What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation? Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E10 Show notes, Transcript and References: https://www.coreimpodcast.com/2023/03/08/trac/ Time stamps 2:56 Trach Components 12:47 Trach Complication Management 27:48 Airway Clearance 34:53 Speaking Valve 38:54 Decannulation Tags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacy Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Why are safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care? Show notes, Transcript and References: https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/ Timestamps: 0:00 Hahnemann University Hospital 4:36 What is a Safety Net Hospital? 11:11 The Origins and Paradox of the Safety Net Hospital Links to other episodes: A Complex Patchwork of Supplemental Payments: https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/ The Future of Safety Net Hospitals & Payment Policies: https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/ Tags: IM Core, CoreIM, health policy, health disparities, insurance, medicare and medicaid Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How does your problem representation change as we get more history in this episode? How can we use Oxaam's razor & Hickman's dictum as powerful diagnostic tools IF used properly? Show notes, Transcript and References: https://www.coreimpodcast.com/2023/02/15/25438/ Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Time stamps 01:51 Intro 07:57 Case 13:09 Differential 16:15 Diagnosis 22:20 Problem Representation Tags: IM Core, CoreIM, diagnostic tools, Occam's razor, Hickam's dictum, data collection, mental model, clinical reasoning, rheumatology Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this? Show notes, Transcript and References: https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/ Time stamps 04:45 What do we mean by “futility”? 11:20 Definitions 20:23 Ethical Analysis 39:13 Recommendations Tags: IM Core, CoreIM, ATS, autonomy, justice, values, emotions, communication, medical humanities, ethics Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What does the duration of afib tell you about the thromboembolic risk? When do you start anticoagulation for post-op afib? What do the most recent guidelines recommend for perioperative anticoagulation management? How many devices do you know that can be useful in post-discharge cardiac monitoring in new atrial fibrillation? How can we improve our communication regarding afib management? Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Show notes, Transcript and References: https://www.coreimpodcast.com/2023/01/18/diagnosis-of-atr…-matters-segment/  Time stamps 01:12 Intro 03:51 Deep Dive 1 08:16 Deep Dive 2 15:25 Deep Dive 3 21:05 Deep Dive 4 27:07 Deep Dive 5 Tags: IM Core, CoreIM, Devices, cardiac, risk, perioperative, stroke, surgery, anticoagulation Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Is it enough to look at LDL-C? What is Apo-B? How do you use TG/HDL ratio to understand your patients cardiovascular risk? Do you need to get a fasting lipid panel? How does it affect the triglycerides and LDL? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/12/15/reimagining-the-…-the-gap-segment/ Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E8 Time stamps 01:24 Intro 03:37 Fasting vs. Nonfasting Lipid Panel 05:11 Current guidelines 07:43 Pathophysiology Overview 09:04 Pathophysiology of Apo-B vs. LDL-C with traffic analogy 11:23 Apo-B 15:40 TG-to-HDL ratio 17:06 Takeaways Tags: IM Core, CoreIM, risk, USPSTF, ACC/AHH, family medicine, cardiology, primary care Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are some ways you address unrealistic hopes with your patients? How can you build a portfolio of hope with your patients? Can you learn to guide your patients hope? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/11/23/hope/ Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E7 Time stamps 01:20 Intro 04:37 What are some definitions of hope? 09:57 How can we address unrealistic hope? 21:39 Addressing hope in clinical practice 32:10 Conclusion Tags: IM Core, CoreIM, care, communication, goal setting, support, strategies , medical humanities Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What tests and history points help with the diagnosis of alcohol-associated hepatitis? What other etiologies should be ruled out? To steroid or not to steroid? What are the medications for alcohol use disorder? Do you make sure your patients have a late night snack? How do you prognosticate? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/11/09/alcoholic-hepati…5-pearls-segment/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps 01:42 Intro 04:37 Pearl 1: Diagnosis 13:20 Pearl 2: Differential & Treatment 20:48 Pearl 3: Nutrition & Alcohol Cessation 27:45 Pearl 4: To steroids or to not steroids?! 35:34 Pearl 5: Throwback Tags: IM Core, CoreIM, ALT, AST, liver abnormalities, gastroenterology, alcohol use disorder, nutrition, MELD, Lille, Steroids, Alcoholic Hepatitis Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you educate your patients on aspirin use? For what reasons do you start, continue or stop aspirin? What does trial data tell us? How does aspirin exerts its effect? Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E6 ACP CME: http://bit.ly/CIMCME Show notes, Transcript and References: https://www.coreimpodcast.com/2022/10/19/mind-the-gap-asp…imary-prevention/ Time stamps 03:03 Guideline recommendations 07:00 How does Aspirin work? 09:11 Trial Data 13:00 ASCVD Risk Calculator 18:07 Starting vs. Stopping Aspirin 22:11 Summary Tags: IM Core, CoreIM, guidelines, atherosclerosis, ASCVD, plaque, bleeding, shared decision-making Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Is a positive ANA always significant? What does the titer mean? Is the pattern of the ANA helpful? What patient histories should you not get an ANA for and which aspects of the history would raise suspicion for autoimmunity? How can you use the physical exam to assess likelihood of autoimmune disease? What is the ddx for a positive ANA? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/10/05/ana-antinuclear-…5-pearls-segment/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Sponsor: Visit www.medmastery.com/coreim for 15% off on all subscriptions. Discount code: “COREIM” Timestamps: 01:37 Pearl 1 03:54 Pearl 2 13:53 Pearl 3 18:07 Pearl 4 29:30 Pearl 5 Tags: IM Core, CoreIM, autoimmune, joint disease, titers, Raynaud's, lupus, Rheumatology Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you decide which lung nodules should be worked up inpatient or outpatient? How common are incidental lung nodules? What considerations are there for patients that could potentially get lost to follow up? What risk adopted approach can be implement in our practice? Do you know what fast forward rounds are? Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E5 Show notes, Transcript and References: https://www.coreimpodcast.com/2022/09/21/discharge-with-i…atters-segment-2/ Time stamps 01:30 Deep Dive #1 17:27 Deep Dive #2 Tags: IM Core, CoreIM, outpatient, inpatient, PCP, management, communication, discharge summary, incidentaloma Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Can you identify where along the clinical reasoning pathway the learner is struggling? What coaching exercises can be helpful? What feedback do you fall back on when working with learners? What are common challenges? Digital Education Conference 2022 in Oct 7 2022: https://cmecatalog.hms.harvard.edu/digital-education Show notes, Transcript and References: https://www.coreimpodcast.com/2020/12/09/hoofbeats-strugg…inical-reasoning/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Hear personal stories about racial trauma or stereotype threat. How can we respond and how do we differentiate an up stander from a bystander? What barriers exist when we try to respond? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/08/24/upstander/ Time stamps 00:59 Intro 05:51Overview of Microaggressions 09:11 Prevalence 12:43 How to respond 22:03 Barriers to appropriate response 27:00 Conclusion Tags: IM Core, CoreIM, bystander, race, microaggressions, hidden curriculum, DEI Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are the 3 types of solutes you can use in hyponatremia? What are each of their drawbacks? How do loop diuretics work help in hyponatremia? What can you use to tell you on day 1 that fluid restriction alone will not work? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/08/03/hyponatremia-man…5-pearls-segment/ Sponsor: https://go.amboss.com/CoreIM-E4 Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps: 01:20 Intro 04:46 Pearl 1 13:13 Pearl 2 24:03 Pearl 3 32:49 Pearl 4 37:05 Pearl 5 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Digital Education Conference 2022 in Oct 7 2022: https://cmecatalog.hms.harvard.edu/digital-education What does each diagnostic test tell you? How do you interpret urine osmolality, urine sodium, or urine urea? What studies can be used to better assess response to treatment? How can uric acid be utilized as a diagnostic tool? What is the interplay between ADH and UOsm? Show notes and Transcript: https://www.coreimpodcast.com/2021/02/10/5-pearls-on-hyponatremia-episode-1/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Amboss Article on Hyponatremia Tags: urine studies, SIADH, Core IM, IMCore, antidiuretic hormone, hospital medicine, family medicine, nephrology Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Other than infection, what do you think about as other causes of fever? How can you distinguish sepsis from drug fever from antibiotics? What medications are most likely to cause neurotoxicity? What are some risk factors? How do you think about goals of care with patients? Show notes & Transcript: https://bit.ly/3P8wqG6 Sponsor: Visit www.medmastery.com/coreim for 15% off on all subscriptions Discount code: "coreim" Time stamps 02:50 Deep Dive #1 13:12 Deep Dive #2 26:39 Deep Dive Recap Tags: IM Core, CoreIM, antibiotics, CMO, DNR/DNI, sepsis, reflection, grey matters Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are the 3 different types of inhaler devices and what should you educate patients about each? When do you stop the inhaled steroid in COPD? And when do you think of increasing the dose? What is important to communicate at the time of diagnosis, and during goals of care discussions? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/06/22/5-pearls-on-copd-management/ Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E3 Timestamps: Pearl 1: 3:20 Pearl 2: 8:20 Pearl 3: 15:47 Pearl 4: 26:55 Pearl 5: 34:10 Tags: IMCore, CoreIM, Pulmonary, medication management, spirometry Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you ask about spiritual health? How is spirituality different from religion? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/06/15/spirituality/ Time stamps 00:01 What is spirituality? 7:12 Why does spirituality matter? 12:09 How do we screen for it? 18:50 Chaplains 27:49 Conclusion Tags: IM Core, CoreIM, ethics, medical humanities Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are the indications for a simple transfusion? And what the indications for an exchange transfusion? What is your approach to pain management in patients with sickle cell? What are the treatment options for sickle cell and which ones actually decrease sickle crisis and improve mortality? What are some of the major sickle cell complications to watch out for and how can we prevent some of them? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/06/01/5-pearls-on-sickle-cell-anemia/ Sponsor: https://go.amboss.com/CoreIM-E2 Timestamps: 1:33 Pearl 1 4:48 Pearl 2 18:43 Pearl 3 29:45 Pearl 4 35:22 Pearl 5 Tags: IM Core, CoreIM, hematology oncology, health inequity, vaso-occlusive crisis Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you counsel patients on beta blockers? Is one beta-blocker better than the other? What is preferred: ACEi, ARBs or ARNIs? What are the pros and cons of each? How does spironolactone compare to eplerenone? When do you stop mineralocorticoid receptor antagonist? What are risks with SGLT2 inhibitors? How do you initiate GDMT? Which meds do you start first and in what order? Show notes, Transcript and References: https://www.coreimpodcast.com/2022/05/11/5-pearls-on-guideline-directed-medical-therapy/ Sponsor: https://go.amboss.com/GDMT Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps: 03:13 Pearl 1 12:14 Pearl 2 20:36 Pearl 3 26:42 Pearl 4 32:16 Pearl 5 Tags: IM Core, CoreIM, heart failure with reduced ejection fraction, GDMT, treatment, cardiology Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy