Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care. Show Notes & Transcript Time Stamps 01:47 Evolving story of asthma management 03:26 Pathophysiology of asthma management 06:01 Key players & terms 08:56 Story of asthma through the decades 17:55 MANDALA Trial Tags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalers Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula? What is a Fishbane reaction? And how is it different from anaphylaxis? Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training! Time stamps: 02:09: Spaced repetition from the last Gray Matters Episode 05:29: Choosing between oral and IV iron 11:17: Considerations with oral iron repletion 24:02: Considerations with IV iron repletion 32:36: Complications and side effects of IV iron Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history? Sponsor: Freed is an AI scribe that listens, prepares your notes, and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed Expert Interviews on Youtube Time stamps: 03:43 Iron deficiency labs and interpretation in inflammation 16:08 Heavy menstrual bleeding evaluation 27:04 When should a premenopausal woman with iron deficiency have endoscopy? 35:15 Recap Tags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosis Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Uncover many blind spots on tube feeds! Sponsor: At Panacea Financial, every single customer gets their OWN 24/7 primary care banker who actually knows you! Youtube Interviews: Short-term enteral access Durable enteral access What is venting aka decompression? Show Notes & Transcript Timestamp 02:21 Indications for tube feeds 09:36 Routes of enteral access 19:20 Components of tube feeds 7:03 Tube feeds complications 34:50 Counseling patients before discharge and medication interactions Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feeds Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship? Sponsor: Echonous, the maker of Kosmos, is redefining point-of-care ultrasound at half the price (or less) of comparable carts. Mention Core IM at the Demo to get a free A.I application of choice! Youtube Interviews: When to consider a guardian? Guardianship Process Limitation and value of individualism Show Notes & Transcript Timestamp 04:03 Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult? 11:55 Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship? 28:30 Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred? 33:27 Reflections 37:06 Recap Tags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case management Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more Show Notes & Transcript Time Stamps 02:30 Epidemiology of RSV 03:46 Development of RSV vaccine 05:55 Vaccine trial design 12:22 ARESVI and RENOIR Trials 18:18 Who should we recommend the RSV vaccine to? 19:50 What don’t we know? Tags: IMCore, CoreIM, primary care, infectious disease, nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement? Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more Youtube interview on key points on magnesium Youtube interview on key points on phosphate CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamp 01:37 Pearl 1: Magnesium 09:39 Pearl 2: Framework for hypomagnesemia 16:53 Pearl 3: Magnesium repletion 22:39 Pearl 4: Phosphorous 28:36 Pearl 5: Phosphorous repletion Tags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renal Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Sharpen your de-escalation skills! Sponsor: GlassHealth | Get unlimited A.I queries for 1 month with promo code: COREIM ! Timestamps: 02:26 Difficult Patients 10:25 Mediation Toolkit 17:20 Maxims of Mediation 26:46 When the Conversation Still Breaks Down 35:11 Conclusion Tags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnout Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Show Notes & Transcript 01:50 Pathophysiology of Steroids and Infection 03:50 Steroids in PNA Studies 08:56 CAPE COD Trial 14:13 Discussion of CAPE COD Trial 18:36 Takeaways/Discussion Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray! Sponsor: Post Investment: Real Estate Syndications Show Notes & Transcript Timestamps: 01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs? 06:31 Pearl 2: Considerations for patients with implantable devices before surgery. 12:26 Pearl 3: Considerations for patients with implantable devices before MRI. 14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-ray Tags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria? Sponsor: Panacea Financial Student Loan Consultation CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamp: 00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage 04:20" What's wrong with how we estimate GFR? 06:50 Why is creatinine flawed as an estimator of GFR? 10:52 Enter new contender...Cystatin C! 16:16 Importance of the A Stage! 20:21 Which patients should you measure proteinuria in? 22:10 Treatments for albuminuria! 24:27 Summary and Closing Tag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, nurse practitioner, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Check out the original interview on Youtube: Essentials on Genetic Counselor | Lynch Syndrome Who should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting! Show Notes & Transcript Timestamp 03:13 Part 1: Who should be referred to genetic counseling? 11:23 Part 2: How do we set up genetic counselors for success? 22:38 Part 3: Genetic counseling myth busting! Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, nurse practitioner, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

See some of the original interviews on Youtube! What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?! CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamp 01:45 Pearl 1: Evidence for potassium repletion 09:10 Pearl 2: Framework for hypokalemia 17:09 Pearl 3: Repletion goals 23:00 Pearl 4: Options for hypokalemia treatment 29:13 Pearl 5: Frequency of lab checks and repletion Tags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional education Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss? Sponsors: Post Investment: Real Estate Syndications || Hellofresh Show Notes & Transcript 02:08 Framework for thinking about obesity 03:42 History of obesity treatment 06:29 Gila monsters and GLP and GIP mechanisms 08:29 Story of how medications for diabetes were found to have a weight loss benefit 12:50 SURMOUNT-1 trial Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers? Sponsors: Hellofresh | Pranay's Effective Living Formula Course Pranay's Free Masterclass (Sept 20 and 27th at 5pm PST) CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamps 01:54 Pearl 1 – Recap of GDMT and CKD 09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate 20:59 Pearl 3 – Ivabradine 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT 30:55 Pearl 5 – Ejection Fraction Recovery Tags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence? Timestamps 01:00 System 1 vs. System 2 07:46 Cognitive Biases 13:46 Case for Knowledge 18:29 Other Practices to Decrease Error 28:26 Conclusion CME: http://bit.ly/CIMCME || Show Notes & Transcript This episode is made in part of ACP’s Diagnostic Excellence curriculum Tags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflection Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection? Timestamps 02:41 Types of Immunosuppression 14:31 Medication Reconciliation 22:36 AKI in the Transplant Patient 31:53 Infections in the Transplant Patient 40:00 Transplant rejection, cancer after transplant CME: http://bit.ly/CIMCME || Show Notes & Transcript Tags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressive Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery. How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group. Show notes & Transcript Access to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF. Timestamps 00:50 Question REVIVED addressed 01:44 Revascularication in HFrEF 06:32 Revascularization in stable CAD 10:02 REVIVED trial 12:20 Summary and takeaways Tags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicine Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories ! Listen to the original July Stories: https://bit.ly/3Y4n8jG Subscribe to our new Youtube Channel ! Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedback Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Show notes & Transcript Subscribe to our new Youtube Channel ! Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigue Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Our Sponsors: * Give Factor meals a try: factormeals.com/coreim50 (use code "Coreim50" for 50% of your 1st weekly box & 20% of your next box!) Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy