#59 Flu Diagnosis and Treatment: Mind the Gap Series

What are the new guidelines for influenza treatment? What are the diagnostic ratios of flu symptoms and tests? Time Stamps * 03:10 The art of diagnosing the flu * 05:17 Bayesian statistics and the diagnostic odds ratio * 07:09 The ins and outs of diagnostic testing for the flu * 08:44 Changes in influenza guidelines - testing and treatment * 11:17 The not-so-rosy origin story of neuraminidase inhibitors (NAIs) * 13:47 Neuraminidase inhibitors (NAIs), mortality benefit and limitations of studies * 15:49Take aways

#58 Case Managers and Social Workers: Interprofessional Education Series

What is the difference between a case manager and social worker? What are the limitations that social workers and case managers face? How do you create a safe space for the interdisciplinary team? Show Notes and References (https://www.coreimpodcast.com/2020/02/06/cms-and-sws/) Get CME-MOC credit (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) with ACP! Time Stamps: * 03:54 What are the various roles within a multidisciplinary teams? * 10:42 Understanding limitations of social workers and case managers * 15:55 The “behind the scenes” paperwork * 18:42 Insurance and medications * 22:17 Insurance and disposition options * 25:08 The importance of creating a safe space for better communication

Novel Coronavirus: What the Clinician Needs to Know Interview

What are the symptoms?What distinguishes coronavirus from other influenza-like illness? When coronavirus is suspected, what should you do? Show notes and references (https://www.coreimpodcast.com/2020/02/04/coronavirus-what-the-clinican-needs-to-know/) CME credit:https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) ACP Interactive Learning Module (https://www.acponline.org/cme-moc/online-learning-center/novel-coronavirus-a-physicians-guide) Time Stamps 01:30 Novel parts of coronavirus 03:00 What symptoms do patients present with for the novel coronavirus? 04:22 What distinguishes coronavirus from other influenza-like illness? 05:31 When coronavirus is suspected, what should you do? 07:13 What does testing for coronavirus entail? 09:06 What kind of isolation is required? 10:13 Do patients need to be isolated in biocontainment units? 10:42 What is treatment for the novel coronavirus? 12:30 P...

#57 A 39M on Inpatient Psychiatry with a Fever: Hoofbeats Segment

How do you learn from diagnostic errors? Walk through a case that the host had initiallygotten wrong and uncover possible reasons as why from data gathering to hypothesis generation to theinterplay between hypothesis generation and evaluation. Learn interesting tidbits on prior work in medical education around how we think, particularly around diagnostic failures. CME Credit:https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) Time Stamps * 02:39 Case Introduction * 04:46 Yes/No questions with our first two discussants * 18:43 The diagnosis is revealed * 21:14 Why did I miss the diagnosis? * 27:44 Using diagnostic problem solving to break down the case and understand our errors * 30:20 The importance of data gathering * 30:49 Introducing our third clinician * 34:17 Hypothesis generation * 37:11 The interplay between hypothesis generation and evaluation * 38:34 The win-stay, lose-shift heur...

#56 Prognosis: At the Bedside Segment

Why is prognostication hard?How do we improve at communicating prognosis?How should we approach uncertainty? Explore this and more on this At the Bedside episode! Prognosis Calculators, Transcript and References (https://www.coreimpodcast.com/2020/01/01/prognosis/) Time Stamps * 02:48 What is prognosis? * 04:00 Why offer prognostication? * 08:32 Why is prognostication hard? * 16:41 How do we improve at communicating prognosis? * 21:56 How should we approach uncertainty? * 31:06 Take Aways Tag: life expectancy, CoreIM

#55 Influenza History and Vaccine: Mind the Gap Segment

Dive deeper into hx of the influenza virus, how vaccines are made and vaccine effectiveness ! Time Stamps * 02:59 The history of the influenzavirus * 08:18 What does the influenza vaccine target? * 13:20 Chickens, and bugs, and mammalian cells, oh my! How the vaccine is made. * 14:00 What to do about egg allergies. * 15:53 Vaccine effectiveness and herd immunity. * 17:43 Waning immunity and other debates Show Notes, Transcript and References (https://www.coreimpodcast.com/2019/12/18/influenza-history-and-vaccine/) Get CME-MOC credit (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) with ACP!

