the internist and primary care clinician.  This episode will empower you to provide evidence based, patient-centered care to erectile dysfunction while maintaining an astute and holistic diagnostic approach.  We also explore treatment and patient counseling techniques.  Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/ Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Hannah R. Abrams, MD Infographic and Cover Art: Kate Grant, MBChB MRCGP DipGUMed Show Notes: Hannah R. Abrams, MD; Avital O’Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Hannah R. Abrams, MD Reviewer: Molly Heublein, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Ashley Winter, MD Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders  Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content. Sponsor:  SquareSpace Go to squarespace.com/curb to save 10% off your first purchase of a website or domain! Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer, guest bio Guest one-liner Defining ED Additional history, exam, and labs How to talk about ED Addressing ED for transgender and nonbinary patients Treatment of ED Advanced therapies and referral Take Home Points; Outro; Bonus clip

We have seen our esteemed guests, and they are us!  Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Paul Williams, MD, FACP Infographic and Cover Art: Matthew Watto, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto, MD, FACP    Editor: Clair Morgan of nodderly.com Sponsor: Stamps.com Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB. 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, register before January 31.  Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer Picks of the Week* The case of Lynn Fedema Pathophysiology of edema Differential diagnosis of chronic edema Chronic edema work-up Management of chronic edema Calvin Fedema and acute edema Evaluation of acute edema Outro

Explore the actively evolving clinical landscape of Long COVID as we discuss epidemiology, pathogenesis, manifestations, and patient-centered management options including the role of a dedicated Long COVID clinic.  Listen as our expert guest Dr. Monica Verduzco-Gutierrez @MVGutierrezMD (Long School of Medicine at UT Health, San Antonio) helps us navigate this rapidly emerging syndrome. This episode will empower you to provide evidence based, patient-centered care for this challenging facet of the ongoing COVID-19 pandemic. We explore the manifestations including fatigue, dyspnea, psychiatric symptoms, and other neurologic effects.  We also examine the emergence of dedicated Long COVID clinics and the imperative of interdisciplinary care. Update: The original version of this episode contained a brief, but incorrect characterization of  mast cell disorders that was subsequently removed after feedback from our allergy/immunology colleagues. We apologize for this inconvenience and thank our colleagues for their peer review. Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/ Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Avital O’Glasser MD, FACP, SFHM Infographic: Edison Jyang Cover Art: Kate Grant, MBChB MRCGP DipGUMed Show Notes: Avital O’Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, SFHM Reviewer: Hannah Abrams, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Monica Verduzco-Gutierrez, MD Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB 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, register before January 31.  Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer, guest bio Guest one-liner Case 1 from Kashlak Definition of Long COVID or post-COVID symptoms Pathogenesis of Long COVID Illness script for mast cell activation Epidemiology and risk factors for Long COVID Interdisciplinary care for Long COVID Illness script for POTS-like phenotype in Long COVID Illness script for chronic fatigue syndrome/myalgic encephalomyelitis in Long COVID Management of fatigue and post-exertional malaise (PEM) Case 2 from Kashlak Neuropsychiatric manifestations of Long COVID Anosmia and smell training Role of the patient voice and community in Long COVID Disability assessments and management Take Home Points; Outro; Bonus clip

Move smoothly through constipation evaluation and management. Learn how to evaluate for the various etiologies of constipation including pelvic floor dysfunction, IBS-C and more with our esteemed guest Dr. Xiao Jing (Iris) Wang @IrisWangMD! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Show Notes, Infographic & Cover Art: Elena Gibson MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD  Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Xiao Jing (Iris) Wang MD Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content. Sponsor: SquareSpace https://www.squarespace.com 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.  Show Segments (Note: timestamps are without ads) Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* (6:00) Case from Kashlak; Definitions (11:00)  Physiology of a bowel movement (10:00)  Definitions (16:00) Bowel Habit Review of Systems (17:00)  Rectal Exam (33:00) Initial Constipation Evaluation  Common categories of constipation (43:40) Additional evaluation of Constipation (52:00) Treatment options (1:10:00) Outro

