#146 NephMadness: Pain Meds in Chronic Kidney Disease
Pain management in patients with chronic kidney disease (CKD) often goes something like this: NSAIDs are evil, acetaminophen hardly works, opioids are dangerous, and all the rest (tramadol, gabapentinoids, antidepressants) are messy. But, we tackle the complexities of pain management in patients with chronic kidney disease in this special @NephMadness (https://twitter.com/nephmadness) 2019 epis...
1hr 24m Apr 01, 2019
1hr 24m
#145 NephMadness: Hepatorenal Syndrome vs AKI
Does your sympathetic nervous system get activated when you notice acute kidney injury in patients with cirrhosis? Ever wonder how to really diagnose hepatorenal syndrome (HRS)? Think you have the bile-acid-stones to start diuretics on a patient requiring pressor support for kidney failure? You have come to the right place! Listen to @kidney_boy (https://twitter.com/kidney_boy/) Joel Topf, HRS ...
1hr 19m Mar 25, 2019
1hr 19m
HCP: Primary Care Workforce with Fatima and Deep
Some precocious policy wonks take a deep dive into the evolving trends and future directions for our primary care workforce. Experts, Dr. Fatima Syed and Dr. Deep Shah return to school us on Physician Supply and Demand, the Access Gap, role of NPs and PAs, Retail Clinics, and Managed Care Clinics. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episo...
1hr 1m Mar 20, 2019
1hr 1m
#144 NephMadness: Inpatient Hypertension
Inpatient hypertension is tricky. What’s the best way to answer those overnight nursing phone calls for elevated blood pressures? What’s the role of treating hypertensive urgency in the hospital? Plus, Our nephrology experts put a new issue on the generalist’s radar: are ACE-inhibitors dangerous to give (or hold) during an operation? This NephMadness 2019 (https://ajkdblog.org/category/nephmadn...
44m Mar 18, 2019
44m
#143 NephMadness: Fluid Wars
The battle over the superiority of resuscitation fluids is coming to a boil. Enter the Fluid Wars. Are Lactated Ringers superior to normal saline? Will LR increase a patient’s lactate? What about albumin? The Curbsiders quench the thirst for knowledge by turning to masters Dr. Pascale Khairallah (@Khairallah_P (https://twitter.com/khairallah_p?lang=en) ), Dr. Charlie Wray (@WrayCharles (https:/...
52m Mar 15, 2019
52m
#142 Cirrhosis TIPS for Acute Complications
Cirrhosis TIPS for the decompensated cirrhotic & acute on chronic liver failure from expert hepatologist and keto-practitioner Scott Matherly MD, @liverprof and chief hepatologist at @KashlakHospital. We walk through acute management of variceal bleeds, when to suspect SBP in decompensated cirrhosis (all the time, it turns out), how much fluid to remove in paracentesis, and some definitions abo...
1hr 30m Mar 11, 2019
1hr 30m
Reboot - Diuretics, leg cramps, and resistant hypertension
Listen to our first ever discussion with @kidney_boy (https://twitter.com/kidney_boy) , Joel Topf MD. It’s a classic episode with a fresh intro as we prepare for @NephMadness (https://twitter.com/NephMadness) 2019 with our friends from Twitter and @AJKDonline (https://twitter.com/AJKDonline) Dominate leg cramps, diuretic therapy, and resistant hypertension with tips from @kidney_boy (https://t...
1hr 5m Mar 04, 2019
1hr 5m
#141 Wound Care Pearls
Demystify chronic wound care management with high yield pearls from wound care expert Dr. Elizabeth (Foy) White-Chu. She takes us through a simple yet thorough approach to manage complex chronic wounds. We discuss everything from selecting a dressing, to pain management, and what kind of water should you really use when cleansing a wound. Answers to all of these burning questions and more await...
1hr 10m Feb 25, 2019
1hr 10m
#140 Psychopharmacology 2.0 - Antidepressant Master Class
Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visi...
59m Feb 18, 2019
59m
#139 Genetic Testing in Primary Care
Join us at the forefront as we talk genetic testing in primary care with Dr Dallas Read, esteemed gynecologist and **the only** medical geneticist at Tufts Medical Center. Topics include: what internists should be comfortable testing for in the office, how and when to refer for screening, what tests to order, how to interpret test results, how to handle direct-to-consumer results or requests, a...