#54 Home Health Aides: Interprofessional Education Series

Explore gaps in your knowledge about the home health world, particularly on home health aides! * Get CME-MOC credit (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) with ACP ! * Full transcript, show notes, references (https://www.coreimpodcast.com/2019/11/27/home-health-aides-interprofessional-education-series/) Time Stamps: 02:33 What support do our patients have at home and how does those people play a role in their care? 06:00 Are there various types of home care workers? 07:25 What role do home attendants play in caring for a patient? 08:31 What tasks do home health aides do? 10:11 What are the types of "skilled carez'? 13:17 What can Medicare cover for older adults in terms of home health aides? 15:17 How does Medicare define homebound? 16:03 How does having Medicaid impact access to home care? 19:10 What if a patient isn’t eligible for Medicare or Medicaid? 19:43 What is the cost to use a private agency for home health services? 24:02 What are some ...

#53 Heparin-Induced Thrombocytopenia: 5 Pearls Segment

Get CME Credit (https://www.acponline.org/cme-moc/online-learning-center/heparin-induced-thrombocytopenia-5-pearls-segment) with ACP! Full Transcript with references and show notes (https://www.coreimpodcast.com/2019/11/13/5-pearls-on-heparin-induced-thrombocytopenia/) Time Stamps 4:30 What is the daily risk of thrombosis if HIT Is left untreated? 5:40 What happens during platelet activation? 07:11 How long does it take for patients to develop for IgG antibodies to Heparin to form? 09:52 Is HIT common? 10:28 Who is at higher risk for HIT? 11:48 Why does low molecular weight heparin have a lower risk for HIT than unfractionated heparin? 15:30 Approach to thrombocytopenia 17:44 How do medications cause thrombocytopenia? 18:38 With medications, what is the time course between medication initiation and thrombocytopenia? 22:20 What is the sensitivity and specificity of anti-PF4 antibody? 23:58 How does the serotonin-release assay (SRA) work? 29:10 What type of anticoagulant do you choose...

#52 Gallows Humor: At the Bedside Segment

House of God author, Samuel Shem and Prof Katharine Watson share thought-provoking takes on Gallows Humor. Laugh and listen to this captivating take on the different shades of humor in the day-to-day of medicine. Time Stamps * 02:33 Episode preview and Guest Introductions * 04:20 Definition of Gallows Humor * 07:25 Gallows Humor by Comedians vs Patients vs Physicians The Good * 08:15 Benefits/Functions of Humor in General * 11:10 Connection * 13:07 Coping/Catharsis * 16:22 Resistance Against Oppression * 19:03 Humor as our Authenticity/Humanity The Bad, The Ugly * 21:01 Unintended Audiences (e.g., patients, families) * 25:30 “Corporeal” Joking * 28:00 Toxic Role Modeling * 31:10 Desensitization/Losing Empathy * Tips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes * 35:45 Excessive Gallows Humor: Signal of Distress? * 37:17 Using Gallows Humor: Questions to Ask Yourself * 38:40 Keeping the Faith! * 41:11 Excerpt from Man’s 4th Best Hospital by Samuel Shem Transcript a...

#51 A 65M with Fatigue: Hoofbeats Segment

1st outpatient clinical reasoning case on Core IM Hoofbeats! Get CME-MOC Credit (https://www.acponline.org/cme-moc/online-learning-center/a-65m-with-fatigue-hoofbeats-segment) (live at 9AM EST on 10/16) Time Stamps * 01:18 Case introduction * 11:40 The Casablanca strategy * 23:17 The diagnosis revealed * 25:30 Logical fallacy: Denying the antecedent * 33:22 Components of illness scripts * 41:37 Conclusion Show notes, transcripts and references (https://www.coreimpodcast.com/2019/10/16/hoofbeats-a-65m-with-fatigue/)! Do you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.com (hello@coreimpodcast.com) Tag: normocytic anemia, splenomegaly, CoreIM, endocarditis, clinic case