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The Curbsiders Internal Medicine Podcast Profile

The Curbsiders Internal Medicine Podcast

English, Health / Medicine, 1 season, 490 episodes, 6 days, 4 hours, 54 minutes
About
Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.
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#439 Shoulder Pain: Impingement, Bursitis, Tendonitis, Cuff Tears, and Arthritis with Dr. Ted Parks

Repair and replace your old approach to shoulder pain! We cover shoulder anatomy, explain the continuum of impingement syndrome (from bursitis to tendonitis to rotator cuff tears to cuff tear arthropathy), how to take a good shoulder history, perform a high-yield physical exam, when to refer, and when to get an MRI. Plus, how to differentiate glenohumeral joint arthritis from frozen shoulder, and how to diagnose AC joint pathology. We’re joined by everyone’s favorite orthopedic surgeon, inventor, and renaissance man, Dr. Ted Parks. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Intro 05:38 Shoulder Anatomy 14:47 Continuum of Impingement Syndrome 33:41 When to order an MRI 36:28 Glenohumeral joint arthritis vs frozen shoulder 51:50 AC joint arthritis  62:25 Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Ted Parks MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Pattern Request your disability insurance quote online at patternlife.com/curbsiders. Sponsor: Panacea Financial  Visit panaceafinancial.com to learn more about a nationwide digital bank built for doctors, by doctors.
5/13/20241 hour, 7 minutes, 30 seconds
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#438 Recap from SHM #Converge24

We went to it so you don’t have to We recap the top pearls for the hospitalist from #SHM #Converge24 covering discussions on heart failure, gastrointestinal bleeds, sepsis, updates in critical care, updates in hospital medicine, oncologic emergencies, pneumonia, COPD, transitions of care, vulnerable populations, AI, and more! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Heart Failure Patients with Disabilities POCUS on Inpatient Service GI Updates High Value Delivery of Medical Education Molecular Testing for Infectious Diseases Interhospital Transfers Artificial intelligence in Inpatient Care Care of the Incarcerated Patient Periop Updates Oncologic Emergencies--Neutropenic Fever Oral vs IV Antibiotics Updates in Hospital Medicine Updates in Critical Care & Guidelines in Hospital Medicine Post Acute Care Things We Do For No Reason ™ Iron Deficiency Anemia Updates in Community Acquired Pneumonia Updates in Palliative Care Outro Credits Written, produced and show notes by: Monee Amin MD, Caroline Coleman MD, Meredith Trubitt MD  Cover Art: Caroline Coleman MD Hosts: Monee Amin MD, Meredith Trubitt MD  Reviewer: Rahul Ganatra, MD, MPH Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guests: Harika Gorti MD, Sneha Neurgaonkar MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Pattern Request your disability insurance quote online at patternlife.com/curbsiders.
5/6/20241 hour, 19 minutes, 27 seconds
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#437 Clinical Pearls ACP #IM2024

We cover angina, COPD-asthma overlap, home oxygen, colon cancer screening, cancer survivorship, tobacco cessation, e-cigarettes, step counts for health,  new drugs, the RSV vaccine, addiction medicine, interstitial lung disease, APOL1-mediated kidney disease, testosterone therapy, antimicrobial resistance, office-based allergy testing and more! The Curbsiders review highlights, clinical pearls, and practice-changing updates from the American College of Physician Internal Medicine Meeting #IM2024!  No CME for this episode due to rapid turnaround, but claim CME for most episodes at  curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro ACP Pearls Outro Credits Producers: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD Show Notes: Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein MD, Nora Taranto MD, Chris Chiu MD, Rahul Ganatra MD MPH, Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer:Matthew Watto MD FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Beginly Health Visit https://beginlyhealth.com/curbsiders for the job matching platform for every Physician and Advanced Practice Clinician, from training to practice Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
4/29/202457 minutes, 32 seconds
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#436 Endometriosis for the Internist with Dr. Cope & Dr. Green

Energize your education on endometriosis! Learn common clinical presentations, optimal diagnostic imaging tests, and how to counsel patient on treatment options. We are joined by Dr. Adela Cope (Mayo Clinic) and Dr. Isabel Green @isabelgreenMD (Mayo Clinic). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Intro  03:00 Guest Introduction 06:45 Topic 07:30 Endo Definition & Symptoms 14:40 Endo phenotypes 21:30 Differential Diagnoses to Consider 25:47 Making a Diagnosis  31:00 Imaging to consider 37:40 Endo Hormonal Treatment Optiosn 48:30 Monitoring Treatment 52:20 When to Refer 57:30 Surgical Treatment 1:09:20 Pain Management 1:13:30 Take Homes 1:19:00 Outro Credits Producer, Show notes, Infographics: Carolyn Chan, MD, MHS Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi, MD, MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Adela Cope and Dr. Isabel Green Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts. Sponsor: Babbel Curbsiders listeners get 60% off at babbel.com/CURB
4/22/20241 hour, 24 minutes, 24 seconds
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#435 Neck Pain with Dr. Anthony Mikula

A real pain in the neck (Get it?! We have fun.) Protect your neck!  Learn how to evaluate a patient with neck pain, and differentiate between mechanical neck pain, radiculopathy, and myelopathy. You’ll learn who should be reassured, who should see a surgeon, and what nonoperative options are available.  We’re joined by Dr. Anthony Mikula @anthony_mikula from Mayo Clinic.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction  06:14 Anatomy and Pain Generators 09:58 Approach to Neck Pain 22:57 Differentiating Radiculopathy from Non-Specific Neck Pain 24:05 Management of Mechanical Neck Pain 27:36 Indications for Imaging 29:21 Terminology and Explanation of Spondylosis, Spondylolisthesis, and Spondylolysis 30:48 Diffuse Idiopathic Skeletal Hyperostosis (DISH) 32:23 Imaging Terminology and Plain Films 36:19 Pathophysiology of Cervical Radiculopathy 38:34 Physical Examination for Cervical Radiculopathy 44:54 Diagnostic Work-up for Radiculopathy 51:53 Interventions for Cervical Radiculopathy 53:53 Considerations for Surgery 57:49 Recognizing Cervical Myelopathy 01:00:17 Natural History of Myelopathy 01:02:25 Referral and Treatment for Myelopathy 01:09:28 Summary and Takeaways Credits Written and Produced by: Paul Williams, MD, FACP Show Notes: Paul Williams, MD, FACP Infographic and Cover Art: Paul Williams, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Anthony Mikula, MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Grammarly Make a bigger impact at work with Grammarly. Sign up and download for FREE at grammarly.com/PODCAST
4/15/20241 hour, 14 minutes, 33 seconds
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#434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher

It’s NOT Always a UTI! Sounds like another UTI but it could be more than that! Time to explore the entire pelvic floor and see what more you can treat. School’s in session with the Bladder Teacher,  Kellen Choi, DO from the University of Louisville @KellenChoi Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions/Picks of the Week Case #1 and Definitions Bowel habits Water intake  Case #2 Vaginal Estrogen Non-antibiotic prophylaxis Antibiotic in prophylaxis Pelvic Floor Physical Therapy Take-home points Outro Credits Producer, Writer & Show Notes: Isabel Valdez, PA Infographic & Covert Art: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Kellen Choi DO, FAOCS Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.
4/8/20241 hour, 2 minutes, 40 seconds
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#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction and Diabetes Puns 01:00 Introduction of Guest and Topic 09:12 Qualifications and Eligibility for CGMs 11:32 Types of CGMs and Sensor Placement 24:47 Interpreting CGM Data and Alarms 34:30 Troubleshooting Patterns and Adjustments 35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses 36:15 The Rule of 15 and Addressing Hypoglycemia 37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia 38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin 39:51 Managing Exercise-Induced Hypoglycemia 41:43 Preventing Exercise-Induced Hypoglycemia with Snacks 43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas 45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin 46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia 51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin 56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin 57:44 Addressing Adherence and Medication Barriers 59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management 01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap 01:05:49 Considering Patient Adherence and Barriers to Treatment Credits Writer and Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jeff Colburn MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Panacea Financial Download the 2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.
4/1/20241 hour, 13 minutes, 48 seconds
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#432 Hotcakes: E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, Lidocaine for neck pain, C diff risk by antibiotic type, and “dosing by clicks” for GLP1’s

Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Introduction and disclaimer E-cigarettes for smoking cessation Gabapentinoids and COPD exacerbations Topical lidocaine for neck pain Association between specific antibiotics and C. diff infection Shortage of GLP-1 agonists and “dosing by clicks” Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts. Sponsor: Freed  You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. 
3/25/202456 minutes, 13 seconds
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#431 Myocarditis and Pericarditis

Show description:  Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter!  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro, disclaimer A case of pericarditis Diagnosing pericarditis The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis Etiologies of pericarditis and initial testing recommendations Treatment of acute uncomplicated pericarditis Using colchicine to prevent recurrent pericarditis Patient counseling after diagnosing pericarditis A case of myocarditis Interpreting elevated troponin levels Distinguishing between myocardial infarction and myocardial injury Diagnostic testing for suspected myocarditis When to pursue cardiac MRI and endomyocardial biopsy The spectrum of myocarditis presentations Fulminant myocarditis Common etiologies of myocarditis Immune checkpoint inhibitor myocarditis Myocarditis from mRNA vaccines and from SARS-CoV-2 infection Management of patients with myocarditis Activity restrictions for patients with myocarditis Outro Credits Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP Guest: Vivek Kulkarni, MD, FACC Producer, Script, and Show Notes: Adam Barelski, MD Infographics and Cover Art: Edison Jyang Reviewer: Leah Witt, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Panacea Financial Download the full  2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report. Sponsor: Factor Head to factormeals.com/curb50 and use code curb50 to get 50% off.
3/18/202454 minutes, 5 seconds
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Unlocked Weight Management, Low Carb, Listener Q&A, Picks of the Weeks (Patreon #19)

This episode has been Unlocked from patreon.com/curbsiders! Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM#SGIM23 in Denver, Colorado This audio episode is only available on Patreon!  Below are links to the original interview & show notes. #405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips Picks of the week: Paul recommends: Blue Eye Samurai (Netflix) Matt recommends:  Live, Die, Repeat aka Edge of Tomorrow (film) Show Segments 00:00 Introduction and Happy New Year 02:22 Overview of Obesity Medicine 04:13 Challenges in Weight Maintenance 06:07 Prevention of Obesity 08:04 Barriers to Obesity Care 09:29 Setting Realistic Weight Loss Goals 10:24 Counseling Patients on Weight Loss 11:45 Measuring Waist Circumference 12:44 Telemedicine and Tracking Apps 13:41 Psychological Considerations in Obesity Medicine 15:05 Low-Carb Diets 21:04 Managing Side Effects of GLP-1 Agonists 23:54 New Medication for Obesity 24:52 Prolia and Forteo for Osteoporosis 26:18 Statins and Lab Testing 29:30 Annual Labs and Urine Testing 32:37 Picks of the Week 35:02 Outro Join our Patreon today and save 16% on an annual membership at patreon.com/curbsiders. Kashlak Admitting Privileges comes with ad-free episodes, access to the Kashlak Vault, which contains PDF files and graphics from over 400 Curbsiders shows, access to our private Discord group, plus twice monthly bonus episodes like this one!
3/13/202437 minutes, 20 seconds
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#430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024!

Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It’s NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Time stamps refer to the ad-free version 00:00 Introduction and Guest Bio 07:46 Case Presentation 08:42 Initial Approach to CKD Management 09:10 Metabolic Acidosis in CKD 13:30 Consequences of Metabolic Acidosis 22:28 Administration of Bicarbonate 23:54 Alternative Options for Bicarbonate Repletion 24:47 Citrate and Bicarbonate 26:02 Sodium Bicarbonate for CKD 30:19 Dietary Modifications 33:35 Renal Diet 38:20 Counseling CKD Patients 41:39 Veverimer and Other Treatments 44:36 Mistakes and Pitfalls 46:55 Conclusion Credits Writer and Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Timothy Yau MD Sponsor: Rocket Money  Cancel your unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Freed You can try Freed for free right now by going to freed.ai And listeners of Curbsiders can use code CURB 50 for $50 off their first month. 
3/11/202453 minutes, 4 seconds
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#429 Anxiety 2.0: with Dr. Jessi Gold

Elevate your primary care management of anxiety. Become confident in counseling patients about a new anxiety diagnosis, 2nd and 3rd line medications, augmentation for anxiety treatment, and options for non-pharmacological anxiety treatment. We are joined by psychiatrist and mental health expert Dr. Jessi Gold, @drjessigold (University of Tennessee System; drjessigold.com).  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak Diagnosing anxiety Explaining anxiety to patients Non-pharmacological management of anxiety Pharmacological management of anxiety 2nd and 3rd line treatments Cannabis and anxiety Outro Credits Writer, Producer, Show Notes, Infographic, Cover Art: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai Achi MD, MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jessi Gold MD Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts. Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Allbirds   Visit Allbirds.com and use code CURB for a free pair of socks with a purchase of $48 or more.
3/4/20241 hour, 32 minutes, 52 seconds
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#428 DIGEST: DVT prophylaxis in patients with cancer, anticoagulation in subclinical AFib, steroids in COPD exacerbations, breast cancer genetic testing guidelines, and at-home STI testing

Join us as we review recent articles and news featured in The DIGEST #48, #49, and #50 including thromboprophylaxis for patients receiving chemotherapy,  eosinophil count to guide steroids in COPD exacerbations, anticoagulation in subclinical atrial fibrillation, the new genetic testing recommendations for patients with breast cancer, and at-home STI testing–not to mention trial names galore.  Fill your brain hole with a fully digestible meal! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).  Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Nora Taranto MD  Reviewer: Emi Okamoto MD  Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments 00:00 Introduction + Pun  06:06 Target TP Trial: Thromboprophylaxis in Cancer Patients 13:07 Steroids for COPD Exacerbations 25:25 Anticoagulation in Subclinical Atrial Fibrillation 34:01 Genetic Testing in Breast Cancer 43:38 Home STI Testing Transcript Disclaimer We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content. Sponsor: Factor Head to FactorMeals.com/curb50 and use code curb50 to get 50% off.  Sponsor: NetSuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance - absolutely free, at NetSuite.com/CURBSIDERS. Sponsor: Freed  You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
2/26/202455 minutes, 39 seconds
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#427 Kittleson Rules Amyloidosis

The clinical picture of an underrecognized disease Amyloidosis demystified. Learn the clinical clues that suggest possible amyloidosis and how to order the correct tests to diagnose this disease. We are joined by Dr. Michelle Kittleson who shows us the ropes of treating fibril accumulation, @MKittlesonMD (Cedars Sinai).  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Introduction Case Presentation: Mr. Smith Differential Diagnosis of Heart Failure with Preserved Ejection Fraction Understanding Amyloidosis Clinical Clues and Red Flags for Amyloidosis Physical Examination Findings Workup for Amyloidosis Treatment Options AL Amyloidosis and Hematologist's Role ATTR Amyloidosis and Cardiologist's Role Other Therapies for TTR Amyloidosis Therapy on the Horizon Cost and Access to Tafamidis Alternative Therapies and Supplements Monitoring and Side Effects of Tafamidis Symptomatic Management and Anticoagulation Take Home Points Credits Written and Produced by; Deborah Gorth, MD, PhD Infographic and Cover Art: Meryl Gorth, RD, MPH and Deborah Gorth, MD, PhD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S. Achi MD MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Michelle Kittleson, MD, PhD Sponsor: Panacea  Visit panaceafinancial.com today to open your free account. Sponsor: Grammarly  Make a bigger impact at work with Grammarly. Sign up and download for FREE at grammarly.com/PODCAST Sponsor: Rocket Money  Stop wasting money on things you don’t use. Cancel your unwanted subscriptions by going to RocketMoney.com/CURB.
2/19/20241 hour, 8 minutes, 20 seconds
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#426 Breast Cancer for the PCP With Dr Sandhya Pruthi

Join us as Sandhya Pruthi, MD talks us through basics of breast cancer, specifically how to share a new diagnosis with a patient, the spectrum of disease from favorable to more aggressive, and the basics of what to expect with initial treatment. Feel more confident sharing a new diagnosis of breast cancer and supporting your patients through this journey. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction 02:18 Getting to Know Dr Sandhya Pruthi 09:49 Picks of the Week 12:35 Case 1: Diagnosis and Treatment of ductal carcinoma in situ (DCIS) 21:24 Risk Stratification and Active Surveillance for DCIS 23:43 Genetic Testing Recommendations 28:08 Case 2: Evaluation and Diagnosis of a Breast Lump 39:14 Invasive Ductal Carcinoma 47:49 Initial Management of invasive ductal carcinoma (IDC) 48:19 Preoperative Discussion and MRI 49:19 Lumpectomy and Sentinel Lymph Node Biopsy 50:16 Radiation and Hormonal Adjuvant Therapy 51:46 Considerations for Chemotherapy 55:51 Signs of Late Recurrence or Metastasis 58:20 Screening Guidelines and Age 01:02:25 Importance of Breast Self-Awareness Credits Written and produced, Show Notes:  Molly Heublein MD Infographic and Cover Art: Edison Jyang Hosts: Molly Heublein MD, Era Kryzhanovskaya MD  Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Sandhya Pruthi MD Sponsor: Freed You can try Freed for free right now by going to freed.ai Listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Babbel Get 50% off at Babbel.com/CURB Sponsor: NetSuite Get your own KPI Checklist at NetSuite.com/CURBSIDERS
2/12/202458 minutes, 42 seconds
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#425 Perioperative Management of Antithrombotics with Dr. Poorvi Hardman

Get rid of those clots around anticoagulation and antiplatelet management Join us for a review of the perioperative risk assessment of bleeding and clotting and how to manage each patient’s own antithrombotics. We are joined by Dr. Poorvi Hardman from Ohio State University.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid Fire Questions/Picks of the Week Case 1 Risk stratification of thromboembolism and bleeding Review of types of surgeries and risk associated with surgical intervention Utilizing scoring systems to aid decision making Bridging Considerations for VKAs, DOACs  Pitfalls to bridging Case 2 Aspirin Management P2Y12 Management Consultants Outro Credits Written, produced and show notes by: Jaimie Patel MD Infographic and Cover Art by: Caroline Coleman MD Hosts: Monee Amin MD; Meredith Trubitt MD   Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Poorvi Hardman MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Pathway Improve your clinical decision-making process and enhance patient care. Download the Pathway app today by visiting pathway.md
2/5/20241 hour, 1 minute, 8 seconds
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R.S.V. Immunization with The Cribsiders

The Curbsiders and Cribsiders are back with a very special Med-Peds collaboration on RSV immunizations! Dr. Buddy Creech, Pediatric Infectious Disease at Vanderbilt, walks us through these breakthrough “vaccines" for both adults and kids. He teaches us about their mechanisms of action, eligibility criteria, and why it’s been so challenging to find doses this season. Get ready for your next shot of fun!
1/31/202449 minutes, 43 seconds
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#424 Hotcakes: Transfusion in Acute MI, COVID-19 Rebound after Paxlovid, Every-other-day Iron Revisited, Oral Phenylephrine Doesn’t Work, and Stop Correcting Serum Calcium

Join us as we review recent practice-changing articles on transfusion thresholds in acute MI, COVID-19 rebound after treatment with ritonavir-boosted nirmatrelvir (PaxlovidTM), the prevalence of iron deficiency, as well as the debut of our new “corrections and omissions” section, in which we cover important knowledge updates on oral iron dosing and correcting serum calcium. And, find out why oral phenylephrine does not work and what you should prescribe instead for upper respiratory symptoms. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written, Produced, and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments 00:00 Introduction and Calcium Puns 03:11 Iron Deficiency and Iron Supplementation 12:20 Corrected Calcium 18:09 Virologic Rebound after nirmatrelvir/ritonavir (Paxlovid™) 32:09 Phenylephrine and its Ineffectiveness 37:00 Restrictive vs. Liberal Transfusion Strategy in MI (MINT trial) 49:20 Outro Sponsor: Rocket Money Cancel unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Netsuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance for free, at NetSuite.com/CURBSIDERS Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. 
1/29/202456 minutes, 7 seconds
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#423 Dental Pain, Caries, Gingivitis, and Oral Care Tips & Tactics for Primary Care With Dr Lisa Simon

Join Lisa Simon, MD, DMD (@lisathedoc) as we discuss dental care for the PCP- from examination techniques, treatment options, emergencies in dental care, and general dental advice.  Help your patients manage caries, gingivitis, dry mouth, and temporomandibular joint (TMJ) dysfunction.  Be aware of dental side effects of medications, how to manage anticoagulants during dental procedures, and when to recommend antibiotic prophylaxis.  Claim CME for this episode at curbsiders.vcu health.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction and Overview 09:13 Diagnosing Dental Pain and Examination Techniques 18:44 Treatment Options for Dental Pain 29:34 Complications and Emergencies in Dental Care 32:36 Post-operative Care and General Dental Advice 40:35 Dry Mouth and Treatment Options 44:05 Gingivitis 49:39 Temporomandibular Joint (TMJ) Dysfunction 55:43 Medications and Dental Side Effects 56:12 Anticoagulants and Dental Procedures 01:00:55 Endocarditis Prophylaxis 01:03:15 Joint Replacements and Antibiotic Prophylaxis 01:04:10 Oral Health in Patients with Opioid Use Disorder Credits Written and produced, Show Notes, Infographic and Cover Art by Dr Kate Grant  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Lisa Simon MD, DMD Sponsor: Grammarly Go to grammarly.com/PODCAST to download for FREE today. Sponsor: Factor Head to FactorMeals.com/curb50 and use code curb50 to get 50% off.  Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
1/22/20241 hour, 15 minutes, 7 seconds
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#422 LIVE! Inpatient Management of Sickle Cell Crisis, Acute Pain, RBC Transfusions & Acute Chest Syndrome

Learn practical tips for the inpatient management of patients with sickle cell disease and vaso-occlusive crisis from guest, Dr. Yoo Mee Shin (Emory). We cover acute pain management including adjuvant therapies, IV fluids, oxygen therapy, the management of acute chest syndrome, and when to perform simple vs exchange transfusions. Key takeaways include the importance of early triage and analgesia, addressing misconceptions about opioid use disorder in patients with sickle cell disease, and recognizing complications of vaso-occlusive crises. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Intro 01:27 Getting to know our guest 07:48 Case Presentation and Initial Management of Sickle Cell Disease (SCD) 13:46 Misconceptions about opioid use disorder and sickle cell 17:02 Management of Acute Pain in Sickle Cell Disease 25:46 Adjuvant therapy for pain 29:04 Transition to outpatient care 32:46 General admission orders for sickle cell 38:44 Management of Acute Chest Syndrome 42:01 Simple vs exchange transfusion 47:08 Transfusion in preoperative and pregnant patients 48:03 Transitions and follow-up care 49:35 Key takeaways and Outro Credits Written and Produced by:  Matthew Watto MD, FACP Cover Art & Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Yoo Mee Shin MD Sponsor: Green Chef Go to greenchef.com/60curb and use code 60curb to get 60% off, plus 20% off your next two months. Sponsor: NetSuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance -absolutely free, at NetSuite.com/CURBSIDERS
1/15/202457 minutes, 16 seconds
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#421 Antiphospholipid Syndrome with Dr. Arielle Langer

Conquer your fear of antiphospholipid syndrome! Dr. Arielle Langer leads us through what clinical features raise suspicion for antiphospholipid syndrome, how to interpret laboratory testing, and the nuances of antiphospholipid syndrome management. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak What is antiphospholipid syndrome? Clinical features that raise suspicion for antiphospholipid syndrome Laboratory testing and diagnosis of antiphospholipid syndrome Management of antiphospholipid syndrome: initial treatment Management of antiphospholipid syndrome: managing recurrent thrombosis Return to Case: Pregnancy in patients with a history of thrombotic APLS Obstetric APLS Final questions Outro Credits Producer, Writer, Show Notes, Infographics, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Arielle Langer MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Rocket Money Cancel your unwanted subscriptions by going to RocketMoney.com/CURB. Sponsor: Allbirds Get your shoes at Allbirds.com and use code CURB and score a free pair of socks with purchase today. Sponsor: Green Chef Get sixty percent off Green Chef, plus twenty percent off your next two months, with code 60curb at GREENCHEF.com/60curb.
1/8/20241 hour, 20 minutes, 35 seconds
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REBOOT: #334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI)

Discover DGBI! Learn its pathophysiology, evaluation and individualized treatments so you can leave the fear of managing DGBI behind. We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic) Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions (6:20)  Definition of Disorders of the Gut-Brain Interaction (7:30-11:00) Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments  (24:30-36:00) Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00) Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11) Take home points Outro Credits Producer: Elena Gibson MD Writer:Andréa Perdigão, Elena Gibson Show Notes and Infographics: Andréa Perdigão Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Xiao Jing (Iris) Wang MD
1/1/20241 hour, 37 minutes, 44 seconds
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#420 Recap Extravaganza: 2023 Highlights and Top Stories

Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders. Our team needed a break so we did not make CME for this episode.  Show Segments Time Stamps are for Patreon (Ad-Free) Version 00:00 Introduction and Overview 09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms 14:20 Understanding Hemochromatosis 19:24 Evaluation and Management of Hematuria 25:00 Updates in Diabetes Management 29:35 Xylazine Overdose and Withdrawal 35:35 Primary Aldosteronism 39:36 Resistant Hypertension 44:12 Delirium and its Implications 46:29 The Acorn trial and AKI risk 49:47 HIV trial: Reprieve 51:11 Updates in hospital medicine 56:00 Kratom and its implications 59:11 RSV vaccines and their effectiveness 01:05:38 Reflections and Gratitude Credits Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art: Matthew Watto MD, FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor - Glass Health Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.  Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.  You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.  Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI.  You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS  Glass, like a clinical reference text or podcast, should never replace clinician judgment. 
12/25/20231 hour, 16 minutes, 34 seconds
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REBOOT #281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry.  Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).   Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium and what to do when that regulation goes awry.  Not to mention that PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending).  Show Segments Intro, disclaimer, guest bio Dr. Pallais One-Liner Case from Kashlak Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin Causes of hypercalcemia How Lithium works!  Testing for Hypercalcemia: Get that PTH, and that phos  Symptoms of Hypercalcemia, and Questions on History  Indications for Surgery for Parathyroidectomy  Management of Hypercalcemia and Hypercalcemic Emergency  Outro Credits Producer, Writer, Infographic, Cover Art: Nora Taranto MD  Hosts: Matthew Watto MD, FACP; Nora Taranto MD   Reviewer: Yan Emily Yuan MD, MSc Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Carl Pallais MD, MPH  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Sponsor - Glass Health Glass Health was founded in 2021 and has the mission of empowering doctors with AI-powered clinical decision support.  Glass helps clinicians to draft differential diagnoses and draft clinical plans using physician-validated context.  You can also use Glass to capture knowledge of all the schemas, scripts, cases, and pearls that you encounter and leverage them to take better care of patients.  Try Glass for yourself by visiting https://glass.health Personal knowledge management features are completely free and with Glass Pro, you get access to their powerful AI. You can get one month of Glass Pro free by signing up at https://glass.health and using the code CURBSIDERS. Glass, like a clinical reference text or podcast, should never replace clinician judgment.  Sponsor - PatternAt Pattern, we give you a quick, simple way to compare and buy disability insurance. Busy doctors shouldn't have to worry about whether or not they are getting the best rates and discounts. Trying to research all your options and make the right decision while in training can make the process even more overwhelming. That’s why thousands of doctors trust Pattern to help them compare and understand the disability insurance they are buying.  We do this in three simple steps: First off, request your quotes online at patternlife.com/curbsiders. Second, compare your options and ask questions. And third, secure your policy! So check disability insurance off your list today! Be confident that you have the right policy so that your income is protected. With huge discounts for doctors in training, now is truly the best time to request your disability insurance quotes with Pattern at patternlife.com/curbsiders.
12/18/20231 hour, 26 minutes, 13 seconds
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REBOOT #250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf

We’re taking a short break, but we’ll be back in two week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 17 of them available to feed your brain hole! Yummy! Time Stamps* Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! | Transcript Time Stamps* *Note: Time Stamps refer to ad free version Intro, disclaimer, guest bio - 00:00 Picks of the Week - 3:10 Case from Kashlak - 6:30 Nephrotic syndrome definition- 12:30 Proteinuria evaluation - 15:04 Additional lab testing - 27:08; 40:09 Types of Nephrotic syndrome - 30:15 Mechanism of nephrotic syndrome edema - 33:08 Management of nephrotic syndrome - 44:07 Second Kashlak Case- Glomerulonephritis - 55:05 Treatment of glomerulonephritis - 65:05 Outro and post-credits scene - 73:20 Credits Producer, writer, infographic, cover art: Elena Gibson MD Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) Guest: Joel Topf MD Sponsor - Pattern Life  Request your quotes online at patternlife.com/curbsiders
12/11/20231 hour, 16 minutes, 41 seconds
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#419 Rapid Response Series: Sepsis with Dr. Mohleen Kang A shock to the system

A shock to the system Join us for an infectious conversation about sepsis as we learn about the recognition and initial management of sepsis on the wards. We are joined by Dr. Mohleen Kang (@KangMohleen, Emory University). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions/Picks of the Week Case Managing rapid response logistics Sepsis Scoring Systems Diagnostic Work-up for Sepsis Access  Antibiotic Management Fluids Pressors  Supportive Measures for Sepsis Outro Credits Producers, Writers, and Hosts: Meredith Trubitt, MD  and Monee Amin, MD  Show Notes: Meredith Trubitt, MD Infographic and Cover Art: Sean Evans or Caroline Coleman Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Mohleen Kang, MD, MSc Sponsor: Birch  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb when you use code BIRCHPARTNER20! Sponsor: Green Chef Go to greenchef.com/60curb to get 16% off, plus 20% off your next 2 months.  Sponsor: Grammarly  Go to grammarly.com/podcast to download for FREE today. 
12/4/20231 hour, 18 minutes, 51 seconds
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#418 DIGEST (Tofurkey Edition): Semaglutide for HFpEF, TCAs for IBS, Aspirin vs Clopidogrel after PCI, Pitavastatin for HIV, Starchy Vegetables & Weight Gain, Heavy Metals in Cannabis

Join us as we review recent articles and news featured in The DIGEST #45 and #46, including semaglutide in HFpEF and obesity (STEP HFpEF), TCAs for irritable bowel syndrome (ATLANTIS), clopidogrel versus aspirin as long-term secondary prevention after PCI (HOST-EXAM), statins in HIV (REPRIEVE), weight changes and diet, and heavy metal exposure in cannabis users. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewers: Nora Taranto MD; Paul Williams, MD, FACP; Matthew Watto MD, FACP; Sai Achi, MD MBA Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer STEP HFpEF: semaglutide for HFpEF in obesity  TCAs for IBS  HOST-EXAM and post-PCI  clopidogrel versus aspirin after DAPT  REPRIEVE and pitavastatin in HIV Starchy vegetables and weight changes  Cannabis and heavy metal content  Outro Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/CURB Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com.
11/27/20231 hour, 3 minutes, 6 seconds
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#417 USPSTF Update: PrEP for HIV Prevention with Dr. John Wong MD

Become a pro on pre-exposure prophylaxis! Review the updated 2023 United States Preventive Task Force (USPSTF) guidelines on PrEP for HIV Prevention with Dr. John Wong. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro What is PrEP? USPSTF PrEP for HIV Prophylaxis recommendations Defining Increased Risk for HIV Counseling pearls Types of PrEP, considerations about choice of PrEP Talking about Safer Sex practices, HIV and STI screening on PrEP Recap; outro Credits Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD Hosts: Paul Williams MD, FACP, Beth Garbitelli MD Reviewer:Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: John Wong MD
11/22/202341 minutes, 46 seconds
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#416: Antifungals, Candida, Mucorales, Aspergillus, Pneumocystis: The Fungus Among Us with Dr. Ilan Schwartz MD

“I collect spores, molds and fungus” - Dr. Egon Spengler Dr. Ilan Schwartz MD PhD (@GermHunterMD) teaches us that we should always at least consider fungi in the differential diagnosis of unexplained sepsis, especially in patients with impaired immune systems or complex medical or surgical histories, and walks us through an approach to antifungals.  Be sure to check out the Mycoses Study Group Education & Research Consortium (@MSG_ERC), an organization of clinicians who are dedicated to advancing diagnostics and treatment of fungal disease (where Dr. Schwartz serves on the board of directors!) Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions, get to know our guest Intentionally vague case; When should we be worried about fungal infection? Overnight emergencies: Candidiasis and mucormycosis Starting empiric anti-fungals Testing basics: direct versus indirect Fungemia, fungal endocarditis Resistant candida; candida auris Pneumocystis jiroveci pneumonia Outro Credits Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Ilan Schwartz MD, PhD Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/CURB. Sponsor: NetSuite Go to NetSuite.com/CURBSIDERS to get your own KPI Checklist.  Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com.
11/20/20231 hour, 12 minutes, 34 seconds
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#415 Bipolar Disorder With Dr. Kevin Johns

Diagnosing and treating bipolar disorder is not always black-and-white. Dr. Kevin Johns teaches us how to not get tripped up on this tricky diagnosis. (The Ohio State University Wexner Medical Center) Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case Screening for mania History for diagnosing bipolar disorder Definition Mimickers Treatment Outro Credits Written and Produced by: Deborah Gorth MD, PhD  Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth MPH, RD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deborah Gorth MD, PhD  Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:   Kevin Johns MD Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com.  Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/CURB.
11/13/20231 hour, 17 minutes, 31 seconds
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#300 Celiac Disease with Dr. Amy Oxentenko

We’re taking a short break, but we’ll be back next week with a brand-new episode. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 15 of them available to feed your brain hole! Yummy! Tighten up your glute-n facts! Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and  understand diagnostic testing, management and proper follow-up for patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; Definitions Workup for a typical celiac patient Nonclassical features of CD When to do a small bowel biopsy Management of CD Considerations for atypical celiac patient and differentials Non-celiac gluten sensitivity Outro Credits Production and Script: Matthew Watto MD, FACP Production, Show Notes and Infographics: Edison Jyang Cover Art: Kate Grant MBChB, MRCGP, DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli    Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Amy Oxentenko MD, FACG Birch Living Birch is giving 20% off all mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you you use cade BIRCHPARTNER20! Panacea Financial Visit panaceafinancial.com today to open your free account. Grammarly Go to grammarly.com/PODCAST to download for free today. 
11/6/20231 hour, 13 minutes, 42 seconds
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#414 Spooky Cakes: VKA vs DOACs in Frail Adults, RSV Vaccine, Cuff Size Matters, Bloating & Belching, AKI & Pip-Tazo

Join us as we review recent practice-changing articles on VKAs vs DOACs in frail adults with atrial fibrillation, RSV vaccine for adults over 60, how much does blood pressure cuff size matter, cotton fever in people who inject drugs, new bloating and belching guidelines, and does pip-tazo cause more AKI than cefepime. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Sai Achi, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer VKAs vs DOACs in frail adults with atrial fibrillation,  RSV vaccine for adults over 60,  how much does blood pressure cuff size matter? cotton fever in people who inject drugs,  new bloating and belching guidelines, does pip-tazo cause more AKI than cefepime? Outro Sponsor: Pathway  Download the Pathway app for free today. Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com.
10/30/202358 minutes, 9 seconds
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#413: Common Ear Complaints, Ear Exam 101, Cerumen Remedies, and more! Get an EARful with Dr. Angela Peng!

Common Ear Complaints, Tips and (Keratin) Pearls in Primary Care Get an earful from ENT expert Dr. Angela Peng about how to approach common ear concerns, basic ear exam skills, safely clearing earwax and more! Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro with great pun! Rapid fire questions/Picks of the Week Case #1: Inner ear complaint Ear Exam 101 Eustachian Tube Dysfunction Cholesteatoma Case #2: Outer ear complaint Malignant otitis externa Open tympanic membrane treatments Cerumen impaction Itchy Ears Outro Credits Producer, Writer, Show Notes, Cover Art and Infographics: Isabel Valdez, PA-C Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Angela Peng, MD Sponsor: Pathway  Download the Pathway app for free today.
10/23/20231 hour, 17 minutes, 6 seconds
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#24 Treating OUD in the Fentanyl Era: ASAM Treatment Week with Dr. Melissa Weimer

Keep saving lives by prescribing methadone and buprenorphine. Learn how initiations of each have changed in the era of high-potency synthetic opioids (HPSOs) like fentanyl and how to continue to provide person-centered care to people with opioid use disorder. We’re joined by Dr Melissa Weimer, @DrMelissaWeimer (Yale University). This episode is in honor of National Addiction Treatment Week (treataddictionsavelives.org). Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | [email protected] | Free CME! Credits Producers: Shawn Cohen MD,  Kenneth Morford MD Writer: Carolyn Chan MD MHS Show Notes: Shawn Cohen MD Infographic and Cover Art: Kenneth Morford MD Hosts: Carolyn Chan MD. MHS Shawn Cohen MD, Natalie Stahl MD, Kenneth Morford MD Reviewer: Kento Sonoda MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Melissa Weimer DO MCR Show Segments Intro, disclaimer, guest bio 00:00 Guest one-liner 05:02 National Addiction Treatment Week  06:00 Case from Kashlak; Definitions 08:30 Starting methadone  11:01 Common methadone pitfalls 15:00 Buprenorphine precipitated opioid withdrawal  23:50 High-dose buprenorphine 32:20 Treating buprenorphine precipitated withdrawal 36:50 Low-dose buprenorphine 41:50 Maintenance dose of buprenorphine 48:15 ER buprenorphine 49:00 Take home points 53:31
10/17/202354 minutes, 35 seconds
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#412 Low Carb, Keto, Fasting: Lifestyle Interventions for Weight Management

Semaglutide can’t fix everything… Recommend lifestyle interventions for weight management with Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center and Interim Chief of Division of General Internal Medicine at Duke (@DrWillYancy).  Learn about the ketogenic diet, lower carbohydrate diets, and exercise, and their impacts on your patients.   Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer and writer: Fatima Syed, MD, MSc, FACP Show Notes, Infographic, and Cover Art: Fatima Syed, MD, MSc, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Will Yancy, MD Sponsor: Babbel Get 55% off at Babbel.com/CURB Sponsor: Locumstory  Visit locumstory.com to learn more more about all things locum tenens. Sponsor: Pathway  Download the Pathway app today, 100% free for Curbsiders listeners Full Transcript available HERE
10/16/20231 hour, 19 minutes, 6 seconds
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#411 Adrenal Insufficiency with Dr. Atil Kargi

Show description:  Feel confident diagnosing adrenal insufficiency. Learn how to accurately interpret a stimulation test, differentiate primary from secondary adrenal insufficiency, and teach patients about preventing an adrenal crisis with Dr. Atil Kargi (UNC School of Medicine)  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 Case 2 Topic Outro Credits Written and Produced by: Elena Gibson, MD Infographic and Cover Art: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi, MD MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Atil Kargi, MD Sponsor: Pathway Download the Pathway app today, 100% free for Curbsiders listeners  https://link.pathway.md/o53W/curb Sponsor: NetSuite Download NetSuite’s popular KPI Checklist at NetSuite.com/CURBSIDERS Sponsor: Grammarly Go to grammarly.com/PODCAST to download for FREE today. Full transcript available HERE
10/9/20231 hour, 28 minutes, 47 seconds
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#410 Diabetic Foot Infections

A Guide to Seeing Them and Stopping Them in Their Tracks Be a step ahead of diabetic foot infections! Learn who really needs that MRI, when to call your vascular colleagues, and when you really need that pseudomonas and anaerobic coverage. We are joined by Dr. Andrew Webster, infectious disease physician and antimicrobial stewardship director at the Atlanta VA.  Emory Division of Infectious Diseases Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Case Definitions Risk Stratifications Diagnostic Work-up Vascular evaluations Treatment Outro Credits Writer, producer and show Notes: Reaford Blackburn, Jr., MD Cover Art and Infographic: Monee Amin, MD Hosts: Monee Amin, MD and Meredith Trubitt, MD    Reviewer:  Sai Achi, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Andrew Webster Sponsor: Green Chef Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping. Sponsor: Pathway Download the Pathway app today by visiting pathway.md Sponsor: Birch Living  Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb when you use code BIRCHPARTNER20 Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com Full transcript available HERE
10/2/20231 hour, 21 minutes, 39 seconds
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#409 Hormonal and Nonhormonal Therapy for Vasomotor Symptoms of Menopause

Master hormonal and nonhormonal therapies for menopausal symptoms including vasomotor symptoms (VMS).  We’re joined by Dr. Monica Christmas, @drmonicaxmas (UChicago Medicine).  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Nonpharmacologic management of vasomotor symptoms (VMS) Non-hormonal therapy for menopause Taking a history for menopausal symptoms, VMS Hormone therapy (HT) risk assessment, counseling Prescribing Hormone therapy Troubleshooting hormone therapy Premature menopause and primary ovarian insufficiency Discontinuation of hormone therapy Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Monica Christmas MD Sponsor: Locumstory Get a comprehensive view of locums and decide if it’s right for you at locumstory.com. Full transcript available HERE.
9/25/20231 hour, 18 minutes, 56 seconds
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#408 COPD in Older Adults with Leah Witt, MD & Amber Lanae Martirosov, PharmD

Definitions, 4Ms & Inhaler Pro Tips Level up COPD management in older adults. Start with learning the latest in COPD diagnosis and classification, then stay for the mind-blowing inhaler misuse & cost discussion. We’re joined by a dynamic (and interprofessional) duo: Dr. Leah Witt (@leahjwitt) and Dr. Amber Lanae Martirosov, PharmD (@AmberMartirosov). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid Fire Questions Case Part 1 COPD Definition COPD alphabet soup: ABE Case Part 2 Geriatric 4Ms & COPD Inhaler Use & Cost Outro Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/ INTERNALMEDICINE. Offer good for a limited time.  Sponsor: Babbel Get 55% off at Babbel.com/CURB. Full transcript available HERE
9/18/20231 hour, 16 minutes, 11 seconds
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#407 DIGEST: Bempedoic acid and cardiac risk, Alpha-Gal Syndrome, Orforglipron, Zuranolone, DOACs for VTE of Malignancy, mAbs for Dementia, New Med for Smoking Cessation, Kiwis and Constipation

Join us as we review recent articles and news featured in The DIGEST #43 and #44, including bempedoic acid to lower cardiovascular risk, Alpha-Gal Syndrome, tick bites and meat allergy, orforglipron an oral GLP1 agonist for weight loss, zuranolone for postpartum depression, DOACs for VTE of malignancy, monoclonal antibodies (mAbs) for Dementia, cytisinicline for smoking cessation, and two kiwis a day for constipation. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | Free CME! Credits Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewers: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Sponsor: Netsuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance for free, at NetSuite.com/CURBSIDERS Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com. Sponsor: Grammarly  Go to grammarly.com/GO to download for FREE today. Sponsor: Pathway Download the Pathway app today by visiting pathway.md Show Segments Intro, disclaimer Bempedoic Acid for CV risk reduction DOACs to prevent recurrent VTE of malignancy Cytisinicline for smoking cessation Alpha-Gal Syndrome, tick bites, and meat allergy Zuranolone for postpartum depression Orforglipron, an oral GLP1 agonist, for weight management mAbs for Alzheimer’s dementia Kiwis to prevent constipation Outro
9/11/20231 hour, 6 minutes, 5 seconds
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REBOOT #293 The Best of Liver Tests with Dr. Elliot Tapper

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!  Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Produced by: Elena Gibson MD  Cover Art and Infographic: Kate Grant MD; Elena Gibson MD  Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD  (written materials); Clair Morgan of nodderly.com Guest: Elliot Tapper MD Sponsor: Panacea  If you’re ready to join the thousands of doctors who have declared independence from traditional banks, visit panaceafinancial.com today to open your free account. Sponsor: Birch Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb when you use code BIRCHPARTNER20! CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org. Show Segments Intro, disclaimer, guest bio Guest one-liner Definitions of liver enzymes, liver function tests   Patterns of acute liver injury Drug-induced liver injury Isolated alkaline phosphatase elevation  Isolated total bilirubin elevation  Livery Injury During Pregnancy  Acute liver failure Outro
9/4/20231 hour, 6 minutes, 6 seconds
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REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more. Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Writer: Matthew Watto, MD, FACP Producers: Matthew Watto, MD, FACP and Malini Gandhi Show Notes, Infographic, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Jordy Cohen MD CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak: New diagnosis of hypertension How to make a diagnosis of hypertension When to start anti-hypertensive medication Initial blood pressure regimen Case from Kashlak: White coat hypertension Case from Kashlak: Hypertension in chronic kidney disease ACEis and ARBs in chronic kidney disease Diuretics in chronic kidney disease Case from Kashlak: Refractory hypertension History and initial workup for refractory hypertension Treatment of primary hyperaldosteronism Outro Sponsor: Green Chef Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping.
8/28/20231 hour, 20 minutes, 7 seconds
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REBOOT #324: Obesity Medicine FAQ with Dr. Fatima Cody Stanford

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Not only that, we’ve been thinking about obesity the wrong way for decades. Join us with Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital as we reframe our approach to this disease and learn tips on prescribing  older,  but still very effective, medications used to treat obesity.  Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C Show Notes, Infographics: Maddison McLellan Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Monee Amin, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Fatima Cody Stanford, MD  Sponsor: Locumstory Get a comprehensive view of Locumstory at locumstory.com Sponsor: Babbel .Get 55% off your Babbel subscription at Babbel.com/curb. Rules and restrictions apply.  CME Partner: VCU Health CEThe 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.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. Show Segments Intro, disclaimer, guest bio Guest one-liner by Dr. Fatima Cody Stanford Case from Kashlak  Guidelines for treatment  Getting the history and discussing weight goals The Care Team:  Dietician, Behavioral Specialist, Provider Medications: Phentermine, Topiramate, Bupropion, Naltrexone Obesity treatment in pregnancy Referring to bariatric surgery Take home points Outro
8/21/202353 minutes, 26 seconds
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REBOOT #316 Lower Extremity Edema with The Curbsiders

Your swell guide to the swollen leg We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! We have seen our esteemed guests, and they are us!  Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema. Credits Written and produced by: Paul Williams, MD, FACP Infographic and Cover Art: Matthew Watto, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto, MD, FACP    Editor: Clair Morgan of nodderly.com Show Segments Intro, disclaimer Picks of the Week* The case of Lynn Fedema Pathophysiology of edema Differential diagnosis of chronic edema Chronic edema work-up Management of chronic edema Calvin Fedema and acute edema Evaluation of acute edema Outro Sponsor: Pathway Pathway is an innovative tool to improve your clinical decision-making process and enhance patient care. Download the app at pathway.md
8/14/20231 hour, 2 minutes, 25 seconds
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REBOOT: #372 Endocrine Emergencies featuring Dr. Sara Markley Webster

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm. Free CME for this episode at curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits ●  Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD ●  Show Notes, Infographic and Cover Art: Caroline Coleman, MD ●  Reviewer: Emi Okamoto, MD ●  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●  Technical Production: PodPaste ●  Guest: Sara Markley Webster, MD Sponsor: Grammarly Go to grammarly.com/GO to download and learn more about GrammarlyGO. Sponsor: Locumstory Get a comprehensive view of locums and decides if its right for you at locumstory.com Sponsor: Birch Living  Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb when you use code BIRCHPARTNER20! CME Partner: 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. Show Segments ●  Intro, disclaimer, guest bio ●  Guest one-liner, Picks of the Week* ●  Case 1 from Kashlak ●  Adrenal crisis identification, workup and management ●  Case 2 from Kashlak ●  Myxedema identification, workup and management ●  Case 3 from Kashlak ●  Thyroid storm identification, workup and management ●  Outro Full transcript available HERE
8/7/20231 hour, 24 minutes, 7 seconds
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#406 Kneedful Things: Knee Pain 201 with Dr. Ted Parks

Ready for more knee pain?  You’ve already memorized episode #98, so join us as Ted Parks to returns to teach us even more about common causes of knee pain (anterior knee pain, patellofemoral pain, knee bursitis, pain after knee replacement) and what to do about them! Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer: Paul Williams, MD, FACP Writer: Paul Williams, MD, FACP  Show Notes: Paul Williams, MD, FACP Infographic and Cover Art: Paul Williams, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD, MSc Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Edward (Ted) Parks, MD Sponsor: Pathway Download the free Pathway app today by visiting https://www.pathway.md/ Full transcript available HERE
7/31/20231 hour, 7 minutes, 23 seconds
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#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips

Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM #SGIM23 in Denver, Colorado  Claim free CME for this episode at curbsiders.vcuhealth.org! Show Segments Intro Barriers to treating medicine in primary care Patient counseling and obesity pathophysiology  Motivational Interviewing  Telemedicine for obesity Tools and tips for a weight loss program Medications for Obesity GLP1 agonist prescribing tips Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP In-studio Technical Production: Chris Chiu MD, FACP, FAAP Technical Production: PodPaste Guest: Kimberly Anne Gudzune MD, MPH
7/24/202357 minutes, 33 seconds
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#404 Hematuria with Dr. Derek Fine

When there’s blood in the water… Work-up hematuria with confidence.  Learn what you should be worrying about, what tests are worth considering, and how to figure out if this is a job for a urologist or nephrologist. Claim free CME for this episode at https://curbsiders.vcuhealth.org! Credits Producer and writer: Paul Williams, MD, FACP Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Derek Fine, MD
7/17/202353 minutes, 19 seconds
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#403 Hotcakes: Ketamine, Kratom, Nonhormone therapy for menopause, Metformin for long COVID, and New Breast Cancer Screening Recs

Join us as we review recent practice-changing articles on ketamine vs ECT for refractory depression, nonhormone treatment (fezolinetant) for menopause, metformin for long COVID, new breast cancer screening draft recommendations, and a primer on kratom.  Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Go to https://thecurbsiders.com for more info Become a Kashlak Memorial Hospital member and support us by joining our Patreon Claim free CME for this episode at curbsiders.vcuhealth.org!
7/10/202355 minutes, 19 seconds
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Addiction Medicine #12 - Listener Q & A on Substance Use Disorders

Put on your Primary Care Cat-Hat We are thrilled to be back to kick off season 2! Carolyn Chan, MD (@CarolynAChan) soon to be at the University of Cincinnati, Shawn Cohen MD (@ShawnCohen_MD) at Yale University, Kenneth Morford MD at Yale University, and Natalie Stahl MD (@NanouTheNomad) at Greater Lawrence Family Health Center are back and on this episode, they answer burning questions submitted by listeners. We cover topics such as targeted naltrexone, increasing buprenorphine doses, treating kratom dependence, and so much more!  Claim free CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and  completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | Swag! | iTunes | [email protected] | Free CME! Credits Producer, Show Notes:  Kenneth Morford, MD Infographic and Cover Art: Carolyn Chan, MD, MHS Hosts: Carolyn Chan MD, MHS, Shawn Cohen MD, Kenneth Morford MD, Natalie Stahl MD, MPH Reviewer: Payel Jhoom Roy, MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste
7/6/20231 hour, 4 minutes, 19 seconds
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#402 Don’t Get Caught with a CAUTI

Dominate naughty CAUTIs. Learn how to define them, which studies to order, and how to treat and prevent these pesky infections. We’re joined by Dr. Laila Woc-Colburn, @DocWoc71 (Emory University). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Please consolidate if performing multiple jobs (e.g. Written and Produced by: Cyrus Askin MD; cover art and infographic by Kate Grant) Producer and Writer:: Noble Maleque MD Show Notes: Caroline Coleman MD & Noble Maleque MD Cover Art and Infographic: Caroline Coleoman MD & Sean Evans MD Hosts: Monee Amin MD & Meredith Trubitt MD Reviewer: Sai S Achi, MD MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Laila Woc-Colburn MD
7/3/20231 hour, 22 seconds
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#36 Launching a Clinician Educator Career with Drs. Sue Farrell and Caroline Okorie

Guests Dr. Sue Farrell, Harvard University and Dr. Caroline Okorie, Stanford University, discuss careers  as clinician educators.  They share their own roadmap for advancement in academic medicine while reflecting on the concept of ikigai.  We review tips for success for academic clinicians across the spectrum- how to create your strategic plan, think about advancement, and integrate scholarship into your work.   Claim free CME for this episode at curbsiders.vcuhealth.org! Website | Instagram | Twitter | Subscribe | Patreon | Free CME!| Youtube  [email protected] Credits Script, Guest Selection: Frances Ue MD MPH Infographic, Cover Art: Megan Connor MD Hosts: Frances Ue MD MPH, Era Kryzhanovskaya MD, Molly Heublein MD    Show Notes/CME: Molly Heublein MD Editor: (audio materials) Podpaste; Frances Ue MD MPH, Era Kryzhanovskaya MD (written materials)  Guests: Sue Farrell MD EdM, Caroline Okorie MD MPH Show Credits Intro, disclaimer, guest bio Guest one-liner/ Best piece of advice Case #1 from Kashlak Memorial Hospital Learning from senior faculty vs mid-level Ce vs cE Tips to building your early career Ikigai/ Roadmap to becoming a CE What our guests wish they knew from the beginning You don’t always have to say yes Mid-Career Educator ACGME CE Milestones Strategic Plan Dr Okorie’s Personal Path What she has learned through this process Advancement/Promotion Bias and Equity in Promotion Scholarship Take Home Points Outro
6/27/20231 hour, 7 minutes, 5 seconds
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#401 Updates in Addiction Medicine - SGIM 2023

We are far too classy for a “Rocky Mountain High” joke. Live from SGIM 2023 in Aurora, Colorado!  We talk to a panel of Addiction Medicine specialists who recap their outstanding talk on all of the exciting developments in treating addiction.  We review major policy changes, trends in drug overdose, outpatient screening for alcohol use, and all of the ways we might be using psychedelics to treat addiction.  We are joined by Stefan Kertesz, MD @StefanKertesz (University of Alabama at Birmingham), Ximena Levander, MD, MCR, FACP @XimenaLevander (OHSU), Kenneth L. Morford MD, FASAM (Yale), and Katherine Mullins, MD, AAHIV @_kmullins_ (NYU Langone). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer: Carolyn Chan, MD and Paul Williams, MD, FACP Writer: Carolyn Chan, MD and Paul Williams, MD, FACP Show Notes, Infographic, and Cover Art: Paul Williams, MD, FACP Hosts: Carolyn Chan, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guests: Stefan Kertesz, MD, MSc; Ximena A. Levander, MD, MCR, FACP; Kenneth L. Morford, MD, FASAM; Katherine Mullins, MD, AAHIV
6/26/20231 hour, 2 minutes, 21 seconds
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#400 Antiplatelets, Anticoagulation for Coronary Artery Disease and Afib

Master the prescription of antiplatelets and anticoagulation for coronary artery disease and afib (atrial fibrillation). We discuss why, when, and how long to prescribe aspirin, clopidogrel, ticagrelor, prasugrel, and/or anticoagulation for primary, secondary, and “primary and a half” prevention including the definition and discussion of mono, dual, and triple therapy for patients with coronary disease who need anticoagulation for atrial fibrillation. We’re joined by preventive cardiologist, Dr. Donald Lloyd-Jones MD, ScM (@dmljmd from NMCardioVasc)! This episode was recorded in person at ACP’s (@ACPIMPhysicians) Internal Medicine Meeting 2023 #im2023 in San Diego. Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Getting to know our guest Definition mono, dual, triple therapy, DAPT Post-PCI for NSTEMI with existing afib Stable CAD with new Afib CABG with New Afib Prior stent with New Afib Antiplatelet therapy after Acute Coronary Syndrome Primary Prevention Primary “and a half” Prevention Life’s Essential 8 Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art & Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD, MSc Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Donal Lloyd-Jones MD, ScM
6/19/202359 minutes, 5 seconds
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#399 Wisely Ordering Autoantibodies - ACP IM2023

The ANA, anti-CCP, RF, and beyond! We all have ‘rheum’ to grow when it comes to making sense of autoantibodies and common markers. We talk through the nuances with rheumatologist Dr. Matthew B. Carroll (biography here!). Our interview covers physical exam tips for inflammatory arthritis, basic interpretation of rheumatologic testing, and what to do with the dreaded ‘vaguely positive’ speckled ANA! Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 History clues Physical exam pearls; what does synovitis look like? Interpreting mixed labs Rheumatoid Factor tips Role for imaging Importance of early diagnosis New testing modalities Case 2 Oh no– a vaguely positive ANA! ANA testing basics Outro Credits Showrunners, Hosts, Producers and Writers: Matthew Watto MD, FACP; Paul Williams MD, FACP    Show Notes, Infographic, Cover Art: Beth Garbitelli MD Reviewer: Emi Okamoto MD  Technical Production: PodPaste Guest: Matthew B. Carroll MD Sponsor: Brooklinen Visit Brooklinen.com today and get $20 off plus free shipping on orders of $100+ with code [CURB] Sponsor: Grammarly Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Sponsor: Glass Health You can get one month of Glass Pro free by signing up at glass.health and using the code: CURBSIDERS.
6/12/202352 minutes, 18 seconds
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# 398:Live! From SHM: Inpatient Cirrhosis Management

Learn to bust through inpatient cirrhosis management! The basics of ascites, HRS, portal vein thrombosis and hepatic encephalopathy management are all here. We’re joined by Dr. Suchita Sata (@suchitasata) (Duke University). Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Austin Picks of the week Case Ascites Portal Vein Thrombosis AKI/HRS SBP Diuretic Management Albumin Case HRS treatment GIB Management Hepatic Encephalopathy Management Palliative Care Outro Credits Producer, Writer: Monee Amin MD, Meredith Trubitt MD Show Notes, Cover Art:  Monee Amin MD Infographic: Caroline Coleman MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Suchita Sata MD Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine.  Sponsor: Birch Living  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Green Chef  Go to GreenChef.com/curb60 and use code curb60 to get 60% off plus free shipping.  Sponsor: Glass Health  You can get one month of Glass Pro free by signing up at glass.health and using the code CURBSIDERS   Full Transcript available HERE
6/5/202352 minutes
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#397: Insulin, Type 2 Diabetes, Fanny Packs, and Hypoglycemia with Dr. Jeff Colburn

Don’t be scared of insulin or hypoglycemia anymore!  Our Kashlak Friend of the Pod Dr. Jeff Colburn gives us all the essentials you’ll need in your fanny pack for navigating the ups and downs of insulin in type 2 diabetes.  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions/Picks of the Week Case #1: Starting insulin Types of basal insulin: glargine, detemir, NPH, 70/30 NPH/regular Glucose monitoring while on insulin Glucose targets  when taking insulin Overbasalization  Adding additional agents to basal insulin Case #2: Deescalating insulin Insulin use in the geriatric population Hypoglycemia Rule of 15  Glucagon how-to  Outro Credits Producer, Writer, Show Notes, Infographic and Cover Art: Isabel Valdez, PA-C  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Jeff Colburn, MD Sponsor: Pattern  Request your quotes online at patternlife.com/curbsiders Sponsor: Birch Birch is giving 20% off ALL mattresses and two free eco-rest pillows at birchliving.com/curb
5/29/20231 hour, 11 minutes, 34 seconds
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#396 Recap, Top Pearls from #SGIM23

Don’t miss this rapid-fire recap of our top pearls from #SGIM23 in Aurora, Colorado, including obesity medicine, GLP1 agonists, trauma-informed care, an update on hormone therapy for vasomotor symptoms of menopause, treating low sexual desire in women, dementia diagnosis and treatment, chronic pain and buprenorphine, complex persistent opioid dependence, chlorthalidone vs hydrochlorothiazide, the timing of blood pressure medication, how to prescribe CPAP or auto-PAP, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk), Chris Chiu (@cjchiu), Carolyn Chan (@CarolynAChanMD, Curbsiders Addiction Medicine), and Era Kryzhanovskaya (@EraKryzhMD, Curbsiders TEACH).  No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Recap, Top Pearls Part 1 Recap, Top Pearls Part 2 Outro Credits Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Carolyn Chan MD; Era Kryzhanovskaya MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Show Notes: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP   Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor:  Pattern Request your disability insurance quotes with Pattern at patternlife.com/curbsiders.
5/22/20231 hour, 18 minutes, 1 second
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#395 Dysphagia with Dr. Diana Snyder

There might be a lot to swallow, but you will master an initial approach to dysphagia in this episode. Review the types of dysphagia, common etiologies, initial evaluations and treatment plans. We are joined by Dr. Diana Snyder @DianaSnyderMD (Mayo Clinic) Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro & Picks of the Week Case  Dysphagia definitions Oropharyngeal vs esophageal dysphagia  Associated symptoms and alarm signs  Outro Credits Producer, Writer & Show Notes: Elena Gibson MD  Show Notes: Elena Gibson MD Cover Art & Infographic: Kate Grant MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed MD  Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Diana Snyder MD Sponsor: Locumstory Get a comprehensive view of locum and decide if it’s right for you at locumstory.com Sponsor: Brooklinen Your Memorial Day Sale is coming soon! Shop 20% off in-store or online at Brooklinen.com Sponsor: Panacea Financial  Visit panaceafinancial.com to open your free account today.  
5/15/202354 minutes, 52 seconds
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#394 Recap, Top Pearls from ACP #IM2023

Don’t miss this rapid fire recap of our top pearls from ACP #IM2023 in San Diego including hypertension, hypogonadism, frailty, afib, sleep medicine, in-flight emergencies, nephroprotective meds, order of antibiotics for pneumonia in the hospital, genitourinary syndrome of menopause, pickle juice for leg cramps, bristol stool scale and hepatic encephalopathy, coronary calcium, tirzepatide, cystatin c,  functional dyspepsia, hair and nails, and more! Paul and Watto are joined by Drs. Justin Berk (@justinberk) and Chris Chiu (@cjchiu) of The Cribsiders Podcast. No CME for this episode due to rapid turnaround, but claim CME for most episodes at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Recap, Top Pearls Part 1 Recap, Top Pearls Part 2 Outro Credits Written, Produced, and Hosted by: Justin Berk MD, MBA, MPH; Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP  Show Notes: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP   Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Grammarly Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer good for a limited time.
5/8/20231 hour, 40 minutes, 21 seconds
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#393 Live from SHM: Clinical Updates in Hospital Medicine

Join us for this Hotcakes style episode as we talk through impactful literature for the hospitalist with Dr. Heather Nye (UCSF) and  Dr. Rahul Ganatra (@rbganatra, Harvard University) who presented the Clinical Updates in Hospital Medicine at SHM #Converge23.  Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro, disclaimer Rapid fire questions/Picks of the Week EMPULSE ADVOR STRONG-HF CRISTAL Perioperative Gabapentin Waterfall Midline catheters vs PICC lines What’s in a Name? Outro Credits Producer, Writer, Show Notes: Monee Amin MD; Rahul Ganatra, MD; Meredith Trubitt MD;  Cover Art: Monee Amin MD  Hosts: Monee Amin MD; Meredith Trubitt MD   Reviewer: Fatima Syed MD  Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Rahul Ganatra and Dr. Heather Nye Sponsor: Birch Living Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at indeed.com/internalmedicine.
5/1/202355 minutes, 3 seconds
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#392 Live! Opioid and Xylazine Withdrawal in the Hospital

Dominate opioid and xylazine (aka tranq) withdrawal in the hospital with expert insights from Dr. Joseph D’Orazio (@dorazepam) recorded LIVE! at Pennsylvania Hospital Grand Rounds in Philadephia, PA. Xylazine, an alpha-2 adrenergic agonist,  has emerged as a frequent contaminant in the opioid supply with a distinct withdrawal syndrome. You’ll learn to manage this common withdrawal syndrome while also addressing acute pain complaints and opioid withdrawal.   Sorry, no CME for this episode, but check out CME for past episodes at curbsiders.vcuhealth.org. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Xylazine basics Management of xylazine withdrawal Opioid withdrawal and acute pain Outpatient considerations for xylazine Audience questions Outro Credits Writer and Producer: Matthew Watto MD, FACP Infographic and Cover Art: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Joseph D’Orazio MD
4/26/202345 minutes, 27 seconds
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#391 Hypercoagulable Work-Up with Dr. Jean Connors

Master the nuances of the hypercoagulable work-up! Our expert discussant, Dr. Jean Connors, leads us through when to send testing for thrombophilia and how to interpret the results. Claim free CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak: DVT after a trip to Singapore History-taking in a patient with a venous thromboembolism (VTE) Risk factors for VTE Who to test for thrombophilia, and how this testing influences management Thrombophilia panel: what to order When to send thrombophilia testing Case from Kashlak: potential obstetric antiphospholipid syndrome Antiphospholipid syndrome: diagnosis Antiphospholipid syndrome: management Outro Credits Producers and Writers: Malini Gandhi and Nora Taranto MD Show Notes, Infographics, and Cover Art: Malini Gandhi  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Jean Connors MD Sponsor: Locumstory Go to locumstory.com to get a comprehensive view of locums  and decide if it’s right for you. Sponsor: Panacea Financial Visit panaceafinancial.com today to open your free account.
4/24/20231 hour, 17 minutes, 7 seconds
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#390 Resistant Hypertension

Hypertension FAQ Round #2 Dr. Jordy Cohen Strikes Back Tackle resistant hypertension. Learn when it is pseudo resistant hypertension, and how to treat this pesky condition when it is true resistant hypertension. Dr. Jordy Cohen (@jordy_bc) leads us through her approach to keeping the BP where it should be (University of Pennsylvania). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | Contact | Swag! | CME Show Segments Intro Case Hypertension definition Mechanisms of hypertension Vascular stiffness and aging Antihypertensive agents Anxiety and hypertension Escalating blood pressure management Resistant hypertension Ruling out pseudo resistant hypertension Substance induced pseudo resistant hypertension Pick of the Week Outro Credits Written and Produced by: Deborah Gorth MD, PhD Infographic and Cover Art: Deborah Gorth MD, PhD and Meryl Gorth Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi MD, MBA Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jordy Cohen MD, MSCE Sponsor: Indeed Visit Indeed.com/INTERNALMEDICINE to start hiring now
4/17/20231 hour, 17 minutes, 30 seconds
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#389 Recap: SHM 2023 #Converge

We recap the top pearls for the hospitalist from #SHM #Converge2023 covering discussions on syncope, heart failure, COPD, pneumonia, sickle cell pain management, nausea and dyspnea, complex pain management issues, delirium, geriatrics updates, severe infections from injection drug use, electrolyte management, perioperative anemia and anticoagulation, and GI updates.  Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Syncope Heart Failure Nausea and Dyspnea  COPD and Pneumonia Sickle Cell Pain Management Pain Management for the Hospitalist Delirium  Geriatrics Updates Electrolyte Management  Perioperative Anticoagulation Perioperative Anemia  Severe Infections from Injection Drug Use GI updates Outro Credits Written, Produced and Hosted by: Christina Sensabaugh MD, Meredith Trubitt MD, and Monee Amin MD Cover Art: Monee Amin MD  Show Notes: Meredith Trubitt MD, Monee Amin MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Sponsor: Brooklinen For a limited time, visit Brooklinen.com to get $20 off plus free shipping on orders of $100+ with code CURB. Sponsor: Locumstory Get a comprehensive view of locums — and decide if it’s right for you — at locumstory.com. Sponsor: Indeed  Visit Indeed.com/INTERNALMEDICINE to start hiring now.
4/10/20231 hour, 8 minutes, 24 seconds
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#388 HIV in Primary Care with Dr. Jonathan J. “JJ” Nunez MD

LIVE! Updates in HIV management at Hershey Highly active, high-yield points on HIV management in Primary Care!  We are joined by Infectious Disease specialist Dr. Jonathan J. “JJ” Nunez MD (of Penn State Health - Hershey) to review basics of management, important comorbidities, and new horizons in HIV care.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | [email protected] | Swag! | Free CME! Show Segments Intro Establishing HIV Care, Initial History Taking Privacy and HIV Physical Exam Tips for HIV Weight gain, managing cardiometabolic risks Initial labs, tracking viral load Undetectable = Untransmissible Sexual history considerations, PEP, PrEP,  Anal paps, cervical cancer screening Long-Acting HIV Medications Take-home points Outro Credits Producer, Writers: Paul Williams MD, FACP, Beth Garbitelli MD Show Notes, Infographic, Cover Art: Beth Garbitelli MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  J.J. Nunez MD Sponsor: Green Chef Go to GreenChef.com/curb60 and use code curb60 to get 60% off plus free shipping. Sponsor: Birch Living   Birch is giving 20% off ALL mattresses and 2 free eco-rest pillows at Birchliving.com/curb Full transcript available HERE
4/3/202354 minutes, 40 seconds
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#387: Diabetes Updates with Dr. Marie McDonnell: New Tools for the New Rules

Drop the pounds and the sugar with new guidelines New rules to manage diabetes means using new tools. Leverage GLP-1 RA and SGLT2-i to drop with pounds and the sugars with the expert insight from our guest, Dr. Marie McDonnell. Claim free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Puns and Intro. Disclaimer and Guest bio Case from Kashlak Labs to distinguish type 1 from type 2 diabetes Selecting initial therapy: Focus on weight loss and glucose control HbA1c goals  Yeast infections and SGLT2-i Using sulfonylureas and extended release metformin Pancreatitis and GLP-1 RA Cancer and GLP-1 RA Semaglutide tips Tirzepatide, how it works and benefits Take home points Outro Credits Producer: Matthew Watto, MD and Isabel Valdez, PA Writer: Matthew Watto, MD Show Notes, Cover Art and Infographics: Isabel Valdez, PA Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest:  Marie E. McDonnell, MD Sponsor: Locumstory Get a comprehensive view of locums at locumstory.com Full transcript available HERE 
3/27/20231 hour, 1 minute, 2 seconds
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#386 Primary Aldosteronism, MRAs, and Renovascular Hypertension: NephMadness Pod Crawl 2023

We demystify primary aldosteronism, MRAs (mineralocorticoid receptor antagonists), non-steroidal MRAs, and how to recognize and treat renovascular hypertension with nephrologist/hypertension expert, Dr. Matt Luther (@DrJMLuther) as part of the NephMadness  PodCrawl 2023. Fill out a bracket for NephMadness and check out all eight NephMadness PodCrawl participants at NephMadness.com/podcrawl (list below) and the MRA region write-up by Micah Schub (@AcidBassMD). The Curbsiders gets the skinny on mineralocorticoid receptor antagonists Core IM will be covering Kidney Transplant in their classic Five Pearl format The CardioNerds will be covering the effect of Heart Failure Devices on Kidney Health Freely Filtered will try to understand thrombotic microangiopathy ISN Global Kidney Care goes deep on IgA nephropathy The Cribsiders look at transitions, first the Pediatrics to Adult nephrology transition and then from living to death with palliative nephrology  Fellow on Call will be covering Onconephrology And finally, The Nephron Segment looks at Transgender Health and CKD Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | Contact | Swag | CME Show Segments Intro Diagnosis and Management of Primary Aldosteronism (PA) MRAs vs non-steroidal MRAs (mineralocorticoid receptor antagonists) NephMadness MRA region picks Renovascular Hypertension Outro Credits Writer and Producer: Matthew Watto MD Show Notes: Matthew Watto MD Cover Art & Infographic: Matthew Watto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: J. Matthew Luther MD Sponsor: Locumstory Get a comprehensive view of locums, and decide if it;s right for you, at locumstory.com Sponsor: indeed Visit indeed.com/internalmedicine to start hiring now. Full Transcript available HERE
3/20/20231 hour, 11 minutes, 19 seconds
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#385 TIA/Stroke for the Hospitalist featuring Dr. Karima Benameur

We’ve got the hard-hitting questions and must-know answers on all things TIA and stroke from neurology expert, Dr. Karima Benameur (Emory University). Topics: TIA and stroke supportive management, indicated workup, and anticoagulation and antiplatelet management pearls for the hospitalist. Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments  Intro, disclaimer, guest bio Case 1 from Kashlak; Definitions Initial stroke triage, imaging, and assessing for interventions  Supportive care for stroke Managing patients already on antiplatelet or anticoagulant therapy Inpatient stroke workup Dual antiplatelet therapy Case 2 from Kashlak; Definitions TIA workup and management Transitions of care: “the invisible deficits” Brain health and nutrition Guest questions and Picks of the Week* Outro Credits Written, Produced, Infographic and Cover Art, Show Notes: Caroline Coleman MD Hosts: Monee Amin MD; Meredith Trubitt MD, MPH; Caroline Coleman MD Reviewer: Molly Heublein MD Executive Producer: Karly Loy Showrunner: Matthew Watto MD, FACP Editor: Pod Paste Guest: Karima Benameur MD Sponsor: Indeed  Visit indeed.com/internalmedicine to start hiring now. Sponsor: Glass Health You can get one month of Glass Pro free by signing up at glass.health and using the code CURBSIDERS. Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions. Full transcript available HERE
3/13/20231 hour, 5 minutes, 31 seconds
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#384 Updates in Chronic Kidney Disease with Dr. Joel Topf

Stay up-to-date with advances in chronic kidney disease (CKD)! Join our esteemed Chief of Nephrology at Kashlak Memorial Hospital, Dr. Joel Topf, as he leads us through the latest on SGLT2 inhibitors, finerenone, potassium binders, and treatment of CKD-associated metabolic acidosis. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | YouTube | Mailing List | [email protected] | Swag! | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak SGLT2i: when to initiate SGLT2i: adverse effects Finerenone Potassium binders Treatment of CKD-associated metabolic acidosis  Outro Credits Writer, Producer, Show Notes, Infographics, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Joel Topf MD Sponsor: Better Help Visit betterhelp.com/curb today to get 10% off your first month.  Sponsor: Birch Living Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: PanaceaFinancial Visit panaceafinancial.com to open a free account.  Full transcript available HERE
3/6/20231 hour, 14 minutes, 48 seconds
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#383 Hotcakes: Loop Diuretics for CHF, Time Restricted Eating, Breaks from Sitting, Early FMT for C. diff

