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Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.

The Curbsiders Internal Medicine Podcast Matthew Watto MD, Stuart Brigham MD, Paul Williams MD

    • 의학

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.

    #191 Lipids Update with Erin Michos MD

    #191 Lipids Update with Erin Michos MD

    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
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    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 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 00:11:50 Digging into ASCVD Risk Calculator 00:16:12 Who should get 10 year ASCVD Risk assessment and what are the categories? 00:18:13 How Dr. Michos discusses healthy lifestyle and “Primordial Prevention” 00:19:42 What are “Risk Enhancing Factors”? 00:22:36 Who should get biomarker testing vs CAC scoring? 00:29:35 How Dr. Michos discusses statin therapy with her patients 00:32:18 How to address risks of side effects 00:37:57 Primary vs Secondary Prevention 00:39:40 “What should my cholesterol be?” 00:42:03 How often to follow-up labs? 00:46:00 Differences between stain intensity 00:47:57 How to manage side effects 00:52:05 PCSK9 inhibitor discussion 00:55:06 Aspirin, Fibrates and Icosapent Ethyl 01:02:13 High Risk vs Stable ASCVD 01:06:50 Take home points and the future 01:10:50 Outtro *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 feel comfortable managing both primary and secondary prevention for ASCVD among different patient scenarios. 
    Learning objectives After listening to this episode listeners will…  
    Recognize the different risk levels and further ways to hone risk-stratification. Describe primary prevention management including how to discuss lifestyle changes, statins, and managing common statin-related complaints. Recognize the importance of lipid reduction for secondary prevention and different medications to achieve this. Disclosures Dr Erin Michos reports no relevant financial disclosures. The Curbsiders report no relevan

    • 1 hrs 12분
    REBOOT #137 Hyperkalemia Master Class with Joel Topf MD

    REBOOT #137 Hyperkalemia Master Class with Joel Topf MD

    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; The Nice Guys (film) by Shane Black; Forgotten Anne (PS4 videogame), “your local library” 09:00 Sponsor -ACP’s IM Meeting 2020 in LA 09:55 Clinical case of hyperkalemia; discussion of pseudohyperkalemia 17:00 Hyperkalemia and the EKG 20:31 Threshold for treatment of hyperkalemia 24:20 Use of telemetry and the U-shaped curve for potassium and mortality 27:11 Choice of therapy for acute hyperkalemia 30:13 Albuterol for hyperkalemia 31:24 First rule out urinary obstruction and hyperglycemia; Use of IV insulin and dextrose and frequency of monitoring 36:44 Loop diuretics plus fluid; Distal sodium delivery and potassium handling in the nephron 40:10 Fludrocortisone for hyperkalemia 42:05 Calcium for elevated potassium 45:43 SPS, potassium binding resin 49:43 Risks of SPS (sodium polystyrene sulfonate) and colonic necrosis 55:28 Sodium bicarbonate for acute and chronic hyperkalemia 58:00 Back to the case; TMP-SMX, ace inhibitors (or ARBs) and hyperkalemia 60:05 Threshold for admission; Diet and potassium 62:52 Treatment of chronic hyperkalemia and a bit more on high potassium foods 65:45 Patiromer and sodium zirconium 68:51 Loop diuretics and empiric potassium supplementation 71:12 Can diet alone be used to treat HYPOkalemia? 72:26 Take home points 74:40 NephMadness is coming! March 2019 76:53 Outro 78:00 Stuart’s shares a few puns *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 my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Disclosures Dr Topf’s blog lists the following disclosures “I have an ownership stake in a few Davita run dialysis clinics and a vascular access center. Takeda Oncology made a donation to MM4MM the program that is taking me to Mount Everest in 2018”. The Curbsiders were sponsored by ACP’s Internal Medicine Meeting 2019 for this episode.
    Citation Topf J, Williams PN, Brigham SK, Watto MF. “#137 Hyperkalemia Master Class with Joel Topf MD.” The Curbsiders Internal Medicine Podcast https://thecurbsiders.com/episode-list. Original air date: January 28, 2019. 

    • 1 hrs 18분
    REBOOT #129 Depression and Physician Suicide with Elisabeth Poorman MD

    REBOOT #129 Depression and Physician Suicide with Elisabeth Poorman MD

    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 Poorman, MD  Time Stamps  00:00 Sponsor - ACP’s Internal Medicine Meeting 2020 in LA 00:45 Fresh intro by Beth Garbitelli and Nora Taranto MD 10:15 Sponsor - ACP’s Internal Medicine Meeting 2020 in LA 11:08 Guest one-liner 12:18 Wellness Recommendations: Find a Therapist  15:05 How to find a therapist in training; Licensing and Mental Health  21:07 Disclaimer and Trigger Warning: Stories are Sensitive. National suicide hotline info  Next, Dr Poorman and each of The Curbsiders share their personal experiences with mental health (see below). 22:25 Shreya story 30:30 Stuart’s story 40:12 Elisabeth’s story 45:10 Watto’s story 55:27 Passive suicidal ideaiton, a definition; Suicide and Depression: Do they always coexist? (No); Life Cycle of Depression and Suicide in the Medical Profession  56:07 Depression and Suicide in Primary Care  56:44 Mini-Cases  62:39 Noticing signs in a colleague: how to help  66:40 Specific programs doing things well  71:55 Questions from Social Media: Burnout vs. Depression; Will getting treatment affect your board applications  75:03 Take home points 76:49 Outro Goal Listeners will learn about the risk factors for depression and suicide in medical training, and be empowered to advocate for themselves and their colleagues to be safe.
    Learning objectives  After listening to this episode listeners will
    Learn about the life cycle of depression in training and its prevalence at different stages in our careers. Analyze the risk factors that lead to depression and why depression is becoming more prevalent in doctors over time. Evaluate barriers to effective care for physi

