Get rid of those clots around anticoagulation and antiplatelet management Join us for a review of the perioperative risk assessment of bleeding and clotting and how to manage each patient’s own antithrombotics. We are joined by Dr. Poorvi Hardman from Ohio State University.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid Fire Questions/Picks of the Week Case 1 Risk stratification of thromboembolism and bleeding Review of types of surgeries and risk associated with surgical intervention Utilizing scoring systems to aid decision making Bridging Considerations for VKAs, DOACs  Pitfalls to bridging Case 2 Aspirin Management P2Y12 Management Consultants Outro Credits Written, produced and show notes by: Jaimie Patel MD Infographic and Cover Art by: Caroline Coleman MD Hosts: Monee Amin MD; Meredith Trubitt MD   Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Poorvi Hardman MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Pathway Improve your clinical decision-making process and enhance patient care. Download the Pathway app today by visiting pathway.md

The Curbsiders and Cribsiders are back with a very special Med-Peds collaboration on RSV immunizations! Dr. Buddy Creech, Pediatric Infectious Disease at Vanderbilt, walks us through these breakthrough “vaccines" for both adults and kids. He teaches us about their mechanisms of action, eligibility criteria, and why it’s been so challenging to find doses this season. Get ready for your next shot of fun!

Join us as we review recent practice-changing articles on transfusion thresholds in acute MI, COVID-19 rebound after treatment with ritonavir-boosted nirmatrelvir (PaxlovidTM), the prevalence of iron deficiency, as well as the debut of our new “corrections and omissions” section, in which we cover important knowledge updates on oral iron dosing and correcting serum calcium. And, find out why oral phenylephrine does not work and what you should prescribe instead for upper respiratory symptoms. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written, Produced, and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments 00:00 Introduction and Calcium Puns 03:11 Iron Deficiency and Iron Supplementation 12:20 Corrected Calcium 18:09 Virologic Rebound after nirmatrelvir/ritonavir (Paxlovid™) 32:09 Phenylephrine and its Ineffectiveness 37:00 Restrictive vs. Liberal Transfusion Strategy in MI (MINT trial) 49:20 Outro Sponsor: Rocket Money Cancel unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Netsuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance for free, at NetSuite.com/CURBSIDERS Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. 

Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice.  Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction.  Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.  Claim CME for this episode at curbsiders.vcu health.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction and Overview 09:13 Diagnosing Dental Pain and Examination Techniques 18:44 Treatment Options for Dental Pain 29:34 Complications and Emergencies in Dental Care 32:36 Post-operative Care and General Dental Advice 40:35 Dry Mouth and Treatment Options 44:05 Gingivitis 49:39 Temporomandibular Joint (TMJ) Dysfunction 55:43 Medications and Dental Side Effects 56:12 Anticoagulants and Dental Procedures 01:00:55 Endocarditis Prophylaxis 01:03:15 Joint Replacements and Antibiotic Prophylaxis 01:04:10 Oral Health in Patients with Opioid Use Disorder Credits Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Lisa Simon MD, DMD Sponsor: Grammarly Go to grammarly.com/PODCAST to download for FREE today. Sponsor: Factor Head to FactorMeals.com/curb50 and use code curb50 to get 50% off.  Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

Learn practical tips for the inpatient management of patients with sickle cell disease and vaso-occlusive crisis from guest, Dr. Yoo Mee Shin (Emory). We cover acute pain management including adjuvant therapies, IV fluids, oxygen therapy, the management of acute chest syndrome, and when to perform simple vs exchange transfusions. Key takeaways include the importance of early triage and analgesia, addressing misconceptions about opioid use disorder in patients with sickle cell disease, and recognizing complications of vaso-occlusive crises. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Intro 01:27 Getting to know our guest 07:48 Case Presentation and Initial Management of Sickle Cell Disease (SCD) 13:46 Misconceptions about opioid use disorder and sickle cell 17:02 Management of Acute Pain in Sickle Cell Disease 25:46 Adjuvant therapy for pain 29:04 Transition to outpatient care 32:46 General admission orders for sickle cell 38:44 Management of Acute Chest Syndrome 42:01 Simple vs exchange transfusion 47:08 Transfusion in preoperative and pregnant patients 48:03 Transitions and follow-up care 49:35 Key takeaways and Outro Credits Written and Produced by:  Matthew Watto MD, FACP Cover Art & Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Yoo Mee Shin MD Sponsor: Green Chef Go to greenchef.com/60curb and use code 60curb to get 60% off, plus 20% off your next two months. Sponsor: NetSuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance -absolutely free, at NetSuite.com/CURBSIDERS

Conquer your fear of antiphospholipid syndrome! Dr. Arielle Langer leads us through what clinical features raise suspicion for antiphospholipid syndrome, how to interpret laboratory testing, and the nuances of antiphospholipid syndrome management. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak What is antiphospholipid syndrome? Clinical features that raise suspicion for antiphospholipid syndrome Laboratory testing and diagnosis of antiphospholipid syndrome Management of antiphospholipid syndrome: initial treatment Management of antiphospholipid syndrome: managing recurrent thrombosis Return to Case: Pregnancy in patients with a history of thrombotic APLS Obstetric APLS Final questions Outro Credits Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Arielle Langer MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Rocket Money Cancel your unwanted subscriptions by going to RocketMoney.com/CURB. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Green Chef Get sixty percent off Green Chef, plus twenty percent off your next two months, with code 60curb at GREENCHEF.com/60curb.

Discover DGBI! Learn its pathophysiology, evaluation and individualized treatments so you can leave the fear of managing DGBI behind. We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic) Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions (6:20)  Definition of Disorders of the Gut-Brain Interaction (7:30-11:00) Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments  (24:30-36:00) Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00) Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11) Take home points Outro Credits Producer: Elena Gibson MD Writer:Andréa Perdigão, Elena Gibson Show Notes and Infographics: Andréa Perdigão Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Xiao Jing (Iris) Wang MD

Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders. Our team needed a break so we did not make CME for this episode.  Show Segments Time Stamps are for Patreon (Ad-Free) Version 00:00 Introduction and Overview 09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms 14:20 Understanding Hemochromatosis 19:24 Evaluation and Management of Hematuria 25:00 Updates in Diabetes Management 29:35 Xylazine Overdose and Withdrawal 35:35 Primary Aldosteronism 39:36 Resistant Hypertension 44:12 Delirium and its Implications 46:29 The Acorn trial and AKI risk 49:47 HIV trial: Reprieve 51:11 Updates in hospital medicine 56:00 Kratom and its implications 59:11 RSV vaccines and their effectiveness 01:05:38 Reflections and Gratitude Credits Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art: Matthew Watto MD, FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor - Glass Health Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.  Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.  You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.  Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI.  You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS  Glass, like a clinical reference text or podcast, should never replace clinician judgment. 

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry.  Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).   Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry.  Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).  Show Segments Intro, disclaimer, guest bio Dr. Pallais One-Liner Case from Kashlak Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin Causes of hypercalcemia How Lithium works!  Testing for Hypercalcemia: Get that PTH, and that phos  Symptoms of Hypercalcemia, and Questions on History  Indications for Surgery for Parathyroidectomy  Management of Hypercalcemia and Hypercalcemic Emergency  Outro Credits Producer, Writer, Infographic, Cover Art: Nora Taranto MD  Hosts: Matthew Watto MD, FACP; Nora Taranto MD   Reviewer: Yan Emily Yuan MD, MSc Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Carl Pallais MD, MPH  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Sponsor - Glass Health Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.  Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.  You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.  Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI. You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS. Glass, like a clinical reference text or podcast, should never replace clinician judgment.  Sponsor - PatternAt Pattern, we give you a quick, simple way to compare and buy disability insurance. Busy doctors shouldn't have to worry about whether or not they are getting the best rates and discounts. Trying to research all your options and make the right decision while in training can make the process even more overwhelming. That’s why thousands of doctors trust Pattern to help them compare and understand the disability insurance they are buying.  We do this in three simple steps: First off, request your quotes online at patternlife.com/curbsiders. Second, compare your options and ask questions. And third, secure your policy! So check disability insurance off your list today! Be confident that you have the right policy so that your income is protected. With huge discounts for doctors in training, now is truly the best time to request your disability insurance quotes with Pattern at patternlife.com/curbsiders.

We’re taking a short break, but we’ll be back in two week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 17 of them available to feed your brain hole! Yummy! Time Stamps* Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! | Transcript Time Stamps* *Note: Time Stamps refer to ad free version Intro, disclaimer, guest bio - 00:00 Picks of the Week - 3:10 Case from Kashlak - 6:30 Nephrotic syndrome definition- 12:30 Proteinuria evaluation - 15:04 Additional lab testing - 27:08; 40:09 Types of Nephrotic syndrome - 30:15 Mechanism of nephrotic syndrome edema - 33:08 Management of nephrotic syndrome - 44:07 Second Kashlak Case- Glomerulonephritis - 55:05 Treatment of glomerulonephritis - 65:05 Outro and post-credits scene - 73:20 Credits Producer, writer, infographic, cover art: Elena Gibson MD Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) Guest: Joel Topf MD Sponsor - Pattern Life  Request your quotes online at patternlife.com/curbsiders

A shock to the system Join us for an infectious conversation about sepsis as we learn about the recognition and initial management of sepsis on the wards. We are joined by Dr. Mohleen Kang (@KangMohleen, Emory University). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions/Picks of the Week Case Managing rapid response logistics Sepsis Scoring Systems Diagnostic Work-up for Sepsis Access  Antibiotic Management Fluids Pressors  Supportive Measures for Sepsis Outro Credits Producers, Writers, and Hosts: Meredith Trubitt, MD  and Monee Amin, MD  Show Notes: Meredith Trubitt, MD Infographic and Cover Art: Sean Evans or Caroline Coleman Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Mohleen Kang, MD, MSc Sponsor: Birch  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb when you use code BIRCHPARTNER20! Sponsor: Green Chef Go to greenchef.com/60curb to get 16% off, plus 20% off your next 2 months.  Sponsor: Grammarly  Go to grammarly.com/podcast to download for FREE today. 

Join us as we review recent articles and news featured in The DIGEST #45 and #46, including semaglutide in HFpEF and obesity (STEP HFpEF), TCAs for irritable bowel syndrome (ATLANTIS), clopidogrel versus aspirin as long-term secondary prevention after PCI (HOST-EXAM), statins in HIV (REPRIEVE), weight changes and diet, and heavy metal exposure in cannabis users. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewers: Nora Taranto MD; Paul Williams, MD, FACP; Matthew Watto MD, FACP; Sai Achi, MD MBA Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer STEP HFpEF: semaglutide for HFpEF in obesity  TCAs for IBS  HOST-EXAM and post-PCI  clopidogrel versus aspirin after DAPT  REPRIEVE and pitavastatin in HIV Starchy vegetables and weight changes  Cannabis and heavy metal content  Outro Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/CURB Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com.

Become a pro on pre-exposure prophylaxis! Review the updated 2023 United States Preventive Task Force (USPSTF) guidelines on PrEP for HIV Prevention with Dr. John Wong. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro What is PrEP? USPSTF PrEP for HIV Prophylaxis recommendations Defining Increased Risk for HIV Counseling pearls Types of PrEP, considerations about choice of PrEP Talking about Safer Sex practices, HIV and STI screening on PrEP Recap; outro Credits Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD Hosts: Paul Williams MD, FACP, Beth Garbitelli MD Reviewer:Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: John Wong MD

“I collect spores, molds and fungus” - Dr. Egon Spengler Dr. Ilan Schwartz MD PhD (@GermHunterMD) teaches us that we should always at least consider fungi in the differential diagnosis of unexplained sepsis, especially in patients with impaired immune systems or complex medical or surgical histories, and walks us through an approach to antifungals.  Be sure to check out the Mycoses Study Group Education & Research Consortium (@MSG_ERC), an organization of clinicians who are dedicated to advancing diagnostics and treatment of fungal disease (where Dr. Schwartz serves on the board of directors!) Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions, get to know our guest Intentionally vague case; When should we be worried about fungal infection? Overnight emergencies: Candidiasis and mucormycosis Starting empiric anti-fungals Testing basics: direct versus indirect Fungemia, fungal endocarditis Resistant candida; candida auris Pneumocystis jiroveci pneumonia Outro Credits Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Ilan Schwartz MD, PhD Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/CURB. Sponsor: NetSuite Go to NetSuite.com/CURBSIDERS to get your own KPI Checklist.  Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com.

Diagnosing and treating bipolar disorder is not always black-and-white. Dr. Kevin Johns teaches us how to not get tripped up on this tricky diagnosis. (The Ohio State University Wexner Medical Center) Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case Screening for mania History for diagnosing bipolar disorder Definition Mimickers Treatment Outro Credits Written and Produced by: Deborah Gorth MD, PhD  Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth MPH, RD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deborah Gorth MD, PhD  Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:   Kevin Johns MD Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com.  Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/CURB.

We’re taking a short break, but we’ll be back next week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 15 of them available to feed your brain hole! Yummy! Tighten up your glute-n facts! 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 | thecurbsiders@gmail.com | Free CME! 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 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 Birch Living Birch is giving 20% off all mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you you use cade BIRCHPARTNER20! Panacea Financial Visit panaceafinancial.com today to open your free account. Grammarly Go to grammarly.com/PODCAST to download for free today. 

Join us as we review recent practice-changing articles on VKAs vs DOACs in frail adults with atrial fibrillation, RSV vaccine for adults over 60, how much does blood pressure cuff size matter, cotton fever in people who inject drugs, new bloating and belching guidelines, and does pip-tazo cause more AKI than cefepime. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Sai Achi, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer VKAs vs DOACs in frail adults with atrial fibrillation,  RSV vaccine for adults over 60,  how much does blood pressure cuff size matter? cotton fever in people who inject drugs,  new bloating and belching guidelines, does pip-tazo cause more AKI than cefepime? Outro Sponsor: Pathway  Download the Pathway app for free today. Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com.

Common Ear Complaints, Tips and (Keratin) Pearls in Primary Care Get an earful from ENT expert Dr. Angela Peng about how to approach common ear concerns, basic ear exam skills, safely clearing earwax and more! Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro with great pun! Rapid fire questions/Picks of the Week Case #1: Inner ear complaint Ear Exam 101 Eustachian Tube Dysfunction Cholesteatoma Case #2: Outer ear complaint Malignant otitis externa Open tympanic membrane treatments Cerumen impaction Itchy Ears Outro Credits Producer, Writer, Show Notes, Cover Art and Infographics: Isabel Valdez, PA-C Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Angela Peng, MD Sponsor: Pathway  Download the Pathway app for free today.

Keep saving lives by prescribing methadone and buprenorphine. Learn how initiations of each have changed in the era of high-potency synthetic opioids (HPSOs) like fentanyl and how to continue to provide person-centered care to people with opioid use disorder. We’re joined by Dr Melissa Weimer, @DrMelissaWeimer (Yale University). This episode is in honor of National Addiction Treatment Week (treataddictionsavelives.org). Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME! Credits Producers: Shawn Cohen MD,  Kenneth Morford MD Writer: Carolyn Chan MD MHS Show Notes: Shawn Cohen MD Infographic and Cover Art: Kenneth Morford MD Hosts: Carolyn Chan MD. MHS Shawn Cohen MD, Natalie Stahl MD, Kenneth Morford MD Reviewer: Kento Sonoda MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Melissa Weimer DO MCR Show Segments Intro, disclaimer, guest bio 00:00 Guest one-liner 05:02 National Addiction Treatment Week  06:00 Case from Kashlak; Definitions 08:30 Starting methadone  11:01 Common methadone pitfalls 15:00 Buprenorphine precipitated opioid withdrawal  23:50 High-dose buprenorphine 32:20 Treating buprenorphine precipitated withdrawal 36:50 Low-dose buprenorphine 41:50 Maintenance dose of buprenorphine 48:15 ER buprenorphine 49:00 Take home points 53:31

Semaglutide can’t fix everything… Recommend lifestyle interventions for weight management with Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center and Interim Chief of Division of General Internal Medicine at Duke (@DrWillYancy).  Learn about the ketogenic diet, lower carbohydrate diets, and exercise, and their impacts on your patients.   Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer and writer: Fatima Syed, MD, MSc, FACP Show Notes, Infographic, and Cover Art: Fatima Syed, MD, MSc, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Will Yancy, MD Sponsor: Babbel Get 55% off at Babbel.com/CURB Sponsor: Locumstory  Visit locumstory.com to learn more more about all things locum tenens. Sponsor: Pathway  Download the Pathway app today, 100% free for Curbsiders listeners Full Transcript available HERE

Show description:  Feel confident diagnosing adrenal insufficiency. Learn how to accurately interpret a stimulation test, differentiate primary from secondary adrenal insufficiency, and teach patients about preventing an adrenal crisis with Dr. Atil Kargi (UNC School of Medicine)  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 Case 2 Topic Outro Credits Written and Produced by: Elena Gibson, MD Infographic and Cover Art: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi, MD MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Atil Kargi, MD Sponsor: Pathway Download the Pathway app today, 100% free for Curbsiders listeners  https://link.pathway.md/o53W/curb Sponsor: NetSuite Download NetSuite’s popular KPI Checklist at NetSuite.com/CURBSIDERS Sponsor: Grammarly Go to grammarly.com/PODCAST to download for FREE today. Full transcript available HERE

A Guide to Seeing Them and Stopping Them in Their Tracks Be a step ahead of diabetic foot infections! Learn who really needs that MRI, when to call your vascular colleagues, and when you really need that pseudomonas and anaerobic coverage. We are joined by Dr. Andrew Webster, infectious disease physician and antimicrobial stewardship director at the Atlanta VA.  Emory Division of Infectious Diseases Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Case Definitions Risk Stratifications Diagnostic Work-up Vascular evaluations Treatment Outro Credits Writer, producer and show Notes: Reaford Blackburn, Jr., MD Cover Art and Infographic: Monee Amin, MD Hosts: Monee Amin, MD and Meredith Trubitt, MD    Reviewer:  Sai Achi, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Andrew Webster Sponsor: Green Chef Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping. Sponsor: Pathway Download the Pathway app today by visiting pathway.md Sponsor: Birch Living  Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb when you use code BIRCHPARTNER20 Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com Full transcript available HERE

Master hormonal and nonhormonal therapies for menopausal symptoms including vasomotor symptoms (VMS).  We’re joined by Dr. Monica Christmas, @drmonicaxmas (UChicago Medicine).  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Nonpharmacologic management of vasomotor symptoms (VMS) Non-hormonal therapy for menopause Taking a history for menopausal symptoms, VMS Hormone therapy (HT) risk assessment, counseling Prescribing Hormone therapy Troubleshooting hormone therapy Premature menopause and primary ovarian insufficiency Discontinuation of hormone therapy Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Monica Christmas MD Sponsor: Locumstory Get a comprehensive view of locums and decide if it’s right for you at locumstory.com. Full transcript available HERE.

Definitions, 4Ms & Inhaler Pro Tips Level up COPD management in older adults. Start with learning the latest in COPD diagnosis and classification, then stay for the mind-blowing inhaler misuse & cost discussion. We’re joined by a dynamic (and interprofessional) duo: Dr. Leah Witt (@leahjwitt) and Dr. Amber Lanae Martirosov, PharmD (@AmberMartirosov). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid Fire Questions Case Part 1 COPD Definition COPD alphabet soup: ABE Case Part 2 Geriatric 4Ms & COPD Inhaler Use & Cost Outro Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/ INTERNALMEDICINE. Offer good for a limited time.  Sponsor: Babbel Get 55% off at Babbel.com/CURB. Full transcript available HERE

Join us as we review recent articles and news featured in The DIGEST #43 and #44, including bempedoic acid to lower cardiovascular risk, Alpha-Gal Syndrome, tick bites and meat allergy, orforglipron an oral GLP1 agonist for weight loss, zuranolone for postpartum depression, DOACs for VTE of malignancy, monoclonal antibodies (mAbs) for Dementia, cytisinicline for smoking cessation, and two kiwis a day for constipation. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | Free CME! Credits Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewers: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Sponsor: Netsuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance for free, at NetSuite.com/CURBSIDERS Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com. Sponsor: Grammarly  Go to grammarly.com/GO to download for FREE today. Sponsor: Pathway Download the Pathway app today by visiting pathway.md Show Segments Intro, disclaimer Bempedoic Acid for CV risk reduction DOACs to prevent recurrent VTE of malignancy Cytisinicline for smoking cessation Alpha-Gal Syndrome, tick bites, and meat allergy Zuranolone for postpartum depression Orforglipron, an oral GLP1 agonist, for weight management mAbs for Alzheimer’s dementia Kiwis to prevent constipation Outro

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!  Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Produced by: Elena Gibson MD  Cover Art and Infographic: Kate Grant MD; Elena Gibson MD  Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD  (written materials); Clair Morgan of nodderly.com Guest: Elliot Tapper MD Sponsor: Panacea  If you’re ready to join the thousands of doctors who have declared independence from traditional banks, visit panaceafinancial.com today to open your free account. Sponsor: Birch Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb when you use code BIRCHPARTNER20! CME Partner: VCU Health CEThe 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 Definitions of liver enzymes, liver function tests   Patterns of acute liver injury Drug-induced liver injury Isolated alkaline phosphatase elevation  Isolated total bilirubin elevation  Livery Injury During Pregnancy  Acute liver failure Outro

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! 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. Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | 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 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: 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 Sponsor: Green Chef Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping.

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Not only that, we’ve been thinking about obesity the wrong way for decades. Join us with Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital as we reframe our approach to this disease and learn tips on prescribing  older,  but still very effective, medications used to treat obesity.  Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | 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: Locumstory Get a comprehensive view of Locumstory at locumstory.com Sponsor: Babbel .Get 55% off your Babbel subscription at Babbel.com/curb. Rules and restrictions apply.  CME Partner: VCU Health CEThe 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.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 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

Your swell guide to the swollen leg We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! 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. 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 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 Sponsor: Pathway Pathway is an innovative tool to improve your clinical decision-making process and enhance patient care. Download the app at pathway.md

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm. Free CME for this episode at curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits ●  Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD ●  Show Notes, Infographic and Cover Art: Caroline Coleman, MD ●  Reviewer: Emi Okamoto, MD ●  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●  Technical Production: PodPaste ●  Guest: Sara Markley Webster, MD Sponsor: Grammarly Go to grammarly.com/GO to download and learn more about GrammarlyGO. Sponsor: Locumstory Get a comprehensive view of locums and decides if its right for you at locumstory.com Sponsor: Birch Living  Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you use code BIRCHPARTNER20! 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 1 from Kashlak ●  Adrenal crisis identification, workup and management ●  Case 2 from Kashlak ●  Myxedema identification, workup and management ●  Case 3 from Kashlak ●  Thyroid storm identification, workup and management ●  Outro Full transcript available HERE

Ready for more knee pain?  You’ve already memorized episode #98, so join us as Ted Parks to returns to teach us even more about common causes of knee pain (anterior knee pain, patellofemoral pain, knee bursitis, pain after knee replacement) and what to do about them! Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer: Paul Williams, MD, FACP Writer: Paul Williams, MD, FACP  Show Notes: Paul Williams, MD, FACP Infographic and Cover Art: Paul Williams, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD, MSc Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Edward (Ted) Parks, MD Sponsor: Pathway Download the free Pathway app today by visiting https://www.pathway.md/ Full transcript available HERE

Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM #SGIM23 in Denver, Colorado  Claim free CME for this episode at curbsiders.vcuhealth.org! Show Segments Intro Barriers to treating medicine in primary care Patient counseling and obesity pathophysiology  Motivational Interviewing  Telemedicine for obesity Tools and tips for a weight loss program Medications for Obesity GLP1 agonist prescribing tips Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP In-studio Technical Production: Chris Chiu MD, FACP, FAAP Technical Production: PodPaste Guest: Kimberly Anne Gudzune MD, MPH

When there’s blood in the water… Work-up hematuria with confidence.  Learn what you should be worrying about, what tests are worth considering, and how to figure out if this is a job for a urologist or nephrologist. Claim free CME for this episode at https://curbsiders.vcuhealth.org! Credits Producer and writer: Paul Williams, MD, FACP Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Derek Fine, MD

Join us as we review recent practice-changing articles on ketamine vs ECT for refractory depression, nonhormone treatment (fezolinetant) for menopause, metformin for long COVID, new breast cancer screening draft recommendations, and a primer on kratom.  Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Go to https://thecurbsiders.com for more info Become a Kashlak Memorial Hospital member and support us by joining our Patreon Claim free CME for this episode at curbsiders.vcuhealth.org!

Put on your Primary Care Cat-Hat We are thrilled to be back to kick off season 2! Carolyn Chan, MD (@CarolynAChan) soon to be at the University of Cincinnati, Shawn Cohen MD (@ShawnCohen_MD) at Yale University, Kenneth Morford MD at Yale University, and Natalie Stahl MD (@NanouTheNomad) at Greater Lawrence Family Health Center are back and on this episode, they answer burning questions submitted by listeners. We cover topics such as targeted naltrexone, increasing buprenorphine doses, treating kratom dependence, and so much more!  Claim free CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and  completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME! Credits Producer, Show Notes:  Kenneth Morford, MD Infographic and Cover Art: Carolyn Chan, MD, MHS Hosts: Carolyn Chan MD, MHS, Shawn Cohen MD, Kenneth Morford MD, Natalie Stahl MD, MPH Reviewer: Payel Jhoom Roy, MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste

Dominate naughty CAUTIs. Learn how to define them, which studies to order, and how to treat and prevent these pesky infections. We’re joined by Dr. Laila Woc-Colburn, @DocWoc71 (Emory University). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Please consolidate if performing multiple jobs (e.g. Written and Produced by: Cyrus Askin MD; cover art and infographic by Kate Grant) Producer and Writer:: Noble Maleque MD Show Notes: Caroline Coleman MD & Noble Maleque MD Cover Art and Infographic: Caroline Coleoman MD & Sean Evans MD Hosts: Monee Amin MD & Meredith Trubitt MD Reviewer: Sai S Achi, MD MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Laila Woc-Colburn MD

We are far too classy for a “Rocky Mountain High” joke. Live from SGIM 2023 in Aurora, Colorado!  We talk to a panel of Addiction Medicine specialists who recap their outstanding talk on all of the exciting developments in treating addiction.  We review major policy changes, trends in drug overdose, outpatient screening for alcohol use, and all of the ways we might be using psychedelics to treat addiction.  We are joined by Stefan Kertesz, MD @StefanKertesz (University of Alabama at Birmingham), Ximena Levander, MD, MCR, FACP @XimenaLevander (OHSU), Kenneth L. Morford MD, FASAM (Yale), and Katherine Mullins, MD, AAHIV @_kmullins_ (NYU Langone). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer: Carolyn Chan, MD and Paul Williams, MD, FACP Writer: Carolyn Chan, MD and Paul Williams, MD, FACP Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP Hosts: Carolyn Chan, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guests: Stefan Kertesz, MD, MSc; Ximena A. Levander, MD, MCR, FACP; Kenneth L. Morford, MD, FASAM; Katherine Mullins, MD, AAHIV

Master the prescription of antiplatelets and anticoagulation for coronary artery disease and afib (atrial fibrillation). We discuss why, when, and how long to prescribe aspirin, clopidogrel, ticagrelor, prasugrel, and/or anticoagulation for primary, secondary, and “primary and a half” prevention including the definition and discussion of mono, dual, and triple therapy for patients with coronary disease who need anticoagulation for atrial fibrillation. We’re joined by preventive cardiologist, Dr. Donald Lloyd-Jones MD, ScM (@dmljmd from NMCardioVasc)! This episode was recorded in person at ACP’s (@ACPIMPhysicians) Internal Medicine Meeting 2023 #im2023 in San Diego. Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Getting to know our guest Definition mono, dual, triple therapy, DAPT Post-PCI for NSTEMI with existing afib Stable CAD with new Afib CABG with New Afib Prior stent with New Afib Antiplatelet therapy after Acute Coronary Syndrome Primary Prevention Primary “and a half” Prevention Life’s Essential 8 Outro Sponsor: Pattern https://www.patternlife.com/ Sponsor: Panacea Financial https://panaceafinancial.com/ Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art & Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD, MSc Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Donal Lloyd-Jones MD, ScM

The ANA, anti-CCP, RF, and beyond! We all have ‘rheum’ to grow when it comes to making sense of autoantibodies and common markers. We talk through the nuances with rheumatologist Dr. Matthew B. Carroll (biography here!). Our interview covers physical exam tips for inflammatory arthritis, basic interpretation of rheumatologic testing, and what to do with the dreaded ‘vaguely positive’ speckled ANA! Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 History clues Physical exam pearls; what does synovitis look like? Interpreting mixed labs Rheumatoid Factor tips Role for imaging Importance of early diagnosis New testing modalities Case 2 Oh no– a vaguely positive ANA! ANA testing basics Outro Credits Showrunners, Hosts, Producers and Writers: Matthew Watto MD, FACP; Paul Williams MD, FACP    Show Notes, Infographic, Cover Art: Beth Garbitelli MD Reviewer: Emi Okamoto MD  Technical Production: PodPaste Guest: Matthew B. Carroll MD Sponsor: Brooklinen Visit Brooklinen.com today and get $20 off plus free shipping on orders of $100+ with code [CURB] Sponsor: Grammarly Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Sponsor: Glass Health You can get one month of Glass Pro free by signing up at glass.health and using the code: CURBSIDERS.

Learn to bust through inpatient cirrhosis management! The basics of ascites, HRS, portal vein thrombosis and hepatic encephalopathy management are all here. We’re joined by Dr. Suchita Sata (@suchitasata) (Duke University). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Austin Picks of the week Case Ascites Portal Vein Thrombosis AKI/HRS SBP Diuretic Management Albumin Case HRS treatment GIB Management Hepatic Encephalopathy Management Palliative Care Outro Credits Producer, Writer: Monee Amin MD, Meredith Trubitt MD Show Notes, Cover Art:  Monee Amin MD Infographic: Caroline Coleman MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Suchita Sata MD Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.  Sponsor: Birch Living  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Green Chef  Go to GreenChef.com/curb60 and use code curb60 to get 60% off plus free shipping.  Sponsor: Glass Health  You can get one month of Glass Pro free by signing up at glass.health and using the code CURBSIDERS   Full Transcript available HERE

Don’t be scared of insulin or hypoglycemia anymore!  Our Kashlak Friend of the Pod Dr. Jeff Colburn gives us all the essentials you’ll need in your fanny pack for navigating the ups and downs of insulin in type 2 diabetes.  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions/Picks of the Week Case #1: Starting insulin Types of basal insulin: glargine, detemir, NPH, 70/30 NPH/regular Glucose monitoring while on insulin Glucose targets  when taking insulin Overbasalization  Adding additional agents to basal insulin Case #2: Deescalating insulin Insulin use in the geriatric population Hypoglycemia Rule of 15  Glucagon how-to  Outro Credits Producer, Writer, Show Notes, Infographic and Cover Art: Isabel Valdez, PA-C  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Jeff Colburn, MD Sponsor: Pattern  Request your quotes online at patternlife.com/curbsiders Sponsor: Birch Birch is giving 20% off ALL mattresses and two free eco-rest pillows at birchliving.com/curb Full Transcript available HERE

Don’t miss this rapid-fire recap of our top pearls from #SGIM23 in Aurora, Colorado, including obesity medicine, GLP1 agonists, trauma-informed care, an update on hormone therapy for vasomotor symptoms of menopause, treating low sexual desire in women, dementia diagnosis and treatment, chronic pain and buprenorphine, complex persistent opioid dependence, chlorthalidone vs hydrochlorothiazide, the timing of blood pressure medication, how to prescribe CPAP or auto-PAP, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk), Chris Chiu (@cjchiu), Carolyn Chan (@CarolynAChanMD, Curbsiders Addiction Medicine), and Era Kryzhanovskaya (@EraKryzhMD, Curbsiders TEACH).  No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Recap, Top Pearls Part 1 Recap, Top Pearls Part 2 Outro Credits Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Carolyn Chan MD; Era Kryzhanovskaya MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Show Notes: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP   Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor:  Pattern Request your disability insurance quotes with Pattern at patternlife.com/curbsiders.

There might be a lot to swallow, but you will master an initial approach to dysphagia in this episode. Review the types of dysphagia, common etiologies, initial evaluations and treatment plans. We are joined by Dr. Diana Snyder @DianaSnyderMD (Mayo Clinic) Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro & Picks of the Week Case  Dysphagia definitions Oropharyngeal vs esophageal dysphagia  Associated symptoms and alarm signs  Outro Credits Producer, Writer & Show Notes: Elena Gibson MD  Show Notes: Elena Gibson MD Cover Art & Infographic: Kate Grant MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD  Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Diana Snyder MD Sponsor: Locumstory Get a comprehensive view of locum and decide if it’s right for you at locumstory.com Sponsor: Brooklinen Your Memorial Day Sale is coming soon! Shop 20% off in-store or online at Brooklinen.com Sponsor: Panacea Financial  Visit panaceafinancial.com to open your free account today.   Full transcript available HERE

Don’t miss this rapid fire recap of our top pearls from ACP #IM2023 in San Diego including hypertension, hypogonadism, frailty, afib, sleep medicine, in-flight emergencies, nephroprotective meds, order of antibiotics for pneumonia in the hospital, genitourinary syndrome of menopause, pickle juice for leg cramps, bristol stool scale and hepatic encephalopathy, coronary calcium, tirzepatide, cystatin c,  functional dyspepsia, hair and nails, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk) and Chris Chiu (@cjchiu) of The Cribsiders Podcast. No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Recap, Top Pearls Part 1 Recap, Top Pearls Part 2 Outro Credits Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP  Show Notes: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP   Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Grammarly Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer good for a limited time. Full transcript available HERE

Join us for this Hotcakes style episode as we talk through impactful literature for the hospitalist with Dr. Heather Nye (UCSF) and  Dr. Rahul Ganatra (@rbganatra, Harvard University) who presented the Clinical Updates in Hospital Medicine at SHM #Converge23.  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro, disclaimer Rapid fire questions/Picks of the Week EMPULSE ADVOR STRONG-HF CRISTAL Perioperative Gabapentin Waterfall Midline catheters vs PICC lines What’s in a Name? Outro Credits Producer, Writer, Show Notes: Monee Amin MD; Rahul Ganatra, MD; Meredith Trubitt MD;  Cover Art: Monee Amin MD  Hosts: Monee Amin MD; Meredith Trubitt MD   Reviewer: Fatima Syed MD  Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Rahul Ganatra and Dr. Heather Nye Sponsor: Birch Living Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at indeed.com/internalmedicine. Full transcript available HERE

Dominate opioid and xylazine (aka tranq) withdrawal in the hospital with expert insights from Dr. Joseph D’Orazio (@dorazepam) recorded LIVE! at Pennsylvania Hospital Grand Rounds in Philadephia, PA. Xylazine, an alpha-2 adrenergic agonist,  has emerged as a frequent contaminant in the opioid supply with a distinct withdrawal syndrome. You’ll learn to manage this common withdrawal syndrome while also addressing acute pain complaints and opioid withdrawal.   Sorry, no CME for this episode, but check out CME for past episodes at curbsiders.vcuhealth.org. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Xylazine basics Management of xylazine withdrawal Opioid withdrawal and acute pain Outpatient considerations for xylazine Audience questions Outro Credits Writer and Producer: Matthew Watto MD, FACP Infographic and Cover Art: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Joseph D’Orazio MD Full transcript available HERE 

Master the nuances of the hypercoagulable work-up! Our expert discussant, Dr. Jean Connors, leads us through when to send testing for thrombophilia and how to interpret the results. Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak: DVT after a trip to Singapore History-taking in a patient with a venous thromboembolism (VTE) Risk factors for VTE Who to test for thrombophilia, and how this testing influences management Thrombophilia panel: what to order When to send thrombophilia testing Case from Kashlak: potential obstetric antiphospholipid syndrome Antiphospholipid syndrome: diagnosis Antiphospholipid syndrome: management Outro Credits Producers and Writers: Malini Gandhi and Nora Taranto MD Show Notes, Infographics, and Cover Art: Malini Gandhi  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Jean Connors MD Sponsor: Locumstory Go to locumstory.com to get a comprehensive view of locums  and decide if it’s right for you. Sponsor: Panacea Financial Visit panaceafinancial.com today to open your free account. Full transcript available HERE

Hypertension FAQ Round #2 Dr. Jordy Cohen Strikes Back Tackle resistant hypertension. Learn when it is pseudo resistant hypertension, and how to treat this pesky condition when it is true resistant hypertension. Dr. Jordy Cohen (@jordy_bc) leads us through her approach to keeping the BP where it should be (University of Pennsylvania). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | Contact | Swag! | CME Show Segments Intro Case Hypertension definition Mechanisms of hypertension Vascular stiffness and aging Antihypertensive agents Anxiety and hypertension Escalating blood pressure management Resistant hypertension Ruling out pseudo resistant hypertension Substance induced pseudo resistant hypertension Pick of the Week Outro Credits Written and Produced by: Deborah Gorth MD, PhD Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi MD, MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jordy Cohen MD, MSCE Sponsor: Indeed Visit Indeed.com/INTERNALMEDICINE to start hiring now Full transcript available HERE

We recap the top pearls for the hospitalist from #SHM #Converge2023 covering discussions on syncope, heart failure, COPD, pneumonia, sickle cell pain management, nausea and dyspnea, complex pain management issues, delirium, geriatrics updates, severe infections from injection drug use, electrolyte management, perioperative anemia and anticoagulation, and GI updates.  Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Syncope Heart Failure Nausea and Dyspnea  COPD and Pneumonia Sickle Cell Pain Management Pain Management for the Hospitalist Delirium  Geriatrics Updates Electrolyte Management  Perioperative Anticoagulation Perioperative Anemia  Severe Infections from Injection Drug Use GI updates Outro Credits Written, Produced and Hosted by: Christina Sensabaugh MD, Meredith Trubitt MD, and Monee Amin MD Cover Art: Monee Amin MD  Show Notes: Meredith Trubitt MD, Monee Amin MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Sponsor: Brooklinen For a limited time, visit Brooklinen.com to get $20 off plus free shipping on orders of $100+ with code CURB. Sponsor: Locumstory Get a comprehensive view of locums — and decide if it’s right for you — at locumstory.com. Sponsor: Indeed  Visit Indeed.com/INTERNALMEDICINE to start hiring now. Full transcript available HERE

LIVE! Updates in HIV management at Hershey Highly active, high-yield points on HIV management in Primary Care!  We are joined by Infectious Disease specialist Dr. Jonathan J. “JJ” Nunez MD (of Penn State Health - Hershey) to review basics of management, important comorbidities, and new horizons in HIV care.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | askcurbsiders@gmail.com | Swag! | Free CME! Show Segments Intro Establishing HIV Care, Initial History Taking Privacy and HIV Physical Exam Tips for HIV Weight gain, managing cardiometabolic risks Initial labs, tracking viral load Undetectable = Untransmissible Sexual history considerations, PEP, PrEP,  Anal paps, cervical cancer screening Long-Acting HIV Medications Take-home points Outro Credits Producer, Writers: Paul Williams MD, FACP, Beth Garbitelli MD Show Notes, Infographic, Cover Art: Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  J.J. Nunez MD Sponsor: Green Chef Go to GreenChef.com/curb60 and use code curb60 to get 60% off plus free shipping. Sponsor: Birch Living   Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb Full transcript available HERE

Drop the pounds and the sugar with new guidelines New rules to manage diabetes means using new tools. Leverage GLP-1 RA and SGLT2-i to drop with pounds and the sugars with the expert insight from our guest, Dr. Marie McDonnell. Claim free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Puns and Intro. Disclaimer and Guest bio Case from Kashlak Labs to distinguish type 1 from type 2 diabetes Selecting initial therapy: Focus on weight loss and glucose control HbA1c goals  Yeast infections and SGLT2-i Using sulfonylureas and extended release metformin Pancreatitis and GLP-1 RA Cancer and GLP-1 RA Semaglutide tips Tirzepatide, how it works and benefits Take home points Outro Credits Producer: Matthew Watto, MD and Isabel Valdez, PA Writer: Matthew Watto, MD Show Notes, Cover Art and Infographics: Isabel Valdez, PA Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Marie E. McDonnell, MD Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com Full transcript available HERE 

We demystify primary aldosteronism, MRAs (mineralocorticoid receptor antagonists), non-steroidal MRAs, and how to recognize and treat renovascular hypertension with nephrologist/hypertension expert, Dr. Matt Luther (@DrJMLuther) as part of the NephMadness  PodCrawl 2023. Fill out a bracket for NephMadness and check out all eight NephMadness PodCrawl participants at NephMadness.com/podcrawl (list below) and the MRA region write-up by Micah Schub (@AcidBassMD). The Curbsiders gets the skinny on mineralocorticoid receptor antagonists Core IM will be covering Kidney Transplant in their classic Five Pearl format The CardioNerds will be covering the effect of Heart Failure Devices on Kidney Health Freely Filtered will try to understand thrombotic microangiopathy ISN Global Kidney Care goes deep on IgA nephropathy The Cribsiders look at transitions, first the Pediatrics to Adult nephrology transition and then from living to death with palliative nephrology  Fellow on Call will be covering Onconephrology And finally, The Nephron Segment looks at Transgender Health and CKD Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | Contact | Swag | CME Show Segments Intro Diagnosis and Management of Primary Aldosteronism (PA) MRAs vs non-steroidal MRAs (mineralocorticoid receptor antagonists) NephMadness MRA region picks Renovascular Hypertension Outro Credits Writer and Producer: Matthew Watto MD Show Notes: Matthew Watto MD Cover Art & Infographic: Matthew Watto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: J. Matthew Luther MD Sponsor: Locumstory Get a comprehensive view of locums, and decide if it;s right for you, at locumstory.com Sponsor: indeed Visit indeed.com/internalmedicine to start hiring now. Full Transcript available HERE

We’ve got the hard-hitting questions and must-know answers on all things TIA and stroke from neurology expert, Dr. Karima Benameur (Emory University). Topics: TIA and stroke supportive management, indicated workup, and anticoagulation and antiplatelet management pearls for the hospitalist. Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments  Intro, disclaimer, guest bio Case 1 from Kashlak; Definitions Initial stroke triage, imaging, and assessing for interventions  Supportive care for stroke Managing patients already on antiplatelet or anticoagulant therapy Inpatient stroke workup Dual antiplatelet therapy Case 2 from Kashlak; Definitions TIA workup and management Transitions of care: “the invisible deficits” Brain health and nutrition Guest questions and Picks of the Week* Outro Credits Written, Produced, Infographic and Cover Art, Show Notes: Caroline Coleman MD Hosts: Monee Amin MD; Meredith Trubitt MD, MPH; Caroline Coleman MD Reviewer: Molly Heublein MD Executive Producer: Karly Loy Showrunner: Matthew Watto MD, FACP Editor: Pod Paste Guest: Karima Benameur MD Sponsor: Indeed  Visit indeed.com/internalmedicine to start hiring now. Sponsor: Glass Health You can get one month of Glass Pro free by signing up at glass.health and using the code CURBSIDERS. Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Full transcript available HERE

Stay up-to-date with advances in chronic kidney disease (CKD)! Join our esteemed Chief of Nephrology at Kashlak Memorial Hospital, Dr. Joel Topf, as he leads us through the latest on SGLT2 inhibitors, finerenone, potassium binders, and treatment of CKD-associated metabolic acidosis. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | askcurbsiders@gmail.com | Swag! | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak SGLT2i: when to initiate SGLT2i: adverse effects Finerenone Potassium binders Treatment of CKD-associated metabolic acidosis  Outro Credits Writer, Producer, Show Notes, Infographics, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Joel Topf MD Sponsor: Better Help Visit betterhelp.com/curb today to get 10% off your first month.  Sponsor: Birch Living Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: PanaceaFinancial Visit panaceafinancial.com to open a free account.  Full transcript available HERE

Join us as we review recent practice-changing articles on loop diuretics for heart failure exacerbation (torsemide vs furosemide), time-restricted eating vs small frequent meals for weight loss, how sedentary breaks from sitting effect blood glucose & blood pressure, early FMT for C. diff, and a brief rant on medications for obesity. Fill your brain hole with a delicious stack of hotcakes! Featuring Nora Taranto (@norataranto, The DIGEST), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer Loop diuretics (torsemide vs furosemide) for heart failure exacerbation Time-restricted eating vs small frequent meals for weight loss Sedentary breaks for lowering blood glucose and blood pressure Early fecal microbiota transplant (FMT) for C. diff infection  Outro Credits Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Full transcript available HERE

With Dr Holly Wong Cummings Listen in as we talk through abnormal uterine bleeding (AUB) with our esteemed guest Holly Wong Cummings, MD.  We review the PALM-COEIN framework for AUB diagnosis and discuss options for acute and chronic treatment of AUB.  We can get bleeding under control! Many of the treatments including progesterone only pills, combined oral contraceptives, and tranexamic acid are medications we in primary care should feel confident prescribing to our patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak Normal Menstrual Cycle Nomenclature for AUB- PALM COEIN History and Physical Exam Laboratory and radiologic evaluation Structural causes for bleeding/interpreting the ultrasound Acute treatment of AUB When to refer to ED Chronic treatment for AUB When to refer to gyn Take home points Outro Credits Producer, Writer, Show Notes: Molly Heublein MD Infographic: Edison Jyang Cover Art: Sarah Phoebe Roberts Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD Reviewer: Sai S Achi MD, MBA Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Holly Wong Cummings MD Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full transcript available HERE

Join Drs. Amin and Trubitt as they go rogue and LIVE!  from Southern Hospital Medicine to discuss Things We Do For No ReasonTM in the hospital that impact the patient experience. They cover NPO at midnight, fluid restriction, VTE chemoprophylaxis and routine vital signs via the hospital course of one poor, unfortunate soul. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro NPO at midnight Fluid restriction VTE chemoprophylaxis Frequency of vital sign monitoring Outro Credits Written and Produced by: Monee Amin MD and Meredith Trubitt MD Cover art and presentation graphics: Caroline Coleman, MD Show Notes: Monee Amin MD and Meredith Trubitt MD Hosts: Monee Amin, MD and Meredith Trubitt MD Technical Production: PodPaste Showrunner: Matthew Watto MD, FACP Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions.  Sponsor: Indeed Visit indeed.com/internalmedicine to start hiring now.  Sponsor: BetterHelp  ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb  Full Transcript available HERE

Recognize when to consider the diagnosis of hemochromatosis  and how to recognize common mimics of an elevated ferritin level. We’re joined by Dr. Elliot Tapper,@ebtapper on twitter (University of Michigan) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Initial evaluation of Hemochromatosis  Etiology of elevated ferritin in liver disease Potential mimics of hemochromatosis  Diagnosis of hemochromatosis Evaluation of hepatic fibrosis in hemochromatosis Manifestations & complications of hemochromatosis  Outro Credits Producer & Writer:: Elena Gibson MD    Infographic & Cover Art:Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Elliot Tapper Sponsor: Green Chef Go to greenchef.com/curb60 and use code curb60 to get 60% off plus free shipping.  Sponsor: Birch Living  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Better Help  Visit betterhelp.com/curb to get 10% off your first month.  Full transcript available HERE

With Dr Steven Rauch Demystify hearing loss, identify who will benefit from hearing aids and learn to evaluate hearing complaints in primary care including an overview of tinnitus and how to recognize and treat Meniere’s disease with guest expert, Dr. Steven Rauch (Harvard University). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak;  Definitions, etiology and risk factors for hearing loss  Initial workup for hearing loss What is an audiogram and what does it show  Hearing loss red flags  How to manage hearing loss Tinnitus: what can help patients  Diagnose, distinguish and treat Meniere’s disease  Outro Credits Script and Show Notes written by,  Produced by: Kate Grant MBChB, MRCGP and Andréa Perdigão Infographic and Cover Art: Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Steve Rauch MD Sponsor: Better Help Visit betterhelp.com/curb to get 10% off your first month.  Full Transcript HERE

Pro Tips & Practical Insights from Dr. Jim O’Brien Are acute COPD exacerbations taking the wind out of YOUR sails? Join us as we navigate the stormy waters that can be AECOPD with our guest expert,  Dr. Jim O’Brien                                                                          from National Jewish Health Center. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio What is a COPD  Case from Kashlak - Natalie Harrison Knee jerk reaction: Determining level of illness & disposition Initial work-up considerations What’s in your differential? The second-order assessment - shuffling the differential, honing in on the patient AECOPD: Triggers & Pathophysiology Treatment Pearls I: Steroids Treatment Pearls II: Antibiotics Treatment Pearls III: Bronchodilators Treatment Pearls IV: Oxygen Therapy Preparing for discharge Take home points Lightning Round! Getting to know Dr. O’Brien &  Picks of the Week* Outro Credits Writer & Producer:  Cyrus Askin MD Show Notes, Infographic & Cover Art: Cyrus Askin MD  Hosts: Meredith Trubitt MD, Monee Amin MD & Cyrus Askin MD    Reviewer:  Sai Achi, MD MBA  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jim O’Brien MD Sponsor: Medmastery Go to www.medmastery.com/curbsiders to claim a 15% discount off an annual Medmastery Pro Subscription.  Full Transcript available HERE

Conquer your fear of adrenal incidentalomas! We’re joined by Dr. William Young, who teaches us pearls for evaluating imaging characteristics of adrenal incidentalomas, tips for assessing and managing functioning adenomas, approaches to follow-up and surgical considerations, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case #1 from Kashlak; Definitions Discussing adrenal incidentalomas with patients Imaging characteristics of adrenal incidentalomas Evaluation of hormonal hypersecretion - overview Subclinical Cushing’s syndrome Pheochromocytoma Surgical considerations based on nodule size and imaging phenotype Follow-up imaging Case#2 from Kashlak  Primary hyperaldosteronism - work-up and management Bilateral adrenal nodules Guest Picks of the Week Outro Credits Producer, Writer, Show Notes, Infographic, and Cover Art: Malini Gandhi  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: William Young MD Sponsor: Grammarly Go to grammarly.com/podcast to sign up for an account and download! And when you’re ready to upgrade to Grammarly Premium, get 20% off.  Sponsor: BetterHelp Visit betterhelp.com/curb to get 10% off your first month.  Full Transcript HERE

We have better tools for prevention, but let’s talk! Should we be offering hormone therapy for primary prevention in postmenopausal patients?  Dr. Carol Mangione (UCLA) talks us through the potential benefits and harms, and explains how this can be a jumping off point for important conversations about preventive care. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers, Hosts: Elena Gibson MD and Paul Williams MD, FACP Writer, Infographic, and Cover Art: Elena Gibson MD Show notes: Paul Williams MD, FACP Reviewer: Molly Heublein MD Production team: Podpaste Guest: Carol Mangione MD Full transcript available HERE

In this episode you will learn to master delirium in the hospital!  We discuss preventing, recognizing, and managing this common and dangerous condition.  We are joined by delirium expert and President of the American Delirium Society, Dr. Esther Oh @EstherOh_MDPhD (Johns Hopkins University) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case 1 from Kashlak: hypoactive delirium Definition of delirium Delirium vs. encephalopathy vs. dementia Delirium assessment tools Prevention of delirium Discharging patients with delirium Case 2 from Kashlak: hyperactive delirium Antipsychotics Working up etiologies of delirium Treatment/management pitfalls Outro Credits Produced, Script, Show Notes: Adam Barelski MD  Infographic & Cover Art: Edison Jyang; Sarah Phoebe Roberts Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Adam Barelski MD    Reviewer: Molly Heublein MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Esther Oh MD, PhD Sponsor: Panacea Financial  Visit panaceafinancial.com to open your free account. Full transcript HERE