We recap the top pearls from 2021, including celiac disease, kidney stones, SGLT2 inhibitors for weight loss & HFpEF, smoking cessation, buprenorphine for acute pain, metabolic alkalosis, nephrotic syndrome, bronchiectasis, obesity hypoventilation syndrome, acute diarrhea, osteoporosis, and diabetes. Plus, Paul and Watto express their gratitude to The Curbsiders family and look forward to 2022. Finally, it’s our annual recap extravaganza 2021 with guest host Chris “the Chiu Man” Chiu (@cjchiu), providing a rapid review of previous Curbsiders episodes for your spaced learning. Special thanks to the whole Curbsiders team and our listeners for an incredible six years of podcasting! Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Click here for full show notes Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Christopher Chiu MD, FACP FAAP Cover Art: Beth Garbitelli Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com 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 Garbs’ picks: Pelvic pain, smoking cessation Addiction medicine pearls: Nicotine use disorder; Acute pain in OUD Nephrology: Kidney stones, nephrotic syndrome, metabolic alkalosis Cardiology: Peripheral arterial disease (PAD), SGLT2 inhibitors for HFpEF Pulmonology: Bronchiectasis, OHS Gastroenterology: Celiac disease, Liver test abnormalities Bariatric Medicine: Semaglutide for weight loss; bariatric surgery Endocrinology: Osteoporosis; Diabetes FAQ Outro

Master endocarditis! Don’t feel thwarted by a positive set of blood cultures. We’re joined by Dr. David Serota (@serotavirus) for a comprehensive discussion of the pathophysiology of infective endocarditis, frameworks for work-up and diagnosis, the TTE vs. TEE debate, indications for valve surgery, antibiotic tips,  harm reduction strategies, and more!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer and Producer: Adam Barelski MD Show Notes: Beth Garbitelli; Adam Barelski MD Infographic: Adam Barelski MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Adam Barelski MD Reviewer: Meredith Trubitt, MD Executive Producer, Cover Art: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: David Serota MD  Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB. Sponsor: Southern California Permanente Medical Group Want to make a difference in a community that appreciates your passion and expertise? Then join SCPMG as an Outpatient Internal Medicine Physician. Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684. Sponsor: P3 P3 is a revenue cycle management provider that takes over your workload for claim submissions, and denial management. P3 is offering a 10% discount on all invoices for a limited time period. Visit www.p3care.com/curb and avail your offer today! 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, Picks of the Week* Case from Kashlak; Definitions What to do with positive blood cultures Initial workup for endocarditis  How to diagnose endocarditis When to get a TTE and a TEE Indications for valve surgery Antibiotic tips Oral vs IV antibiotics Treatment considerations for patients who inject drugs Take-home points Outro

Pelvic pain is not just a gyn issue!  As a PCP,  you can feel confident doing an initial workup and starting treatment for pelvic pain.  Dr. Lamvu shares a great framework to narrow down your diagnosis and provides amazing resources for those who work in an under-resourced center.   We’ll walk you through what to focus on in the history, a trauma-informed physical exam, and the first-line treatments.  Feel confident with your ability to help your chronic pelvic pain patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writers/Producer: Molly Heublein, MD Infographic: Edison Jyang Cover Art: Kate Grant, MBChB MRCGP DipGUMed Hosts: Beth Garbitelli, Molly Heublein, MD Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Georgine Lamvu, MD MPH Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Locumstory Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine.  Locumstory is your source for all things locum tenens! Check out their website,  locumstory.com,  for resources, FAQs, and more! 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 introduction and recommendations Picks of the Week Case from Kashlak Persistent Pelvic Pain Definitions Differential diagnosis/organ system approach History Physical Exam Trauma informed Care First line Treatments Resources for patient education and to build speciality team Summary and take home points  Outro

