The Curbsiders Internal Medicine Podcast

Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest! Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP, Cover Art and Infographic by: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Helena Pasieka MD, MS Sponsors Provider Solutions & Development Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders. VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio 04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders 08:30 Case 1: Alopecia 12:05 Assessing scalp for inflammatory changes and follicular drop-out 13:10 Central Centrifugal Cicatricial Alopecia (CCCA) 14:00 Alopecia/hair loss non-scarring subtypes 25:00 Alopecia Treatments 28:55 Case 2: Psoriasis vs. Seborrheic Dermatitis 31:45 Looking for psoriatic plaques 32:11 Seborrheic dermatitis hallmarks 35:19 Treatment for Seborrheic Dermatitis 42:10 Case 3: Rosacea vs. Acne 50:40 Differentiating rosacea rash from SLE 52:40 Rosacea management & treatment 55:00 Identifying rosacea in Black skin 56:50 Acne management & treatment 59:10 Retinoid dermatitis 1:00:30 Maskne 1:02:29 Antibiotics for acne 1:03:38 Retinoids and pregnancy 1:04:09 Doxycycline for rosacea 1:06:15 Take home points Sponsor - VCU Health Continuing Education Links* Hamilton and Alexander Hamilton by Ron Chernow, Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance) The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones) Brown Skin Matters on Twitter and Instagram Skin of Color Society American Academy of Dermatology Society for Dermatology Hospitalists Black Skin Directory Learning Journal Mind the Gap (2020) by Malone Mukwende Ethnic Dermatology: Principles and Practice (2013) Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012) An Atlas of African Dermatology (2001) *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goals Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic. Learning objectives After listening to this episode listeners will... Recognize and treat common skin complaints of the scalp and face in primary care. Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care. Be able to differentiate non-scarring versus scarring hair loss on physical exam. Comprehend nuances in total body presenta

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more. Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Original episode written and produced by: Matthew Watto MD, FACP Show Notes and CME questions by: Deb Gorth ScM Cover Art and Infographic by: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Molly Heublein (written materials); Matthew Watto MD (audio) Guest: Joel Topf MD Sponsors POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team. Interview season is in full swing and they’re actively accepting applications. Please go to pennultrasound.org or contact [email protected] for information. You can apply for fellowship using the eusfellowships.com portal. VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps 00:00 Intro 03:30 Guest interview 07:15 Pick of the week w/Dr. Topf 16:20 Clinical case of hyponatremia 17:48 False hyponatremia normal osmolality 19:34 False hyponatremia high osmolality 20:36 Understanding why osmolality matters 23:28 Workup false hyponatremia 24:45 Recap of discussion so far 25:40 ADH dependent vs independent hyponatremia 27:00 Psychogenic polydipsia 289:15 Renal failure and hyponatremia 30:03 Tea and toast, and Beer Drinker’s potomania 35:22 ADH dependent hyponatremia 38:15 Volume versus osmolality 40:00 Volume status exam 45:14 Additional testing with urine lytes and uric acid 47:30 Treatment for SIADH 52:42 Discussion of the vaptans 58:21 Additional testing in SIADH 62:50 When to admit patient for hyponatremia 63:59 Clinical case of hyponatremia complications 68:56 Fluids and rate of correction 73:36 DDAVP clamp 76:30 Moderate hyponatremia 78:35 Diuretic dosing DOES matter! 81:59 Loop diuretics for SIADH 84:25 Take home points 87:25 Outro Links* Dr. Joel Topf’s Textbook Dr. Joel Topf’s Blog Dungeons and Dragons Tartine (cookbook) by Elizabeth M. Prueitt I Hate You, Don’t Leave Me by Hall Strauss Intentional Parenting by Sissy Goff Mindset by Carol Dweck Nintendo Switch 8.0 Bit Techno- The Curbsiders Theme Song by Stuart Kent Brigham Ure-Na European Society of Endocrinology Clinical Practice Guidelines. Don’t miss Dr. Topf on twitter aka @kidney_boy. *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goal Listeners will recall the pathophysiology of hyponatremia and develop a systematized approach to identifying the type and cause of hyponatremia, as well as how to safely manage hyponatremia. Learning objectives After listening to this episode listeners will… Differentiate true and false hyponatremia Recall the pathophysiology of true and false hyponatremia Interpret blood and urine tests to identify the cause of hyponatremia Recall the limitations of the volume status exam List ADH dependent causes of hyponatremia List ADH independent causes of hyponatremia Explain the pathophysiology of beer drinker’s potomania and “tea and toast” hyponatremia Use uric acid to differentiate SIADH from other causes of hyponatremia Basic therapy for SIADH Recall safe rates of correction for hyponatremia Disclosures Dr. Topf has received honoraria from AstraZeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures. Citation Topf J, Gorth DJ, Williams PN, Brigham SK, Heublein

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot! NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively. Credits Written and Produced by: Shannon Snellgrove Infographic: Shannon Snellgrove Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders) Hosts: Justin Berk MD and Christopher Chiu MD Editor:Justin Berk MD; Clair Morgan of nodderly.com Guest(s): Hussein Abdullatif MD *Sponsors* POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates! In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship. Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team. Interview season is in full swing and we’re actively accepting applications. Please go to pennultrasound.org or contact [email protected] for information. You can apply for fellowship using the eusfellowships.com portal. VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps Diagnosis of T1DM 6:50 Presentation of T1DM 10:10 Explaining T1DM to a parent 12:00 Genetic Predisposition to Diabetes 15:20 T1DM Antibodies 17:10 Initial work-up for concomitant autoimmune disease 21:10 Atypical Presentation of T1DM 22:44 Treatment of T1DM 29:10 Dietary Modifications in T1DM 33:10 Checking blood sugars 39:50 Honeymoon Period 42:25 Hypoglycemia 44:00 Sports, Sickness, Alcohol and Glucose levels 48:25 Periop glucose management 51:10 Long-term complications of T1DM 53:50 Closed Loop System and Future Treatments 56:10 Goal Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes. Learning objectives After listening to this episode listeners will… Identify the signs and symptoms of type 1 diabetes Practice appropriate work-up in the diagnosis of type 1 diabetes Manage type 1 diabetes with evidence-based therapies Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes) Disclosures Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures. Citation Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (link goes live on 9/2/2020)

Are U Talkin’ UTIs Re: Me? Infectious Diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED) schools us on the diagnosis and management of urinary tract infections: updated definitions of complicated and uncomplicated UTI, pitfalls of the urinalysis, first line antibiotics, duration of therapy and which agents to use for complicated UTI. This episode is liquid gold! Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Cover Art and Infographic by: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Boghuma Kabisen Titanji MD, PhD Sponsor - VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Time Stamps Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio 02:50 Guest one-liner, Picks of the Week*: Urban gardening, Behave (book) by Robert Sapolsky 08:54 Defining UTI; Framework for UTI 16:35 Case 1 - Cath Foley; Acute uncomplicated cystitis; Interpreting the Urinalysis 28:00 Women with recurrent UTIs 38:55 Case 2 - UTI in a man 47:15 Treatment of complicated infections; Duration of therapy 52:27 Case 3 - Catheter associated UTI; MRSA UTI 61:25 Duration of therapy for bacteremia from UTI 64:40 Take home points, plugs and outro Sponsor - VCU Health Continuing Education Links* Behave (book) by Robert Sapolsky Boghuma’s blog theiddoc.net Boghuma’s TED Talk Emory’s ID fellowship program *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goals Listeners will appropriately recognize, diagnose and treat the various presentations of urinary tract infection. Learning objectives After listening to this episode listeners will... Define UTI and feel confident making the diagnosis of UTI based on lab tests, history and exam findings Differentiate between complicated and uncomplicated UTI Recognize how UTI may presents differently in differ groups (paraplegic, chronic foley catheter, men and women) Choose the appropriate antibiotic and duration with an eye towards antibiotic stewardship Determine an approach to the patient with recurrent UTIs, including who may benefit from long term antibiotic prophylaxis. Disclosures Dr Titanji reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Citation Titanji BK, Williams PN, Watto MF. “#231 U Talkin’ UTIs Re: Me”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date August 24, 2020.

Does the thought of managing acute decompensated heart failure (ADHF) give you paroxysmal nocturnal dyspnea? Recline for a bit while Dr. Michelle Kittleson MD, PhD @MKittlesonMD (Cedars Sinai) takes us through the Zen of jugular venous pressure (JVP) exams, how to approach diuresis, and the fine points of hospital discharge. This knowledge food is easier to swallow than an oral potassium replacement. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Deborah Gorth ScM Cover Art and Infographic by: Edison Jyang Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Michelle Kittleson MD, PhD Sponsor - VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Time Stamps 00:00 Intro 02:40 Guest one-liner; Picks of the Week 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic) 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction? 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?! 28:36 Labs to trend during an ADHF admission 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2? 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB) 56:05 Who needs a right heart cath? 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care 64:04 SGLT2i in heart failure 68:15 Take home points and outro

Join us for an extra-hot summer episode featuring our critical appraisal expert, Rahul Ganatra MD, MPH @rbganatra. Prepare to marvel as he breaks down his recent tweetorial on the RECOVERY trial of dexamethasone for COVID-19; to gasp as Paul Williams updates us on statins and ASCVD prevention and to be enthralled by the dulcet tones of Matt Watto explaining the latest research on DAPT vs. monotherapy with ticagrelor. Bonus: a new hotcakes rating scale has arrived! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Sarah Phoebe Roberts Show Notes by: Sarah Phoebe Roberts Writer: Rahul Ganatra MD, Sarah Phoebe Roberts, Matthew Watto MD, Paul Williams MD Cover Art: Matthew Watto MD Hosts: Rahul Ganatra MD, Matthew Watto MD, Paul Williams MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Time Stamps 00:00 Intro 02:15 Picks of the Week 06:15 New Hotcakes rating scale 09:20 RECOVERY trial 17:30 Rapid home-testing for COVID 20:15 Statins and ASCVD prevention 32:30 Ticagrelor monotherapy after ACS 41:30 Outro Picks of the week Paul: U Talkin' Talking Heads 2 My Talking Head podcast Sarah: New hotcakes scale! Rahul: Chromeo’s new Quarantine Casanova album Watto: 30 Rock season 1, episode 3 “Blind Date”

Blazing hot tips to diagnose and treat hyperthyroidism with Dr Eve Bloomgarden, @evebmd (Northwestern). We cover a ton of ground including how to: interpret thyroid function tests, use your thumbs (or an ultrasound) to examine the thyroid, become an expert on Graves’ orbitopathy, prescribe methimazole and decide who needs surgery or radioactive iodine therapy. Plus, a bit on subclinical hyperthyroidism. This episode is on fire! Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Tima Karginov and Matthew Watto MD, FACP Infographic by: Tima Karginov Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Eve Bloomgarden MD Sponsors: Pediatrics On Call podcast by the American Academy of Pediatrics If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here. VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Time Stamps 00:00 Intro 03:15 Guest one-liner, favorite failure, Picks of the Week* 08:50 Sponsor 10:37 Background, Definition of Hyperthyroidism, thyrotoxicosis; Basic labs 14:20 Case from Kashlak, Symptoms of Hyperthyroidism 25:00 Grave’s eye disease: exam, therapy and counseling 32:35 Thyroid exam and ultrasound 38:55 Thyroid Stimulating Immunoglobulin 41:00 Biotin 44:30 Thyroid Scintigraphy 49:00 Causes of Thyrotoxicosis 52:00 Treatment & Adherence to antithyroid medication (methimazole) 56:20 Beta Blockers in thyrotoxicosis 64:50 Subclinical Hyperthyroidism 67:00 Take Home Points, Outro

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year! Credits Producers & Writers: Edward Corty, Nicholas Lee MD Infographic: Nicholas Lee MD Cover Art: Chris Chiu MD Hosts: Justin Berk MD, Chris Chiu MD, Edward Corty Editor:Justin Berk MD; Chris Chiu MD Guest(s): Joshua Sharfstein MD Sponsors: Pediatrics On Call Sponsor: VCU Health Continuing Education - to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org or cribsiders.vcuhealth.org Time Stamps Introduction 1:00 How to answer “What do you think about school openings?” 11:30 Risk Assessment of School Re-openings 14:40 Evidence of Transmission among Children 17:10 What Other Countries Have Done 19:40 Community Threshold for Re-Opening and Using Protocols 20:30 The Reasons to Cohort 22:45 How to Address Scenarios 24:20 Health Disparities and Return to School 27:00 Existing Inequities and Children’s Sacrifice of Education 29:00 “Opting Out” of School Return and Feeling Safe 31:30 How Can Governments Help Support the Return 35:50 Guidance to give as PCP 37:50 School Alternatives / Innovations to Going Back 40:10 The Difference Between Equity and Equality 42:50 Testing in Schools 43:45 Resources to Follow For More Information 46:00 Take-Away Points 47:10 Optimism 48:25 Picks of the Week 53:50

Swim through the sea of acronyms as Dr Scott Matherly (@liverprof) helps us become a little less baffled by the thought of NAFLD. We discuss the initial diagnosis of fatty liver disease, indications for additional evaluation with imaging and/or biopsy, and potential treatment options. With a quarter of the world affected, it’s crucial to understand the various forms of disease and how to counsel patients about this all-too-common condition! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Elena Gibson MD Infographic and Cover Art: Elena Gibson MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Scott Matherly MD Sponsor: Pediatrics On Call Sponsor: VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 03:15 Guest one-liner; Picks of the Week* : 08:15 Sponsor 08:50 Case from Kashlak part 1; What is hepatic steatosis? 11:43 NAFLD acronyms and definitions 18:20 Alcohol and Fatty Liver 23:15 Initial Evaluation of NAFLD 35:12 Dr Matherly’s piel to patients with fatty 41:11 NASH/Fibrosis Risk Assessment 48:54 Outcomes in NASH with Fibrosis 51:20 Statins are safe in liver disease 56:15 Treatment Options (surgery, Vitamin E, Pioglitazone, SLGT2 inhibitors and GLP1 agonists; Coffee?!) 71:42 Take home points and Outro

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written (including CME questions) and Produced by: Cyrus Askin, MD Infographic by: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Joel Topf, MD Sponsor: Pediatrics On Call Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); 08:45 Sponsor 09:15 Definition of acute kidney injury (AKI) and fundamentals 11:00 Cardiorenal syndrome 12:24 Schema for AKI 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities 21:22 AKI in the otherwise-healthy patient; 32:20 Rhabdomyolysis 38:21 Vancomycin 41:43 Acute interstitial nephritis (AIN) 44:52 Contrast induced nephropathy (CIN) 50:37 Gadolinium in AKI and/or CKD 52:53 Timing of dialysis 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; 62:01 Is Ultrasound necessary in AKI 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology

Listen as our expert guests, Kelly Graham, MD, MPH (@KellyGrahamMD) and Lekshmi Santhosh, MD MAEd (@LekshmiMD), detail the professional and personal challenges faced by women in medicine during the COVID-19 pandemic. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Produced by: Leah Witt MD & Shreya Trivedi MD Written by: Molly Heublein MD, Isabel Valdez PA-C, Leah Witt MD & Shreya Trivedi MD Infographic & Cover Art: Edison Jyang Hosts: Leah Witt MD & Shreya Trivedi MD, Justin Berk MD, MPH, MBA Editor: Molly Heublein MD and Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Kelly Graham, MD, MPH; Lekshmi Santhosh, MD MAEd Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Episode Breakdown Intro, disclaimer Introduction and bio for Kelly Graham, MD, MPH Introduction and bio for Lekshmi Santhosh, MD MAEd One-liner for Kelly Graham, MD, MPH One-liner for Lekshmi Santhosh, MD MAEd Gender Awakening Moments Picks of the Week* Case from Kashlak Difficulty with lack of childcare while working Hippocratic Oath paradox Dr. Santhosh’s 3 Ps Motherhood penalty-fatherhood bonus Two Pandemics, One Response Breadwinner-homemaker bias Female physician burnout Minority Tax Silver Linings Take home points and Outro

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter. In this episode we talk to addiction medicine expert, Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Topics include: the management of polysubstance withdrawal, approaching acute pain management for a person with opioid use disorder, and inpatient harm reduction strategies. After this episode listeners will gain new tools to help them best care for hospitalized patients with substance use disorders. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Writers and Producers: Carolyn Chan MD, Deb Gorth, and Nora Taranto MD Cover Art and Infographics by: Carolyn Chan, MD Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Carolyn Chan MD Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Melissa Weimer Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps Intro, disclaimer, guest bio : 00:00 Guest one-liner: 03:00 Picks of the Week*: 08:20 Case from Kashlak: 10:30 Urine Toxicology Screens 11:30 Discussing Urine Toxicology Screens with Patients 13:20 Management of Polysubstance Withdrawal 16:16 Tapering Benzodiazepines 19:56 Acute Pain Management and Opioid Use Disorder 30:35 Active Drug Use in the Hospital 38:52 Harm Reduction 40:00 Discharges - Planned 43:43 Perioperative Buprenorphine and Methadone: 46:50 QT Prolongation and Methadone - 52:53 Outro 56:21

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas. Show notes: https:/www.thecribsiders.com/. Credits Writer, Producer, Infographic, CME Questions: Clara Mao Cover Art: Christopher Chiu MD Hosts: Justin Berk MD, Christopher Chiu MD, and Matthew Watto MD Editor: Justin Berk MD; Clair Morgan of nodderly.com Guest: Whittney Warren DO Time Stamps Intro / Disclaimer 0:00 Guest bio 2:25 Guest one-liner, picks of the week 3:15 Explaining CF to patients, life expectancy 7:00 Types of CF mutations and phenotypes 11:50 Presentation of CF in older patients 15:20 Screening and diagnosis 16:40 PFTs and airway clearance 25:20 Nutrition and the “CF diet” 29:10 CF exacerbations and antibiotic selection 32:25 Extrapulmonary manifestations 39:35 Transition of care for CF adolescents (alcohol, exercise, sex) 43:50 CFTR modulator therapy 51:35 Lung transplantation 54:45 Goal Listeners will develop a systematic approach towards long-term management and acute exacerbations of cystic fibrosis. Learning objectives After listening to this episode listeners will… Explain the pathophysiology underlying cystic fibrosis. Identify maintenance therapies that optimize pulmonary function and nutritional status in patients with cystic fibrosis. Choose evidence-based practices in the management of cystic fibrosis-associated pulmonary exacerbations.

This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening. Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written and Produced by: Rahul Ganatra MD, MPHl Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD Show Notes and CME questions by: Deborah J. Gorth ScM Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD, MPH Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro, disclaimer, guest bio 02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Netflix; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page! 07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19 26:10 Dexamethasone for COVID-19 28:55 Hormonal therapy for depression 38:16 Probiotics 45:00 Outro

Listen as our esteemed guest Dr. Utibe Essien @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings.Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME!Credits Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD Cover Art: Hannah Abrams MD Infographic: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!Time Stamps 00:00 Intro, disclaimer, guest bio 02:40 Guest one-liner, Picks of the Week*: Just Mercy 09:20 Statement from the show; Importance of discussing racism in medicine 14:11 Definitions 18:06 Identifying how racism manifests in the clinical setting 37:46 Ideas for advocacy 49:50 Take points and Outro

Throw out your down pillows and join The Curbsiders for this lively discussion on interstitial lung disease. While the hundreds of interstitial lung disease types make this topic a bit overwhelming, breathe easy knowing that pulmonologist, Dr. Erin Narewski @erinnarewski (Temple), can boil things down to an easy to approach framework in less time than it takes to complete a few 6-minute walk tests. In this episode, we walk through the classification, relevant patient history, workup, and management of interstitial lung disease. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written and Produced by: Paul Williams, MD, FACP; Nicole Kus, David Madnick, and Peter Wikoff Infographic and Cover Art: Edison Jyang Show Notes: Deborah Gorth Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Paul Williams MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Erin Narewski DO, FCCP Sponsor: ACP membership acponline.org/member Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 0:00 Intro 03:14 Guest one-liner, career advice, favorite failure, Picks of the Week*: The Strain, FX Horror TV Show; One Hundred Years of Solitude (book) by Gabriel Garcia Marquez; Hypoallergenic pillows; Peanut butter whiskey 10:02 Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT 11:00 Case from Kashlak, Definitions 16:40 Buckets of ILD 32:06 Discussion of testing ILD: Labs and Imaging 44:20 Imaging findings in ILD 49:44 Basic Management of ILD 61:00 Take home points and Outro

We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written and Produced by: Emi Okamoto MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Karen DeSalvo MD, MPH, MSc Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account! Time Stamps Intro, disclaimer, guest bio 0:44 Dr Desalvo’s one-liner 3:34 Picks of the Week*- The Great Influenza book by John M Barry 5:01 Dr Desalvo’s advice and past experience 6:10 Case from Kashlak 10:30 What about the evidence for social determinants? 13:40 What to do about this in the clinic, and is it worth screening? 16:06 Approaching as a team and with the community 19:40 How do we affect the upstream, before the downstream consequences? 22:40 NAM recommendations and framework 26:00 The role of technology 30:00 What are Social Determinants of Health (SDOH), and who they affect 34:00 Start paying attention to SDOH 37:00 Outro 38:49

Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written: Hannah Abrams MD, Avital O’Glasser MD Produced by, Infographic and Cover Art by: Hannah Abrams MD Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com Guest: Avital O’Glasser MD Sponsor: ACP - acponline.org/member Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students 09:28 Sponsor 10:17 Kashlak case; How to collaborate with our surgical colleagues 13:45 Questions to ask at the time of transfer 23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea 44:25 Co-managing Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis 57:55 Outro

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.” We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment, modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255.Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!Credits Producer/Writer/Graphics: Beth Garbitelli Co-Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Megan Gerber MD, MPH, FACP Sponsor: ACP - Visit acponline.org/member Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!Time Stamps Intro, disclaimer, guest bio (0:00 - 3:15) Guest one-liner (3:30) Kashlak Cases (13:45) Epidemiology of trauma (15:18) Trauma and #MeToo (18:10) Defining Trauma-Informed Care (TIC) (19:00) Integrating TIC into primary care (22:48) Screening in TIC (25:00) Containment and retraumatization (29:00) Inquiring about trauma (30:45) Recap and Office Visit Mechanics (35:30) Building the Relationship (38:00) Common Inquiry Mishaps (38:52) TIC Physical Exam (40:20) Resources for Patients (44:30) Office Environment (48:00) Provider Burnout (50:00) TIC in Covid-19 (52:30) Take-home Points (56:20)

Introducing our friends, The Curious Clinicians: Why do human bodies work how they do? Why do medications work, or not work? Do you miss digging into the “why” behind what we do every day? Join Hannah Abrams (@hannarabrams), Tony (@tony_breu), and Avi (@AvrahamCooperMD) in the Curious Clinicians podcast as they delve into these questions & more, starting with episode 1: Why does fingernail clubbing happen in so many different diseases? https://curiousclinicians.com/ Check out their website and subscribe on your favorite podcast player.

Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross! Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD, Rahul Ganatra MD MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsors: ACP and VCU Health CE Time Stamps 00:00 Sponsors 00:30 Intro, disclaimer 02:40 Fomites, groceries and killer rats 08:22 Sponsor 09:22 ACTT-1 trial of remdesivir 18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon 33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests? 44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics 50:30 Outro

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!). Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is.Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!Credits Written and Produced by Nora Taranto MD Infographics by Nora Taranto MD Cover Art by Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com Guest: Stefan Kertesz MD Sponsor: VCU Health CETime Stamps 00:00 Intro, disclaimer, guest bio 3:17 Guest one-liner 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/ 10:07 Case from Kashlak 10:56 Language: How to ask where a patient lives? 13:25 Terminology: Persons Experiencing Homelessness: 14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors 20:44 How to start the visit, and how to establish trust early on? 27:40 Why is the mortality rate higher? 35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C 54:15 COVID and homeless healthcare 57:00 Care Models 62:30 Take Home Points and Outro

Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist.Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME!Credits Written and Produced by: Justin Berk, MD MPH MBA Infographic and Cover Art: Beth Garbitelli Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Douglas Paauw, MD Sponsor: VCU Health CETime Stamps 00:00 Intro, disclaimer, guest bio 02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories! 06:15 Medical Myth Definitions 10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol 19:09 Expired Medications; Military Stockpiling Study 24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap 31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%) 41:07 Epinephrine in extremity; RCT of Epi in Extremities Study showing Experts use it; Podiatry journal 48:39 Take home points and Outro

Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again!Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME!Credits Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD Cover Art: Beth Garbitelli Hosts: Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD , Sarah P. Roberts MPH, Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CETime Stamps 00:00 Intro 02:10 Fun animal facts: Llama antibodies 09:10 Remdesivir RCT by Wang et al 12:40 Power and Sample Size 16:32 Baseline Characteristics, Results and Author’s conclusions 19:15 Rahul’s conclusions: How chance and bias affected the results 24:00 Right censoring; Viral load and timing of antivirals 30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial 33:53 Are patients really having fewer strokes and heart attacks? 38:20 Awake proning 43:30 Paul teaches us not to use the term “happy hypoxemic” 45:00 CIDRAP viewpoint on future waves and exit strategies 50:22 Outro

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond!Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!Credits Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Nina Mingioni MD, FACP Sponsor: VCU Health CETime Stamps 00:00 Intro, disclaimer, guest bio and a bad pun 03:00 Guest one-liner 07:10 Case from Kashlak, Defining fatigue; Taking a general history 11:36 Most common causes of fatigue and how to elicit them from the history 20:39 Physical exam for fatigue; Medications that cause fatigue; 25:25 Exam findings and LRs for anemia; Sleep apnea 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme 47:55 Spiel to the patient when no answer is found 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis 55:09 Take home points and Outro

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal! Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!).Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CMECredits Written and Produced by Nora Taranto MD Infographic and Cover Art by: Nora Taranto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Joji Suzuki MD Sponsor: VCU Health CETime Stamps 00:00 Intro, disclaimer, guest bio 02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film) 08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk 17:32 Outpatient Versus Inpatient Treatment 25:27 Gabapentin for alcohol withdrawal 27:10 Indicators for ICU level Care 31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs 36:55 And which benzo? 39:47 A Natural History of Withdrawal 44:10 Banana Bags and Thiamine Deficiency 48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing 56:36 Outro and Bonus clip

In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us! Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD Writer: Emi Okamoto MD, Rahul Ganatra MD MPH, Cover Art: Chris Chiu MD Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsors: Apollohct.com and VCU Health CE Time Stamps 00:30 Intro, disclaimer 02:30 Picks of the Week 6:36 Remdesivir trial rundown 21:52 Thrombosis in COVID-19 29:50 Asymptomatic/Presymptomatic transmission 41:42 Quick takes 49:00 Outro

It’s NephMadness! Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from the Freely Filtered Podcast led by Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist. Topics: indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME Credits Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew Infographic: Cyrus Askin MD Cover Art: Kate Grant MBChB DipGUMed Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE Time Stamps 00:00 Announcement, Intro to Freely Filtered and NephMadness 04:00 Case of advanced CKD; Who/when to refer for transplant 12:05 Benefits of renal transplant 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors 20:40 Medications after transplant; Drug-drug interactions 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness 32:07 Calcineurin inhibitor levels 36:42 Prophylaxis for long term complications 40:21 Allograft rejection; BAMF criteria 50:40 Cardiovascular risk; Statins 56:11 Malignancy after kidney transplant 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy 72:23 Outro

LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!Credits Written and Produced by: Matthew Watto MD, FACP Infographic: Michelle Brooks MD Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Clair Morgan of nodderly.com Guest: Michelle Brooks MD Sponsor: VCU Health CETime Stamps 00:00 Guest one liner, favorite failure, career advice, 08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series) 11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles 23:04 Negative aspects of social media 26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer 37:14 Pros and Cons of #medtwitter 42:02 Tweetorials 44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media 51:34 Outro

Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Elena Gibson MD Cover art and Infographic by: Dr Kate Grant MBChb MRCGP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com Guest: Susan Mandel MD, MPH Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice 09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms 13:20 When to Test for Hypothyroidism 17:43 Biotin interaction 19:49 Which thyroid tests should we order? 26:15 Subclinical hypothyroidism 29:00 Etiology/Types of hypothyroidism 33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam 37:10 Levothyroxine replacement time of administration 42:10 TSH goal 46:00 Levothyroxine manufacturers 48:33 Dosing in older adults 50:27 T3 treatment 56:52 Pregnancy 59:42 Dose adjustments 61:43 Estrogen and thyroid binding protein 63:33 Who needs a referral? 65:40 Plugs, Outro

Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and produced by: Matthew Watto MD Cover art and Infographic by Matthew Watto MD Hosts: Matthew Watto MD and Paul Williams MD Editor: Clair Morgan of Nodderly.com Time Stamps 00:00 Announcement, Intro, Disclaimer 02:53 Our top podcasting pearls 07:01 Find your niche 09:46 Logistics 13:25 Business, finances and legal matters 14:40 Equipment 21:48 Recording and editing 24:56 Website, web and media hosting 28:53 How to setup and record your podcast 35:08 Editing software 35:58 Search engine optimization 37:45 Post-processing 39:49 Take home points and outro

Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management in these challenging times. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD Show Notes: Cyrus Askin MD Infographic: Elena Gibson, MD Cover Art: Dr. Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: COL Kevin Chung, MD, FACP Sponsors: McGraw HillTime Stamps 00:00 Intro 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice 07:40 Sponsor 08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs 16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation 23:40 Proning patients for hypoxemia 29:15 ARDS basics: diagnostic criteria, Brief Recap 33:22 Mechanical ventilation: Initial settings, following the blood gas 40:55 Peak and plateau pressure, Lung compliance and Troubleshooting a high pressures 51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs 62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19 68:10 Take home points; Plugs; Outro

Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston). Plus, @Paulnwilliamz and @cjchiu give us some telehealth along with the usual antics. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written, Produced, Hosted by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art and Show Notes by: Matthew Watto MD, FACP Editor: Matthew Watto MD Guest: Rahul Ganatra MD Time Stamps 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site 11:50 Telehealth best practices 16:42 Convalescent plasma and Serology 21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report) 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality 25:30 Critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial 49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)

Get under the hood of SGLT2 inhibitors! Listen as our guests Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf give us a tour through the NephMadness 2020 SGLT2i region! How do these promising drugs work, and what evidence is there for using them in non-diabetic kidney disease or kidney transplant patients. Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) Guests: Harish Seethapathy MD; Matthew Sparks MD; Joel Topf MD Sponsor: McGraw Hill Time Stamps 00:00 Sponsor 00:26 Intro, disclaimer, guest bio 02:57 Guest one-liner and Picks of the Week*: Michael Pollan audiobook on Coffee and Caffeine Addiction 03:52 SGLT2i definition, background, and why we now consider CV endpoints in diabetes 11:16 Sponsor 12:00 Tubuloglomerular feedback; Balloon analogy 17:40 Other mechanisms for SGLT2i 23:05 Back to the case; Risks from SGLT2i; Counseling and Monitoring 34:18 SGLT2i for non-diabetic kidney disease; Possible mechanisms: Joel’s caution against early adoption 41:42 SGLT2 inhibitors in kidney transplant 45:20 Take home points and picks for the SGLT2 inhibitor region 49:50 Outro

Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running.Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Written and Produced by: Paul Williams MD, FACP Cover art and Show notes by: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Kat Zechar MD and Amreet Sidhu MD Time Stamps 00:00 Announcement: We’re looking for pre-med and medical Student members. Send applications to [email protected] by deadline April 10, 2020. 01:22 Intro, disclaimer and guest bios 03:38 Guest one-liners, Picks of the week 09:30 Why you might need an online meded curriculum 16:33 Overview of Amreet and Kat’s online curriculum 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org) 46:35 Time commitment 50:55 Take home points and Outro

LIVE! from Mayo Clinic, a practical approach to lymphadenopathy with Carrie Thompson MD @cathompsonmd (Hematology Oncology, Mayo Clinic). Dr. Thompson provides her simplified approach to the history, differential diagnosis, high yield lab testing, imaging, how to counsel patients with adenopathy and tips on when, where and how to biopsy!The Curbsiders are insanely grateful to the Mayo Clinic Internal Medicine Residency Chief Residents @mayomn_imres (@JasonEckmannMD @SamiRyanMD @BHuffmanMD @CourtHarrisMD) and their amazing program director @AmyOxentenkoMD for an amazing trip to Rochester!Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Written and Produced by: Carrie Thompson MD and Matthew Watto MD, FACP Infographic: Matthew Watto MD, FACP Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Carrie Thompson MD Time Stamps 00:00 Announcement: We’re looking for Medical Student members. Send applications to [email protected] by April 10, 2020. 01:20 Intro, guest bio, one-liner, career advice; Pick of the week*: In Shock by Rana Awdish 07: 00 Lymphatic system 09:19 Differential diagnosis for lymphadenopathy 11:38 Taking a history (ALL AGES mnemonic), Red Flags 19:15 Physical exam for lymphadenopathy 22:30 Which labs to order; Flow cytometry 26:05 Imaging 28:30 Counseling patients with LAD 31:10 Biopsy: How to choose type and location 37:35 Take Home Points 39:00 Audience Questions 42:25 Outro

Listen as the pioneers of the COVID pandemic share their experiences taking care of some of the first COVID patients in the US. Our guests have a broad range of expertise and experiences. This episode features hospitalist Dr. Francisco Alvarez (University of California at San Francisco, @fnalvarez), Infectious Disease fellow Dr. Karolina Maciag (University of Washington, @KMaciag), Critical Care and Pulmonology Fellow Dr. David Furfaro (Columbia University, @david_furfaro ) and intensivist and founder of onepagericu.com, Dr. Nick Mark (Seattle, WA). Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced: Justin Berk MD MPH MBA Cover Art: Kate Grant MBChB DipGUMed Hosts: Justin Berk MD MPH MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Francisco Alvarez, Dr. Karolina Maciag, Dr. Dave Furfaro, Dr. Nick Mark Sponsors: Cayuga Time Stamps 00:00 Intro 04:28 Francisco: Process leading up to first case 07:42 Karolina: The perspective of the consultant- calm in the storm 11:40 (Karolina) Seattle Flu Study as early warning 16:00 Dave: ICU patients 20:30 Nick: making decisions with a moving target 25:05 Sponsor 25:53 Francisco: data available on Twitter 28:00 Francisco: the role of generalist during the COVID pandemic 31:15 Karolina: on vulnerable populations during pandemic 38:26 Dave/Nick: how generalists should be preparing themselves 45:16 Avoiding aerosolized procedures / nebulizers 47:46 What was the big surprises 54:20 How do you address the anxiety 60:12 Plugs 64:20 Outro

Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral! Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP Cover Art and Infographic by: Beth Garbitelli Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Paul Sax MD Sponsor: CayugaTime Stamps 00:00 Intro 04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza 07:00 Rahul highlights areas of caution interpreting COVID cases studies 12:35 Sponsor 13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms 18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity 21:15 Who merits testing for COVID-19 23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine 25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital 30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible? 32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine 36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces? 40:20 Do exposed HCWs without symptoms require quarantine? 41:30 Personal Protective equipment (PPE) 45:00 COVID-19 in pregnancy 47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.) 50:45 Where should you get your COVID-19 information? 52:30 Closing remarks and outro

NephMadness 2020 is here! Listen as Dr. Ryann Sohaney (@ryannsohaney), Dr. Deborah Clegg and Dr. Joel Topf (@kidney_boy) discuss this year’s first Nephmadness topic, Hyperkalemia in CKD. They will (1) review the use of potassium binders for management of hyperkalemia in CKD (2) identify the potential health benefits of dietary potassium and challenge the use of low-potassium diets in CKD, and (3) describe how exercise influences serum potassium and consider exercise recommendations in CKD. Check out the regions and fill out your brackets for NephMadness 2020 here! Sign-up as a part of The Curbsiders team! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Elena Gibson MD Infographic: Caitlyn Vlasschaert MD Cover Art: Elena Gibson MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan Nodderly.com (audio) Guest: Ryann Sohaney, MD; Deborah Clegg, PhD; Joel Topf, MD Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit AccessMedicine to learn more: http://bit.ly/MHCurbsiders. Time Stamps 00:00

Polycystic ovary syndrome (PCOS) is more common than we think! Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Molly Heublein, MD Cover Art and Infographic: Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Molly Heublein, MD Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Katherine Sherif, MD Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit AccessMedicine to learn more: http://bit.ly/MHCurbsiders. Primary Care Physician Opportunity in beautiful Ithaca, NY! Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello [email protected] to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/. Time Stamps 00:00 Sponsors - AccessMedicine.com (McGraw-Hill)

Join us as we demystify the world of pulmonary nodules & lung cancer screening. During this episode, Dr. Denitza Blagev (@mybetterdoctor) makes her triumphant return to The Curbsiders to help us tackle this topic. She is currently the Medical Director for Quality/Specialty-Based Care at Intermountain Healthcare and a Pulmonary & Critical Care physician. We learn to take command of the recommendations for lung cancer screening, disambiguate the terms used by pulmonologists and radiologists, and appreciate some of the nuances of lung cancer screening all with the hope of making YOU a better primary care physician! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Cyrus Askin MD & Leah Witt, MD Infographic: Leah Witt, MD Cover Art: Dr. Kate Grant MBChB DipGUMed CME/MOC: Cyrus Askin, MD Hosts: Cyrus Askin MD; Leah Witt, Matthew Watto MD, FACP; Paul Williams MD, FACP Editors: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Denitza Blagev, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 00:15 Intro, disclaimer, guest bio 02:15 Guest one-liner;

Develop your approach to refugee health in the primary care setting. We discuss important considerations for primary care of the refugee patient with Dr. Tanuja Devaraj (Penn State), an internist with expertise in migration health. We review barriers to primary care, how to take a migration history, and common health concerns that occur in this patient population. We also discuss strategies for screening for trauma and mental health issues, which are common among patients who have gone through migration. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Producer: Paul Williams MD, FACP Writer: Tanuja Devaraj MD and Paul Williams MD, FACP Infographic: Emi Okamoto MD Cover Art: Paul Williams MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) Guest: Tanuja Devaraj MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders 00:15 Intro, disclaimer, guest bio 02:08 Guest one-liner, book recommendations, career advice 07:12 Picks of the Week*:

Discover common practices that persist in the hospital wards despite no proven benefit! We review how potassium replacement goals should not drive you bananas, extra oxygen should not give you comfort, and how you should maybe calm down with antipsychotics for delirium. Join returning guests: high-value care specialist Dr. Lenny Feldman (@DocLennyF, Johns Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 3 of “Things We Do for No ReasonTM. SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Burton H. Shen MD, Justin Berk, MD MPH MBA Infographic: Cover Art: Hosts: Justin Berk MD MPH MBA; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FaCP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Lenny Feldman MD, Tony Breu MD Sponsors The Society of Hospital Medicine Hospital Medicine 2020 (HM20) is the Society of Hospital Medicine’s Annual Conference April 15th through the 18th in sunny San Diego. Don’t miss the largest hospital medicine meeting. Register now at https://shmannualconference.org/ and use the code CURBSIDERS to receive a $50 discount. Primary Care Internal Medicine of Ithaca

Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder. Your patients need you! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Carolyn Chan, MD Cover Art and Infographic: Carolyn Chan, MD Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Marlene Martin, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order! Time Stamps 00:00 Sponsor -ACP’s MKSAP 18

Join us as we discuss how to approach “The Struggling Learner” with Dr. Melissa McNeil (@missydoc0128), Professor Medicine and Associate Chief of General Internal Medicine at the University of Pittsburgh Medical Center (UPMC), recorded LIVE in Pittsburgh, PA! In this episode, we discuss how to approach the struggling learner, highlighting the 5-Step process discussed in a recent article co-written by Dr. McNeil (Merriam 2019). This episode is not intended to give educators a roadmap for how to develop and implement a corrective action plan, but was put together to provide a common toolset on how to approach a struggling learner. As such, the topics discussed can be applied to all kinds of learners that struggle, not just in medicine. However, the techniques discussed involve a common framework routinely taught in medical education (assessment, diagnosis, and referral) and, therefore, is communicated using this shared language. Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | [email protected] Credits Written and Produced by: Stuart Brigham MD Infographic: Matthew Watto MD, FACP Cover Art: Stuart Brigham MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham, MD Editor: Stuart Brigham MD (written materials); Clair Morgan at Nodderly.com Guest: Melissa McNeil MD, MACP Special thanks to Dr. William Kelly, FACP, FCCP Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!

Kidney Boy Returns! Compare the types of dialysis, learn how nephrologists approach medication management in ESRD, and avoid the most common mistakes non-nephrologists make in patients on dialysis! Kashlak Chief of Nephrology Dr. Joel Topf, @kidney_boy, walks us through what you need to know to take care of a patient on dialysis and gives us an idea of how nephrologists think through mineral bone disease (calcium, phosphorus and vitamin D), anemia, iron repletion, and hypertension. We answer all your questions about co-managing patients on dialysis! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Producer: Hannah R. Abrams Written and produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R. Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials), Clair Morgan of Nodderly.com (audio) Guest: Joel Topf MD Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Time Stamps 00:00 Sponsor -ACP’s Internal Medicine Meeting 2020 00:15 Intro, disclaimer, guest bio 01:45 Guest one-liner, Picks of the Week*: KidneyCon, CATS (film) 06:00 Sponsor -ACP’s Internal Medicine Meeting 2020 06:50 Case of Anne Yuric; Assessing risk of progression to dialysis; Candidacy for dialysis and renal

Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Rate our infographics! Tell us what you think in this brief survey. Credits Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA Infographic: Beth “Garbs” Garbitelli Cover Art: Kate Grant MBChB DipGUMed Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Erin Michos MD MHS Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Time Stamps 00:00:00 Intro 00:01:52 Getting to know Dr. Erin Michos 00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and

A Curbsiders classic with a fresh intro by Hannah Abrams @hannahRabrams (soon to be 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 fludrocortisone?; Plus, answers to all your questions about a high potassium diet and oral potassium supplements! Join us for Dr Topf’s masterful insights on hyperkalemia and potassium homeostasis. Get deeper into potassium physiology with a FREE pdf copy of Joel’s book The Fluid Electrolyte and Acid Base Companion here. Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | [email protected] Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Credits Written, edited and produced by: Matthew Watto MD, FACP Intro: Hannah R Abrams Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Infographic and Cover Art: Matthew Watto MD, FACP Guest: Joel Topf MD Time Stamps 00:00 Sponsor -ACP’s IM Meeting 2020 in LA 00:28 Disclaimer, intro and guest bio 03:00 Guest one-liner Picks of the week* —Peloton indoor bike;

Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic! Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that. The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of 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 (read: we think need to be coming) down the line. N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at [email protected], or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need. New episodes return January 20, 2020! Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | [email protected] Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20 Credits Written and produced by: Nora Taranto MD, Shreya Trivedi MD Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD Edited by: Matthew Watto MD Guest: Elisabeth Po

Recap extravaganza 2019 featuring top pearls from our staff’s favorite episodes of 2019 and voicemails from Kashlak faculty, Dr. Avital O’Glasser (@aoglasser), Dr. Kimberly Manning (@gradydoctor), Dr. Renee Dversdal (@DrSonosRD) and The Curbsiders team. Topics include: HFpEF, the PARAGON-HF trial, Buprenorphine, Opioid Use Disorder, Cirrhosis, Coagulopathy, SBP, Hyperkalemia treatment, Multimorbidity, and how to think about NNT. Plus, the team shares a bunch of other favorite moments and random pearls! Upcoming shows: The next two weeks will feature REBOOT episodes with fresh intros from The Curbsiders team. Season 9 starts January 20, 2020 with a Lipid Update from Cardiologist Dr. Erin Michos (@ErinMichos) Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | [email protected] Credits Produced by: Sarah Phoebe Roberts MPH and Chris Chiu MD, FACP, FAAP Writer: Sarah Phoebe Roberts MPH Infographic: Sarah Phoebe Roberts MPH Cover Art: Kate Grant MBChB DipGUMed Hosts: Chris Chiu MD, FACP, FAAP; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Chris Chiu MD, FACP, FAAP (audio), Matthew Watto MD, FACP (show notes) Time Stamps 00:00 Intro and disclaimer 04:25 Picks of the year*: The Expanse (TV show) -Chiu Man’s pick;