1hr 22m Feb 11, 2019
1hr 22m
#138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis
Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich, Assistant Professor of Medicine and co-director of the Inflammatory Bowel Disease Program at Temple University Hospital.  In this episode, we learn about the initial work-up, general principles of management, and important primary care considerations for Crohn’s disease and ulcerative c...
1hr 26m Feb 04, 2019
1hr 26m
#137 Hyperkalemia Master Class with Joel Topf MD
Master the management of hyperkalemia with tools, tips and tactics from @kidney_boy, Joel Topf MD, Chief of Nephrology @KashlakHospital. We cover: common causes of hyperkalemia; the U-shaped curve of potassium levels and mortality; albuterol nebs; how to safely use insulin; potassium binding resins and colonic necrosis; Does it make sense to give loop diuretics and fluids?; Should we be using f...
1hr 21m Jan 28, 2019
1hr 21m
#136 Sickle Cell Disease, Management & Complications
Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sick...
1hr 9m Jan 21, 2019
1hr 9m
#135 Perioperative Medicine with Dr Avital O'Glasser
Optimize perioperative risk and dominate perioperative medicine. Topics include surgical risk calculators, preoperative labs, stress testing, use of BNP and troponins, postoperative MI, cardiac and pulmonary risk stratification, and more! We’re joined by perioperative medicine expert, Avital O’Glasser MD, Associate Professor of Medicine at Oregon Health & Science University and Assistant Progra...
1hr 24m Jan 14, 2019
1hr 24m
#134 Urinary Tract Infections Delirium and Voltaire
“Urinary tract infections” (UTIs) are overdiagnosed. Antibiotics are overprescribed. UTIs are inappropriately blamed for geriatric syndromes (eg delirium) despite little supporting evidence. Our guest, Tom Finucane MD, Emeritus Professor of Medicine at Johns Hopkins makes us question everything. Topics: How can we diagnose “UTI”? Who needs treatment? Do urinary tract symptoms matter? Does malod...
54m Jan 07, 2019
54m
2018 Recap Extravaganza
Take a trip down memory lane with top clinical pearls and favorite moments from The Curbsiders in 2018. Welcome to our 2018 Recap Extravaganza! Since last year, the Curbsiders team has grown substantially and the podcast has undergone several exciting developments. These include our collaboration with ACP that allows us to provide CME and MOC credit for select episodes, our new partnership wit...
51m Dec 31, 2018
51m
#133 Herpes for Everyone
Master the diagnosis and management of Genital Herpes with tips from expert, Robert Bettiker MD . Topics include: the natural history, diagnosis & screening guidelines for genital herpes; cold sores; options for primary and recurrent episodes including prophylaxis; and consideration of specific populations including symptomatic and asymptomatic patients, pregnancy and MSM (men who have sex with...
58m Dec 24, 2018
58m
#132 A Case of Abdominal Pain
Sharpen your diagnostic schema for abdominal pain and eosinophilia with this mystery case http://hdx.org/Rxg (click link to follow along). Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project (https://www.humandx.org/) aka Human Dx attempts to solve this challenging case with the help of The Curbsiders. Use this link http://hdx.org/Rxg to follow along with the case on...
50m Dec 19, 2018
50m
#131 A Case of Cough and Dyspnea
Hone your diagnostic skills with this mystery case of cough and dyspnea http://hdx.org/pdp (click link to follow along). The Curbsiders deconstruct the case and discuss their diagnostic schemas for these common problems with the help of returning guest, Reza Manesh MD, editor of Global Morning Report at The Human Diagnosis Project (https://www.humandx.org/) aka Human Dx. Use this link http://h...
48m Dec 17, 2018
48m
#130 Work-Life Fit: Women In Medicine
Create a successful partnership and career withs tips from Wonder Woman, Sue Hingle MD of ACP.  Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro ti...
53m Dec 13, 2018
53m
#129 Depression and Suicide: Occupational Hazards of Practicing Medicine
Dr Elisabeth Poorman MD joins us to discuss the natural history of physician depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming...
1hr 9m Dec 10, 2018
1hr 9m
#128 Aspirin Overhyped and Overused
Aspirin’ to figure out if ASA can help prevent a heart attack? Interpreting all the new trials doesn’t have to cause chest pain! Join Dr. Ambarish Pandey from UT Southwestern as he helps The Curbsiders ASCEND the mountains of the latest studies to ARRIVE at some well-informed conclusions on the role of aspirin in primary prevention for cardiac events. The team also discusses secondary preventio...
53m Dec 03, 2018
53m
Hotcakes: Exercise, Aspirin, Fish Oil and Hypertension
Tony Breu MD joins us for some hotcakes, and “cold cakes” including: how aspirin and zodiac sign affect the treatment of acute MI, a recent study on how exercise is probably still good for you, the recently announced REDUCE-IT trial, and the evidence (or lack thereof) for the treatment of hypertensive urgency. Welcome to another edition of Hotcakes and Hot Takes, where we discuss the most inter...
49m Nov 29, 2018
49m
#127 STIs: Syphilis, Gonorrhea and Chlamydia
Master the diagnosis and management of common STIs (sexually transmitted infections) with tips from expert, Dana Dunne MD, Associate Professor of Medicine in Infectious Diseases at Yale. Topics include: the stages and many presentations of syphilis, syphilis treatment and counseling, the natural history, diagnosis, and screening guidelines for gonorrhea and chlamydia, treatment options in the a...
1hr 15m Nov 26, 2018
1hr 15m
#126 Kashlak Morning Report with Human Dx
Practice solving diagnostic puzzles with The Curbsiders and Internist / Diagnostician, Reza Manesh MD, Assistant Program Director for Clinical Reasoning of the Osler Medical Training Program at Johns Hopkins! Solve along with us at these links: Case 1 (http://hdx.org/I2B) http://hdx.org/I2B and Case 2 (http://hdx.org/uM2)  http://hdx.org/uM2. Topics include: clinical reasoning terminology, how ...
1hr 6m Nov 19, 2018
1hr 6m
#125 Hidden Curriculum
Check out this audio treasure map to find the hidden curriculum and learn how it can change your practice. Learn how positive teaching spans not just the classroom or bedside but, how we simply talk about patients. Sanjay Desai MD, coauthor of ACP’s Position Paper on Hidden Curriculum and Internal Medicine program director at Johns Hopkins guides us through several cases that illustrate how our...
1hr 2m Nov 15, 2018
1hr 2m
#124 The Shoulder - Simplify Your Approach
Shoulder pain made simple. Develop your confidence and skills with tips from sports medicine specialist Dr. Carlin Senter MD. We discuss her simplified approach to the basic shoulder exam, including when and how to do special tests, high yield exam maneuvers, when to refer shoulder pain patients to orthopedic surgery, and who can be managed conservatively. Full show notes available at http://t...
1hr 11m Nov 12, 2018
1hr 11m
#123 Sleep Apnea Pearls and Pitfalls
The sleep apnea episode that won’t put you to sleep. Become a sleep apnea guru with incredible insights from Barbara Phillips MD, MSPH, FCCP an expert in pulmonary medicine, critical care and sleep medicine who is also a past president of CHEST! We discuss high-yield topics in the world of obstructive sleep apnea including: home sleep studies vs in-lab polysomnography, the importance of oxygen ...
52m Nov 05, 2018
52m
#122 Headaches Advanced Class
We delve into advanced management of headaches, including novel therapies, migraines with aura, migraines in complicated patients, and headaches of short duration with Dr. Rebecca Burch, a headache medicine specialist at the John R. Graham Headache Center at Brigham and Women’s Hospital. Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes (https://itunes.apple.com/...
1hr 18m Oct 29, 2018
1hr 18m
#121 HIV Care for the Internist
HIV care for the internist with author and HIV expert, Michael Saag MD, Professor of Infectious Diseases at University of Alabama and founder of the 1917 Clinic (https://www.uab.edu/medicine/1917clinic/) . We discuss the specifics of screening & diagnostic testing in HIV, monitoring CD4 counts and viral loads, first line antiretroviral therapy, harm reduction, and how to provide excellent HIV c...
1hr Oct 22, 2018
1hr
#120 Policy, Patients, Payments, Paperwork
Join us in this roundtable discussion of patients before paperwork, administrative burden, the new CMS payment model proposal, and a bit on health insurance with cohost, Fatima Syed MD MSc and guest, Deep Shah MD MSc. Doctors Syed and Shah are both early career physicians with masters degrees in comparative social policy from Oxford University and are active members of the American College of P...