Listen in as expert Dr Calvin Chou (UCSF)  leads us through concrete tips to optimize your feedback dialogue with learners.  We cover the importance of creating a relationship built on mutual goals of getting to our personal best, helping learners form SMART goals, the ARTful approach to a feedback conversation, ways to minimize bias, and you even get to hear Era role play! This brand new weekly Curbsiders' mini-series, TEACH, is available on its own feed (Apple, Spotify) with new episodes every Tuesday. Claim free CME for this episode at curbsiders.vcuhealth.org! Credits Infographic: Andrew Delaat  Hosts, producers, writers:  Era Kryzhanovskaya, MD; Molly Heublein, MD Audio Editor: Clair Morgan of nodderly.com Guest: Calvin Chou, MD Sponsor: Masterworks Masterworks uses data and technology to determine investment-grade works of art. Then they securitize them and allow anyone to invest in artwork at an affordable entry point.  While making great art is difficult, investing in it is easier than ever. Go to masterworks.art/curbsiders to get started. 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  Picks of the Week  Case from Kashlak  Definition of Feedback  Creating a relationship to give feedback Helping learners set goals ARTful approach Giving feedback on hearsay Reducing bias Accepting feedback up the hierarchy Outro

Don’t sweat inpatient hypertension any longer. Who needs guidelines when Dr. Noble Maleque (@nobility75, Emory University, Division of Hospital Medicine) explains the spectrum of hypertensive disorders in the inpatient setting, and an approach for thinking about treatment. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Production, Script, Infographic, and Cover Art: Monee Amin, MD, Meredith Trubitt, MD MPH  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Monee Amin, MD, Meredith Trubitt, MD MPH  Reviewer: Adam Barelski MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Noble Maleque MD Sponsor: Panacea Financial Join the growing number of doctors nationwide that expect more from their bank and have switched to Panacea Financial. Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Panacea Financial is a division of Primis, Member FDIC Sponsor: Ten Thousand Ten Thousand is offering our listeners 15% off your purchase! Go to tenthousand.cc and enter code CURB  to receive 15% off your purchase!. Sponsor: Locumstory Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine.  Locumstory is your source for all things locum tenens! Check out their website,  locumstory.com,  for resources, FAQs, and more! 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, Picks of the Week* Definitions Case from Kashlak Elevated blood pressure / hypertensive urgency Contributing factors to elevated blood pressure in the hospital Hypertensive urgency—to treat or not to treat Transitions of care and case against intensification of treatment Case from Kashlak Hypertensive emergency diagnosis and treatment Secondary Hypertension Outro

Curbsiders Teach is THE internal medicine podcast for all things medical education. We use expert interviews to inspire the next generation of medical educators by providing listeners with teaching pearls, practice-changing knowledge, and a learning objective-based dosing of Edutainment (medical education, made entertaining). This weekly mini-series will air every Tuesday starting December 14th, 2021 on our website or wherever you get your podcasts! Subscribe on Apple Podcasts Subscribe on Spotify We are so excited to bring you this new series in the Curbsiders Family focusing on medical education.  Molly Heublein, MD and Era Kryzhanovskaya, MD are your new hosts for the Curbsiders Teach- they are Clinician Educators with a passion for teaching.   Whether you precept students, teach small groups, are involved in curricular design, or give CME lectures, we think you’ll find valuable skills.  We have the pleasure of interviewing a variety of amazing experts in topics ranging from bedside teaching, feedback conversations, learner mental health, and time-based competencies in medical education.   We can’t wait to share their expertise with you!   Subscribe on Apple Podcasts Subscribe on Spotify Send questions or suggestions to [email protected]    

Sweeten your day with  a review of the updated 2021 USPSTF Prediabetes and Type 2 Diabetes screening guidelines with expert guest Dr. Chien-Wen Tseng! We review the new screening recommendations, assess different testing modalities, talk through screening intervals, and emphasize other risk factors that impact screening!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Paul Williams MD & Elena Gibson MD Cover Art: Beth Garbitelli Hosts: Paul Williams MD, FACP; Elena Gibson MD     Reviewer: USPSTF Team Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Chien-Wen Tseng MD Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: GreenChef The #1 Meal Kit for Eating Well! Go to GreenChef.com/curb10 and use the code curb10 to get 10 Free Meals including free shipping! 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps* *Note: Time Stamps refer to ad free version.  Intro, disclaimer, guest bio: 0:33 Guest one-liner: 3:30 Picks of the Week: Sneaky pick at 3:00! Guest pick: 4:45 Case from Kashlak of Mr. Sugar: 5:30  Screening recommendations: 6:00 Testing modalities: 10:00  Possible harms of screening: 15:50 Screening intervals: 18:00 Prediabetes screening: 20:45 Other risk factors that impact screening: 26:30 Recap: 34:15 Outro: 36:25

@Kidney_Boy returns to school us on metabolic alkalosis and hypokalemia! What do diuretics, hyperaldosteronism, black licorice, and milk-alkali have in common? Our Chief of Nephrology, Dr. Joel Topf, talks through the pathophysiology of metabolic alkalosis, the utility of urine chloride and pH measurements, why normal saline is sometimes better than balanced solutions, when to reach for acetazolamide, and more! Urine for a good time ; ) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Show Notes, CME, Infographic and Cover Art by: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli   Reviewer: Emi Okamoto MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Joel Topf MD Sponsor: ACP Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.   Sponsor: Grammarly Take the stress out of getting the words right with Grammarly. Our listeners get 20% off Grammarly Premium at grammarly.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 Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Case of Al Kaline - metabolic alkalosis from vomiting Pathophysiology of metabolic alkalosis Case of Mike Arbonate - hypokalemic, metabolic alkalosis from aggressive IV diuresis and therapies to mitigate Case of Fracture Franny - milk-alkali syndrome Case of Hyper Al - metabolic alkalosis from excess mineralocorticoid receptor activation Outro

Fill up your plate with some spooky tofurkey cakes! Drs. Rahul Ganatra (@rbganatra) and Nora Taranto (@norataranto) help catch us up recent practice-changing articles and guidelines including EMPEROR-Reduced (SGLT2 inhibitors for HFpEF), the 2021 CHEST VTE guidelines update, whether or not antibiotics are needed for diverticulitis, and what treatments are most effective for rotator cuff disease! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art: Beth Garbitelli Hosts: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Rahul Ganatra MD, MPH Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and two free eco-rest pillows at BirchLiving.com/curb   Sponsor: BetterHelp Get 10% off your first month at betterhelp.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,  Picks of the Week EMPEROR-Reduced (SGLT2 inhibitors for HFpEF) GRASP trial for rotator cuff disease (physiotherapy and steroid injections) DINAMO trial (no antibiotics for outpatients with uncomplicated diverticulitis) 2021 CHEST VTE Guidelines Update Outro

Take a deep breath and inhale high-yield knowledge molecules about the perplexing conditions known as bronchiectasis and NTM (nontuberculous mycobacteria)! Learn the pitfalls and pearls of diagnosis and management from one of the world’s experts, the great Dr. PJ McShane from UT Health - East Texas! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writers/Producers: Cyrus Askin MD; Leah Witt MD Infographic & Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD    Reviewer: PJ McShane MD Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com Guest: PJ McShane MD  Sponsor: Ten Thousand.  Ten Thousand is offering our listeners 15% off your next purchase! Go to https://www.tenthousand.cc  and enter code: CURB to receive 15% off your purchase at checkout! Sponsor: The American College of Physicians  Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.   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 introduction and recommendations Case from Kashlak - Part I: The Basics What is bronchiectasis, how do we define it? Symptoms and history Why does it matter? What should you ask, how do you work this up? A brief discussion on antibiotics Case from Kashlak - Part II: Getting into the ManagementAirway Clearance Case from Kashlak - Part III: The Sputum (Plot) Thickens What is a bronchiectasis exacerbation? Pitfall and pearls regarding exacerbation management Case from Kashlak - Part IV: The Sputum (Plot) Thickens Even Further! Non-tuberculous Mycobacterial Infections - the basics Triple Drug Therapy for MAC The new kid on the block: Liposomal Inhaled Amikacin for refractory MAC Summary and take home points from Dr. McShane Outro