    • 1 hrs 18분
    #190 Recap Extravaganza 2019

    #190 Recap Extravaganza 2019

    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; Midsommar (film) -Paul’s pick; Point-of-care-ultrasound (ACP course at IM2020 in LA or AIUM courses with Dr. Renee Dversdal @DrSonosRD) -Matt’s pick; Sleep!!! -Stuart pick 08:37 Hyperkalemia Master Class Joel Topf MD 14:53 Multimorbidity Games with Josh Uy MD 21:54 Buprenorphine Master Master Class with Michael Fingerhood MD 27:50 Cirrhosis TIPS for Acute Complications with Scott Matherly MD 31:55 HFpEF with Clyde Yancy MD 39:50 Chronic pain, sickle cell disease, opioid tapers 43:13 Teaching in the Hospital 46:00 A quote from Paul Williams 47:35 Celebrity voicemails from Avital O’Glasser MD, Kimberly Manning MD,  and Renee Dversdal MD 51:55 Voicemails and favorite pearls from our Curbsiders team! 62:23 Outro Goal Listeners will recall some of the top pearls from Curbsiders episodes on cirrhosis, buprenorphine, HFpEF, multimorbidity and hyperkalemia.
    Links* The Expanse (TV show) -Chiu Man’s pick Midsommar (film) -Paul’s pick Point-of-care-ultrasound (ACP course at IM2020 in LA or AIUM courses with Dr. Renee Dversdal @DrSonosRD) -Matt’s pick Sleep!!! -Stuart pick *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 my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Disclosures The Curbsiders report no relevant financial disclosures. 
    Citation Roberts SP, Chiu CJ, Williams PN, Brigham SK, Watto MF. “#190 Recap Extravaganza 2019”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. December 30, 2019.

    • 1 hrs 5분
    #189 Medical Overuse: Common Cases of Overtesting, Overdiagnosis, Overtreatment

    #189 Medical Overuse: Common Cases of Overtesting, Overdiagnosis, Overtreatment

    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 The Broken Earth Trilogy by NK Jemisen; The Great Believers: A Novel by Rebecca Makkai; A Constellation of Viral Phenomena by Anthony Marra 09:22 Best advice 11:18 Defining Medical Overuse and defining categories 19:20 Procalcitonin testing for pneumonia 27:42 Imaging and incidentalomas 37:38 Lung cancer screening CT scan; the Bach model 46:25 Urgent care and antibiotic prescriptions for viral illnesses 52:43 Subclinical hypothyroidism 58:32 Take home points 61:00 Outro and Stuart tells us about his knee pain *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 my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Goal Listeners will consider 5 of the top articles from 2018 that demonstrate signs of medical overuse that seem to offer more harm than benefit to patients.
    Learning objectives After listening to this episode listeners will…  
    Define medical overuse Discuss recent data about the utility of procalcitonin for antibiotic stewardship in respiratory infections. Recall the frequency incidentalomas on imaging and which modalities are associated with the highest risk. Identify the differences in benefits of annual lung cancer screening with CT based on baseline risk Recall the lack of evidence for treatment of asymptomatic subclinical hypothyroidism Describe the locations that are associated with more antibiotic prescriptions for viral infections. Disclosures Dr. Morgan and Dr. Korenstein report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 
    Citation Morgan D, Korenstein D, Berk J, Williams PN, Brigham SK, Watto MF. “#189 Medical Overuse”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. December 23, 2019.

    • 1 hrs 3분
    #188 GERD and Dyspepsia with Dr. Amy Oxentenko MD

    #188 GERD and Dyspepsia with Dr. Amy Oxentenko MD

    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 Naked and Afraid; Book: Blind Eye: The Terrifying Story Of A Doctor Who Got Away With Murder by James B. Stewart 08:50 Favorite failure 10:55 Best Advice 13:34 A case of GERD, Defining GERD, basic pathophysiology and risk factors 19:18 A bit more on diagnosis of GERD 21:56 Chest pain, mimics of GERD, red flag symptoms 25:12 Are labs required for diagnosis?, testing for Barrett’s esophagus 28:43 Who needs lifelong PPI therapy?, Choice of PPI 33:09 Lifestyle changes and GERD 37:50 H2 blocker vs PPI therapy, Risks of PPI therapy 44:40 How to counsel patients about the risks and benefits of PPI therapy; Recent 3 year RCT investigating safety of PPI therapy 48:18 Adjuvant therapy and further workup for patients with refractory GERD 51:57 pH and impedance studies 54:29 Duration of PPI therapy; Intermittent and On-Demand PPI therapy; Weaning off long term PPI therapy 59:30 Who may benefit from anti-reflux surgery 63:48 Dyspepsia 68:17 Workup of dyspepsia; Definition and diagnosis of functional dyspepsia 74:09 2nd line therapy for dyspepsia (TCAs, Buspirone, GI psychologist, STW 5, complementary and alternative therapies, etc.) 78:13 Take Home Points; Plugs *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 my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Disclosures Dr. Oxentenko reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 
    Citation Oxentenko A, Williams PN, Garbitelli B, Watto MF. “#188 GERD and Dyspepsia with Amy Oxentenko MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. December 16, 2019.

    • 1 hrs 21분

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