Core IM | Internal Medicine Podcast

“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and support their recovery. Also discover blind spots in detox and rehab centers.
🔹Transcript and Show Notes
🔹 Explore ACP’s Substance Use Disorder Education Hub for videos and an AI-powered patient simulation to practice alcohol-use conversations: https://www.coreimpodcast.com/SUDhub
Alcohol Use and Chronic Health Conditions Mini Video Series
01:55 | #1: Naltrexone
12:06 | #2 Acamprosate
16:15 | #3: Topiramate
21:12 | #4: Other meds
29:31 | #5: Detox and rehab blind spots 

Tags: CoreIM, Medical Education, Addiction Medicine, Alcohol Withdrawal, Addiction Treatment, GLP-1, pharmacology

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Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always obvious. We also discuss ways to work through that grief, recognize when it becomes complicated, and lean on your team for support.  

🔹Transcript and Shownotes
04:12 | What is Clinician Grief?
10:02 | Types of Losses
10:22 | Loss of a close relationship with a particular patient
12:56 | Loss due to a professional's identification with the pain of family members
13:56 | Loss of one's unmet goals and expectations and one's professional self-image and role
18:47 | Loss related to one's personal system of beliefs and assumptions about life
21:30 | Past unresolved losses or anticipated future losses
23:29 | The death of the self
25:44 | Coping

Tags: CoreIM, Medical Education, Clinician Wellbeing, Burnout, Secondary Traumatic Stress, Complicated Grief, Coping With Grief, Medical humanities, medical ethics

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How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about sphincterotomy, stents, and stone removal? Plus, how to interpret bile duct dilation without jumping straight to obstruction?

🔹Sponsor: Oakstone CME
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP

🔹Transcript and Shownotes

02:11 | Pearl 1: Gallbladder Problems Spectrum
07:33 | Pearl 2: Choose Imaging Strategically: Start with RUQUS, Escalate as Needed
14:34 | Pearl 3: Biliary Tree Diagnostics
19:19 | Pearl 4: Invasives that are Diagnostic and Therapeutic
27:06 | Pearl 5: Stenting in ERCP

Tags: CoreIM, Internal Medicine, Medical Education, Gallstones, Cholecystitis, Biliary Disease, ERCP, Biliary Imaging

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Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia management, from fluids and solutes to loop diuretics and identifying the underlying cause. 

🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here.

🔹Transcript and Shownotes

6:46 | Pearl 1: Key Principles
15:13 | Pearl 2: Fluids in hyponatremia
26: 03 | Pearl 3: Solutes in hyponatremia management
35:49 | Pearl 4: Lasix in hyponatremia management
40:05 | Pearl 5: Etiologies

Tags: CoreIM, Internal Medicine, Medical Education, SIADH, Fluid Restriction, Nephrology, Hospital Medicine, Urine Osmolality

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Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers, Thiazides) is the preferred first-line framework, and how to personalize medication choices based on comorbidities and side effects.

🔹Sponsor: Oakstone CME
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 

🔹Transcript and Shownotes

03:00 | Diagnosing Hypertension 
04:10 | When to Start Combination Therapy Instead of Monotherapy 
07:00 | Choosing First-Line Therapy Using the ACT Framework 
13:23 | Why ARBs Are Often Preferred Over ACE Inhibitors 
16:02 | Choosing the Right ARB: Candesartan vs Losartan 
18:39 | Comparing Potency & Duration Across First-Line Antihypertensives 
20:54 | Amlodipine Edema: Why It Happens and How to Fix It 
23:54 | Thiazides: Practical Tips, Electrolyte Problems & Class-Killer Side Effects 
29:33 | Managing Patients Who 'Can't Tolerate' Blood Pressure Medications 

Tags: Hypertension Management, High Blood Pressure, Primary Care, Internal Medicine, Core IM

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