What to expect when you’re taking care of a patient who’s expecting! This fantastic episode will help you work through preconception counseling with ease, assess and treat non-obstetrical acute concerns in pregnant patients, and help you conceptualize best practices for postpartum care. We are joined by expert guest Dr. Xiaolei Chen.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli  Show Notes by: Shelagh Browne Cover Art and Infographic: Edison Jyang  Reviewer:   Molly Heublein MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Xiaolei Chen MD Sponsor: GreenChef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping! GreenChef.com/curb125 Sponsor: Need to hire? You need Indeed. Get started RIGHT NOW with a $75SPONSORED JOB CREDIT to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer valid through December 31st. Terms and conditions apply.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/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 . Show Segments Intro Picks of the week  Preconception counseling Lifestyle: caffeine, alcohol, exercise  Preconception medications  Management of acute complaints during pregnancy  Go-to medications for acute complaints during pregnancy Chronic diseases during pregnancy Postpartum management Breastfeeding recommendations Take-home points Outro 

Who gets a COVID booster? Can we mix and match COVID vaccines?  What are monoclonal antibodies and when should we use them? What is molnupiravir and does it work? Shots for kids? Ready yourself to answer these questions and more with our guest, Dr. Monica Gandhi @MonicaGandhi9.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer and Writer: Isabel Valdez PA, Molly Heublein MD Infographic: Edison Jyang Cover Art:  Edison Jyang,  Isabel Valdez, PA Hosts: Molly Heublein MD, Chris Chui MD, Isabel Valdez PA Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Monica Gandhi MD Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/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, Picks of the Week* Case from Kashlak Covid Boosters Pfizer data Moderna Data DNA vaccines Pediatric Vaccines Monoclonal Antibodies Molnupiravir Dr Gandhi’s crystal ball Outro

Explore burnout and gender-based differences in well-being with our esteemed guests Drs. Clif Knight, Tammy Lin, and Kim Templeton. We discuss workarounds for leading our way to wellness.  Dr. Clif Knight is a family physician and Senior Vice President for Education at the American Academy of Family Physicians (AAFP) with extensive leadership and expertise in well-being.  Dr. Tammy Lin is an internal medicine specialist and a Voluntary Assistant Clinical Professor at the University of California, San Diego Health Sciences. We originally met her as a member of the Wellness through Equity and Leadership (WEL) Program and she started a podcast called "The DEI Shift" (pronounced The "Day" Shift), which focuses on diversity, equity, and inclusion within the medical field. Dr. Knight and Dr. Lin participated in the 2019-2020 WEL program-- six different specialty organizations came together to think about the core tenets of equity, well-being and leadership and how you really can’t have one without the other.  Dr. Kim Templeton is Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City.  Her research focuses on women physicians and the inclusion of sex and gender medicine in medical education. No CME for this episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD Infographic: Leah Witt, MD Cover Art: Kate Grant MBChB MRCGP DipGUMed Hosts: Matthew Watto MD, FACP; Leah Witt, MD, Shreya Trivedi, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Clif Knight, MD, Tammy Lin, MD, Kim Templeton, MD Sponsor: Grammarly Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Panacea Financial Learn about their $1,000 giveaway at panaceafinancial.com/curb. Panacea Financial is a division of Primis member FDIC. Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer, guest bios Burnout & Wellness The Case: Dr. Elizabeth Blackwell & her friend in primary care The Part-Time Discussion Outro