Don’t get distracted, pay attention to the details, and manage ADHD in your patients! Dr. Kevin Simon, @DrKMSimon (Boston Children’s Hospital) shows us how to stay focused and diagnose and manage attention deficit hyperactivity disorder (ADHD)  in your patients.  Learn how to make the right diagnosis, choose an appropriate medication, and modify therapy.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak; Definitions and diagnosis of ADHD Stimulant medications for ADHD Non-stimulant medications for ADHD Mitigating diversion of medications for ADHD Managing ADHD in patients with substance use disorder Lightning round and picks of the week Outro Credits Written and Produced by: Paul Williams, MD, FACP Show Notes: Paul Williams, MD, FACP Infographic and Cover Art: Paul Williams, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed, MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Kevin Simon, MD Sponsor: Better Help Save 10% off your first month at betterhelp.com/curb Sponsor: Birch Living  Visit birchliving.com/curb to get $400 off all mattresses and 2 free eco-rest pillows.  Full Transcript HERE

Celebrate the holiday season with top pearls on constipation, palpitations, hypertension, meds for obesity, cardiorenal syndrome, hepatitis C, staging the liver, vitamin supplementation and more! Plus, Watto and Paul share their reflections on seven years of podcasting, give their picks of the year, and tease upcoming episodes for 2023! Note No CME for this episode but visit curbsiders.vcuhealth.org to claim credit for shows from 2022! Episodes | Subscribe | Spotify | Swag! | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, Reflections on 2022 Constipation,  Palpitations,  Hypertension,  Obesity medications,  Cardiorenal syndrome,  Hepatitis C,  Vitamin supplementation Picks of the Year Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP Cover Art design: Matthew Watto MD, FACP Technical Production: Pod Paste Full transcript HERE

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm. Free CME for this episode at curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments ●  Intro, disclaimer, guest bio ●  Guest one-liner, Picks of the Week* ●  Case 1 from Kashlak ●  Adrenal crisis identification, workup and management ●  Case 2 from Kashlak ●  Myxedema identification, workup and management ●  Case 3 from Kashlak ●  Thyroid storm identification, workup and management ●  Outro Credits ●  Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD ●  Show Notes, Infographic and Cover Art: Caroline Coleman, MD ●  Reviewer: Emi Okamoto, MD ●  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●  Technical Production: PodPaste ●  Guest: Sara Markley Webster, MD Sponsor: Locumstory If you would like to learn more about locums visit locumstory.com Sponsor: Pattern Visit patternlife.com/curbsiders to get a free disability insurance quote. Full Transcript HERE

Navigating guidelines, parsing through the PSA, Survivorship, & More! Become a pro when addressing prostate cancer! We tackle the nuances surrounding screening for this all-to-common cancer and discuss important considerations in survivorship with our guest Dr. Petar Bajic (Twitter: @PBajicMD, Instagram: @the.sexdoc) of Cleveland Clinic! You’re IN for a good time listening to this episode! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments ●      Intro, disclaimer, guest bio ●      Guest one-liner ●      Case from Kashlak ●      Epidemiology of Prostate Cancer ●      Screening Basics ●      What is the PSA? ●      Next Steps After Elevated PSA ●      Thresholds and techniques for biopsy ●      Free PSA, Other testing modalities, Prostate MRI ●      Active Surveillance Nuts and Bolts ●      Survivorship ●      Take home points, Outro Credits ●      Producer,Writer, Show Notes,  Infographic, Cover Art: Beth Garbitelli MD ●      Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD ●      Reviewer: Sai S Achi, MD MBA ●      Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●      Technical Production: PodPaste ●      Guest: Dr. Petar Bajic MD Sponsor: Better Help  Learn more and save 10% off your first month ast betterhelp.com/curb Sponsor: Birch Living  Birch is giving $400 off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Hello Fresh Go to hellofresh.com/curb18 and use code curb18 for 18 free meals plus free shipping.  Sponsor: Pattern Life Visit patternlife.com/curbsiders to request your free physician disability insurance quote. Full Transcript HERE

 Master the ins-and-outs of Parkinson’s Disease! We’re joined by Dr. Albert Hung, who teaches us pearls for the initial history and physical exam in a patient with undiagnosed Parkinson’s, a framework for management of early and advanced motor symptoms, tips for treating autonomic symptoms and cognitive / psychiatric features, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Initial history in a patient with undiagnosed Parkinson’s “Pre-motor” symptoms of Parkinson’s disease Physical exam in Parkinson’s disease Drug-induced Parkinsonism “Red flags” suggesting atypical parkinsonian syndromes Role of imaging in diagnosis Typical discussion with patient at initial diagnosis Initial management of motor symptoms Management of autonomic symptoms Management of advanced motor symptoms Management of cognitive and psychiatric symptoms Outro Credits Producer, Writer, Show Notes, and Infographic: Malini Gandhi Cover Art: Kate Grant  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Albert Hung MD, PhD Full transcript HERE

Recap and review the top pearls from recent episodes #339 Hand and Wrist Pain, #348 Foot and Ankle Pain,  and #351 Myopathy and Myositis with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #339, #348 and #351! Episodes | Subscribe | Spotify | Swag! | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Hand and Wrist pain: CMC joint arthritis, tenosynovitis, carpal tunnel syndrome, trigger finger Foot and Ankle pain: Ankle sprains, Achilles tendon injuries, Posterior tibial tendon dysfunction Myopathy and Myositis pearls Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Full transcript HERE

A Rational Approach: Who to Image, How to Treat, and More! Back pain is one of the most common concerns our patients bring to us in the outpatient setting.  It’s a lot more complicated than rest, ice, and NSAIDs!  Fortunately, we have pain expert, strength coach, and academic internist Dr. Austin Baraki (Austin Baraki, MD (@AustinBaraki) / Twitter) to help us develop a comprehensive, patient centered approach to help our patients manage their pain and lead healthier lives. Take control of your patients’ back pain!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak Introduction to Back Pain Eliciting the Patient’s Story Risk Stratification, Intro to Red Flags,  and and the STarT Back Tool  The Importance of Language and Patient-Centered Outcomes A Deeper Dive into Red Flags Setting Expectations for Care Therapeutics for Back Pain - Does anything work? The Exercise Prescription Credits Producers: Isabel Valdez, PA-C & Cyrus Askin, MD  Writer, Cover Art and Infographics:  Isabel Valdez, PA-C Show Notes: Cyrus Askin, MD Hosts: Matthew Watto MD, FACP;  Isabel Valdez, PA-C Reviewer: Molly Heublein, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Austin Baraki, MD Sponsor: Grammarly  Go to grammarly.com/CURB to sign up for a free account! And when you’re ready to upgrade to Grammarly Premium, get 20% off. Full transcript HERE

Join us as we review recent practice-changing articles addressing the questions: Do weekend warriors experience a mortality benefit from exercise? Is an aggressive fluid strategy superior to a moderate strategy in acute pancreatitis? Does an invite for colonoscopy decrease colon cancer-related mortality? Did the benefits of intensive blood pressure control continue after the SPRINT trial ended? Fill your plate with a stack of hot tofurkey cakes! Featuring Drs. Era Kryzhanovskaya (@erakryzhmd), Nora Taranto (@norataranto), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer Do weekend warriors experience a mortality benefit? Should you choose aggressive or moderate fluid resuscitation for acute pancreatitis? Does an invite for screening colonoscopy reduce colon cancer and CRC-related mortality? Did benefits from the SPRINT trial persist in observational follow up? Outro Credits Written and Hosted by: Era Kryzhanovskaya, MD, Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatral MD, MPH Technical Production: Pod Paste Sponsor: Better Help Visit betterhelp.com/curb to save 10% off your first month.  Sponsor: Birch Living  Go to birchliving.com/curb to get $400 off and 2 free eco-rest pillows.

With Carolyn Chan MD and Shawn Cohen MD Conquer acute pain in the hospitalized patient with opioid use disorder! It’s challenging to treat opioid withdrawal and acute pain simultaneously. This episode features clinical pearls on prescribing methadone, buprenorphine, low-dose buprenorphine initiation, and how to incorporate opioids as part of multimodal pain treatment responsibly. We’re joined by The Curbsiders Addiction Medicine Podcast hosts, Drs. Carolyn Chan (@carolynachan) and Shawn Cohen (@shawncohen)! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Acute pain in the patient on buprenorphine maintenance Acute pain in the patient on methadone maintenance Acute pain in the patient with opioid withdrawal Standard buprenorphine initiation Methadone initiation Low dose buprenorphine initiation Take-home points Outro Credits Writer and Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP   Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Carolyn Chan MD and Shawn Cohen MD Sponsor: ExpressVPN Visit expressvpn.com/curb to get and extra three months free.  Sponsor: Southern California Permanente Medical Group  Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684.  Full transcript HERE

We’ve Come a Long Way From Ether Learn how an anesthesiologist approaches perioperative medicine from how to choose the right type of anesthesia (general anesthesia vs regional anesthesia vs MAC), to preoperative risk assessment, and how to avoid anesthesia related complications. Our guest, anesthesiologist, Dr. Angela Selzer (Denver, CO) helps us explore high yield pearls regarding the practice of anesthesiology to empower the internal medicine clinician to deliver team-based, perioperative care. Claim Free CE credit for this episode through VCU Health CE at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Introduction to anesthesiology  Introduction to regional anesthesiology   Walk through what an anesthesiologist does in the operating room Ambulatory surgery center exclusions  Approach to preop assessments “Will it change management?” applied to anesthesiologists ASA Classes  Anesthesia complications Take Home Points; Outro; Bonus clip Credits Written and Produced by: Edison Jyang; Avital O’Glasser MD, FACP, SFHM Cover Art: Sarah Phoebe Roberts, MPH Infographic:  Avital O’Glasser MD, FACP, SFHM; Edison Jyang Show Notes: Avital O’Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Avital O’Glasser MD, FACP, SFHM Technical Production: Pod Paste  Reviewer: Sai S Achi, MD MBA Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Angela Selzer, MD Sponsor: Better Help Save 10% off your first month at BetterHelp.com/curb  Sponsor: Hello Fresh Go to HelloFresh.com/curb65 and use code curb65 for 65% off plus free shipping.  Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full transcript HERE

We ran the numbers, and it’s still important! Should patients be screened for syphilis? If so, which ones? Dr. Katrina Donahue (USPSTF) talks us through this re-affirmation of the USPSTF syphilis screening guideline, including who might be high risk and how to screen them. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers: Elena Gibson, MD and Paul Williams MD, FACP Writer: Elena Gibson, MD Show notes: Paul Williams MD, FACP Infographic and Cover Art: Elena Gibson, MD Hosts: Paul Williams MD, FACP and Elena Gibson MD  Production team: Podpaste Guest: Katrina Donahue MD Full Transcript HERE

Optimize and update your approach to atrial fibrillation (afib) as we discuss early rhythm control, antiarrhythmic drugs, TTE/cardioversion, afib ablation, new onset afib in the hospitalized patient, and left atrial appendage closure. Plus, we try to answer, Does afib burden matter? Our guest is cardiologist-electrophysiologist, Hugh Calkins MD, @hughcalkinsMD, Professor of Cardiology at Johns Hopkins, @hopkinsheart.  Sorry, but we won’t be offering CME for this episode. You can claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions An approach to new-onset afib in the office Rhythm control Lifestyle modification is a pillar of afib treatment Indications for hospitalization in afib More on rhythm control and when to pursue afib ablation Rhythm control in heart failure New onset afib in the hospitalized patient Does afib burden matter? Left atrial appendage closure  Watto and Paul recap what we’ve learned Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover art and Infographic by: Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP    Technical Production: PodPaste Guest: Hugh Calkins MD Sponsor: Grammarly Go to grammarly.com/curb to sign up for a free account. And when you’re ready to upgrade to Grammarly Premium, get 20% off.  Full transcript HERE

Recap and review the top pearls from recent episodes #341 Migraine Headaches Update and #350 Acute Hypoxemia with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #341 and #350! Show Segments Intro, disclaimer, guest bio Migraine Headaches Update An approach to Hypoxemia Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Full transcript HERE

Lipids Update 2022: Cardiovascular Risk Reduction and New Medications on the Horizon with Erin Michos, MD Show description:  Ready to take the next step in management of your patient with hyperlipidemia? Dr. Erin Michos (@erinmichos) returns to give us a lesson in Advanced Lipidology. She updates us on what new medications we can use for those difficult to treat lipids and what medications are on the horizon. Unfortunately, this episode will not be available for CME. You can claim free CME for other episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, Getting to know Dr. Erin Michos, Pick of the Week Patient Case, Digging into ASCVD Risk  Coronary artery calcium scoring - why it’s important What are “Risk Enhancing Factors”? Biomarker testing, what is the significance of Lip a and how can we use it to drive management? Introduction to PCSK9 inhibitors More than just statins - other LDL-lowering medications siRNAs, ASOs - Pelacarsen and more Apollo Trial regarding Pelacarsen Importance of Family History What to do if maxed out on a statin or statin intolerance - Ezetimibe, PCSK9 inhibitors, MAB therapies, and more Bempedoic Acid discussion Medication side effects Homozygous FH - approach to treatment, ANGPTL3 inhibitors Triglycerides discussion, icosapent ethyl, the REDUCE-IT trial Wrap-up and Take home points, Outtro Credits Producer and written by: Christopher Chiu MD, FACP, FAAP Show Notes: James Antaki MD Infographic: Edison Jyang Cover Art: Kate Grant MBChB, DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Erin Michos MD, MHS Sponsor: Birch Living Birch is giving $400 off all mattresses and 2 free eco-rest pillows at BirchLiving.com/curb.  Full transcript HERE

The treatment your patients need but may not be getting! Take a bite out of our latest episode featuring guest expert Dr. Michelle McMacken (@DrMcMacken) and learn how you can help your patients effectively and sustainably reap the health benefits of improved nutrition. Discover the enormous evidence base for nutritional recommendations, develop scripts to engage patients, and update your CVD, T2DM, and hyperlipidemia treatment plans to meaningfully incorporate nutrition. Get your truffle-hunting outfit on, it’s time to go foraging for some tasty knowledge food!  Show Segments Intro, disclaimer, guest bio Guest one-liner, favorite advice Case from Kashlak; definitions “Evidence-based nutrition” vs plant-based diet Unifying the guidelines for patient care Treating the skeptical patient Tailoring recommendations to patients’ needs  Treating the motivated patient Host questions Outro Credits Written and Produced by: Deep Shah MD Show Notes:  Sarah Phoebe Roberts, Deep Shah MD Infographic and Cover Art: Lyan Chang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deep Shah MD Reviewers:  Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Michelle McMacken MD, FACP, DipABLM Sponsor: BetterHelp Visit BetterHelp.com/curb today to get 10% off your first month. Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Super foods handout  Full transcript HERE

Master the latest knowledge on the ongoing monkeypox outbreak with Dr. Boghuma Titanji (@Boghuma)! Learn how to recognize monkeypox in the clinic, how to test for monkeypox, how to approach management (including options for antiviral agents), and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak History of monkeypox - past and current outbreaks Transmission of monkeypox Risk factors for monkeypox Clinical presentation of monkeypox Testing for monkeypox Management of monkeypox: supportive care and antivirals Monkeypox in patients with HIV Monkeypox in pregnancy Monkeypox vaccines Outro Credits Producer and Writer: Paul Williams MD, FACP Show Notes: Malini Gandhi  Infographic: Sarah Phoebe Roberts Cover Art: Kate Grant MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Boghuma Titanji MD Sponsor: Green Chef Go to GreenChef.com/curb135 and use code curb135 to get $135 off across five boxes and your first box ships free.  Sponsor: Medmastery Go to medmastery.com/curbsiders to claim your discount. Full Transcript HERE

From Cord Compression to Tumor Lysis Syndrome Do you freak out over oncologic emergencies like cord compression or tumor lysis syndrome? Join Dr. Aditi Singh (University of Pennsylvania, Abramson Cancer Center, @AditiSinghMD) for this comprehensive conversation on six commonly encountered oncologic emergencies we see in the hospital! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Cord Compression SVC Syndrome Malignant Obstruction Tumor Lysis Syndrome Blast Crisis Outro Credits Producer, Writer, Hosts: Meredith Trubitt, MD MPH; Monee Amin, MD Infographic and Cover Art: Caroline Coleman Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Aditi Singh, MD Sponsor: BetterHelp Visit BetterHelp.com/curb today to get 10% off your first month.   Sponsor: Indeed  Visit Indeed.com/internalmedicine to start hiring now.   Sponsor: Hello Fresh   Go to HelloFresh.com/curb65 and use code curb65 for 65% off plus free shipping.    Full Transcript HERE

Find out if ultra-short course (two days) antibiotics work for pneumonia, if acetazolamide improves diuretic efficiency in acute decompensated heart failure, should we prescribe psilocybin (magic mushrooms) to treat alcohol use disorder, and if removal of asymptomatic kidney stones decreases the incidence of future events! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto) catch up on recent practice-changing articles and guidelines!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer Ultra-short Antibiotics for Pneumonia,  Acetazolamide for acute heart failure exacerbations,  Psilocybin for AUD, Asymptomatic Kidney Stone Removal Outro Credits Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatral MD, MPH Technical Production: Pod Paste Full transcript HERE

Brush up on your COPD skills and learn some new tips for diagnosis and management of this common respiratory condition from our expert Dr. Antonio Anzueto (University of Texas San Antonio).  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Epidemiology Diagnosis Workup Characterization of disease Treatment Outro Credits Writer and Producer: Cyrus Askin, MD Show Notes: Deborah Gorth MD, PhD Infographic: Kate Grant MD Cover Art: Kate Grant MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Antonio Anzueto, MD Sponsor: Wild Grain Start your subscription at Wildgrain.com/curb and get $30 off your first box plus free croissants in every box. Sponsor: Grammarly Go to grammarly.com/curb to sign up for a free account and get 20% off when you upgrade to Grammarly Premium. Full Transcript HERE

Upper and Lower GI Bleed Diagnosis and Management Handle the gush of upper and lower GI bleeds with ease thanks to Dr. Tanvi Dhere (@DhereMdEmory)! Learn diagnosis, initial management as well as post-procedure management including when to resume anticoagulation and antithrombotic therapy. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | askcurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Upper GI bleed Labs, Stool Studies Initial Management of GI bleed Endoscopy Post-procedure management Lower GI bleed Colonoscopy Imaging/Interventional Radiology Outro Credits Producers and Writers: Meredith Trubitt MD, MPH; Monee Amin MD Show Notes:  Monee Amin, MD Infographics and Cover Art: Caroline Coleman, MD Hosts: Meredith Trubitt MD, MPH; Monee Amin MD   Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Tanvi Dhere, MD Sponsor: Birch Birch is giving $400 off all mattresses and 2 free eco-resy pillows at BirchLiving.com/curb Sponsor: BetterHelp Visit BetterHelp.com/curb to get 10% off your first month. Sponsor: Medmastery Go to medmastery.com/curbsiders to claim a discount on any of your subscriptions. Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full Transcript HERE

We’re back with another women in medicine episode– this time Shreya and Leah interview their she-ro Dr. Kemi Doll, career coach extraordinaire to women of color in academic medicine. She is breaking down the biggest challenges she’s seen her clients face and how to tackle them!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Dr. Doll’s journey into coaching women of color in academic medicine Top 5 challenges faced by women of color in academic medicine Solutions to the challenges Outro Credits Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD Infographic and Cover Art: Shreya Trivedi, MD Show Notes: Leah Witt, MD Hosts: Leah Witt, MD, Shreya Trivedi, MD and Matthew Watto MD, FACP Associate Editor: Emi Okamoto, MD Showrunners: Leah Witt, MD and Shreya Trivedi, MD Technical Production: PodPaste Guest: Kemi Doll, MD Full transcript HERE

Polyps, polypectomy & surveillance with Dr. Jennifer Maranki Learn how to recommend a good bowel prep, read colonoscopy reports, and review recommended polyp surveillance with Dr. Jennifer Maranki, @jenmarankimd (Penn State Health) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; definitions Polyp definitions and categories  Bowel prep & colonoscopy quality Colorectal polyp surveillance  Potential complications  When to consider polyposis syndromes  Outro Credits Producer & Writer: Elena Gibson MD Show Notes: Elena Gibson MD Infographic & Cover Art: Kate Grant MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Jennifer Maranki MD Sponsor: ExpressVPN Secure your online Activity and  get three months free by visiting ExpressVPN.com/curb Sponsor: Green Chef Go to GreenChef.com/curb135 and use code Curb135 to get $135 off across five boxes and your first box ships free.  Full Transcript HERE

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | ask@gmail.com | Free CME! Show Segments Intro, Getting to know our guest Clinical Case Why can’t patients describe their dizziness? Classifying dizziness The 3 vestibular syndrome buckets defined Episodic vestibular syndrome differential diagnosis Acute vestibular syndrome differential diagnosis Chronic vestibular syndrome differential diagnosis Challenges of medical history taking Approach to the acute vestibular syndrome/HINTS How to evaluate nystagmus How to perform the head impulse test (aka head thrust) How to perform “test of skew” (alternate cover testing) Recap of HINTS exam and discussion of MRI Signs and symptoms of cerebellar stroke Use of Dix-Hallpike for episodic vertigo What happens when you choose the wrong test Continuous versus triggered dizziness, or vertigo Meclizine use in BPPV How to cure horizontal canal BPPV Treatment for vestibular neuritis Treatment for Meniere’s disease Who benefits from vestibular rehab/exercises Dizziness and giddiness Take home points Outro Credits Produced and Written by: Cyrus Askin MD Show Notes: Matthew Watto MD Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP Guest: David Newman-Toker MD, PhD Sponsor: Better Help Visit BetterHelp.com/curb today to get 10% off your first month. Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you. Sponsor: Indeed  Visit Indeed.com/internalmedicine to start hiring now.

Recap and review the top pearls from recent episodes #322 H. Pylori and #324 Obesity Medicine FAQ with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #322 and #324! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio H. pylori Obesity Medicine FAQ Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Full transcript HERE

On this Curbsiders classic, we discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)! This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! Original show notes here. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | ask@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* How to approach antibiotics Choosing antibiotics / Framework Dr. Shah’s favorite antibiotics Pneumonia Diabetic Foot Infections Take-home points Outro Credits Produced and Written by: Nora Taranto MD Infographic, Cover Art, Show Notes: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com Reviewer: Victor Kovac MD Guest: Adi Shah MBBS Sponsor: Grammarly  Go to grammarly.com/CURB to sign up for a free account! And when you’re ready to upgrade to Grammarly Premium, get 20%.

The Thrill of Victory and the Agony of the Feet Don’t fear foot pain!  Learn how to evaluate the painful foot and ankle, what needs imaging, and who needs rehab.  We are joined by Dr. Joan Ritter (Walter Reed National Military Medical Center) for a special live Curbsiders episode!   Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Relevant anatomy Ankle sprains Achilles tendon rupture and tendonitis Plantar fasciitis Posterior tibial tendon dysfunction Midfoot pain Morton’s neuroma Audience questions Outro Credits Writer and Producer: Paul Williams MD, FACP Show Notes and Infographic: Paul WIlliamsMD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Joan Ritter MD Sponsor: Birch Living Birch is giving $400 off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Wildgrain For a limited time, you can get $30 off the first box, plus free croissants in every box, when you go to wildgrain.com/curb to start your subscription.  Sponsor: Ochsner Health Visit ochsner.org/primarycareJobs to find out more about opportunities with with Ochsner Health.  Sponsor: Provider Solutions and Development Visit  info.psdconnect.org/curbsiders to see new job opportunities. Fully Transcript HERE 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. 

Diagnosing & Managing Acute Hypoxemia with Nick Mark MD Quick! Your patient is desaturating! Have no fear, for in this installment of our Rapid Response series we have recruited pulmonologist/intensivist extraordinaire, the great Dr. Nick Mark of ICU One Pager, to share with us all the pitfalls and pearls we need to have under our collective belt when it comes to understanding, managing, and considering the etiologies of acute hypoxemia!  Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; Definitions How does a pulse oximeter work? Clinical approach to hypoxemia The SIX causes of hypoxemia Delivering supplemental oxygen  Credits Written and Produced by: Cyrus Askin MD & Edison Jyang MS4 Infographic and Cover Art: Edison Jyang MS4 Show Notes: Cyrus Askin, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste  Guest: Nick Mark MD Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Offer good for a limited time.    Sponsor: Betterhelp Listeners get 10% off their first monmouth at BetterHelp.com/Curb Sponsor: Ten Thousand Go to tenthousand.cc/curb to get 10% off your purchase. Sponsor: Medmastery Listeners can claim a discount at medmastery.com/curbsiders.. Full Transcript HERE 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 how tirzepatide might revolutionize weight loss, pharmacogenomics might improve antidepressant prescribing, seasonal edema affects Google searches, and whether nirmatrelvir/ritonavir helps standard-risk patients with COVID-19, and patient-centered recommendations for inpatient care from SHM/Choosing Wisely! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, Picks of the Week Case from Kashlak; Definitions Tirzepatide for weight loss Pharmacogenomics for personalized antidepressants Seasonal Edema Nirmatrelvir/ritonavir for standard-risk COVID-19 Hospital Medicine Choosing Wisely recommendations Outro Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatral MD, MPH Technical Production: Pod Paste Sponsor: Medmastery Visit medmastery.com/curbsiders to claim a discount on any subscription.  Sponsor: Green Chef Go to GreenChef.com/curb135 and use curb135 to get $135 off across 5 boxes and your first box shipped free.  Sponsor: South California Permanente Medical Group Visit scpmgphysiciancareers.com or call (866) 449-1684 to apply to join SCPMG as an Outpatient Internal Medicine Physician. Full Transcript HERE 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 to recognize myositis and myopathy (aka the idiopathic inflammatory myopathies), perform the appropriate initial testing, whether or not statins and exercise are safe to continue, and how to partner with our subspecialist colleagues to treat these patients in primary care.  Recorded LIVE at Johns Hopkins, we’re joined by Dr. Lisa Christopher-Stine, @DrLisaCS of @HopkinsMedicine, a rheumatologist and leading expert on myositis and myopathy!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak History and Exam Workup for suspected myositis Cancer screening Safety of statin use and exercise Our role in primary care Audience Questions Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Andréa Perdigão Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Technical Production: Pod Paste Guest: Lisa Christopher-Stine MD, MPH Sponsor: Grammarly Go to grammarly.com/CURB to sign up for a free account and 20% off when you upgrade to Grammarly Premium. Sponsor: Betterhelp Visit BetterHelp.com/Curb to get 10% off your first month. Sponsor: Wildgrain Sign up at Wildgrain.com/CURB or use CURB at the checkout to get $30 off your first box plus free croissants in every box. Full Transcript HERE 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. 

USPSTF Update with Dr. John Wong Review the updated 2022 United States Preventive Task Force (USPSTF) guidelines on aspirin use to prevent cardiovascular disease (CVD) with Dr. John Wong. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer & Writer: Elena Gibson MD Show Notes: Elena Gibson MD  Cover Art & Infographic: Elena Gibson MD  Hosts: Paul Williams MD, FACP; Elena Gibson MD   Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: John Wong, MD  Sponsor: Medmastery Visit medmastery.com/curbsiders to receive a discount.  Full Transcript HERE

There’s nothing that gets a hospitalist more anxious and excited at the same time than a case of suspected meningitis. In this episode, we learn that if the thought crosses our mind, a lumbar puncture is almost certainly indicated. Our guest, Dr. Payal Patel, helps us with the balancing act that is diagnosing and managing meningitis! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; history and physical Initial workup for meningitis Treatment choices and duration Transitions of Care Credits Written and Produced by: Monee Amin MD, Meredith Trubitt MD, MPH Infographic and Cover Art: Caroline Coleman, MD Show Notes: Monee Amin, MD Hosts: Matthew Watto MD, FACP; Monee amin,, MD Reviewer: Rahul Ganatra, MD MPH Executive Producer: Karly Loy Showrunner: Matthew Watto MD, FACP Editor: podpaste Guest: Payal Patel, MD Sponsor: Indeed  Visit Indeed.com/internalmedicine to start hiring now.  Sponsor: Birch  Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Green Chef  Go to greenchef.com/curb135 and use code curb135 to get $135 off across five boxes and your first box shipped for free. Full Transcript HERE 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. 

Can vitamins prevent CVD and cancer? We kind of don’t have the answer! Is vitamin and mineral supplementation safe? Effective? Listen as our esteemed guest Dr. Michael Barry talks to us about the new United States Preventive Services Task Force recommendation regarding the role of vitamin and mineral supplementation in preventing cardiovascular disease and cancer. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers: Paul Williams MD, FACP and Elena Gibson, MD Writer: Paul Williams MD, FACP Show notes: Paul Williams MD, FACP Infographic and Cover Art: Elena Gibson, MD Hosts: Paul Williams MD, FACP and Elena Gibson MD  Production team: Podpaste Guest: Michael Barry MD Full Transcript HERE

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow-up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! Get the original show notes here! Prior lipid episodes:  #37 Lipids, PCSK9, and ezetimibe: Lower is better. #10 Cholesterol, lipids, statins, fish oil. Become a Master Lipidologist. Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro Getting to know Dr. Erin Michos Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel Digging into ASCVD Risk Calculator Who should get 10 year ASCVD Risk assessment and what are the categories? How Dr. Michos discusses healthy lifestyle and “Primordial Prevention” What are “Risk Enhancing Factors”? Who should get biomarker testing vs CAC scoring? How Dr. Michos discusses statin therapy with her patients How to address risks of side effects Primary vs Secondary Prevention “What should my cholesterol be?” How often to follow-up labs? Differences between stain intensity How to manage side effects PCSK9 inhibitor discussion Aspirin, Fibrates and Icosapent Ethyl High Risk vs Stable ASCVD Take home points and the future Outro Credits Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli MD Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA Infographic: Beth “Garbs” Garbitelli MD Cover Art: Kate Grant MBChB DipGUMed Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP    Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Erin Michos MD MHS Sponsor: Better Help Visit BetterHelp.com/curb to 10% off your first month. Sponsor: Green Chef Go to GreenChef.com/curb135 and use code curb135 to get $135 off across five boxes and your first box ships free. Sponsor: Medmastery Listeners of this show can claim a 15% lifetime discount on any of their subscriptions. Just go to www.medmastery.com/curbsiders claim your discount and use the code curbsiders15.

Recognize multiple sclerosis in the clinic, learn how to diagnose it, and partner with your neurology colleagues to help care for these patients. Dr. Annette Okai expertly walks us through multiple sclerosis (North Texas Institute of Neurology & Headache).  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Patient presentation Physical exam Labs and imaging Pathophysiology Treatment Recognizing and treating relapses Outro Credits Written and Produced by: Deborah Gorth MD, PhD Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Annette Okai MD Sponsor: Panacea Financial Visit panaceafinancial.com to learn how a bank for doctors, by doctors can help you.  Sponsor: Ten Thousand  Go to tenthousand.cc/curb to get 15% off Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Business only pay for quality applications matching the sponsored job description.  Sponsor: Medmastery Go to medmastery.com/curbsiders and use curbsiders15 to claim a 15% lifetime discount on any subscription.  Full Transcript HERE 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. 

Supercharge your knowledge on using methadone for the treatment of opioid use disorder! We discuss treatment goals, and how to start or continue methadone in the hospital.  We’re joined by guest Dr Ruth Potee, addiction medicine physician, full-scope family medicine doc, feminist, and expert composter.  She inspires us to be strong advocates for our patients.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | CurbsidersAddictionMed@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio 0:46 Guest one-liner 3:23 Case from Kashlak 5:00 Methadone for OUD 5:47 Methadone Dosing 16:35 72 hour Rule 25:35 What is a methadone clinic  31:00 Methadone Checklist 35:44 QTc Prolongation and Methadone 39:15 Confirming Methadone Dose 43:17 Managing Missed Methadone doses: 45:20 Outro 50:40 Credits Producer, Writer: Kenneth Morford, MD Show Notes, Infographic, Cover Art: Zina Huxley-Reicher, MD Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD; Kenneth Morford, MD  Reviewer: Shawn Cohen MD Showrunner: Carolyn Chan, MD Technical Production: Castos Guest: Dr. Ruth Potee The Curbsiders Addiction Medicine are proud to partner with  The American College of Addiction Medicine (ACAAM) to bring you this mini-series.  ACAAM is the proud home for academic addiction medicine faculty and trainees and is dedicated to training and supporting the next generation of academic addiction medicine leaders. Visit their website at acaam.org to learn more about their organization. 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. 

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn. Get the original show notes here! Prior diabetes episodes:  #330 & #331 Inpatient Diabetes with Dr. Dave Lieb #309 USPSTF Quick Update: Prediabetes & Type 2 Diabetes Screening #296 Diabetes FAQ with Dr. Jeff Colburn #243 Diabetes Triple Distilled #168 Diabetes Update with Jeff Colburn MD #96: Diabetes: A1C targets & ACP guidelines controversy #51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro Rapid fire questions Definitions and classification of diabetes DKA in type 2 diabetes? Pathophysiology of DKA Severe hyperglycemia mislabeled as DKA Which type 2 diabetics get DKA? The cardinal issue is dehydration Starvation ketosis vs DKA vs other How to handle severe hyperglycemia in outpatients Sick day management in type 1 diabetes Initial testing for diagnosis of DKA Subcutaneous or IV insulin for DKA Initial evaluation and management in ER Fluids and electrolyte management SGLT2 inhibitors and euglycemic DKA Credits Writer, Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Stuart Brigham MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Jeffrey Colburn MD, FACP, FACE Sponsor: Better Help Visit BetterHelp.com/curb to get 10% off your first month.  Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you. 

Recap and review the top pearls from recent episodes #321 Hypertension FAQ and #326 Cardiorenal Syndrome (NephMadness 2022) with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #321, and #326! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Hypertension FAQ Cardiorenal syndrome Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Sponsor: Grammarly Go to grammarly.com/CURB to sign up for a free account! And when you’re ready to upgrade to Grammarly Premium, get 20% off for being my listener. Sponsor: Pattern Request your disability insurance quotes with Pattern at patternlife.com/curbsiders. Full Transcript HERE 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.

With great power comes great immunogenicity.  Learn about the ins and outs of immunotherapy–its indications, its power, and its adverse effects–in this episode with Dr. Christian Cable, hematologist/oncologist and medical educator extraordinaire.  We learn a riveting history of immunotherapy and about how checkpoint inhibitors work, as well as the best practices for identifying downstream effects of checkpoint inhibitors and their immune system activation (it’s all about the -Itis!). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro What is Immunotherapy? A History Lesson Immune Checkpoint Inhibitors (ICIs)  Immune Related Adverse Events (irAEs)  Endocrine complications of checkpoint inhibitors Rheumatologic complications of checkpoint inhibitors  Considerations before starting checkpoint inhibitors (and what labs to check)  Diagnosing and Managing irAEs  Common post-irAE questions  New Kids on the Block: CAR-T  Take Home Points  Credits Written and Produced by: Nora Taranto MD Hosted by: Molly Heublein MD; Nora Taranto MD; Paul Williams MD, FACP   Guests: Christian Cable MD  Show Notes: Nora Taranto MD  Cover Art: Andrea Perdigão Infographics: Andrea Perdigão Reviewer: Emi Okamoto MD, FACP  Production team: Pod Paste Sponsor: Southern California Permanente Medical Group Learn more or apply at scpmgphysiciancareers.com Sponsor: Locumstory Visit locumstory.com to learn more about locums. Full transcript HERE 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

Dr. Kevin Weber @KwebMD (Ohio State University Wexner Medical School) takes the pain out of headache management!  Have the confidence to prescribe new CGRP-antagonists and ditans for migraine prevention and acute relief.  We also dive deep into when to order imaging and alternatives like infusions and devices.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak Definitions Imaging for headaches Labs Headache types Acute Migraine Treatment Ditans Anti-cgrp medications Prophylactic Migraine Treatment CGRP antagonists Devices Take home points Outro Credits Producer, writer, and show notes: Isabel Valdez PA-C Infographic: Edison Jyang Cover Art: Chris Chiu MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Chris Chiu MD    Reviewer: Molly Heublein MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Dr. Kevin Weber Sponsor: Better Help Go to betterhelp.com/curb to get 10% off your first month.  Sponsor: Birch Living Birch is giving $200 off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Indeed Sign up at indeed.com/internalmedicine now and get $75 credit toward your first sponsored job. Sponsor: Locumstory Visit locumstory.com to learn more about locums.  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. 

Help your patients navigate gallbladder disease, including asymptomatic stones, incidental polyps, and uncomplicated cholecystitis. Dr. Rahul Pannala (@RahulPannala) talks us through how to diagnose biliary colic, what imaging to order, and what to anticipate for potential post-cholecystectomy complications (eg persistent pain or diarrhea). Feel confident in sending the right patients for cholecystectomy!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Typical biliary pain Imaging for cholelithiasis Treatment for symptomatic gallstones Post-cholecystectomy diarrhea and pain Inpatient management of cholecystitis Advanced imaging- HIDA scans and MRCP Incidental gallbladder findings Outro Credits Producer, Writer, Show Notes: Molly Heublein, MD Infographic/Cover Art: Lyan Chang Hosts: Molly Heublein, MD, Nora Taranto, MD; Paul Williams MD, FACP    Associate Editor: Leah Witt, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Audio Engineer for this live episode: Chris Chiu, MD Guest: Rahul Pannala, MD Sponsor: Ten Thousand Go to tenthousand.cc/CURB to get 15% off. Sponsor: Blueland You can get 20% off your first order when you go to Blueland.com/CURB Sponsor: Locumstory Visit Locumstory.com to find out more about locum tenens. 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 Curbsiders favorite Dr. Ted Parks gives us a hand with the diagnosis and management of common causes of hand and wrist pain. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments  Intro, disclaimer, guest bio Guest one-liner Anatomy review: the thumb is the short one Pathophysiology of De Quervain’s tenosynovitis Physical examination for thumb pain Management of DeQuervain’s and CMC arthritis Pathophysiology of trigger finger Management of trigger finger Pathophysiology of carpal tunnel syndrome Physical examination for carpal tunnel syndrome Carpal tunnel syndrome management Outro Credits Writer and Producer: Paul Williams, MD Infographic and Cover Art: Paul Williams, MD Hosts: Paul Williams MD and Molly Heublein, MD Editor: Emi Okamoto, MD (written materials) Guest: Ted Parks, MD Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you. Sponsor: Better Help Visit betterhelp.com/curb to get 10% off your first month. Sponsor:  Provider Solutions & Development  Visit info.psdconnect.org/curbsiders to start a conversation with and with an expert recruitment advisor. Sponsor: Indeed Sign up at indeed.com/internalmedicine now and get a $75 credit toward your first sponsored job.  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. 

It’s high time we revisit the benefits and harms Master the ins-and-outs of medical cannabis! Dr. Julia Arnsten (@DrArnsten) will lead us through the initial evaluation of a patient interested in medical cannabis, summarize the state of evidence for the benefits and harms, lay out a schema for dosing and formulations, provide pearls on how to counsel patients, and more! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Definitions and terminology A brief history of medical cannabis Case from Kashlak History to obtain for a patient interested in medical cannabis Medical cannabis dosing and formulations Conditions for which the evidence supports considering medical cannabis Risks of medical cannabis Disparities in access to medical cannabis Does medical cannabis reduce opioid use? Outro Credits Producer and Writer: Matthew Watto MD, FACP Show Notes, Infographic, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt MD Showrunner: Matthew Watto MD, FACP Production Team: PodPaste Guest: Julia Arnsten MD, MPH Sponsor: Grammarly Visit grammarly.com/CURB and get 20% off when you upgrade to Grammarly Premium.  Sponsor: Medmastery Visit medmastery.com/curbsiders to claim a 15% lifetime discount on and of their subscriptions. Sponsor: Locumstory Visit Locumstory.com to learn more about locums Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping 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. 

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

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

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

Learn diagnostic and therapeutic management strategies for IBS, functional dyspepsia, and cyclic vomiting (aka disorders of gut brain interaction (DGBI))! It's like three episodes in one as we run through how to individualize evaluation and management for patients with functional dyspepsia, IBS, and cyclic vomiting. Topics: scripts for counseling patients, the pathophysiology of DGBI, which diagnostic tests are necessary, pharmacologic and nonpharmacologic options, and even hypnotherapy?! We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions (6:20)  Definition of Disorders of the Gut-Brain Interaction (7:30-11:00) Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments  (24:30-36:00) Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00) Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11) Take home points Outro Credits Producer: Elena Gibson MD Writer:Andréa Perdigão, Elena Gibson Show Notes and Infographics: Andréa Perdigão Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Xiao Jing (Iris) Wang MD Sponsor: Ten Thousand Go to tenthousand.cc/curb to receive 10% off. Sponsor: Pattern Visit patternlife.com/curbsiders to request a disability insurance quote. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | Free CME! Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Reviewer: 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 thecurbsidersteach@gmail.com    

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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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 | thecurbsiders@gmail.com | 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

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!       Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Elena Gibson MD  Cover Art and Infographic: Kate Grant MD; Elena Gibson MD  Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD  (written materials); Clair Morgan of nodderly.com Guest: Elliot Tapper MD  Sponsor: BetterHelp betterhelp.com/curb Sponsor: Panacea Financial panaceafinancial.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, disclaimer, guest bio Guest one-liner Definitions of liver enzymes, liver function tests   Patterns of acute liver injury Drug-induced liver injury     Isolated alkaline phosphatase elevation  Isolated total bilirubin elevation  Livery Injury During Pregnancy  Acute liver failure Outro

Enjoy this rapid clinical overview of heart failure based on Episode #230 Kittleson Rules Acute Heart Failure Featuring Dr. Michelle Kittleson @MKittlesonMD (Cedars Sinai)!  This triple distilled episode is not available for CME, but claim CME for #230 Kittleson Rules Acute Heart Failure at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Locumstory locumstory.com Visit Locumstory.com to see if a locum tenens assignment is right for you. Show Segments Intro, disclaimer, guest bio The History, Failure mnemonic CHF exam CHF Labs, Swan (RHC) Management of ADHF Outro

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea?  Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement. Enjoy this Curbsiders classic and stay tuned this Wednesday, September 1, 2021 for a brand new CHF Triple Distilled episode. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Deborah Gorth ScM Cover Art and Infographic by: Edison Jyang Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP    Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Michelle Kittleson MD, PhD Sponsor: Ten Thousand tenthousand.cc Head to tenthousand.cc and enter our code CURB at checkout to save 15%.  Sponsor: BetterHelp betterhelp.com/curb ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb     Time Stamps* Time Stamps refer to ad-free version 00:00 Intro, disclaimer, guest bio 02:40 Guest one-liner; Picks of the Week 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic) 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction? 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?! 28:36 Labs to trend during an ADHF admission 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2? 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB) 56:05 Who needs a right heart cath? 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care 64:04 SGLT2i in heart failure
 68:15 Take home points and outro


Enjoy this rapid clinical overview of CBC abnormalities based on Episode #167 LIVE! Common CBC Abnormalities Featuring Dr. Mary Kwok! Production & graphics by our very own and very talented Dr. Matt Watto! Unfortunately, this episode is not available for CME : ( Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Show Segments Intro, disclaimer, guest bio Approaching a mildly abnormal CBC, red flags Build the diff, Fy(a-b-) phenotype Physical exam and advanced testing Polycythemia vera Thrombocytopenia Outro

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 25, 2021 for a brand new CBC Abnormalities Triple Distilled episode. Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written, Produced and Edited by: Matthew Watto MD, FACP Cover Art and Infographic by: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Guest: Mary Kwok MD Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024! Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb   Time Stamps* Time Stamps refer to ad-free version 00:00 Intro; Paul shame’s the audience; Guest bio 03:17 Guest one-liner, book recommendation* –Emperor of All Maladies (book) by Siddhartha Mukherjee, When Breath Becomes Air (book) by Paul Kalanithi; Career advice -set goals for whatever you’re learning. 08:43 Picks of the week: John Wick 3 (film); The Movies That Made Me (podcast) by Joe Dante; The Tim Ferriss Podcast with Julie Rice of Soul Cycle; Infinity Chamber (film) by Travis Milloy 11:50 A case of asymptomatic leukocytosis; Red flags; Repeat the CBC until it’s normal 17:30 The peripheral smear; Leukemoid reaction 20:00 The physical exam; When to send flow cytometry? 22:18 A case of lymphopenia; benign ethnic neutropenia; What to look for in the history 27:10 A case of erythrocytosis; Checking EPO levels; JAK2 mutation; Differential Diagnosis; Therapeutic Phlebotomy; Physical findings of Polycythemia Vera 36:53 A case of thrombocytopenia; Lab workup; Differential diagnosis; Pathophysiology; Culprit meds 45:35 Advice for internists 46:36 Take Home Points 47:46 Dr. Kwok’s disclaimer 48:10 Outro and post credit scene

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #164 with Neurologist Dr. Chris Favilla!  This mini episode is not available for CME, but episode #164 on Stroke and TIA is available for CME credit through the ACP! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Ten Thousand tenthousand.cc Head to tenthousand.cc and enter our code CURB at checkout to save 15%.  Show Segments Intro, disclaimer, guest bio Afib prevention Workup for afib Treatment of afib Updates on ablation, Left atrial appendage occlusion Outro

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 18, 2021 for a brand new Stroke and TIA Triple Distilled episode. Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences.  Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders  Credits Producers: Molly Heublein MD; Matthew Watto MD, FACP Writer (including CME questions): Molly Heublein MD Cover Art: Bryan Brown MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto, MD; Matthew Watto MD, FACP Guest: Chris Favilla, MD Sponsor: Indeed indeed.com/internalmedicine Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Sponsor: Qalo qalo.com/curb Head to qalo.com/curb to get 20% off your purchase today. Time Stamps* Time Stamps refer to ad-free version 00:00 Intro, disclaimer, guest bio, and a bad pun 04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch,  07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter 08:40 A case of TIA; definition of TIA 12:14 Stroke territories 14:24 New definition of TIA 16:00 Differentiation from complex migraine 19:17 Risk stratifying TIA and ABCD2 score 22:00 A bit on tPA 24:01 Workup for TIA; workup for amaurosis fugax 25:36 CNS imaging studies after stroke or TIA; Choice of imaging study 33:15 HINTS exam for posterior circulation stroke 34:48 Is an echo necessary? Bubble study for PFO? 38:32 Duration of afib monitoring 40:24 Echo reports: what to look for in patient with stroke or TIA; “soft markers” 41:55 Blood testing after Stroke and TIA (lipid panel, HbA1C; +/- RPR, coags, CBC) 43:50 Folic acid; Sparkle trial: high dose atorvastatin versus placebo for secondary prevention 47:00 Incidental finding: multiple patchy infiltrates in a patient without stroke or TIA; Is it significant? 48:50 Aspirin therapy after TIA; Dosage adjustment based on weight? 51:10 A case of stroke; TOAST trial and classification of acute stroke; ESUS; aortic arch atheromas 55:58 Large artery strokes (hypoperfusion, acute thrombosis, artery to artery embolization) 57:15 Antiplatelets after stroke and TIA; DAPT and duration of therapy 62:57 Antidiabetic drugs and stroke 63:40 Lightning round: CHA2DS2VASc score and women; how much afib is significant?; 66:32 Are all DOACs created equal?; 68:20 Regaining function after a stroke; 69:47 Silent infarcts on imaging 71:54 Resources for stroke: Decision making in neurology textbook 73:28 Outro

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #159 with Cardiologist Dr. James Furgerson; Plus, updates on ablation and left atrial appendage occlusion!  This episode is not available for CME, but episode #159 on Atrial Fibrillation is available for CME credit through the ACP! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: FIGS wearfigs.com Head to wearfigs.com and enter our code CURB at checkout to save 15%.  ASN Loan Mitigation Pilot Program: asn-online.org/lmpp The American Society of Nephrology’s Loan Mitigation Pilot Program (LMPP) aims to decrease the loan burden of those entering the field of nephrology, while also increasing interest in the specialty. Year 1 of the program will center on individuals historically underrepresented in medicine. Visit ASN-online.org/lmpp or email grants@asn-online.org  Show Segments Intro, disclaimer, guest bio Afib prevention Workup for afib Treatment of afib Updates on ablation, Left atrial appendage occlusion Outro

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 11, 2021 for a brand new Afib Triple Distilled version. Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD  is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up – This episode is going to send your heart racing! You might even skip a beat!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com  Credits Writer and Producer: Cyrus Askin MD Infographic: Cyrus Askin MD Cover Art: Cyrus Askin MD Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD Editors: Matthew Watto MD Guest: James Furgerson MD Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 100 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024! Sponsor: Panacea Financial panaceafinancial.com Visit panaceafinancial.com today to open your account and join a bank built with you in mind.  Time Stamps* *Note: Time stamps refer to ad-free version  00:00 Intro, disclaimer and guest bio 03:45 Guest one liner, a bit on physician well-being and some other randomness 08:15 A case of palpitations; risk factors for atrial fibrillation 12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters?  15:08 Case summary and next steps in initial work up 18:48 Counseling patient about atrial fibrillation and its consequences 21:40 Ischemic heart disease and atrial fibrillation 24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation 25:25 Rate versus rhythm control; AFFIRM trial 30:50 Strict versus lenient rate control;  RACE trial 33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy 36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials 40:40 When to refer to cardiology and electrophysiology 42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation 45:22 DOACs in CKD and some other nuances in choice of agent 52:27 Bleeding and anticoagulation 58:38 Cardioversion for atrial fibrillation (initial versus delayed) 63:32 Anticoagulation before and after cardioversion 67:48 Lifestyles measures for atrial fibrillation 70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism 74:12 Aspirin monotherapy is not appropriate for atrial fibrillation 76:42 Take home points 78:50 Outro

We’ve got a neutropenic fever and the only cure is...more cowbell? LIVE! It’s neutropenic fever (aka febrile neutropenia) deconstructed with infectious diseases expert, Dr. Susan Seo (Memorial Sloan Kettering Cancer Center). Topics: identifying low vs high risk patients, initial labs & imaging, empiric antibiotic therapy, when to add antifungals, de-escalation, and the G-CSF controversy.  Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Writer and Producer: Matthew Watto MD, FACP Infographic: Edison Jyang Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Matthew Watto MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Susan Seo MD Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024! Sponsor: BetterHelp betterhelp.com/curb ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders 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, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Initial workup for neutropenic fever  Low risk neutropenic fever High risk neutropenic fever When to add antifungal coverage, G-CSF Audience questions Outro

We recap the top pearls on angina, Stable CAD, Heavy Menstrual Bleeding, and Hypercalcemia. 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 #279, #280, and #281.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli, Avital O’Glasser, and Nora Taranto Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Amercian College of Physicians acponline.org/100curb ACP’s all-new CME 100 video package is now available at acponline.org/100CURB Use code 100CURB. Sponsor: The Jordan Harbinger Show jordanharbinger.com/subscribe 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 Angina and Stable CAD Heavy Menstrual Bleeding and Anticoagulation in Menstruating patients Hypercalcemia and primary hyperparathyroidism Outro