Join us as we review recent practice-changing articles on loop diuretics for heart failure exacerbation (torsemide vs furosemide), time-restricted eating vs small frequent meals for weight loss, how sedentary breaks from sitting effect blood glucose & blood pressure, early FMT for C. diff, and a brief rant on medications for obesity. Fill your brain hole with a delicious stack of hotcakes! Featuring Nora Taranto (@norataranto, The DIGEST), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer Loop diuretics (torsemide vs furosemide) for heart failure exacerbation Time-restricted eating vs small frequent meals for weight loss Sedentary breaks for lowering blood glucose and blood pressure Early fecal microbiota transplant (FMT) for C. diff infection  Outro Credits Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Full transcript available HERE
2/27/202340 minutes, 15 seconds
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#382 Abnormal Uterine Bleeding

With Dr Holly Wong Cummings Listen in as we talk through abnormal uterine bleeding (AUB) with our esteemed guest Holly Wong Cummings, MD.  We review the PALM-COEIN framework for AUB diagnosis and discuss options for acute and chronic treatment of AUB.  We can get bleeding under control! Many of the treatments including progesterone only pills, combined oral contraceptives, and tranexamic acid are medications we in primary care should feel confident prescribing to our patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak Normal Menstrual Cycle Nomenclature for AUB- PALM COEIN History and Physical Exam Laboratory and radiologic evaluation Structural causes for bleeding/interpreting the ultrasound Acute treatment of AUB When to refer to ED Chronic treatment for AUB When to refer to gyn Take home points Outro Credits Producer, Writer, Show Notes: Molly Heublein MD Infographic: Edison Jyang Cover Art: Sarah Phoebe Roberts Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Molly Heublein MD Reviewer: Sai S Achi MD, MBA Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Holly Wong Cummings MD Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full transcript available HERE
2/20/202356 minutes, 56 seconds
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#381 LIVE! Patient Centered Things We Do For No ReasonTM

Join Drs. Amin and Trubitt as they go rogue and LIVE!  from Southern Hospital Medicine to discuss Things We Do For No ReasonTM in the hospital that impact the patient experience. They cover NPO at midnight, fluid restriction, VTE chemoprophylaxis and routine vital signs via the hospital course of one poor, unfortunate soul. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro NPO at midnight Fluid restriction VTE chemoprophylaxis Frequency of vital sign monitoring Outro Credits Written and Produced by: Monee Amin MD and Meredith Trubitt MD Cover art and presentation graphics: Caroline Coleman, MD Show Notes: Monee Amin MD and Meredith Trubitt MD Hosts: Monee Amin, MD and Meredith Trubitt MD Technical Production: PodPaste Showrunner: Matthew Watto MD, FACP Sponsor: Grammarly  Go to grammarly.com/tone to download and learn more about Grammarly Premium’s advanced tone suggestions.  Sponsor: Indeed Visit indeed.com/internalmedicine to start hiring now.  Sponsor: BetterHelp  ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb  Full Transcript available HERE
2/13/202335 minutes, 39 seconds
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#380 Hemochromatosis with Elliot Tapper

Recognize when to consider the diagnosis of hemochromatosis  and how to recognize common mimics of an elevated ferritin level. We’re joined by Dr. Elliot Tapper,@ebtapper on twitter (University of Michigan) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Initial evaluation of Hemochromatosis  Etiology of elevated ferritin in liver disease Potential mimics of hemochromatosis  Diagnosis of hemochromatosis Evaluation of hepatic fibrosis in hemochromatosis Manifestations & complications of hemochromatosis  Outro Credits Producer & Writer:: Elena Gibson MD    Infographic & Cover Art:Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Elliot Tapper Sponsor: Green Chef Go to greenchef.com/curb60 and use code curb60 to get 60% off plus free shipping.  Sponsor: Birch Living  Birch is giving 20% off all mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Better Help  Visit betterhelp.com/curb to get 10% off your first month.  Full transcript available HERE
2/6/202359 minutes, 2 seconds
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#379 Hearing Loss, Tinnitus, and Meniere's Disease

With Dr Steven Rauch Demystify hearing loss, identify who will benefit from hearing aids and learn to evaluate hearing complaints in primary care including an overview of tinnitus and how to recognize and treat Meniere’s disease with guest expert, Dr. Steven Rauch (Harvard University). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak;  Definitions, etiology and risk factors for hearing loss  Initial workup for hearing loss What is an audiogram and what does it show  Hearing loss red flags  How to manage hearing loss Tinnitus: what can help patients  Diagnose, distinguish and treat Meniere’s disease  Outro Credits Script and Show Notes written by,  Produced by: Kate Grant MBChB, MRCGP and Andréa Perdigão Infographic and Cover Art: Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Steve Rauch MD Sponsor: Better Help Visit betterhelp.com/curb to get 10% off your first month.  Full Transcript HERE
1/30/20231 hour, 26 minutes, 50 seconds
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#378 Acute Exacerbations of COPD (AECOPD)

Pro Tips & Practical Insights from Dr. Jim O’Brien Are acute COPD exacerbations taking the wind out of YOUR sails? Join us as we navigate the stormy waters that can be AECOPD with our guest expert,  Dr. Jim O’Brien                                                                          from National Jewish Health Center. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio What is a COPD  Case from Kashlak - Natalie Harrison Knee jerk reaction: Determining level of illness & disposition Initial work-up considerations What’s in your differential? The second-order assessment - shuffling the differential, honing in on the patient AECOPD: Triggers & Pathophysiology Treatment Pearls I: Steroids Treatment Pearls II: Antibiotics Treatment Pearls III: Bronchodilators Treatment Pearls IV: Oxygen Therapy Preparing for discharge Take home points Lightning Round! Getting to know Dr. O’Brien &  Picks of the Week* Outro Credits Writer & Producer:  Cyrus Askin MD Show Notes, Infographic & Cover Art: Cyrus Askin MD  Hosts: Meredith Trubitt MD, Monee Amin MD & Cyrus Askin MD    Reviewer:  Sai Achi, MD MBA  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jim O’Brien MD Sponsor: Medmastery Go to www.medmastery.com/curbsiders to claim a 15% discount off an annual Medmastery Pro Subscription.  Full Transcript available HERE
1/23/20231 hour, 16 minutes, 10 seconds
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#377 Adrenal Incidentalomas, Primary Aldosteronism with Dr. William Young

Conquer your fear of adrenal incidentalomas! We’re joined by Dr. William Young, who teaches us pearls for evaluating imaging characteristics of adrenal incidentalomas, tips for assessing and managing functioning adenomas, approaches to follow-up and surgical considerations, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Case #1 from Kashlak; Definitions Discussing adrenal incidentalomas with patients Imaging characteristics of adrenal incidentalomas Evaluation of hormonal hypersecretion - overview Subclinical Cushing’s syndrome Pheochromocytoma Surgical considerations based on nodule size and imaging phenotype Follow-up imaging Case#2 from Kashlak  Primary hyperaldosteronism - work-up and management Bilateral adrenal nodules Guest Picks of the Week Outro Credits Producer, Writer, Show Notes, Infographic, and Cover Art: Malini Gandhi  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: William Young MD Sponsor: Grammarly Go to grammarly.com/podcast to sign up for an account and download! And when you’re ready to upgrade to Grammarly Premium, get 20% off.  Sponsor: BetterHelp Visit betterhelp.com/curb to get 10% off your first month.  Full Transcript HERE
1/16/20231 hour, 32 seconds
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#376 Hormone Therapy for Primary Prevention of Chronic Conditions in Postmenopausal Persons - a USPSTF update with Dr. Carol Mangione

We have better tools for prevention, but let’s talk! Should we be offering hormone therapy for primary prevention in postmenopausal patients?  Dr. Carol Mangione (UCLA) talks us through the potential benefits and harms, and explains how this can be a jumping off point for important conversations about preventive care. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers, Hosts: Elena Gibson MD and Paul Williams MD, FACP Writer, Infographic, and Cover Art: Elena Gibson MD Show notes: Paul Williams MD, FACP Reviewer: Molly Heublein MD Production team: Podpaste Guest: Carol Mangione MD Full transcript available HERE
1/11/202326 minutes, 57 seconds
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#375 Delirium in the Hospital featuring Dr. Esther Oh

In this episode you will learn to master delirium in the hospital!  We discuss preventing, recognizing, and managing this common and dangerous condition.  We are joined by delirium expert and President of the American Delirium Society, Dr. Esther Oh @EstherOh_MDPhD (Johns Hopkins University) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case 1 from Kashlak: hypoactive delirium Definition of delirium Delirium vs. encephalopathy vs. dementia Delirium assessment tools Prevention of delirium Discharging patients with delirium Case 2 from Kashlak: hyperactive delirium Antipsychotics Working up etiologies of delirium Treatment/management pitfalls Outro Credits Produced, Script, Show Notes: Adam Barelski MD  Infographic & Cover Art: Edison Jyang; Sarah Phoebe Roberts Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Adam Barelski MD    Reviewer: Molly Heublein MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Esther Oh MD, PhD Sponsor: Panacea Financial  Visit panaceafinancial.com to open your free account. Full transcript HERE
1/9/20231 hour, 14 minutes, 36 seconds
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#374 ADHD with Dr. Kevin Simon

Don’t get distracted, pay attention to the details, and manage ADHD in your patients! Dr. Kevin Simon, @DrKMSimon (Boston Children’s Hospital) shows us how to stay focused and diagnose and manage attention deficit hyperactivity disorder (ADHD)  in your patients.  Learn how to make the right diagnosis, choose an appropriate medication, and modify therapy.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Case from Kashlak; Definitions and diagnosis of ADHD Stimulant medications for ADHD Non-stimulant medications for ADHD Mitigating diversion of medications for ADHD Managing ADHD in patients with substance use disorder Lightning round and picks of the week Outro Credits Written and Produced by: Paul Williams, MD, FACP Show Notes: Paul Williams, MD, FACP Infographic and Cover Art: Paul Williams, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Fatima Syed, MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Kevin Simon, MD Sponsor: Better Help Save 10% off your first month at betterhelp.com/curb Sponsor: Birch Living  Visit birchliving.com/curb to get $400 off all mattresses and 2 free eco-rest pillows.  Full Transcript HERE
1/2/20231 hour, 3 minutes, 22 seconds
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#373 Recap Extravaganza 2022

Celebrate the holiday season with top pearls on constipation, palpitations, hypertension, meds for obesity, cardiorenal syndrome, hepatitis C, staging the liver, vitamin supplementation and more! Plus, Watto and Paul share their reflections on seven years of podcasting, give their picks of the year, and tease upcoming episodes for 2023! Note No CME for this episode but visit curbsiders.vcuhealth.org to claim credit for shows from 2022! Episodes | Subscribe | Spotify | Swag! | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, Reflections on 2022 Constipation,  Palpitations,  Hypertension,  Obesity medications,  Cardiorenal syndrome,  Hepatitis C,  Vitamin supplementation Picks of the Year Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP Cover Art design: Matthew Watto MD, FACP Technical Production: Pod Paste Full transcript HERE
12/26/20221 hour, 3 minutes, 48 seconds
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#372 Endocrine Emergencies featuring Dr. Sara Markley Webster

In this episode, we discuss an overview of inpatient management of can’t miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm. Free CME for this episode at curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments ●  Intro, disclaimer, guest bio ●  Guest one-liner, Picks of the Week* ●  Case 1 from Kashlak ●  Adrenal crisis identification, workup and management ●  Case 2 from Kashlak ●  Myxedema identification, workup and management ●  Case 3 from Kashlak ●  Thyroid storm identification, workup and management ●  Outro Credits ●  Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD ●  Show Notes, Infographic and Cover Art: Caroline Coleman, MD ●  Reviewer: Emi Okamoto, MD ●  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●  Technical Production: PodPaste ●  Guest: Sara Markley Webster, MD Sponsor: Locumstory If you would like to learn more about locums visit locumstory.com Sponsor: Pattern Visit patternlife.com/curbsiders to get a free disability insurance quote. Full Transcript HERE
12/19/20221 hour, 20 minutes, 43 seconds
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#371 Prostate Cancer: Screening, Advanced Testing, and Survivorship

Navigating guidelines, parsing through the PSA, Survivorship, & More! Become a pro when addressing prostate cancer! We tackle the nuances surrounding screening for this all-to-common cancer and discuss important considerations in survivorship with our guest Dr. Petar Bajic (Twitter: @PBajicMD, Instagram: @the.sexdoc) of Cleveland Clinic! You’re IN for a good time listening to this episode! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments ●      Intro, disclaimer, guest bio ●      Guest one-liner ●      Case from Kashlak ●      Epidemiology of Prostate Cancer ●      Screening Basics ●      What is the PSA? ●      Next Steps After Elevated PSA ●      Thresholds and techniques for biopsy ●      Free PSA, Other testing modalities, Prostate MRI ●      Active Surveillance Nuts and Bolts ●      Survivorship ●      Take home points, Outro Credits ●      Producer,Writer, Show Notes,  Infographic, Cover Art: Beth Garbitelli MD ●      Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli MD ●      Reviewer: Sai S Achi, MD MBA ●      Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●      Technical Production: PodPaste ●      Guest: Dr. Petar Bajic MD Sponsor: Better Help  Learn more and save 10% off your first month ast betterhelp.com/curb Sponsor: Birch Living  Birch is giving $400 off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Hello Fresh Go to hellofresh.com/curb18 and use code curb18 for 18 free meals plus free shipping.  Sponsor: Pattern Life Visit patternlife.com/curbsiders to request your free physician disability insurance quote. Full Transcript HERE
12/12/20221 hour, 2 minutes, 49 seconds
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#370 Parkinson’s Disease for Primary Care with Dr. Albert Hung

 Master the ins-and-outs of Parkinson’s Disease! We’re joined by Dr. Albert Hung, who teaches us pearls for the initial history and physical exam in a patient with undiagnosed Parkinson’s, a framework for management of early and advanced motor symptoms, tips for treating autonomic symptoms and cognitive / psychiatric features, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Initial history in a patient with undiagnosed Parkinson’s “Pre-motor” symptoms of Parkinson’s disease Physical exam in Parkinson’s disease Drug-induced Parkinsonism “Red flags” suggesting atypical parkinsonian syndromes Role of imaging in diagnosis Typical discussion with patient at initial diagnosis Initial management of motor symptoms Management of autonomic symptoms Management of advanced motor symptoms Management of cognitive and psychiatric symptoms Outro Credits Producer, Writer, Show Notes, and Infographic: Malini Gandhi Cover Art: Kate Grant  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Albert Hung MD, PhD Full transcript HERE
12/5/20221 hour, 16 minutes, 58 seconds
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#369 Hand, Foot, Wrist and Ankle Pain, Myositis and Myopathy: A Rapid Review (TFTC)

Recap and review the top pearls from recent episodes #339 Hand and Wrist Pain, #348 Foot and Ankle Pain,  and #351 Myopathy and Myositis with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #339, #348 and #351! Episodes | Subscribe | Spotify | Swag! | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Hand and Wrist pain: CMC joint arthritis, tenosynovitis, carpal tunnel syndrome, trigger finger Foot and Ankle pain: Ankle sprains, Achilles tendon injuries, Posterior tibial tendon dysfunction Myopathy and Myositis pearls Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Full transcript HERE
11/30/202232 minutes, 34 seconds
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#368 Back Pain Update with Dr. Austin Baraki

A Rational Approach: Who to Image, How to Treat, and More! Back pain is one of the most common concerns our patients bring to us in the outpatient setting.  It’s a lot more complicated than rest, ice, and NSAIDs!  Fortunately, we have pain expert, strength coach, and academic internist Dr. Austin Baraki (Austin Baraki, MD (@AustinBaraki) / Twitter) to help us develop a comprehensive, patient centered approach to help our patients manage their pain and lead healthier lives. Take control of your patients’ back pain!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak Introduction to Back Pain Eliciting the Patient’s Story Risk Stratification, Intro to Red Flags,  and and the STarT Back Tool  The Importance of Language and Patient-Centered Outcomes A Deeper Dive into Red Flags Setting Expectations for Care Therapeutics for Back Pain - Does anything work? The Exercise Prescription Credits Producers: Isabel Valdez, PA-C & Cyrus Askin, MD  Writer, Cover Art and Infographics:  Isabel Valdez, PA-C Show Notes: Cyrus Askin, MD Hosts: Matthew Watto MD, FACP;  Isabel Valdez, PA-C Reviewer: Molly Heublein, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Austin Baraki, MD Sponsor: Grammarly  Go to grammarly.com/CURB to sign up for a free account! And when you’re ready to upgrade to Grammarly Premium, get 20% off. Full transcript HERE
11/28/20221 hour, 25 minutes, 59 seconds
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#367 Weekend Warriors, Fluids for Acute Pancreatitis, Colonoscopy Screening & Mortality, and SPRINT trial Revisited (Hotcakes)

Join us as we review recent practice-changing articles addressing the questions: Do weekend warriors experience a mortality benefit from exercise? Is an aggressive fluid strategy superior to a moderate strategy in acute pancreatitis? Does an invite for colonoscopy decrease colon cancer-related mortality? Did the benefits of intensive blood pressure control continue after the SPRINT trial ended? Fill your plate with a stack of hot tofurkey cakes! Featuring Drs. Era Kryzhanovskaya (@erakryzhmd), Nora Taranto (@norataranto), Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer Do weekend warriors experience a mortality benefit? Should you choose aggressive or moderate fluid resuscitation for acute pancreatitis? Does an invite for screening colonoscopy reduce colon cancer and CRC-related mortality? Did benefits from the SPRINT trial persist in observational follow up? Outro Credits Written and Hosted by: Era Kryzhanovskaya, MD, Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatral MD, MPH Technical Production: Pod Paste Sponsor: Better Help Visit betterhelp.com/curb to save 10% off your first month.  Sponsor: Birch Living  Go to birchliving.com/curb to get $400 off and 2 free eco-rest pillows.
11/21/202246 minutes, 40 seconds
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#366 Opioid Use Disorder and Acute Pain in the Hospitalized Patient

With Carolyn Chan MD and Shawn Cohen MD Conquer acute pain in the hospitalized patient with opioid use disorder! It’s challenging to treat opioid withdrawal and acute pain simultaneously. This episode features clinical pearls on prescribing methadone, buprenorphine, low-dose buprenorphine initiation, and how to incorporate opioids as part of multimodal pain treatment responsibly. We’re joined by The Curbsiders Addiction Medicine Podcast hosts, Drs. Carolyn Chan (@carolynachan) and Shawn Cohen (@shawncohen)! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Acute pain in the patient on buprenorphine maintenance Acute pain in the patient on methadone maintenance Acute pain in the patient with opioid withdrawal Standard buprenorphine initiation Methadone initiation Low dose buprenorphine initiation Take-home points Outro Credits Writer and Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP   Reviewer: Fatima Syed MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Carolyn Chan MD and Shawn Cohen MD Sponsor: ExpressVPN Visit expressvpn.com/curb to get and extra three months free.  Sponsor: Southern California Permanente Medical Group  Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684.  Full transcript HERE
11/14/20221 hour, 2 minutes, 38 seconds
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#365: Perioperative Medicine with Anesthesiologist Dr. Angela Selzer

We’ve Come a Long Way From Ether Learn how an anesthesiologist approaches perioperative medicine from how to choose the right type of anesthesia (general anesthesia vs regional anesthesia vs MAC), to preoperative risk assessment, and how to avoid anesthesia related complications. Our guest, anesthesiologist, Dr. Angela Selzer (Denver, CO) helps us explore high yield pearls regarding the practice of anesthesiology to empower the internal medicine clinician to deliver team-based, perioperative care. Claim Free CE credit for this episode through VCU Health CE at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Introduction to anesthesiology  Introduction to regional anesthesiology   Walk through what an anesthesiologist does in the operating room Ambulatory surgery center exclusions  Approach to preop assessments “Will it change management?” applied to anesthesiologists ASA Classes  Anesthesia complications Take Home Points; Outro; Bonus clip Credits Written and Produced by: Edison Jyang; Avital O’Glasser MD, FACP, SFHM Cover Art: Sarah Phoebe Roberts, MPH Infographic:  Avital O’Glasser MD, FACP, SFHM; Edison Jyang Show Notes: Avital O’Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Avital O’Glasser MD, FACP, SFHM Technical Production: Pod Paste  Reviewer: Sai S Achi, MD MBA Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Angela Selzer, MD Sponsor: Better Help Save 10% off your first month at BetterHelp.com/curb  Sponsor: Hello Fresh Go to HelloFresh.com/curb65 and use code curb65 for 65% off plus free shipping.  Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full transcript HERE
11/7/20221 hour, 2 minutes, 45 seconds
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#364 Screening for syphilis: A USPSTF Update with Dr. Katrina Donahue

We ran the numbers, and it’s still important! Should patients be screened for syphilis? If so, which ones? Dr. Katrina Donahue (USPSTF) talks us through this re-affirmation of the USPSTF syphilis screening guideline, including who might be high risk and how to screen them. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers: Elena Gibson, MD and Paul Williams MD, FACP Writer: Elena Gibson, MD Show notes: Paul Williams MD, FACP Infographic and Cover Art: Elena Gibson, MD Hosts: Paul Williams MD, FACP and Elena Gibson MD  Production team: Podpaste Guest: Katrina Donahue MD Full Transcript HERE
11/2/202217 minutes, 55 seconds
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#363 Afib: Rhythm Control, Catheter Ablation, Afib in the hospital, and Left Atrial Appendage Closure

Optimize and update your approach to atrial fibrillation (afib) as we discuss early rhythm control, antiarrhythmic drugs, TTE/cardioversion, afib ablation, new onset afib in the hospitalized patient, and left atrial appendage closure. Plus, we try to answer, Does afib burden matter? Our guest is cardiologist-electrophysiologist, Hugh Calkins MD, @hughcalkinsMD, Professor of Cardiology at Johns Hopkins, @hopkinsheart.  Sorry, but we won’t be offering CME for this episode. You can claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions An approach to new-onset afib in the office Rhythm control Lifestyle modification is a pillar of afib treatment Indications for hospitalization in afib More on rhythm control and when to pursue afib ablation Rhythm control in heart failure New onset afib in the hospitalized patient Does afib burden matter? Left atrial appendage closure  Watto and Paul recap what we’ve learned Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover art and Infographic by: Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP    Technical Production: PodPaste Guest: Hugh Calkins MD Sponsor: Grammarly Go to grammarly.com/curb to sign up for a free account. And when you’re ready to upgrade to Grammarly Premium, get 20% off.  Full transcript HERE
10/31/202253 minutes, 23 seconds
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#362 Migraine Headaches, Acute Hypoxemia: A rapid review (TFTC)

Recap and review the top pearls from recent episodes #341 Migraine Headaches Update and #350 Acute Hypoxemia with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #341 and #350! Show Segments Intro, disclaimer, guest bio Migraine Headaches Update An approach to Hypoxemia Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Full transcript HERE
10/26/202239 minutes, 54 seconds
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#361 Advanced Lipidology

Lipids Update 2022: Cardiovascular Risk Reduction and New Medications on the Horizon with Erin Michos, MD Show description:  Ready to take the next step in management of your patient with hyperlipidemia? Dr. Erin Michos (@erinmichos) returns to give us a lesson in Advanced Lipidology. She updates us on what new medications we can use for those difficult to treat lipids and what medications are on the horizon. Unfortunately, this episode will not be available for CME. You can claim free CME for other episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, Getting to know Dr. Erin Michos, Pick of the Week Patient Case, Digging into ASCVD Risk  Coronary artery calcium scoring - why it’s important What are “Risk Enhancing Factors”? Biomarker testing, what is the significance of Lip a and how can we use it to drive management? Introduction to PCSK9 inhibitors More than just statins - other LDL-lowering medications siRNAs, ASOs - Pelacarsen and more Apollo Trial regarding Pelacarsen Importance of Family History What to do if maxed out on a statin or statin intolerance - Ezetimibe, PCSK9 inhibitors, MAB therapies, and more Bempedoic Acid discussion Medication side effects Homozygous FH - approach to treatment, ANGPTL3 inhibitors Triglycerides discussion, icosapent ethyl, the REDUCE-IT trial Wrap-up and Take home points, Outtro Credits Producer and written by: Christopher Chiu MD, FACP, FAAP Show Notes: James Antaki MD Infographic: Edison Jyang Cover Art: Kate Grant MBChB, DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Erin Michos MD, MHS Sponsor: Birch Living Birch is giving $400 off all mattresses and 2 free eco-rest pillows at BirchLiving.com/curb.  Full transcript HERE
10/24/20221 hour, 18 minutes, 28 seconds
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#360 Disease-Modifying Nutrition with Dr. Michelle McMacken

