How long can fatigue last for after radiation? Are all patient post radiation immunocompromised? What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACP Show notes & Transcript Whiteboard Animation Video of Radiation Physiology Time Stamps 02:37 Systemic Radiation Side Effects 14:29 Lung Radiation Side Effects 18:22 Breast Radiation Side Effects 21:45 Prostate Radiation Side Effects 24:54 Brain Radiation Side Effects Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapy Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation? Show notes & Transcript Whiteboard Animation Video of Radiation Physiology Time Stamps 02:04 What is radiation? 03:17 How does radiation therapy work? 04:50 How is today’s radiation different from the past? 05:40 What role does radiation play in cancer treatment? 07:48 What are the different types of radiation? 15:34 How do you write a rad onc one-liner as an internist? 19:59 What is palliative radiation and how/when should we use it? Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members? Show notes & Transcript Time Stamps 01:12 Learning Journey 05:58 Lifelong Learning 11:14 Time Management 16:38 Role Modeling 19:59 Re-Calibrating Failure Tags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time management Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric? Show notes, Transcript and References Time stamps 00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test 03:03 Hemoglobin A1c 08:26 Fructosamine and Glycated Albumin 10:50 Continuous Glucose Monitoring 15:44 The Overlooked Issue of Insulin Resistance 19:11 Summary Tags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complication Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD? Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15” Use this link for CME-MOC credit with ACP Show notes, Transcript and References Time stamps 02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do? 21:28 How to determine which type of device your patient has? 25:10 What can a device interrogation tell you and doesn't tell you? 32:13 Do all patients with bacteremia need their implantable cardiac devices taken out? 38:44 End-of-life considerations with pacemakers vs. ICDs Tags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacing Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors? Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACP Show notes, Transcript and References Time stamps 03:49 Episode start 07:13 Dialysis vs. kidney transplant morbidity and mortality 11:44 Eligibility for kidney transplant and when to refer 21:34 Pre-transplant evaluation process 25:38 How long are wait times on the transplant list? 36:21 What benefits of living donation? What are risks to the kidney donor? Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidney Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

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? 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 04:51Overview of Microaggressions 08:11 Prevalence 11:43 How to respond 21:03 Barriers to appropriate response 26:00 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