Shaken by a shortage of shingles savvy? Vexed by varicella-zoster imposters? Perplexed by post-herpetic neuralgia? Get ready to sharpen your expertise in varicella vaccines, learn how to tell a zoster from a zebra, and administer infection interventions with an eye towards prevention. We are joined today by special guest and returning Curbsiders expert, Dr. Boghuma Kabisen Titanji MD, M.Sc., DTM&H, PhD. (@Boghuma on Twitter!). Unfortunately, CE credit is NOT YET available for this episode : ( Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Sarah Phoebe Roberts, MPH Show Notes by: Sarah Phoebe Roberts MPH, Kate GrantMBChB MRCGP DipGUMed Cover Art: Kate Grant MBChB MRCGP DipGUMed  Infographic: Sarah Phoebe Roberts  Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH   Reviewer: Paul Williams MD, FACP   Editor: Kate Grant MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Boghuma Titanji, MD, M.Sc., DTM&H, PhD Sponsor: BetterHelp betterhelp.com/curb Special offer for listeners: get 10% off your first month at betterhelp.com/curb Sponsor: Grammarly grammarly.com/curb 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 . Show Segments Intro, disclaimer Guest bio and one-liner First Kashlak case: Diagnosis of varicella-zoster virus (VZV, aka shingles)  Mimics and atypical presentations Treatment for uncomplicated shingles cases  Second Kashlak case: Post-herpetic neuralgia (PHN) PHN treatment options  Management of complicated shingles cases  VZV prophylaxis and infection control Third Kashlak case: Immunization guidelines for older adults VZV vaccine efficacy, live attenuated vs. recombinant vaccine Varicella (chickenpox) vaccine guidelines Final pearls and Outro 

Walk with us through common skin complaints in primary care, focusing on the trunk and extremities. Our favorite skinternist, Dr. Helena Pasieka (Chief of Dermatology at Kashlak) schools us on tinea versicolor, the fluff test, treatment of skin tags, how to work up and manage generalized pruritus, venous insufficiency, and how to get ready for sandal season in the face of onychomycosis. #dermismedicine! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers: Maddie “Mad Dog” Morgan, Edison Jyang  Infographic and Cover Art: Edison Jyang  Writer: Beth Garbs Garbitelli  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP  Reviewer: Emi Okamoto MD, FACP  Editor: Emi Okamoto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Dr. Helena Pasieka  Sponsor: Qalo qalo.com/curb Listeners get 20% off at qalo.com/curb (Promo code: CURB20) Sponsor: Green Chef GreenChef.com/curb100 Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!  Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders  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 to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* Tinea (pityriasis) versicolor and the fluff test, bumps, and lesions  Generalized Pruritus: clinical features, work-up and supportive care   Lower Extremity Venous Insufficiency and Lipodermatosclerosis Onychomycosis Take-Home Points  Outro

This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! We discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and so much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer, Script and Show Notes: Nora Taranto MD Infographic, Cover Art, Show Notes: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com Reviewer: Victor Kovac MD Guest: Adi Shah MBBS Sponsor: Panacea Financial panaceafinancial.com Panacea Financial is a division of Primis, member FDIC Sponsor: Provider Solutions and Development 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 to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* How to approach antibiotics Choosing antibiotics / Framework Dr. Shah’s favorite antibiotics Pneumonia Diabetic Foot Infections Take-home points Outro

Review the 2021 USPSTF Guidelines on Colorectal Cancer (CRC) screening with our guest, Dr. Michael Barry (vice-chair of the U.S. Preventive Services Task Force). Topics include a breakdown of testing modalities (stool tests versus direct visualization), screening ages, what to do for patients older than 75, and more!         Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Elena Gibson MD  Cover Art and Infographic: Elena Gibson MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Reviewer: Matthew Watto MD  Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Michael Barry MD  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 and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner Benefits of CRC screening How to choose a testing modality Testing in adults over 75 years old Health disparities in CRC screening Outro

We recap the top pearls from our SGIM & ACP 2021 highlight shows (including gabapentin for pain, LGBTQ  and Women’s health pearls, CCBs and edema, MRSA swabs, IPMNs, DILI, and more!) plus recent interviews on bariatric surgery and osteoporosis. It’s Tales from the Curbside! (TFTC #6), 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 #275 Bariatric Surgery and #277 Bone Up on Osteoporosis.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Sarah Roberts, Edison Jyang, and Isabel Valdez Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Qalo qalo.com/curb Head to qalo.com/curb to get 20% off. 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 LGBTQ health, Gabapentin, Care of the Muslim Patient, MRSA swabs IPMNs, DILI, CCB and Prescribing Cascades Bariatric Surgery  Osteoporosis Outro

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium, and what to do when that regulation goes awry.  Not to mention that, at the end of the day, PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending). Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer, Writer, Infographic, Cover Art: Nora Taranto MD  Hosts: Matthew Watto MD, FACP; Nora Taranto MD   Reviewer: Yan Emily Yuan MD, MSc Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Carl Pallais MD, MPH  Sponsor: Grammarly Grammarly.com/CURB Sponsor: Native NativeDeo.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 . Show Segments Intro, disclaimer, guest bio Dr. Pallais One-Liner Case from Kashlak Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin Causes of hypercalcemia How Lithium works!  Testing for Hypercalcemia: Get that PTH, and that phos  Symptoms of Hypercalcemia, and Questions on History  Indications for Surgery for Parathyroidectomy  Management of Hypercalcemia and Hypercalcemic Emergency  Outro

Explore the intersection of hematology and women’s health as we discuss heavy menstrual bleeding (HMB), gynecologic risks of therapeutic anticoagulation, and prescribing contraception in the setting of venous thromboembolic disease.  Wondering how to expand your women’s health knowledge as an internist? Listen as our insightful guest Dr. Bethany Samuelson Bannow @bsamuelson_md (Oregon Health & Science University) helps us navigate the intersections between non-malignant hematology and menstrual health. This episode will empower you to tackle the stigma and overcome knowledge gaps with regard to abnormal menstrual bleeding, as well as learn treatment, and management pearls.  We also explore the intersection between therapeutic anticoagulation, heavy menstrual bleeding, and thromboembolic disease of different contraceptive options.  Finally, we face the themes of overcoming sexism, and even misogyny, in women’s health head-on throughout this episode. After all, half the population has a uterus. Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/ Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Avital O’Glasser MD, FACP, FHM Infographic: Avital O’Glasser MD, FACP, FHM Cover Art : Kate Grant MBChB MRCGP DipGUMed Show Notes: Kate Grant MBChB MRCGP DipGUMed, Maddie Morgan, and Avital O’Glasser MD, FACP, FHM Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM Reviewer: Carolyn Chan, MD Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Bethany Samuelson Bannow, MD Sponsor: Birch by Helix birchliving.com/curb Sponsor: Green Chef GreenChef.com/curb100 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 Definitions related to menstrual health Quantifying/defining heavy menstrual bleeding Overcoming stigma of asking about menstrual history/health Clinical evaluation/management of the patient with heavy menstrual bleeding Case 2 from Kashlak Risk of heavy menstrual bleeding (HMB) in the setting of therapeutic anticoagulation Hormonal and nonhormonal therapy options for HMB while anticoagulated Contraception options for someone who develops VTE Case 3 from Kashlak Counseling about VTE risk of different contraception options Take Home Points; Outro; Bonus clip

Learn how to dominate stable angina. Coronary artery disease with stable angina is a different beast than acute coronary syndrome.  We deconstruct it’s pathophysiology, diagnosis, and management with Drs. Dan Ambinder and Rick Ferraro. Topics: When to order coronary CT vs Stress testing; An approach to non-obstructive coronary disease; What treatments are life prolonging; Medical therapy vs Stenting; An approach to antianginal therapy; and how to partner with each patient. Listen as we dive deep into the recent literature and recommendations to dominate stable angina. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Molly Heublein, MD Writer: Molly Heublein, MD, Michael Sternberg MD Show Notes: Molly Heublein, MD, Beth Garbitelli Infographic, Cover Art: Beth Garbitelli Hosts: Molly Heublein, MD; Paul Williams MD, FACP    Editor: (written materials); Cyrus Askin MD, Clair Morgan of nodderly.com Guest: Daniel Ambinder, MD; Rick Ferraro, MD Sponsor: Panacea Financial panaceafinancial.com Panacea Financial a nationwide digital bank built for doctors by doctors. Panacea offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com. Panacea Financial is a division of Primis, member FDIC Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders. Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for 30 days. Visit Audible.com/curb or text curb to 500-500. 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 of stable angina, unstable angina INOCA Assessing risk Treatment - life prolonging vs symptom relief Diagnosis- stress testing vs anatomical studies Angioplasty/stenting- ISCHEMIA trial Take home points Outro

Delve into the neuro Ddx with expert diagnosticians the @CPSolvers, Drs. Reza Manesh (@DrRxEdu) and Rabih Geha (@rabihmgeha). Play along as they solve a neurology mystery case, and give us a tour of the neuraxis.  No CME for this episode, but claim it for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Matthew Watto MD, FACP Writer (case): Daniel Minter MD (@dminter89) Show Notes: Matthew Watto, MD, FACP Cover Art: Sawyer Watto Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Reza Manesh MD and Rabih Geha MD Sponsor: Panacea Financial panaceafinancial.com Sponsor: Provider Solutions and Development 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 Weakness and Falls Localization on the neuraxis NM junction Lung Mass Cognitive Autopsy Outro

Bone up on osteoporosis in primary care! Don’t let osteoporosis sneak up on your patients with a vertebral fracture or a hip fracture! Make no bones about your osteoporosis knowledge, from knowing when to screen your patients to selecting a treatment that matches your patient’s lifestyle. Join us as we discuss these topics and more with osteoporosis expert and internal medicine physician, Dr. Carolyn Crandall (UCLA). Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Isabel Valdez, PA-C Show Notes: Isabel Valdez, PA-C Infographic: Isabel Valdez, PA-C Cover Art: Kate Grant MD Hosts: Isabel Valdez, PA-C; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto MD FACP and Leah Witt, MD  (written materials); Clair Morgan of nodderly.com Guest: Carolyn Crandall MD Sponsor: Indeed indeed.com/internalmedicine Get started RIGHT NOW with a FREE $75 SPONSORED JOB CREDIT to upgrade your job post at indeed.com/internalmedicine. Offer valid through JUNE 30TH. Terms and conditions apply. Sponsor: Native NativeDeo.com/curb Stay fresh, stay clean with Native by going to NativeDeo.com/curb, or use promo code curb at checkout, and 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week First Case from Kashlak Definitions of Osteoporosis and Low Bone Density (formerly Osteopenia) Patient Counseling on Treatment Side Effects Frequency of Testing Dental Clearance  CKD and Osteoporosis Treatment  Prevention Vitamin D and Calcium Take-home Points and Outro

Recap the top pearls from recent shows on Chronic Diarrhea, Dementia, OHS, and MSK (Shoulder, Hip, and Knee).. 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 #267 Chronic Diarrhea, #268 Dementia, and #269 OHS, and  #274 MSK Triple Distilled. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Elena Gibson, Emi Okamoto, Cyrus Askin, and Matt Watto Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Grammarly Grammarly.com/CURB Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500. 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 Chronic Diarrhea,  Dementia,  OHS, MSK: Shoulder, Hip, Knee Outro

What if we told you there was a powerful tool that could help promote significant weight loss, correct uncontrolled diabetes, improve quality of life, and even improve patient mortality?  What if we told you it was offered less than 1% of the time to patients who qualify for it?  Listen as our esteemed guest Dr. Vivan Sanchez (Boston University) talks us through the patient selection, preoperative workup, and postoperative considerations for bariatric surgery, and how it might benefit your patients. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Paul Williams MD, FACP Infographic: Edison Jyang Cover Art: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Molly Heublein, MD; Clair Morgan of nodderly.com Guest: Vivian Sanchez, MD Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 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 Intro, disclaimer, guest bio Guest one-liner Picks of the Week Case from Kashlak Criteria for bariatric surgery Benefits of bariatric surgery Presurgical workup Postoperative management Complications Outro

Dominate MSK complaints in primary care! A packed recap from our past musculoskeletal episodes, triple distilled to what you need to know.  Learn some buckets to consider when addressing knee pain, just how simple hip complaints are, when to urgently refer shoulder problems, and easy exam maneuvers to differentiate elbow pain.  Use our simple framework to help with the top diagnoses walking into your primary care clinic.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Molly Heublein, MD Show Notes by: Molly Heublein, MD Cover Art and Infographics: Matthew Watto Hosts: Stuart Brigham MD; Molly Heublein, MD Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD, FACP; Clair Morgan of nodderly.com (audio) Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at 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 Case from Kashlak- general orthopedic complaints Yellow flags Case from Kashlak Knee 4 buckets of knee pain Ligamentous injury Meniscus Patellofemoral Knee exam Knee Imaging Osteoarthritis treatment Case from Kashlak: hip Three steps to hip diagnosis Case from Kashlak: Shoulder Case from kashlak: elbow Take-home points

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: primary care management of anxiety and depression, insomnia, medical marijuana, venous thromboembolism, COVID-19 and coagulopathy, syncope, diverticulitis, aspirin, and delirium! Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Paul Williams MD, FACP; Chris Chiu MD FACP; Sarah Roberts MPH, Beth “Garbs” Garbitelli Show Notes by: Beth Garbitelli Cover Art: Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial panaceafinancial.com Panacea Financial offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com today to open your account and join a bank built with you in mind. Panacea Financial is a division of Primis, member FDIC Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  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 Top Pearls on: Primary care management of anxiety and depression Insomnia Medical Marijuana Venous Thromboembolism COVID-19 and Coagulopathy Syncope Diverticulitis Aspirin Delirium

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: Heart Failure, Hypertension, IV vs PO antibiotics, Hepatology, Kiwifruit for constipation, Perioperative Sleep Apnea, Thyroid, Bariatric Surgery, Neurology, Super Gonorrhea, and more! Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Deborah Gorth; Paul Williams MD, FACP; Matthew Watto MD FACP; Avital O’Glasser MD, FACP; Molly Heublein MD Show Notes by: Matthew Watto MD Cover Art: Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial panaceafinancial.com Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  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 Heart Failure Oral vs IV antibiotics for osteomyelitis, bacteremia, and endocarditis Inpatient Blood Pressure Management Perioperative sleep apnea Thyroid pearls (pregnancy and weekly dosing) Bariatric Surgery pearls GI disorders (Cdiff, constipation, diverticulitis) Super Gonorrhea; Sunscreen! Outro

Recap our top pearls from recent shows on peripheral arterial disease (PAD), Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea. 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 #260 PAD, #263 Iron CKD, and #266 Acute Diarrhea. CME is not available for #261-262 Abdominal Pain Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli and Edison Jyang Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.com/Curb.   Sponsor: Indeed Indeed.com/INTERNALMEDICINE Get a $75 credit at Indeed.com/INTERNALMEDICINE. Offer valid through JUNE 30TH. Terms and conditions apply. 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 Peripheral Arterial Disease (Dx and Management) Abdominal Pain and the Abdominal Exam Iron deficiency and Anemia in CKD Acute Diarrhea Outro

It’s SGIM 2021, #SGIM21! LGBTQ health, updates in primary care for patients of all ages, caring for the Muslim patient, periop pearls, MRSA in your nose, and more! It’s the most wonderful time of the year for internists: SGIM and ACP, all in one month!  We’re here to help you make the most out of these action-packed virtual events, starting with our SGIM 2021 conference highlights. We hope you enjoy this grab-bag of clinical pearls, from LGBTQ healthcare to periop medicine to primary care, reproductive health, and beyond. Stay tuned for our upcoming ACP IMM2021 recaps for even more knowledge food! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced, and Hosted by: Sarah Phoebe Roberts MPH; Becca Raymond-Kolker, Paul Williams MD, FACP; Chris Chiu MD, FACP, FAAP; Matthew Watto MD FACP  Show Notes by: Sarah Phoebe Roberts MPH Cover Art and Infographic: Sarah Phoebe Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process. Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500. 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 Top Pearls on: LGBTQ health Gynecological health  Reproductive medicine  Primary Care  Hospital Medicine  Perioperative Medicine  Caring for the Muslim patient  Young adult medicine pearls (including COVID19; and Down Syndrome) Reflections on SGIM 2021 and Outro

Does obesity hypoventilation syndrome (OHS) give you respiratory distress? Are you baffled by bilevel? The wait is over! Learn all the ins and outs about OHS from Dr. Aneesa Das, @AneesaDas,  a sleep specialist and pulmonologist at The Ohio State University! You’ll learn tips and tricks regarding the diagnosis and management of OHS, the important role PCPs can play, and why on earth we’re discussing the didgeridoo! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Cyrus Askin, MD Infographic: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Cyrus Askin, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Reviewer: Leah Witt, MD Editor: Matthew Watto, MD (written materials); Clair Morgan of nodderly.com Guest: Aneesa Das, MD Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb   Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process. 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 Basic risk factors for OHS and red flags That pathophysiologic trifecta Physical Exam & History - OHS Surveys and specific testing Labs and other tests (PFTs, Echo, and more) OSA, OHS, and Central Sleep Apnea Treating OSA: CPAP vs Bilevel The importance of weight loss Keys for inpatient management Perioperative considerations Take-home points Outro

Dust off your dementia playbook and re-evaluate your approach as Dr. Josh Uy walks us through this common (yet perplexing) condition. Dr. Uy (@joshuy) is the geriatric fellowship director at University of Pennsylvania in addition to a nursing home director and shares his skills in simplifying dementia screening, management, and treatment. Set your chairs up for the “triad visit” and prepare to ‘stew in the milieu’ of dementia! Free CME for this episode at curbsiders.vcuhealth.org! Credits Producer, cover art, infographic: Emi Okamoto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com Guest: Josh Uy MD Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 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 and picks of the Week* Case from Kashlak Definitions of dementia and cognitive impairment Subtyping dementia Cases to refer and basic laboratory testing Potential imaging Management of dementia Take-home points, Outro

Flow with us through Diarrhea Disemboweled Part 2 as Dr. Xiao Jing (Iris) Wang @IrisWangMD  walks us through the differential diagnosis and initial evaluation of chronic diarrhea. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Elena Gibson MD Writer: Elena Gibson MD, Beth Garbitelli Cover Art: Kate Grant, MD  Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Matthew Watto MD (written); Clair Morgan of nodderly.com (audio) Guest: Xiao Jing (Iris) Wang MD Sponsor: Express VPN ExpressVPN.com/curb Protect your online activity TODAY with the VPN rated #1 by CNET and Wired. Visit our exclusive link ExpressVPN.com/curb and you can get an extra 3 months FREE on a one-year package! 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.  Show Segments Intro, disclaimer, guest bio  Case from Kashlak  Osmotic diarrhea & stool osmotic gap Causes of osmotic Diarrhea Algorithm for evaluating diarrhea workup Testing workup for chronic diarrhea Endoscopic evaluation indications Disorders of the Gut-Brain Axis

Flow with us through Diarrhea Disemboweled Part 1 as Dr. Xiao Jing (Iris) Wang @IrisWangMD  walks us through the evaluation and management of acute diarrhea.  NOTE: CME will not Go LIVE until Wed 4/7/21 for both #266 and #267. Then, claim 2 hours credit in one shot! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Elena Gibson MD Writer: Elena Gibson MD, Beth Garbitelli Cover Art: Kate Grant, MD  Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Matt Watto MD (written); Clair Morgan of nodderly.com (audio) Guest: Xiao Jing (Iris) Wang MD Sponsor: The American College of Physicians  Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their 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, guest bio  Picks of the Week  Case from Kashlak  Definitions Small bowel vs. Large bowel pathology Red flags Microbiologic evaluation of acute diarrhea Non-Culture based testing panels Supportive Management Post infectious diarrhea Oral Rehydration Solution  Take-Home points and Outro

Recap our top pearls from recent shows on hypertension, sarcoidosis, and seizure. It’s Tales from the Curbside (TFTC)!, our monthly series providing a rapid review of recent Curbsiders episodes. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #254, #256, and #257.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli and Edison Jyang Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Show Segments Intro, disclaimer Hypertension pearls Sarcoidosis pearls Seizures pearls Outro

Fresh hotcakes! Practice-changing articles that you need to know: semaglutide for weight loss; metronidazole plus a fluoroquinolone versus amoxicillin/clavulanic acid for uncomplicated diverticulitis; and the perioperative risks of COVID19. We’re joined by Dr. Adnan Khan (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced and hosted by: Rahul Ganatra MD, MPH; Adnan Khan MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Cover Art: Matthew Watto MD, FACP Editor: Rahul Ganatra MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial panaceafinancial.com This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com. Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: ACP’s MKSAP 19 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at check out. 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 Pick of the week: Dark (Netflix TV series) Preventive Medicine Updates Semaglutide for weight loss Amox-clav vs FQ-metronidazole for Diverticulitis Perioperative COVID19 infection and timing of surgery Rahul’s take-home points Outro

Dominant iron deficiency and anemia of CKD! We discuss how to interpret iron studies, when and how to start treatment with PO vs. IV iron, and ESAs vs. the new HIF-PHIs! Iron deficiency in chronic kidney disease is common but frequently overlooked in primary care.  This episode features Kashlak Memorial’s own Chief of Nephrology, Dr. Joel Topf (@kidney_boy), joined by NephMadness experts, Dr. Matthew Spark (@Nephro_Sparks), and Dr. Pascale Khairallah (@Khairallah_P)!  Our guests lay out an easy-to-follow framework for primary care and give us some inside information to #Nephmadness! Read the Anemia Region scouting report. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Writer, Producer:  Stuart Brigham, MD Cover Art:  Kate Grant MBChB, MRCGP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Joel Topf MD, Matt Sparks MD, Pascale Khairallah MD Sponsor: Grammarly Grammarly.com/CURB Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Segments Intro, disclaimer, guest bio Case from Kashlak Approaching CKD in Primary Care Iron and anemia labs in CKD Ferritin Goals in CKD Oral Replacement of Iron in CKD IV Replacement of Iron in CKD Discussing treatment option for Anemia of CKD Basic information on HIF Stabilizers/ PHIs in CKD Take-home points and Outro

In this part 2 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of the DX: Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com Guest: Andrew Olson MD Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at 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.

In this part 1 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of DX: the Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com Guest: Andrew Olson MD Sponsor: Panacea Financial panaceafinancial.com This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: BetterHelp betterhelp.com/Curb  This podcast is sponsored by BetterHelp and Curbsiders listeners get 10% off their 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.

A painless walk through the diagnosis and management of peripheral artery disease (PAD). PAD is one of those diagnoses that you know about, but maybe don’t feel comfortable diagnosing and managing.  Listen as our esteemed guest Dr. Vladimir Lakhter @VladLakhter (Temple Health) talks us through its diagnosis and management.  Dr. Lakhter gives us a straightforward framework for categorizing and triaging peripheral artery disease and talks us through the important components of medical management and who benefits from revascularization. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and produced by: Jake Kieserman and Paul Williams MD, FACP Infographic: Edison Jyang Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Vladimir Lakhter, DO 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. Time Stamps* *Note: Time Stamps refer to ad-free version.  Intro, disclaimer, guest bio- 00:33 Guest one-liner- 3:25 Dr. Lakhter book recommendations- 5:36 Case from Kashlak- 8:35 Definition and background for PAD- 10:25 Classification schema for PAD- 12:45 The physical examination- 21:05 ABIs and PVR in the diagnosis of PAD- 33:50 Exercise program for PAD-  46:08 Medication therapy-  52:05 Revascularization- 62:50 Outro- 68:45

Let's recap our favorite addiction medicine pearls!  We cover the treatment of alcohol use disorder, opioid use disorder and discuss strategies surrounding the management of long-term opioid therapy.  Please share your favorite addiction medicine pearls with us that we may have forgotten in the comments or by tagging us on Twitter @thecurbsiders.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers: Carolyn Chan MD; Nora Taranto MD Infographics: Hannah R Abrams; Justin Berk MD, MPH, MBA; Carolyn Chan MD; Nora Taranto MD Writer and Cover Art: Carolyn Chan, MD Hosts: Carolyn Chan MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Justin Berk MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial, you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea is also excited to announce their “Match Day Giveaway.” $500 will be awarded to five medical students entering the match in 2021. Entry is free, and students can enter the giveaway on their website until March 31, 2021. Winners will be selected randomly on April 1st,  2021. No purchase necessary for entry. Go to panaceafinancial.com/matchday today to learn more. Panacea Financial, a Division of Sonabank, Member FDIC Partner: The Cribsiders Pediatric Medicine Podcast A Pediatric Podcast here to feed pediatric knowledge food to your adult-sized brain hole & provide weight-based dosings of fun. New episodes drop every other Wednesday! https://thecribsiders.com/  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 to claim credit. Time Stamps Intro, disclaimer 00:00 Alcohol Use disorder (inpatient and outpatient management) 03:50  Sponsor -Panacea Finanicial 24:00 Partner -The Cribsiders Pediatric Medicine Podcast Chronic Pain and  Opioid Therapy (prescribing buprenorphine; microdosing) 25:30 Benzo Tapers 46:11 Outro

Recap our top pearls from recent shows on nephrotic syndrome vs nephritic syndrome, smoking cessation and updates in preventive medicine. Tales from the Curbside (TFTC) is a monthly series providing a rapid review of recent Curbsiders episodes. Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #250, #251 and #252.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Elena Gibson MD, Beth Garbitelli and Carolyn Chan MD Cover Art: Matthew Watto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: Grammary grammarly.com/curb

Seize control of your differential for epilepsy! This week, we review the basics of seizure work-up and management with our esteemed guest  Dr. Sara Dawit @DrSaraDawit a board-certified neurologist who is an Assistant Professor of Neurology and Neurophysiology Fellow at  The Mayo Clinic, Scottsdale Campus. Dr. Dawit takes us through rapid response to witnessed seizure, how to approach first-time seizures and adult-onset seizure disorders, gives us some facts about non-epileptic seizure disorders, and describes how to approach medication management in epilepsy!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Paul Williams MD, Beth Garbitelli          Writer and Infographics: Beth Garbitelli Cover Art: Kate Grant  MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Sara Dawit MD Sponsor: ACP’s MKSAP MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout. Sponsor: Green Chef GreenChef.com/90curb 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 .

This grand overview of granulomas will leave you comfortable tackling an often breathtaking disease, sarcoidosis. Listen as our esteemed guests Dr. Mary Beth Scholand (University of Utah) and Dr. Jonathan Boltax (University of Utah) rheum-inate on sarcoidosis. We discuss the pathophysiology, diagnosis, and treatment of this disease, role of the primary care clinician and why sarcoidosis in the chart reminds Paul of Shakespeare.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Cyrus Askin MD and Deborah Gorth Writer: Deborah Gorth Infographic and Cover art: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Drs. Mary Beth Scholand & Jonathan Boltax Sponsor: ACP’s MKSAP MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout. Sponsor: birch by Helix Visit 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. Time Stamps 00:00 Intro, disclaimer, guest bio, Awful(ly good?) Pun 03:42 Guest one-liners 06:28 Sponsor - ACP’s MKSAP19 07:40 Case from Kashlak 08:40 Explaining sarcoidosis 12:19 Possible drivers of sarcoidosis 13:30 Taking a sarcoidosis history 17:26 Suggestions for catching sarcoidosis 21:44 Sponsor - birchliving.com/curb 23:52 Sarcoidosis physical exam, Diagnosis 33:00 Lofgren’s and Heerfordt’s syndromes; Imaging for sarcoidosis 40:44 Initiating therapy for sarcoidosis; Prognosis; the Treatment team 51:23 Primary care considerations for sarcoidosis  54:55 Diagnosing and treating a sarcoidosis exacerbation 61:20 Take home points and outro

Fresh hotcakes! Practice changing articles that you need to know: low dose colchicine for stable CAD; colchicine vs naproxen for acute gout flares; and physical therapy vs glucocorticoid injection for chronic Knee osteoarthritis. We’re joined by Michael Sternberg (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Hosts: Rahul Ganatra MD, MPH; Michael Sternberg MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: ACP’s MKSAP18 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021. 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 . Time Stamps Intro, disclaimer 01:45 Fun animal fact; Picks of the Week* 06:33 PT vs steroid injection for chronic knee OA 21:00 Colchicine for stable CAD 33:00 Low dose colchicine vs naproxen for acute gout flares

Listen as our esteemed guest Dr. Wanpen Vongpatanasin, @DrWanpen (UT Southwestern) discusses the nitty-gritty of blood pressure monitoring and hypertension treatment.  We review the thresholds for HTN diagnosis and how to accurately measure blood pressure levels at home and in the office.  Dr Vongpatanasin shares the latest guideline recommendations for first line pharmaceutical therapies as well as her pearls about how to treat special populations. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Produced by: Deborah Gorth and Isabel Valdez, PA Written by: Deborah Gorth  Infographic and Cover Art: Edison Jyang Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; Paul Williams, MD, FACP    Editor: Molly Heublein, MD (written materials); Clair Morgan of nodderly.com Guest: Wanpen Vongpatanasin, MD Sponsor: ACP’s MKSAP18 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021. Sponsor: Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.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. Time Stamps 00:00 Sponsors, Intro, disclaimer, guest bio 03:20 Guest one-liner 05:50 Sponsor - ACP’s MKSAP 18 07:05 Case from Kashlak; Defining hypertension and treatment thresholds 10:43 Measuring blood pressure (at home, in the office, validatebp.org) 16:46 Wrist BP cuff 19:50 Home monitoring and ambulatory BP monitoring; What time to take BP medication 31:23 Sponsor - Provider Solutions and Development 32:10 Approach to treatment; Combo pills; How to titrate meds 42:20 Treating resistant hypertension; hyperaldosteronism; Isolated systolic hypertension 52:04 Take home points and Outro

Answer all your burning questions (and your patients’ burning questions) about the different COVID-19 vaccines currently authorized in the US. Infectious diseases / HIV expert, Dr Monica Gandhi @MonicaGandhi9 (UCSF) joins us to cover: the Pfizer-BioNTech and Moderna novel mRNA vaccine mechanisms, trial data, and practicalities of who should receive them.  We discuss data around the Oxford-AstraZeneca adenovirus vaccine, which is authorized in the UK and India, and may be available in the US later this year.  Feel confident recommending COVID-19 vaccines to your patients! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Molly Heublein, MD Cover Art: Chris Chiu, MD, FACP, FAAP Infographic: Tima Karginov Hosts: Chris Chiu, MD, FACP, FAAP; Molly Heublein, MD; Paul Williams, MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Monica Gandhi, MD, MPH Sponsor: Panacea Financial  This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: 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. Time Stamps Intro, disclaimer, guest bio - 00:00  Guest one-liner, book recommendation - 3:40 Authorized vaccines in the US - 8:30 AstraZeneca vaccine mechanism- 9:26 mRNA vaccine mechanism - 10:30 Vaccine distribution issues (cold chain) - 16:05 mRNA safety - 18:24 mRNA vaccine efficacy/data from phase 3 trials - 19:40 How did we get this so quickly - 23:40 Vaccine impact on asymptomatic infection - 26:18 AstraZeneca trials - 28:20 Pregnancy - 35:10 Anaphylaxis - 37:10 Prior COVID-19 infection - 39:07 Side effects - 42:05 Pediatric patients - 45:12 Phases of role outs in the US -46:50 Herd immunity - 48:16 Thoughts of how to make this happen - 52:45 Preexisting conditions - 53:40 How long will immunity last - 57:15 Mutant strains - 58:25 Future of mRNA vaccines - 1:00:30 Take home points and Outro - 1:02:12

Get all the details on varenicline, nicotine replacement therapy, and integrating psychosocial interventions into a comprehensive smoking cessation treatment plan! Smoking cigarettes is the leading cause of preventable death worldwide. Listen as our esteemed guest Dr. Steve Baldassarri (Yale) provides us expert pearls to help our patients quit smoking.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and produced by: Carolyn Chan, MD Infographic: Edison Jyang Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin, MD (written materials); Clair Morgan of nodderly.com Guest: Steve Baldassarri MD MHS Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.   “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org. (Prices shown online at registration pages reflect Discounted Rates.)   Register now—Early Bird savings end January 31st! Sponsor: 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. Time Stamps* *Note: Time Stamps refer to ad free version.  03:02 Intro, disclaimer, guest bio 04:35 Guest one-liner  09:50 Tobacco Use Disorder - Chronic Disease 11:08 Case from Kashlak 11:56 Obtaining a history 13:39 Motivations for Smoking Cessation 15:29 Factors associated with challenges in smoking cessation: 21:40 Gradual Tapers vs Cold Turkey 25:18 Nicotine Replacement 32:40 28:57 Pharmacotherapy - “Controller” Medications 31:05 Pharmacotherapy - Short Acting Medications 33:20 Dosing Medications 38:35 Varenicline 39:00 Nicotine gum dosing  44:40 Duration of therapy 48:08 Bupropion  49:05 Behavioral Interventions 55:24 Vaping and electronic cigarettes  57:03 Vaping for smoking cessation 01:02:35 EVALI 01:05:49 Outro

What the USPSTF?! It’s time for some preventive medicine updates on: screening for unhealthy drug use, cervical cancer, hepatitis C and draft recs for colorectal cancer; plus how to interpret USPSTF screening recs. Dr. Amber-Nicole Bird @ABirdMD (Penn Medicine) refreshes our love for preventive medicine, with updates on the newest recommendations. She reviews how to appropriately interpret and adopt guidelines for our patients, being cognizant of the source. We shine light on the mechanism of USPSTF, including how their guidelines differ from others, so we can understand the value and context when utilizing the guidance in the clinic. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Produced and Written by: David Madick MD; Peter Wikoff MD; Paul Williams MD, FACP Infographic: Beth Garbitelli Cover Art: Chris Chiu MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto, MD (Show notes); Clair Morgan of nodderly.com Guest: Amber-Nicole Bird, MD Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st! Sponsor: 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.

Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer, writer, infographic, cover art: Elena Gibson MD Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) Guest: Joel Topf MD Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st! Sponsor: 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.

Recap the top pearls from recent shows on vulvovaginitis, cellulitis and bites, MGUS and the SPEP. Tales from the Curbside (TFTC) is pilot project providing a rapid review of recent Curbsiders episodes. Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #244, #246 and #247. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Infographics by: Kate Grant MBChb, MRCGP, Beth Garbitelli and Nora Taranto MD Cover Art: Matthew Watto Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st! Time Stamps* *Note: Time Stamps refer to ad free versions. 00:00 Intro, disclaimer, guest bio 02:35 Vulvovaginitis 05:35 Cellulitis and Bites 09:45 SPEP it Up 15:15 Outro

Our team shares the top pearls of 2020 in our annual recap extravaganza featuring guest host, Chris “The Chiu Man” Chiu @cjchiu. Check out the video version at YouTube. Topics: hypothyroidism, women in medicine, hypothermia, diuretics, heart failure, AKI, lipids, post-op fever, refugee health, SGLT2 inhibitors, euglycemic DKA, UTIs, bat bites, rabies, ILD, statins in NAFLD, framework for hair loss, and more! Plus: Our picks of the year and the Curbsiders gift guide! Note: This episode is not available for CME but #208 through #247 are available for CME/MOC at curbsiders.vcuhealth.org for free! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Chris Chiu MD, FACP, FAAP Written by: The Curbsiders Team Show Notes: Matthew Watto MD, FACP Cover Art: Chris Chiu MD, FACP, FAAP Hosts: Chris Chiu MD, FACP, FAAP, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC

On this episode, Dr. Jorge Castillo (Harvard, Dana Farber) walks us through some immunology basics, teaches us the limitations of the SPEP, plus some additional tests that complement it (think Immunofixation), shares his clinical gestalt about when to suspect  MGUS, Myeloma, Waldenstrom’s, and Amyloidosis--and finally, how to talk to patients about them. If you, like Stuart, have ever wondered what on earth to do with that pesky free light chain ratio or the SPEP that so often gets inboxed to you without explanation, then fear not, Dr Castillo has your back! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by Nora Taranto MD Infographics by Nora Taranto MD Cover Art by Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, FACP, Nora Taranto MD Editor: Matthew Watto MD, FACP ; Clair Morgan of nodderly.com Reviewer: Jooho Chung MD, PhD Guest: Jorge Castillo MD Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your account!

Master common skin and soft tissues infections: cellulitis, abscesses, human and animal bites with returning guest, infectious diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED). Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written (including CME) and Produced by: Matthew Watto MD, FACP Cover Art and Infographic by: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto (written materials); Clair Morgan of nodderly.com Guest: Boghuma Titanji MD, M.Sc., DTM&H, PhD Sponsor: Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders. Sponsor: 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. Time Stamps* *Note: Time Stamps refer to ad free version. 00:00 Intro, disclaimer, guest bio 02:00 Picks of the Week 06:00 Definitions, Initial Approach to cellulitis 10:35 Nonpurulent cellulitis; antibiotic choice
18:10 Fish handler’s disease 24:30 Recurrent cellulitis 31:30 Purulent cellulitis and MRSA; Antibiotic choice; Step down therapy 47:33 Abscesses; Adjuvant antibiotics; Packing Wounds 53:30 Decolonization for recurrent MRSA infections 56:30 Human Bites (clenched fist injury); Dog bites and Cat bites 67:10 Take home points and Outro

Diagnosis, Management, and Social Implications of Attention Deficit Hyperactivity Disorder.  Ever gotten overwhelmed by all the categories of ADHD, or interpreting the scores on a Vanderbilt form? Join us with Dr. Sarah Vinson, a triple-boarded clinician in adult  psychiatry, child psychiatry, and pediatrics who helps us optimize a diagnosis and management process for ADHD. What other conditions can masquerade as ADHD? Which type of stimulant should you use? Listen to find out more! Show notes at: https://thecurbsiders.com/cribsiders/13 Subscribe at: Apple , Google, Spotify Credits Writer, Producer, Infographic: Angela Zhang Cover Art: Chris Chiu Hosts: Justin Berk, Chris Chiu Editor:Justin Berk; Clair Morgan of nodderly.com Guest(s): Dr. Sarah Y. Vinson Time Stamps 5:30 Diagnosis of ADHD 6:53 Considering a differential diagnosis of ADHD 8:43 Categories of ADHD 15:02 Ancillary Supports 18:27 Consequences of Misdiagnosis 19:53 Parent Counseling 22:08 Behavioral Interventions Treatment 25:56 Gender Differences in ADHD 28:00 Anaphylaxis Promo 28:39 Alternative Treatments 30:54 Pharmacotherapy for ADHD 37:29 Side Effects of Medical Treatments 44:33 Monitoring Progress 46:19 Treating concurrent mood disorders 49:21 ADHD in Young Adults 55:29 ADHD and Race 1:08:13 Future of ADHD

Learn about the latest in COVID-19: Do masks prevent infection?, SARS-CoV-2 home testing, vaccine advice, and how to prevent and treat VTE in COVID-19. Join us as our tzar-of-clinical-appraisal Curbsider/internist/epidemiologist Rahul Ganatra MD MPH (@rbganatra) talks us through the controversial DANMASK-19 trial, plus Watto reports back on his conversation with Dr Parth Rali @parthrali (Temple Lung Center) who helped write the CHEST anticoagulation guidelines for COVID-19. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Deb Gorth ScM Show Notes, Cover Art, and CME by: Deb Gorth ScM and Matthew Watto MD Written by: Matthew Watto MD, Paul Williams MD, and Rahul Ganatra MD MPH Hosts: Rahul Ganatra MD MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts. Sponsor: 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. Time Stamps 00:00 Intro, disclaimer, Picks of the week* and Vaccines 08:00 DANMASK-19 25:00 Anticoagulation in COVID-19 35:06 COVID-19 home PCR testing Outro

Everything you need to know about vulvovaginitis: candidiasis, bacterial vaginosis, and Genitourinary Syndrome of Menopause. Join us on the journey of a lifetime as we learn all about diagnosing, treating and managing vulvovaginal conditions in patients of all ages. Plus, a bit on how to recognize and treat lichen sclerosus. Our brilliant guest for this episode is Dr. Monica Christmas (@drmonicaxmas on Twitter), who is a self-described yoga enthusiast, avid reader, wannabe artist and gynecologist. Dr. Christmas is currently an Assistant Professor at the University of Chicago in the section of Minimally Invasive Gynecologic Surgery where she is the director of the Menopause Program. Monica specializes in gynecologic surgery, abnormal uterine bleeding and menopause management with an interest in sexual dysfunction. Her focus is on helping women live healthy, vibrant, happy lives. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Produced by: Kate Grant MD; Sarah Phoebe Roberts MPH Written by: Kate Grant MD Show Notes by: Sarah Phoebe Roberts MPH, Kate Grant MD Cover Art and Infographic: Kate Grant MD Hosts: Kate Grant MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Monica Christmas, MD Sponsor: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts. Sponsor: 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.

Listen in as we recap four of our favorite diabetes episodes to bring you the pearls you need to stay up to date on type 2 diabetes management in the clinic.  We cover pitfalls of A1c testing, guidelines for A1C targets, when and how to use the newer medications SGLT-2 inhibitors and GLP-1 agonists.  We wrap up with a discussion of managing DM2 in patients with kidney disease and in which patients to consider de-intensifying treatment.  Feel confident managing diabetes with the latest data in 2020! Listeners can claim 4 HOURS of Free CE credit for this episode through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Molly Heublein, MD Infographic and Cover Art: Isabel Valdez, PA Show Notes: Isabel Valdez, PA; Molly Heublein, MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein, MD Editors: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Sponsors: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts. 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 0:00 Intro, 2:45 Pitfalls of A1c testing, 7:00 Diabetes goals/A1c guidelines; Macrovascular vs Microvascular benefits, 16:20 Choosing between SGLT2 inhibitors vs GLP1 agonists, 19:10 Stuart rants on insulin for symptomatic hyperglycemia, 22:32 Start your patient on an SGLT2i and counsel them about potential adverse events, 30:30 GLP-1 agonists, 36:50 Deintensification; Diabetes Treatment in CKD, Tags Diabetes, hypoglycemia, SGLT2 inhibitors, GLP-1 agonist, metformin, CKD, primary care, assistant, doctor, education, family, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, physician, resident, student

Explore the essentials of Wilderness Medicine and prepare yourself for austere environments as we discuss Altitude Sickness, Frostbite, Animal Bites, Thermoregulation, Wound Care and the proper way to apply a tourniquet.   Thinking about outdoor escapes and vacations now more than ever? Listen as our esteemed guest Dr. Thomas DeLoughery @Bloodman (Oregon Health & Science University) takes us through the fascinating, and at times chilling, world of Wilderness Medicine. This episode will empower you to explore the great outdoors as safely as possible.  We discuss the breadth of wilderness medicine, multiple unique clinical entities encountered in austere environments, and practical ways to protect yourself and others on your adventures.  This episode is truly wild!   Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written, Produced, and Infographic by: Avital O’Glasser MD, FACP, FHM Show Notes: Deborah Gorth ScM and Avital O’Glasser MD, FACP, FHM Cover Art: Kate Grant, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Thomas DeLoughery MD, MACP, FAWM   Sponsors:   Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.   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 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ Sponsor - VCU Health CE curbsiders.vcuhealth.org    00:00 Intro, disclaimer, guest bio 03:45 Guest one-liner, advice and Picks of the Week* 08:10 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ 09:00 Case of mountaineering; What is Wilderness Medicine?
 12:05 What’s in your first aid kit?
 21:36 Altitude sickness: acute mountain sickness, high altitude cerebral edema and High altitude pulmonary edema
 31:25 Hypothermia   39:36 Frostbite 
 47:25 Hyperthermia: Heat exhaustion and Heat stroke; How much water should you drink?
 51:55 Bat bites and rabies
 58:20 Snake bites
 66:03 Wound care and tourniquets
 75:40 Take Home Points; Outro; Bonus clip Sponsor - VCU Health CE curbsiders.vcuhealth.org      Links* De Gaulle by Julian Jackson  Command and Control by Eric Schlosser Auerbach's Wilderness Medicine, 2-Volume Set  Whatever book Paul said he was reading, sounds nerdy (The First Law Trilogy)  Wilderness Medicine Society Stop The Bleed: Home  Into Thin Air: A Personal Account of the Mt. Everest Disaster by Jon Krakauer National Outdoor Leadership School Advanced Wilderness Life Support  Inside the ER at Mt. Everest  Annapurna by Maurice Herzog  K2, The Savage Mountain: The Classic True Story Of Disaster And Survival On The World's Second-Highest Mountain– by Charles Houston and Robert Bates    *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will learn the basics of wilderness medicine and how to approach a few common conditions.    Learning objectives After listening to this episode listeners will…   Appreciate Wilderness Medicine as a medicine subspeciality and understand why or how someone might pursue this clinical focus area Recognize signs and symptoms of high altitude sickness Develop an approach to treating animal bites and injuries Learn high yield tips for administering first aid in the wilderness including field hemostasis   Disclosures Dr DeLoughery reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation O’Glasser AY, Gorth D, Deloughery T, Williams PN, Watto MF. “#242 Wilderness Medicine: Prfor Disaster”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date November 16, 2020.   Tags Wilderness Medicine, Travel medicine, first aid, first aid kit, altitude sickness, acute mountain sickness, high altitude cerebral edema, high altitude pulmonary edema, acetazolamide, dexamethasone, hypothermia, frostbite, frostnip, heat exposure, heat exhaustion, heat syncope, hyperthermia, hyponatremia, animal bites, bats, rabies, snakes, antivenom, wound care, tourniquet, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Rejoice! as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward. Listeners can claim free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). We hope you enjoy learning from this episode as much as we enjoyed producing it!   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written (including CME questions) and Produced by: Cyrus Askin MD Infographic by: Cyrus Askin MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Paul Williams MD, FACP    Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Brad Hayward MD   Sponsors: Panacea Financial  This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC     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   Sponsor - Panacea Financial panaceafinancial.comSponsor - VCU Health CE curbsiders.vcuhealth.org 00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week* 06:23 Sponsor - Panacea Financial panaceafinancial.com 07:30 Case of Post Infectious Cough; Basic definitions for cough Important aspects of the history Empiric therapies for post-viral cough 22:50 Case of idiopathic chronic cough; Physical exam 29:20 Basic testing and empiric therapy for the common causes of chronic cough 41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds 54:28 Take home message; Outro Sponsor - VCU Health CE curbsiders.vcuhealth.org   Links* 90 Day Fiancé (show)   Below Deck Mediterranean (show) Mastering Communication with Seriously Ill Patients by  Anthony Back, Robert Arnold & James Tulsky (book)    *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will develop a pragmatic approach to evaluating subacute and chronic cough in adult patients.   Learning objectives After listening to this episode listeners will be able to…   ... define sub-acute vs chronic cough ... build a repertoire of history questions geared towards identifying the etiology of cough in a patient ... build a toolbox of diagnostic studies / tests that can be used in the evaluation of cough ... marry history, physical and diagnostic studies into a coherent approach to diagnosing subacute and chronic cough through a tiered/logical approach ... understand empiric therapies for cough that may have an advantageous risk-reward profile, even in the absence of diagnosis  ... educate patients on common causes for subacute cough and chronic cough, as well as how to appropriately set expectations regarding symptoms severity and duration   Disclosures Dr. Hayward reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Askin CA, Hayward B, Williams PN, Brigham SK, Okamoto E, Watto MF. “241: Chronic Cough”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date: November 9, 2020.   Tags Cough, dyspnea, asthma, COPD, eosinophil, IL-5, allergy, ENT, allergist, pulmonary, pulmonologist, PFT, spirometry,  post-nasal drip, GERD, reflux, eczema, rash, atopy, mucus, bronchiectasis, lung, antihistamine, CT, X-Ray,  smoking, vaping, birds, dust, cockroaches, steroids, ICS, inhaled, gabapentin,  primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Returning guest expert Dr Ted Parks helps us get the elbow straight with a simple approach to common causes of elbow pain for primary care.  Listen as he guides Stuart through physical exam techniques (or watch them on YouTube) for epicondylitis and learn what the bursa is there for anyways. Find out what fracture you can treat in your office, why you shouldn’t stab straight into the olecranon bursa and when elbow pain should be referred.  Feel confident when your patient comes in with elbow pain! Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Molly Heublein, MD Cover Art and Infographic: Edison Jyang Hosts: Stuart Brigham MD, Matthew Watto MD, FACP; Molly Heublein, MD Editor: Emi Okamoto, MD (written materials); Clair Morgan of Nodderly.com (audio/video) Guest: Ted Parks, MD     Sponsors   Provider Solutions and Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.     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 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ Sponsor - VCU Health CE curbsiders.vcuhealth.org    00:00 Intro, disclaimer, guest bio 04:00 Picks of the Week* Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ 09:50 Medial and lateral epicondylitis case, Elbow anatomy 13:00 Pathophysiology of epicondylitis, Epicondylitis exam, Epicondylitis treatment 34:11 Olecranon bursitis, Bursitis diagnosis and aspiration 46:12 Radial head fracture diagnosis, Radial head fracture treatment 55:30 Cubital tunnel nerve entrapment 57:45 Platelet rich plasma 60:39 Take home points, Plug and Outro 64:00 Bonus Pick of the Week Sponsor - VCU Health CE curbsiders.vcuhealth.org      Goals Listeners will have a working differential of elbow complaints that commonly present in primary care, and understand how to diagnose these and initiate treatment.   Learning objectives After listening to this episode listeners will... Perform an exam for medial and lateral epicondylitis. Describe treatment options for medial and lateral epicondylitis Identify when further evaluation for clinical olecranon bursitis beyond clinical exam is needed Explain how radial head fractures differ from most other fractures, and why casting or surgery is generally not needed.   Links* Molly’s Pick: The Warmth of Other Suns (book) by Isabel Wilkerson  Stuart’s Pick: The Fringe (TV show), JJ Abrams Practical Office Orthopedics (textbook) by Ted Parks, MD   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   References Johnson GW, Cadwallader K, Scheffel SB, Epperly TD. Treatment of lateral epicondylitis. Am Fam Physician. 2007 Sep 15;76(6):843-8. PMID: 17910298. Simental-Mendía M, et al. Clinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials. Clin Rheumatol. 2020 Aug;39(8):2255-2265. doi: 10.1007/s10067-020-05000-y. Epub 2020 Feb 26. PMID: 32103373. Parks, Ted.  Practical Office Orthopedics.   McGraw-Hill Education / Medical; 1st Edition (December 29, 2017).   Khodaee M. Common Superficial Bursitis. Am Fam Physician. 2017 Feb 15;95(4):224-231. PMID: 28290630. Liow RY, Cregan A, Nanda R, Montgomery RJ. Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols. Injury. 2002 Nov;33(9):801-6. doi: 10.1016/s0020-1383(02)00164-x. PMID: 12379391. Boone S, Gelberman RH, Calfee RP. The Management of Cubital Tunnel Syndrome. J Hand Surg Am. 2015 Sep;40(9):1897-904; quiz 1904. doi: 10.1016/j.jhsa.2015.03.011. Epub 2015 Aug 1. PMID: 26243318.   Tags Elbow, orthopedics, olecranon bursitis, bursa, aspiration, septic joint, medial epicondylitis, lateral epicondylitis, radial head fracture, PRP, platelet rich plasma, humerus, olecranon, radius, tendonitis, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student   Disclosures Dr Parks reports is the author of Practical Office Orthopedics (McGraw-Hill 2017) . The Curbsiders report no relevant financial disclosures.    Citation Heublein M, Parks T, Jyang E, Brigham SK, Okamoto E, Watto MF. “#240 Elbow Pain: Straighten it out. A dabble into elbow care  with Dr Ted Parks”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list November 02, 2020.

A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL).    Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli Cover Art: Kate Grant MBChb, MRCGP  Infographic by:  Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio) Guest: Dink Jardine, MD   Sponsors:   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.     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 Sponsor – National Internal Medicine Day, The American College of Physicians Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio 03:00 Guest one-liner, Favorite failure, Pick of the Week*:  Still Life by Louise Penny Sponsor – National Internal Medicine Day, The American College of Physicians 09:30 Case 1 - Acute Viral Rhinosinusitis  10:40 Rhinosinusitis vs. Sinusitis  14:20 Physical exam in rhinosinusitis 20:40 Counseling patients about viral vs. bacterial infection 22:56  Sinus regimen/nasal irrigation - “Is there a sinus toilet” 27:10 Intranasal fluticasone and other intranasal medications  29:40 Rhinitis medicamentosa 30:40 Nasal spray positioning 33:50 Case 1 - Double Sickening 37:40 Worst case scenarios from rhinosinusitis 40:40 Antibiotic treatment for bacterial rhinosinusitis 43:20 Failed improvement on antibiotics? Second-line options 49:30 Case 2 - Chronic rhinosinusitis  52:28 Etiology of chronic rhinosinusitis 53:33 Making a diagnosis of chronic rhinosinusitis 55:25 Treating chronic rhinosinusitis  58:40 Vasomotor rhinitis  60:40 Sinus irrigation counseling and tips (YouTube) 65:30 Case 3 - Allergic Rhinitis  70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis  73:51 Take-home points   Links* Still Life: A Chief Inspector Gamache Novel by Louise Penny,  Chief Inspector Gamache series “Dr. Adappa and Dr. Palmer teach you How to do Nasal Irrigation” https://www.youtube.com/watch?v=Br928VfiC1M   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goals Listeners will develop an approach to the diagnosis and management of rhinosinusitis.   Learning objectives After listening to this episode listeners will... Classify rhinosinusitis, including acute, chronic, bacterial, and viral. Discuss the microbiology and pathophysiology underpinning rhinitis and sinusitis. Differentiate the presentation and management of acute bacterial and acute viral rhinosinusitis. Develop an approach to the diagnosis and management of allergic rhinosinusitis. Recognize and manage patients with non-allergic rhinitis. Discuss the role of antibiotic therapy and surgery in the management of rhinosinusitis.   Disclosures Dr. Jardine reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Williams PN, Garbitelli B, Jardine D, Heublein M, Watto MF.. “#239 Sinusitis: It’s not that tricky.” The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 26, 2020.   Tags sinus, sinusitis, rhinitis, acute bacterial, rhinosinusitis, bacterial, viral, virus, nose, chronic sinusitis, ENT, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates.    Listeners can claim 2 hours of Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written and Produced by: Matthew Watto MD, FACP Cover Art by: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com   Sponsor:  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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps 00:00 Intro, disclaimer 01:40 Making the diagnosis of VTE 09:07 Triage and risk stratify Pulmonary Embolism 14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE 21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight,  advanced CKD and in antiphospholipid syndrome 28:22 IVC filters  30:20 Outro   Links Check out the full show notes from previous Curbsiders’ shows covering VTE.  Dr Oren Friedman #92 Pulmonary Embolism for the Internist  Dr Michael Streiff #154 DVT and PE Master Class   Goals Listeners will feel confident in the diagnosis and management of VTE   Learning objectives After listening to this episode listeners will...   Diagnose (VTE) DVT and PE using imaging, risk scores and clinical gestalt Risk stratify patients with pulmonary embolism Choose the appropriate initial anticoagulant for VTE Decide duration of anticoagulation for VTE Recall real risks and questionable benefits of IVC filters in DVT / PE Determine need for cancer or thrombophilia workup in unprovoked DVT / PE     Disclosures The Curbsiders report no relevant financial disclosures.    Citation Watto MF, Williams PN, Brigham SK, Watto MF. “#238 DVT / PE Triple Distilled”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 22, 2020.   Tags Pulmonary embolism, vte, dvt, pe, heparin, anticoagulation, right ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC filter, TPA, echocardiogram, CT scan, bleed, clot, deep, vein, thrombosis, DOAC, NOAC, anticoagulation, d-dimer, Wells, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Fun, fluorescein, and fundoscopy unite as our esteemed guest, Dr. Nisha Chadha @iEducatorMD (Mount Sinai School of Medicine) brings us ophthalmology for primary care! Dr. Chadha is a medical educator and the content creator of the med-ed simulation website 20/20 Sim. She teaches us the 3-vital signs of ophthalmology, how to recognize common diabetic eye diseases, how to explain diabetic retinopathy to our patients, how to optimize a patient for cataract surgery and so much more. This episode is truly vision-ary!   Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written, Produced, and Infographic by: Carolyn Chan, MD Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Nisha Chadha   Sponsors:   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential. 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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps Sponsor – National Internal Medicine Day, The American College of Physicians Sponsor – VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio   03:21 Guest one-liner, Carolyn’s Pick of the Week  09:05  Picks of the Week* 10:13 Case from Kashlak, 3 - Vital Signs of Ophthalmology  17:09  Ocular complications of diabetes 20:22 Screening for diabetic retinopathy; Reports and Abbreviations 26:07 Counseling Patients: The eye is a camera; Clinical symptoms of ocular complications  32:07 Fluorescein Stain; Treatment Options for Diabetic Eye Disease: NPDR, PDR, VH, and RD  41:16 Eye Vitamins for Macular Edema 43:35 Cataracts  47:22 Missing Glaucoma Drops  50:50 Periop Optimization for Cataract Surgery, Anticoagulation and Other Medical Management  58:14 Take Home Points, Plug: 20/20 Sim; Outro Sponsor – VCU Health Continuing Education     Links* Mindset: The New Psychology of Success by Carol S.  Dwek  Crackdown Podcast 20/20 Sim Site   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will discuss screening, counseling, and management of common ocular diseases seen within primary care.    Learning objectives After listening to this episode listeners will…   Define and assess the three vital signs of ophthalmology.  List ocular complications of diabetes. Counsel a patient on a new diagnosis of  diabetic retinopathy. Describe treatments for diabetic retinopathy. Define proliferative retinopathy, non-proliferative retinopathy, and macular edema. Compose a perioperative medication management plan for cataract surgery   Disclosures Dr. Chadha reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Chan C., Chadha N., Okamoto E., Watto MF. “#237 Ophthalmology for Primary Care”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date October 19, 2020.   Tags Eye, ophthalmology, ophtho, optometry, glaucoma, diabetes, diabetic retinopathy, macular edema, cataracts, cataract surgery, perioperative management, physical exam,  primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student  

Learn which exam maneuvers are worthwhile and which ones are worthless in your approach to shortness of breath. In our evidence based series on the physical exam, we discuss the approach to the dyspneic patient with Dr. Brian Garibaldi (Hopkins, SBM), associate professor of pulmonary and critical care medicine at Johns Hopkins, and co-president of the Society of Bedside Medicine. We discuss the physical exam’s effect on our differential diagnosis, maneuvers that are commonly taught, and some simple tests with great data that may go overlooked. Be prepared, this episode may take your breath away!   Credits Written and Produced by: Justin Berk, MD, MPH, MBA and Sam Masur, MD  Infographic: Sam Masur, MD, Beth Garbitelli Cover Art: Beth Garbitelli Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; and Paul Williams, MD, FACP Editor:Justin Berk MD; Clair Morgan of nodderly.com Guest(s): Brian Garibaldi, MD   Sponsors:   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.   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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps Sponsor – National Internal Medicine Day, The American College of Physicians Sponsor – VCU Health Continuing Education 00:00 Intro, disclaimer, guest bio Sponsor – National Internal Medicine Day, The American College of Physicians 03:47 Introduction to evidence-based exam, pre-test probability, and likelihood ratios 05:29 Case from Kashlak Memorial  06:51 Dr. Garibaldi’s initial maneuvers for the dyspneic patient 11:33 Recapping the exam maneuvers 14:05 Likelihood ratios for common maneuvers 18:25 Over 6/Under 6 maneuvers 25:30 Recap of Dr. Garibaldi’s go-to maneuvers 28:19 Role of labs and diagnostic imaging 31:03 Role of point-of-care ultrasound (POCUS) 34:10 Friday at 5pm 36:31 Take home points 39:25 Outro Sponsor – VCU Health Continuing Education   Links* Stanford 25: Teaching and promoting bedside exam skills to students, residents and healthcare professionals both in person and online The 5 Minute Moment at the Society of Bedside Medicine The POCUS Atlas: Evidence Based Point of Care Ultrasound   Goal Listeners will feel confident how to optimally use the physical exam to guide clinical decision-making in patients presenting with dyspnea.   Learning objectives After listening to this episode listeners will…   Describe the effectiveness of the exam when it comes to aiding diagnosis in a patient with dyspnea Identify specific exam maneuvers that can aid clinical decision-making  Identify exam maneuvers that may not offer more information compared to imaging such as POCUS   Disclosures This episode was made with assistance from the Society of Bedside Medicine and funding from the New York Academy Medicine.  Dr Garibaldi reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Masur S, Garibaldi BT, Watto M, Williams P, Brigham S, Berk J.  #236 Physical Exam Series: Approach to Shortness of Breath. The Curbsiders Internal Medicine Podcast. https:/www.thecurbsiders.com/episode-list. Original Air Date October 12,  2020.   References Mochizuki K et al. Importance of respiratory rate for the prediction of clinical deterioration after emergency department discharge: a single-center, case-control study. Acute Med Surg. Nov 2016. doi:10.1002/ams2.252 Sarkar M et al. Physical signs in patients with chronic obstructive pulmonary disease. Lung India. 2019. doi:10.4103/lungindia.lungindia_145_18 Fagan TJ. Letter: Nomogram for Bayes theorem. N Engl J Med. 1975;293(5):257. doi:10.1056/NEJM197507312930513 Simel, David, et al. Rational Clinical Examination, McGraw-Hill Professional Publishing, 2009. ProQuest Ebook Central  McGee, Steven. Evidence-based physical diagnosis [4th edition] Elsevier, 2018. Clinical Key Benbassat, J., Baumal, R. Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?. J GEN INTERN MED 25, 865–872 (2010). https://doi.org/10.1007/s11606-010-1327-8 Al Deeb M et al. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-852. doi:10.1111/acem.12435 Yousefifard et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emerg (Tehran). 2016;4(1):1-10. Martindale et al. Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016;23(3):223-242. doi:10.1111/acem.12878 Caldentey et al. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure). JACC Heart Fail 2014.. doi:10.1016/j.jchf.2013.10.004   Tags Physical exam, dyspnea, shortness of breath, auscultation, PMI, percussion, heart failure, wheeze, POCUS, COPD, JVD, hepatojugular reflux, observation, asymmetry, Brian Garibaldi, practice, pallor, lung, heart, hands.

Time for spooky cakes with a side of candy corn. We discuss Dapagliflozin (SGLT2i) for CKD, Turmeric for knee pain and Honey for URTI (cough) on this halloween themed hotcakes with Rahul Ganatra MD, MPH @rbganatra   Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (Note: CME for this episode won’t be available until 10/12/20. We apologize for the inconvenience).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Producer: Sarah Phoebe Roberts Written by: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH    Cover Art: Matthew Watto MD, FACP Hosts: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com   Sponsors   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.   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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps 00:00 Sponsor – National Internal Medicine Day, The American College of Physicians 00:25 Sponsor – VCU Health Continuing Education 00:40 Intro, disclaimer, Picks of the Week 07:38 Sponsor – National Internal Medicine Day, The American College of Physicians 08:40 Dapa-CKD 20:00 Turmeric for Knee Osteoarthritis 32:10 Honey for URTI and Cough 46:32 Shout out to @votehealth2020 and PatientVoting.com  48:25 Outro Sponsor – VCU Health Continuing Education   Links* Candy Corn (autumn mix) and (classic) Paul’s Halloween movie marathon: Cabin in the Woods, The Descent, The Witch, Ghostbusters   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will review and perform critical appraisal of recent articles with the potential to change internal medicine practice   Learning objectives After listening to this episode listeners will…   Review the potential benefits of dapagliflozin for prevent of CKD progression and death Evaluate the utility of turmeric for osteoarthritis with inflammatory synovitis Discuss the efficacy of honey for the treatment of acute upper respiratory tract infection and persistent post-infectious cough   Disclosures The Curbsiders report no relevant financial disclosures.    Citation Watto M, Ganatra R, Williams PN, Brigham SK, Roberts SP. “235 Spooky Cakes”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 5, 2020.   Tags Dapagliflozin, slgt2i, sglt2 inhibitors, ckd, turmeric, curcumin, knee osteoarthritis, knee pain, synovitis, honey, urti, respiratory tract infection, cough, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Master your breast cancer screening spiel, cultivate your approach to the breast mass, and empower your patients with empathetic shared decision-making (which we know you’re all already fabulous at)!  On this fantastic episode, we are joined by Dr. Nancy Keating @NancyKeatingMD, policy wonk and primary care doc extraordinaire at Brigham and Women’s Hospital. This episode is rife with drama, as the ACS butts heads with the USPTF and the ACR, and you have to figure out  what’s right for the patient by talking with them--almost as exciting as that moment on Grey’s when Izzie cuts the...anyway, I won’t ruin a key plot point in the most excellent medical show of all time, all in a day’s work, here at The Curbsiders. Enjoy!    Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Producer and Writer: Nora Taranto MD Show Notes: Nora Taranto MD, Isabel Valdez PA  Infographic: Nora Taranto MD Cover Art: Kate Grant, MD  Hosts: Stuart Brigham MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Reviewer: Arielle Medford MD  Guest: Nancy Keating MD, MPH   Sponsors   Provider Solutions & Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.     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. Note: A free VCU Health CloudCME account is required in order to seek credit.     Time Stamps Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. Sponsor - VCU Health Continuing Education 00:30   Intro & Guest Bio 03:27   Guest one-liner 05:27   Best Advice for Women in Medicine 07:34   Picks of the Week Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. 10:00   Case 1: Brenda Cantwell and Breast Lump DDx 13:39   Clinical Breast Exam vs Self Breast Exam 17:26   Practical Tips for the Clinical Breast Exam 21:50   Imaging to Evaluate the Breast Lump 26:36   Demystifying BIRADS 28:36   Epidemiology Potpourri 33:02   Breast Pain without a Mass 34:30   Case 2: Mammie Gram and Breast Screening 46:03   Average Risk vs High Risk Screening 47:18   Breast Risk Prediction Tools 48:51   Breast Density 53:16   Imaging Modalities 61:28     Shared Decision Making in Screening   68:04    Case 3: Ms Britta Lumpworth and When to Stop Screening Mammograms 74:42    Take Home Points and Outro Sponsor - VCU Health Continuing Education     Links* Evicted: Poverty and Profit in the American City by Matthew Desmond Run The List podcast  ACOG Practice Bulletin 179, 2017 Elmore et al, Ten Year Risk of False Positive Screening Mammograms and Clinical Breast Examinations, N Engl J Med, 1998.  Thomas, et al, Randomized trial of breast self-exam in Shanghai: final results. JNCI, 2002. Semagliazov et al, Results of a prospective randomized investigation [Russia] to evaluate the significance of self-examination for the early detection of breast cancer, Vopr Onkol, 2003.  Fuller, M. S., Lee, C. I., & Elmore, J. G. Breast cancer screening: an evidence-based update. The Medical clinics of North America, 2015. Chan et al, False-negative rate of combined mammography and ultrasound for women with palpable breast masses. Breast Cancer Res Treat, 2015.  ACS Recommendations for the Early Detection of Breast Cancer, 2020. USPTF Breast Cancer Screening Recommendations, 2016.  Henderson et al, Breast Examination Techniques, 2020.  Kolb et al. Comparison of the performance of screening mammography, physical exam, and breast ultrasound and evaluation of factors that influence them: an analysis of 27.825 patient evaluations, Radiology, 2002.  Mammogram Interpretation, Chapter 2. Radiology Key.Com.  Flobbe et al, The Additional Diagnostic Value of Ultrasonography in the Diagnosis of Breast Cancer. Arch Intern Med, 2003.  ACS Understanding Mammogram Readings, 2019.  Bittner, Guide to mammography reports: BIRADS terminology, Am Fam Physician, 2010.  Seer cancer statistics review, 1975-2017. 2020.  Anders CK et al, Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes?. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011  ACS How Common is Breast Cancer?  SEER Lifetime Risk (%) of Dying from Cancer by Site and Race/Ethnicity: Females, Total US, 2014-2016 Garcia et al, Cardiovascular disease in women: clinical perspectives, Circ res, 2017.  Cancer Statistics Center: Breast Statistics.  Independent UK Panel on Breast Cancer Screening, The Benefits and harms of breast cancer screening: an independent review, Lancet, 2012.  CDC Breast Cancer Screening Guidelines 2020  ACS Breast Cancer Screening Guidelines, 2015 USPTF Breast Cancer Screening Recommendations, 2016.  ACR Breast Cancer Screening Update, 2018.  Canadian Task Force Breast Cancer Screening Recommendations  UK-NHS Breast Cancer Screening Recommendations  Biller-Andorno et al. Perspective: Abolishing Mammography Screening Programs? A View from the Swiss Medical Board, N Eng J Med, 2014.  Nelson et al, Effectiveness of Breast Cancer Screening: Systematic Review and Meta-analysis to Update the 2009 US PTF Recommendation, Ann Intern Med, 2016.  Miller et al, Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial, BMJ, 2014.  Breast Cancer Risk Assessment Tool (NCI)   BCSC Breast Cancer Risk Assessment Tool  Health Decision/University of Wisconsin Decision Tool Harding Center for Risk Literacy Fact Box   Keating et al, Breast Cancer Screening in 2018: Time for Shared Decision Making, Jama Insights, 2018.  ePrognosis life expectancy calculator      *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will learn how to evaluate a breast lump in the primary care clinic, what the guidelines recommend for asymptomatic breast cancer screening, and how to engage a patient in shared-decision making given the data available on mammograms.    Learning objectives After listening to this episode listeners will…   Triage and evaluate the Breast Lump  Perform breast cancer risk assessment  Recall the Guideline Recommendations for Breast Cancer Screening and how they vary  Engage patients in conversation about b...

Listen to our medical education heroes, Dr. Abby Spencer, @abbyCCim (Cleveland Clinic), and Dr. Alia Chisty, @aliachisty (Penn State Health), school us on how to give effective and meaningful feedback! Topics include: the ADAPT framework, how to give difficult feedback, keywords and phrases when giving feedback, how to avoid gender and racial bias when giving feedback, giving feedback to your peers and how to solicit effective feedback as a team leader.     Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written and Produced by Paul Williams MD, FACP Cover Art: Paul Williams, MD, FACP Infographic: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Abby Spencer MD and Alia Chisty MD   Sponsors   Provider Solutions & Development   Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders. 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. Note: A free VCU Health CloudCME account is required in order to seek credit.    Time Stamps Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio, pun 04:00 Guest one-liners, Picks of the Week* (see links below) 10:25 Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. 11:00 Case from Kashlak, Feedback definitions 15:00 Addressing perceived barriers to feedback 31:45 ADAPT model of feedback 38:10 Addressing potentially gendered feedback;  42:45 Giving feedback to those who lack insight 48:29 Feedback and racial bias 52:25 Giving peer feedback 58:10 Tips for soliciting feedback as a supervisor 69:05 Does giving difficult feedback mean people won’t like you? 75:10 Take home points and Outro Sponsor - VCU Health Continuing Education   Links* Radical Candor (book) Host (film) Percy Jackson & The Olympians: The Lightning Thief movie  Hamilton on Disney Plus Her (film)    *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will demonstrate effective techniques to deliver and solicit meaningful feedback.   Learning objectives After listening to this episode listeners will…   Discuss the definitions and terms used to discuss feedback. Deliver effective feedback that is concordant with the learning goals of their trainees. Address potential perceived barriers to feedback. Utilize the ADAPT framework to partner with their learners and develop shared goals. Develop strategies to mitigate against using gender- or racially-biased narrative language. Deliver feedback to learners with limited insight by leveraging the impact of perception on achieving goals. Solicit effective and meaningful feedback despite being in a position of authority   Disclosures Drs. Spencer and Chisty report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Williams PN, Spencer A, Chisty A, Brigham SK, Jyang E, Watto MF. “#233 Giving effective feedback with Abby Spencer and Alia Chisty”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 21, 2020.   References  Ende J. Feedback in Clinical Medical Education.  JAMA.  1983. . [https://pubmed.ncbi.nlm.nih.gov/6876333/]  Brown B.  2018.  Dare to Lead.  Random House. Stone D and Heen S.  2014.  Thanks for the Feedback.  Penguin Books. Scott K.  2019.  Radical Candor.  St. Martin’s Press. Fainstad T et al.  Feedback can be less stressful: Medical trainee perceptions of using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) framework.  Cureus.  2018. [https://pubmed.ncbi.nlm.nih.gov/30906679/]  Rojek AE et al.  Differences in narrative language in evaluations of medical students by gender and under-represented minority status.  J Gen Int Med.  2019.  [https://pubmed.ncbi.nlm.nih.gov/30993609/]  Mueller AS et al.  Gender differences in attending physicians’ feedback to residents.  JGME.  2017.  [https://pubmed.ncbi.nlm.nih.gov/29075375/]  Ross, DA et al.  Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations.  PLoS ONE.  2017.  [https://pubmed.ncbi.nlm.nih.gov/28792940/] 

Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest! Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).  Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights.  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP,  Cover Art and Infographic by:  Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli   Editor:  Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Helena Pasieka MD, MS   Sponsors   Provider Solutions & Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.   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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio 04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders 08:30 Case 1: Alopecia  12:05 Assessing scalp for inflammatory changes and follicular drop-out 13:10 Central Centrifugal Cicatricial Alopecia (CCCA) 14:00 Alopecia/hair loss non-scarring subtypes 25:00 Alopecia Treatments 28:55 Case 2:  Psoriasis vs. Seborrheic Dermatitis  31:45 Looking for psoriatic plaques 32:11 Seborrheic dermatitis hallmarks  35:19 Treatment for Seborrheic Dermatitis 42:10 Case 3: Rosacea vs. Acne  50:40 Differentiating rosacea rash from SLE 52:40 Rosacea management & treatment 55:00 Identifying rosacea in Black skin 56:50 Acne management &  treatment 59:10 Retinoid dermatitis 1:00:30 Maskne 1:02:29 Antibiotics for acne 1:03:38 Retinoids and pregnancy 1:04:09 Doxycycline for rosacea 1:06:15 Take home points Sponsor - VCU Health Continuing Education   Links* Hamilton and Alexander Hamilton by Ron Chernow,  Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance)  The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt  Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones)  Brown Skin Matters on Twitter and Instagram Skin of Color Society American Academy of Dermatology Society for Dermatology Hospitalists Black Skin Directory Learning Journal Mind the Gap (2020) by Malone Mukwende  Ethnic Dermatology: Principles and Practice (2013) Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012) An Atlas of African Dermatology (2001)   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goals Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic.   Learning objectives After listening to this episode listeners will... Recognize and treat common skin complaints of the scalp and face in primary care. Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care. Be able to differentiate non-scarring versus scarring hair loss on physical exam. Comprehend nuances in total body presentations of psoriasis as a means to differentiate from seborrheic dermatitis.  Review when referral to dermatology for hair loss or skin changes of the face/scalp  is necessary. Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.   Disclosures Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Pasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more. Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Original episode written and produced by: Matthew Watto MD, FACP  Show Notes and CME questions by: Deb Gorth ScM Cover Art and Infographic by: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Molly Heublein (written materials); Matthew Watto MD (audio)  Guest: Joel Topf MD Sponsors   POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates!  In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship.  Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team.   Interview season is in full swing and they’re actively accepting applications.  Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information.  You can apply for fellowship using the eusfellowships.com portal.   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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps 00:00 Intro 03:30 Guest interview 07:15 Pick of the week w/Dr. Topf 16:20 Clinical case of hyponatremia 17:48 False hyponatremia normal osmolality 19:34 False hyponatremia high osmolality 20:36 Understanding why osmolality matters 23:28 Workup false hyponatremia 24:45 Recap of discussion so far 25:40 ADH dependent vs independent hyponatremia 27:00 Psychogenic polydipsia 289:15 Renal failure and hyponatremia 30:03 Tea and toast, and Beer Drinker’s potomania 35:22 ADH dependent hyponatremia 38:15 Volume versus osmolality 40:00 Volume status exam 45:14 Additional testing with urine lytes and uric acid 47:30 Treatment for SIADH  52:42 Discussion of the vaptans 58:21 Additional testing in SIADH 62:50 When to admit patient for hyponatremia 63:59 Clinical case of hyponatremia complications 68:56 Fluids and rate of correction 73:36 DDAVP clamp 76:30 Moderate hyponatremia 78:35 Diuretic dosing DOES matter! 81:59 Loop diuretics for SIADH 84:25 Take home points 87:25 Outro Links* Dr. Joel Topf’s Textbook Dr. Joel Topf’s Blog Dungeons and Dragons Tartine (cookbook) by Elizabeth M. Prueitt I Hate You, Don’t Leave Me by Hall Strauss Intentional Parenting by Sissy Goff Mindset by Carol Dweck Nintendo Switch 8.0 Bit Techno- The Curbsiders Theme Song by Stuart Kent Brigham Ure-Na  European Society of Endocrinology Clinical Practice Guidelines.  Don’t miss Dr. Topf on twitter aka @kidney_boy.   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.     Goal Listeners will recall the pathophysiology of hyponatremia and develop a systematized approach to identifying the type and cause of hyponatremia, as well as how to safely manage hyponatremia.    Learning objectives After listening to this episode listeners will…   Differentiate true and false hyponatremia Recall the pathophysiology of true and false hyponatremia  Interpret blood and urine tests to identify the cause of hyponatremia Recall the limitations of the volume status exam List ADH dependent causes of hyponatremia List ADH independent causes of hyponatremia  Explain the pathophysiology of beer drinker’s potomania and “tea and toast” hyponatremia Use uric acid to differentiate SIADH from other causes of hyponatremia Basic therapy for SIADH Recall safe rates of correction for hyponatremia   Disclosures Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures.    Citation Topf J, Gorth DJ, Williams PN, Brigham SK, Heublein M, Jyang E, Watto MF. “REBOOT #48 Hyponatremia Deconstructed”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date: July 17, 2017; Updated September 7, 2020.

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot!    NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively.   Credits Written and Produced by: Shannon Snellgrove Infographic: Shannon Snellgrove Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders) Hosts: Justin Berk MD and Christopher Chiu MD Editor:Justin Berk MD; Clair Morgan of nodderly.com Guest(s): Hussein Abdullatif MD   *Sponsors*   POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates!  In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship.  Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team.   Interview season is in full swing and we’re actively accepting applications.  Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information.  You can apply for fellowship using the eusfellowships.com portal.     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 Diagnosis of T1DM 6:50 Presentation of T1DM 10:10 Explaining T1DM to a parent 12:00 Genetic Predisposition to Diabetes 15:20 T1DM Antibodies 17:10 Initial work-up for concomitant autoimmune disease 21:10 Atypical Presentation of T1DM 22:44 Treatment of T1DM 29:10 Dietary Modifications in T1DM 33:10 Checking blood sugars 39:50 Honeymoon Period 42:25 Hypoglycemia 44:00 Sports, Sickness, Alcohol and Glucose levels 48:25 Periop glucose management 51:10 Long-term complications of T1DM 53:50 Closed Loop System and Future Treatments 56:10   Goal Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes.   Learning objectives After listening to this episode listeners will…   Identify the signs and symptoms of type 1 diabetes  Practice appropriate work-up in the diagnosis of type 1 diabetes Manage type 1 diabetes with evidence-based therapies Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes)   Disclosures Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures.    Citation Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (link goes live on 9/2/2020)

Are U Talkin’ UTIs Re: Me? Infectious Diseases expert, Dr Boghuma Titanji MD, PhD  @boghuma (Emory; TED) schools us on the diagnosis and management of urinary tract infections: updated definitions of complicated and uncomplicated UTI, pitfalls of the urinalysis, first line antibiotics, duration of therapy and which agents to use for complicated UTI. This episode is liquid gold!  Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written and Produced by: Matthew Watto MD, FACP  Cover Art and Infographic by: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Boghuma Kabisen Titanji MD, PhD Sponsor - 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 Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio 02:50 Guest one-liner, Picks of the Week*: Urban gardening, Behave (book) by Robert Sapolsky 08:54 Defining UTI; Framework for UTI 16:35 Case 1 - Cath Foley; Acute uncomplicated cystitis; Interpreting the Urinalysis 28:00 Women with recurrent UTIs 38:55 Case 2 - UTI in a man 47:15 Treatment of complicated infections; Duration of therapy 52:27 Case 3 - Catheter associated UTI; MRSA UTI 61:25 Duration of therapy for bacteremia from UTI 64:40 Take home points, plugs and outro Sponsor - VCU Health Continuing Education   Links* Behave (book) by Robert Sapolsky Boghuma’s blog theiddoc.net Boghuma’s TED Talk  Emory’s ID fellowship program   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goals Listeners will appropriately recognize, diagnose and treat the various presentations of urinary tract infection.   Learning objectives After listening to this episode listeners will... Define UTI and feel confident making the diagnosis of UTI based on lab tests, history and exam findings Differentiate between complicated and uncomplicated UTI Recognize how UTI may presents differently in differ groups (paraplegic, chronic foley catheter, men and women) Choose the appropriate antibiotic and duration with an eye towards antibiotic stewardship Determine an approach to the patient with recurrent UTIs, including who may benefit from long term antibiotic prophylaxis.    Disclosures Dr Titanji reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Titanji BK, Williams PN, Watto MF. “#231 U Talkin’ UTIs Re: Me”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 24, 2020.

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea?  Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Deborah Gorth ScM Cover Art and Infographic by: Edison Jyang Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Michelle Kittleson MD, PhD Sponsor - 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. Time Stamps 00:00 Intro 02:40 Guest one-liner; Picks of the Week 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic) 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction? 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?! 28:36 Labs to trend during an ADHF admission 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2? 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB) 56:05 Who needs a right heart cath? 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care 64:04 SGLT2i in heart failure 68:15 Take home points and outro

Join us for an extra-hot summer episode featuring our critical appraisal expert, Rahul Ganatra MD, MPH @rbganatra. Prepare to marvel as he breaks down his recent tweetorial on the RECOVERY trial of dexamethasone for COVID-19; to gasp as Paul Williams updates us on statins and ASCVD prevention and to be enthralled by the dulcet tones of Matt Watto explaining the latest research on DAPT vs. monotherapy with ticagrelor. Bonus: a new hotcakes rating scale has arrived! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Sarah Phoebe Roberts Show Notes by: Sarah Phoebe Roberts Writer: Rahul Ganatra MD, Sarah Phoebe Roberts, Matthew Watto MD, Paul Williams MD Cover Art: Matthew Watto MD Hosts: Rahul Ganatra MD, Matthew Watto MD, Paul Williams MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: 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. Time Stamps 00:00 Intro 02:15 Picks of the Week 06:15 New Hotcakes rating scale 09:20 RECOVERY trial 17:30 Rapid home-testing for COVID 20:15 Statins and ASCVD prevention 32:30 Ticagrelor monotherapy after ACS 41:30 Outro Picks of the week Paul: U Talkin' Talking Heads 2 My Talking Head podcast Sarah: New hotcakes scale! Rahul: Chromeo’s new Quarantine Casanova album Watto: 30 Rock season 1, episode 3 “Blind Date”

Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Tima Karginov and Matthew Watto MD, FACP Infographic by: Tima Karginov Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Eve Bloomgarden MD Sponsors: Pediatrics On Call podcast by the American Academy of Pediatrics If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here. 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. Time Stamps 00:00 Intro 03:15 Guest one-liner, favorite failure, Picks of the Week* 08:50 Sponsor 10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs 14:20  Case from Kashlak, Symptoms of Hyperthyroidism 25:00 Grave’s eye disease: exam, therapy and counseling 32:35 Thyroid exam and ultrasound 38:55 Thyroid Stimulating Immunoglobulin 41:00 Biotin 44:30 Thyroid Scintigraphy 49:00 Causes of Thyrotoxicosis 52:00 Treatment & Adherence to antithyroid medication (methimazole) 56:20 Beta Blockers in thyrotoxicosis 64:50 Subclinical Hyperthyroidism 67:00 Take Home Points, Outro

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year! Credits Producers & Writers: Edward Corty, Nicholas Lee MD Infographic: Nicholas Lee MD Cover Art: Chris Chiu MD Hosts: Justin Berk MD, Chris Chiu MD, Edward Corty Editor:Justin Berk MD; Chris Chiu MD Guest(s): Joshua Sharfstein MD Sponsors: Pediatrics On Call Sponsor: VCU Health Continuing Education - to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org or cribsiders.vcuhealth.org Time Stamps Introduction 1:00 How to answer “What do you think about school openings?” 11:30 Risk Assessment of School Re-openings 14:40 Evidence of Transmission among Children 17:10 What Other Countries Have Done 19:40 Community Threshold for Re-Opening and Using Protocols 20:30 The Reasons to Cohort 22:45 How to Address Scenarios 24:20 Health Disparities and Return to School 27:00 Existing Inequities and Children’s Sacrifice of Education 29:00 “Opting Out” of School Return and Feeling Safe 31:30 How Can Governments Help Support the Return 35:50 Guidance to give as PCP 37:50 School Alternatives / Innovations to Going Back 40:10 The Difference Between Equity and Equality 42:50 Testing in Schools 43:45 Resources to Follow For More Information 46:00 Take-Away Points 47:10 Optimism 48:25 Picks of the Week 53:50

Swim through the sea of acronyms as Dr Scott Matherly (@liverprof) helps us become a little less baffled by the thought of NAFLD. We discuss the initial diagnosis of fatty liver disease, indications for additional evaluation with imaging and/or biopsy, and potential treatment options. With a quarter of the world affected, it’s crucial to understand the various forms of disease and how to counsel patients about this all-too-common condition! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Elena Gibson MD Infographic and Cover Art: Elena Gibson MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Scott Matherly MD Sponsor: Pediatrics On Call Sponsor:  VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 03:15 Guest one-liner; Picks of the Week*
: 08:15 Sponsor 08:50 Case from Kashlak part 1; What is hepatic steatosis? 11:43 NAFLD acronyms and definitions 18:20 Alcohol and Fatty Liver 23:15 Initial Evaluation of NAFLD 35:12 Dr Matherly’s piel to patients with fatty 41:11 NASH/Fibrosis Risk Assessment 48:54 Outcomes in NASH with Fibrosis 51:20 Statins are safe in liver disease 56:15 Treatment Options (surgery, Vitamin E, Pioglitazone, SLGT2 inhibitors and GLP1 agonists; Coffee?!) 71:42 Take home points and Outro

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.  Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written (including CME questions) and Produced by: Cyrus Askin, MD Infographic by: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Joel Topf, MD Sponsor: Pediatrics On Call  Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); 08:45 Sponsor 09:15 Definition of acute kidney injury (AKI) and fundamentals 11:00 Cardiorenal syndrome 12:24 Schema for AKI 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities 21:22 AKI in the otherwise-healthy patient; 32:20 Rhabdomyolysis
38:21 Vancomycin 41:43 Acute interstitial nephritis (AIN) 44:52 Contrast induced nephropathy (CIN) 50:37 Gadolinium in AKI and/or CKD 52:53 Timing of dialysis 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; 62:01 Is Ultrasound necessary in AKI 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology

Listen as our expert guests, Kelly Graham, MD, MPH (@KellyGrahamMD) and Lekshmi Santhosh, MD MAEd (@LekshmiMD), detail the professional and personal challenges faced by women in medicine during the COVID-19 pandemic. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Produced by: Leah Witt MD & Shreya Trivedi MD  Written by: Molly Heublein MD, Isabel Valdez PA-C, Leah Witt MD & Shreya Trivedi MD Infographic & Cover Art: Edison Jyang Hosts: Leah Witt MD & Shreya Trivedi MD, Justin Berk MD, MPH, MBA Editor: Molly Heublein MD and Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Kelly Graham, MD, MPH; Lekshmi Santhosh, MD MAEd    Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!   Episode Breakdown Intro, disclaimer Introduction and bio for Kelly Graham, MD, MPH Introduction and bio for Lekshmi Santhosh, MD MAEd One-liner for Kelly Graham, MD, MPH One-liner for Lekshmi Santhosh, MD MAEd Gender Awakening Moments Picks of the Week* Case from Kashlak Difficulty with lack of childcare while working Hippocratic Oath paradox Dr. Santhosh’s 3 Ps Motherhood penalty-fatherhood bonus Two Pandemics, One Response Breadwinner-homemaker bias Female physician burnout Minority Tax Silver Linings Take home points and Outro

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter.  In this episode we talk to addiction medicine expert, Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Topics include: the management of polysubstance withdrawal,  approaching acute pain management for a person with opioid use disorder, and inpatient harm reduction strategies. After this episode listeners will gain new tools to help them best care for hospitalized patients with substance use disorders. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Writers and Producers: Carolyn Chan MD, Deb Gorth, and Nora Taranto MD Cover Art and Infographics by: Carolyn Chan, MD Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Carolyn Chan MD Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Melissa Weimer Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps Intro, disclaimer, guest bio : 00:00 Guest one-liner:    03:00 Picks of the Week*:   08:20 Case from Kashlak:  10:30 Urine Toxicology Screens 11:30 Discussing Urine Toxicology Screens with Patients  13:20 Management of Polysubstance Withdrawal 16:16 Tapering Benzodiazepines   19:56 Acute Pain Management and Opioid Use Disorder 30:35 Active Drug Use in the Hospital 38:52 Harm Reduction 40:00 Discharges - Planned 43:43 Perioperative Buprenorphine and Methadone: 46:50 QT Prolongation and Methadone - 52:53 Outro 56:21

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas. Show notes: https:/www.thecribsiders.com/.   Credits Writer, Producer, Infographic, CME Questions: Clara Mao  Cover Art: Christopher Chiu MD Hosts: Justin Berk MD, Christopher Chiu MD, and Matthew Watto MD Editor: Justin Berk MD; Clair Morgan of nodderly.com Guest: Whittney Warren DO    Time Stamps Intro / Disclaimer 0:00 Guest bio 2:25 Guest one-liner, picks of the week 3:15 Explaining CF to patients, life expectancy  7:00 Types of CF mutations and phenotypes 11:50 Presentation of CF in older patients 15:20 Screening and diagnosis 16:40 PFTs and airway clearance 25:20 Nutrition and the “CF diet” 29:10 CF exacerbations and antibiotic selection 32:25 Extrapulmonary manifestations 39:35 Transition of care for CF adolescents (alcohol, exercise, sex) 43:50 CFTR modulator therapy 51:35 Lung transplantation 54:45   Goal Listeners will develop a systematic approach towards long-term management and acute exacerbations of cystic fibrosis.   Learning objectives After listening to this episode listeners will…   Explain the pathophysiology underlying cystic fibrosis. Identify maintenance therapies that optimize pulmonary function and nutritional status in patients with cystic fibrosis. Choose evidence-based practices in the management of cystic fibrosis-associated pulmonary exacerbations.

This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening.  Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Rahul Ganatra MD, MPHl Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD Show Notes and CME questions by: Deborah J. Gorth ScM Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD, MPH Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro, disclaimer, guest bio 02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Netflix; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page! 07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19 26:10 Dexamethasone for COVID-19 28:55 Hormonal therapy for depression 38:16 Probiotics 45:00 Outro

Listen as our esteemed guest Dr. Utibe Essien @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD Cover Art: Hannah Abrams MD Infographic: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro, disclaimer, guest bio 02:40 Guest one-liner, Picks of the Week*: Just Mercy 09:20 Statement from the show; Importance of discussing racism in medicine 14:11 Definitions 18:06 Identifying how racism manifests in the clinical setting 37:46 Ideas for advocacy 49:50 Take points and Outro

Throw out your down pillows and join The Curbsiders for this lively discussion on interstitial lung disease. While the hundreds of interstitial lung disease types make this topic a bit overwhelming, breathe easy knowing that pulmonologist, Dr. Erin Narewski @erinnarewski (Temple), can boil things down to an easy to approach framework in less time than it takes to complete a few 6-minute walk tests. In this episode, we walk through the classification, relevant patient history, workup, and management of interstitial lung disease. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Paul Williams, MD, FACP; Nicole Kus, David Madnick, and Peter Wikoff Infographic and Cover Art: Edison Jyang Show Notes: Deborah Gorth Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Paul Williams MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Erin Narewski DO, FCCP Sponsor: ACP membership acponline.org/member Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 0:00  Intro 03:14 Guest one-liner, career advice, favorite failure, Picks of the Week*: The Strain, FX Horror TV Show; One Hundred Years of Solitude (book) by Gabriel Garcia Marquez; Hypoallergenic pillows; Peanut butter whiskey 10:02 Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT 11:00 Case from Kashlak, Definitions 16:40 Buckets of ILD 32:06 Discussion of testing ILD: Labs and Imaging 44:20 Imaging findings in ILD 49:44 Basic Management of ILD 61:00 Take home points and Outro

We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Emi Okamoto MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Karen DeSalvo MD, MPH, MSc Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account! Time Stamps Intro, disclaimer, guest bio 0:44 Dr Desalvo’s one-liner 3:34 Picks of the Week*- The Great Influenza book by John M Barry  5:01 Dr Desalvo’s advice and past experience 6:10 Case from Kashlak 10:30 What about the evidence for social determinants? 13:40 What to do about this in the clinic, and is it worth screening? 16:06 Approaching as a team and with the community 19:40 How do we affect the upstream, before the downstream consequences? 22:40 NAM recommendations and framework 26:00 The role of technology 30:00 What are Social Determinants of Health (SDOH), and who they affect 34:00 Start paying attention to SDOH 37:00 Outro 38:49

Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written: Hannah Abrams MD, Avital O’Glasser MD Produced by, Infographic and Cover Art by: Hannah Abrams MD Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com Guest: Avital O’Glasser MD Sponsor: ACP - acponline.org/member Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students 09:28 Sponsor 10:17 Kashlak case; How to collaborate with our surgical colleagues 13:45 Questions to ask at the time of transfer 23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea 44:25 Co-managing Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis 57:55 Outro

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.”  We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment,  modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer/Writer/Graphics: Beth Garbitelli Co-Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Megan Gerber MD, MPH, FACP Sponsor: ACP - Visit acponline.org/member Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps Intro, disclaimer, guest bio (0:00 - 3:15) Guest one-liner (3:30) Kashlak Cases (13:45) Epidemiology of trauma (15:18) Trauma and #MeToo (18:10) Defining Trauma-Informed Care (TIC) (19:00) Integrating TIC into primary care (22:48) Screening in TIC (25:00) Containment and retraumatization (29:00) Inquiring about trauma (30:45) Recap and Office Visit Mechanics (35:30) Building the Relationship (38:00) Common Inquiry Mishaps (38:52) TIC Physical Exam (40:20) Resources for Patients (44:30) Office Environment (48:00) Provider Burnout (50:00) TIC in Covid-19 (52:30) Take-home Points (56:20)

Introducing our friends, The Curious Clinicians: Why do human bodies work how they do? Why do medications work, or not work? Do you miss digging into the “why” behind what we do every day? Join Hannah Abrams (@hannarabrams), Tony (@tony_breu), and Avi (@AvrahamCooperMD) in the Curious Clinicians podcast as they delve into these questions & more, starting with episode 1: Why does fingernail clubbing happen in so many different diseases? https://curiousclinicians.com/ Check out their website and subscribe on your favorite podcast player.

Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums  about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross!   Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!     Credits Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD, Rahul Ganatra MD MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com   Sponsors: ACP and VCU Health CE   Time Stamps 00:00 Sponsors 00:30 Intro, disclaimer 02:40 Fomites, groceries and killer rats 08:22 Sponsor 09:22 ACTT-1 trial of remdesivir 18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon 33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests? 44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics 50:30 Outro

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!).  Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by Nora Taranto MD Infographics by Nora Taranto MD Cover Art by Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com Guest: Stefan Kertesz MD Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 3:17 Guest one-liner 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/ 10:07 Case from Kashlak 10:56 Language: How to ask where a patient lives? 13:25 Terminology: Persons Experiencing Homelessness: 14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors 20:44 How to start the visit, and how to establish trust early on? 27:40 Why is the mortality rate higher? 35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C 54:15 COVID and homeless healthcare 57:00 Care Models 62:30 Take Home Points and Outro

Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Justin Berk, MD MPH MBA Infographic and Cover Art: Beth Garbitelli Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Douglas Paauw, MD Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories! 06:15 Medical Myth Definitions 10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol 19:09 Expired Medications; Military Stockpiling Study 24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap 31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%) 41:07 Epinephrine in extremity; RCT of Epi in Extremities Study showing Experts use it; Podiatry journal 48:39 Take home points and Outro

Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD Cover Art: Beth Garbitelli Hosts: Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD , Sarah P. Roberts MPH, Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE Time Stamps 00:00 Intro 02:10 Fun animal facts: Llama antibodies 09:10 Remdesivir RCT by Wang et al 12:40 Power and Sample Size 16:32 Baseline Characteristics, Results and Author’s conclusions 19:15 Rahul’s conclusions: How chance and bias affected the results 24:00 Right censoring; Viral load and timing of antivirals 30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial 33:53 Are patients really having fewer strokes and heart attacks? 38:20 Awake proning 43:30 Paul teaches us not to use the term “happy hypoxemic” 45:00 CIDRAP viewpoint on future waves and exit strategies 50:22 Outro

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Nina Mingioni MD, FACP Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio and a bad pun 03:00 Guest one-liner 07:10 Case from Kashlak, Defining fatigue; Taking a general history 11:36 Most common causes of fatigue and how to elicit them from the history 20:39 Physical exam for fatigue; Medications that cause fatigue; 25:25 Exam findings and LRs for anemia; Sleep apnea 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme 47:55 Spiel to the patient when no answer is found 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis 55:09 Take home points and Outro

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal!  Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!). Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME Credits Written and Produced by Nora Taranto MD Infographic and Cover Art by: Nora Taranto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Joji Suzuki MD Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film) 08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk 17:32 Outpatient Versus Inpatient Treatment 25:27 Gabapentin for alcohol withdrawal 27:10 Indicators for ICU level Care 31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs 36:55 And which benzo? 39:47 A Natural History of Withdrawal 44:10 Banana Bags and Thiamine Deficiency 48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing 56:36 Outro and Bonus clip

In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD Writer: Emi Okamoto MD, Rahul Ganatra MD MPH, Cover Art: Chris Chiu MD Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsors: Apollohct.com and VCU Health CE Time Stamps 00:30 Intro, disclaimer 02:30 Picks of the Week 6:36 Remdesivir trial rundown 21:52 Thrombosis in COVID-19 29:50 Asymptomatic/Presymptomatic transmission 41:42 Quick takes 49:00 Outro

It’s NephMadness! Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from the Freely Filtered Podcast led by Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist. Topics: indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME Credits Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew Infographic: Cyrus Askin MD Cover Art: Kate Grant MBChB DipGUMed Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE Time Stamps 00:00 Announcement, Intro to Freely Filtered and NephMadness 04:00 Case of advanced CKD; Who/when to refer for transplant 12:05 Benefits of renal transplant 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors 20:40 Medications after transplant; Drug-drug interactions 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness 32:07 Calcineurin inhibitor levels 36:42 Prophylaxis for long term complications 40:21 Allograft rejection; BAMF criteria 50:40 Cardiovascular risk; Statins 56:11 Malignancy after kidney transplant 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy 72:23 Outro

LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media.  Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Infographic: Michelle Brooks MD Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Clair Morgan of nodderly.com Guest: Michelle Brooks MD Sponsor: VCU Health CE Time Stamps 00:00 Guest one liner, favorite failure, career advice, 08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series) 11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles 23:04 Negative aspects of social media 26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer 37:14 Pros and Cons of #medtwitter 42:02 Tweetorials 44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media 51:34 Outro

Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Elena Gibson MD Cover art and Infographic by: Dr Kate Grant MBChb MRCGP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com Guest: Susan Mandel MD, MPH Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice 09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms 13:20 When to Test for Hypothyroidism 17:43 Biotin interaction 19:49 Which thyroid tests should we order? 26:15 Subclinical hypothyroidism 29:00 Etiology/Types of hypothyroidism 33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam 37:10 Levothyroxine replacement time of administration 42:10 TSH goal 46:00 Levothyroxine manufacturers 48:33 Dosing in older adults 50:27 T3 treatment 56:52 Pregnancy 59:42 Dose adjustments 61:43 Estrogen and thyroid binding protein 63:33 Who needs a referral? 65:40 Plugs, Outro

Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com   Credits Written and produced by: Matthew Watto MD Cover art and Infographic by Matthew Watto MD Hosts: Matthew Watto MD and Paul Williams MD Editor: Clair Morgan of Nodderly.com   Time Stamps 00:00 Announcement, Intro, Disclaimer 02:53 Our top podcasting pearls 07:01 Find your niche 09:46 Logistics 13:25 Business, finances and legal matters 14:40 Equipment 21:48 Recording and editing 24:56 Website, web and media hosting 28:53 How to setup and record your podcast 35:08 Editing software 35:58 Search engine optimization 37:45 Post-processing 39:49 Take home points and outro  

Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management  in these challenging times. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD Show Notes: Cyrus Askin MD Infographic: Elena Gibson, MD Cover Art: Dr. Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: COL Kevin Chung, MD, FACP Sponsors: McGraw Hill Time Stamps 00:00 Intro 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice 07:40 Sponsor 08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs 16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation 23:40 Proning patients for hypoxemia 29:15 ARDS basics: diagnostic criteria, Brief Recap 33:22 Mechanical ventilation: Initial settings, following the blood gas 40:55 Peak and plateau pressure, Lung compliance and  Troubleshooting a high pressures 51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs 62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19 68:10 Take home points; Plugs; Outro

Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston). Plus, @Paulnwilliamz and @cjchiu give us  some telehealth along with the usual antics. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written, Produced, Hosted by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art and Show Notes by: Matthew Watto MD, FACP Editor: Matthew Watto MD Guest: Rahul Ganatra MD Time Stamps 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site 11:50 Telehealth best practices 16:42 Convalescent plasma and Serology 21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report) 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality 25:30 Critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial 49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)

Get under the hood of SGLT2 inhibitors! Listen as our guests Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf give us a tour through the NephMadness 2020 SGLT2i region! How do these promising drugs work, and what evidence is there for using them in non-diabetic kidney disease or kidney transplant patients. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) Guests: Harish Seethapathy MD; Matthew Sparks MD; Joel Topf MD Sponsor: McGraw Hill Time Stamps 00:00 Sponsor 00:26 Intro, disclaimer, guest bio 02:57 Guest one-liner and Picks of the Week*: Michael Pollan audiobook on Coffee and Caffeine Addiction 03:52 SGLT2i definition, background, and why we now consider CV endpoints in diabetes 11:16 Sponsor 12:00 Tubuloglomerular feedback; Balloon analogy 17:40 Other mechanisms for SGLT2i 23:05 Back to the case; Risks from SGLT2i; Counseling and Monitoring 34:18 SGLT2i for non-diabetic kidney disease; Possible mechanisms: Joel’s caution against early adoption 41:42 SGLT2 inhibitors in kidney transplant 45:20 Take home points and picks for the SGLT2 inhibitor region 49:50 Outro

Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Paul Williams MD, FACP Cover art and Show notes by: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Kat Zechar MD and Amreet Sidhu MD Time Stamps 00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020. 01:22 Intro, disclaimer and guest bios 03:38 Guest one-liners, Picks of the week 09:30 Why you might need an online meded curriculum 16:33 Overview of Amreet and Kat’s online curriculum 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org) 46:35 Time commitment 50:55 Take home points and Outro

LIVE! from Mayo Clinic, a practical approach to lymphadenopathy with Carrie Thompson MD @cathompsonmd (Hematology Oncology, Mayo Clinic). Dr. Thompson provides her simplified approach to the history, differential diagnosis, high yield lab testing, imaging, how to counsel patients with adenopathy and tips on when, where and how to biopsy! The Curbsiders are insanely grateful to the Mayo Clinic  Internal Medicine Residency Chief Residents @mayomn_imres (@JasonEckmannMD @SamiRyanMD @BHuffmanMD @CourtHarrisMD) and their amazing program director @AmyOxentenkoMD for an amazing trip to Rochester! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Carrie Thompson MD and Matthew Watto MD, FACP Infographic: Matthew Watto MD, FACP Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Carrie Thompson MD Time Stamps 00:00 Announcement: We’re looking for Medical Student members. Send applications to thecurbsiders@gmail.com by April 10, 2020. 01:20 Intro, guest bio, one-liner, career advice; Pick of the week*: In Shock by Rana Awdish 07: 00 Lymphatic system 09:19 Differential diagnosis for lymphadenopathy 11:38 Taking a history (ALL AGES mnemonic), Red Flags 19:15 Physical exam for lymphadenopathy 22:30 Which labs to order; Flow cytometry 26:05 Imaging 28:30 Counseling patients with LAD 31:10 Biopsy: How to choose type and location 37:35 Take Home Points 39:00 Audience Questions 42:25 Outro

Listen as the pioneers of the COVID pandemic share their experiences taking care of some of the first COVID patients in the US. Our guests have a broad range of expertise and experiences. This episode features hospitalist Dr. Francisco Alvarez (University of California at San Francisco, @fnalvarez), Infectious Disease fellow Dr. Karolina Maciag (University of Washington, @KMaciag), Critical Care and Pulmonology Fellow Dr. David Furfaro (Columbia University, @david_furfaro ) and intensivist and founder of onepagericu.com, Dr. Nick Mark (Seattle, WA). Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced: Justin Berk MD MPH MBA Cover Art: Kate Grant MBChB DipGUMed Hosts: Justin Berk MD MPH MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Francisco Alvarez, Dr. Karolina Maciag, Dr. Dave Furfaro, Dr. Nick Mark Sponsors: Cayuga Time Stamps 00:00 Intro 04:28 Francisco: Process leading up to first case 07:42 Karolina: The perspective of the consultant- calm in the storm 11:40 (Karolina) Seattle Flu Study as early warning 16:00 Dave: ICU patients 20:30 Nick: making decisions with a moving target 25:05 Sponsor 25:53 Francisco: data available on Twitter 28:00 Francisco: the role of generalist during the COVID pandemic 31:15 Karolina: on vulnerable populations during pandemic 38:26 Dave/Nick: how generalists should be preparing themselves 45:16 Avoiding aerosolized procedures / nebulizers 47:46 What was the big surprises 54:20 How do you address the anxiety 60:12 Plugs 64:20 Outro

Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP Cover Art and Infographic by: Beth Garbitelli Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Paul Sax MD Sponsor: Cayuga Time Stamps 00:00 Intro 04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza 07:00 Rahul highlights areas of caution interpreting COVID cases studies 12:35 Sponsor 13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms 18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity 21:15 Who merits testing for COVID-19 23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine 25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital 30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible? 32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine 36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces? 40:20 Do exposed HCWs without symptoms require quarantine? 41:30 Personal Protective equipment (PPE) 45:00 COVID-19 in pregnancy 47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.) 50:45 Where should you get your COVID-19 information? 52:30 Closing remarks and outro

NephMadness 2020 is here! Listen as Dr. Ryann Sohaney (@ryannsohaney), Dr. Deborah Clegg and Dr. Joel Topf (@kidney_boy) discuss this year’s first Nephmadness topic, Hyperkalemia in CKD. They will (1) review the use of potassium binders for management of hyperkalemia in CKD (2) identify the potential health benefits of dietary potassium and challenge the use of low-potassium diets in CKD, and (3) describe how exercise influences serum potassium and consider exercise recommendations in CKD. Check out the regions and fill out your brackets for NephMadness 2020 here! Sign-up as a part of The Curbsiders team! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Elena Gibson MD  Infographic: Caitlyn Vlasschaert MD  Cover Art: Elena Gibson MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan Nodderly.com (audio) Guest: Ryann Sohaney, MD; Deborah Clegg, PhD; Joel Topf, MD  Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders. Time Stamps 00:00

Polycystic ovary syndrome (PCOS) is more common than we think!  Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Molly Heublein, MD Cover Art and Infographic: Kate Grant MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Molly Heublein, MD Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Katherine Sherif, MD Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders.   Primary Care Physician Opportunity in beautiful Ithaca, NY! Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/.  Time Stamps 00:00 Sponsors - AccessMedicine.com (McGraw-Hill)

Join us as we demystify the world of pulmonary nodules & lung cancer screening. During this episode, Dr. Denitza Blagev (@mybetterdoctor) makes her triumphant return to The Curbsiders to help us tackle this topic. She is currently the Medical Director for Quality/Specialty-Based Care at Intermountain Healthcare and a Pulmonary & Critical Care physician. We learn to take command of the recommendations for lung cancer screening, disambiguate the terms used by pulmonologists and radiologists, and appreciate some of the nuances of lung cancer screening all with the hope of making YOU a better primary care physician! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by:  Cyrus Askin MD & Leah Witt, MD Infographic: Leah Witt, MD Cover Art: Dr. Kate Grant MBChB DipGUMed CME/MOC: Cyrus Askin, MD Hosts: Cyrus Askin MD; Leah Witt, Matthew Watto MD, FACP; Paul Williams MD, FACP    Editors: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Denitza Blagev, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 00:15 Intro, disclaimer, guest bio 02:15 Guest one-liner;

Develop your approach to refugee health in the primary care setting.  We discuss important considerations for primary care of the refugee patient with Dr. Tanuja Devaraj (Penn State), an internist with expertise in migration health.  We review barriers to primary care, how to take a migration history, and common health concerns that occur in this patient population.  We also discuss strategies for screening for trauma and mental health issues, which are common among patients who have gone through migration. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Producer: Paul Williams MD, FACP Writer: Tanuja Devaraj MD and Paul Williams MD, FACP Infographic: Emi Okamoto MD Cover Art: Paul Williams MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) Guest: Tanuja Devaraj MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders  00:15 Intro, disclaimer, guest bio 02:08 Guest one-liner, book recommendations, career advice 07:12 Picks of the Week*:

Discover common practices that persist in the hospital wards despite no proven benefit! We review how potassium replacement goals should not drive you bananas, extra oxygen should not give you comfort, and how you should maybe calm down with antipsychotics for delirium. Join returning guests: high-value care specialist Dr. Lenny Feldman (@DocLennyF, Johns Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 3 of “Things We Do for No ReasonTM. SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Burton H. Shen MD, Justin Berk, MD MPH MBA Infographic: Cover Art: Hosts: Justin Berk MD MPH MBA; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FaCP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Lenny Feldman MD, Tony Breu MD Sponsors The Society of Hospital Medicine Hospital Medicine 2020 (HM20) is the Society of Hospital Medicine’s Annual Conference April 15th through the 18th in sunny San Diego. Don’t miss the largest hospital medicine meeting. Register now at https://shmannualconference.org/ and use the code CURBSIDERS to receive a $50 discount. Primary Care Internal Medicine of Ithaca

Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder.  Your patients need you! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Carolyn Chan, MD Cover Art and Infographic: Carolyn Chan, MD Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Marlene Martin, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18

Join us as we discuss how to approach “The Struggling Learner” with Dr. Melissa McNeil (@missydoc0128), Professor Medicine and Associate Chief of General Internal Medicine at the University of Pittsburgh Medical Center (UPMC), recorded LIVE in Pittsburgh, PA!  In this episode, we discuss how to approach the struggling learner, highlighting the 5-Step process discussed in a recent article co-written by Dr. McNeil (Merriam 2019).  This episode is not intended to give educators a roadmap for how to develop and implement a corrective action plan, but was put together to provide a common toolset on how to approach a struggling learner.  As such, the topics discussed can be applied to all kinds of learners that struggle, not just in medicine. However, the techniques discussed involve a common framework routinely taught in medical education (assessment, diagnosis, and referral) and, therefore, is communicated using this shared language. Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Stuart Brigham MD Infographic: Matthew Watto MD, FACP Cover Art: Stuart Brigham MD Hosts:  Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham, MD Editor: Stuart Brigham MD (written materials); Clair Morgan at Nodderly.com Guest: Melissa McNeil MD, MACP Special thanks to Dr. William Kelly, FACP, FCCP Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Kidney Boy Returns! Compare the types of dialysis, learn how nephrologists approach medication management in ESRD, and avoid the most common mistakes non-nephrologists make in patients on dialysis! Kashlak Chief of Nephrology Dr. Joel Topf, @kidney_boy, walks us through what you need to know to take care of a patient on dialysis and gives us an idea of how nephrologists think through mineral bone disease (calcium, phosphorus and vitamin D), anemia, iron repletion, and hypertension. We answer all your questions about co-managing patients on dialysis! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Producer: Hannah R. Abrams Written and produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R. Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials), Clair Morgan of Nodderly.com (audio) Guest: Joel Topf MD Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Time Stamps 00:00 Sponsor -ACP’s Internal Medicine Meeting 2020 00:15 Intro, disclaimer, guest bio 01:45 Guest one-liner, Picks of the Week*: KidneyCon, CATS (film) 06:00 Sponsor -ACP’s Internal Medicine Meeting 2020 06:50 Case of Anne Yuric; Assessing risk of progression to dialysis; Candidacy for dialysis and renal

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”!  ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Rate our infographics! Tell us what you think in this brief survey. Credits Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli  Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA Infographic: Beth “Garbs” Garbitelli Cover Art: Kate Grant MBChB DipGUMed Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP    Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Erin Michos MD MHS Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Time Stamps 00:00:00 Intro 00:01:52 Getting to know Dr. Erin Michos 00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and

A Curbsiders classic with a fresh intro by Hannah Abrams @hannahRabrams (soon to be MD)! Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis. Get deeper into potassium physiology with a FREE pdf copy of Joel’s book The Fluid Electrolyte and Acid Base Companion here. Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Credits Written, edited and produced by: Matthew Watto MD, FACP Intro: Hannah R Abrams Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Infographic and Cover Art: Matthew Watto MD, FACP Guest: Joel Topf MD Time Stamps 00:00 Sponsor -ACP’s IM Meeting 2020 in LA 00:28 Disclaimer, intro and guest bio 03:00 Guest one-liner Picks of the week* —Peloton indoor bike;

Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic! Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that.  The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line.  N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at doctorpoorman@gmail.com, or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need. New episodes return January 20, 2020! Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Credits Written and produced by: Nora Taranto MD, Shreya Trivedi MD Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD Edited by: Matthew Watto MD  Guest: Elisabeth Po

Recap extravaganza 2019 featuring top pearls from our staff’s favorite episodes of 2019 and voicemails from Kashlak faculty, Dr. Avital O’Glasser (@aoglasser), Dr. Kimberly Manning (@gradydoctor), Dr. Renee Dversdal (@DrSonosRD) and The Curbsiders team. Topics include: HFpEF, the PARAGON-HF trial, Buprenorphine, Opioid Use Disorder, Cirrhosis, Coagulopathy, SBP, Hyperkalemia treatment, Multimorbidity, and how to think about NNT. Plus, the team shares a bunch of other favorite moments and random pearls! Upcoming shows: The next two weeks will feature REBOOT episodes with fresh intros from The Curbsiders team. Season 9 starts January 20, 2020 with a Lipid Update from Cardiologist Dr. Erin Michos (@ErinMichos) Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Produced by: Sarah Phoebe Roberts MPH and Chris Chiu MD, FACP, FAAP  Writer: Sarah Phoebe Roberts MPH Infographic: Sarah Phoebe Roberts MPH Cover Art: Kate Grant MBChB DipGUMed Hosts: Chris Chiu MD, FACP, FAAP; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Chris Chiu MD, FACP, FAAP (audio), Matthew Watto MD, FACP (show notes) Time Stamps 00:00 Intro and disclaimer 04:25 Picks of the year*: The Expanse (TV show) -Chiu Man’s pick;

Team up with the authors of the JAMA Medicine series on Medical Overuse, Dr. Dan Morgan @dr_dmorgan (University of Maryland) and Dr. Deborah Korenstein @DKorenstein (Memorial Sloan Kettering). We discuss procalcitonin (again!), the dangers of incidentalomas, risks of chest CT for lung cancer screening, the easiest place to get antibiotics for a viral infection, and why not to treat subclinical hypothyroidism despite guidelines. Trying to find ways to shed the fat off of some common medical practices? Look no further.  ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Justin Berk, MD MPH MBA Infographic: Justin Berk, MD MPH MBA Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Molly Heublein MD, Matthew Watto MD, FACP, Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest:  Daniel Morgan MD, Deborah Korenstein MD, FACP Time Stamps 00:00 Intro, disclaimer, guest bios 04:45 Guest one-liners Picks of the Week*: The Fifth Season is part of

Delve into the diagnosis and management of GERD and dyspepsia with Dr. Amy Oxentenko (@AmyOxentenkoMD), Gastroenterologist and the Internal Medicine Residency Program Director, Associate Chair for the Department of Internal Medicine, and Professor of Medicine at Mayo Clinic in Rochester, MN. Our discussion features a review of the standard presentations of GERD and dyspepsia, alarm symptoms and who needs referral for endoscopy or other specialized testing (pH, impedance testing, screening for Barrett’s esophagus). Additionally, we comprehensively cover proton pump inhibitor (PPI) therapy including: choice of agent, dose, frequency, how taper, how to counsel patients about risk, what labs should be monitored and the use of adjuvant therapies like H2 blockers, antacids and even carafate. After this episode, you will be flexing on reflux! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli CME Questions: Beth Garbitelli, Matthew Watto MD, FACP Infographic: Beth Garbitelli  Cover Art: Kate Grant MBChB DipGUMed Hosts:  Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan at Nodderly.com Guest: Amy Oxentenko MD Time Stamps 00:00 Intro, disclaimer, guest bio 02:47 Guest one-liner, Picks of the Week*: Reality TV Shows: Survivor  and

How to initiate buprenorphine like a pro. Treating people with Opioid Use Disorder can be the most rewarding part of your practice!  Get comfortable with counseling and pharmacotherapy for OUD with tips from Dr. Michael Fingerhood, Associate Professor of Medicine at Public Health at Johns Hopkins.  We review building a therapeutic relationship with people with substance use disorders, the differences between the three FDA-approved medications for opioid use disorder (buprenorphine, methadone and extended-release naltrexone), and the nitty-gritty of prescribing buprenorphine. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Justin Berk, MD MPH MBA, Joseph “Seffy” Muller MD Infographic: Hannah R Abrams and Justin Berk MD, MPH, MBA Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Justin Berk, MD MPH MBA Editor: Matt Watto MD, FACP (written materials), Clair Morgan at Nodderly.com (audio) Guest: Michael Fingerhood MD Time Stamps 00:00: Introduction 04:40: Guest introduction & questions (great stories about addiction) Picks of the Week*: Papillon (film) and Papillon (book) per Dr. Fingerhood;

Make some gains with Drs. Feigenbaum (@Jordan_theCoach) & Baraki (@AustinBaraki) of Barbell Medicine as we delve into the topic of sarcopenia! Together we’ll learn what exactly is sarcopenia, how it is diagnosed, and explore approaches to both management and counseling including: exercise prescriptions,  recommendations for protein intake, and even how to treat patients with multiple comorbidities. Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by:  Cyrus Askin MD Infographic: Cyrus Askin MD, Hannah Abrams Cover Art: Dr. Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editors: Matthew Watto MD, FACP; Clair Morgan of Nodderly.com Guests: Jordan Feigenbaum MD; Austin Baraki MD Check Out our friends at Barbell Medicine! Learn more about Barbell Medicine through their website at www.barbellmedicine.com or their YouTube channel - Barbell Medicine. They also have their own Podcast, The Barbell Medicine Podcast and can be found on Instagram: @barbell_medicine, Twitter via @BarbellMedicine. Drs. Feigenbaum and Baraki can

“Guidelines” galore! From Community-Acquired Pneumonia to asthma to...red meat? While you may be listening to this around Thanksgiving, we actually recorded on October 30th‒the best and spookiest time of the year. To really set the mood I wanted to include some terrible skeleton puns, but the ones I found weren’t humerus. What we do have for you are some tasty knowledge treats, courtesy of our ghosts‒oops, I mean our HOSTS‒Chris, Matt, Stuart and Paul. Join us as we review the most terrifyingly relevant research findings and creepiest clinical pearls! Today also marks the debut of our newest Hotcakes team member, the frighteningly talented Dr. Rahul Ganatra. Rahul will now be our resident statistician/study design expert, and will use his research skulls‒no wait, SKILLS‒to provide even more insight into the practice-changing findings we love to highlight for you.   ACP members can claim CME-MOC at CME credit https://www.acponline.org/curbsiders. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits  Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD Statistics Expert: Rahul Ganatra MD Editors: Christopher Chiu MD (audio/text), Emi Okamoto MD (text) Cover-Art: Sarah Phoebe Roberts MPH Music: Stuart Brigham MD Time stamps 00:00 Introduction/Disclaimer 03:18 Getting to know Dr. Rahul Gantra 05:35 Community-Acquired Pneumonia Guidelines 15:13 Sarah explains Hotcakes ratings 16:45 A new Asthma Strategy 17:26 Chris forgets what LABA stands for 27:37 Stuart makes a joke 29:00 A lot of meat talk 37:22 Rahul’s Napkin Calculations 51:40 Honorable Mentions 52:42 Take-away Points & Outtro Meet Rahul: Rahul Ganatra is a Medical Attending and Director of Continuing Medical Education for the Medical Service at the VA Boston Healthcare System.  He fell in love with clinical epidemiology and public health while taking night classes for his MPH during medical school. and we

Score some great insights and clinical pearls from Dr. Christine Won on the incredibly important topic of sleep medicine during this live recording at CHEST! On this episode we’ll tackle why we sleep, how to treat insomnia, the “Z-drugs” and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Cyrus Askin MD, Matthew Watto MD, FACP  Infographic: Matthew Watto MD, FACP Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP; Emi Okamoto MD Guest: Christine Won, MD MSc Sponsor The American College of Chest Physicians Time Stamps 00:00 Intro, disclaimer, guest bio 06:10 Guest one-liner 10:15 Picks of the Week*: Become Your Child’s Sleep Coach (book) by Lynelle Schneeberg; Sleep in Art: How artists portrayed sleep and dreams in the last 7000 years (book) by Meir Kryger; The Toxic Avenger (film);

We want to live longer… and healthier too! Dr Peter Attia, a physician focusing on the applied science of longevity, walks us through lifespan and healthspan, exploring tactics aimed at extending both. Listeners will challenge the conventional approach to primary care and explore tactics to optimize exercise, nutrition, and health, including counseling on different dietary patterns, fasting, exercise, emotional well-being and how to prepare for the Centenarian Olympics! Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Matthew Watto MD, FACP and Elena Gibson MD  Cover Art and Infographic: Elena Gibson MD Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto MD Audio Editor: Clair Morgan of Nodderly Guest: Peter Attia MD    Time Stamps 00:00 Intro, disclaimer, guest bio 04:22 Guest one-liner, Career Advice, Picks of the Week* 14:30 Case: A couple seeking maximize longevity; Defining longevity, healthspan, lifespan and the 4 types of death 19:30 Lifespan, the longevity curve and the long tail 23:50 Peter’s approach to shepherding patients toward longevity; Exploring motivations 32:06 Back to our couple: What exercises should they perform 42:09 Peter’s advice on nutrition; the standard American diet; Intermittent fasting; Dietary Restriction 51:20 Periodic fasting and water only fasting 54:33 Genetics and longevity 56:40 Metformin;

This podcast covers several concrete steps that residents can do or program directors can suggest to help residents transition to assuming the role of PGY3. A year is a long time, but requires a strategic approach to ensure that residents get the most out of it. It’s our latest offering from ACP’s IMpower series for residents featuring our friends from Walter Reed IM Residency: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray).   If you are a PGY3 you should: LEAD like someone’s life depends on it! Credits Written and Produced by: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD Infographics: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP Guests:  Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray)   Sponsor - ACP IMpower: Catalyzing your professional future Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future. Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower. Time Stamps 00:00 Sponsor, disclaimers, intro, guest bios 05:10 Guest one-liners 07:43 Precocious Passion for teaching 09:30 Picks of the Week*: High Life (film);

Learn how to approach the geriatric patient with multimorbidity and how to parse through and prioritize a mile-long problem list with Dr Josh Uy, master geriatrician at the University of Pennsylvania. We review different approaches to a clinic visit with a patient who takes fifteen daily medications with just as many chief complaints, all in a thirty minute (or less!) appointment time. We discuss what the term “multimorbidity” even means, how to ask about patient preferences and use them to inform the treatment plan, and what the evidence has to say about adjusting treatment goals of common conditions for individual patients. (Spoiler alert: It all depends on the patient, comorbid conditions and goals!)  Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Producer: Nora Taranto MD  Writer:  Nora Taranto MD, Leah Witt MD  Infographic:  Leah Witt MD  Cover Art: Nora Taranto MD  Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Leah Witt MD, Paul Williams MD, FACP Editor: Matthew Watto MD, FACP; Clair Morgan Guest: Josh Uy MD Time Stamps 00:00 Pun, Intro, disclaimer, guest bio 04:30 Guest one-liner; Career advice;  Picks of the Week*: Unbroken (book), Down Dog Yoga (app); Check out Dimash’s music on YouTube; Off Your Rocker (TV show); Finishing Well to the Glory of God (book) 12:30

CHEST 2019 Recap Part 2 featuring random pearls and highlights from #CHEST2019 in New Orleans including: tips for addressing futile end-of-life care, bleeding in the ICU, DOAC reversal agents, use of procalcitonin and monocyte distribution width to identify sepsis, vitamin C for sepsis treatment, small particles and lung cancer risk, augmented reality/virtual learning, and tech as a teaching tool. Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality.  Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced, and co-hosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP Edited by: Matthew Watto MD, FACP Special Guests: Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Chidinma Chima-Melton MD, FCCP (@LABritishLady), Kim Fabyan MD (@kfabsMD) Time Stamps 00:00 Pun, Disclaimer, Intro 03:58 Dr Erin Narewski on end of life conversations 13:30 Bleeding in the ICU 15:40 DOACs and reversal agents 18:40 Dr Chidinma Chima-Melton on ICU visiting hours 22:50 Vitamin C use in the ICU, Stuart’s Vitamin C rant 29:22 Monocyte distribution width for identifying patients with sepsis 30:55 Sarah Phoebe Roberts on Procalcitonin and CRP for sepsis 39:36 Dr Nina on technolo

Recap of random pearls and highlights from #CHEST2019 including: A pop quiz on inhaler use, interstitial lung disease, pulmonary fibrosis (IPF), limitations of supplemental oxygen, lung cancer screening, imposter syndrome, and is it safe to use beta blockers in COPD.  Special thanks to Dr. Bill Kelly and his team at CHEST (@accpchest) for their hospitality.  Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced, and cohosted by: Sarah Phoebe Roberts MPH; Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP Edited by: Matthew Watto MD, FACP Special Guests: Leah Witt MD (@leahJwitt); Nina Maouelainin DO, MBA (@lungsolutions); Erin Narewski DO, FCCP (@erinnarewski); Hassan Bencheqroun MD, FCCP (@drBcalifornia); Chidinma Chima-Melton MD, FCCP (@LABritishLady) Time Stamps 00:00 Intro, disclaimer 05:20 Dr Leah Witt @leahwitt (UCSF) quizzes us on inhalers. 09:55 Dr Leah Witt on ILD in geriatric patients 13:09 Dr Erin Narewski @erinnarewski (Temple) on supplement oxygen.  15:07 Dr Erin Narewski discusses the brand new BLOCK trial. 18:11 Dr Chidinma Chima-Melton

Catch up on the latest guidelines and insights on tuberculosis with help from Dr. Laila Woc-Colburn, @docwoc71 (Baylor)! We cover new recommendations for screening health care workers, treatment of both latent and active TB, and best practices for counseling patients throughout the process. Listen to find out more… And say goodbye to the annual PPD? ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Full notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R. Abrams; Matthew Watto MD, FACP Editors: Matthew Watto MD, FACP; Emi Okamoto MD Guest: Laila Woc-Colburn, MD, FACP Partners   Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019! What makes you proud to practice internal medicine or one of the I.M. subspecialties?  What recent patient experience made you proud to be an internist or subspecialist? How is internal medicine unique from other subspecialties? See us at the CHEST 2019 Annual Meeting in New Orleans! We’ll be doing two live interviews on stage, plus recording two rec

ACR osteoarthritis guidelines author, Dr. Tuhina Neogi (Boston University; @tuhinaneogi) schools us on all things OA, including new understandings of pathophysiology, diagnosis, when to order imaging and labs, and an overview of pharmacologic and nonpharmacologic therapies. Plus, get answers to your questions from Twitter on CBD, turmeric, glucosamine, chondroitin, NSAIDS, intra-articular steroid and hyaluronic acid injections, tai chi, and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written (including CME questions) and Produced by: Beth Garbitelli and Matthew Watto MD, FACP Cover Art and Infographic by: Beth Garbitelli Hosts: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP Guest: Tuhina Neogi MD, PhD Partners Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting www.acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019! What makes you proud to practice internal medicine or one of the I.M. subspecialties?  What recent patient experience made you proud to be an internist or subspecialist? How is internal medicine unique from other subspecialties? See us at the CHEST 2019 Annual Meeting in New Orleans!

Dominate the most common in-flight emergencies with tools and tips from this classic Curbsiders episode. Our guest, Angelica Zen MD, (formerly an IM Chief Resident at UCLA), recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane. Original air date November 21, 2016. Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced and edited by: Matthew Watto MD, FACP Cover Art by: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Matthew Watto MD, FACP Guest: Angelica Zen MD Partners Win a prize! Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019! What makes you proud to practice internal medicine or one of the I.M. subspecialties?  What recent patient experience made you proud to be an internist or subspecialist? How is internal medicine unique from other subspecialties? See us at the CHEST 2019 Annual Meeting in New Orleans! We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!! Time Stamps 0

Tools, tips and tactics to survive intern year from Alex Glaser MD (PENN) and Saumil Chudgar MD @saumilchudgar (Duke). It’s our latest offering from ACP’s IMpower series for residents!  The transition from medical student to intern is one of the world’s most notorious times in a career, and tales of woe from intern year have even permeated into TV shows and movies.  Ultimately, while the transition seems daunting with multiple challenges, it should not be feared. Many physicians look back fondly on this early time in their training, and life-long friendships often develop among an intern class.  This is a time of major growth, and unease about intern year should be met with excitement for the career that is yet to come! For meeting notes, a discussion guide and facilitators guide visit https://www.acponline.org/impower. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.   Credits Written and Produced by: Alex Glaser MD  Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD; Matthew Watto MD, FACP Guests: Alex Glaser MD, Saumil Chudgar MD   Sponsor - ACP IMpower: Catalyzing your professional future Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future. Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.

We dive deep into the relationship between HPV and cervical cancer and identify when and how to screen women with tips from Dr. Karen Smith-McCune (UCSF), Professor in the Department of Obstetrics and Gynecology! We review common cytology findings, screening guidelines, and basic indications for HPV vaccination.  Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on  iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Producer: Molly Heublein MD Writer: Elena Gibson MD and Molly Heublein MD Infographic: Beth Garbitelli MS2 Cover Art: Kate Grant MBChB DipGUMed Hosts: Molly Heublein MD; Matthew Watto MD, FACP Editor: Emi Okamoto MD; Matthew Watto MD, FACP Guest: Karen K. Smith-McCune MD, PhD   Sponsors Win a prize! Help ACP Celebrate National Internal Medicine Day and tell us why you’re I.M. Proud. Tell us why you are I.M. Proud and enter the contest by visiting acponline.org/improud to submit your story today! Answer one of the three questions below and share your story on social media using the hashtags #IMProud #NationalInternalMedicineDay, and tag @acpinternists. Prizes will be given out 3 times through June of 2020. The first group of winners will be announced on the first ever National Internal Medicine Day October 28, 2019! What makes you proud to practice internal medicine or one of the I.M. subspecialties?  What recent patient experience made you proud to be an internist or subspecialist? How is internal medicine unique from other subspecialties? See us at the CHEST 2019 Annual Meeting in New Orleans! We’ll be doing two live interviews on stage, plus recording two recap episodes to bring you high yield clinical pearls from the conference. Look out for us in our red Curbsiders shirts and say hello. Take a picture with Stuart! Give Paul a hug! Register today https://chestmeeting.chestnet.org/ !!!!

Dominate perioperative medication management with tips from Kashlak’s newly minted Chief of Perioperative Medicine, @aoglasser, Avital O’Glasser MD, FACP, FHM (OHSU). We cover perioperative anticoagulation, why “bridging is dead”, aspirin, dual antiplatelet therapy, DMARDS, diabetic medications, buprenorphine, and much more! Be sure to check out Dr. O’Glasser’s previous episode #135 Perioperative Medicine: Assess and Optimize Risk to get a full overview of perioperative medicine. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Full show notes https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Avital O’Glasser MD, FACP, FHM and Matthew Watto MD, FACP  CME Questions: Matthew Watto MD, FACP Infographic: Matthew Watto MD, FACP Cover Art: Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Matthew Watto MD, FACP Guest: Avital O’Glasser MD, FACP, FHM Time Stamps 00:00 Intro, disclaimer, guest bio 03:20 Guest one-liner 04:46 Picks of the Week*: A Moment of Lift (book) by Melinda Gates; Crawl (film); Rich Roll (podcast) episodes w/

Dr Kimberly Manning joins to discuss imposter syndrome, how vacations affect health, and an update on the pneumonia vaccine, PCV13. Plus, hot takes on the dangers of vaping, and using procalcitonin and CRP to determine need for antibiotics.  Howdy, gentle listeners! It’s that special time of year when the school doors reopen, classrooms are awash in ‘new pencil’ smell, and FOAMed fans grab their trays and head to the cafeteria for some tasty knowledge food. Rest assured your Curbsiders friends have saved you a seat at the lunch table for this very special September 2019 episode!  Today we are joined by Dr. Kimberly Manning MD, FACP, FAAP, who is an Associate Professor of Medicine at Emory University School of Medicine. Dr. Manning authors a blog (“Reflections of a Grady Doctor”) that was named in 2010 by ‘O’ The Oprah Magazine as one of “four top medical blogs you should read.” She can also be found on Twitter, @gradydoctor. Thanks for listening! Full show notes at https://thecurbsiders.com/episode-list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits  Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD, FACP, FAAP Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH, Paul Williams MD, FACP; and Christopher Chiu MD, FACP, FAAP Editor: Christopher Chiu MD, FACP, FAAP; Emi Okamoto MD Cover-Art: Christopher Chiu MD, FACP, FAAP Guest: Kimberly Manning MD, FACP, FAAP

  Recognize the importance of cost-of-care conversations and identify resources to facilitate these discussions with help from Gwen Darien, executive vice president at the National Patient Advocate Foundation, and Dr.  Jessica Dine, Associate Professor and Chief of the division of Pulmonology and Critical Care at Perelman School of Medicine.  We review barriers to cost-of-care conversations and identify tools to help make these conversations a part of routine care discussions.  Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Elena Gibson, MD Infographic and Cover Art: Elena Gibson, MD Hosts: Elena Gibson MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Matthew Watto MD, FACP; Emi Okamoto MD  Guest: Gwen Darien and Jessica Dine MD Partners and Grant Support The American College of Physicians. Check out this supplement to the Annals of Internal Medicine from May 2019 on Fostering Productive Health Care Cost Conversations https://annals.org/aim/issue/937992 The Robert Wood Johnson Foundation https://www.rwjf.org provided grant support for this episode.

Diagnose and treat lupus in primary care with tips from rheumatologist, Beth Jonas MD, FACR (UNC). We discuss the history and exam findings in lupus, initial lab workup, the dreaded ANA, who needs expanded lab testing, lifestyle factors in lupus, vaccinations, the basics of treatment...and Jethro Tull?!  Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced: Kate Grant MBChB DipGUMed; Matthew Watto MD, FACP Infographic: Matthew Watto MD, FACP Cover Art: Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP Guest:  Beth Jonas MD, FACR 

Solve hypernatremia with tips and tactics from Dr. Joel Topf, MD (@kidney_boy), our Kashlak Chief of Nephrology. We review the diagnostic workup for hypernatremia, polydipsia and polyuria, review the pathophysiology of diabetes insipidus, and how to differentiate between nephrogenic and central DI. Plus, we walk through how to treat hypernatremia in the acute setting and Dr. Topf shares clinical pearls on why hypernatremia is the opposite of hyponatremia… It’s easy! Full show notes at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written by Hannah R. Abrams and Joel Topf MD Producer: Hannah R. Abrams Cover Art and infographic by: Hannah R. Abrams Hosts: Hannah R. Abrams; Stuart Brigham MD; Matthew Watto MD, FACP Editors: Matthew Watto MD, FACP; Emi Okamoto MD  Guest: Joel Topf MD Check out Dr. Topf’s podcast! The  NephJC podcast, Freely Filtered, discusses the latest NephJC topic every two weeks. Subscribe here or on iTunes.  

Search and secure your first job after residency. Dr. Alia Chisty (Penn State) returns to school us on surviving the PGY3 and beyond, part of ACP’s IMpower series. Topics: finding mentors, how to plan ahead as an intern and PGY2, master the interview day, avoid common pitfalls and confidently enter your early career. We’re joined by Curbsider and recent graduate Justin Berk MD, MPH, MBA who shares his experiences from the job trail. Flip the classroom! For meeting notes, a discussion guide and facilitators guide visit visit IMpower: Catalyzing your professional future.  Credits Written and Produced by: Paul Williams MD, FACP and Alia Chisty MD, MS  Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP Guests: Alia Chisty MD, MS; Justin Berk MD, MPH, MBA Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on  iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Sponsor Join The American College of Physicians today! Resident members get exclusive access to IMpower: Catalyzing your professional future. 

Step up your diabetes game! We answer your questions from #MedTwitter with help from returning guest, Jeff Colburn MD, FACP, FACE (USU) Topics include: the pitfalls of A1C testing, the A1C target controversy, lifestyle interventions, continuous glucose monitoring, pathophysiology of T2DM, use of SGLT2 inhibitors, GLP1 agonists, and how to initiate and titrate insulin therapy. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer (including CME Questions) and Producer: Matthew Watto MD, FACP Cover Art and Infographic: Bryan Brown MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP; Emi Okamoto MD Guest: Jeff Colburn MD, FACP, FACE

Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia.  Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, Produced and Edited by: Matthew Watto MD, FACP Cover Art and Infographic by: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Guest: Mary Kwok MD

Join us for this roundtable discussion of advocacy in healthcare and a rundown of hot topics: coding and billing, the Affordable Care Act, universal healthcare, gender equity, women’s health, gun violence and more! Returning guest, Dr. Robert McLean (@rmmclean84), current president of the American College of Physicians, helps us answer questions like, What is advocacy in healthcare? What are the issues that are impacting your profession? What can your medical home do for you? He’s been heavily involved in advocacy throughout his career including testifying before Congress. Guest hosts Drs. Fatima Syed MD, MSc and Deep Shah MD, MSc join!  Full show notes available at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Fatima Syed, MD, MSc; Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Fatima Syed, MD, MSc; Deep Shah, MD, MSc Editor: Matthew Watto MD, FACP Guest: Robert McLean MD, FACP

Discover more common practices that persist in the hospital wards despite no proven benefit! We review how hospitals prescribe a “crapload” of docusate which only clogs up the medication list, how unnecessary echocardiograms are ordered enough times to make your head spin, and how basal insulin needs to slide back into your inpatient diabetes management instead of correctional insulin monotherapy. Join high-value care specialist Dr. Lenny Feldman (@DocLennyF, Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 2 of “Things We Do For No Reason™.”  SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose. Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Justin Berk, MD MPH MBA, Matthew Watto MD Infographic: Justin Berk MD MPH MBA Cover Art: Matthew Watto MD Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD   Editor: Matthew Watto MD, Emi Okamoto MD Guest: Lenny Feldman MD, Tony Breu MD   Sponsor The Society of Hospital Medicine / Journal of Hospital Medicine - Things We Do For No Reason™series. Check out all the Things We Do For No ReasonTM articles here: Master Index of TWDFNR articles . 

Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at www.acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine.  Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written by: Christopher Chiu MD, FACP and Renee Dversdal MD, FACP  Produced and CME questions by: Christopher Chiu MD, FACP Edited by: Matthew Watto MD, FACP  Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Christopher Chiu MD, FACP  Guest Expert: Renee Dversdal MD, FACP  Special thanks to our POCUS friends! ACP We can speak first hand that the following courses are amazing POCUS learning experiences! Sign up today Point-of-Care Ultrasound: Foundational Skills for Internists November 7-8, 2019 and November 9-10, 2019 (same 2-day course repeated back to back) Crowne Plaza O’Hare Hotel and Conference Center, Rosemont, IL Registration is now open at acponline.org/pocus Point-of-Care Ultrasound: Foundational Skills for Internists April 21-22, 2020 (during Internal Medicine Meeting 2020) Los Angeles Convention Center Registration will open at the end of September  Point-of-Care Ultrasound: Advanced Skills for Outpatient Practice April 22, 2020 (during Internal

Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences.  Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Producers: Molly Heublein MD; Matthew Watto MD, FACP Writer (including CME questions): Molly Heublein MD Cover Art: Bryan Brown MD Hosts: Stuart Bringham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto, MD; Matthew Watto MD, FACP Guest: Chris Favilla, MD

Summary The sun is shining, the cakes are hot, and the takes are even hotter. Welcome to our July 2019 Hotcakes episode! Join us as our beloved hosts Chris, Matt, Stuart and Paul share some of the latest practice-changing knowledge, news and research in medical science. Today’s discussion covers studies on the use of IV iron supplementation for heart failure, aspirin as VTE prophylaxis after arthroplasty, and the relationship between physician burnout and ability to address patients’ social determinants of health. Honorable mentions include a throwback to the life-changing magic of Pokémon GO.    Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits  Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD Editor: Christopher Chiu MD, Emi Okamoto MD Cover-Art: Matthew Watto MD

Dr. Reshma Jagsi (TIME’S UP Healthcare;  UMichigan) schools us on sexual harassment and describes the systemic and cultural changes that need to happen to effect real change. She unpacks the definition of sexual harassment, describes the state of the #MeToo and TIME’s UP movements across the science and medicine fields and highlights how we all can recognize/respond to harassment. This is the third episode of our Women in Medicine series. Last August, you heard us talk to Dr. Vinny Arora about the paucity of women in leadership positions, finding sponsors for career advancement, and being bold about career decisions. In December, we spoke to Dr. Susan Hingle about work-life integration. Her advice? Stop worrying about what other people think, acknowledge that being a doctor is hard, especially for women due to disproportionate out-of-work responsibilities, and define a beautiful life that is individualized to you.  Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits   Written and produced by: Leah Witt MD, Shreya Trivedi MD, Nora Taranto MD, Sarah P. Roberts MPH. Editor: Matthew Watto MD Hosts: Shreya Trivedi MD, Chris Chiu MD, Leah Witt MD Guest: Reshma Jagsi MD, DPhil Special thanks to: Hannah Abrams MS4, Beth Garbitelli MS2, and Molly Heublein MD  

Tackle rashes with wisdom from Kashlak’s resident Skinternist (or Internist-Externist) Dr. Helena Pasieka (MedStar, Georgetown), board certified in both Internal Medicine and Dermatology.  She offers “a rash approach to rashes” including: initial triage, ‘inside job’ vs ‘outside job’, differential diagnosis, a review of common culprits, basic management techniques, and how to determine if the reaction is life-threatening. Plus, Dr Pasieka teaches us how to handle family and friends asking, “Can you take a look at this rash?”.  Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced: Beth Garbitelli MS2 Infographic and Cover Art: Beth Garbitelli MS2 Hosts: Stuart Bringham MD, Matthew Watto MD, Paul Williams MD   Editor: Matthew Watto MD Guest: Helena Pasieka MD 

Confession: we have been holding out on you. Specifically, we’ve been sitting on a special episode of Hotcakes and Hot Takes that we recorded this March, with featured guest Armand Gottlieb, MD of the online publication The Scope. But here it is! We hope you’ll enjoy our discussion of topics like the ever-controversial e-cigarettes for smoking cessation question, outcomes related to antibiotic treatment of UTIs among elderly adults, and the role of sacubitril-valsartan for acute decompensated heart failure in inpatient settings (the PIONEER-HF study).  Special guest is Dr. Armand Gottlieb @ArmandGottlieb, who was a third year internal medicine resident at Columbia University Medical Center in New York City at the time of recording. He is a co-Editor of the The Scope, a free and brief weekly roundup of the most recent and relevant medical literature. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits  Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD Guest Presenter and Content Planning: Armand Gottlieb, MD Editor: Christopher Chiu MD Cover-Art: Christopher Chiu MD   Pick of the Week The SCOPE. The week’s best in evidence-based medicine, written in plain language and delivered to your inbox. Sign-up for weekly emails or download the app. 

Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD  is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up - This episode is going to send your heart racing! You might even skip a beat! Full notes at https://thecurbsiders.com. ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).  Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer and Producer: Cyrus Askin MD Infographic: Cyrus Askin MD Cover Art: Cyrus Askin MD Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD Editors: Matthew Watto MD Guest: James Furgerson MD

Expand your knowledge about how--and how well--we manage the health of incarcerated patients in the United States, with the expert knowledge of correctional health experts Drs. Aaron Fox @adfoxmd, Jon Giftos @JonGiftosMD, and Emily Wang @ewang422. Correctional medicine is a black box for many providers who do not work in prison and jail settings. But it’s ever more relevant to primary care physicians everywhere, with increasing rates of incarceration the last decade.  In this episode, recorded live at SGIM 2019 #SGIM19, Dr. Fox, Dr. Giftos, and Dr. Wang talk us through the variability of the correctional healthcare systems throughout the country, the challenges to health for patients both while incarcerated and in the transition after release, and some essential nuts and bolts for providers about how to provide better care to this vulnerable population.   Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Justin Berk MD MPH MBA, Nora Taranto MD Cover Image: Beth Garbitelli MS2 Infographic: Beth Garbitelli MS2 Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MPH MBA Edited by: Matthew Watto MD Guests: Aaron Fox MD, Jon Giftos MD, Emily Wang MD MAS Sponsor This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Rethink how you’re diagnosing and managing chronic pain with high-yield tips from pain experts and primary care doctors Soraya Azari MD @azarimugs (UCSF), and Phoebe Cushman MD, MS (UMass Memorial). Because let’s face it, managing chronic pain can be very difficult. Expand your toolbox for management-- including the importance of activity, empowering your patient, risk stratification for patients prior to opioid initiation, how to identify opioid use disorder, and how to taper opioids. Plus, updates on recent practice changing articles in chronic pain. Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MD Hosts: Nora Taranto MD, Paul Williams MD, Matthew Watto MD Edited by: Emi Okamoto MD, Matthew Watto MD Guests: Soraya Azari MD; Phoebe Cushman MD, MS Sponsor This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today!

Build your knowledge base to improve primary care for LGBT patients! This episode is chock full of clinical pearls and updates for LGBT health from SGIM presenters, Dr. Jenny Siegel (Boston University) and Dr. Megan McNamara (Louis Stokes Cleveland VAMC). They define common gender identity terms and provide tips on how to take a sexual history. You’ll develop an approach to the unique clinical concerns of LGBT patients and learn how to phrase medical information in a gender neutral framework. This is a must listen episode for all health care providers! Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Carolyn Chan MD Graphics: Hannah Abrams Hosts: Carolyn Chan MD, Paul Williams MD, Matthew Watto MD Guest: Megan McNamara MD, Jenny Siegel MD Sponsor This episodes was recorded LIVE at #SGIM19 in Washington DC! Join the Society for General Internal Medicine today! 

What do Judas Priest, surfing, and clots have in common? They are the passionate interests of expert Dr. Michael Streiff who guides us through the diagnosis and management of DVT and PE aka venous thromboembolism (VTE). By the end of the episode you will know how to catch a clot very Wells! We dive deep into the treatment options, literature, and some unique cases. ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by (including CME questions): Justin Berk MD, MPH, MBA Cover art by: Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Edited by: Matthew Watto, MD, FACP Guest:  Michael Streiff MD

Expand your idea of ischemic heart disease to include non-obstructive patterns, which as our guest, Dr Noel Bairey Merz, a clinical investigative cardiologist whose multiple roles include Director of the Barbra Streisand Women’s Heart Center and the Preventive Cardiac Center at the Smidt Cedars-Sinai Heart Institute, shares with us, is incredibly common, especially in women.  Learn to recognize these women and treat according to guidelines, preventing unnecessary IHD mortality in our female (and some male) patients. We review a variety of non-obstructive pathologies and the best techniques to evaluate them. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Shreya Trivedi MD, Molly Heublein MD Hosts: Paul Williams MD, FACP; Shreya Trivedi MD; Molly Heublein MD Edited by: Matthew Watto MD, FACP; Emi Okamoto MD Graphics by: Hannah Abrams Guest: Dr. C Noel Bairey Merz MD, FACC, FAHA Curbsiders' Schwag! We’ve got the perfect father’s day gift for every internal medicine nerd. The Curbsiders have opened our own online shop. Get your Curbsiders t-shirts, hoodies, stickers, and coffee mugs. Help support the show and gain instant bragging rights. Note: All purchases come with admitting privileges at Kashlak Memorial Hospital!

Dare to lead. Master the transition to PGY2 with tips from expert educator Abby Spencer MD, MS, FACP, IM Residency Program Director and Vice Chair for Education for the Medicine Institute at Cleveland Clinic and Shreya Trivedi MD, GIM Fellow at NYU School of Medicine. Topics include: how to run work rounds, preparing your team for attendings rounds, how to teach on the fly, finding your leadership style, and what to read during residency. This is the first of three episodes that we’re co-developing with the American College of Physicians for their Resident Transitions Series. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Shreya Trivedi MD Graphics and Show Notes by: Hannah R Abrams Hosts: Paul Williams MD, FACP; Stuart Brigham MD; Matthew Watto MD, FACP; Shreya Trivedi MD Guest: Abby Spencer MD, MS, FACP Sponsor The Resident Transitions Series is brought to you by The American College of Physicians with support from its Council of Resident/Fellow Members. Visit acponline.org/resident to learn more about the benefits of Resident/Fellow Membership and join our proud internal medicine community today!

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?! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Full show notes available at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer (interview, show notes & CME questions) and cover art: Emi Okamoto MD Infographic by: Emi Okamoto MD Hosts: Matthew Watto MD, FACP; Stuart Brigham MD Editors: Matthew Watto MD, FACP Guest: Olajumoke Fadugba MD Special thanks to Sarah Phoebe Roberts MPH for booking! 

HFpEF (heart failure with preserved ejection fraction) with master cardiologist, Dr Clyde Yancy MD, Chief of Cardiology and Professor of Medicine (Cardiology) and Medical Social Sciences, Northwestern, Feinberg School of Medicine. Topics include: pathophysiology, HFpEF phenotypes, how to interpret a borderline ejection fraction, evidence based therapies, diuretics, and future directions (pulmonary artery monitors, intra-atrial shunts, ARNI compounds), and more! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Paul Williams MD, FACP; Sarah Phoebe Roberts MPH Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Show Notes: Justin Berk MD, MPH, MBA; and Beth Garbitelli MS1 Infographics: Beth Garbitelli MS1 Editor: Matthew Watto MD, FACP Guest: Clyde Yancy MD, MSc, MACC, FAHA, MACP, FHFSA

Recap of random pearls and highlights from SGIM19 Day 2 including: methadone and buprenorphine, perioperative buprenorphine, medical cannabis, HPV vaccination, young adult medicine, academic promotions, long term sequelae of childhood kidney disease, stage 1 hypertension, some great free resources in addiction medicine, and more! Special thanks to the Society for General Internal Medicine for their hospitality. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Nora Taranto MS4 (soon to be MD!) Edited by: Matthew Watto MD

Recap of random pearls and highlights from SGIM19 Day 1 including: Kidney stone treatment (roller coasters, sex and tamsulosin), aspirin, SGLT2 inhibitors to reduce kidney events, oral antibiotics for endocarditis, preferred physician attire, sexual harassment, writing letters of recommendation, triple therapy for COPD, DAPT for stroke, and more! Special thanks to the Society for General Internal Medicine for their hospitality. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Abby Spencer MD, MS, Nora Taranto MS4 (soon to be MD!) Edited by: Matthew Watto MD Special Guest: Abby Spencer MD, MS 

Identify and treat the most common causes of hip pain in the outpatient setting with returning guest, Dr Ted Parks. A large majority of hip pain in the office setting will be due to one of three conditions (hip osteoarthritis, greater trochanteric pain syndrome, and lumbo-sacral back pain). Learn to easily identify these conditions, how to initiate conservative treatment, and more about hip replacements. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Molly Heublein MD, Nora Taranto MS4 CME questions by:  Molly Heublein MD, Nora Taranto MS4 Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein MD Edited by: Matthew Watto MD, Emi Okamoto MD Guest Presenter: Ted Parks MD

Electric cars, virtual reality, nanotechnology, and now… telemedicine? We chat with Dr. Ana María López MD, FACP about the future of telehealth, how to implement it in your practice, and the challenges you might face in doing so. Dr. López is immediate past president of the American College of Physicians (ACP) as well as Vice Chair of Medical Oncology and Chief of New Jersey Division Sidney Kimmel Cancer Center of Thomas Jefferson University. Her main areas of professional interest and expertise include cancer prevention and equity, integrative oncology, implementation of innovations in health care including telemedicine, and women’s health. We learned immensely from our talk with her and we hope you will, too! ACP members can claim free CME & MOC credit at https://acponline.org/curbsiders. Download Dr Brigham’s telehealth cheat sheet as a PDF at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Hannah Abrams, Stuart Brigham MD Cohosts: Matt Watto MD, Stuart Brigham MD, Paul Williams MD, Hannah Abrams Guest: Ana María López MD

This week we narrow in on the enlarging prostate and decipher the common issue of benign prostatic hyperplasia with Adam C. Reese MD, Associate Professor of Urology at the Lewis Katz School of Medicine at Temple University and Chief of Urologic Oncology at Temple University Hospital. Learn how to interpret the symptom profile for patients presenting with common urinary issues, what to feel for in the digital rectal exam, how to treat BPH, and when to refer. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). See you at SGIM 2019! Find us in our red Curbsider’s t-shirts handing out Curbsiders and Kashlak stickers/patches at SGIM 2019 in Washington DC! We’ll be recording full length shows and daily recaps! Credits Written and produced by: Paul Williams MD Hosts: Paul Williams MD, Matthew Watto MD Images and infographics: Elena Gibson, Beth Garbitelli Show Notes: Elena Gibson, Beth Garbitelli Edited by: Matthew Watto MD, Chris Chiu MD Guest: Adam Reese MD Time Stamps 00:00 SGIM announcement 00:30 Disclaimer, intro and guest bio 03:20 Guest one liner, book recommendation, favorite failure and surgical M&M 10:56 Case of benign prostatic hyperplasia, defining terms and obstructive/voiding versus storage/irritative symptoms 16:11 IPSS score and evaluating symptoms 22:10 Digital rectal exam. Will this give any useful information? 26:55 Taking a history about BPH and some lifestyle modifications 29:20 Lab studies for urinary tract symptoms and interpreting PSA and free PSA 36:20 Initial therapy for BPH and managing patient expectations, alpha blocker side effects 39:25 Choice of agent and monitoring symptoms on therapy 42:25 Nonpharmacologic management of bladder complaints 45:10 Who and when to refer to urology 47:33 Counseling about use of 5 alpha reductase inhibitors, their side effects and is there a risk for high grade cancer? 52:35 Phosphodiesterase inhibitors for BPH symptoms 53:50 Urethral milking. NOT prostate milking 54:55 Desmopressin for nocturia 56:20 Take home points 59:03 Prostate volume and PSA 61:10 Outro Full show notes available at http://thecurbsiders.com/episode-list.

