Core IM | Internal Medicine Podcast

• #193 Venous Congestion & VEXUS Interview with Dr. Ross Prager

  Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score?🔹 Sponsor: Oakstone CMEUse the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes(00:00) | Volume overload vs. Venous Congestion(05:49) | Venous Congestion and AKI, mortality, possible delirium(10:10) | Measuring Venous Congestion and the Role of VEXUS(15:05) | Common Mistakes and Best Practices of VEXUS score(23:13) | Assessing Fluid Tolerance and Risks with Venous Doppler in Acute Care(25:29) | Fluid vs. Vasopressor Strategy Guided by Venous Assessment Tags: CoreIM, Internal Medicine, Critical Care, Nephrology, Cardiology, Fluid Management, POCUS, Ultrasound, Doppler, Hospital Medicine, Clinical Reasoning, Medical EducationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics: https://branchbasics.com/COREIM and use the code CoreIM for 15% * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Washington Red Raspberries: https://redrazz.orgAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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• #192 Debate on First-Line Medications for Diabetes

  SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use?🔹 Sponsor:Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript and Show NotesTimestamps:(01:43) | Case 1: Managing Uncontrolled Diabetes in a 47-Year-Old Male(07:15) | Understanding Cost and Insurance Barriers in Diabetes Care(09:26) | Case 2: Addressing Weight Gain and Financial Stress in a 52-Year-Old Male(14:16) | Case 3: Managing Coronary Artery Disease and CKD in a 66-Year-Old Male(19:41) | Case 4: Severe Obesity and Pain Management in a 59-Year-Old Female(24:19) | Case 5: High A1C and Vascular Comorbidities in a 67-Year-Old Female (35:34) | Weighing Side Effects and Practical Use of GLP-1 and SGLT2 InhibitorsTags: CoreIM, Primary Care, Endocrinology, Diabetes Mellitus, Type 2 Diabetes, Type 1 Diabetes, Metformin, GLP-1, SGLT2, Insulin, CGM, A1C, DKA, Medical Education, Clinical Reasoning, Hospital MedicineFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics: https://branchbasics.com/COREIM and use the code CoreIM for 15% * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Washington Red Raspberries: https://redrazz.orgAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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• #191 Hepatorenal Syndrome Part 2 on Management: 5 Pearls Segment

  What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care?🔹 Sponsor: Oakstone CMEUse the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps: (00:12) | Introduction and Overview of Hepatorenal Treatment (03:38) | Vasoconstrictors Focus: Terlipressin, Norepinephrine, and Midodrine (12:32) | Finding the Right Dose of Albumin and Knowing When to Stop (15:06) | Volume Management: Balancing MAP, Diuretics, and Creatinine (21:42) | Understanding the High Mortality of HRS-AKI (32:30) | Transplant, Dialysis, or Palliation CareTags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Hepatorenal Syndrome, HRS-AKI, Cirrhosis, Nephrology, Liver DiseaseFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics: https://branchbasics.com/COREIM and use the code CoreIM for 15% * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Washington Red Raspberries: https://redrazz.orgAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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• #190: Hepatorenal Syndrome Part 1: 5 Pearls Segment

  HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right?🔹 Sponsor: Oakstone CMEUse the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps: (00:57) | Understanding the Pathophysiology of HRS (03:42) | How Portal Hypertension Traps the Kidneys (10:32) | Sorting the Differential of AKI in Cirrhosis Beyond HRS (18:28) | Hyponatremia and Urine Sodium in Advanced Cirrhosis (24:04) | Official Diagnosis and Evolving Criteria of HRS (29:30) | Albumin: When It Helps and When to Hold Back (34:00) | Recap and Future DirectionsTags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Nephrology, renal, hepatology, Portal Hypertension, Liver DiseaseFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics: https://branchbasics.com/COREIM and use the code CoreIM for 15% * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Washington Red Raspberries: https://redrazz.orgAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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• #189 Bisphosphonates and Fracture Prevention Trial: Beyond Journal Club with NEJM Group

  Who’s really at risk for fractures, and how should we be treating them? Most fragility fractures occur in patients without osteoporosis. Should we rethink who gets treated? And could just one or two IV infusions (spread years apart) of zoledronate prevent fractures for years? Have the concerns about bisphosphonates been overblown?Find out all the nuances on this episode of Beyond Journal Club, a series brought to you by Core IM in collaboration with NEJM Group.🔹 Sponsor: Oakstone CMEUse the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP🔹 Transcript & Show NotesTimestamps:(00:59) | Diagnosing Osteoporosis and Hidden Fracture Risk(05:38) | Evolution of Bisphosphonate Use in Osteoporosis Treatment(07:51) | Current Use of Bisphosphonates: Benefits, Risks, and Side Effects(10:31) | Exploring Non-Bisphosphonate Options for Fracture Prevention(11:44) | Teriparatide and Alternative Osteoporosis Medications(14:53) | Inside the Latest Bisphosphonate Clinical Trial(18:07) | Key Findings from the Zoledronate Fracture Prevention Study(22:38) | Public Health Impact of Fracture Prevention Strategies(24:24) | Final Takeaways and Expert Perspectives on Osteoporosis CareTags:  CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Osteoporosis, Fragility Fractures, Zoledronate, Bone HealthFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics: https://branchbasics.com/COREIM and use the code CoreIM for 15% * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Washington Red Raspberries: https://redrazz.orgAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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