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 Eligibili ..read more

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 ..read more

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 H ..read more

Is all melena a GI Bleed? 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 ..read more

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 ..read more

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 ..read more

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, comm ..read more

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 ..read more

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 Aspir ..read more

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 ..read more