Random pearls from ACP #IM2019 Day 3. The Curbsiders crew is joined by Dr Alan Dow of VCU to discuss highlights from ACP’s Internal Medicine Meeting in Philadelphia including: sleep deprivation, the glymphatics system, inflammatory back pain, heart failure, dermatology pearls, a new definition for pulmonary hypertension and more! "Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. #IM2019 Curbsiders Crew Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD Director of operations: Chris Chiu MD Twitter: Cyrus Askin MD, Hannah Abrams MS3 Instagram: Beth Garbitelli MS1 Facebook: Chris Chiu MD Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4 Marketing: Jen Watto

Random pearls from ACP #IM2019 Day 2. The Curbsiders crew is joined by Dr Alia Chisty (future PD at Penn State Hershey) at ACP’s Internal Medicine Meeting in Philadelphia to discuss highlights including: baloxavir a new drug for flu, stress testing and coronary CT angiography pearls, celiac disease, H. pylori pearls, and a bunch of random pearls from infectious diseases, palliative care and more! "Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. #IM2019 Curbsiders Crew Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD Director of operations: Chris Chiu MD Twitter: Cyrus Askin MD, Hannah Abrams MS3 Instagram: Beth Garbitelli MS1 Facebook: Chris Chiu MD Off-air producer: Sarah Phoebe Roberts MPH, Nora Taranto MS4 Marketing: Jen Watto  

Random pearls from #IM2019 Day 1. The Curbsiders crew is joined by Kashlak’s POCUS Chief, Renee Dversdal MD at ACP’s Internal Medicine Meeting in Philadelphia to discuss day 1 highlights inlcuding: POCUS, lyme rash, back pain, syphilis, women’s health, patient handoffs, the flip-flop fungal sign a ton of cardiology pearls (ie diuretics, paracentesis for CHF, beta blockers, LBBB, when is it safe to have intercourse after an MI?) and more! "Sorry, no time stamps or full show notes for this one. We're too tired." -The Curbsiders Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. #IM2019 Curbsiders Crew Guest: Renee Dversdal MD, Alan Dow MD, Alia Chisty MD Cohosts: Paul Williams MD, Stuart Brigham MD, Shreya Trivedi MD, Molly Heublein MD, Emi Okamoto MD, Justin Berk MD, Cyrus Askin MD, Matthew Watto MD, Chris Chiu MD Director of operations: Chris Chiu MD Twitter: Cyrus Askin MD, Hannah Abrams MS3 Instagram: Beth Garbitelli MS1 Facebook: Chris Chiu MD Off-air producer: Sarah Phoebe Roberts MPH Marketing: Jen Watto

Join(t) us in learning about rheumatoid arthritis care for the internist with Robert McLean MD, rheumatologist, Associate Clinical Professor at Yale, and President Elect of the ACP! We discuss the complexity of rheumatoid arthritis, how to differentiate from other arthritic conditions, and how to have a patient-centered framework for the evaluation and treatment of affected patients. ACP members can claim CME-MOC credit at on ACP's site.. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer (Interview & CME questions): Cyrus Askin MD Show Notes and Infographic by: Elena Gibson MS4 Hosts: Matthew Watto MD, Stuart Brigham MD Editors: Matthew Watto MD, Emi Okamoto MD Guest: Robert McLean MD

Pain management in patients with chronic kidney disease (CKD) often goes something like this: NSAIDs are evil, acetaminophen hardly works, opioids are dangerous, and all the rest (tramadol, gabapentinoids, antidepressants) are messy. But, we tackle the complexities of pain management in patients with chronic kidney disease in this special @NephMadness 2019 episode that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Earn CME and read about each region in NephMadness 2019 at AJKD blog. Credits Written and produced by: Justin Berk MD, Samantha Gelfand MD NephMadness Pun Contest produced by: Hannah R Abrams MS3 Cover art by: Kate Grant MBChB, Dip GUMed Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD, Emi Okamoto MD Guests:  Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD 

Does your sympathetic nervous system get activated when you notice acute kidney injury in patients with cirrhosis? Ever wonder how to really diagnose hepatorenal syndrome (HRS)? Think you have the bile-acid-stones to start diuretics on a patient requiring pressor support for kidney failure? You have come to the right place! Listen to @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) tackle the complex pathophysiology and treatment of hepatorenal syndrome in this NephMadness 2019 special episode! Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Earn CME and read about each region at AJKD blog. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Justin Berk MD, Nora Taranto MS4 Infographic by: Alex M @nephroguy Hosts: Matthew Watto MD Edited by: Matthew Watto MD, Emi Okamoto MD Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD Sponsor Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Some precocious policy wonks take a deep dive into the evolving trends and future directions for our primary care workforce. Experts, Dr. Fatima Syed and Dr. Deep Shah return to school us on Physician Supply and Demand, the Access Gap, role of NPs and PAs, Retail Clinics, and Managed Care Clinics. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Catch up on our previous discussions with Dr. Syed and Dr. Shah:  Episode #62: Pod Save Health Care: The Curbsiders Foray into health policy and  Episode #120 Health Policy, Patients, Payments, Paperwork for more context. We also did an overview of health care policy essentials with Dr. Sue Bornstein in  Episode #64: Stuff You Should Know About Health Policy Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Fatima Syed MD, MSc; Deep Shah MD, MSc CME questions by: Chris Chiu MD, Beth Garbitelli MS1, Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD, Images and infographics: Beth Garbitelli MS1 Edited by: Matthew Watto MD, Chris Chiu MD Guest: Fatima Syed MD, MSc, Deep Shah MD, MSc

Inpatient hypertension is tricky. What’s the best way to answer those overnight nursing phone calls for elevated blood pressures? What’s the role of treating hypertensive urgency in the hospital? Plus, Our nephrology experts put a new issue on the generalist’s radar: are ACE-inhibitors dangerous to give (or hold) during an operation? This NephMadness 2019 episode, features special guests Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) to better understand the role of anti-hypertensives in the inpatient setting and keep your blood pressure down on those overnight calls.  Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Justin Berk MD, MPH, MBA; Pascale Khairallah MD Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto, MD Guest:  Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD Sponsor  Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

The battle over the superiority of resuscitation fluids is coming to a boil. Enter the Fluid Wars. Are Lactated Ringers superior to normal saline? Will LR increase a patient’s lactate? What about albumin? The Curbsiders quench the thirst for knowledge by turning to masters Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) for guidance in this special @NephMadness episode that will get your feet wet with the complicated world of fluid resuscitation.  Fill out your bracket for NephMadness 2019 today and sign up as part of The Curbsiders! Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Credits Written and produced by: Justin Berk MD, Pascale Khairallah MD NephMadness Pun Contest produced by: Hannah R Abrams MS3 Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD Guest:  Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD

Cirrhosis TIPS for the decompensated cirrhotic & acute on chronic liver failure from expert hepatologist and keto-practitioner Scott Matherly MD, @liverprof and chief hepatologist at @KashlakHospital. We walk through acute management of variceal bleeds, when to suspect SBP in decompensated cirrhosis (all the time, it turns out), how much fluid to remove in paracentesis, and some definitions about what decompensated cirrhosis and acute on chronic liver failure really mean. Take our pretest on cirrhosis! Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MS4, Matthew Watto MD Pretest by: Cyrus Askin MD Hosts: Matthew Watto MD, Paul Williams MD, Images and infographics: Hannah Abrams MS3 Edited by: Matthew Watto MD Guest: Scott Matherly MD Sponsor  Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 2019.

Listen to our first ever discussion with @kidney_boy, Joel Topf MD. It’s a classic episode with a fresh intro as we prepare for @NephMadness 2019 with our friends from Twitter and @AJKDonline Dominate leg cramps, diuretic therapy, and resistant hypertension with tips from @kidney_boy, Joel Topf MD @kidney_boy, Chief of Nephrology Kashlak Memorial Hospital, co-creator @NephMadness. We start with basic renal physiology and build up to the treatment of resistant hypertension. Corrections: Dr Topf posted the following corrections on his blog PBfluids.com 3/22/2017 “I enjoyed the experience immensely, but in an hour of talking off the cuff I made some embarrassing mistakes: In describing water reabsorption I said it occured in the cortical collecting duct rather than the medullary collecting duct. In describing my cure for cramps I tell the story of Gitelman’s and say it is like congenital loop diuretics rather than congenital thiazide diuretics I mucked up the story about the MRFIT story and how it allowed a head to head comparison of HCTZ and chlorthalidone. I really oversold what happened.”   Full show notes at https://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written by: Matthew Watto MD Produced by: Stuart Brigham MD and Matthew Watto MD Cohosts: Stuart Brigham MD and Matthew Watto MD Guest: Joel Topf MD Sponsor Get your ACP membership today and use the code CURB100 to save $100 when you join by March 31, 201

Demystify chronic wound care management with high yield pearls from wound care expert Dr. Elizabeth (Foy) White-Chu. She takes us through a simple yet thorough approach to manage complex chronic wounds. We discuss everything from selecting a dressing, to pain management, and what kind of water should you really use when cleansing a wound. Answers to all of these burning questions and more await you, so don’t waste anymore time! Press play and let Dr. White-Chu take you on a journey through evidence based practices for the management of chronic wounds. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written by: Carolyn Chan MD CME questions by: Justin Berk MD Produced by: Matthew Watto MD Hosts: Matthew Watto MD, Paul Williams MD, Carolyn Chan MD Guest: Dr. Elizabeth (Foy) White-Chu Sponsor Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.  

Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Molly Heublein, MD CME questions by: Molly Heublein, MD Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein, MD Edited by: Matthew Watto MD Guest Presenter: Patrick Finley, PharmD BCPP Sponsor Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Join us at the forefront as we talk genetic testing in primary care with Dr Dallas Read, esteemed gynecologist and **the only** medical geneticist at Tufts Medical Center. Topics include: what internists should be comfortable testing for in the office, how and when to refer for screening, what tests to order, how to interpret test results, how to handle direct-to-consumer results or requests, and so much more! For years, the medical community has been talking about the immense potential for genetic testing to guide diagnosis and treatment. But has it realized its full potential? The answer to that seems to be a resounding no at the moment--but the days of ubiquitous genetic testing to identify disease and disease risk may not be so far off after all. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Coming to you from the Curbsiders, we hope you’ll enjoy this latest episode about the genes you wear, whether you want to put them on or not. Genes, Genes, they’re (maybe) good for your heart. But do patients want to know if they are, or if they aren’t? Full show notes available at http://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MS4 CME questions by: Nora Taranto MS4 Hosts: Stuart Brigham MD, Matthew Watto MD, Nora Taranto MS4 Images and infographics: Beth Garbitelli MS1 Edited by: Matthew Watto MD, Chris Chiu MD Guest: Dr. Dallas Reed MD Sponsor  Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich, Assistant Professor of Medicine and co-director of the Inflammatory Bowel Disease Program at Temple University Hospital.  In this episode, we learn about the initial work-up, general principles of management, and important primary care considerations for Crohn’s disease and ulcerative colitis (ie endoscopic surveillance, immunizations, bone health/osteoporosis, and more!). Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Paul Williams MD Edited by: Matthew Watto MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Adam Ehrlich MD Sponsor Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.

Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Sponsor Join us at ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there! Credits Written and produced by: Matthew Watto, MD Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Infographic: Matthew Watto MD Edited by: Matthew Watto MD Guest: Dr Joel Topf MD

Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sickle Cell Center for Adults at Johns Hopkins joins! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Sponsor ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA. We'll see you there! Credits Written (including CME questions) and produced by: Justin Berk MD, Martha Brucato MD PhD, Beth Garbitelli MS1 Hosts: Paul Williams MD, Justin Berk MD, Matthew Watto MD Edited by: Matthew Watto MD Guest: Sophie Lanzkron MD MHS Time Stamps 00:00 Announcements, intro 02:30 A quick refresher on hemoglobinopathy 03:45 Guest bio 05:03 Guest one-liner, movie recommendation, career advice, picks of the week 10:53 ACP Internal Medicine Meeting 2019 (ad read) 12:33 Clinical case; defining sickle cell; pathophysiology 16:23 Different types of hemoglobinopathy genotypes and phenotypes 20:20 Preventive care for sickle cell disease 22:56 Taking a history at the initial visit in patient with sickle disease 26:40 Life expectancy in SCD 28:30 Hydroxyurea 30:40 Chronic red blood cell transfusion therapy; complications; monitoring 37:07 Silent cerebral infarcts and mild cognitive impairment in SCD  40:10 Chronic pain management; opioid use disorder in sickle cell disease 46:00 Acute pain crisis management; PCAs vs bolus therapy 54:08 Reticulocyte count in sickle cell disease 55:40 Itching, opioids and naloxone? 58:10 Red blood cell transfusion threshold in sickle cell disease (anemia) 60:03 Acute fever in SCD 61:48 Acute chest syndrome 66:45 Transition from pediatrics to adult medicine in sickle cell 68:00 Incentive spirometry to prevent acute chest syndrome 68:45 Take home points 70:00 Outro

Optimize perioperative risk and dominate perioperative medicine. Topics include surgical risk calculators, preoperative labs, stress testing, use of BNP and troponins, postoperative MI, cardiac and pulmonary risk stratification, and more! We’re joined by perioperative medicine expert, Avital O’Glasser MD, Associate Professor of Medicine at Oregon Health & Science University and Assistant Program Director for Scholarship and Social Media. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Matthew Watto MD CME questions by: Matthew Watto MD Hosts: Matthew Watto MD, Stuart Brigham MD Edited by: Matthew Watto MD Guest: Avital O’Glasser MD Time Stamps 00:00 Disclaimer, intro and guest bio 04:20 Guest one-liner, book and movie recommendations, career advice 11:20 ACP Internal Medicine Meeting 2019 details 14:02 Patient with coronary artery calcifications going for elective hip surgery and wants "clearance" 20:50 Functional capacity 25:00 Preoperative stress testing and coronary revascularization 31:55 Canadian guidelines, BNP and troponin testing 36:30 The METS trial and predicting perioperative cardiac events and mortality 40:44 Preoperative testing (labs, imaging, urine studies) 50:24 Choosing your perioperative cardiac and surgical risk calculator (RCRI, MICA, ACS-NSQIP) 59:50 Communicating risk to patient and their surgeon 61:30 Pulmonary risk assessment and complications 70:35 Perioperative use of opioids 75:30 Who needs an echocardiogram prior to surgery? 79:00 Canceling a patient's surgery 82:55 Take home points 83:45 Outro

“Urinary tract infections” (UTIs) are overdiagnosed. Antibiotics are overprescribed. UTIs are inappropriately blamed for geriatric syndromes (eg delirium) despite little supporting evidence. Our guest, Tom Finucane MD, Emeritus Professor of Medicine at Johns Hopkins makes us question everything. Topics: How can we diagnose “UTI”? Who needs treatment? Do urinary tract symptoms matter? Does malodorous urine correlate with infection? Who’s at risk for pyelonephritis and sepsis? Don’t miss this paradigm changing episode. And stop using the term “urinary tract infection” unless it’s prefaced by air quotes! Sponsor: Join ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA . We'll see you there! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Matthew Watto MD Hosts: Matthew Watto MD, Paul Williams MD Edited by: Matthew Watto MD Guest: Tom Finucane MD, MACP Time Stamps 00:00 Disclaimer, intro and guest bio 04:00 Guest one liner, book recommendation, career advice 08:22 The “medical ignorome” 13:40 ACP Internal Medicine Meeting 2019 details 16:20 Case of malodorous urine; Urine is NOT sterile; Defining terms 25:14 Stop saying UTI unless using air quotes 28:34 What symptoms or history matters in evaluation for “UTI”? And can we predict who will become systemically ill? 34:47 Voltaire and when treatment is warranted for “urinary tract infections” 37:15 Delirium in an older adult with possible UTI, how to work it up, and who warrants antibiotics 51:55 Take home points 53:38 Outro

Take a trip down memory lane with top clinical pearls and favorite moments from The Curbsiders in 2018. Welcome to our 2018 Recap Extravaganza! Since last year, the Curbsiders team has grown substantially and the podcast has undergone several exciting developments. These include our collaboration with ACP that allows us to provide CME and MOC credit for select episodes, our new partnership with Human Dx as featured in our Kashlak Morning Reports, and the launch of our Women in Medicine series. For our 2017 year-end show, we had listeners vote for their favorite episodes from the past year. This year, we're changing it up a bit and have invited our Curbsider colleagues to share their picks for pearliest pearls and most illuminating episodes of 2018. We hope you’ll enjoy hearing the team’s highlights, and we’ll be back in 2019 with fresh content. Note: No CME-MOC credit for this episode, but stay tuned in 2019 for eligible episodes. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Chris Chiu MD and Sarah Phoebe Roberts, MPH Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Chris Chiu MD Edited by: Chris Chiu MD Time Stamps 00:00 Disclaimer, Intro 06:39 Clinical Reasoning Pearls 12:35 Pulmonary Hypertension Pearls 15:52 Women In Medicine Pearls 20:40 Iron Deficiency Pearls 24:52 Tick-Borne Illness Pearls 28:00 STI Pearls 31:00 Physical Exam Pearls 32:51 “Things we do for no reason” Pearls 36:16 Host Picks 42:38 Paul Wraps-up the Year 43:38 Outro and Curbsider Team sign-offs

Master the diagnosis and management of Genital Herpes with tips from expert, Robert Bettiker MD . Topics include: the natural history, diagnosis & screening guidelines for genital herpes; cold sores; options for primary and recurrent episodes including prophylaxis; and consideration of specific populations including symptomatic and asymptomatic patients, pregnancy and MSM (men who have sex with men). We also discuss partner notification and treatment. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Kate Grant MBChB DipGUMed, Matthew Watto MD Images by: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD Guest: Robert Bettiker MD Time Stamps 00:00 Disclaimer, guest bio, intro 01:50 Guest one liner, memorable teaching moment and a few failures 10:50 Intro to herpes 12:25 Case 1: Genital herpes in a married man 15:42 Overview of testing options 18:50 Marital counseling in Herpes 22:18 Prophylaxis in serodiscordant partners and asymptomatic shedding 25:08 Case 2: Severe outbreak of genital herpes in a young woman 31:50 Case 3: Young male with recent exposure to herpes 38:45 Herpes 1 (HSV1) versus Herpes 2 (HSV2) 44:12 Case 4: Herpes in pregnancy 50:45 Do topical agents work for herpes 55:05 Take home points 56:10 Outro 57:52 Stuart shares a PUN!

Sharpen your diagnostic schema for abdominal pain and eosinophilia with this mystery case http://hdx.org/Rxg (click link to follow along). Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx attempts to solve this challenging case with the help of The Curbsiders. Use this link http://hdx.org/Rxg to follow along with the case on the Human Dx app and check out more Global Morning Report cases. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Hannah R Abrams Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD Guest: Reza Manesh MD Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes. Time Stamps 00:00 Announcement, disclaimer, intro, guest bio 01:20 Picks of the week 05:42 How Reza fell in love with clinical reasoning 08:58 Case of 50 yo male with abdominal pain 21:14 Some unexpected findings 43:00 Case conclusion/answer, cognitive autopsy and Reza’s take home points 48:35 Outro

Hone your diagnostic skills with this mystery case of cough and dyspnea http://hdx.org/pdp (click link to follow along). The Curbsiders deconstruct the case and discuss their diagnostic schemas for these common problems with the help of returning guest, Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project aka Human Dx. Use this link http://hdx.org/pdp to follow along with the case on the Human Dx app or website and check out more Global Morning Report cases. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Hannah R Abrams Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD Guest: Reza Manesh MD Special thanks to: Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing and editing the cases; and to Tyler Brandon for helping to coordinate these wonderful episodes. Time Stamps 00:00 Announcement, disclaimer, intro, guest bio 03:13 When and how to practice clinical reasoning 05:53 Creating diagnostic schemas and Clinical Problem Solvers Podcast 09:40 A bit on Human Dx and the show format 12:00 Case of a 40 yo male with a cough 23:22 Some insights from Reza on “signal versus noise” 37:10 Case conclusion/answer, cognitive autopsy and Reza’s take home points 45:36 Outro

Create a successful partnership and career withs tips from Wonder Woman, Sue Hingle MD of ACP.  Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro tip: stop worrying about what others think!). Dr. Hingle is Professor in the Department of Internal Medicine and Vice Chair of Education and Faculty Development and Associate Internal Medicine Residency Program Director at Southern Illinois University. She is also the Immediate Past Chair of the Board of Regents of the American College of Physicians (ACP). She has served at the ACP in a variety of ways, including as a member of the ACP Women’s Task Force. Her clinical expertise is in women’s health, health promotion, and disease prevention. Enjoy the episode! ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MS4, Shreya Trivedi MD, Leah Witt MD, Sarah P. Roberts MPH. CME Questions by: Shreya Trivedi MD Editors: Matthew Watto MD and Chris Chiu MD Hosts: Shreya Trivedi MD, Paul Williams MD, Leah Witt MD Guest: Susan Hingle MD Time Stamps 00:00 Disclaimer, intro and guest bio 02:52 Guest one liner, WIM Moment of awakening, advice for her younger self 07:45 Picks of the week 10:30 Physician with family and caregiver responsibility; How to plan for personal and professional goals 18:20 What to look for in a partner, how to work with them to achieve work life fit, and non-traditional roles 28:35 Advice on family planning 31:40 Residency programs and life events 32:55 Should you go part-time? 39:43 Work life balance? Or work life fit? And some examples/tips for success 49:54 Take home points 50:45 Outro

Dr Elisabeth Poorman MD joins us to discuss the natural history of physician depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line. The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available either via email, private msg on FB or twitter (@DrPoorman), or any of us on twitter. We are happy to talk and see that you get support you need. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MS4, Shreya Trivedi MD Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD Edited by: Matthew Watto MD Guest: Elisabeth Poorman, MD

Aspirin’ to figure out if ASA can help prevent a heart attack? Interpreting all the new trials doesn’t have to cause chest pain! Join Dr. Ambarish Pandey from UT Southwestern as he helps The Curbsiders ASCEND the mountains of the latest studies to ARRIVE at some well-informed conclusions on the role of aspirin in primary prevention for cardiac events. The team also discusses secondary prevention, aspirin and dual (or triple) antiplatelet therapy, and whether it’s okay to stop giving aspirin to older adults without known CAD (Spoiler alert: it’s okay). ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Justin Berk MD, Matthew Watto MD CME questions by: Justin Berk MD Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD and Chris Chiu MD Guest: Dr. Ambarish Pandey MD Time Stamps 00:00 Disclaimer, intro and guest bio 04:15 Guest one liner, book recommendation, career and research advice 11:07 Case of aspirin for primary prevention, aspirin’s public persona, and nocebo effects of statins 21:40 ARRIVE and ASCEND trials 28:14 Aspree trial 32:38 Coronary artery calcium; aspirin use for secondary prevention 37:42 Dual antiplatelet therapy and the DAPT score 41:25 Should we continue aspirin when a patient also needs a DOAC? 46:14 Should we continue DAPT in a patient who needs a DOAC (or warfarin)? 49:40 Deprescribing aspirin for primary prevention in older adults? 50:51 Closing remarks 52:33 Outro

Tony Breu MD joins us for some hotcakes, and “cold cakes” including: how aspirin and zodiac sign affect the treatment of acute MI, a recent study on how exercise is probably still good for you, the recently announced REDUCE-IT trial, and the evidence (or lack thereof) for the treatment of hypertensive urgency. Welcome to another edition of Hotcakes and Hot Takes, where we discuss the most interesting articles and news that we have been reading. Special guest is the prolific Dr. Tony Breu (@tony_breu) who is an Assistant Professor of Medicine at Harvard Medical School and a Hospitalist and Director of Internal Medicine Resident Education at the VA Boston Healthcare System. He is known for his series on "Things We Do For No Reason” as well as his thought-provoking “Tweetorials” online. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST on day of release). Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD CME Questions: Christopher Chiu MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD Guest Presenter and Content Planning: Anthony Breu MD Editor: Christopher Chiu MD Cover-Art: Christopher Chiu MD Time stamps 00:00 Disclaimer, intro, guest bio 05:53 Discussion on Tweetorials 08:00 Cold Cake: ISIS-2 and the treatment of acute MI with aspirin 14:04 ISIS-2 and zodiac subgroup analysis 16:19 What is the relationship between cardiorespiratory fitness on mortality? 24:40 Discussion of the REDUCE-IT study 33:00 Cold Cake: VA Cooperative study and the evidence for treating essential hypertension 36:42 TWDFNR and the treatment of hypertensive urgency 46:36 Wrap-up and outro

Master the diagnosis and management of common STIs (sexually transmitted infections) with tips from expert, Dana Dunne MD, Associate Professor of Medicine in Infectious Diseases at Yale. Topics include: the stages and many presentations of syphilis, syphilis treatment and counseling, the natural history, diagnosis, and screening guidelines for gonorrhea and chlamydia, treatment options in the age of growing resistance, and a discussion of partner notification and treatment. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Bryan Brown MD Hosts: Bryan Brown MD, Paul Williams MD, Matthew Watto MD Guest: Dana Dunne MD Special thanks to Kate Grant MBChB, Dip GUMed for her contribution of knowledge and artwork. Time Stamps 00:00 Announcement, disclaimer, intro and guest bio 04:29 Guest onliner, book recommendation, advice for learners/teacher, and picks of the week 11:00 A case of syphilis, clinical manifestations and discussion of the stages 26:05 Testing for syphilis 39:05 Mandatory reporting and partner tracing 42:40 Counseling patients with syphilis 44:44 A case of gonorrhea and chlamydia, clinical manifestations, screening guidelines 52:30 How to counsel patients to obtain samples from urethra, rectum, vagina, oropharynx; Mycoplasma genitalium 59:40 CDC treatment guidelines, Super gonorrhea, test of cure, and treatment of partners 72:35 Take home points 74:30 Outro

Practice solving diagnostic puzzles with The Curbsiders and Internist / Diagnostician, Reza Manesh MD, Assistant Program Director for Clinical Reasoning of the Osler Medical Training Program at Johns Hopkins! Solve along with us at these links: Case 1 http://hdx.org/I2B and Case 2 http://hdx.org/uM2. Topics include: clinical reasoning terminology, how to use cases to practice diagnostic reasoning, how to build a diagnostic schema, and how to conduct your own cognitive autopsy. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Hannah Abrams Hosts: Hannah Abrams, Paul Williams MD, Stuart Brigham MD, Matthew Watto MD Guest: Reza Manesh MD Special thanks to: Doctors Steph Sherman, Zaven Sargsyan, Anand Jagannath, John Inou Hwang, and Rabih Geha for contributing cases Time Stamps 00:00 Disclaimer, intro and guest bio 04:02 Guest one liner, book recommendation, favorite failure, advice for learners 11:27 Human Dx Project and Global Morning Report 15:35 Diagnostic terminology 21:25 Case #1, Reza solves 33:40 Diagnostic autopsy and teaching points for case #1 38:00 Case #2, The Curbsiders solve 57:30 Diagnostic autopsy and teaching points for case #2 61:33 Take home points and a plug 64:30 Outro

Check out this audio treasure map to find the hidden curriculum and learn how it can change your practice. Learn how positive teaching spans not just the classroom or bedside but, how we simply talk about patients. Sanjay Desai MD, coauthor of ACP’s Position Paper on Hidden Curriculum and Internal Medicine program director at Johns Hopkins guides us through several cases that illustrate how our institutional norms can shape the practice of medicine...for better or worse. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Sanjay Desai MD; Justin Berk MD, MPH, MBA; Matthew Watto MD CME questions by: Justin Berk MD Editors: Chris Chiu MD & Matthew Watto MD Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD Guest: Sanjay Desai MD Time Stamps 00:00 Disclaimer, Intro and guest bio 04:00 Guest one liner, book recommendations, career advice 10:50 Intro to the hidden curriculum and ACP’s three recommendations 22:00 Case #1: A patient with schizophrenia 32:10 Case #2: The iPatient 38:07 Case #3: Attending forgets to wash their hands 41:10 Case #4: A dying patient’s primary care doctor saves the day 46:26 Case #5: A case of violating duty hours 60:10 Take home points 62:00 Outro

Shoulder pain made simple. Develop your confidence and skills with tips from sports medicine specialist Dr. Carlin Senter MD. We discuss her simplified approach to the basic shoulder exam, including when and how to do special tests, high yield exam maneuvers, when to refer shoulder pain patients to orthopedic surgery, and who can be managed conservatively. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Molly Heublein MD and Nora Taranto MS4 Editor: Matthew Watto MD Hosts: Molly Heublein, MD, Paul Williams MD, Matthew Watto MD Guest: Carlin Senter, MD Time Stamps 00:00 Disclaimer, intro, and guest bio 03:15 Guest one liner, book recommendation, career advice, and some picks of the week 13:20 Clinical case of shoulder pain; helpful historical features 18:54 Differentiating referred pain from c-spine pathology from shoulder pathology 21:00 A framework for shoulder pain, HIP-ROT, and using ROM to generate a differential 27:40 Frozen shoulder aka adhesive capsulitis 31:57 Glenohumeral joint arthritis 33:52 Rotator cuff disease 40:53 Specific testing for rotator cuff tears 51:45 Impingement syndrome versus bursitis 56:25 Counseling patient with shoulder pain or injury 59:03 Steroid injections, topical therapy, and AC joint arthritis 65:18 When to refer to surgery and some take home points

The sleep apnea episode that won’t put you to sleep. Become a sleep apnea guru with incredible insights from Barbara Phillips MD, MSPH, FCCP an expert in pulmonary medicine, critical care and sleep medicine who is also a past president of CHEST! We discuss high-yield topics in the world of obstructive sleep apnea including: home sleep studies vs in-lab polysomnography, the importance of oxygen saturation (the T90 and ODI) when interpreting sleep study results, tricks to improve CPAP adherence, and alternatives therapies for obstructive sleep apnea. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Cyrus Askin MD CME questions by: Cyrus Askin MD Editor: Chris Chiu MD & Matthew Watto MD Hosts: Cyrus Askin MD & Matthew Watto MD Guest: Barbara Phillips, MD Cover-Art & Infographic - Beth Garbitelli, MS1 Time Stamps 00:00 Disclaimer, intro, guest bio 03:00 Guest one liner, book recommendation, advice for trainees 08:10 Clinical case of sleep apnea, some basic stats, and key predictors of sleep apnea 12:38 Barriers to diagnosis and treatment of OSA 15:23 Discussion of T90, hypoxemia and sleep fragmentation 17:05 How to read a sleep study report 21:55 Home sleep apnea testing 24:15 What are the consequences of sleep apnea 28:30 What is the efficacy of cpap for lowering blood pressure and mortality 31:45 Counseling a patient who is new to cpap 33:45 Choice of mask 40:10 Do alternatives to cpap work? e.g. surgery, mandibular advancement devices 44:17 Modafinil and z-drugs 47:15 Driver’s license issues in sleep apnea 48:35 Future of sleep medicine and take home points

We delve into advanced management of headaches, including novel therapies, migraines with aura, migraines in complicated patients, and headaches of short duration with Dr. Rebecca Burch, a headache medicine specialist at the John R. Graham Headache Center at Brigham and Women’s Hospital. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Paul Williams MD Edited by: Matthew Watto MD Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD Guest: Rebecca Burch MD Time Stamps 00:00 Disclaimer, intro and guest bio 03:28 Guest one-liner, movie and podcast recommendations, favorite failure and picks of the week from The Curbsiders 10:38 Clinical case of migraines; diagnosis and classification 14:12 Does medication overuse headache exist? 16:16 Chronic daily headache; Conversion from episodic to chronic and vice versa 21:43 Approaches to medication overuse headache 25:54 Case 2: migraine with aura and other types of migraine (retinal, hemiplegic, etc.) 32:09 Pathophysiology of migraine; how triptans work; How should aura effect management? 38:44 Migraine cocktails 41:15 Comorbid mood disorders; Use of psych meds and triptans 45:08 Migraines and oral contraceptives 48:42 Botulinum toxin and new CGRP therapies 53:36 What does success look like in migraine therapy? 55:32 Nonpharmacologic management 60:45 Case 3: headaches of short duration 66:36 Headache red flags; Imaging for headaches; pathophysiology of high and low pressure headaches 72:00 Idiopathic intracranial hypertension 75:25 Take home points 77:00 Outro  

HIV care for the internist with author and HIV expert, Michael Saag MD, Professor of Infectious Diseases at University of Alabama and founder of the 1917 Clinic. We discuss the specifics of screening & diagnostic testing in HIV, monitoring CD4 counts and viral loads, first line antiretroviral therapy, harm reduction, and how to provide excellent HIV care in your primary care clinic. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written & Produced by: Elena Gibson MS4, Justin Berk MD MBA MPH Artwork by: Elena Gibson MS4 Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MBA MPH Editor: Matthew Watto MD Guest: Michael Saag MD Time Stamps 00:00 Disclaimer, intro, and guest bio 04:35 Getting to know our guest, a movie recommendation, and words of wisdom 08:48 Clinical case, HIV screening, in-depth discussion of HIV testing & diagnosis 15:56 New diagnosis of HIV, counseling after diagnosis, confirmation, follow-up testing, the second visit 24:20 Treatment - what to start and when; some basic comments on therapy 30:05 Primary care after diagnosis, vaccines, cancer screening, cardiovascular disease prevention 34:35 Monitoring CD4 counts and viral load; interpreting CD4 count; time course of response for CD4 and viral load 42:02 Harm reduction counseling; addressing medication non-adherence 47:40 PCP prophylaxis 49:43 The 1917 Clinic, Ryan White Clinics, and linking patients to care 53:10 Take home points 55:40 Plugs 57:45 Will a cure or vaccine for HIV emerge? 59:16 Outro

Join us in this roundtable discussion of patients before paperwork, administrative burden, the new CMS payment model proposal, and a bit on health insurance with cohost, Fatima Syed MD MSc and guest, Deep Shah MD MSc. Doctors Syed and Shah are both early career physicians with masters degrees in comparative social policy from Oxford University and are active members of the American College of Physicians. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Fatima Syed MD MSc and Matthew Watto MD CME questions by: Matthew Watto MD Hosts: Fatima Syed MD MSc, Matthew Watto MD Guest: Deep Shah MD MSc Time Stamps 00:00 Disclaimer, intro, and guest bios 02:18 Guest one liners, book recommendations, picks of the week 11:00 Administrative burden 16:00 Will the documentation problem get better? Suggestions for improvement 25:11 Why do CMS rules spread to the private insurance sector? 29:30 What innovations might reduce administrative burden? 32:40 The Affordable Care Act, health insurance, price transparency 40:20 Take home points 43:20 Outro

Nutrition pearls from integrative cardiologist, Steven Devries MD, Associate Professor of Medicine, Northwestern Feinberg School of Medicine, Executive Director of The Gaples Institute. Clinicians receive little formal nutritional training in medical school and residency. It’s time to fill that gap! We discuss the strength of the literature supporting dietary interventions for cardiovascular health and review practical tips to help patients achieve healthy eating patterns. Patients need to hear from us that nutrition matters! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written & Produced by: Molly Heublein MD Hosts: Matthew Watto MD, Paul Williams MD, Molly Heublein MD Guest: Stephen Devries MD Editor: Matthew Watto MD Special thanks to Elena Gibson MS4 for writing our show notes

Houston, we have a female sexual dysfunction problem. Female sexual problems, which can affect women of all ages, are underdiagnosed and undertreated--in part because clinicians are not the best at asking about sex in primary care visits. In the course of this episode, learn about how to have that sex talk you’ve (maybe) been avoiding, what to ask when working up sexual problems in women, and find the words to talk to patients about sex. Today, we’re lucky to have the female sexual health expert of experts, Dr. Stacy Lindau, MD, MA, Professor of Obstetrics and Gynecology and Medicine-Geriatrics at the University of Chicago Medicine, on the show to teach us the best “sex talk” language, the differential for female sexual problems, and explore therapies. Sadly, there’s no sildenafil-like magic bullet, but a multidisciplinary team can make real impact on female sexual problems. Don’t forget to check out http://womanlab.org Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Nora Taranto MS4 Hosts: Leah Witt MD and Matthew Watto MD Infographic: Leah Witt MD Editor: Matthew Watto MD Guest: Stacy Lindau MD Time Stamps 00:00 Disclaimer 00:35 Intro and guest bio 03:30 Guest one liner, book recommendations, favorite failure, career advice and picks of the week 12:57 Clinical Case of female sexual dysfunction and some definitions 15:08 Are sexual problems a normal part of aging?; How to take a sexual history; Etiology of sexual dysfunction; “Diagnostic sex”; Red flags 27:54 Medications that contribute to sexual dysfunction 31:00 Labs 34:45 Treatment: pelvic PT, medications, counseling, flibanserin, herbal supplements 49:05 Screening for female sexual problems 51:58 Take home points; WomanLab.org 55:19 Outro

Summary Conquer Clostridium difficile (Clostridioides difficile) with this “spore-tacular” episode featuring infectious diseases expert, Dr. Curtis Donskey, Professor at Case Western Reserve University and clinician at the Louis Stokes VA Hospital. We discuss the updates in the 2017 IDSA C. difficile guidelines plus a bunch of random pearls. If you have ever laid awake at night wondering how many pills are needed for a fecal transplant, then this is the episode for you!  We discuss why metronidazole was dropped as the first line therapy for Clostridium difficile infection (CDI) along with other hot topics such as two-step testing, loperamide use, which antibiotics are the least likely to cause CDI, and more. Do not miss this episode! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written by: Carolyn Chan MD Produced by: Matthew Watto MD Hosts: Carolyn Chan MD, Matthew Watto MD, Paul Williams MD Editor: Matthew Watto MD Guest: Curtis Donskey, MD

Geriatric psychiatry returns. We tackle sleep problems and behavioral disturbances in patients with dementia with returning guest, and Geriatric Psychiatrist Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: pharmacologic and nonpharmacologic management of insomnia; treating agitation and irritability; medical management of psychotic symptoms and paranoia; ethical concerns about the treatment of challenging behaviors in dementia; and the shortage of geriatricians and geriatric psychiatrists. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD Artwork by: Kate Grant MD Hosts: Jordana Kozupsky NP, Matthew Watto MD Editor: Matthew Watto MD Guest: Dennis Popeo, MD Time Stamps 00:00 Intro and guest bio 01:55 Case of sleep disturbance in a patient with dementia; medications for sleep disturbances; nonpharmacologic strategies for sleep 11:32 Irritability and agitation versus paranoia, or psychotic symptoms; benzodiazepines in older adults 15:40 Antipsychotic medications, the black box warning and ethical concerns 23:50 Geriatricians, geriatric psychiatrists in short supply; Behavioral interventions 28:16 Outro Tags psychiatry, psych, geri, geriatrics, dementia, paranoia, psychosis, sleep, insomnia, agitation, antipsychotics, atypical, black, box, warning, adverse, zolpidem, benzodiazepine, side, effects, therapy, mirtazapine, gabapentin, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Summary Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and titrate medications, and how long to continue therapy. Stay tuned for part two of our discussion with Dr Popeo on managing sleep and behavioral problems in older adult patients with dementia. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written & Produced by: Jordana Kozupsky NP, Matthew Watto MD Artwork by: Kate Grant MD Hosts: Jordana Kozupsky NP, Matthew Watto MD Editor: Matthew Watto MD Guest: Dennis Popeo, MD Time Stamps 00:00 A question for you, the listeners 01:12 Disclaimer, intro and guest bio 05:00 Getting to know our guest, recommendations for reading, and career advice 14:13 Case of geriatric depression; effective history taking; recognizing associated symptoms; depression scales 19:03 Suicide in older adults; firearm safety 24:26 Choice of therapy; Pharmacologic agents; Counseling patients and managing expectations; Dose titration and tracking symptoms 34:41 Augmenting therapy versus cross-titration to another agent; When is it okay to stop an antidepressant 40:50 Take home points 44:40 Outro Tags: psychiatry, psych, geri, geriatrics, depression, mdd, sleep, insomnia, appetite, agitation, suicide, SSRIs, side, effects, therapy, diagnosis, serotonin, mirtazapine, bupropion, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Kick up the quality of your care with tips and tactics from Caitlin Clancy MD, coauthor of ACP’s High Value Care Curriculum. We learn to define quality and value in healthcare; the most common barriers to high value care; use of probability and likelihood ratios to boost clinical reasoning and combat diagnostic uncertainty; some useful tools to estimate cost; sources of healthcare waste; and some general pearls on how the healthcare system works...or doesn’t. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written & Produced by: Matthew Watto MD Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD Guest: Caitlin Clancy MD Time Stamps 00:00 Disclaimer, intro and guest bio 03:50 Guest one-liner, some discussion on non traditional paths, and picks of the week 12:10 Case 1: Defining value, cost, quality; sources of healthcare waste; and how to avoid the waste of daily labs 23:00 Case 2: An uninsured patient who needs major surgery; costs for uninsured versus insured patients 28:35 Do insured patients have better outcomes? 31:15 How to determine cost and “fair market price” 36:29 Case 3: Clinical case of suspected heart failure 45:45 Case 4: Clinical case of patient requesting antibiotics; barriers to high value care and how to overcome them 57:05 Outro Tags: high, value, care, quality, cost, diagnostic, uncertainty, likelihood, ratio, testing, treatment, consumer, acp, college, american, insured, uninsured, bill, charge, reimbursement,

Master the management of gout with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. Topics include: how to initiate and titrate urate lowering therapy, guidelines controversy over uric acid targets, colchicine & NSAIDS for anti-inflammatory prophylaxis, uricosuric agents, febuxostat, HLA B5801, use of uric acid levels in the acute setting and more random gout facts. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written and produced by: Matthew Watto MD Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD Guest: Tuhina Neogi MD, PhD Time Stamps 00:00 Intro and guest bio 01:30 Allopurinol initiation and titration 07:10 Uricosuric therapy 09:10 Controversy over uric acid targets for gout 17:40 Parachutes and randomized controlled trials 19:15 Colchicine or NSAIDS for prophylaxis 23:20 Who needs febuxostat? 26:20 When to refer for gout, HLA B5801, and checking uric acid levels in the acute setting   33:29 Take home points 36:15 Outro Tags: allopurinol, uric, urate, acid, level, therapy, management, gout, flare, crystal, arthritis, titration, probenecid, febuxostat, target, acr, acp, guidelines, nsaids, colchicine, hla b5801, septic, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Crystalize your knowledge of gout and stop flares in their tracks with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. On this first of two gout episodes we learn to diagnose gout with or without arthrocentesis, how to treat flares, and how to counsel patients about gout, which apparently involves fire fighting and bathtubs. Don’t miss next week’s episode on urate lowering therapy, gout guidelines controversy, and answers to your gout questions from social media. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written and produced by: Matthew Watto MD Hosts: Paul Williams MD, Stuart Brigham MD, Matthew Watto MD Guest: Tuhina Neogi MD, PhD Time Stamps 00:00 Disclaimer, intro 01:40 Guest bio 03:20 Guest one liner, music recommendations, advice for researchers, and some comments on failure 09:15 Clinical diagnosis of gout 12:15 Is taking a diet history useful? 14:30 Classification criteria for gout 17:35 MSK ultrasound and Physical exam findings in gout 21:06 Arthrocentesis and MSU crystals 24:45 A recap of how to make the diagnosis of gout 26:50 The bathtub analogy and how to counsel a patient with a new diagnosis of gout 30:55 Pathophysiology of gout 34:55 Treatment for acute gout flares (steroids, colchicine, NSAIDS. And topical NSAIDS?)  45:30 Outro Tags: gout, crystal, colchicine, steroids, nsaids, joint, flare, acute, chronic, urate, uric, acid, arthritis, acr, exam, diagnosis, rheumatology, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Dr. Neda Frayha (@nedafrayha) of Primary Care RAP (Hippo Education) joins us this month for our thoughts and analysis of some recent (and not so recent) journal articles that interested us this month. Our articles spanned topics that include at cancer survival among patients pursuing treatment with complementary medicine, the effect of body weight on effectiveness of preventive aspirin dosing, strategies to promote physician leadership, respiratory symptoms in those with marijuana use and MRSA risk among patients with penicillin allergies. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.   Credits: Written by: Sarah Phoebe Roberts MPH, Neda Frayha MD, Christopher Chiu MD Producers: Sarah Phoebe Roberts MPH, Christopher Chiu MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD Editor: Matthew Watto MD  Time stamps: 00:00 Disclaimer, intro, guest bio 05:05 Do patients using complementary medicine for cancer therapy have worse outcomes? 13:11 Does low dose aspirin work for primary prevention of major adverse cardiac events? 19:16 Do physicians make better leaders? 24:55 Does marijuana cause respiratory symptoms? 30:40 Does penicillin allergy confer increased risk for C Diff and MRSA infection? 38:40 Wrap-up and outro Tags:​ aspirin, cardiac risk, mortality, cancer, complementary, alternative, conventional, therapy, marijuana, cannabis, respiratory, symptoms, leader,

Get schooled on driver’s safety for older adults by expert, Alice Pomidor MD, Professor of Geriatrics at Florida State University. Whether or not older adults can continue to drive is a huge problem faced by for primary care clinicians, and will remain one until driverless cars become ubiquitous. Topics covered include: how to take a driving history, red flags, physical exam, cognitive exam, and vision assessment for driver’s safety, resources, when to refer, alternate means of transportation, and the legal repercussions of reporting...or not reporting. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written and produced by: Matthew Watto MD and Elizabeth Garbitelli MD Candidate 2022 Editor: Matthew Watto MD Cover Image by: Kate Grant MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Alice Pomidor MD  Time Stamps 00:00 Disclaimer 00:35 Intro and guest bio 03:10 Guest onliner, book recommendations, and career advice 10:43 Clinical case, and the 5 Rs of clinicians responsibility 19:15 Taking a history from older adult drivers 26:28 The clinical exam for driver’s safety (cognition, vision, and MSK tests) 37:24 How can we avoid patient anger towards clinician and family members? 41:10 When and where to refer for driving evaluation 47:00 Alternative transportation 52:00 What to do if someone refuses or forgets to stop driving 59:45 Reporting requirements and legal ramifications 69:15 Take home points 72:00 Outro  Tags: driving, elderly, geriatrics, dementia, treatment, prevention, cognition, seniors, drivers, safety, crash, motor, vehicle, car, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student  

Things We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound and urine electrolytes in acute kidney injury (AKI), folate deficiency and anemia work-up, prealbumin and malnutrition, blood transfusions, shellfish and contrast allergies, monitoring after switch from IV or oral antibiotics, and “against medical advice” discharges. Don't forget to check out Clinicwiki.org a free, online resource for teaching ambulatory medicine. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Credits: Written and produced by: Justin Berk MD, MPH, MBA Editor: Matthew Watto, MD Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD, FACP Guest: Lenny Feldman MD, FACP Time Stamps 00:00 Announcements 00:38 Disclaimer, intro, and guest bio 03:53 Guest one liner, some recommendations, and advice 08:35 Defining high value care and things we do for no reason (TWDFNR) 12:40 Why do clinicians order useless testing? 14:58 Urine electrolytes for acute kidney injury 20:30 Renal ultrasound for acute kidney injury 25:54 Stop ordering folate for anemia workup 31:47 How many units should I transfuse? 34:40 Prealbumin and albumin for malnourishment. 43:24 Iodine, shellfish and contrast allergy 50:28 Patient leaving against medical advice 56:45 Switching from IV to oral antibiotics 63:27 Dr Feldman’s plugs 65:36 Outro

Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the appropriateness of billing. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at acponline.org/curbsiders (goes live at 9am on release date). Follow this link to read the ACP’s statement in support of POCUS in Internal Medicine. Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Christopher Chiu MD and Renee Dversdal MD Produced and CME questions by: Christopher Chiu MD Edited by: Matthew “Mike” Watto MD Hosts: Matthew Watto MD, Stuart Brigham MD, Christopher Chiu MD Guest Expert: Renee Dversdal MD Tags: point-of-care, acp, impocus, ultrasound, bedside, POCUS, CLUE, exam, training, lifestyle, management, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

“Women in medicine, be bold.” Medical World, powerful women are here to stay. Dr. Vineet (Vinny) Arora, Professor of Medicine at University of Chicago, an exemplary Woman in Medicine and Leadership, shares snippets of her own story, valuable career advice to folks at all levels of training, and fascinating data about the gender disparities that exist in training, promotion, and pay.  We hope you’ll learn from this episode, whether you have faced or anticipate facing these struggles as a Woman in Medicine or as a member of another marginalized group, or whether you’re an ally and want to learn more about the issue. Women are entering medical school now more than ever, and are learning to provide the best possible care to patients (didn’t you see that patients of female physicians have significantly lower mortality rates than patients of male physicians? (Tsugawa et al., 2016)).  The modern medical woman wants to teach, mentor, and lead--and be fairly evaluated, and promoted. That’s where We In Medicine (both women and men) have some work to do.  Because gender disparities (and other disparities hinging on identity) do exist. N.b. This episode is our inaugural in what we hope will be a Women in Medicine series for the Curbsiders.  We have many more topics with which we’d like to engage, from career trajectory to imposter syndrome to sexual harassment to balancing career and personal lives (as inequity is not only at work (Khullar. Being a Doctor is Hard. It’s Harder for Women. NYT 2017)), to conversations about race, gender, and LGBTQ identity in medicine.  We’re passionate, at The Curbsiders, about all these topics, and we want to dive deep into how to make Medicine a more welcoming and ceiling-less place for all.  We can’t wait to bring this series to you, not to mention to bring some more fabulous female experts on air. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written and produced by: Leah Witt MD, Shreya P. Trivedi MD, Nora Taranto AB, Sarah Phoebe Roberts MPH, Molly Heublein MD, Beth Garbitelli, Hannah R Abrams, Images by: Beth Garbitelli and Hannah Abrams Editor: Matthew Watto MD Hosts: Leah Witt MD, Shreya P. Trivedi MD, Matthew Watto MD Guest: Vineet Arora MD