44m Oct 19, 2018
44m
#119 Nutrition Pearls, Heart Health and Bacon
Nutrition pearls from integrative cardiologist, Steven Devries MD, Associate Professor of Medicine, Northwestern Feinberg School of Medicine, Executive Director of The Gaples Institute (https://www.gaplesinstitute.org/) . Clinicians receive little formal nutritional training in medical school and residency. It’s time to fill that gap! We discuss the strength of the literature supporting dietary...
58m Oct 15, 2018
58m
#118 Female Sexual Problems with Stacy Lindau MD
Houston, we have a female sexual dysfunction problem. Female sexual problems, which can affect women of all ages, are underdiagnosed and undertreated--in part because clinicians are not the best at asking about sex in primary care visits. In the course of this episode, learn about how to have that sex talk you’ve (maybe) been avoiding, what to ask when working up sexual problems in women, and f...
56m Oct 08, 2018
56m
#117 Clostridium Difficile: IDSA Guidelines, Bad Puns, and Random Pearls
Summary Conquer Clostridium difficile (Clostridioides difficile (https://www.ncbi.nlm.nih.gov/pubmed/27370902) ) with this “spore-tacular” episode featuring infectious diseases expert, Dr. Curtis Donskey, Professor at Case Western Reserve University and clinician at the Louis Stokes VA Hospital. We discuss the updates in the 2017 IDSA C. difficile guidelines plus a bunch of random pearls. If y...
1hr 3m Oct 01, 2018
1hr 3m
#116 Geriatric Psychiatry: Sleep, Dementia, and Behavioral Disturbances
Geriatric psychiatry returns. We tackle sleep problems and behavioral disturbances in patients with dementia with returning guest, and Geriatric Psychiatrist Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: pharmacologic and nonpharmacologic management of insomnia; treating agitation and irritability; medical management of psychotic symp...
30m Sep 27, 2018
30m
#115 Geriatric Depression
Summary Geriatric depression got you down? Boost your spirits with tips and tactics from Geriatric Psychiatrist, Dennis Popeo MD, Clinical Associate Professor of Psychiatry at NYU Langone Medical Center. Topics include: suicide in the older adults; how to diagnosis depression in older adults; how to counsel patients about antidepressants, how to choose an antidepressant, how to monitor and tit...
46m Sep 24, 2018
46m
#114 High Value Care: Assess Quality, Mitigate Diagnostic Uncertainty, Overcome Barriers
Kick up the quality of your care with tips and tactics from Caitlin Clancy MD, coauthor of ACP’s High Value Care Curriculum. We learn to define quality and value in healthcare; the most common barriers to high value care; use of probability and likelihood ratios to boost clinical reasoning and combat diagnostic uncertainty; some useful tools to estimate cost; sources of healthcare waste; and so...
58m Sep 17, 2018
58m
#113 Gout: Uric acid targets, urate lowering therapy, and random questions from social media
Master the management of gout with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. Topics include: how to initiate and titrate urate lowering therapy, guidelines controversy over uric acid targets, colchicine & NSAIDS for anti-inflammatory prophylaxis, uricosuric agents, febuxostat, HLA B5801, use of uric acid levels in the acute setting an...
38m Sep 10, 2018
38m
#112 Gout Flares: Bathtubs and Firefighting
Crystalize your knowledge of gout and stop flares in their tracks with tips from expert, Tuhina Neogi MD, PhD, Professor of Medicine at Boston University School of Medicine. On this first of two gout episodes we learn to diagnose gout with or without arthrocentesis, how to treat flares, and how to counsel patients about gout, which apparently involves fire fighting and bathtubs. Don’t miss next...
48m Sep 03, 2018
48m
#111: Hotcakes - Complementary Medicine in Cancer, Dosing Aspirin by Body Weight, Marijuana & Respiratory Symptoms, Penicillin Allergies and More!
Dr. Neda Frayha (@nedafrayha (https://twitter.com/nedafrayha) ) of Primary Care RAP (Hippo Education) joins us this month for our thoughts and analysis of some recent (and not so recent) journal articles that interested us this month. Our articles spanned topics that include at cancer survival among patients pursuing treatment with complementary medicine, the effect of body weight on effectiven...