Fine-tune your approach to liver tests!  It’s LFTs Triple Distilled! Paul and Matt channel the wisdom of hepatologist, Dr. Elliot Tapper (@ebtapper) to cover hepatocellular vs cholestatic vs mixed patterns, which tests to order, which ones to skip, how to handle isolated alkaline phosphatase elevation, mild, chronic ALT elevation, and even how to interpret liver test abnormalities in pregnancy.  Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #293 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographic by: Elena Gibson Cover Art: Matthew Watto MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb  Sponsor: Locumstory Visit Locumstory.com to see if a locum tenens assignment is right for you. 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 Hepatocellular pattern Cholestatic pattern Chronic ALT elevation Isolated Alkaline phosphatase elevation Liver test abnormalities in pregnancy Outro

Join us for this rapid fire review of systems featuring our top pearls and articles LIVE! from the TriService ACP conference. Matt and Paul serve up their favorite practice changing knowledge food on antibiotics, MRSA, hair loss, dementia, seizures, diabetes, medications for hypertension, foods for constipation, diverticulitis, colon cancer screening, colon polyps, chronic sinusitis, chronic cough, treatment of uterine bleeding, and more!  No CME for this episode, but check out curbsiders.vcuhealth.org for past CME offerings! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Matthew Watto MD, FACP; Paul Williams MD, FACP    Cover Art: Sawyer Watto Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb.         Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. 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 ID: Shorter is better; MRSA swabs; Antibiotics for diverticulitis Endo: Prediabetes in older adults,  MSK: Knee OA, orthopedic surgery Derm: Alopecia Neuro: Seizures, dementia quick typing Cardio: Coffee and arrhythmias; Hypertension management, ACEi vs ARBs Respiratory: Chronic cough and sinusitis GI: CRC screening, foods for constipation GU: treatment of uterine bleeding Addiction Medicine: smoking cessation, buprenorphine Outro

Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and  understand diagnostic testing, management and proper follow-up for patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Production and Script: Matthew Watto MD, FACP Production, Show Notes and Infographics: Edison Jyang Cover Art: Kate Grant MBChB, MRCGP, DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli    Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Amy Oxentenko MD, FACG Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. Sponsor: Grammarly Get 20% off Grammarly Premium by signing up at Grammarly.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 Guest one-liner, Picks of the Week Case from Kashlak; Definitions Workup for a typical celiac patient Nonclassical features of CD When to do a small bowel biopsy Management of CD Considerations for atypical celiac patient and differentials Non-celiac gluten sensitivity Outro Links Crucial Conversations (book) Gluten-free flour (flour) Pie crust recipe (recipe) What Remains of Edith Finch (game) Doughboys (podcast)

Confidently manage acute pain in the hospital! In this episode listeners will learn  how to develop a multimodal analgesia plan for acute pain in the hospital, as well as how to safely initiate and discharge a patient on opioids. We’re joined by Dr. Melissa Weimer @DrMelissaWeimer  (Yale School of Medicine). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer and Writer: Carolyn Chan, MD Script: Carolyn Chan, MD, Avi O’Glasser, MD Cover Art and Infographic: Edison Jyang Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD Reviewer: Emi Okamoto, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Melissa Weimer DO Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. Sponsor: Green Chef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping! 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 01:39 Intro, disclaimer, guest bio 03:20 Guest one-liner, Picks of the Week 09:18 Case from Kashlak; Definitions 11:00 Assessing Acute Pain 12:12 Types of Pain 15:08 Initiating Opioids 22:32 Counseling on Opioid Exit Strategy 25:26  Opioid Dependence vs. Opioid Use Disorder 29:50 Post-Op Pain Management 31:00 Other cool stuff 37:00 PCA 41:00 Opioid Taper 46:50 Acute Pain and Opioid Use Disorder 58:00 Methadone Titration 1:04:00 Outro