Short on time but hungry for knowledge? Curbsiders’ Journal Club gives you the speedy article analysis you crave. We provide brief summaries of recent research and news items in the field of internal medicine, so you can save time and stay on top of the literature. On this episode, we were joined by Kashlak Memorial’s very own Chair of Medicine, Dr. Robert Centor AKA @medrants on Twitter or “Uncle Bob” to the Curbsider Crew. This month’s topics include: estimating atherosclerotic cardiovascular disease risk, whether CT pulmonary angiography (CTPA) effectively rules out pulmonary embolism, discharging low risk patients with pulmonary embolism from the ED, metformin and risk of acidosis in patients with CKD, treating opioid use disorder after a nonfatal overdose, Canagliflozin and renal protection in type 2 diabetes, screening for diabetes among patients below age 40, and the association between nose-picking and staphylococcus. ACP members can claim free CME-MOC at  acponline.com/curbsiders (goes live 0900 EST on podcast release date). Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.   Credits: Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH Editor: Matthew Watto MD Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD Guest: Robert Centor MD

Lyme disease and tick-borne illness deconstructed by Infectious Diseases expert, Paul E. Sax MD, of episode 78 fame. Oh, Summer Nights. The time for romance between Danny Zuko and good girl Sandy, the time to sit in the backyard around the bonfire, the time for sunset hikes in the woods and mountains…..and don’t forget, it’s also the time for those pesky woodland ticks who’ll go for a ride on you and maybe suck your blood (gross!). Dr. Sax takes us through the essentials of tick-borne illness, with a focus on Lyme Disease: diagnosing it, treating it, identifying possible co-infections, and managing Post-Lyme residual symptoms.   Our (And Dr. Sax’s) Disclaimer about this episode, and the shownotes: Tick-borne illness is a very serious problem in public health in the US, but management is quite a controversial issue. We’ve done our best with this episode to stay as evidence-based as possible. Moreover, given the limited time we have on air, we have tried to focus on what we think is most clinically relevant. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Shreya P. Trivedi MD, Nora Taranto AB Produced by: Shreya P. Trivedi MD, Nora Taranto AB Editor: Matthew Watto MD Images by:  Hannah R. Abrams Hosts: Shreya P. Trivedi MD, Matthew Watto MD, Paul Williams MD Guest: Paul E. Sax MD

Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at http://thecurbsiders.com/podcast . Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Matthew Watto MD and Joel Topf MD Produced by: Matthew Watto MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Joel Topf MD Time Stamps 00:00 Announcements 01:02 Disclaimer 01:40 Intro and guest bio 04:00 Joel’s one liner 06:05 Joel’s “favorite failure” 11:45 Paul shares a failure 13:20 Tweetorials 16:39 Clinical case of non gap metabolic acidosis 18:06 Three buckets of NAGMA and GI losses 21:02 Chloride intoxication and normal saline 25:14 Renal tubular acidosis and normal role of kidney in acid base 35:03 Proximal (type 2) RTA 40:33 Cases of proximal RTA 43:38 Distal (type 1) RTA 53:15 Bicarbonate dosing and titration 55:28 Type 4 RTA (hypoaldosteronism) 62:09 Urinary anion gap and ammonium 67:26 Replacing GI losses of bicarbonate 70:25 Joel reviews quick cases of RTA and NAGMA 74:49 Outro  Tags: renal, tubular, acidosis, non, gap, rta, nagma, metabolic, kidney, diarrhea, sodium, normal, saline, ringer's, lactate, tubule, bicarbonate, physiology, acid, base, ammonia, ammonium, nephrolithiasis, assist

Expert diagnostician, Dr. Gurpreet Dhaliwal, again joins The Curbsiders to dive deeper into the topic of clinical expertise.  Topics include, and are mainly focused on, Dr. Dhaliwal’s “training regimen:” feedback, simulation, quizzing, learning from consultants, and how to read the medical literature as a clinician.  While we found this episode to be incredibly useful (and entertaining to record), don’t let our bias sway your opinion! In fact, just listen to the episode and listen for practical advise on how to improve your own clinical acumen.   Dr Brigham’s comment:  Be forewarned, much of what we talk about is seemingly common sense, but, upon listening to the episode many times, I realize that we have, over time, overly complicated the fundamentals of expertise.  I’m just as guilty as the next physician. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by:  Stuart Brigham MD Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD Guest: Gurpreet Dhaliwal MD Images by: Beth Garbitelli Edited by:  Matthew Watto MD

Curbsiders’ Journal Club features rapid summary and critical appraisal of recent articles and news stories in internal medicine by The Curbsiders. This month’s topics include: asthma, maintenance versus as needed inhaler use, procalcitonin, Pneumocystis pneumonia prophylaxis, colon cancer screening, smoking cessation, cannabis and cognitive impairment, LDL cholesterol and mortality, plus some medical podcast recommendations. Over the last month, we have developed a list of more than 40 interesting articles and news stories that we have been feeding our own brain holes. From this list we have plucked a select few that we really wanted to highlight and share with you. Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! We are also on Facebook, Instagram, and Twitter: @thecurbsiders. Credits: Written by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH Producers: Christopher J Chiu MD, Sarah Phoebe Roberts MPH Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD Editor: Matthew Watto MD Time Stamps: 00:00 Announcements 00:20 Disclaimer 01:00 Intro to Curbsiders Journal Club 03:07 Mild asthma and as needed versus maintenance inhaler use 09:50 Smoking cessation, e-cigarettes, and financial incentives 17:23 Pneumocystis pneumonia prophylaxis 22:18 Cannabis and cognitive impairment 26:15 Colorectal cancer screening update by American Cancer Society 30:37 Procalcitonin for lower respiratory tract infections in the ED 37:29 Cholesterol, baseline LDL-C, mortality and cardiovascular events 41:01 Incorrect symbology and some podcast recommendations 46:22 Outro Tags: asthma, maintenance, inhaler, procalcitonin, Pneumocystis, pcp, pneumonia, prophylaxis, colon, cancer, screening, crc, smoking, cessation, marijuana, cannabis, cognitive impairment, LDL, cholesterol, mortality, cardiovascular, podcast, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed

Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology! Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Cyrus Askin MD Infographics: Beth Garbitelli Produced by: Cyrus Askin MD and Matthew Watto MD Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Scott Matherly MD Time Stamps 00:00 Announcements 00:54 Disclaimer 01:30 Guest bio 02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis 06:56 Clinical case of decompensated cirrhosis 09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics 18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin 25:10 Timing of medical therapy 26:39 MAP of 82 mmHg, beta blockers and variceal bleeding 31:04 Use of midodrine for hypotension 33:45 Prophylaxis of SBP 36:05 Take home points 38:04 Outro Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

Cirrhosis. Finally. Take your liver game to the next level with tips from @liverprof, Scott Matherly MD, Assistant Professor of Medicine at Virginia Commonwealth University. Topics include: exam findings in cirrhosis, interpreting liver function tests, incidental cirrhosis on imaging, fatty liver disease, steatohepatitis, hep c, shear wave elastography, screening for varices and hepatocellular carcinoma, pathophysiology, and lifestyle measures for initial management. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at  acponline.org/curbsiders (goes live at 9am on release date). Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Cyrus Askin MD CME questions by: Cyrus Askin MD Produced by: Cyrus Askin MD and Matthew Watto MD Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD Guest: Scott Matherly MD

Step up your primary care of cancer survivors with tips from Dr Regina Jacob, Assistant Professor of Medicine at Temple University. Care of the cancer patient does not end when their cancer treatment is over, and there is more to a past diagnosis of cancer than surveillance. We discuss cancer survivorship care with Dr. Regina Jacob, including the changing demographics of survivorship, the importance of survivorship care plans, and how survivorship is largely just good primary care. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Paul Williams MD Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD Produced by: Paul Williams MD Edited by: Matthew Watto MD Guest: Regina Jacob MD  Time Stamps 00:00 Disclaimer 00:35 Intro to the topic and guest bio 02:15 Guest one liner, book and app recommendations 06:58 Paul’s pick of the week. 07:40 Clinical case, definitions, and phases survivorship 12:36 Survivorship statistics 15:04 Co-survivorship 17:41 Care models for survivorship 20:56 Assigning roles in care of cancer survivors 22:59 Sample survivorship care plan 27:39 Childhood, adolescent and young adult cancer survivorship 34:18 Sexual dysfunction in cancer survivorship Turn down Watto and Regina tracks 35:56 Stressors in young adult cancer survivors 37:33 Fatigue 43:28 Guidelines on survivorship 45:06 Late cardiac toxicity 46:23 Support groups and resources 49:04 Take home points 50:29 Outro 

Knee pain is easy with practical tips from Orthopedist, medical educator, car-builder, and inventor extraordinaire Dr. Ted Parks. He teaches us the four buckets of knee pain, how to perform a 30-second knee exam, choose a knee brace, order x-rays, and the red flags to look for in a history and physical that should have you shouting for your closest neighborhood orthopedic surgeon. This episode is brought to you in partnership with the American College of Physicians. ACP members can claim free CME-MOC credit at  acponline.org/curbsiders. Check out our video of the Parks-Approved 30-second knee exam! Credits: Written by: Nora Taranto BA, Matthew Watto MD Produced by: Chris Chiu MD and Nora Taranto BA Edited by: Matthew Watto MD. Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD. Guest: Ted Parks MD.   Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. 

Keep current with this monthly journal club covering landmark articles through May 2018, plus rapid fire hot takes from the medical literature and health news. We rate each article according to a highly scientific ‘Hotcakes’ scale to highlight what practice-changing knowledge we’ll take to work this month. Topics: Hypertension, blood pressure monitoring, prostate cancer screening, Intimate Partner Violence screening, alcohol is killing you, new diabetes drugs and mortality, DPP-4 inhibitors and IBD risk, NT-proBNP-guided therapy vs usual care, effect of teaching status on mortality, and more! If you’re a listener and have something interesting for us to discuss, please send it our way. Join our mailing list to receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders. Credits: Written and produced by: Christopher J Chiu MD, Sarah Phoebe Roberts MPH Hosts: Christopher J Chiu MD, Stuart Brigham MD, Paul Williams MD, and Matthew Watto MD Editor: Matthew Watto MD Time Stamps:  00:00 The Curbsiders need a web master 00:50 Disclaimer 01:25 Intro to the format 03:25 Ambulatory BP monitoring and mortality 09:08 Blood pressure treatment strategies: CVD risk score vs systolic BP targets 14:14 Repeated BP measurements important at office visits and future directions of BP management 21:25 Hot takes in order of appearance: Prostate cancer screening, intimate partner violence, alcohol, DPP4 inhibitors mortality and IBD, teaching status and mortality in US hospitals, 5 lifestyle factors that may add to life expectancy, NT pro-BNP, BNP and mortality 38:12 Outro

Get schooled on hemoglobin a1c targets in type 2 diabetes mellitus by American College of Physicians guidelines coauthor, Devan Kansagara MD MCR, Associate Professor of Medicine, Oregon Health Sciences University. We summarize outcomes from the landmark diabetes trials (ACCORD, ADVANCE, VADT, UKPDS 33 & 34), how a1c targets effect microvascular and macrovascular events, estimating life expectancy, and how to personalize diabetes control for your patients. We’re proud to announce our new partnership with the ACP to provide free CME credit and MOC points on select episodes of The Curbsiders. ACP members can visit acponline.org to redeem free CME/MOC credit. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list to receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written, produced, and edited by: Matthew Watto MD. Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD. Guest: Devan Kansagara MD, MCR Time Stamps 00:00 Announcement 00:48 Disclaimer and intro 03:11 Getting to know our guest: one liner, book recommendation, mentorship 06:50 How and why did ACP write their guidance statement on diabetes, A1C targets 09:18 Landmark trials in type 2 diabetes 11:36 Does tight control prevent micro or macrovascular complications 13:20 Trials of newer agents like SGLT2i, GLP-1 and DPP4i 14:33 How do ACP’s guidelines differ from other published guidelines 17:20 Quick recap of landmark trial findings 22:24 Personalizing glycemic control 24:30 Controversy over an A1C goal of 7-8% 28:05 Clinical inertia 30:26 Legacy effect and metabolic memory 34:00 Deintensifying therapy 38:29 Life expectancy and comorbid conditions 43:15 Performance measures in diabetes 44:42 Take-home points 46:30 The Curbsiders recap and give some closing remarks 49:13 Outro 

Separate the wheat from the chaff when it comes to food allergy, food intolerance, and celiac disease. Featuring renowned gastroenterologist and current president of the American Gastroenterological Association, Dr. Sheila Crowe MD FRCPC FACP FACG AGAF, we discuss how to differentiate a food allergy from an intolerance, what diagnostic testing is appropriate, and why fructans might be the real culprit in patients with ‘gluten sensitivity’. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits: Written by: Sarah P. Roberts, MPH Guest: Sheila Crowe, MD Hosts: Matthew Watto, MD; Stuart Brigham, MD; Paul Williams, MD Producers: Sarah P. Roberts, MPH and Chris Chiu, MD Editor: Matthew Watto, MD Time Stamps: 00:00 Disclaimer 03:35 Getting to know our guest, book recs, and career advice 10:35 Clinical case 11:40 Defining allergy, intolerance 14:05 Food intolerance and FODMAP 18:02 Taking a history in patient with potential food allergy vs intolerance 21:34 Dermatitis herpetiformis, gluten ataxia, and extraintestinal manifestations of celiac 26:12 Diagnosing celiac disease 30:53 Next steps if celiac testing is negative; lactose, fructose intolerance, IBS 33:48 Non-celiac gluten sensitivity (NCGS) 37:48 Study of NCGS 40:41 Olmesartan and drug-induced enteropathy 43:38 Dieticians, dietary recs, elimination diets 48:10 “Voodoo” testing 52:36 Counseling patients on diet 54:35 Take home points 55:50 Outro

A random serving of knowledge food for your brain hole with returning guest, Dr. Alan Dow, Professor of Internal Medicine at Virginia Commonwealth University School of Medicine. Our final live recap show from ACP 2018 covering: human microbiome, copper deficiency, POTS syndrome, substances of abuse, drugs for delirium and how to be more like Leonardo Da Vinci. Please let us know what you liked, didn’t like and how we can make the show better. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders. Time stamps: 00:00 Disclaimer 01:30 Guest bio 03:19 Getting to know our guest, podcast, and book recommendations 08:55 Human microbiome 11:05 A case of anemia and neuropathy 13:30 Physiology and treatment of POTS syndrome 17:00 Novel substances of abuse 20:17 Benzodiazepines for delirium 24:00 Leonardo Da Vinci versus the modern physician 27:18 Outro Tags: microbiome, transplant, bupropion, gabapentin, pregabalin, copper, POTS, substance, use, disorder, leonardo, da, vinci, acp, journal, article, literature, news, media, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

A fast moving recap of hot topics and clinical pearls live from Internal Medicine’s largest national conference, ACP 2018 in New Orleans! Dr. Nina Mingioni, Clinical Associate Professor and director of Undergraduate Medical Education in Internal Medicine at Thomas Jefferson University Hospital serves up some knowledge food for our brain holes. Topics: the athlete as a patient, sports physicals, food as medicine, medical marijuana (cannabis), and more! Listeners, please let us know what you liked, didn’t like and how we could make this better. YouTube video of this episode available here: ACP 2018 Recap with Nina Mingioni.  You can join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.    Time stamps: 00:00 Music and disclaimer 02:48 Getting to know our guest 06:07 The athlete as a patient 10:20 Relative energy deficiency in sports 12:00 Drug interactions 15:51 Food as medicine 21:56 Marijuana 30:24 Outro Credits:  Written by: Nina Mingioni MD, Hannah Abrams. Producer/videographer: Chris Chiu MD. Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD. Editor: Matthew Watto MD Tags: food, microbiome, marijuana, athlete, ekg, ecg, physical, sports, training, energy, relative, deficiency, cannabinoid, entourage, effect, cannabidiol, thc, cannabis, acp, 2018, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 5:10 - Start of Interview / Introduction 10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology 16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”) 23:30 - Other ways to risk-stratify (Other CT findings, clot burden) 28:45 - What does a low-risk patient look like? 30:35 - When to consider treatment modalities other than general anticoagulation 35:12 - Anticoagulation treatment options 36:38 - Next step intensive interventions after anticoagulation 42:00 - Evidence behind catheter-directed lysis 44:05 - IVC Filter discussion 47:22 - Discharge criteria for PE 50:00 - Incidental PEs 52:40 - Interdisciplinary PERT Team Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

Random clinical pearls from day 2 of ACP 2018 live in New Orleans. Topics include: Perioperative medicine, DOACs, anticoagulation, reversal agents, ACP statements on hidden curriculum, physician well being and burnout, modeling behavior, dermatology pearls, rashes, venous stasis ulcers, pentoxifylline, biotin and Grave's disease, dermatology pearls, Stuart's tips on sports doping, and how chocolate milk improves recovery time. Doctors Chris Chiu and Chris Thrash join us to discuss their favorite teaching points from today's sessions. Cochrane Review on Venous Ulcers https://bit.ly/2JdQAMu Joinour mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

The Curbsiders share random clinical pearls from day 1 of ACP 2018 live in New Orleans. Topics covered include: breast density and cancer risk, patients before paperwork, diverticulitis, social determinants of health, migraine prevention, PrEP and thunderclap headaches. Doctors Chris Chiu and Chris Thrash join us on air to discuss their favorite teaching points from today's sessions. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.    

Keep up-to-date with this fast moving discussion of recent journal articles and thought-provoking headlines in medicine. Welcome to the first-ever Curbsiders journal club covering landmark articles from March to April 2018, plus rapid fire hot takes and the unveiling of our new hotcake based rating system. Please let us know what you liked, didn’t like and how we can make this better next month. Topics: Resident work hours, saline versus balanced IV fluids, barber shops and hypertension, coffee causes cancer, Twitter based medicine, clonidine versus spironolactone, opioids versus nonopioids and aromatherapy for nausea! Written by: Chris J Chiu, MD; Producer: Sarah Phoebe Roberts MPH; Edited by: Matthew Watto, MD Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.  Time stamps: 00:00 Disclaimer 00:35 Host intros, featuring special guest and correspondent Chris Chiu, MD 01:30 Introducing a new Curbsiders segment! 03:20 First article: Duty-Hour Flexibility Trial 08:55 Second article: Trial of Blood-Pressure Reduction in Black Barbershops 14:27 Third article: SALT-ED Trial 20:00 Hot takes—intro 20:36 Hot take #1, Dr. Milton Packer and Twitter-based medicine 24:07 Hot take #2, Coffee and cancer risk 26:24 Hot take #3 Aromatherapy for nausea 28:10 Hot take #4 Opiates vs. non-opiates for chronic pain 29:00 Hot take #5, Surgeon general’s statement on naloxone 29:46 Hot take #6, Spironolactone vs clonidine for resistant HTN 31:54 Outro & announcements

Become an expert diagnostician like Dr Gurpreet Dhaliwal, Professor of Medicine at UCSF. Join us for this deep dive into clinical reasoning and how doctors think! Topics include: how to improve your own clinical reasoning and diagnostic skills, how to teach these skills, and the initial steps to building your own expertise/mastery in clinical medicine! Dr. Osler once admonished his students to build experiential wisdom and follow-up with their clinical cases (clear cases, doubtful cases, and mistakes), but to do so, one must “...learn to play the game fair, no self-deception, no shrinking from the truth; mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.” Test yo’ self: Take our quiz here Written and produced by:  Stuart Brigham, MD; Images by Hannah Abrams; Edited by:  Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Revolutionize your approach to the red eye in pr-eye-mary care! Dr. Glaucomflecken (of GomerBlog/Twitter--fame) teaches us to recognize and manage common eye complaints. You’ll develop an approach to diagnosing and treating your patient with the dreaded red eye. We answer: What presentations should have us running down the hallway for that prized ophtho consult? What on earth does glaucomflecken stand for? Which eye drops are best? What is an eye dentist? Plus, answers to your twitter questions, and so much more! By the end of this episode, you’ll be sure to say “Eye Understand!” Self Assessment Questions: Take the ophtho self-assessment! Donate at FirstDescents.org to support young cancer survivors like Dr. Glaucomflecken! Written and produced by: Nora Taranto AB, Carolyn Chan MD; Original art by: Bryan Brown, MD. Edited by: Matthew Watto, MD. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. 

Dominate acid-base disturbances with the wisdom of @kidney_boy aka Joel Topf, MD, Chief of Nephrology at Kashlak Memorial Hospital.  Master his 5 key steps for interpreting acid-base disorders and decode any ABG, VBG, and BMP to find the primary disorder, and any other disorders tucked away in the ABG! Plus: Henderson-Hasselbach and pH simplified; the anion gap, should your correct it?; choice of IV fluid; osmolar gaps, methanol, ethylene glycol, isopropyl alcohol; and how metabolic disorders are like a boy band. Be sure to follow along the Dr. Topf’s brilliant acid-base powerpoint. Written and produced by Joel Topf MD, Shreya Trivedi MD, Xavi Jimenez MD; Images by Hannah Abrams; Edited by Matthew Watto MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. 

Want to look cool like a toxicology consultant, sipping coffee on rounds? Ever check a patient for armpit sweat? Learn the secrets of tox from the titans of toxicology podcasting, The Dantastic Mr. Tox & Howard (AKA Dr. Dan Rusyniak and Dr. Howard Greller), as they loquaciously dish on all things tox. Topics include: how to approach the patient with an unknown overdose, are toxidromes clinically useful, clues on physical exam, is GI decontamination still recommended, and why they hate bupropion and tramadol. We recommend cautious ingestion of fluids while listening because this was a seriously funny episode. Try our Self Assessment Questions Toxicology 101 Quiz. Written and produced by: Christopher Chiu, MD; Graphics by: Beth Garbitelli; Edited by: Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. 

Take a deep breath and tune in to this week’s episode full of COPD diagnosis and management pearls, with expert Dr. Denitza Blagev, a pulmonologist, intensivist, and Medical Director for Quality, Speciality Care at Intermountain Healthcare in Utah with a particular interest in physician wellness and issues related to women in medicine. We cover: history taking, interpreting PFTs, patient counseling, inhalers and medications, exacerbations, antibiotics, steroids, and who needs BIPAP...so basically everything you ever wanted to know about chronic obstructive pulmonary disease. Take our self assessment here. Sponsored by @nephmadness. Registration opens March 15th at AJKDblog.org Written and produced by: Leah Witt, MD, Cyrus Askin, MD. Edited by Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Contraception simplified with clinical pearls from reproductive health and family planning experts, Dr Angeline Ti, and Dr Moira Rashid. We cover it all including: the menstrual cycle, mechanism of action for various methods of birth control, hormonal versus nonhormonal contraceptives (e.g. intrauterine devices, patches, pills, rings, implants), patient counseling, and lots of resources to make your job easier. Women’s health correspondent, Dr Molly Heublein returns as cohost. Take our self-assessment quiz! Written by: Molly Heublein, MD, Beth Garbitelli and Sarah Roberts, MPH. Edited by Matt Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Abolish anemia, and iron deficiency w/tips on IV iron therapy from real life iron man, Michael Auerbach, MD, FACP, Clinical Professor of Medicine Georgetown University School of Medicine. Topics include oral versus IV iron therapy, safety of IV iron, ferritin cutoffs, and how to diagnosis/ treat iron deficiency in patients with chronic inflammation, chronic kidney disease, pregnancy, heart failure, and more! Take our Self Assessment Test Here. Images by Beth Garbitelli; Written and produced by Justin Berk, MD and Matthew Watto, MD. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Get the latest on valvular heart disease: TAVR vs SAVR, choice of valve type, rheumatic heart disease, antibiotic prophylaxis for endocarditis, who needs an echocardiogram, and anticoagulation goals with tips from cardiologist, Dr Eli Gelfand, Section Chief of General Cardiology at Beth Israel Deaconess Medical Center in Boston and an Assistant Professor of Medicine at Harvard Medical School. Correspondent Dr Kate Grant joins us for this conversation w/Dr Gelfand about his common sense approach to the evaluation and management of valvular heart disease. Written by Kate Grate, MD and Matthew Watto, MD. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Challenge your beliefs on the efficacy of pervasive treatments used in dementia with expert Eric Widera, MD, Professor and clinician-educator in the Division of Geriatrics at the University of California-San Francisco. We explore the use of cholinesterase inhibitors, antipsychotics for behavior disturbances, feeding tubes, medications and supplements used for weight gain (inspired by Choosing Wisely and the American Geriatric Society’s “Ten Things Clinicians and Patients Should Question”). Plus, we introduce our new correspondent, Dr. Leah Witt, Geriatrics Fellow at UCSF. Written and produced by: Jordana Kozupsky, NP, Nora Taranto, MS3, Leah Witt, MD; Edited by: Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Self Assessment Questions Take the quiz now!  Time Stamps 00:00 Disclaimer 00:37 Guys set up the show 02:00 Dr Widera’s bio 03:15 Getting to know our guests 13:10 Picks of the week 16:40 Clinical case: new diagnosis of dementia 17:40 Discussing dementia with patients and caregivers 23:42 Cholinesterase inhibitors 27:35 Stopping cholinesterase inhibitors 33:35 Follow up to therapy 36:05 Dealing with behavior disturbances 39:15 DICE approach 44:17 Risks of antipsychotic medications 48:00 Use of benzos or sedative hypnotics 49:45 Melatonin for delirium or sleep 52:00 Mirtazapine 53:54 Clinical case: patient with dementia not eating 54:40 Feeding tubes 59:40 Dysphagia and NPO orders 62:04 Misinformation on malnutrition and girth creep 65:10 Thickened liquid challenge 70:25 Appetite stimulants 72:38 Megestrol 73:54 Take home points from Dr Widera 79:17 Outro Tags: dementia, donepezil, cholinesterase, inhibitor, antipsychotic, behavior, disturbance, agitation, benzodiazepine, supplement, feeding, tube, restraints, thickened, liquids, geriatric, choosing, wisely, american, society, ags, assistant, care, doct

Boost treatment efficacy and amplify the “doctor as a placebo” phenomenon with tips from placebo expert (and ex-cartoonist), Mark W. Green, MD, Director of Headache/Pain Medicine and Professor of Neurology, Anesthesiology, and Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai. Topics include: What’s that pesky sugar pill actually doing to us? Why do we get a boost from taking medicines that have no active compounds within them? How does placebo work? How can it be leveraged? What does it mean for study design/blinding? And what’s with its pesky dark twin--the nocebo effect? “Enjoy this, our only placebo-controlled episode”  (Thanks, Stuart!). Written and produced by: Molly Heublein, MD and Nora Taranto MS3; Edited by: Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. 

Pulmonary hypertension deconstructed with clinical pearls from cardiologist, John J. Ryan MD, FACC, FAHA, director of University of Utah Pulmonary Hypertension Center. We discuss classification, diagnosis/differentiation, initial workup, additional testing, echo findings, how to counsel patients with pulmonary hypertension, and why cows never get ankle edema! Written and produced by: Jordana Kozupsky, NP and Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps: 00:00 Disclaimer 01:30 Introducing our new Correspondent Jordy 03:05 Listener feedback 04:40 Guest bio 06:25 Getting to know Dr Ryan 09:33 Picks of the week 15:20 Clinical case 16:35 How to explain pulmonary hypertension to a patient 18:12 Groupings of pulmonary HTN 21:20 Taking a history. Ask these questions. 23:30 Physical exam 25:45 Initial testing 27:40 Overnight pulse oximetry 29:00 Echo findings in pulmonary HTN 31:30 Transpulmonary gradient 33:33 What is a normal pulmonary artery pressure 35:15 Accuracy of PA pressure estimate by echo 39:04 Mechanism of shortness of breath in PH 40:10 Should you hold PAH meds in a hypotensive patient? 41:55 Therapy for PH and follow up 46:28 Who to refer 47:40 PAH risk factors 52:09 Mortality in PH 58:22 Take Home Points & Outro

Differentiate, diagnose, and treat the various forms of dermatitis and stop the ‘itch that rashes’ with this in-depth, myth-busting episode of “The Dermsiders” with Dr. Kalman Watsky Clinical Professor of Dermatology at Yale Medical School. Topics include: how to differentiate between and diagnosis various forms of dermatitis, topical therapies, common pitfalls, patch testing, and more! Special thanks to Bryan Brown and Beth Garbitelli who wrote and produced this episode and the show notes! Written by: Bryan Brown, MD and Beth Garbitelli Edited by: Matthew Watto, MD Infographics by: Bryan Brown, MD Cover image by: Beth Garbitelli Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

It's a potpourri of Infectious Diseases with tips from expert, Dr Paul Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women's Hospital, and Professor of Medicine at Harvard Medical School. We discuss the man flu, the flu vaccine, travel medicine, malaria, lyme disease, post lyme syndrome, chronic lyme, shingles, cellulitis, abscesses, antibiotics, c diff, antibiotic associated diarrhea, the dangers of fluoroquinolones, why doxycycline is awesome, and more! Told you it was a potpourri. Dr Shreya Trivedi joins Matt and Paul as guest host. Show Notes, MCQ by Shreya Trivedi, MD Edited by Matthew Watto, MD Infographics and cover image by Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps: 00:00 Announcement 01:38 Intro 03:46 Picks of the Week 06:47 Guest bio 08:47 Getting to know our guest 15:40 Flu vaccination 19:54 Barriers to the flu vaccine 23:34 Can you give the flu vaccine to an ill patient 24:14 Man flu 26:27 Travel Medicine 30:35 Tick bites 33:49 Lyme serologies 35:38 Lyme prophylaxis 37:37 Chronic lyme disease and post lyme syndrome 38:55 Penicillin and antibiotic allergies 41:48 Fluoroquinolones and adverse reactions 45:24 Should antibiotics be given after an I&D of an abscess  49:34 Antibiotic associated diarrhea, C diff 52:10 Probiotics, stool transplantation, and C diff 54:50 Shingles, recurrent zoster, complications, and the new subunit vaccine 61:45 Using salad tongs at a buffet 63:04 Take home points 64:26 Outro Tags:  ID, infectious, diseases, disease, flu, influenza, lyme, doxycycline, cdiff, antibiotics, infection, cellulitis, abscess, vaccine, zoster, shingles, malaria, travel, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes. Time Stamps 00:00 The setup 02:15 Disclaimer 03:32 Picks of the Week 08:13 Getting to know Dr Forciea 13:35 Broad overview and a clinical case of geriatric hypertension 14:45 Brief history on BP targets 18:05 How do you measure a blood pressure? What type of monitors are available? 22:13 How to standardize BP in the office? 23:55  Ambulatory BP monitoring 24:55 Home blood pressure monitoring 26:11 Standing blood pressure readings and orthostatic hypotension 27:53 How guidelines are written 30:51 Evaluating evidence quality and strength of recommendation 32:35 Timeline and process for guideline generation 34:27 How to read guidelines with a “critical eye” 36:15 Return to our case of uncontrolled hypertension 38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults 40:33 Counsel patients on BP targets    42:25 Low diastolic blood pressure 45:35 SPRINT and the ACP BP guidelines 48:58 Take home points from Dr Forciea 50:07 HTN targets and pay for performance in clinical practice 51:45 Curbsiders recap the ACP guidelines 53:45 Matt and Paul recap the AHA guidelines 54:47 AHA definitions of hypertension 56:15 Diagnosing hypertension and how to measure a blood pressure 60:35 Choosing a blood pressure monitor and HBPM 62:29 Blood pressure goals in ACC guidelines 66:08 Non-pharmacologic measures 69:15 Will we follow these new strict targets? 72:45 Outro Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resid

Conquer community acquired pneumonia and avoid misdiagnosis with tips from Dr. Robert Centor, Professor Emeritus University of Alabama and newly appointed Chair of Medicine at Kashlak Memorial Hospital. We discuss diagnosis, misdiagnosis, procalcitonin, steroids for severe pneumonia, pneumonia severity index versus CURB-65, and how to determine antibiotic choice and duration. Special thanks to Correspondents Neela Bhajandas (cohost), Justin Berk and Bryan Brown who all contributed several articles, resources, and questions to prep for this show. Cover image by Dr Kate Grant paintscientific.com. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Join us for this recap of the key clinical pearls and favorite fan voted episodes from 2017 including: lipids, asthma, diuretics, hyponatremia, CKD, vertigo, and dizziness. Plus, Picks of the Year, exciting announcements for 2018, and Paul reveals that he has a wife! Matt, and Paul are joined by Curbsiders Correspondent, Dr. Chris Chiu, who wrote and produced this episode. Stuart was out with the Man Flu. My apologies to Dr. Bryan Brown whose name I forgot to shout-out when listing our Correspondents. Thanks to Kate Grant for her beautiful cover image. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps  00:00 Intro 01:18 Getting to know Chris Chiu introduction 03:07 Picks of the week and 06:10 Picks of the year and discussion of vancomycin and pip-tazo causing AKI 11:41 Recap of Scott Weingart and EM vs IM episode 17:45 Discussion of Lipids, PCSK9, CAC, CCTA 27:10 Asthma pearls recapped 32:43 Dizziness and vertigo recapped 38:40 Diuretics, diuretic resistance, and secondary hypertension diagnosis and treatment 44:35 Diuretic dosing 46:25 Hyponatremia, volume status, solute loads and SIADH 50:08 CKD, when to refer, and an argument about low protein diets 54:25 Matt, Paul, and Chris reflect on important lessons learned from 2017 59:32 Listener questions and comments 63:35 Wrap-up, and shout outs 66:22 Announcements for 2018 67:25 Outro Tags: hyponatremia, salt, kidney, ckd, asthma, vancomycin, zosyn, injury, weingart, emcrit, emergency, lipids, pcsk9, statin, dizziness, vertigo, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Combat opioid use disorder and the opioid epidemic as we review common clinical scenarios with addiction medicine specialists,  Dr. Stefan Kertesz, University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton,Virginia. We need all hands on deck, and that means you! Learn the basics of opioid use disorder treatment as Dr. Manhapra gives us the scoop on “bup, bup, bup” (buphrenophine), and Dr. Kertesz primes us on opioid related health care policy and reminds us that “We can all do something about the opioid crisis”. Plus, Stuart and Paul express some concerns about how to approach these patients. Do not miss this episode filled with clinical pearls, policy, and joy! Special thanks to writers and producers, Dr. Carolyn Chan and Elena Gibson (MD Candidate, MS4), for their hard work on both of our addiction medicine episodes. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Take the pain out of pain management with clinical pearls from addiction medicine specialists Dr. Stefan Kertesz at the University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton, Virginia. They walk us through an approach to pain management in persons with a history of opioid use disorder (OUD), discuss treatment options for OUD, plus hot tips on how to interpret guidelines surrounding opioids, and more! What are you waiting for? Hit the play button! Special thanks to Elena Gibson, MD and Carolyn Chan, MD Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Elena Gibson and Carolyn Chan Writer: Carolyn Chan Infographic: Elena Gibson Cover Art: Elena Gibson Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Dr. Stefan Kertez and Dr. Ajay Manhapra Time Stamps 00:00 Intro 01:58 Host picks of the week 04:10: Intro to the episode 04:35: Guest Bios 12:32: Case from Kashlak Memorial 13:40 Define substance dependence, substance use, unhealthy use 17:42 Where to go next conversation about pain control 17:54: Assessing risk of relapse 19:35 Screening Tools 20:10 Risk factors for developing OUD when initiating opioids. 25:10: CDC Guidelines length of prescription and risk of substance use disorder (7) 27:00: Defining optimal length of opioid after common surgical procedures (6) 30:30: Long term use of opioids 33:50: OUD treatment options 37:30: Duration of buprenorphine/naloxone treatment, tapering risks (8) 38:50: POATs: Prescription opioids (9) 40:05 Social support and mental health services for SUD treatment 41:10 Risk of abstinence and adverse outcomes 42:35 Protracted withdrawal 43:35: Editorial BMJ Golden Month of Opioid use disorder (10) 44:00 Overdose risk in patients on long term opioids 44:40 Op-Ed on the Hill (11) 45:40 Example of protracted withdrawal syndrome 47:40 Reducing Harms: Naloxone, who to prescribe to? 50:30 Take home points 53:40 Outro

Trans patients need excellent primary care and you can provide it with expert tips from endocrinologists, Dr Vin Tangpricha, Professor of Medicine at Emory University School of Medicine, and Dr Jeffrey Colburn, Assistant Professor of Medicine at Uniformed Services University. Learn practical tips in caring for transgender patients including: defining terms like gender dysphoria, gender nonconformity, transgender; use of pronouns; patient counseling; fertility concerns; initiating and monitoring hormonal therapy; surgical options; and how to help trans patients navigate the complexities of gender affirming therapy. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Knock the wind out of asthma with tips from Dr Denitza Blagev, a pulmonologist and intensivist who currently serves as Director for the Schmidt Chest Clinic at Intermountain Medical Center in Murray, Utah. We simplify the approach to diagnosis, spirometry, patient counseling, choice of agent, stepwise therapy, and de-escalation...plus, a little myth busting. Special thanks to Dr Cyrus Askin for writing and producing this episode and to Dr Bryan Brown for his wonderful infographics. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. 

Dr Kevin Pho, founder KevinMD.com “Social Media’s Leading Physician Voice" schools Matt, Paul and Stuart on a potpourri of topics including physician advocacy, the dangers and benefits of social media, the pros and cons of electronic health records, health policy, health advocacy and lastly primary care and the integration of advanced practice providers/clinicians. Special thanks to Dr Chris Chiu who helped produce the show and write our show notes. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps: 00:00 Intro 00:54 Picks of the week 06:58 Getting to know our guest 10:30 Why physicians need to understand health policy 11:21 Best advice Dr Poh has received in his career and why variety is important to avoid burnout 13:45 Advice to young physicians about to start using social media 16:40 Why are physicians afraid of social media 18:54 Risks of social media 21:20 Discussion of “Twitter bates” aka debates 23:20 Physician advocacy and social media 26:18 The next big health care debate...is it a right? 31:03 Why electronic health records are so painful to use? 34:49 How can charting be worked into clinic workflow? 37:50 Conspiracy theories on EHRs 39:11 Advanced practice providers/clinicians 46:40 Primary care shortage 50:16 Growth of medical administrators and how to take back control as physicians 52:38 Advice on how to break into medical writing 54:08 Paul ends the show with some wisdom and steals the show 55:59 Outro  Tags: kevinmd, advocacy, policy, health, care, ehr, chart, advanced, practice, clinician, physician, meded, foamed, social, media, twitter, kevin, pho, nurse, practitioner, medicine, internal, family, primary, education, internist, hospitalist

Making all your nephrology dreams come true with part 2 of our interview with  @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Flush away your bad prescribing habits when it comes to nephrotoxic drugs in this fast paced run down of the medications which must stay on or off Santa’s naughty-list, backed up with a sack full of memorable research studies. Special thanks to Annie Medina, Justin Berk and Kate Grant for writing/producing this show and to physician artist, Kate Grant for her lovely/hilarious artwork (more at paintscientific.com). Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 03:00 Which medications should we exercise caution over in CKD? 03:31 Bactrim (Trimethoprim+Sulfamethoxazole) 07:00 NSAIDS 08:29 NSAIDS and the ‘Precision’ Trial NEJM 2016 looking at cardiovascular safety 12:50 The Male Physician Study JAMA 2001 13:50 Discussion about Nurses Health Study and use of analgesia, and CKD 15:15 Acute Interstitial Nephritis, Beta Lactam Antibiotics, and the risk of Acute kidney injury +/- CKD with Proton Pump Inhibitors 18:20 Advice for co-prescribing NSAIDS,ACE inhibitors and diuretics 20:39 Creatinine levels and ACE/ARB prescribing. How High can you go? 24:55 Facebook question from listener: measures to reduce proteinuria in hypertensive patients 27:20 Empagliflozin and renal protection in diabetic patients 32:00 Contrast Induced Nephropathy, the AMACING trial 2016. 38:00 Take Home Points 39:57 Outro Tags:  chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, medications, pharmacology, bactrim, nsaid

Steady your hand and annihilate tremor with tips from Neurologist, and Movement Disorder specialist, Andres Deik, MD, Assistant Professor of Clinical Neurology at Kashlak Memorial Hospital (we can’t tell you where he really works: ) We teach you to differentiate benign causes of tremor from Parkinson’s disease with simple history and physical exam skills, plus nonpharmacologic and pharmacologic therapies for tremor. Special thanks to Beth Garbitelli and Chris Thrash who wrote and produced this episode and the show notes! Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro and disclaimer 01:08 Listener feedback - Paul is not fired. 02:09 Picks of the week. 05:35 Dr. Deik intro 07:19 Icebreaker questions 12:20 Wikipedia definition 13:02 Classifying tremor 14:33 Postural tremor vs. reemerging rest tremor 15:48 Important history questions 17:58 Medications that can induce tremor 21:39 Physical exam techniques 27:30 Exam characteristics between typical PD tremor and ET 28:36 History components to distinguish between PD and ET 34:10 Misdiagnosis of Parkinson’s 36:54 Imaging workup 39:03 Case from Dr Deik 41:33 Nonpharmacologic management 44:18 Pharmacologic management 49:06 Dosing propranolol 51:07 Distinguishing between physiologic tremor and pathologic tremor’ 54:06 Website recommendations 55:50 Handwriting 59:14 Take home points 61:34 Outro Tags: tremor, essential, postural, neurology, Parkinsons, disease, beta, blockers, primidone, movement, disorders, antidepressants, occupational, therapy, rest, intention

Take control of chronic kidney disease with tools, and tips from @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Learn which equation is best for eGFR, how to counsel patients about progression/prognosis, how to monitor patients in CKD, and who needs a referral to Nephrology. Special thanks to Annie Medina, and Justin Berk for writing/producing this show and to physician-artist, Kate Grant for her lovely and hilarious artwork (more at paintscientific.com).  Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 00:00 Intro 03:13 Pick of the weeks 08:49 Clinical Case 09:36 How to explain CKD to patients 12:16 Loss of GFR with age 13:22 Which equation should be used to estimate GFR 18:05 Creatinine clearance from 24 hour urine collection 22:25 Initial workup upon diagnosis of CKD 25:40 Interpreting tests for proteinuria 26:52 Staging and prognosis in CKD 32:00 Completing the initial workup for CKD 33:52 Who needs a referral to nephrology? 35:53 What labs to check in CKD and a discussion of secondary hyperparathyroidism 40:32 Take home points 42:30 Outro Tags: chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, prognosis, monitoring, iron, pth, proteinuria, hypertension, nephropathy, diabetes, albumin, protein, anemia, hyperparathyroidism, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine, medical, primary, physician, resident, student

Hiding from Hep C? Dive in with experts Dr. Gina Simoncini, MD, MPH Associate Professor of Clinical Medicine at Temple University Hospital, & Dr. David Koren, PharmD, BCPS, AAHIVP,  board-certified pharmacotherapy specialist and infectious diseases clinical pharmacist at Temple University Hospital. They walk us through a simplified approach on whom to screen, how to start antiviral therapy, what to follow up on, and how to navigate insurance waters along the way. Special thanks to Sarah Roberts and Jordana Kozupsky who wrote and produced this episode and the show notes! Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 01:00 Guest bios 03:00 Getting to know our guests 05:35 Picks of the week 10:05 Clinical case 10:54 Diagnosing HCV 12:00 ASCEND study 13:14 Restrictions on HCV treatment 15:17 Ordering and interpreting pre-treatment tests 19:30 Prescribing medication 22:00 Genotyping and drug resistance 24:10 Patient counseling 25:49 Understanding drug classes 27:33 Drug interactions 30:06 Multidisciplinary approach to treatment 33:01 Follow-up 36:47 Reinfection/cure rates 39:35 Patient counseling revisited 41:25 Side effects of treatment 42:53 Screening 44:02 Take home points Tags: hepatitis, virus, hcv, direct-acting, antiviral, therapy, management, primary, care, liver, ultrasound, fibrosis, cirrhosis, side, effects, monitoring, hcc, hiv, infectious, disease, assistant, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine, 

Fighting with Emergency Medicine colleagues is stupid. Learn how EM doctors think and avoid the petty infighting with tips from Dr. Scott Weingart, MD FCCM  FUCEM DipHTFU, host of the EMCrit podcast, Clinical Associate Professor and Chief, Division of Emergency Critical Care at Stony Brook Hospital, NY. We discuss decision making, how to avoid anchoring bias, the devil of the gaps, why the elderly always get admitted, how to build relationships with the ED, and Scott’s pet peeves. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 01:10 Picks of the week 05:28 Guest bio 07:00 Getting to know our guest 12:00 Do EM and IM docs hate each other? 14:04 Where conflicts arise. 17:05 System 1 versus system 2 thinking 20:19 When the patient doesn’t match the story 23:55 Why does every 85 year old get admitted? 26:05 Transitions of care: form ED to medical ward 32:08 Is face-to-face signoff only needed for sick patients? 36:28 The devil in the gaps 41:03 Scott’s beer recommendation 42:17 BP cutoff for discharge home 43:44 Scott’s biggest pet peeve with primary care 45:04 How to make friends and collaborate with your EM colleagues 47:14 Take home points 50:35 Outro Tags: emergency, department, room, em, ed, im, conflict, devil, gaps, post-test, probability, illness, serious, system, one, bias, heuristic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Get schooled on medical homes, payer reform, and what the future might look like for primary care with Dr. Sue Bornstein, MD, FACP and Executive Director of the Texas Medical Home Initiative and Chair of the Health and Public Policy Committee at the ACP. Dr Alex Lane of Cooper University Hospital joins Matt as cohost! Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 02:42 Guest CV and background 04:42 Getting to know our guest 10:40 Helpful resources for learning health policy 12:10 Who are the major players/influencers in health care and how do their interests align 15:02 Defining “medical home” 18:45 Where did the idea for a “medical home” originate 22:33 How does medical home affect cost 29:45 Payer reform and the quality payment program (QPP) 33:06 Recap and defining terms 37:18 How will the QPP be implemented? 41:04 Repeal and replace 43:37 Cuts in funding for safety net hospitals that care for the poorest, sickest patients 46:59 Take home points 48:55 Outro Tags: medicare, medicaid, health, care, policy, spending, quality, improvement, advanced, payment, macra, mips, qpp, apm, medical, home, pcmh, affairs, super, utilizer, texas, physician, doctor, assistant, nurse, practitioner, foamed, meded

Expand your consciousness around medical cannabis (aka marijuana) with expert Dr Donald Abrams, Chief of the Hematology-Oncology Division at San Francisco General Hospital and a Professor of Clinical Medicine at the University of California San Francisco. We explain the cannabinoid system, THC, CBD aka cannabidiol, limitations surrounding cannabis research, current and future medical uses for medical cannabis (marijuana), and potential conditions it may benefit. We take a deep dive on the potential harms of medical cannabis and how to counsel patients on safe use. Plus, the return past guest and new correspondent, Dr Molly Heublein, Assistant Professor of Medicine from UCSF. Thanks to Dr Molly Heublein for writing and producing this episode and it’s show notes! Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Clinical case from Kashlak Memorial:  MM is a 62 yo woman with a history of osteoarthritis and breast cancer, now on an aromatase inhibitor. She struggles with aching and stiffness in her hands, shoulders, knees, and hips. A friend suggested she try medical marijuana. She wants her provider’s opinion on if this is safe and effective. Time Stamps 00:00 Intro 01:30 Picks of the week 03:40 Guest bio 05:11 Getting to know our guest 11:03 Clinical case 11:40 Limitations for cannabis research 12:59 Discussion of THC and cannabidiol 14:50 Smoking versus ingesting cannabis products 16:40 Recap of cannabinoid mechanism of action 18:30 Cannabis and cannabinoid products available 20:20 Synthetic THC (dronabinol) 21:46 How “recommending” cannabis and dispensaries work 25:46 Conditions that respond to medical cannabis 29:15 Potential harms of medical cannabis 34:51 Future directions of cannabinoid medicine research 37:24 Cannabis induced hyperemesis syndrome 39:00 Possible lung cancer risk 40:12 Take home points 42:54 The Curbsiders recap and share their views on the medical cannabis controversy 49:40 Outro

Remedy your ignorance as we review some basics of health care policy with Dr. Fatima Syed, Chair of the Council of Residents and Fellows for the American College of Physicians. Dr. Syed is early career physician whose work is already affecting health policy at a national level. You can do it too and we’ll teach you where to start along with defining basic, but poorly understood concepts like The Affordable Care Act, universal health care, single payer health care, MACRA, MIPS, and how “quality” is really measured. Don’t miss this part one in our health care policy for beginners series. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 00:00 Intro 03:20 Getting to know our guest 07:23 How to get involved in a professional organization 09:37 Resources to learn health policy 14:06 The Affordable Care Act and ObamaCare 17:56 What is MACRA, MIPS and how do they affect physicians? 23:09 Nationalized health care in the US versus other countries 25:33 Universal and “single payer” health care defined 27:00 How is quality health care defined? Why is the US rated so poorly? 32:53 Recap and summary of what we’ve learned 34:09 Dr. Syed’s take home points 35:36 Outro Tags: policy, healthcare, macra, mips, aca, affordable, care, act, health, acp, advocacy, quality, payments, reimbursement, kaiser, commonwealth, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Keep your cool in the face of inflammation, and make the path to vasculitis diagnosis less tortuous with Dr. Rebecca Sharim, Rheumatologist and Assistant Professor of Medicine at Temple University. In this episode, we go with the flow from large vessel to small vessel vasculitides, and then learn how to make the diagnosis and management of Giant Cell Arteritis (GCA) and polymyalgia rheumatica (PMR) less of a headache. Correspondent, Dr. Bryan Brown cohosts!  Special thanks to Dr. Bryan Brown for writing our show notes, and creating figures for our handouts. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case from Kashlak Memorial:  A 75 year-old woman with a PMHx of hypertension presents to the ED with three days of worsening left sided headache, now with left sided vision loss during a Norwegian folk festival. On review of systems, she also endorses a week of soreness of her shoulders and hips. This has never happened to her before. Time Stamps 00:00 Intro 03:07 Picks of the week 09:13 Getting to know our guest 15:00 Clinical case of vasculitis 15:59 Defining and classifying vasculitis 20:55 Workup for suspected vasculitis 23:17 How to explain GCA to a patient 25:08 Typical symptoms of vasculitis 28:00 Chewing gum test 29:34 Interpreting ESR 32:54 Basic exam and lab workup for vasculitis 35:23 Headache and suspicion for GCA/temporal arteritis 38:10 Is a temporal artery biopsy still mandatory? 39:20 Polymyalgia rheumatica 40:59 Steps to take when GCA/temporal arteritis suspected in clinic 43:55 PCP prophylaxis with high dose steroids 46:30 DMARDs and steroid sparing agents 48:12 Imaging studies to aid in diagnosis of GCA 50:50 Complications of long term steroid therapy 52:31 Take home points 53:26 Outro Tags: giant, cell, arteritis, gca, vasculitis, steroids, temporal, biopsy, artery, esr, pmr, polymyalgia, rheumatica, vessel, headache, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