The treatment your patients need but may not be getting! Take a bite out of our latest episode featuring guest expert Dr. Michelle McMacken (@DrMcMacken) and learn how you can help your patients effectively and sustainably reap the health benefits of improved nutrition. Discover the enormous evidence base for nutritional recommendations, develop scripts to engage patients, and update your CVD, T2DM, and hyperlipidemia treatment plans to meaningfully incorporate nutrition. Get your truffle-hunting outfit on, it’s time to go foraging for some tasty knowledge food!  Show Segments Intro, disclaimer, guest bio Guest one-liner, favorite advice Case from Kashlak; definitions “Evidence-based nutrition” vs plant-based diet Unifying the guidelines for patient care Treating the skeptical patient Tailoring recommendations to patients’ needs  Treating the motivated patient Host questions Outro Credits Written and Produced by: Deep Shah MD Show Notes:  Sarah Phoebe Roberts, Deep Shah MD Infographic and Cover Art: Lyan Chang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deep Shah MD Reviewers:  Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Michelle McMacken MD, FACP, DipABLM Sponsor: BetterHelp Visit BetterHelp.com/curb today to get 10% off your first month. Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Super foods handout  Full transcript HERE
10/17/20221 hour, 11 minutes, 1 second
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#359 Monkeypox with Dr. Boghuma Titanji

Master the latest knowledge on the ongoing monkeypox outbreak with Dr. Boghuma Titanji (@Boghuma)! Learn how to recognize monkeypox in the clinic, how to test for monkeypox, how to approach management (including options for antiviral agents), and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak History of monkeypox - past and current outbreaks Transmission of monkeypox Risk factors for monkeypox Clinical presentation of monkeypox Testing for monkeypox Management of monkeypox: supportive care and antivirals Monkeypox in patients with HIV Monkeypox in pregnancy Monkeypox vaccines Outro Credits Producer and Writer: Paul Williams MD, FACP Show Notes: Malini Gandhi  Infographic: Sarah Phoebe Roberts Cover Art: Kate Grant MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Boghuma Titanji MD Sponsor: Green Chef Go to GreenChef.com/curb135 and use code curb135 to get $135 off across five boxes and your first box ships free.  Sponsor: Medmastery Go to medmastery.com/curbsiders to claim your discount. Full Transcript HERE
10/10/20221 hour, 20 minutes, 1 second
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#358 Oncologic Emergencies with Dr. Aditi Singh

From Cord Compression to Tumor Lysis Syndrome Do you freak out over oncologic emergencies like cord compression or tumor lysis syndrome? Join Dr. Aditi Singh (University of Pennsylvania, Abramson Cancer Center, @AditiSinghMD) for this comprehensive conversation on six commonly encountered oncologic emergencies we see in the hospital! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Cord Compression SVC Syndrome Malignant Obstruction Tumor Lysis Syndrome Blast Crisis Outro Credits Producer, Writer, Hosts: Meredith Trubitt, MD MPH; Monee Amin, MD Infographic and Cover Art: Caroline Coleman Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Aditi Singh, MD Sponsor: BetterHelp Visit BetterHelp.com/curb today to get 10% off your first month.   Sponsor: Indeed  Visit Indeed.com/internalmedicine to start hiring now.   Sponsor: Hello Fresh   Go to HelloFresh.com/curb65 and use code curb65 for 65% off plus free shipping.    Full Transcript HERE
10/3/20221 hour, 24 minutes, 22 seconds
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#357 Hotcakes: Ultra-short Antibiotics for Pneumonia, Acetazolamide for CHF, Psilocybin for AUD, and Asymptomatic Kidney Stone Removal

Find out if ultra-short course (two days) antibiotics work for pneumonia, if acetazolamide improves diuretic efficiency in acute decompensated heart failure, should we prescribe psilocybin (magic mushrooms) to treat alcohol use disorder, and if removal of asymptomatic kidney stones decreases the incidence of future events! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto) catch up on recent practice-changing articles and guidelines!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer Ultra-short Antibiotics for Pneumonia,  Acetazolamide for acute heart failure exacerbations,  Psilocybin for AUD, Asymptomatic Kidney Stone Removal Outro Credits Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatral MD, MPH Technical Production: Pod Paste Full transcript HERE
9/28/202240 minutes, 34 seconds
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#356 Chronic Obstructive Pulmonary Disease (COPD) Update with Dr. Antonio Anzueto

Brush up on your COPD skills and learn some new tips for diagnosis and management of this common respiratory condition from our expert Dr. Antonio Anzueto (University of Texas San Antonio).  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Epidemiology Diagnosis Workup Characterization of disease Treatment Outro Credits Writer and Producer: Cyrus Askin, MD Show Notes: Deborah Gorth MD, PhD Infographic: Kate Grant MD Cover Art: Kate Grant MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Antonio Anzueto, MD Sponsor: Wild Grain Start your subscription at Wildgrain.com/curb and get $30 off your first box plus free croissants in every box. Sponsor: Grammarly Go to grammarly.com/curb to sign up for a free account and get 20% off when you upgrade to Grammarly Premium. Full Transcript HERE
9/26/20221 hour, 18 minutes, 55 seconds
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#355 GI Bleed with Dr. Tanvi Dhere

Upper and Lower GI Bleed Diagnosis and Management Handle the gush of upper and lower GI bleeds with ease thanks to Dr. Tanvi Dhere (@DhereMdEmory)! Learn diagnosis, initial management as well as post-procedure management including when to resume anticoagulation and antithrombotic therapy. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Upper GI bleed Labs, Stool Studies Initial Management of GI bleed Endoscopy Post-procedure management Lower GI bleed Colonoscopy Imaging/Interventional Radiology Outro Credits Producers and Writers: Meredith Trubitt MD, MPH; Monee Amin MD Show Notes:  Monee Amin, MD Infographics and Cover Art: Caroline Coleman, MD Hosts: Meredith Trubitt MD, MPH; Monee Amin MD   Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Tanvi Dhere, MD Sponsor: Birch Birch is giving $400 off all mattresses and 2 free eco-resy pillows at BirchLiving.com/curb Sponsor: BetterHelp Visit BetterHelp.com/curb to get 10% off your first month. Sponsor: Medmastery Go to medmastery.com/curbsiders to claim a discount on any of your subscriptions. Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Full Transcript HERE
9/19/20221 hour, 8 minutes, 25 seconds
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#354 Curbsiders Women in Medicine: Top 5 Challenges Faced by Women of Color in Academic Medicine

We’re back with another women in medicine episode– this time Shreya and Leah interview their she-ro Dr. Kemi Doll, career coach extraordinaire to women of color in academic medicine. She is breaking down the biggest challenges she’s seen her clients face and how to tackle them!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Dr. Doll’s journey into coaching women of color in academic medicine Top 5 challenges faced by women of color in academic medicine Solutions to the challenges Outro Credits Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD Infographic and Cover Art: Shreya Trivedi, MD Show Notes: Leah Witt, MD Hosts: Leah Witt, MD, Shreya Trivedi, MD and Matthew Watto MD, FACP Associate Editor: Emi Okamoto, MD Showrunners: Leah Witt, MD and Shreya Trivedi, MD Technical Production: PodPaste Guest: Kemi Doll, MD Full transcript HERE
9/14/20221 hour, 12 minutes, 21 seconds
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#353 Colon Polyps

Polyps, polypectomy & surveillance with Dr. Jennifer Maranki Learn how to recommend a good bowel prep, read colonoscopy reports, and review recommended polyp surveillance with Dr. Jennifer Maranki, @jenmarankimd (Penn State Health) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; definitions Polyp definitions and categories  Bowel prep & colonoscopy quality Colorectal polyp surveillance  Potential complications  When to consider polyposis syndromes  Outro Credits Producer & Writer: Elena Gibson MD Show Notes: Elena Gibson MD Infographic & Cover Art: Kate Grant MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Jennifer Maranki MD Sponsor: ExpressVPN Secure your online Activity and  get three months free by visiting ExpressVPN.com/curb Sponsor: Green Chef Go to GreenChef.com/curb135 and use code Curb135 to get $135 off across five boxes and your first box ships free.  Full Transcript HERE
9/12/202255 minutes, 57 seconds
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REBOOT #49 Vertigo and Dizziness: How to Treat, Who to Send Home, and Who Might Have a Stroke

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, Getting to know our guest Clinical Case Why can’t patients describe their dizziness? Classifying dizziness The 3 vestibular syndrome buckets defined Episodic vestibular syndrome differential diagnosis Acute vestibular syndrome differential diagnosis Chronic vestibular syndrome differential diagnosis Challenges of medical history taking Approach to the acute vestibular syndrome/HINTS How to evaluate nystagmus How to perform the head impulse test (aka head thrust) How to perform “test of skew” (alternate cover testing) Recap of HINTS exam and discussion of MRI Signs and symptoms of cerebellar stroke Use of Dix-Hallpike for episodic vertigo What happens when you choose the wrong test Continuous versus triggered dizziness, or vertigo Meclizine use in BPPV How to cure horizontal canal BPPV Treatment for vestibular neuritis Treatment for Meniere’s disease Who benefits from vestibular rehab/exercises Dizziness and giddiness Take home points Outro Credits Produced and Written by: Cyrus Askin MD Show Notes: Matthew Watto MD Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP Guest: David Newman-Toker MD, PhD Sponsor: Better Help Visit BetterHelp.com/curb today to get 10% off your first month. Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you. Sponsor: Indeed  Visit Indeed.com/internalmedicine to start hiring now.
9/5/20221 hour, 16 minutes, 1 second
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#352 H. pylori and Obesity Medicine FAQ: A rapid review (TFTC)

Recap and review the top pearls from recent episodes #322 H. Pylori and #324 Obesity Medicine FAQ with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #322 and #324! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio H. pylori Obesity Medicine FAQ Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Full transcript HERE
8/31/202235 minutes, 25 seconds
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REBOOT #284 An Antibiotics Primer, with @IDdocAdi

On this Curbsiders classic, we discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)! This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! Original show notes here. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* How to approach antibiotics Choosing antibiotics / Framework Dr. Shah’s favorite antibiotics Pneumonia Diabetic Foot Infections Take-home points Outro Credits Produced and Written by: Nora Taranto MD Infographic, Cover Art, Show Notes: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com Reviewer: Victor Kovac MD Guest: Adi Shah MBBS Sponsor: Grammarly  Go to grammarly.com/CURB to sign up for a free account! And when you’re ready to upgrade to Grammarly Premium, get 20%.
8/28/202257 minutes, 32 seconds
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#351 Live! Foot and Ankle Pain with Dr. Joan Ritter

The Thrill of Victory and the Agony of the Feet Don’t fear foot pain!  Learn how to evaluate the painful foot and ankle, what needs imaging, and who needs rehab.  We are joined by Dr. Joan Ritter (Walter Reed National Military Medical Center) for a special live Curbsiders episode!   Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Relevant anatomy Ankle sprains Achilles tendon rupture and tendonitis Plantar fasciitis Posterior tibial tendon dysfunction Midfoot pain Morton’s neuroma Audience questions Outro Credits Writer and Producer: Paul Williams MD, FACP Show Notes and Infographic: Paul WIlliamsMD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Joan Ritter MD Sponsor: Birch Living Birch is giving $400 off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Wildgrain For a limited time, you can get $30 off the first box, plus free croissants in every box, when you go to wildgrain.com/curb to start your subscription.  Sponsor: Ochsner Health Visit ochsner.org/primarycareJobs to find out more about opportunities with with Ochsner Health.  Sponsor: Provider Solutions and Development Visit  info.psdconnect.org/curbsiders to see new job opportunities. Fully Transcript HERE 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. 
8/22/20221 hour, 6 minutes, 46 seconds
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#350 Rapid Response Series: Acute Hypoxemia

Diagnosing & Managing Acute Hypoxemia with Nick Mark MD Quick! Your patient is desaturating! Have no fear, for in this installment of our Rapid Response series we have recruited pulmonologist/intensivist extraordinaire, the great Dr. Nick Mark of ICU One Pager, to share with us all the pitfalls and pearls we need to have under our collective belt when it comes to understanding, managing, and considering the etiologies of acute hypoxemia!  Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; Definitions How does a pulse oximeter work? Clinical approach to hypoxemia The SIX causes of hypoxemia Delivering supplemental oxygen  Credits Written and Produced by: Cyrus Askin MD & Edison Jyang MS4 Infographic and Cover Art: Edison Jyang MS4 Show Notes: Cyrus Askin, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste  Guest: Nick Mark MD Sponsor: Indeed Start hiring now with a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Offer good for a limited time.    Sponsor: Betterhelp Listeners get 10% off their first monmouth at BetterHelp.com/Curb Sponsor: Ten Thousand Go to tenthousand.cc/curb to get 10% off your purchase. Sponsor: Medmastery Listeners can claim a discount at medmastery.com/curbsiders.. Full Transcript HERE 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. 
8/15/20221 hour, 14 minutes, 10 seconds
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#349 Hotcakes: Tirzepatide for weight loss, Personalized Antidepressants, Seasonal Edema, Nirmatrelvir for low-risk COVID-19

Find out how tirzepatide might revolutionize weight loss, pharmacogenomics might improve antidepressant prescribing, seasonal edema affects Google searches, and whether nirmatrelvir/ritonavir helps standard-risk patients with COVID-19, and patient-centered recommendations for inpatient care from SHM/Choosing Wisely! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, Picks of the Week Case from Kashlak; Definitions Tirzepatide for weight loss Pharmacogenomics for personalized antidepressants Seasonal Edema Nirmatrelvir/ritonavir for standard-risk COVID-19 Hospital Medicine Choosing Wisely recommendations Outro Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatral MD, MPH Technical Production: Pod Paste Sponsor: Medmastery Visit medmastery.com/curbsiders to claim a discount on any subscription.  Sponsor: Green Chef Go to GreenChef.com/curb135 and use curb135 to get $135 off across 5 boxes and your first box shipped free.  Sponsor: South California Permanente Medical Group Visit scpmgphysiciancareers.com or call (866) 449-1684 to apply to join SCPMG as an Outpatient Internal Medicine Physician. Full Transcript HERE 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. 
8/8/202249 minutes, 42 seconds
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#348 Myositis and Myopathy, LIVE!

Learn to recognize myositis and myopathy (aka the idiopathic inflammatory myopathies), perform the appropriate initial testing, whether or not statins and exercise are safe to continue, and how to partner with our subspecialist colleagues to treat these patients in primary care.  Recorded LIVE at Johns Hopkins, we’re joined by Dr. Lisa Christopher-Stine, @DrLisaCS of @HopkinsMedicine, a rheumatologist and leading expert on myositis and myopathy!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak History and Exam Workup for suspected myositis Cancer screening Safety of statin use and exercise Our role in primary care Audience Questions Outro Credits Written and Produced by: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art and Infographic: Andréa Perdigão Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Technical Production: Pod Paste Guest: Lisa Christopher-Stine MD, MPH Sponsor: Grammarly Go to grammarly.com/CURB to sign up for a free account and 20% off when you upgrade to Grammarly Premium. Sponsor: Betterhelp Visit BetterHelp.com/Curb to get 10% off your first month. Sponsor: Wildgrain Sign up at Wildgrain.com/CURB or use CURB at the checkout to get $30 off your first box plus free croissants in every box. Full Transcript HERE 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. 
8/1/20221 hour, 1 minute, 54 seconds
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#347 USPSTF Update: Aspirin for Primary Prevention of CVD

USPSTF Update with Dr. John Wong Review the updated 2022 United States Preventive Task Force (USPSTF) guidelines on aspirin use to prevent cardiovascular disease (CVD) with Dr. John Wong. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer & Writer: Elena Gibson MD Show Notes: Elena Gibson MD  Cover Art & Infographic: Elena Gibson MD  Hosts: Paul Williams MD, FACP; Elena Gibson MD   Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: John Wong, MD  Sponsor: Medmastery Visit medmastery.com/curbsiders to receive a discount.  Full Transcript HERE
7/27/202233 minutes, 38 seconds
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#346 Meningitis

There’s nothing that gets a hospitalist more anxious and excited at the same time than a case of suspected meningitis. In this episode, we learn that if the thought crosses our mind, a lumbar puncture is almost certainly indicated. Our guest, Dr. Payal Patel, helps us with the balancing act that is diagnosing and managing meningitis! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; history and physical Initial workup for meningitis Treatment choices and duration Transitions of Care Credits Written and Produced by: Monee Amin MD, Meredith Trubitt MD, MPH Infographic and Cover Art: Caroline Coleman, MD Show Notes: Monee Amin, MD Hosts: Matthew Watto MD, FACP; Monee amin,, MD Reviewer: Rahul Ganatra, MD MPH Executive Producer: Karly Loy Showrunner: Matthew Watto MD, FACP Editor: podpaste Guest: Payal Patel, MD Sponsor: Indeed  Visit Indeed.com/internalmedicine to start hiring now.  Sponsor: Birch  Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb.  Sponsor: Green Chef  Go to greenchef.com/curb135 and use code curb135 to get $135 off across five boxes and your first box shipped for free. Full Transcript HERE 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. 
7/25/202259 minutes, 17 seconds
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#345 Vitamin and Mineral supplementation: A USPSTF Update with Dr. Michael Barry

Can vitamins prevent CVD and cancer? We kind of don’t have the answer! Is vitamin and mineral supplementation safe? Effective? Listen as our esteemed guest Dr. Michael Barry talks to us about the new United States Preventive Services Task Force recommendation regarding the role of vitamin and mineral supplementation in preventing cardiovascular disease and cancer. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers: Paul Williams MD, FACP and Elena Gibson, MD Writer: Paul Williams MD, FACP Show notes: Paul Williams MD, FACP Infographic and Cover Art: Elena Gibson, MD Hosts: Paul Williams MD, FACP and Elena Gibson MD  Production team: Podpaste Guest: Michael Barry MD Full Transcript HERE
7/20/202221 minutes, 16 seconds
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REBOOT #191 Lipids and Cardiovascular Risk Reduction with Erin Michos MD

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”! Get the original show notes here! Prior lipid episodes:  #37 Lipids, PCSK9, and ezetimibe: Lower is better. #10 Cholesterol, lipids, statins, fish oil. Become a Master Lipidologist. Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro Getting to know Dr. Erin Michos Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel Digging into ASCVD Risk Calculator Who should get 10 year ASCVD Risk assessment and what are the categories? How Dr. Michos discusses healthy lifestyle and “Primordial Prevention” What are “Risk Enhancing Factors”? Who should get biomarker testing vs CAC scoring? How Dr. Michos discusses statin therapy with her patients How to address risks of side effects Primary vs Secondary Prevention “What should my cholesterol be?” How often to follow-up labs? Differences between stain intensity How to manage side effects PCSK9 inhibitor discussion Aspirin, Fibrates and Icosapent Ethyl High Risk vs Stable ASCVD Take home points and the future Outro Credits Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli MD Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA Infographic: Beth “Garbs” Garbitelli MD 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: Better Help Visit BetterHelp.com/curb to 10% off your first month. Sponsor: Green Chef Go to GreenChef.com/curb135 and use code curb135 to get $135 off across five boxes and your first box ships free. Sponsor: Medmastery Listeners of this show can claim a 15% lifetime discount on any of their subscriptions. Just go to www.medmastery.com/curbsiders claim your discount and use the code curbsiders15.
7/18/20221 hour, 15 minutes, 4 seconds
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#344 Multiple Sclerosis with Dr. Annette Okai

Recognize multiple sclerosis in the clinic, learn how to diagnose it, and partner with your neurology colleagues to help care for these patients. Dr. Annette Okai expertly walks us through multiple sclerosis (North Texas Institute of Neurology & Headache).  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Patient presentation Physical exam Labs and imaging Pathophysiology Treatment Recognizing and treating relapses Outro Credits Written and Produced by: Deborah Gorth MD, PhD Infographic and Cover Art by: Deborah Gorth MD, PhD and Meryl Gorth Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Annette Okai MD Sponsor: Panacea Financial Visit panaceafinancial.com to learn how a bank for doctors, by doctors can help you.  Sponsor: Ten Thousand  Go to tenthousand.cc/curb to get 15% off Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Business only pay for quality applications matching the sponsored job description.  Sponsor: Medmastery Go to medmastery.com/curbsiders and use curbsiders15 to claim a 15% lifetime discount on any subscription.  Full Transcript HERE 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. 
7/11/20221 hour, 23 minutes, 40 seconds
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Addiction Medicine Series #1 Methadone for OUD w/Dr. Ruth Potee

Supercharge your knowledge on using methadone for the treatment of opioid use disorder! We discuss treatment goals, and how to start or continue methadone in the hospital.  We’re joined by guest Dr Ruth Potee, addiction medicine physician, full-scope family medicine doc, feminist, and expert composter.  She inspires us to be strong advocates for our patients.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio 0:46 Guest one-liner 3:23 Case from Kashlak 5:00 Methadone for OUD 5:47 Methadone Dosing 16:35 72 hour Rule 25:35 What is a methadone clinic  31:00 Methadone Checklist 35:44 QTc Prolongation and Methadone 39:15 Confirming Methadone Dose 43:17 Managing Missed Methadone doses: 45:20 Outro 50:40 Credits Producer, Writer: Kenneth Morford, MD Show Notes, Infographic, Cover Art: Zina Huxley-Reicher, MD Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD; Kenneth Morford, MD  Reviewer: Shawn Cohen MD Showrunner: Carolyn Chan, MD Technical Production: Castos Guest: Dr. Ruth Potee The Curbsiders Addiction Medicine are proud to partner with  The American College of Addiction Medicine (ACAAM) to bring you this mini-series.  ACAAM is the proud home for academic addiction medicine faculty and trainees and is dedicated to training and supporting the next generation of academic addiction medicine leaders. Visit their website at acaam.org to learn more about their organization. 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. 
7/7/202252 minutes, 22 seconds
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REBOOT #25 Master Hyperglycemia and DKA

Master the management of hyperglycemia, DKA, and learn to avoid common pitfalls. This episode is packed with clinical pearls from repeat guest, Endocrinologist, Dr. Jeffrey Colburn. Get the original show notes here! Prior diabetes episodes:  #330 & #331 Inpatient Diabetes with Dr. Dave Lieb #309 USPSTF Quick Update: Prediabetes & Type 2 Diabetes Screening #296 Diabetes FAQ with Dr. Jeff Colburn #243 Diabetes Triple Distilled #168 Diabetes Update with Jeff Colburn MD #96: Diabetes: A1C targets & ACP guidelines controversy #51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction Sorry, no CME for this reboot episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro Rapid fire questions Definitions and classification of diabetes DKA in type 2 diabetes? Pathophysiology of DKA Severe hyperglycemia mislabeled as DKA Which type 2 diabetics get DKA? The cardinal issue is dehydration Starvation ketosis vs DKA vs other How to handle severe hyperglycemia in outpatients Sick day management in type 1 diabetes Initial testing for diagnosis of DKA Subcutaneous or IV insulin for DKA Initial evaluation and management in ER Fluids and electrolyte management SGLT2 inhibitors and euglycemic DKA Credits Writer, Producer: Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Stuart Brigham MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Jeffrey Colburn MD, FACP, FACE Sponsor: Better Help Visit BetterHelp.com/curb to get 10% off your first month.  Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you. 
7/4/202250 minutes, 19 seconds
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#343 Hypertension FAQ and Cardiorenal: A rapid review (TFTC)

Recap and review the top pearls from recent episodes #321 Hypertension FAQ and #326 Cardiorenal Syndrome (NephMadness 2022) with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #321, and #326! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Hypertension FAQ Cardiorenal syndrome Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP TFTC Cover Art design: Edison Jyang Technical Production: Pod Paste Sponsor: Grammarly Go to grammarly.com/CURB to sign up for a free account! And when you’re ready to upgrade to Grammarly Premium, get 20% off for being my listener. Sponsor: Pattern Request your disability insurance quotes with Pattern at patternlife.com/curbsiders. Full Transcript HERE 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.
6/29/202243 minutes, 2 seconds
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#342 Checkpoint Inhibitors: The power, and adverse effects, of immunotherapy (ACP 2022)

With great power comes great immunogenicity.  Learn about the ins and outs of immunotherapy–its indications, its power, and its adverse effects–in this episode with Dr. Christian Cable, hematologist/oncologist and medical educator extraordinaire.  We learn a riveting history of immunotherapy and about how checkpoint inhibitors work, as well as the best practices for identifying downstream effects of checkpoint inhibitors and their immune system activation (it’s all about the -Itis!). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro What is Immunotherapy? A History Lesson Immune Checkpoint Inhibitors (ICIs)  Immune Related Adverse Events (irAEs)  Endocrine complications of checkpoint inhibitors Rheumatologic complications of checkpoint inhibitors  Considerations before starting checkpoint inhibitors (and what labs to check)  Diagnosing and Managing irAEs  Common post-irAE questions  New Kids on the Block: CAR-T  Take Home Points  Credits Written and Produced by: Nora Taranto MD Hosted by: Molly Heublein MD; Nora Taranto MD; Paul Williams MD, FACP   Guests: Christian Cable MD  Show Notes: Nora Taranto MD  Cover Art: Andrea Perdigão Infographics: Andrea Perdigão Reviewer: Emi Okamoto MD, FACP  Production team: Pod Paste Sponsor: Southern California Permanente Medical Group Learn more or apply at scpmgphysiciancareers.com Sponsor: Locumstory Visit locumstory.com to learn more about locums. Full transcript HERE 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
6/27/202254 minutes, 36 seconds
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#341: Headache Update: Making Migraines Less Painful with Dr. Kevin Weber

Dr. Kevin Weber @KwebMD (Ohio State University Wexner Medical School) takes the pain out of headache management!  Have the confidence to prescribe new CGRP-antagonists and ditans for migraine prevention and acute relief.  We also dive deep into when to order imaging and alternatives like infusions and devices.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak Definitions Imaging for headaches Labs Headache types Acute Migraine Treatment Ditans Anti-cgrp medications Prophylactic Migraine Treatment CGRP antagonists Devices Take home points Outro Credits Producer, writer, and show notes: Isabel Valdez PA-C Infographic: Edison Jyang Cover Art: Chris Chiu MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Chris Chiu MD    Reviewer: Molly Heublein MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Dr. Kevin Weber Sponsor: Better Help Go to betterhelp.com/curb to get 10% off your first month.  Sponsor: Birch Living Birch is giving $200 off all mattresses and 2 free eco-rest pillows at birchliving.com/curb Sponsor: Indeed Sign up at indeed.com/internalmedicine now and get $75 credit toward your first sponsored job. Sponsor: Locumstory Visit locumstory.com to learn more about locums.  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. 
6/20/20221 hour, 14 minutes, 51 seconds
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#340 Gallbladder Disease

Help your patients navigate gallbladder disease, including asymptomatic stones, incidental polyps, and uncomplicated cholecystitis. Dr. Rahul Pannala (@RahulPannala) talks us through how to diagnose biliary colic, what imaging to order, and what to anticipate for potential post-cholecystectomy complications (eg persistent pain or diarrhea). Feel confident in sending the right patients for cholecystectomy!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak; Definitions Typical biliary pain Imaging for cholelithiasis Treatment for symptomatic gallstones Post-cholecystectomy diarrhea and pain Inpatient management of cholecystitis Advanced imaging- HIDA scans and MRCP Incidental gallbladder findings Outro Credits Producer, Writer, Show Notes: Molly Heublein, MD Infographic/Cover Art: Lyan Chang Hosts: Molly Heublein, MD, Nora Taranto, MD; Paul Williams MD, FACP    Associate Editor: Leah Witt, MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Audio Engineer for this live episode: Chris Chiu, MD Guest: Rahul Pannala, MD Sponsor: Ten Thousand Go to tenthousand.cc/CURB to get 15% off. Sponsor: Blueland You can get 20% off your first order when you go to Blueland.com/CURB Sponsor: Locumstory Visit Locumstory.com to find out more about locum tenens. 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. 
6/13/202244 minutes, 12 seconds
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#339 Hand and Wrist Pain with Dr. Ted Parks

Join us as Curbsiders favorite Dr. Ted Parks gives us a hand with the diagnosis and management of common causes of hand and wrist pain. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments  Intro, disclaimer, guest bio Guest one-liner Anatomy review: the thumb is the short one Pathophysiology of De Quervain’s tenosynovitis Physical examination for thumb pain Management of DeQuervain’s and CMC arthritis Pathophysiology of trigger finger Management of trigger finger Pathophysiology of carpal tunnel syndrome Physical examination for carpal tunnel syndrome Carpal tunnel syndrome management Outro Credits Writer and Producer: Paul Williams, MD Infographic and Cover Art: Paul Williams, MD Hosts: Paul Williams MD and Molly Heublein, MD Editor: Emi Okamoto, MD (written materials) Guest: Ted Parks, MD Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you. Sponsor: Better Help Visit betterhelp.com/curb to get 10% off your first month. Sponsor:  Provider Solutions & Development  Visit info.psdconnect.org/curbsiders to start a conversation with and with an expert recruitment advisor. Sponsor: Indeed Sign up at indeed.com/internalmedicine now and get a $75 credit toward your first sponsored job.  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. 
6/6/202247 minutes, 42 seconds
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#338 LIVE! Medical Cannabis: Is it still dope?

It’s high time we revisit the benefits and harms Master the ins-and-outs of medical cannabis! Dr. Julia Arnsten (@DrArnsten) will lead us through the initial evaluation of a patient interested in medical cannabis, summarize the state of evidence for the benefits and harms, lay out a schema for dosing and formulations, provide pearls on how to counsel patients, and more! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Definitions and terminology A brief history of medical cannabis Case from Kashlak History to obtain for a patient interested in medical cannabis Medical cannabis dosing and formulations Conditions for which the evidence supports considering medical cannabis Risks of medical cannabis Disparities in access to medical cannabis Does medical cannabis reduce opioid use? Outro Credits Producer and Writer: Matthew Watto MD, FACP Show Notes, Infographic, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt MD Showrunner: Matthew Watto MD, FACP Production Team: PodPaste Guest: Julia Arnsten MD, MPH Sponsor: Grammarly Visit grammarly.com/CURB and get 20% off when you upgrade to Grammarly Premium.  Sponsor: Medmastery Visit medmastery.com/curbsiders to claim a 15% lifetime discount on and of their subscriptions. Sponsor: Locumstory Visit Locumstory.com to learn more about locums Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping 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. 
5/30/202253 minutes, 12 seconds
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#337 Palpitations, Erectile Dysfunction: A rapid review (TFTC)

Recap and review the top pearls from recent episodes #320 Palpitations and #317 Erectile Dysfunction with Watto and Paul. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Palpitations: Diagnosis, Cardiac Monitors, Treatment, Patient Counseling Erectile Dysfunction Outro Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP Cover Art: Edison Jyang Technical Production: Pod Paste Sponsor: Pattern Get disability insurance quotes with Pattern at patternlife.com/curbsiders 
5/25/202229 minutes, 15 seconds
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#336 Updates in Addiction Medicine: Live from SGIM

Learn from an expert panel in addiction medicine about a potpourri of fascinating topics, with updated data to guide clinical decision-making.  We picked the brains of physicians Stefan Kertesz, Ximena Levander, Kenny Morford, and Katherine Mullins to learn about the latest updates in opioid tapering (don’t do it if there isn’t a good reason!), how to define recovery in alcohol use disorder,  different options to treat methamphetamine use disorder, and Hepatitis C treatment in patients with active IV drug use.  And there’s so much more, that we’re following this with a whole series in Addiction Medicine, set to come out in early July 2022! Visit curbsiders.vcuhealth.org to claim CME credit for this episode.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro Tapering long-term opioids Perioperative buprenorphine management Defining recovery in alcohol use disorder The Fourth Wave Treatment for methamphetamine use disorder E-cigarettes for smoking cessation Disparities in substance use disorder prevalence and treatment  Advocacy opportunities Outro Credits Written and Produced by: Nora Taranto MD Hosted by: Nora Taranto MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Guests: Stefan Kertesz MD MSc; Ximena Levander MD MCR FACP; Kenneth Morford MD FASAM; Katherine Mullins MD  Show Notes, Cover Art, Infographics: Nora Taranto MD  Reviewer: Molly Heublein MD  Production team: Pod Paste Sponsor: Birch by Helix Visit birchliving.com/curb to get $200 off ALL mattresses and 2 free eco-rest pillows.  Sponsor: Blueland Visit Blueland.com/curb to get 20% off your first order. CME Partner: 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. 
5/23/202248 minutes, 2 seconds
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#335 Generalized Anxiety Disorder

Join us as we de-mystify the diagnosis, talk treatment strategies, parse through pharmaceutical options, and figure out follow-up in Generalized Anxiety Disorder with Dr. Dheepa Sekar (@DheepaSekarMD)! Anxiety disorders are one of the most common mental health concerns in our country and this episode will give you the tools to address it in clinic!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Differential diagnosis for GAD Counseling about diagnosis Initial guidance on first-line management, apps for mindfulness Prescribing basics, SSRI and SNRI considerations Bridging with hydroxyzine and buspirone Monitoring treatment response Managing side effects Tapering medication Alternative agents, atypical antipsychotics, and benzos Take Home points, Outro Credits Producer, Scriptwriter, Show Notes, Infographic/Cover Art: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli    Reviewer: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Production Team: PodPaste Guest: Dheepa Sekar MD Sponsor: Indeed Visit indeed.com/internalmedicine to claim you $75 credit now. Sponsor: Locumstory Visit Locumstory.com to learn more about locums Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors can help you.   Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. CME Partner: 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. 
5/16/202254 minutes, 35 seconds
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#334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI)

Learn diagnostic and therapeutic management strategies for IBS, functional dyspepsia, and cyclic vomiting (aka disorders of gut brain interaction (DGBI))! It's like three episodes in one as we run through how to individualize evaluation and management for patients with functional dyspepsia, IBS, and cyclic vomiting. Topics: scripts for counseling patients, the pathophysiology of DGBI, which diagnostic tests are necessary, pharmacologic and nonpharmacologic options, and even hypnotherapy?! We’re joined again by the great Dr. Xiao Jing (Iris) Wang, (@IrisWangMD, Mayo Clinic) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions (6:20)  Definition of Disorders of the Gut-Brain Interaction (7:30-11:00) Functional Dyspepsia: diagnostic criteria, definitions (15:30-24:30), and treatments  (24:30-36:00) Irritable bowel disease: diagnostics (41:00), testing algorithm, and treatments (55:00) Cyclic Vomiting Syndrome and Cannabis Hyperemesis Syndrome: definitions, diagnosis, and management (1:11) Take home points Outro Credits Producer: Elena Gibson MD Writer:Andréa Perdigão, Elena Gibson Show Notes and Infographics: Andréa Perdigão Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Associate Editor: Leah Witt Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Xiao Jing (Iris) Wang MD Sponsor: Ten Thousand Go to tenthousand.cc/curb to receive 10% off. Sponsor: Pattern Visit patternlife.com/curbsiders to request a disability insurance quote. CME Partner: 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. 
5/9/20221 hour, 39 minutes, 6 seconds
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#333 Prescribing pearls, Periop Medicine, PMR, Gout, OSA, Nocturia, Food as Medicine, a new Obesity paradigm, and rethinking Afib! ACP #IM2022 Highlights

We recap the top pearls from ACP #IM2022 including important drug interactions/intolerance (acetaminophen, tramadol, ticagrelor, nirmatrelvir-ritonavir), perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS), recognizing PMR, when to initiate urate-lowering therapy in gout, glucocorticoid-induced osteoporosis, food as medicine, dietary potassium, OSA, nocturia, telemedicine and health equity, a new obesity medicine paradigm, advances in HIV/PrEP, and rethinking atrial fibrillation!  Note: Due to a rapid turnaround there is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro Tapering long-term opioids Physician Wellbeing Common drug interactions (acetaminophen, ticagrelor, tramadol, Nirmatrelvir-ritonavir) Perioperative medicine (bridging, DOAC reversal agents, dental procedures, MINS) Nocturia and OSA Food as Medicine Rheumatology (how to diagnose PMR, when to initiate ULT for gout and steroid-induced osteoporosis) Avi’s pearls on (diversity, telemedicine, telehealth, burnout) Obesity medicine (a new paradigm and a new medication) HIV in primary care (PrEP, long-acting injectable antiviral therapy) Atrial fibrillation Outro Credits Written, Produced, and Hosted by: Nora Taranto MD; Molly Heublein MD; Chris Chiu MD, FACP, FAAP; Avital O’Glasser MD, FACP; Alan Dow MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP   Show Notes: Matthew Watto MD, FACP Cover Art: Chris Chiu MD, FACP, FAAP Production team: Pod Paste Sponsor: Indeed Visit indeed.com/internalmedicine to claim you $75 credit now. Sponsor: Locumstory Visit Locumstory.com to learn more about locums
5/6/20221 hour, 1 minute, 49 seconds
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#332 Inpatient Covid Management with Dr. Nathan Erdmann

Join Dr. Nathan Erdmann (@NerdmannID, University of Alabama Birmingham) as he walks us through inpatient covid management from antivirals, immune modulators and anticoagulation.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Outpatient vs ER therapeutic options Considerations for labs to risk stratify  Antivirals Immunomodulators Anticoagulation Empiric Antibiotics Transitions of Care Take Home Points Outro Credits Producer: Monee Amin, MD Writers: Monee Amin, MD and Meredith Trubitt, MD Show Notes: Meredith Trubitt, MD Infographic and Cover Art: Monee Amin, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Rahul Ganatra, MD Showrunner: Matthew Watto MD, FACP Production Team: PodPaste Guest: Nathan Erdmann, MD Sponsor: Panacea Financial  Visit panaceafinancial.com today to learn how a bank for doctors, by doctors can help you.   Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. CME Partner: 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. 
5/2/20221 hour, 2 minutes, 9 seconds
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#331 Inpatient Diabetes Part 2: DKA, insulin drips, insulin pumps, and CGMs

More inpatient diabetes! In this part 2 of 2, we cover diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro  DKA and HHS - introduction and therapy overview Insulin drips, closing the gap and transitioning to a subcutaneous regimen Euglycemic DKA Pumps and glucose monitors Final take home points Outro Credits Producer: Adam Barelski MD, Cyrus Askin MD Writer: Adam Barelski MD Show Notes:  Cyrus Askin MD Infographic: Edison Jyang Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Adam Barelski MD Technical Production: Pod Paste Showrunner: Matthew Watto MD, FACP Content Editor: Emi Okamoto MD  Guest & Content Reviewer: David Lieb MD, FACE, FACP CME Partner: 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.  Sponsor: Bambee Visit bambee.com/curb for a free HR audit of your business. Sponsor: Grammarly Visit grammarly.com/curb for 20% off when you sign up
4/27/20221 hour, 1 minute, 1 second
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#330 Inpatient Diabetes Part 1: Insulin regimens, oral hypoglycemics, corrections scales and more!

Dominate inpatient diabetes! In this part 1 of 2, we discuss how to handle oral hypoglycemics, how to choose an initial insulin regimen, the use of correction scale insulin monotherapy, how to titrate insulin, how to use NPH for steroid-induced hyperglycemia (check out this Twitter thread on safe dosing), and how to reconcile diabetes meds at discharge! Stay tuned for part 2 (drops Wed April 27th) covering diabetic ketoacidosis (DKA), euglycemic DKA, how to handle insulin pumps in the hospital, continuous glucose monitors, and how to transition patients off an insulin drip! Our guest is Dr. Dave Lieb (@dclieb), an internist, endocrinologist and the endocrinology program director from Eastern Virginia Medical School.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro #1, disclaimer, guest bio Guest one-liner, Picks of the Week* Inpatient diabetes - a bird’s eye view and the goal(s) of therapy Management of outpatient diabetes medications Inpatient insulin - options and dosing Correctional insulin (“sliding scale”) A word on the “Diabetic Diet” Steroids and hyperglycemia Discharge pearls for the patient with diabetes Outro #1 Credits Producer: Adam Barelski MD, Cyrus Askin MD Writer: Adam Barelski MD Show Notes:  Cyrus Askin MD Infographic: Edison Jyang Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Adam Barelski MD Technical Production: Pod Paste Showrunner: Matthew Watto MD, FACP Content Editor: Emi Okamoto MD  Guest & Content Reviewer: David Lieb MD, FACE, FACP Sponsor: Bambee Visit bambee.com/curb for a free HR audit of your business. Sponsor: Grammarly Visit grammarly.com/curb for 20% off when you sign up CME Partner: VCU Health CE The Curbsiders partner 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. 
4/25/20221 hour, 20 minutes, 3 seconds
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#329 Curing Hepatitis C: A Primary Care Primer

DeLiver on the promise of elimination with Dr. Christian Ramers Let’s deLiver on the promise of hepatitis C elimination! Dr. Christian Ramers @cramersmd brings hepatitis C diagnosis, care, and cure into the primary care clinic with a simplified algorithm for workup and treatment. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Who should we screen? Patient Workup  Preparing for treatment Treating hepatitis C Opportunities for integration of care Outro Credits Producer, writer, co-host: Emi Okamoto MD, FACP Show Notes, infographic, cover art: Lyan Chang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Christian Ramers MD, MPH, FIDSA Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. Sponsor: MedMastery Visit www.medmastery.com/curbsiders for a 15% lifetime discount! Sponsor: Birch Matresses Visit birchliving.com/curb to claim your $200 off any Birch Mattress plus two free pillows Sponsor: Indeed Visit Indeed.com/internalmedicine and get a $75 credit to sponsor your first job CME Partner: 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.  Update Description
4/18/20221 hour, 17 minutes, 20 seconds
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#328 Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more! Highlights from #SGIM22

Fill up with delicious practice-changing knowledge food from #SGIM22 as The Curbsiders team discusses breast cancer survivorship, sexual dysfunction, How climate change will affect health, Are PT consults necessary in the hospital?, Do we need antibiotics for aspiration events?, bias in note writing, Are plant-based meats a healthy?, complications after breast implantation, how to get breast reduction approved, doxycycline for chlamydia, the metronidazole and alcohol myth, pearls for clinician-educators, telehealth, TEACHIM.org, CGMs help lower a1c, PT for rotator cuff disease, Is it safe to taper antidepressants? and how to treat methamphetamine use disorder!  Note: There is no CME for this episode, but claim CME for prior episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Hosted by: Nora Taranto MD, Beth Garbitelli (about to be an MD!), Era Kryzhanovskaya MD, Justin Berk MD, MPH, MBA, Shreya Trivedi MD, Chris Chiu MD, Paul Williams MD, Matthew Watto MD Show Notes and Cover Art: Matthew Watto MD, FACP Showrunner: Matthew Watto MD, FACP Technical Production: Pod Paste Show Segments Intro A few ambulatory teaching models include the One Minute Preceptor, SNAPS (summarize, narrow, analyze, probe, plan, and select), PIPP (precepting in the presence of the patient) [see Community Preceptor Toolbox] Ikigai is a Japanese term indicating a motivational force or reason for living. It is associated with decreased mortality [Tanno, 2009]. Explore your ikigai here (PositivePsychology.com). Listening to podcasts while driving does not affect knowledge retention (Gottleib et al. 2021) Treatment of Hot flashes: Avoid paroxetine, fluoxetine, and sertraline in breast cancers survivors taking tamoxifen. Instead use venlafaxine (or another SNRI), citalopram, or escitalopram. Gabapentin given at bedtime is also an option.  (Clinical Update 2019: Tamoxifen and Antidepressants) Distress in patients with cancer can be measured using the NCCN screening tool [NCCN Distress Thermometer] Don’t forget to ask for a Cancer Survivorship Plan from oncology [CDC Cancer Survivorship Care Plans] Ask about sexual dysfunction in cancer survivors. How will climate change impact our patient’s health? NIH framework; CH2OPD2 environmental screening tool [CH2OPD2 ]; and the 15 steps of climate communication. Use the AM-PAC score cutoff of >18 to avoid a PT consult in hospitalized patients (Martinez 2021).  Early antibiotics after an aspiration event do not improve outcomes (Aga 2021).  Biased language is more common in notes about Black patients (Beach 2021). Be thoughtful about what you write and role model good behavior. While plant-based meats are more eco-friendly than animal-sourced meats, they are heavily processed foods (van Vliet 2021) and may have high sodium. Silicone breast implant rupture can be insidious. Guidelines recommend screening with MRI after 6 years, then every 2-3 years (FDA 2020, More FDA info) (Note: FDA’s most recent guidance also recommends ultrasound as an alternative screening method, so always check with the patient's insurance about which modality will be covered) Document a trial of NSAIDs, physical therapy, attempted weight loss, and supportive bra usage before breast reduction surgery for macromastia.  Doxycycline is now first line for chlamydia rather than azithromycin [STI Treatment Guidelines Update], BUT the most effective treatment is the one your patient will take! Metronidazole does not cause a disulfiram-like reaction and is no longer recommended by the guidelines [STI Treatment Guidelines Update] More clinician-educator pearls from Era: Don’t be afraid to brand yourself! Network with like-minded individuals (e.g. interest groups).  BST mode: bite-sized teaching pearls can help reduce extrinsic load and improve retention [Manning, 2021] A guided discussion based on Scrubs episodes can improve resident wellness [Holtzclaw 2021] Chris recaps some posters (click links to see them on Twitter!): Telehealth disparities and tech equity (poster 1, poster 2); TeachIM.org (poster) Continuous glucose monitors can help lower a1c in patients on basal insulin [Martens 2021] A single session of PT improved shoulder pain. The benefits of steroid injections were limited to 8 weeks in the GRASP trial [Hopewell 2021] There is a high risk of recurrence after tapering antidepressants [Lewis 2021] Methamphetamine use disorder can be treated with IM naltrexone every 3 weeks, plus oral bupropion 450 mg daily [Trivedi 2021]. Limitations include cost and co-use of opioids.  Outro Sponsor: Masterworks Get started at masterworks.art/curbsiders.   Sponsor: Ten Thousand Get 15% off at tenthousand.cc/curb Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Blueland Get 20% off your first order at blueland.com/curb 
4/15/20221 hour, 20 minutes, 22 seconds
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#SGIM22 Recap is on it's way! - Teaser Trailer

We need a few days to process the highlights from #SGIM22 in Orlando, FL. We'll be dropping a DELUXE recap and highlights episode this Friday April 15, 2022 covering Updates in Hospital Medicine, Primary Care, Breast Health, Sexual Health, Addiction Medicine, Meded and more!
4/11/20221 minute, 3 seconds
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#327 Acute Pancreatitis

Learn what you really need to diagnose pancreatitis, when to use imaging sources and what is most important in management! Rapidly treating Acute Pancreatitis might change its course! We’re joined by Dr. Kaveh Sharzehi @sharzehi of Oregon Health & Science University (@OHSUNews). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bio Guest one-liner Case from Kashlak Risk factors for severe course Use of Scoring Systems  Requirements to make the diagnosis  Rational use of imaging  Initial management: fluids, analgesia, and nutrition When to use antibiotics  When to perform cholecystectomy  Most common complications and interventions  How to follow up in the outpatient setting  Credits Producer & Scriptwriters: Monee Amin MD and Meredith Trubitt MD Show Notes & Infographics: Andréa Perdigão  Cover Art: Monee Amin MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Molly Heublein MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Kaveh Sharzehi MD, MS Sponsor: BetterHelp Visit betterhelp.com/curb for 10% of your first month. Sponsor: MedMastery Visit www.medmastery.com/curbsiders for a 15% lifetime discount! CME Partner: 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. 
4/4/202258 minutes, 58 seconds
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REBOOT #151 Anaphylaxis

Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic…even when you inject your own thumb?! Original show notes here. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, infographic, and cover art: Emi Okamoto MD Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, Emi Okamoto MD Editor: Matthew Watto MD, FACP Guest: Olajumoke Fadugba MD Special thanks to Sarah Phoebe Roberts MPH for booking! Show Segments Intro and disclaimer Guest one-liner, book recommendation, advice to fellows and trainees Case of anaphylaxis with mucocutaneous and GI symptoms Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin) Vancomycin and non-IgE mediated reactions Common presentations of anaphylaxis and the three diagnostic criteria Biphasic reactions and predicting severity Counseling patients on the use of epinephrine Stuart’s thumb question Adjuvant medications: antihistamines and corticosteroids Are there any contraindications to epinephrine use? Use of tryptase levels when the diagnosis of anaphylaxis is uncertain Outro Sponsor Medmastery - Visit www.medmastery.com/curbsiders for a 15% lifetime discount! 
3/30/202240 minutes, 49 seconds
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REBOOT #145 Hepatorenal Syndrome

Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Justin Berk MD, Nora Taranto MD Infographic by: Alex M @nephroguy Host: Matthew Watto MD Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials) Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD Show Segments NephMadness Kidney Pun Contest Disclaimer Intro, guest one-liners Case of acute kidney injury in a patient with cirrhosis Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium) History and physical in cirrhosis and AKI Fluid choice Diuretic therapy in cirrhosis and volume overload Is a Renal Ultrasound useful in AKI? Recap: the initial approach to AKI in cirrhosis Therapeutic trials when volume status is uncertain Hepatorenal physiology revisited Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine Type 1 versus type 2 hepatorenal syndrome Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?! Diagnostic criteria or HRS NephMadness matchups including bile cast nephropathy Outro Sponsors  Grammarly. Visit grammarly.com/curb for 20% off. Panacea Financial. Visit panaceafinancial.com a bank for doctors, by doctors.
3/28/20221 hour, 8 minutes, 48 seconds
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REBOOT #146 Pain Meds in CKD

We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Justin Berk MD NephMadness Pain Region: Samantha Gelfand MD NephMadness Pun Contest produced by: Hannah R Abrams Cover art by: Kate Grant MBChB, Dip GUMed Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes) Guests:  Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD Show Segments Kidney Pun Disclaimer, intro and guest bios Guest one-liners Clinical Case and Pain Management Disclaimer Modalities for pain meds in ckd Opioids for pain and their metabolites Dave Juurlink reframes the question, “what is our real goal with pain management?” Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD Communicating meds that are contraindicated or relatively contraindicated in CKD Buprenorphine What about the WHO Pain Ladder for CKD? Should we use more cannabinoids? Ketamine? Dave Juurlink rants on Tramadol NSAIDS and CKD Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?! Estimating eGFR in CKD and AKI. Which equation is best? How would each of our experts treat this patient with CKD and knee pain Outro Sponsors:  Birch by Helix birchliving.com/curb for $200 off all mattresses and 2 free eco-rest pillows BetterHelp betterhelp.com/curb for 10% of your first month Indeed indeed.com/internalmedicine for a $75 sponsored job credit  Squarespace squarespace.com/curb offer code: CURB to save 10%
3/21/20221 hour, 6 minutes, 40 seconds
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#326 Cardiorenal Syndrome, Biomarkers, Diuretic Resistance (NephMadness 2022)

Lose your heart to NephMadness 2022! Dr. Joel Topf (@kidney_boy) and Dr. Sadiya Khan (@HeartDocSadiya) tackle the NephMadness 2022 Cardiorenal Syndrome region, leading us through the pathophysiology of cardiorenal syndrome, how to approach the creatinine “bump” with diuresis, managing patients with diuretic resistance, and more. This episode is part of our first ever NephMadness Pod Crawl, so check out the other podcasts, and fill out your NephMadness 2022 brackets! Credits Producer, Writer, Show Notes, Infographics: Malini Gandhi Cover Art:  Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Dr. Joel Topf MD, Dr. Sadiya Khan MD *Claim free CME for this episode at curbsiders.vcuhealth.org! *Available within 24 hours of release. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Show Segments Intro, disclaimer, guest bios Guest one-liners, Introduction to Nephmadness 2022 Case #1 from Kashlak: acute decompensated heart failure with elevated creatinine Definition and pathophysiology of cardiorenal syndrome Use of home ACE-is/ARBs and SGLT-2 inhibitors in cardiorenal syndrome Case #2 from Kashlak: the creatinine bump with diuresis Approach to the creatinine bump with diuresis Tips for the volume exam Interpreting cardiac biomarkers in patients with chronic kidney disease Case #3 from Kashlak: diuretic resistance Maximizing loop diuretic efficacy Sequential nephron blockade Use of hypertonic saline Outro NephMadness 2022 Pod Crawl Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast  Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/ Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered  Twitter: @thecurbsiders @TheCribsiders @NephJC_Podcast @drs_washington @upmynursinggame @medmyths Sponsor: ACP’s Internal Medicine Board Review The Greater Chicago course, beginning on May 23rd  through May 27th     or Washington, D.C., on July 11th through July 15th New registrants will receive 6 months of access to the course recordings. Visit acponline.org/imbr2022 to register or learn more. Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain. Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders  CME Partner: 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. 
3/14/202256 minutes, 35 seconds
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#325 Hotcakes: Fluid Wars revisited, Sleep & Weight Loss, Vitamin D, Pneumonia and HBV Vaccine Updates

Find out whether balanced solutions beat saline in the ICU (fluid wars revisited), how sleep affects weight loss and calorie intake, whether or not Vitamin D can prevent autoimmune disease, new guidelines for pneumonia and hepatitis B (HBV) vaccination, and the utility of ultrasound to measure JVP! Time to fill your plate with a fresh stack of hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto (@doctorwatto) catch us up on recent practice-changing articles and guidelines!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Reviewer: Matthew Watto, MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st. CME Partner: 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.  Show Segments Intro, picks of the week Fluid wars: balance solution vs saline Sleep and energy intake, weight loss Vitamin D to prevent autoimmune disease New ACIP guidelines for Pneumonia and Hepatitis B (HBV) vaccines Ultrasound for JVP Outro
3/7/202245 minutes, 34 seconds
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NephMadness 2022 Pod Crawl is coming!

Resuscitate your inner nephrology nerd with a bolus of kidney themed podcast episodes in the first annual NephMadness Pod Crawl featuring topics like cardiorenal syndrome, hemodialysis, chronic kidney disease (CKD), neonatal AKI, and inequalities in nephrology! The pod crawl starts Monday March 14, 2022 with The Curbsiders Cardiorenal episode and continues all week! See the schedule below, check out the other podcasts in the pod crawl, and fill out your brackets for NephMadness 2022 #nephmadness #NephPodCrawl Pod Crawl Release schedule: Mon 3/14: The Curbsiders - Cardiorenal Syndrome. Listen on Apple or Spotify. Website: https://thecurbsiders.com Tues 3/15: The Drs. Washington - Inequities in Nephrology. Listen on Apple or Spotify. Website: https://www.drlatonyawashington.com/drswashingtonpodcast  Wed 3/16: The Cribsiders - Neonatal AKI. Listen on Apple or Spotify. Website: http://thecurbsiders.com/thecribsiders Thurs 3/17: Up My Nursing Game - Hemodialysis. Listen on Apple or Spotify. Website: www.upmynursinggame.com Fri 3/18: BS Medicine - #505: Albuminuria, basketball and the Great White North. Listen on Apple or Spotify. Website: https://therapeuticseducation.org/ Sat 3/19: Freely Filtered - Animal House Region. Listen on Apple or Spotify. Website: http://www.nephjc.com/freelyfiltered 
3/5/20221 minute, 59 seconds
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#324 Obesity Medicine FAQ

Learn how to prescribe affordable, effective medications for obesity medicine! We discuss metformin, naltrexone, bupropion, phentermine, topiramate, GLP1 agonists, and how to counsel patients about the available weight loss modalities. Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital helps reframe our approach as she walks through these Obesity Medicine FAQs. Obesity treatment has been around since the 1950s but we’ve been underutilizing it for far too long! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C Show Notes, Infographics: Maddison McLellan Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Monee Amin, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Fatima Cody Stanford, MD  Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount: use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  Sponsor: Grammarly Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB Sponsor: MedMastery Listers are eligible for a lifetime 15% off discount on subscription if you go to https://www.medmastery.com/curbsiders! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner by Dr. Fatima Cody Stanford Case from Kashlak  Guidelines for treatment  Getting the history and discussing weight goals The Care Team:  Dietician, Behavioral Specialist, Provider Medications: Phentermine, Topiramate, Bupropion, Naltrexone Obesity treatment in pregnancy Referring to bariatric surgery Take home points Outro
2/28/202254 minutes, 33 seconds
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#323 Pelvic Pain, Constipation, Long COVID (TFTC)

We recap the top pearls on pelvic pain, constipation, and Long COVID. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for shows #311, #314, and #315 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Beth Garbitelli, Matthew Watto MD, FACP; Paul Williams MD, FACP   Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Birch Birch is giving 200 dollars off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb   Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Pelvic Pain Constipation Long COVID Outro
2/23/202239 minutes, 4 seconds
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#322 H. Pylori Infection

Say hi and bye to H. pylori infections! We review the basics of H. pylori screening, refresh your memory on testing basics, discuss treatment strategies, and talk through eradication testing with gastroenterologist Dr. George Saffouri (@gbsaff).  A special thanks to our listener Ana Maria Keilhauer Varona (@KeilhauerMa) of @UFMedu who pitched this episode. Her hard work formed the basis for our script!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Pitch Writer and Initial Script: Ana Maria Keilhauer Varona  Producer, Writer, Show Notes, Infographic, Cover Art: Beth Garbitelli Script Co-Writer: Elena Gibson, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: George Saffouri, MD Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain. Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st. CME Partner: 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.  Show Segments Intro, disclaimer, pitch contest winner, guest bio Guest one-liner, Picks of the Week  Case from Kashlak; Conceptualizing gastritis vs. dyspepsia When to screen for h.pylori Gastric cancer and h.pylori infection Cultural competency in screening Other indications for h.pylori testing, ITP and h.pylori How to test Treatment modalities Eradication testing, persistent infection
2/21/202258 minutes, 24 seconds
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#321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen

Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer: Matthew Watto, MD, FACP Producers: Matthew Watto, MD, FACP and Malini Gandhi Show Notes, Infographic, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Jordy Cohen MD Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org /curbsiders Sponsor: Southern California Permanente Medical Group Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684. Sponsor: Stamps.com Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Just go to Stamps.com, click the microphone at the top of the page, and enter code CURB.  Sponsor: SquareSpace Go to Squarespace.com for a free trial, and when you’re ready to launch, go to squarespace.com/Curb to save 10% off your first purchase of a website or domain. Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak: New diagnosis of hypertension How to make a diagnosis of hypertension When to start anti-hypertensive medication Initial blood pressure regimen Case from Kashlak: White coat hypertension Case from Kashlak: Hypertension in chronic kidney disease ACEis and ARBs in chronic kidney disease Diuretics in chronic kidney disease Case from Kashlak: Refractory hypertension History and initial workup for refractory hypertension Treatment of primary hyperaldosteronism Outro
2/14/20221 hour, 23 minutes, 3 seconds
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#320 Palpitations with Dr. Joshua Cooper

When should you fold or Holt onto your cards for palpitations?  Learn about properly characterizing a patient’s palpitations, red flag symptoms, when to grab an echocardiogram and/or heart monitoring, and when certain “benign” ECG findings can be concerning.  We’re joined by the director of cardiac electrophysiology at Temple University Hospital, Dr. Joshua Cooper (@narrowQRS) for this episode chock full of cardiac pearls to make your heart skip a beat.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Show Notes, Infographic, and Cover Art: Edison Jyang Producer: Paul Williams MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Reviewer: Molly Heublein MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Joshua Cooper MD Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB. Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st. CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Defining what the patient means by palpitations Common causes and misdiagnoses Red flag symptoms Exposures and medications to consider Sinus tachycardia Workup for palpitations Monitors Script for a negative workup Premature ventricular contractions Outro
2/7/20221 hour, 35 minutes, 55 seconds
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#319 Hotcakes: Afib, Chlorthalidone in CKD, Outpatient COVID Treatment Update

Fill up your plate with a fresh stack of 2022 hotcakes! Drs. Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@NoraTaranto), and Matt Watto help catch us up recent practice-changing articles and guidelines including patient-directed interventions in atrial fibrillation, the utilization of chlorthalidone in advanced CKD, and updates on outpatient COVID treatment.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Hosted and Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH, Matthew Watto, MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Grammarly Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org /curbsiders CME Partner: 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 Show Segments Intro, disclaimer Picks of the week, Listener Email I-STOP Afib Chlorthalidone in CKD Outpatient COVID Treatment Update Outro
1/31/202244 minutes, 52 seconds
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#318 LUTS, BPH, and Urinary Incontinence Triple Distilled

Master urinary tract symptoms! Paul and Matt recap, review, and update past episodes on BPH and urinary incontinence so you’ll be able to confidently manage lower urinary tract symptoms (LUTS) in primary care. Topics: categorizing urinary incontinence, lifestyle modifications for LUTS, nonpharmacologic & pharmacologic therapies for urinary incontinence and BPH, plus when to refer to surgery.  Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographic by: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: M3 Global Research To join M3 Global Research’s panel, go to M3research.info/curbsiders! Complete registration before Feb 28, 2022 for a $10 welcome bonus! Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st. CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for most Curbsiders shows! Show Segments Intro, disclaimer, guest bio Urinary incontinence diagnosis, management BPH diagnosis, management Outro
1/26/202246 minutes, 16 seconds
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#317 Erectile Dysfunction for Primary Care

Listen as our expert guest Dr. Ashley Winter @AshleyGWinter (Northwest Kaiser Permanente, Portland, OR) helps us explore the spectrum of erectile dysfunction management for the internist and primary care clinician.  This episode will empower you to provide evidence based, patient-centered care to erectile dysfunction while maintaining an astute and holistic diagnostic approach.  We also explore treatment and patient counseling techniques.  Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/ Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Hannah R. Abrams, MD Infographic and Cover Art: Kate Grant, MBChB MRCGP DipGUMed Show Notes: Hannah R. Abrams, MD; Avital O’Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Hannah R. Abrams, MD Reviewer: Molly Heublein, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Ashley Winter, MD Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders  Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content. Sponsor:  SquareSpace Go to squarespace.com/curb to save 10% off your first purchase of a website or domain! Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Defining ED Additional history, exam, and labs How to talk about ED Addressing ED for transgender and nonbinary patients Treatment of ED Advanced therapies and referral Take Home Points; Outro; Bonus clip
1/24/20221 hour, 13 minutes, 57 seconds
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#316 Lower Extremity Edema with The Curbsiders

We have seen our esteemed guests, and they are us!  Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Paul Williams, MD, FACP Infographic and Cover Art: Matthew Watto, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto, MD, FACP    Editor: Clair Morgan of nodderly.com Sponsor: Stamps.com Sign up with promo code CURB for a special offer that includes a 4-week trial, free postage, and a digital scale. No long-term commitments or contracts. Sponsor: BetterHelp Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB. Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31.  Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  CME Partner: 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. Show Segments Intro, disclaimer Picks of the Week* The case of Lynn Fedema Pathophysiology of edema Differential diagnosis of chronic edema Chronic edema work-up Management of chronic edema Calvin Fedema and acute edema Evaluation of acute edema Outro
1/17/20221 hour, 6 minutes, 43 seconds
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#315 Long COVID

Explore the actively evolving clinical landscape of Long COVID as we discuss epidemiology, pathogenesis, manifestations, and patient-centered management options including the role of a dedicated Long COVID clinic.  Listen as our expert guest Dr. Monica Verduzco-Gutierrez @MVGutierrezMD (Long School of Medicine at UT Health, San Antonio) helps us navigate this rapidly emerging syndrome. This episode will empower you to provide evidence based, patient-centered care for this challenging facet of the ongoing COVID-19 pandemic. We explore the manifestations including fatigue, dyspnea, psychiatric symptoms, and other neurologic effects.  We also examine the emergence of dedicated Long COVID clinics and the imperative of interdisciplinary care. Update: The original version of this episode contained a brief, but incorrect characterization of  mast cell disorders that was subsequently removed after feedback from our allergy/immunology colleagues. We apologize for this inconvenience and thank our colleagues for their peer review. Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/ Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Avital O’Glasser MD, FACP, SFHM Infographic: Edison Jyang Cover Art: Kate Grant, MBChB MRCGP DipGUMed Show Notes: Avital O’Glasser MD, FACP, SFHM Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, SFHM Reviewer: Hannah Abrams, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Monica Verduzco-Gutierrez, MD Sponsor: Blueland Right now, you can get 20% off your first order when you go to Blueland.com/CURB Sponsor: ACP Join us in Chicago for internal medicine’s premier educational meeting April 28-30, 2022! We’ll be there in person. For the Early Bird discount, register before January 31.  Use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  Sponsor: Panacea Financial Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Sponsor: Indeed Go to Indeed.com/INTERNALMEDICINE to claim your $75 CREDIT before March 31st. CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Case 1 from Kashlak Definition of Long COVID or post-COVID symptoms Pathogenesis of Long COVID Illness script for mast cell activation Epidemiology and risk factors for Long COVID Interdisciplinary care for Long COVID Illness script for POTS-like phenotype in Long COVID Illness script for chronic fatigue syndrome/myalgic encephalomyelitis in Long COVID Management of fatigue and post-exertional malaise (PEM) Case 2 from Kashlak Neuropsychiatric manifestations of Long COVID Anosmia and smell training Role of the patient voice and community in Long COVID Disability assessments and management Take Home Points; Outro; Bonus clip
1/10/20221 hour, 15 minutes, 24 seconds
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#314 Constipation: When the Flow Won’t Go with Dr. Iris Wang

Move smoothly through constipation evaluation and management. Learn how to evaluate for the various etiologies of constipation including pelvic floor dysfunction, IBS-C and more with our esteemed guest Dr. Xiao Jing (Iris) Wang @IrisWangMD! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Show Notes, Infographic & Cover Art: Elena Gibson MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD  Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Xiao Jing (Iris) Wang MD Sponsor: ACP For the Early Bird discount, register before January 31. Use code IM22CURB. Visit annualmeeting.acponline.org to learn more. Register today to get the best pricing and bonus content. Sponsor: SquareSpace https://www.squarespace.com Sponsor: Masterworks Masterworks is giving listeners priority access to their newest offerings. Just head to masterworks.art/curbsiders  CME Partner: 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.  Show Segments (Note: timestamps are without ads) Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* (6:00) Case from Kashlak; Definitions (11:00)  Physiology of a bowel movement (10:00)  Definitions (16:00) Bowel Habit Review of Systems (17:00)  Rectal Exam (33:00) Initial Constipation Evaluation  Common categories of constipation (43:40) Additional evaluation of Constipation (52:00) Treatment options (1:10:00) Outro
1/3/20221 hour, 10 minutes, 15 seconds
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#313 Recap Extravaganza 2021

We recap the top pearls from 2021, including celiac disease, kidney stones, SGLT2 inhibitors for weight loss & HFpEF, smoking cessation, buprenorphine for acute pain, metabolic alkalosis, nephrotic syndrome, bronchiectasis, obesity hypoventilation syndrome, acute diarrhea, osteoporosis, and diabetes. Plus, Paul and Watto express their gratitude to The Curbsiders family and look forward to 2022. Finally, it’s our annual recap extravaganza 2021 with guest host Chris “the Chiu Man” Chiu (@cjchiu), providing a rapid review of previous Curbsiders episodes for your spaced learning. Special thanks to the whole Curbsiders team and our listeners for an incredible six years of podcasting! Note: There is no CME for this mini-episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Click here for full show notes Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Christopher Chiu MD, FACP FAAP Cover Art: Beth Garbitelli Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com CME Partner: 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.  Show Segments Intro Garbs’ picks: Pelvic pain, smoking cessation Addiction medicine pearls: Nicotine use disorder; Acute pain in OUD Nephrology: Kidney stones, nephrotic syndrome, metabolic alkalosis Cardiology: Peripheral arterial disease (PAD), SGLT2 inhibitors for HFpEF Pulmonology: Bronchiectasis, OHS Gastroenterology: Celiac disease, Liver test abnormalities Bariatric Medicine: Semaglutide for weight loss; bariatric surgery Endocrinology: Osteoporosis; Diabetes FAQ Outro
12/30/202157 minutes, 33 seconds
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#312 Infective Endocarditis

Master endocarditis! Don’t feel thwarted by a positive set of blood cultures. We’re joined by Dr. David Serota (@serotavirus) for a comprehensive discussion of the pathophysiology of infective endocarditis, frameworks for work-up and diagnosis, the TTE vs. TEE debate, indications for valve surgery, antibiotic tips,  harm reduction strategies, and more!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer and Producer: Adam Barelski MD Show Notes: Beth Garbitelli; Adam Barelski MD Infographic: Adam Barelski MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Adam Barelski MD Reviewer: Meredith Trubitt, MD Executive Producer, Cover Art: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: David Serota MD  Sponsor: Imperfect Foods Right now, Imperfect Foods is offering our listeners 20% off your first 4 orders when you go to https://www.imperfectfoods.com and use promo code CURB. Sponsor: Southern California Permanente Medical Group Want to make a difference in a community that appreciates your passion and expertise? Then join SCPMG as an Outpatient Internal Medicine Physician. Learn more or apply at scpmgphysiciancareers.com or call (866) 449-1684. Sponsor: P3 P3 is a revenue cycle management provider that takes over your workload for claim submissions, and denial management. P3 is offering a 10% discount on all invoices for a limited time period. Visit www.p3care.com/curb and avail your offer today! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions What to do with positive blood cultures Initial workup for endocarditis  How to diagnose endocarditis When to get a TTE and a TEE Indications for valve surgery Antibiotic tips Oral vs IV antibiotics Treatment considerations for patients who inject drugs Take-home points Outro
12/27/20211 hour, 21 minutes, 52 seconds
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#311 Chronic Pelvic Pain

Pelvic pain is not just a gyn issue!  As a PCP,  you can feel confident doing an initial workup and starting treatment for pelvic pain.  Dr. Lamvu shares a great framework to narrow down your diagnosis and provides amazing resources for those who work in an under-resourced center.   We’ll walk you through what to focus on in the history, a trauma-informed physical exam, and the first-line treatments.  Feel confident with your ability to help your chronic pelvic pain patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writers/Producer: Molly Heublein, MD Infographic: Edison Jyang Cover Art: Kate Grant, MBChB MRCGP DipGUMed Hosts: Beth Garbitelli, Molly Heublein, MD Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Georgine Lamvu, MD MPH Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: Locumstory Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine.  Locumstory is your source for all things locum tenens! Check out their website,  locumstory.com,  for resources, FAQs, and more! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest introduction and recommendations Picks of the Week Case from Kashlak Persistent Pelvic Pain Definitions Differential diagnosis/organ system approach History Physical Exam Trauma informed Care First line Treatments Resources for patient education and to build speciality team Summary and take home points  Outro
12/20/20211 hour, 5 minutes, 15 seconds
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Optimize your Feedback Conversations (TEACH ep. 1)

Listen in as expert Dr Calvin Chou (UCSF)  leads us through concrete tips to optimize your feedback dialogue with learners.  We cover the importance of creating a relationship built on mutual goals of getting to our personal best, helping learners form SMART goals, the ARTful approach to a feedback conversation, ways to minimize bias, and you even get to hear Era role play! This brand new weekly Curbsiders' mini-series, TEACH, is available on its own feed (Apple, Spotify) with new episodes every Tuesday. Claim free CME for this episode at curbsiders.vcuhealth.org! Credits Infographic: Andrew Delaat  Hosts, producers, writers:  Era Kryzhanovskaya, MD; Molly Heublein, MD Audio Editor: Clair Morgan of nodderly.com Guest: Calvin Chou, MD Sponsor: Masterworks Masterworks uses data and technology to determine investment-grade works of art. Then they securitize them and allow anyone to invest in artwork at an affordable entry point.  While making great art is difficult, investing in it is easier than ever. Go to masterworks.art/curbsiders to get started. CME Partner: 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. Show Segments:   Intro, disclaimer, guest bio  Guest one-liner  Picks of the Week  Case from Kashlak  Definition of Feedback  Creating a relationship to give feedback Helping learners set goals ARTful approach Giving feedback on hearsay Reducing bias Accepting feedback up the hierarchy Outro
12/16/20211 hour, 25 minutes, 50 seconds
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#310 No Tension About Inpatient Hypertension

Don’t sweat inpatient hypertension any longer. Who needs guidelines when Dr. Noble Maleque (@nobility75, Emory University, Division of Hospital Medicine) explains the spectrum of hypertensive disorders in the inpatient setting, and an approach for thinking about treatment. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Production, Script, Infographic, and Cover Art: Monee Amin, MD, Meredith Trubitt, MD MPH  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Monee Amin, MD, Meredith Trubitt, MD MPH  Reviewer: Adam Barelski MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Noble Maleque MD Sponsor: Panacea Financial Join the growing number of doctors nationwide that expect more from their bank and have switched to Panacea Financial. Visit panaceafinancial.com today for information on their student loan refinance loans and to learn about their “refer a friend” program. Panacea Financial is a division of Primis, Member FDIC Sponsor: Ten Thousand Ten Thousand is offering our listeners 15% off your purchase! Go to tenthousand.cc and enter code CURB  to receive 15% off your purchase!. Sponsor: Locumstory Locum tenens may sound like a funky Latin word, but you’d be surprised what it can mean for your career in medicine.  Locumstory is your source for all things locum tenens! Check out their website,  locumstory.com,  for resources, FAQs, and more! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Definitions Case from Kashlak Elevated blood pressure / hypertensive urgency Contributing factors to elevated blood pressure in the hospital Hypertensive urgency—to treat or not to treat Transitions of care and case against intensification of treatment Case from Kashlak Hypertensive emergency diagnosis and treatment Secondary Hypertension Outro
12/13/20211 hour, 2 minutes, 6 seconds
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Curbsiders TEACH is Coming Soon!