Do kidney stones have you saying “this too shall pass?” Our guest Dr. David S. Goldfarb, MD, FASN, FNKF, FACP can help! In this episode he takes us through risk factors as well as treatment and prevention for urinary stone disease.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli  Show Notes by: Shelagh Browne, Kate GrantMBChB MRCGP DipGUMed,  Cover Art and Infographic: Kate Grant MBChB MRCGP DipGUMed  Reviewer: Molly Heublein, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: David Goldfarb MD, FSN, FNKF, FACP  Sponsor: ACP’s National Internal Medicine Day 2021 acponline.org/NIMD21 Sponsor: Indeed indeed.com/internalmedicine 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 . Show Segments Guest book recommendation and advice   Common risk factors for urinary stone disease Differential diagnosis of kidney stones Symptomatology of kidney stones Types of stones  Urine pH Role of physical exam Role of imaging  STONE score Labs to order  Management of urinary stone disease Prevention of urinary stones and approach to lifestyle/diet changes  Outro 

We recap the top pearls on CRC Screening, Common Skin Complaints, and Antibiotic Pearls. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #283, #284, and #285 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli, and Nora Taranto Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: ACP acponline.org/telemedicine201 Sponsor: Ten Thousand tenthousand.cc code = 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 CRC Screening Antibiotic Pearls Derm Pearls (Common Skin Complaints) Outro

Stumped by diabetes care? Hungry for tips on diagnosis and management? We’ve got you covered with this high-yield Diabetes FAQ covering type 1 and type 2 diabetes. We’re joined by Dr. Jeff Colburn, a board-certified endocrinologist and clinician educator in San Antonio, Texas as we review initial diagnosis, interrogate insulin resistance versus insulin deficiency,  delve into down-titrating insulin, discuss ‘tricky diabetes,’ and talk through dietary approaches!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers and Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Writer: Matthew Watto MD, FACP  Show Notes, Infographic & Cover Art: Beth Garbitelli Reviewer: Molly Heublein MD Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Jeff Colburn, MD Sponsor: BetterHelp betterhelp.com/curb Sponsor: Birch by Helix birchliving.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 Guest one-liner, Picks of the Week* Case from Kashlak Initial Presentation of Diabetes Type 1 or Type 2 Initial Labs, Managing new diagnosis Using GLP-1 agonists, SGLT-2 inhibitors How to down titrate insulin  Diabetes in geriatrics Diets for diabetes management Outro

Advance your care planning with tips from our esteemed guest, Dr. Rebecca Sudore, @prepareforcare (UCSF). She helps us up our ACP game by defining advance care planning, and giving clear examples of how it can be incorporated into a busy primary care practice. It’s her life’s mission is to improve advance care planning and medical decision-making for culturally and ethnically diverse older adults. She is the creator of an interactive ACP website called PREPARE For Your Care, (after this episode, we are sure you’ll be sending patients there for advance care planning!) Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written by: Leah Witt, MD Produced by: Leah Witt, MD & Molly Heublein, MD Reviewer: Lingsheng Li, MD Infographic and Cover Art: Leah Witt, MD Hosts:Matthew Watto MD, FACP; Paul Williams MD, FACP, Leah Witt, MD    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Rebecca Sudore, MD Sponsor: Grammarly grammarly.com/curb Get 20% off Grammarly Premium by signing up at grammarly.com/curb Sponsor: Green Chef greenchef.com/curb100 Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!” 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week Case from Kashlak Part 1: General ACP Defining Advance Care Planning Case from Kashlak Part 1: Dementia & ACP Surrogate decision-makers POLST Outro

Join us as we take a six-minute walk through the definition, presenting symptoms, and diagnosis of pulmonary hypertension with our esteemed guest Dr. Estefania Oliveros, @EstefaniaOS (Temple University). She helps us get on the right side of hypertension on the right side of the heart! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer and producer: Deborah Gorth MD, PhD Infographic and Cover Art: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Estefania Oliveros MD  Sponsor: Indeed indeed.com/internalmedicine Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Sponsor: The American College of Physicians Telemedicine 201 ACP invites you to attend its free 4-part webinar series, Telemedicine 201. Episode one, “Video Visits Beyond the Simple Cases,” is on September 28th. Register today at acponline.org/telemedicine201. 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* Case from Kashlak Definitions Discussion of testing for pulmonary hypertension CTEPH diagnosis and management Rundown of therapies for pulmonary hypertension Outro