42m Aug 31, 2018
42m
#110: Driver’s safety for Older Adults: When is it Time to Give Up the Keys?
Get schooled on driver’s safety for older adults by expert, Alice Pomidor MD, Professor of Geriatrics at Florida State University. Whether or not older adults can continue to drive is a huge problem faced by for primary care clinicians, and will remain one until driverless cars become ubiquitous. Topics covered include: how to take a driving history, red flags, physical exam, cognitive exam, an...
1hr 13m Aug 27, 2018
1hr 13m
#109: Things We Do For No Reason: A High Value Episode
Things We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound a...
1hr 7m Aug 20, 2018
1hr 7m
#108: Point-of-care Ultrasound for the Internist
Point-of-care Ultrasound AKA POCUS ain’t no hocus. Dr. Renee Dversdal (@ReneeDversdal (https://twitter.com/ReneeDversdal) ) Director of the Oregon Health & Science University Point of Care Ultrasound and General Medicine Ultrasound Fellowship Director, joins The Curbsiders to discuss her craft. Topics include: Defining POCUS, the value POCUS adds to the physical exam, training pathways and the ...
1hr Aug 13, 2018
1hr
#107: Women in Medicine, Be Bold
“Women in medicine, be bold.” Medical World, powerful women are here to stay. Dr. Vineet (Vinny) Arora, Professor of Medicine at University of Chicago, an exemplary Woman in Medicine and Leadership, shares snippets of her own story, valuable career advice to folks at all levels of training, and fascinating data about the gender disparities that exist in training, promotion, and pay.  We hope yo...
59m Aug 06, 2018
59m
#106: Hotcakes: Cardiac risk, diabetes, pulmonary embolism, opioid use disorder, neck ties and nose picking?
Short on time but hungry for knowledge? Curbsiders’ Journal Club gives you the speedy article analysis you crave. We provide brief summaries of recent research and news items in the field of internal medicine, so you can save time and stay on top of the literature. On this episode, we were joined by Kashlak Memorial’s very own Chair of Medicine, Dr. Robert Centor AKA @medrants (https://twitter....
56m Jul 30, 2018
56m
#105: Lyme Disease and Tick-Borne Illness with ID Expert Paul Sax
Lyme disease and tick-borne illness deconstructed by Infectious Diseases expert, Paul E. Sax MD, of episode 78 fame (http://thecurbsiders.com/internal-medicine-podcast/78-id-pearls-paul-sax-md) . Oh, Summer Nights. The time for romance between Danny Zuko and good girl Sandy, the time to sit in the backyard around the bonfire, the time for sunset hikes in the woods and mountains…..and don’t forg...
59m Jul 23, 2018
59m
#104: Renal tubular acidosis with Kidney Boy, Joel Topf MD
Renal tubular acidosis aka RTA deconstructed by @Kidney_Boy, Joel Topf MD, Chief of Nephrology at Kashlak Memorial Hospital. We review the three buckets of non gap metabolic acidosis, normal renal physiology & acid base handling, points of failure in RTA, complications and treatment of RTA. Check out Dr Topf’s awesome slides on renal tubular acidosis at http://thecurbsiders.com/podcast . Join ...
1hr 15m Jul 16, 2018
1hr 15m
#103: Train Your Brain: Mapping out your road to expertise
Expert diagnostician, Dr. Gurpreet Dhaliwal, again joins The Curbsiders to dive deeper into the topic of clinical expertise.  Topics include, and are mainly focused on, Dr. Dhaliwal’s “training regimen:” feedback, simulation, quizzing, learning from consultants, and how to read the medical literature as a clinician.  While we found this episode to be incredibly useful (and entertaining to recor...
59m Jul 09, 2018
59m
#102: Hotcakes: Asthma, Smoking Cessation, PCP Prophylaxis, Procalcitonin
Curbsiders’ Journal Club features rapid summary and critical appraisal of recent articles and news stories in internal medicine by The Curbsiders. This month’s topics include: asthma, maintenance versus as needed inhaler use, procalcitonin, Pneumocystis pneumonia prophylaxis, colon cancer screening, smoking cessation, cannabis and cognitive impairment, LDL cholesterol and mortality, plus some m...
1hr 14m Jul 02, 2018
1hr 14m
#101: Cirrhosis: Medications, decompensation, complications
Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowled...
40m Jun 25, 2018
40m