How to individualize learning for yourself, and your learners with tips from Dr. Philip A. Masters, editor-in-chief of MKSAP and IM Essentials, Vice President of Membership/International Programs at the American College of Physicians (ACP) and an Adjunct Professor of Medicine at the University of Pennsylvania School of Medicine. Dr. Masters schools us on work life balance, how to recognize and diagnose struggling learners, what resources to use, teaching exercises, and how to generate a study plan. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 01:50 Listener feedback 04:18 Announcements 04:58 Picks of the Week 10:37 Guest bio and credentials 12:36 Getting to know our guest 18:05 Wellness and work life balance 22:55 How medical education has changed 28:55 Choosing resources as a learner 38:00 Case of a struggling learner 41:50 Learners with knowledge deficits and the role of the clinician (non-professional educator) 47:56 Resources to improve your skills as a medical educator 51:01 Take home points  Tags: study, resources, MKSAP, acp, learner, educator, academic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, primary, physician, resident, student  

Solidify your approach to back pain and sciatica with Dr. Chris Miles, Assistant Professor, Family & Community Medicine and Associate Director, Sports Medicine program, Wake Forest Baptist Medical Center. He schools us on red/yellow flags, physical exam maneuvers, when to order imaging, and practical tools and tips for evidence-based management! Correspondent Dr. Shreya Trivedi cohosts! Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case from Kashlak Memorial: 53 yo M construction worker with a BMI of 29 and PMhx of DM2, HTN, depression presenting with right low back pain. He can't remember any trauma or injury. Denies radiation, no bowel or bladder dysfunction, saddle anesthesia, weakness Case from Kashlak Memorial: 48 yo F nurse who has had intermittent back pain for years presented with acute flare after helping lift a patient. The pain similar to previous episodes but more severe and also radiates to her left foot. She has tried naproxen and exercises/mindful stress reduction for months without improvement. It is unbearable for her to work. Time Stamps 00:00 Intro 02:14 Listener feedback 03:44 Announcements 05:14 Picks of the week 08:20 Millenial learners 10:40 Topic intro and guest bio 12:06 Getting to know our guest 17:30 Clinical case of back pain 20:18 How to hand sensory deficits 21:51 Red and yellow flag symptoms 25:44 How to approach patient with yellow flag symptoms 28:00 Physical exam for back pain 30:00 Special testing: Trendelenburg, Slump test, and Straight leg raise 35:48 Classifying types of back pain and a quick recap of teaching points so far 39:28 How to manage patient expectations 40:42 Treatment of non-radicular back pain 46:33 Home exercises and YouTube training 49:31 When to follow up after initial treatment trial 51:35 The patient with severe acute pain 53:33 Some pearls on muscle relaxants 55:22 Clinical case and how to treat radicular pain 59:40 Invasive treatment of back pain 65:04 Back pain treatments that don’t work

Summary: Get a-HEAD of concussions (aka traumatic brain injuries) with tools, tips, and tricks from The Concussion Guy, Dr. Evan Ratner, Medical Director of Gridiron Heroes. Learn to recognize concussions/traumatic brain injury, what questions to ask, physical exam maneuvers, and how to counsel patients and families on safe return-to-learn/play. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case from Kashlak Memorial: 29F with no significant PMH presents to primary care office less than 24 hours after she accidentally struck her head on the metal of her car door. She experienced temporary altered consciousness lasting about one hour along with a headache. No nausea, vomiting, speech, or vision changes. She rested at home last night, but didn’t feel up to reading, or watching TV. She drove herself to your office today. Time Stamps 00:00 Intro 02:33 Listener feedback 05:35 Picks of the week 12:15 Getting to know our guest 19:41 Defining and classifying concussion 23:00 What questions to ask your patient 26:34 Physical exam for patient with concussion 28:50 Use of neurocognitive testing in concussion 30:45 Specifics of testing eye movements and balance 35:00 Who needs imaging? 41:51 Recap of what we’ve learned so far 43:40 Can you let someone with a concussion go to sleep? 47:08 Return-to-learn protocol 50:30 Return-to-play protocol 52:30 Post-concussive syndrome 53:55 Medications for post-concussive symptoms 58:58 Second impact syndrome 64:40 Counseling the patient with multiple concussions 67:08 Take home points 69:09 The Curbsiders recap their favorite teaching points 71:30 Outro Tags: concussion, post, concussive, syndrome, tbi, traumatic, brain, injury, return, play, school, cognitive, rest, treatment, diagnosis, assistant, care, education, doctor, family, foam,

Improve your prescribing practices with tips from The Curbsiders as Matt, Stuart and Paul “Pwilliams” discuss safe prescribing in frail, older adults with diabetes, chronic kidney disease, hypertension, and/or dementia in this part two episode on polypharmacy and deprescribing. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, diabetes, hypertension, kidney, chronic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Avoid common pitfalls, recognize prescribing cascades, and deprescribe like a champ with tips from Clinical Pharmacist, Dr. Sean M. Jeffery, Clinical Professor of Pharmacy at the University of Connecticut School of Pharmacy, and Chair of the Polypharmacy Special Interest Group for the American Geriatrics society. We discuss how to create better medication lists, tools and tips for deprescribing, how to counsel patients on polypharmacy, and safe use of medication in the elderly. Special thanks to the American Geriatrics Society for setting up this interview. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 01:12 Listener feedback 01:56 Picks of the week 06:28 Topic intro and guest bio 07:49 Getting to know our guest 13:05 Defining polypharmacy and related terms 16:30 Clinical Case of polypharmacy 20:34 Making better medication lists 25:01 Clinical Case from Kashlak Memorial 28:40 Beers Criteria 35:41 Statins in frail, elderly patients 38:00 Treating insomnia in the elderly 44:15 Dosing of meds in patients with CKD 45:50 Tool for analysis of drug-drug interactions 48:10 Take home points from Dr. Jeffery 50:00 Outro Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student  

Enhance your skills in the identification and management of eating disorders with clinical pearls from Dr. Rosalind Kaplan, Clinical Associate Professor of Medicine at Thomas Jefferson University and a Primary Care Physician in Jefferson Women's Primary Care. We learn who to screen for eating disorders, what questions to ask, criteria for diagnosis, common complications, and how to manage them. This is a must listen if you’re like us and don’t know much about eating disorders specified and not otherwise specified. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case from Kashlak Memorial Hospital: 24yo F medical student with history of anxiety, weight loss, and restricting food senior year of high school. She regained weight with psychotherapy. Now she is a medical student who is over exercising, and abusing laxatives. She passes out one day after class and is referred to you at Kashlak. Time Stamps: 00:00 Intro 01:19 Listener feedback 02:43 Picks of the week 06:50 Topic intro and guest bio 09:10 Getting to know our guest 15:18 Clinical case  20:15 Broad overview of eating disorders 26:40 Eating disorder not otherwise specified 29:19 Underreporting and under diagnosis in men 30:25 Who to screen and how to do it 34:33 Questionnaires: SCOFF, ESP, and Binge Eating Disorder Inventory 38:42 Initial lab workup for eating disorders 42:38 Bone density screening, treatment 45:41 Back to the case: Initial patient counseling  49:22 Medical therapy 52:20 Can we use bupropion? 54:02 What’s the role for primary care? 58:14 Hyponatremia in eating disorders 60:34 Complications of purging 66:25 How to be an ally for your patient 69:12 Treatment for binge eating 72:51 Take home points 74:30 Outro Tags: anorexia, nervosa, bulimia, eating, disorder, weight, loss, binge, binging, purge, electrolytes, not, otherwise, specified, ideal, body, image, treatment, screening, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Don’t miss life threatening upper respiratory infections, and stop underusing antibiotics with tools and tips from our wonderful guests: Dr. Robert Centor, Professor of Medicine at University of Alabama, known for developing the Centor Criteria for pharyngitis, and his excellent blog and Twitter feed @medrants; and Dr. Alexandra Lane, Assistant Professor of Medicine, and Director of the Resident Clinic at Cooper University Hospital. We cover red flag signs in upper respiratory tract infections, diagnostic testing, physical exam maneuvers, antibiotic therapy, and symptom management. Plus, we’ll teach you have to counsel patients about upper respiratory infections and recommend some great learning resources. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case from Kashlak Memorial Hospital: 39 yo F with obesity, HTN, fibromyalgia who presents with 3 days of chills, subjective fevers, sinus pressure/congestion, post-nasal drip, and cough with some green/yellow mucus. She says, “I get this every year and it only goes away with antibiotics. They usually give me a z-pack”. Tags: upper, respiratory, infections, cough, cold, nasal, pharyngitis, bronchitis, rhinosinusitis, sinusitis, decongestant, spray, symptoms, management, pneumonia, pertussis, influenza, antibiotics, overuse, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Get control of urinary incontinence with tips from Internist and Women’s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you’re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else. Time Stamps 00:00 Intro 01:06 Listener feedback 02:43 Announcements 03:43 Picks of the week 09:07 Getting to know our guest 14:27 Case of urinary incontinence (UI) 15:30 Epidemiology of UI 16:34 Screening for UI 17:30 The 3IQ Questionnaire 18:44 Additional testing in UI 21:23 Classifying UI 24:00 Nonpharmacologic therapy for UI 32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy 34:50 Case continued. Changing medications 37:42 Mirabegron as an alternative to anticholinergics 40:18 More options for stress UI management 41:40 Next line therapies for urge UI, overactive bladder 44:38 Surgery for stress urinary incontinence 45:50 Botox therapy for urge UI, overactive bladder 48:30 Do we need any more fancy diagnostic tests? 50:30 Take home points 55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds 56:40 Outro Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, educ

Master the anemia algorithm, and take a deep dive on iron deficiency, anemia of chronic kidney disease, anemia of chronic inflammation, causes of macrocytic anemia and more in this discussion with international expert, Dr. David P. Steensma, Senior Physician from Dana Farber Institute, and Associate Professor of Medicine at Harvard Medical School. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Cases from Kashlak Memorial: 62 yo M with diabetes and CKD with asymptomatic Hgb 10, MCV 90, and Cr. 1.9? 72 yo F with HTN with asymptomatic Hgb of 11, MCV 85 and Cr. 0.6. 72 yo F with breast cancer in remission after lumpectomy, adjuvant chemo, and XRT treated 6 years ago presents with fatigue and some dyspnea on exertion. Hgb 9.6, MCV 102. Time Stamps 00:00 Intro 01:18 Listener feedback 04:05 Announcement: We’re looking for on air correspondents to join The Curbsiders 05:05 Picks of the week 11:12 Getting to know our guest 17:50 Case #1 Normocytic anemia 19:15 Defining anemia (WHO criteria) 21:10 Epidemiology of anemia 23:45 Normocytic anemia 25:55 Erythropoietin for diagnosis and treatment 28:22 Anemia of CKD or chronic inflammation? 31:37 Discussion of ferritin and soluble transferrin receptor 33:47 Case #1 Conclusion 35:45 Hemoglobin targets in CKD 36:53 Case #2 Microcytic anemia 37:43 Correct reticulocyte count and reticulocyte index 40:45 Deciding on dose and route for iron repletion 43:44 Does vitamin C improve iron absorption? 45:27 Case #3 Macrocytic anemia 46:54 Vitamin B12 deficiency 51:54 Medication related B12 deficiency 52:35 Myelodysplastic syndrome 55:00 Side effects of common MDS treatments 56:18 Take home points 57:35 The Curbsiders post game analysis 64:16 Outro Tags: anemia, hemoglobin, i

Get cozy with these new drugs for diabetes. Don’t be scared, they won’t bite. On this episode,  we interview Endocrinologist and current president of AACE, Dr. Jonathan D. Leffert, MD, FACP, FACE, ECNU about how to utilize the myriad of new diabetes drugs on the marketplace including SGLT2 inhibitors, DPP4 inhibitors, GLP1 agonists, and new ultra long acting insulins. Plus, we’ll teach you how to choose between agents, common side effects, A1C goals, and the cardiovascular benefits of these newer agents. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case: Case from Kashlak Memorial Hospital: 49 yo M with HTN, BMI 29, hyperlipidemia, family history of premature CAD (dad age 45yo), and DM2 with A1C increase from 6.4% to 9% while on metformin monotherapy. Time Stamps 00:00 Intro 04:33 Getting to know our guest 09:50 Clinical case of diabetes 12:40 Latent autoimmune diabetes 15:16 Life expectancy and A1C goal 16:47 Anemia’s effect on A1C 18:40 Back to our case, choice of agent 20:57 Lifestyle changes effect on A1C 22:55 Starting an SGLT2 inhibitor, what to look for 26:45 SGLT2 inhibitor use in patient already on diuretic 27:53 Discussion of CV risk reduction and newer DM meds 33:27 Euglycemic DKA 34:30 Choice of agent GLP1 vs SGLT2 37:10 Use of DPP4 inhibitors 38:55 Back to the case 39:37 Degludec, long acting insulin 41:34 Clinical case conclusion 43:03 Take home points 45:15 Outro Tags: diabetes, medications, glucose, insulin, oral, therapy, drug, hypoglycemia, a1c, blood, cardiac, risk, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Master this practical approach to reading the medical literature (*No statistics needed!) with expert tips from Dr. Christine Laine, Editor in Chief, Annals of Internal Medicine, and Dr. Darren Taichman, Executive Deputy Editor, Annals of Internal Medicine. They teach us what we should be reading, and detail their thought processes as they appraise an article. Topics covered include: Is 3 minute critical appraisal possible? What’s the deal with P-values? What are common sources of bias? How does the approach differ with clinical trials versus observational studies versus meta-analyses? *Minimal statistics needed ; ) Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 01:13 Listener comment on Entresto 02:50 Picks of the week 09:36 Getting to know our guests 14:00 How to stay up on the medical literature 17:15 Three minute critical appraisal 19:15 Step 1: Assess the outcome being studied 20:50 Statistical versus clinical significance 22:33 Evaluating composite endpoints 24:47 Statistical power 28:58 Evaluating for bias 34:40 Recap of what we’ve learned so far 36:33 Is PICO useful? 39:01 Observational studies and bias 41:09 Evaluating a meta-analysis 46:05 Take home points 50:35 The Curbsiders recap the episode 53:02 Outro Tags: literature, appraisal, meta, analysis, analyze, critical, read, medical, journal, study, randomized, observational, systematic, review, clinical, trial, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Special thanks to Dr. Cyrus Askin who found our expert, wrote the questions for this episode, and acted as our cohost. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case: A 45-year-old man presents to the emergency department because of continuous dizziness, nausea, vomiting and unsteady gait that began 18 hours earlier.

Step up your salt game. We deconstruct hyponatremia with expert tips from our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer. Topics include: true versus false hyponatremia, SIADH, tea and toast/beer potomania, safe rates of sodium correction, fluid restriction, salt tablets, IV fluid choice, DDAVP clamps, and more. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case: 85yo F with anxiety, asthma, HTN (on a CCB), hypothyroidism with TSH of 3 on therapy. Sodium was 128 from previous values 134-137 mg/dL. She is more fatigued than usual. Time Stamps 00:00 Intro 03:00 Guest interview 06:45 Pick of the week w/Dr. Topf 15:50 Clinical case of hyponatremia 17:18 False hyponatremia normal osmolality 19:04 False hyponatremia high osmolality 20:06 Understanding why osmolality matters 22:58 Workup false hyponatremia 24:15 Recap of discussion so far 25:10 ADH dependent vs independent hyponatremia 26:30 Psychogenic polydipsia 28:45 Renal failure and hyponatremia 29:33 Tea and toast, and Beer Drinker’s potomania 34:42 ADH dependent hyponatremia 37:45 Volume versus osmolality 39:30 Volume status exam 44:44 Additional testing with urine lytes and uric acid 47:00 Treatment for SIADH 52:12 Discussion of the vaptans 57:51 Additional testing in SIADH 62:20 When to admit patient for hyponatremia 63:29 Clinical case of hyponatremia complications 68:26 Fluids and rate of correction 73:06 DDAVP clamp 76:00 Moderate hyponatremia 78:05 Diuretic dosing DOES matter! 81:29 Loop diuretics for SIADH 83:55 Take home points 86:55 Outro

Solidify your knowledge of osteoporosis and osteopenia in this discussion with Endocrinologists and osteoporosis guideline authors, Dr. Rachel Pessah-Pollack, and Dr. Dan Hurley from the American Association of Clinical Endocrinologists (AACE). Learn when to start therapy after an acute hip fracture, how to use bone turnover markers to assess fracture risk, more on how to dose calcium and vitamin D, and finally, we discuss the new American College of Physicians (ACP) guidelines and how they differ from the AACE guidelines on osteoporosis. For a more basic talk on osteoporosis check out episode #18 w/Dr. Pauline Camacho. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 03:00 Picks of the week 07:31 Guest and topic intro 10:25 Rapid fire questions 14:45 Clinical Case and defining osteoporosis 17:00 FRAX score 20:35 Secondary evaluation for cause of bone loss 20:54 Bone turnover markers (telopeptides) 23:17 Alkaline phosphatase 26:30 Calcium and Vit D 29:35 Recap of teaching points so far 31:25 Antiresorptive versus anabolic therapy 32:40 Aromatase inhibitors increase fracture risk 34:28 When to start therapy after fracture 35:44 Mechanism of action recombinant PTH 41:38 Vitamin D assay and dosing 46:53 Calcium intake, and formulations 49:45 Take home points 50:54 Recap and discussion of AACE vs ACP guidelines by The Curbsiders 59:42 Outro Tags: bone, osteoporosis, anabolic, osteopenia, vitamin D, calcium, fracture, density, AACE, guidelines, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Master the evaluation of acute and chronic chest pain with coronary CT angiography (CCTA). We deconstruct this game changing technology w/experts from the Society for Cardiovascular Computed Tomography (SCCT), Dr. Todd Villines and Dr. Ahmad Slim. We’ve got answers on what to do when a patient with chest pain has a prior CAC score of zero, and/or a CCTA with non-obstructive disease. Plus: how to select, prepare, and counsel patients; how to interpret reports; choosing between myocardial perfusion study and CCTA, and more! Special thanks to Dr. Emilio Fentanes from SCCT for setting up this interview. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case: 45 yo F active duty Colonel with chronic chest pain syndrome despite negative conventional stress test and CAC score of zero. Time Stamps 00:00 Intro 04:00 Rapid fire questions 08:23 Book recommendations 10:14 Defining terms CCTA vs CAC 12:47 Script for counseling patient about CCTA 14:34 Prep for CCTA 16:40 Why is CCTA controversial? 19:37 Patient selection for CCTA both acute and chronic 25:20 Chronic chest pain and CCTA 27:58 CAC and CCTA in high risk occupations 33:25 Clinical case 36:10 Acute chest pain in patient w/CAC score zero 39:18 Acute chest pain in patient w/CAC score zero and previous CCTA w/non-obstructive CAD 41:22 How to read a CCTA report 45:48 CCTA versus conventional testing and risk MI, death 49:18 Use of CCTA in outpatients 52:16 Plaque characteristics and risk ACS 55:51 CCTA w/non-obstructive disease in patients with acute chest pain 58:14 When is myocardial perfusion scanning better? 61:00 Listener question on small vessel disease 62:09 Take home points 65:00 Curbsiders recap 69:33 Outro

Update your management of heart failure (HF) with expert tips from Cardiologist Dr. Eric Adler, Associate Professor of Medicine and Director of Cardiac Transplant and Mechanical Circulatory Support at UC San Diego. We cover how to use BNP, a simple way to examine jugular venous distention, medical therapy for heart failure, the PARADIGM-HF trial, and how to use sacubitril/valsartan (Entresto). Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 04:25 Rapid fire questions 06:00 Palliative care and heart failure 08:40 Book recommendation 10:20 Advice for teachers and learners 12:27 Clinical case of HF 13:38 Classification and staging of HF 17:07 Discussion of BNP 19:35 How to perform neck vein exam for JVD 21:20 BNP for prognosis 23:00 BNP at hospital discharge 26:36 Factors that affect BNP 27:25 Initial patient counseling 32:35 Exercise in HF 34:00 Additional testing at time of diagnosis 36:28 Initial medical therapy 38:30 Discussion of diuretics and dosing 42:50 Aldosterone antagonists 44:30 PARADIGM-HF and entresto 51:27 Medications to avoid in HF 54:14 Digoxin 57:30 Dr. Adler’s take home points 59:11 Stuart questions dosing conventions 60:48 Outro Tags: arni, assistant, care, diuretics, doctor, education, failure, family, foam, foamed, health, heart, hospitalist, hospital, internal, internist, neprilysin, nurse, management, medicine, medical, physician, practitioner, primary, resident, sacubitril, student

Master the safe and effective use of obesity medications with Endocrinologist, Dr. Karl Nadolsky (co-author of 2016 AACE Obesity guidelines), Director of the Diabetes, Obesity & Metabolic Institute at Walter Reed National Military Medical Center. We get under the hood of each FDA approved obesity medication plus some of our normal hijinks. Check out episode #23 for a more general overview of obesity. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 03:12 Picks of the week 08:44 Rapid fire questions 13:00 Counsel patients about obesity 14:40 Pathophysiology of obesity 18:00 Case 22:46 Phentermine/topiramate (Qsymia) 26:20 Bupropion/naltrexone (Contrave) 29:18 Liraglutide (Saxenda) 34:32 Orlistat (Alli, Xenical) 37:35 Cost issues 40:18 Lifelong medical therapy for obesity 42:44 Dr. Nadolsky’s take home points 44:45 The Curbsiders recap and discuss their experience with obesity medications 52:28 Outro Tags: assistant, care, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, obesity, pharmacotherapy, weight loss, safety, side effects, orlistat, alli, naltrexone, bupropion, contrave, phentermine, topiramate, qsymia, lorcaserin, belviq, FDA

Load up on clinical pearls for your practice in this wide ranging discussion with expert clinician educator, Dr. Jon M. Sweet, Associate Professor of Medicine from Virginia Tech Carilion School of Medicine. Topics include cellulitis, tinea infections, dermatologic emergencies, smoking cessation, heart failure, hormone replacement therapy, iron supplementation, and vocal cord dysfunction. Plus, Stuart gives Paul a new nickname! Special thanks to the Dr. Patrick Alguire and Dr. Darilyn Moyer from the American College of Physicians for setting up this episode. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 02:12 Picks of the week 05:10 Guest intro 07:13 Rapid fire questions 15:25 Tinea infections 18:22 Misdiagnosis of cellulitis 23:53 AGEP (Dermatology) 29:03 DRESS syndrome (Dermatology) 35:28 Smoking cessation 36:55 Back pain, acetaminophen and acupuncture 41:42 Hot flashes and hormone therapy 43:05 Iron supplementation 49:55 Heart failure and sacubitril/valsartan 53:33 Vocal cord dysfunction 56:50 Response from Stuart and Paul 62:20 Outro Tags: AGEP, ARNI, assistant, back pain, care, cellulitis, cessation, dermatology, DRESS, doctor, education family, foam, foamed, health, heart failure, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, smoking, student, tobacco, vocal cord dysfunction

Diagnose, prevent, and treat diabetic foot ulcers and infections like international expert, Dr. Andrew Boulton, Professor of Medicine at the University of Manchester (England). From how to perform a proper foot exam, to foot care, to ulcers and infections we cover the essentials for your practice. For full show notes visit http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Tags: assistant, care, diabetes, diabetic, doctor, education, family, foam, foamed, foot, health, hospitalist, hospital, infection, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, ulcer

Prevent HIV infections with pre-exposure prophylaxis (PrEP), and learn to perform appropriate screening for sexually transmitted infections with tips from expert, Dr. Gina Simoncini, Associate Professor of Medicine at Temple University Hospital. Learn how to implement PrEP in your practice, plus tips on vegetable gardens, fellowships, and where to get the best samosas, in this wide ranging discussion. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 04:50 Rapid fire questions 16:23 Defining preexposure prophylaxis 18:50 Who benefits from PrEP 21:43 Case discussion 23:45 PrEP during pregnancy, breastfeeding 24:45 Baseline testing and STI screening before PrEP use 28:15 Counseling on adherence, side effects 31:25 Adverse effects of PrEP 34:00 Monitoring patients on PrEP 36:46 Collaborative practice 37:30 Discussion of high risk behaviors on PrEP 39:30 Does PrEP promote viral resistance? 41:51 Insurance reimbursement for PrEP 42:50 Take home points 44:24 Outro Tags: assistant, care, doctor, education, emtricitabine, family, foam, foamed, health, HIV, hospitalist, hospital, infection, internal, internist, nurse, meded, medicine, medical, physician, practitioner, primary, prophylaxis, resident, sti, student, tenofovir

Learn “weird” endocrine stuff! How to approach vague complaints like fatigue and weight gain. Reverse T3 syndrome, Wilson’s T3 syndrome, and adrenal fatigue; Do they exist? Learn how to help the challenging patient who is convinced they have an endocrine disorder in this discussion recorded live from AACE 2017 with Dr. Michael T. McDermott, Professor of Medicine, University of Colorado Denver School of Medicine. For full show notes visit http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 05:36 Guest intro 07:50 Definition of “pseudo” endocrine 10:02 Case introduction 13:39 “Reverse T3 Syndrome”, the thyroid and fatigue 20:45 Growth hormone 25:10 Fatigue, and where to start 33:00 Adrenal fatigue 38:00 Lab testing 39:34 Take home points 42:12 Stuart on the thyroid and reverse T3 45:30 Paul’s approach to multisystem complaints 51:12 Outro Tags: adrenal, assistant, care, doctor, education, endocrine, family, fatigue, foam, foamed, growth, health, hormone, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, thyroid, t3

Expert tips on the diagnosis and management of secondary hypertension in this conversation with Dr. Richard Auchus MD, PhD, Professor of Pharmacology and Internal Medicine & Director of the Diabetes, Endocrinology, & Metabolism Fellowship Program at the University of Michigan. Topics include: primary hyperaldosteronism, use of spironolactone, Cushing’s syndrome, pheochromocytoma, and which tests to utilize. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Tags: assistant, care, cushing's, doctor, education, endocrine, family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nurse, medicine, medical, pheochromocytoma, physician, practitioner, primary, resident, resistant, spironolactone, student

Recognize and manage end of life symptoms with competence and confidence. In this extensive discussion with Dr. Brooke Worster, Assistant Professor of Medicine at Sydney Kimmel Medical College and Medical Director, of the Palliative Care Service at Thomas Jefferson University Hospitals we discuss scripts for having difficult conversations, managing patient/family expectations, what comes in the hospice “E” kit, terminal delirium, the “death rattle”, air hunger, and more. Full show notes available at http://thecurbsiders.com Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 03:10 Rapid fire questions 08:33 Defining hospice and palliative care 11:28 Case discussion 21:28 Gunderson, MI and Respecting Choices 24:25 How to counsel patients about home hospice? 37:10 Hospice “E” kit and how to use it 42:09 Air hunger, terminal delirium, death rattle, and Cheyne Stokes breathing 52:48 What is the PCM’s role while patient is on hospice? 58:19 Cancer survivorship and palliative care 60:33 Take home points 62:20 Outro Tags: assistant, care, doctor, end, education, family, foam, foamed, health, hospice, hospitalist, hospital, internal, internist, life, nurse, medicine, medical, palliative, physician, practitioner, primary, resident, student, symptom

Learn the latest in lipid lowering therapy in this extensive discussion with Dr. Paul S. Jellinger, MD, MACE, Professor of Medicine at the University of Miami and Chair of the writing committee for the American Association of Clinical Endocrinologists (AACE) 2017 Guidelines for the Management of Dyslipidemia and Prevention of Cardiovascular Disease (CVD). Topics include ezetimibe, PCSK9, FOURIER trial, statin myopathy, CoQ10, fish oil, fibrates and more. For a more basic discussion of dyslipidemia check out episode #10. Full show notes are available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 03:10 Rapid fire questions 08:15 Dyslipidemia defined 10:26 Classifying dyslipidemia 13:21 Diagnosing Familial Hypercholesterolemia 17:48 A difficult lipid case discussed 22:40 Lp (a), Apo B and LDL particle concentration 28:40 What labs to order 31:31 ACC/AHA versus other risk scores 38:21 IMPROVE-IT 41:35 Non-statin medications discussed 45:05 Hypertriglyceridemia fibrates and fish oil 48:25 How often to check the lipid panel 49:58 Statin Myopathy and CoQ10 54:17 FOURIER, PCSK9 and very low LDLs 59:43 Extreme risk category discussed 62:34 Is plaque regression possible? 64:12 Take home points 67:08 Outro Tags: assistant, care, cholesterol, doctor, education family, fish oil, foam, foamed, health, hospitalist, hospital, internal, internist, ldl, lipid, medicine, medical, myopathy, nurse, pcsk9, physician, practitioner, primary, statin, resident, student

A recap and highlights from ACP 2017, Internal Medicine's largest national conference, with Dr. Alan Dow MD, MSHA, FACP, Professor of Medicine from Virginia Commonwealth University. We discuss iron supplementations, shellfish allergies and IV contrast, proton pump inhibitors, and more! For full show notes visit http://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Tags: acp, allergy, assistant, care, contrast, doctor, education, family, foam, foamed, health, hepcidin, hospitalist, hospital, internal, internist, iron, nurse, medicine, medical, physician, ppi, practitioner, primary, resident, shellfish, student

Master the management of major depressive disorder (MDD) with clinical pearls from Dr. Marius Marcel Commodore, Associate Professor of Clinical Medicine and Psychiatry from Temple University Hospital. We cover diagnosis, patient counseling, choice of agent, dose titration, augmentation...and DJ names? For full show notes visit http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 02:08 Rapid fire questions 11:04 Initial diagnosis and screening 13:06 Tools for diagnosis discussed 17:07 Shared decision making in choice of agent 19:40 Monitoring and follow up 21:51 Choice and comparison of agents 27:38 Augmentation and the STAR-D study 31:03 Quick recap 33:52 Cognitive behavior therapy 40:58 Medication titration and duration of therapy 45:18 Bipolar disorder screening 47:38 Screening for suicidality 49:58 Difficulty getting patients into specialty care 53:38 Mood disorders in health care providers 58:31 Listener Questions 60:48 Take home points 64:10 Outro Tags: antidepressant, assistant, care, depression, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, mood, physician, practitioner, primary, psychiatry, ssri, snri, resident, student

An approach to super utilizers, and difficult patients with Dr. Alex Lane, Assistant Professor of Medicine at Cooper University Hospital. In this wide ranging discussion we cover books, learning, super utilizers, hot spotting, and how to approach difficult patients. For full show notes visit http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 02:04 Getting to know you 06:12 Best advice 07:13 Alex’s tips on keep up with EBM 11:22 Something about Alex we won’t forget 13:06 Listener Mail 15:00 Super Utilizers defined 17:00 Hot spotting defined 24:55 ACE score discussed 30:15 Team based approach to care 33:16 Getting involved in your community 36:18 Outro Tags: assistant, care, difficult, doctor, education family, foam, foamed, health, hot, hospitalist, hospital, internal, internist, nurse, medicine, medical, patient, physician, practitioner, primary, resident, spotting, student, super, utilizer

Dominate the diagnosis and management of dementia with tips from international expert Dr. Stephen Dekosky, Professor of Neurology, and deputy director of the McKnight Brain Institute at the University of Florida. Filled with clinical pearls, we cover everything from basic testing to advanced imaging modalities, as well as current and future therapies for dementia. This episode is a must listen. Big thanks to the American Academy of Neurology for setting up this interview. Full show notes are available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 00:00 Intro 02:20 Rapid fire questions 04:40 Defining dementia 08:40 Choosing a clinical test for dementia 17:20 Diagnostic labs 19:00 Genetic and CSF testing 25:46 Advanced brain imaging 28:18 Preclinical Alzheimer’s disease (AD) 32:17 Routine CNS imaging 36:18 Initiating medical therapy 39:35 Differentiating MCI and dementia 41:45 Vascular Dementia 44:10 CSF testing for AD 45:15 Vitamins, supplements, and foods as treatment or prevention 50:56 Mental exercise for AD prevention 52:36 Anticholinergic, benzos and dementia 54:46 Future directions 57:55 Outro Tags: Alzheimers, assistant, care, education, dementia, disease, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, neurology, nurse, medicine, medical, mri, pet, primary, physician, resident, student, vascular      

Dominate syncope with tools, tips, and tricks from The Curbsiders. No guest on this episode, just doctors Watto, Brigham, and Williams deconstructing the frustrating topic of syncope to provide listeners with some shiny clinical pearls and practice changing knowledge. For full show notes visit http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.   Tags: assistant, cardiology, care, doctor, education, epilepsy, family, foam, foamed, guideline, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, presyncope, primary, resident, student, syncope

Dominate leg cramps, diuretic therapy, and resistant hypertension. Our guest, Dr. Joel Topf, is a clinical nephrologist, pioneer in the use of social media for medical education, and Assistant Clinical Professor at Oakland University William Beaumont School of Medicine, best known for his blog, Precious Bodily Fluids, and hilarious/informative Twitter feed @kidney_boy. We start with basic renal physiology and build up to the treatment of resistant hypertension. For full show notes visit http://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Tags: assistant, care, diuretics, doctor, education family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nephrology, nurse, media, medicine, medical, physician, physiology, practitioner, primary, social, renal, resident, resistant, student  

Dominate the treatment of menopause with tips from expert, Dr. Amy Tremper, Assistant Professor of Obstetrics and Gynecology at the University of Michigan Medical School. We discuss hormone replacement therapy, the Women’s Health Initiative, bio-identical hormones...and game shows?! For full show notes visit http://thecurbsiders.com/podcast. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.   Tags: assistant, care, doctor, education family, foam, foamed, health, hormone, hospitalist, hospital, hot flashes, internal, internist, nurse, medicine, medical, menopause, physician, practitioner, primary, replacement, resident, student, therapy

Stop the madness! Diagnose and treat neuropathy like expert guest, Dr. Grace Kimbaris, Assistant Professor of Clinical Neurology from University of Pennsylvania. We cover the basics along with some random pearls on fluoroquinolones, small fiber neuropathy, alpha lipoic acid, and more!  For full show notes visit http://thecurbsiders.com/podcast.  Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.     Tags: assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medical, medicine, nerve, neuropathy, primary, physician, resident, student

Individualize cardiovascular risk, and optimize risk reduction using cardiac CT with coronary artery calcium (CAC) scoring. Our expert guests from The Society for Cardiovascular Computed Tomography (SCCT), Dr. Harvey Hecht, Professor of Medicine from Mount Sinai, and Dr. Matthew Budoff, Professor of Medicine from UCLA, school us on the use of this powerful tool. Special thanks to Dr. Emilio Fentanes from the SCCT for setting up this interview. Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Get full show notes at http://thecurbsiders.com/category/podcast   Tags/keywords: artery, assistant, cac, calcium, care, cardiovascular, coronary, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Diagnose and treat irritable bowel syndrome (IBS) like master clinician, Dr. Brooks Cash of the American College of Gastroenterology. This condition frustrates clinicians and patients alike, but we’ll give you the tools to conquer IBS. Now with our theme song included! Recommend a guest or topic and give feedback at thecurbsiders@gmail.com   Get full show notes at http://thecurbsiders.com/category/podcast   Tags: assistant, bowel, care, doctor, education, family, foam, foamed, gastroenterology, health, hospitalist, hospital, internal, internist, irritable, nurse, medicine, medical, primary, physician, resident, student, syndrome

Anticipate, and dominate the side effects of radiation therapy. On this episode we interview Dr. John J. Cuaron, Radiation Oncologist from Memorial Sloan Kettering Cancer Center in New York to better understand, “What’s the deal with radiation oncology?”. Recommend a guest or topic and give feedback at thecurbsiders@gmail.com   Get full show notes at http://thecurbsiders.com/category/podcast   Tags: assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student 

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn. Recommend a guest or topic and give feedback at thecurbsiders@gmail.com   Get full show notes at http://thecurbsiders.com/category/podcast   Tags: assistant, care, diabetes, dka, doctor, endocrinology, family, health, hospitalist, hospital, hyperglycemia, internal, internist, ketoacidosis, nurse, medicine, medical, primary, physician, student, resident

More tools, tips, and tricks so you can master obesity in clinic. On this first roundtable episode, The Curbsiders give their take on the management of obesity, and offer their own practice changing tips. Also, Paul announces his goal to watch 365 movies in 365 days, and the guys give more great book, movie, and TV recommendations. Got feedback? Email thecurbsiders@gmail.com   Picks of the week Matt’s pick - Never Eat Alone by Keith Ferrazzi Paul’s pick - Sing Street (film) Stuart’s pick - Lemony Snicket's: A series of unfortunate events Clinical pearls (from Recap and response OR Brief topic review) Obesity is a DISEASE. Not a lifestyle choice. Percent weight loss by intervention Diet and lifestyle 5-10% Medications >10% Bariatric surgery >30% Utilize specialist referral to gain resources e.g. dietician, and psychologist through bariatric surgery referral Put faith in your patients ability to change and they will hold themselves accountable Coding tips If BMI >35 then code “morbid obesity” to increase medical decision making Code “BMI” in addition “Morbid obesity” Be sure to code comorbid conditions e.g. hypertension, diabetes, hyperlipidemia, OSA Time Stamps 00:00 Intro 01:29 Picks of the week 06:07 Recap and responses to our obesity interview with Dr. Garvey 08:55 Mechanisms of obesity 10:15 Discussion of relapse rates, weight gain 11:23 Percent weight loss per therapy 14:35 Treating obesity on a budget 18:51 Coding tips 20:43 Diet, lifestyle counseling and how to leverage resources 26:38 Closing remarks 28:40 Outro Disclosures: The Curbsiders report no relevant financial disclosures, but as always hope to have lots of them in the future. 

Obesity is of epidemic proportions in the United States and, unfortunately, many physicians are ill-equipped to tackle this disease.  In this episode, we talk with Dr. Timothy Garvey, MD, FACE, one of the world’s leading experts in obesity research.  We asked the American Association of Clinical Endocrinology to recommend an obesity expert and they gave us the best! Got feedback? Email thecurbsiders@gmail.com 

Summary: Consolidate your knowledge and reinforce the learning you’ve done with us in 2016. Enjoy this holiday helping of knowledge food for your brain hole. The guys offer their best of recommendations for 2016 and recap key teaching points from the past year so you have the tools to dominate 2017. Recommend a guest or topic and give feedback at thecurbsiders@gmail.com   Clinical Pearls: SPRINT trial debate Bias effects results seen in this trial. e.g. stopped early Blood pressure (BP) control may have been overestimated based on how BP was measured leading to increased CV events (Stuart’s view). BP measurements in trial likely reflected out of office BP so results are useful (Paul’s view). Lower BP is probably safe, even in the elderly so be reluctant to back off on meds. HTN Urgency Verify BP reading and measurement technique Evaluate for pain, anxiety, volume overload, nonadherence, or noncompliance Treat high BP with long term goals in mind (i.e. go up on chronic/long-acting meds) Anticoagulation Avoid warfarin in patients with gastric bypass or Crohn’s with ileitis. Use SPARC tool to visually demonstrate risks and benefits of anticoagulation in Afib. Physicians commonly underestimate benefit of anticoagulation in older sicker patients and overestimate risk of bleeding. Fibromyalgia and chronic pain Recognize the constellation of fatigue, memory problems, sleep disturbance, and multifocal pain as fibromyalgia. Use the 2011 American College of Rheumatology criteria for diagnosis. No tender point exam required! Nonpharmacologic therapies and education are most effective (see video links below). Chronic painful conditions like rheumatoid arthritis, or lupus can lead to fibromyalgia. Functional Medicine At least 80% of your food should be whole foods. Use the Dirty Dozen and Clean 15 to guide organic food choices. Knowledge of pathophysiology and biochemistry can be used to treat disease e.g. treating small intestinal bacterial overgrowth can fix iron deficiency and indirectly treat iron deficiency. Lipids Lowering LDL is key. Some s

Summary: Advance your career and expertly navigate the job hunt with guidance from Dr. Alia Chisty of Temple University Hospital.  Highlights include Dr. Chisty offering up her personal email address for mentorship and Dr. Watto announcing our first contest. This episode is full of wisdom to enhance your career whether you're gainfully employed or looking for your first job. Clinical Pearls: Meet with your mentors at the start of the process. They can: Help clarify your goals Activate your network Look for jobs 9 months in advance. An ideal job: incorporates your interests, skills, and values. Leverage your network (friends, mentors, program director) to identify available opportunities Email your cover letter (typically an email) and CV to the division chair or section chief Craft your elevator pitch. Do your homework. Explain how you will add value. When interviewing: Give yourself credit! Highlight experiences in your CV (e.g. conference attendance, lectures given, etc.) Have someone review and proofread your CV. If an employer makes a promise, then have it included in your contract. Don’t just take their word! Have a lawyer review your contract. Goal: Listeners will learn to craft a systematized approach to finding their perfect job. Learning objectives: By the end of this podcast listeners will: Recognize timeline for applications and finding or switching jobs. Design an effective CV and cover letter. Recognize the importance and utility of mentors in the application process Disclosures: Dr. Chisty reports no relevant financial disclosures. Time Stamps 0:20 Intro 03:40 Rapid fire questions 07:10 When to start looking for jobs 09:22 How to narrow your focus 11:33 Too many choices may be worse 13:05 Asking yourself the right questions 14:40 Quick recap of what we

Summary: On this episode we’ll teach you to dominate hypertensive urgency and severe hypertension (HTN) in the clinic, the ER, or on the hospital wards. The Curbsiders offer you this delicious serving of knowledge food so you can manage high blood pressure (BP) without making the same egregious errors that we made during our more formative years. Of note, The Curbsiders are guestless for this episode. Guestless? Is that a word? Our guest for this episode was supposed to be Dr. Wallace Johnson, a Cardiologist, and expert on HTN from the University of Maryland. He did a fantastic job, but, unfortunately, technical difficulties caused us to lose any useable audio. Our sincerest gratitude and deepest apologies to Dr. Johnson. Nevertheless, we pressed on and used one of our own, the illustrious Dr. Paul Williams, as our expert guest. Clinical Pearls: Hypertensive crisis is divided into hypertensive emergency and hypertensive urgency. “Emergency” needs IV therapy NOW “Urgency” needs increased oral therapy over next 24-72 hours History, physical exam, and familiarity with the patient are key for triage (e.g. verify BP readings, assess compliance, etc.) Severe HTN and hypertensive urgency can often be treated in the outpatient setting IV agents are not indicated outside of true hypertensive emergency (i.e. objective end organ damage) We recommend increasing dose or frequency of existing BP meds as 1st line (better long-term solution) Intermittent dosing of oral labetalol, clonidine, and captopril can be considered as 2nd line (short-term solution) Rule out uncontrolled pain, volume overload, alcohol withdrawal, illicit drug, and missed medications as cause of severe HTN Evidence from observational studies suggests that headaches are NOT caused by HTN Untreated severe HTN was historically fatal in months to years prior to development of antihypertensives Goal: Listeners will become proficient in the appraisal of severe hypertension/ hypertensive urgency and employ safe and practical management strategies. Learning objectives: By the end of this podcast listeners will: Confidently triage patients with severe hypertension and provide appropriate disposition in a variety of settings Employ a safe and common sense approach to the treatment of severe hypertension in the clinic, the ER, or on the wards Be familiar with pharmacologic management of severe hypertension in a variety of settings Recognize the common causes of severe blood pressure elevation in the inpatient setting

Does the thought of responding to an in-flight emergency ruin your air travel? Then tune in because on this episode, Angelica Zen, MD, Chief Resident of Internal Medicine at UCLA, recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane.  

On this episode, we got served! Endocrinologist, Dr. Pauline Camacho, current president of AACE and Professor of Medicine at Loyola University Chicago makes it rain clinical pearls as she schools us on the use of calcium, Vitamin D, bisphosphonate therapy and drug holidays. This is a must listen for anyone treating osteoporosis. Make sure to check out the new 2016 AACE guidelines, which include infographics for patients and their easy to use algorithm.

Dr. Robert Centor’s Knowledge Food, Part 2!  On this episode of The Curbsiders, we continue our discussion with the legendary Dr. Centor, focusing on pharyngitis and the highly entertaining origin of the Centor Criteria.  Not only do we learn how to dominate pharyngitis, but we also uncover one of Dr. Watto’s knowledge deficits - Lemierre’s Syndrome.  (He owes us a two minute talk on Lemierre’s Syndrome in case you’re wondering. I know I am.)

Summary: Dr. Robert Centor’s Knowledge Food, Part 1.  This Halloween, the “Curse of Knowledge” is REAL!  So you think you can teach? This master clinician educator, known for “Centor’s Criteria,” schools us the most common errors made by medical educators and how to improve learner retention.  While we only scratch the surface, Season 1’s arguably penultimate episode should NOT be missed.  After all, how else are you going to learn about Pretty Pimpin’?  Stay tuned for Part Duex when we briefly review Pharyngitis and Dr. Watto finally learns about Lemierre’s Syndrome!  As always, you’re welcome.

Stop feeling helpless in the face of vague complaints like fatigue, digestive problems, mood swings, inability to lose weight, etc. Learn to treat any chronic disease without writing more prescriptions. Heal yourself and your patients with the power of food. Join us for the return of Functional Medicine physician, Dr. Yousef Elyaman, as he schools us on elimination diets, phytonutrients, liver detoxification, going “paleo” and more. This is a deluxe episode so we’ve included a time key below. You’re welcome.

Learn to treat non cancer pain in the elderly. Managing persistent pain in the elderly can be...painful. On this episode Matt and Paul interview Dr. Marissa Galicia-Castillo, a Professor of Geriatrics from Eastern Virginia Medical School board certified in Internal Medicine, Geriatrics, Hospice/Palliative Medicine. Are we being too stingy with opioid prescriptions? How do you assess and treat pain in patients with advanced dementia? We’ve got your answers.

Fifty four percent of physicians report at least one symptom of burnout. On this episode Dr. Philip Kroth an Internist and Chief of Clinical Informatics from the University of New Mexico schools us on how electronic health records (EHR) relate to burnout and tips to promote physician wellness. Miss this episode and you might get burned...out. I refuse to apologize for that pun. Enjoy!

Do complaints of insomnia stress you out? Well, never fear. In this episode our guest is Dr. Karl Doghramji, Professor of Psychiatry, Neurology and Medicine and the Medical Director of the Sleep Disorders Center at Thomas Jefferson University Hospital in Philadelphia. With his help we deconstruct the “dread pirate” insomnia (as I call it) so you can dominate it in your daily practice.

In this episode our guest is Dr. Robert Dickson a Pulmonologist from the University of Michigan who studies the respiratory microbiome. We discuss how the lung microbiome differs in health, chronic illness and acute disease states like pneumonia, sepsis and ARDS. The lung microbiome has the ability to predict frequency of exacerbations and even severity and progression of certain lung diseases. We’ll explore all of this plus Dr. Dickson’s new paper published last month in Nature Microbiology, which had the surprise of finding gut bacteria in the lungs during critical illness. Please enjoy this wide ranging discussion

We explore everything you’ll ever want to know about cholesterol and lipids. Are statins still king when it comes to cholesterol lowering? Should we be rushing to use PCSK9 inhibitors? Should we throw away older drugs like fibrates? Are nonpharmacologic therapies like niacin and fish oil worthwhile?  Our guest is Master Lipidologist, Dr. Peter Howard Jones from Baylor College of Medicine and the National Lipid Association. My guest host is Dr. Paul Williams, Clinician Educator extraordinaire from Philadelphia. 

Treat C. diff, choose the correct antibiotic regimen, and identify who needs fecal transplant as we “curbside” Gastroenterologist, Dr. Adam Ehrlich from Temple University Hospital. On the show, we cover the ins-and-outs of procuring, preparing and performing transplants as well as future directions in this burgeoning field e.g. IBD, obesity, metabolic syndrome and more. Take Home Points: Clostridium difficile infection is the only indication for which FMT is allowed by the FDA without special authorization FMT is VERY effective in these C difficile patients compared to standard of care (approximately 90% cure vs 30%) We are just beginning to understand the role of the microbiome in human health, and I anticipate many changes in the years ahead where modifying the microbiome will be used to help treat a number of diseases.  Links from the Show: Recommended reading... NEJM Journal Watch for Gastroenterology - register here Review on novel uses for fecal transplantation Rossen NG, et al. Fecal microbiota transplantation as novel therapy in gastroenterology: A systematic review. World J Gastroenterol. 2015 May 7;21(17):5359-71. doi: 10.3748/wjg.v21.i17.5359. Randomized controlled trial of fresh vs frozen fecal transplantation Fresh vs Frozen Fecal Microbiota Transplant for C diff Recurrent C difficile infection. JAMA 2016 Review on mechanisms for gut microbiota on metabolic syndromes Qian LL, et al. Effect of the Gut Microbiota on Obesity and Its Underlying Mechanisms: an Update. Biomed Environ Sci. 2015 Nov;28(11):839-47. doi: 10.3967/bes2015.117.

In this episode Dr. Yousef Elyaman from the Institute of Functional Medicine schools us on how the biochemistry and pathophysiology we’ve forgotten from medical school can be used to cure illness. FODMAP diet and Antibiotics to cure restless legs syndrome? Melatonin to treat gastroesophageal reflux disease?  This is just a little taste of the knowledge food served up on this introduction to Functional Medicine.

This episode, part 2 of our last episode, is a must listen if you’ve ever felt helpless in the face of fibromyalgia and chronic pain. Keep listening for part 2 of our “curbside” with expert clinician and prominent researcher Dr. Daniel Clauw, from the University of Michigan’s Chronic Pain and Fatigue Research Center. The show is chock full of clinical pearls for the mastery of chronic pain syndromes.

This episode, part 1 of 2, is a must listen if you’ve ever felt helpless in the face of fibromyalgia and chronic pain. Listen as we “curbside” expert clinician and prominent researcher Dr. Daniel Clauw, from the University of Michigan’s Chronic Pain and Fatigue Research Center. The show is chock full of clinical pearls for the mastery of chronic pain syndromes.

In this episode we “curbside” SoCal Cardiologist, Dr. Neel Patel. If you’re like us and confused by the smorgasbord of cardiac imaging and stress testing then this show is a must listen. Whether you’re in the clinic or on call for Internal Medicine, Dr. Patel has your answers on coronary artery calcium scoring, coronary CT scans and all types of stress testing.  

If headache patients strike fear in your heart, then this is the episode for you. In this episode The Curbsiders interview Internist and Headache Specialist Dr. Glen D. Solomon to deconstruct the topics of migraine and chronic tension type headaches. Dr. Solomon is currently a Professor and Chair of the Department of Internal Medicine at Wright State University and a former director of the Headache Medicine Fellowship at the Cleveland Clinic. Join them as they discuss the approach to diagnosis and management of chronic headaches. 

In this part 1 of 2 episode on the non-Vitamin K oral anticoagulants, The Curbsiders discuss these novel medications and other changes associated with the updated 2016 CHEST guidelines for anticoagulation. 

In this interview, Matt speaks with Dr. Paul Williams about the SPRINT Trial of Intensive blood pressure control and how it is likely to change clinical practice. Tony and Stuart discuss their own take-home points from the trial. Discussion of ARBs you've never heard of and the holy grail of blood pressure cuffs ensues. Tags: assistant, blood, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, hypertension, internal, internist, nurse, medicine, medical, pressure, primary, physician, resident, student

In this inaugural episode, join the Curbsiders as they tackle the hot topic of male hypogonadism and low testosterone by curbsiding Endocrinologist Dr. Jeff Colburn, a leading clinician and educator in San Antonio, Texas   Tags: androgen, andropause, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, hypogonadism, internal, internist, libido, low T, medical, medicine, nurse, primary, physician, resident, student, testosterone