Curbsiders Teach is THE internal medicine podcast for all things medical education. We use expert interviews to inspire the next generation of medical educators by providing listeners with teaching pearls, practice-changing knowledge, and a learning objective-based dosing of Edutainment (medical education, made entertaining). This weekly mini-series will air every Tuesday starting December 14th, 2021 on our website or wherever you get your podcasts! Subscribe on Apple Podcasts Subscribe on Spotify We are so excited to bring you this new series in the Curbsiders Family focusing on medical education.  Molly Heublein, MD and Era Kryzhanovskaya, MD are your new hosts for the Curbsiders Teach- they are Clinician Educators with a passion for teaching.   Whether you precept students, teach small groups, are involved in curricular design, or give CME lectures, we think you’ll find valuable skills.  We have the pleasure of interviewing a variety of amazing experts in topics ranging from bedside teaching, feedback conversations, learner mental health, and time-based competencies in medical education.   We can’t wait to share their expertise with you!   Subscribe on Apple Podcasts Subscribe on Spotify Send questions or suggestions to [email protected]    
12/7/20212 minutes, 45 seconds
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#309 Prediabetes & Type 2 Diabetes Screening: A USPSTF Quick Update

Sweeten your day with  a review of the updated 2021 USPSTF Prediabetes and Type 2 Diabetes screening guidelines with expert guest Dr. Chien-Wen Tseng! We review the new screening recommendations, assess different testing modalities, talk through screening intervals, and emphasize other risk factors that impact screening!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Paul Williams MD & Elena Gibson MD Cover Art: Beth Garbitelli Hosts: Paul Williams MD, FACP; Elena Gibson MD     Reviewer: USPSTF Team Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Chien-Wen Tseng MD Sponsor: BetterHelp Join the over 2,000,000 people who have taken charge of their mental health with the help of an experienced professional. Special offer for The Curbsiders listeners: get 10% off your first month at betterhelp.com/Curb Sponsor: GreenChef The #1 Meal Kit for Eating Well! Go to GreenChef.com/curb10 and use the code curb10 to get 10 Free Meals including free shipping! CME Partner: 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* *Note: Time Stamps refer to ad free version.  Intro, disclaimer, guest bio: 0:33 Guest one-liner: 3:30 Picks of the Week: Sneaky pick at 3:00! Guest pick: 4:45 Case from Kashlak of Mr. Sugar: 5:30  Screening recommendations: 6:00 Testing modalities: 10:00  Possible harms of screening: 15:50 Screening intervals: 18:00 Prediabetes screening: 20:45 Other risk factors that impact screening: 26:30 Recap: 34:15 Outro: 36:25
12/6/202142 minutes, 9 seconds
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#308 Metabolic Alkalosis and Hypokalemia: Kidney Boy Returns!

@Kidney_Boy returns to school us on metabolic alkalosis and hypokalemia! What do diuretics, hyperaldosteronism, black licorice, and milk-alkali have in common? Our Chief of Nephrology, Dr. Joel Topf, talks through the pathophysiology of metabolic alkalosis, the utility of urine chloride and pH measurements, why normal saline is sometimes better than balanced solutions, when to reach for acetazolamide, and more! Urine for a good time ; ) Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Show Notes, CME, Infographic and Cover Art by: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli   Reviewer: Emi Okamoto MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Joel Topf MD Sponsor: ACP Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.   Sponsor: Grammarly Take the stress out of getting the words right with Grammarly. Our listeners get 20% off Grammarly Premium at grammarly.com/CURB CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Case of Al Kaline - metabolic alkalosis from vomiting Pathophysiology of metabolic alkalosis Case of Mike Arbonate - hypokalemic, metabolic alkalosis from aggressive IV diuresis and therapies to mitigate Case of Fracture Franny - milk-alkali syndrome Case of Hyper Al - metabolic alkalosis from excess mineralocorticoid receptor activation Outro
11/29/20211 hour, 9 minutes, 9 seconds
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#307 Spooky Tofurkey Cakes: SGLT2 for HFpEF, Diverticulitis, VTE update, Rotator Cuff Disease

Fill up your plate with some spooky tofurkey cakes! Drs. Rahul Ganatra (@rbganatra) and Nora Taranto (@norataranto) help catch us up recent practice-changing articles and guidelines including EMPEROR-Reduced (SGLT2 inhibitors for HFpEF), the 2021 CHEST VTE guidelines update, whether or not antibiotics are needed for diverticulitis, and what treatments are most effective for rotator cuff disease! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written by: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP Show Notes: Matthew Watto MD, FACP Cover Art: Beth Garbitelli Hosts: Nora Taranto MD; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Rahul Ganatra MD, MPH Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and two free eco-rest pillows at BirchLiving.com/curb   Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb CME Partner: 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.  Show Segments Intro, disclaimer,  Picks of the Week EMPEROR-Reduced (SGLT2 inhibitors for HFpEF) GRASP trial for rotator cuff disease (physiotherapy and steroid injections) DINAMO trial (no antibiotics for outpatients with uncomplicated diverticulitis) 2021 CHEST VTE Guidelines Update Outro
11/24/202151 minutes, 39 seconds
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#306 Bronchiectasis and NTM: You can’t get enough sputum!

Take a deep breath and inhale high-yield knowledge molecules about the perplexing conditions known as bronchiectasis and NTM (nontuberculous mycobacteria)! Learn the pitfalls and pearls of diagnosis and management from one of the world’s experts, the great Dr. PJ McShane from UT Health - East Texas! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writers/Producers: Cyrus Askin MD; Leah Witt MD Infographic & Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin MD    Reviewer: PJ McShane MD Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com Guest: PJ McShane MD  Sponsor: Ten Thousand.  Ten Thousand is offering our listeners 15% off your next purchase! Go to https://www.tenthousand.cc  and enter code: CURB to receive 15% off your purchase at checkout! Sponsor: The American College of Physicians  Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.   CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest introduction and recommendations Case from Kashlak - Part I: The Basics What is bronchiectasis, how do we define it? Symptoms and history Why does it matter? What should you ask, how do you work this up? A brief discussion on antibiotics Case from Kashlak - Part II: Getting into the ManagementAirway Clearance Case from Kashlak - Part III: The Sputum (Plot) Thickens What is a bronchiectasis exacerbation? Pitfall and pearls regarding exacerbation management Case from Kashlak - Part IV: The Sputum (Plot) Thickens Even Further! Non-tuberculous Mycobacterial Infections - the basics Triple Drug Therapy for MAC The new kid on the block: Liposomal Inhaled Amikacin for refractory MAC Summary and take home points from Dr. McShane Outro
11/22/20211 hour, 19 minutes, 1 second
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#305 OB for the Internist: What to Expect

What to expect when you’re taking care of a patient who’s expecting! This fantastic episode will help you work through preconception counseling with ease, assess and treat non-obstetrical acute concerns in pregnant patients, and help you conceptualize best practices for postpartum care. We are joined by expert guest Dr. Xiaolei Chen.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli  Show Notes by: Shelagh Browne Cover Art and Infographic: Edison Jyang  Reviewer:   Molly Heublein MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Xiaolei Chen MD Sponsor: GreenChef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping! GreenChef.com/curb125 Sponsor: Need to hire? You need Indeed. Get started RIGHT NOW with a $75SPONSORED JOB CREDIT to upgrade your job post at Indeed.com/INTERNALMEDICINE. Offer valid through December 31st. Terms and conditions apply.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: 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 . Show Segments Intro Picks of the week  Preconception counseling Lifestyle: caffeine, alcohol, exercise  Preconception medications  Management of acute complaints during pregnancy  Go-to medications for acute complaints during pregnancy Chronic diseases during pregnancy Postpartum management Breastfeeding recommendations Take-home points Outro 
11/15/20211 hour, 1 minute, 33 seconds
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#304 COVID Updates: The Outpatient Edition

Who gets a COVID booster? Can we mix and match COVID vaccines?  What are monoclonal antibodies and when should we use them? What is molnupiravir and does it work? Shots for kids? Ready yourself to answer these questions and more with our guest, Dr. Monica Gandhi @MonicaGandhi9.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer and Writer: Isabel Valdez PA, Molly Heublein MD Infographic: Edison Jyang Cover Art:  Edison Jyang,  Isabel Valdez, PA Hosts: Molly Heublein MD, Chris Chui MD, Isabel Valdez PA Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Monica Gandhi MD Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Covid Boosters Pfizer data Moderna Data DNA vaccines Pediatric Vaccines Monoclonal Antibodies Molnupiravir Dr Gandhi’s crystal ball Outro
11/8/202149 minutes, 28 seconds
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#303 Women in Medicine: Wellness & Workarounds

Explore burnout and gender-based differences in well-being with our esteemed guests Drs. Clif Knight, Tammy Lin, and Kim Templeton. We discuss workarounds for leading our way to wellness.  Dr. Clif Knight is a family physician and Senior Vice President for Education at the American Academy of Family Physicians (AAFP) with extensive leadership and expertise in well-being.  Dr. Tammy Lin is an internal medicine specialist and a Voluntary Assistant Clinical Professor at the University of California, San Diego Health Sciences. We originally met her as a member of the Wellness through Equity and Leadership (WEL) Program and she started a podcast called "The DEI Shift" (pronounced The "Day" Shift), which focuses on diversity, equity, and inclusion within the medical field. Dr. Knight and Dr. Lin participated in the 2019-2020 WEL program-- six different specialty organizations came together to think about the core tenets of equity, well-being and leadership and how you really can’t have one without the other.  Dr. Kim Templeton is Professor of Orthopaedic Surgery at the University of Kansas Medical Center in Kansas City.  Her research focuses on women physicians and the inclusion of sex and gender medicine in medical education. No CME for this episode, but claim CME for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Leah Witt, MD and Shreya Trivedi, MD Infographic: Leah Witt, MD Cover Art: Kate Grant MBChB MRCGP DipGUMed Hosts: Matthew Watto MD, FACP; Leah Witt, MD, Shreya Trivedi, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Clif Knight, MD, Tammy Lin, MD, Kim Templeton, MD Sponsor: Grammarly Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Panacea Financial Learn about their $1,000 giveaway at panaceafinancial.com/curb. Panacea Financial is a division of Primis member FDIC. Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: 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. Show Segments Intro, disclaimer, guest bios Burnout & Wellness The Case: Dr. Elizabeth Blackwell & her friend in primary care The Part-Time Discussion Outro
11/1/202150 minutes, 29 seconds
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#302 LFTs Triple Distilled

Fine-tune your approach to liver tests!  It’s LFTs Triple Distilled! Paul and Matt channel the wisdom of hepatologist, Dr. Elliot Tapper (@ebtapper) to cover hepatocellular vs cholestatic vs mixed patterns, which tests to order, which ones to skip, how to handle isolated alkaline phosphatase elevation, mild, chronic ALT elevation, and even how to interpret liver test abnormalities in pregnancy.  Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #293 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographic by: Elena Gibson Cover Art: Matthew Watto MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Sponsor: Birch by Helix Birch is giving $200 off ALL mattresses and 2 free eco-rest pillows at BirchLiving.com/curb  Sponsor: Locumstory Visit Locumstory.com to see if a locum tenens assignment is right for you. CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Hepatocellular pattern Cholestatic pattern Chronic ALT elevation Isolated Alkaline phosphatase elevation Liver test abnormalities in pregnancy Outro
10/27/202136 minutes, 14 seconds
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#301 LIVE! Top Pearls 2021: A Rapid Fire Review of Systems

Join us for this rapid fire review of systems featuring our top pearls and articles LIVE! from the TriService ACP conference. Matt and Paul serve up their favorite practice changing knowledge food on antibiotics, MRSA, hair loss, dementia, seizures, diabetes, medications for hypertension, foods for constipation, diverticulitis, colon cancer screening, colon polyps, chronic sinusitis, chronic cough, treatment of uterine bleeding, and more!  No CME for this episode, but check out curbsiders.vcuhealth.org for past CME offerings! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Matthew Watto MD, FACP; Paul Williams MD, FACP    Cover Art: Sawyer Watto Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: BetterHelp Get 10% off your first month at betterhelp.com/curb.         Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. CME Partner: 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.  Show Segments Intro, disclaimer ID: Shorter is better; MRSA swabs; Antibiotics for diverticulitis Endo: Prediabetes in older adults,  MSK: Knee OA, orthopedic surgery Derm: Alopecia Neuro: Seizures, dementia quick typing Cardio: Coffee and arrhythmias; Hypertension management, ACEi vs ARBs Respiratory: Chronic cough and sinusitis GI: CRC screening, foods for constipation GU: treatment of uterine bleeding Addiction Medicine: smoking cessation, buprenorphine Outro
10/25/20211 hour, 15 minutes, 10 seconds
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#300 Celiac Disease with Dr. Amy Oxentenko

Take control of celiac disease (CD) with gastroenterologist, Dr. Amy Oxentenko (Chair of Medicine at Mayo Clinic AZ, @AmyOxentenkoMD). Learn how to recognize both classic and non-classical features of CD and  understand diagnostic testing, management and proper follow-up for patients. Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Production and Script: Matthew Watto MD, FACP Production, Show Notes and Infographics: Edison Jyang Cover Art: Kate Grant MBChB, MRCGP, DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli    Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Amy Oxentenko MD, FACG Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. Sponsor: Grammarly Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB  CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week Case from Kashlak; Definitions Workup for a typical celiac patient Nonclassical features of CD When to do a small bowel biopsy Management of CD Considerations for atypical celiac patient and differentials Non-celiac gluten sensitivity Outro Links Crucial Conversations (book) Gluten-free flour (flour) Pie crust recipe (recipe) What Remains of Edith Finch (game) Doughboys (podcast)
10/18/20211 hour, 12 minutes, 10 seconds
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#299 Acute Pain Management for the Hospitalist

Confidently manage acute pain in the hospital! In this episode listeners will learn  how to develop a multimodal analgesia plan for acute pain in the hospital, as well as how to safely initiate and discharge a patient on opioids. We’re joined by Dr. Melissa Weimer @DrMelissaWeimer  (Yale School of Medicine). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer and Writer: Carolyn Chan, MD Script: Carolyn Chan, MD, Avi O’Glasser, MD Cover Art and Infographic: Edison Jyang Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD Reviewer: Emi Okamoto, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Melissa Weimer DO Sponsor: ACP’s National Internal Medicine Day Help the American College of Physicians celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD2021 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtag #NationalInternalMedicineDay. Sponsor: Green Chef Go to GreenChef.com/curb125 and use code curb125 to get $125 off including free shipping! CME Partner: 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.  Show Segments 01:39 Intro, disclaimer, guest bio 03:20 Guest one-liner, Picks of the Week 09:18 Case from Kashlak; Definitions 11:00 Assessing Acute Pain 12:12 Types of Pain 15:08 Initiating Opioids 22:32 Counseling on Opioid Exit Strategy 25:26  Opioid Dependence vs. Opioid Use Disorder 29:50 Post-Op Pain Management 31:00 Other cool stuff 37:00 PCA 41:00 Opioid Taper 46:50 Acute Pain and Opioid Use Disorder 58:00 Methadone Titration 1:04:00 Outro
10/11/20211 hour, 8 minutes, 12 seconds
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#298 Urinary Stone Disease Will Rock Your World

Do kidney stones have you saying “this too shall pass?” Our guest Dr. David S. Goldfarb, MD, FASN, FNKF, FACP can help! In this episode he takes us through risk factors as well as treatment and prevention for urinary stone disease.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli  Show Notes by: Shelagh Browne, Kate GrantMBChB MRCGP DipGUMed,  Cover Art and Infographic: Kate Grant MBChB MRCGP DipGUMed  Reviewer: Molly Heublein, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: David Goldfarb MD, FSN, FNKF, FACP  Sponsor: ACP’s National Internal Medicine Day 2021 acponline.org/NIMD21 Sponsor: Indeed indeed.com/internalmedicine CME Partner: 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 . Show Segments Guest book recommendation and advice   Common risk factors for urinary stone disease Differential diagnosis of kidney stones Symptomatology of kidney stones Types of stones  Urine pH Role of physical exam Role of imaging  STONE score Labs to order  Management of urinary stone disease Prevention of urinary stones and approach to lifestyle/diet changes  Outro 
10/4/20211 hour, 7 minutes, 41 seconds
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#297 CRC Screening, Common Skin Complaints, and Antibiotic Pearls (TFTC #8)

We recap the top pearls on CRC Screening, Common Skin Complaints, and Antibiotic Pearls. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #283, #284, and #285 at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli, and Nora Taranto Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: ACP acponline.org/telemedicine201 Sponsor: Ten Thousand tenthousand.cc code = CURB CME Partner: 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.  Show Segments Intro, disclaimer, guest bio CRC Screening Antibiotic Pearls Derm Pearls (Common Skin Complaints) Outro
9/29/202138 minutes
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#296 Diabetes FAQ with Dr. Jeff Colburn

Stumped by diabetes care? Hungry for tips on diagnosis and management? We’ve got you covered with this high-yield Diabetes FAQ covering type 1 and type 2 diabetes. We’re joined by Dr. Jeff Colburn, a board-certified endocrinologist and clinician educator in San Antonio, Texas as we review initial diagnosis, interrogate insulin resistance versus insulin deficiency,  delve into down-titrating insulin, discuss ‘tricky diabetes,’ and talk through dietary approaches!  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers and Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Writer: Matthew Watto MD, FACP  Show Notes, Infographic & Cover Art: Beth Garbitelli Reviewer: Molly Heublein MD Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Jeff Colburn, MD Sponsor: BetterHelp betterhelp.com/curb Sponsor: Birch by Helix birchliving.com/curb CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Initial Presentation of Diabetes Type 1 or Type 2 Initial Labs, Managing new diagnosis Using GLP-1 agonists, SGLT-2 inhibitors How to down titrate insulin  Diabetes in geriatrics Diets for diabetes management Outro
9/27/20211 hour, 5 minutes, 50 seconds
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#295 Advance Your Care Planning with Dr. Rebecca Sudore

Advance your care planning with tips from our esteemed guest, Dr. Rebecca Sudore, @prepareforcare (UCSF). She helps us up our ACP game by defining advance care planning, and giving clear examples of how it can be incorporated into a busy primary care practice. It’s her life’s mission is to improve advance care planning and medical decision-making for culturally and ethnically diverse older adults. She is the creator of an interactive ACP website called PREPARE For Your Care, (after this episode, we are sure you’ll be sending patients there for advance care planning!) Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written by: Leah Witt, MD Produced by: Leah Witt, MD & Molly Heublein, MD Reviewer: Lingsheng Li, MD Infographic and Cover Art: Leah Witt, MD Hosts:Matthew Watto MD, FACP; Paul Williams MD, FACP, Leah Witt, MD    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Rebecca Sudore, MD Sponsor: Grammarly grammarly.com/curb Get 20% off Grammarly Premium by signing up at grammarly.com/curb Sponsor: Green Chef greenchef.com/curb100 Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!” CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week Case from Kashlak Part 1: General ACP Defining Advance Care Planning Case from Kashlak Part 1: Dementia & ACP Surrogate decision-makers POLST Outro
9/20/20211 hour, 40 seconds
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#294 Pulmonary Hypertension Update

Join us as we take a six-minute walk through the definition, presenting symptoms, and diagnosis of pulmonary hypertension with our esteemed guest Dr. Estefania Oliveros, @EstefaniaOS (Temple University). She helps us get on the right side of hypertension on the right side of the heart! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer and producer: Deborah Gorth MD, PhD Infographic and Cover Art: Edison Jyang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Estefania Oliveros MD  Sponsor: Indeed indeed.com/internalmedicine Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Sponsor: The American College of Physicians Telemedicine 201 ACP invites you to attend its free 4-part webinar series, Telemedicine 201. Episode one, “Video Visits Beyond the Simple Cases,” is on September 28th. Register today at acponline.org/telemedicine201. CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* Case from Kashlak Definitions Discussion of testing for pulmonary hypertension CTEPH diagnosis and management Rundown of therapies for pulmonary hypertension Outro
9/13/202159 minutes, 7 seconds
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#293 The Best of Liver Tests with Dr. Elliot Tapper

Take a walk through Liver Land with Dr. Elliot Tapper (@ebtapper on Twitter) as we stroll through the best of liver tests. Once differentiating a hepatocellular versus cholestatic injury picture, Dr. Tapper shares some targeted labs to help with etiology, as well as what to do with those pesky isolated lab abnormalities. On top of that, we review common causes of severe acute liver disease and issues in pregnancy. Join us, and you’ll be writing more accurate notes as Dr. Tapper schools us on what “liver function tests” really mean!       Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Elena Gibson MD  Cover Art and Infographic: Kate Grant MD; Elena Gibson MD  Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD  (written materials); Clair Morgan of nodderly.com Guest: Elliot Tapper MD  Sponsor: BetterHelp betterhelp.com/curb Sponsor: Panacea Financial panaceafinancial.com CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner Definitions of liver enzymes, liver function tests   Patterns of acute liver injury Drug-induced liver injury     Isolated alkaline phosphatase elevation  Isolated total bilirubin elevation  Livery Injury During Pregnancy  Acute liver failure Outro
9/6/20211 hour, 5 minutes, 29 seconds
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#292 Acute Heart Failure, CHF Triple Distilled

Enjoy this rapid clinical overview of heart failure based on Episode #230 Kittleson Rules Acute Heart Failure Featuring Dr. Michelle Kittleson @MKittlesonMD (Cedars Sinai)!  This triple distilled episode is not available for CME, but claim CME for #230 Kittleson Rules Acute Heart Failure at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Locumstory locumstory.com Visit Locumstory.com to see if a locum tenens assignment is right for you. Show Segments Intro, disclaimer, guest bio The History, Failure mnemonic CHF exam CHF Labs, Swan (RHC) Management of ADHF Outro
9/1/202131 minutes, 19 seconds
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REBOOT #230 Kittleson Rules Heart Failure

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. Enjoy this Curbsiders classic and stay tuned this Wednesday, September 1, 2021 for a brand new CHF Triple Distilled episode. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] 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: Ten Thousand tenthousand.cc Head to tenthousand.cc and enter our code CURB at checkout to save 15%.  Sponsor: BetterHelp betterhelp.com/curb ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb     Time Stamps* Time Stamps refer to ad-free version 00:00 Intro, disclaimer, guest bio 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

8/30/20211 hour, 15 minutes, 19 seconds
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#291 CBC Abnormalities Triple Distilled

Enjoy this rapid clinical overview of CBC abnormalities based on Episode #167 LIVE! Common CBC Abnormalities Featuring Dr. Mary Kwok! Production & graphics by our very own and very talented Dr. Matt Watto! Unfortunately, this episode is not available for CME : ( Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Show Segments Intro, disclaimer, guest bio Approaching a mildly abnormal CBC, red flags Build the diff, Fy(a-b-) phenotype Physical exam and advanced testing Polycythemia vera Thrombocytopenia Outro
8/25/202130 minutes
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Reboot #167 LIVE! CBC Abnormalities

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 25, 2021 for a brand new CBC Abnormalities Triple Distilled episode. Take a deep dive into common CBC abnormalities. We recorded LIVE at joint grand rounds between Walter Reed NMMC and Uniformed Services University with hematologist, Dr. Mary Kwok MD. Topics include: which parts of the complete blood count (CBC) are most important, interpreting the differential, when to order flow cytometry, who needs a hematology consult and simplified approaches to patients with leukocytosis, leukopenia, erythrocytosis and thrombocytopenia. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] Credits Written, Produced and Edited by: Matthew Watto MD, FACP Cover Art and Infographic by: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Guest: Mary Kwok MD Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024! Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb   Time Stamps* Time Stamps refer to ad-free version 00:00 Intro; Paul shame’s the audience; Guest bio 03:17 Guest one-liner, book recommendation* –Emperor of All Maladies (book) by Siddhartha Mukherjee, When Breath Becomes Air (book) by Paul Kalanithi; Career advice -set goals for whatever you’re learning. 08:43 Picks of the week: John Wick 3 (film); The Movies That Made Me (podcast) by Joe Dante; The Tim Ferriss Podcast with Julie Rice of Soul Cycle; Infinity Chamber (film) by Travis Milloy 11:50 A case of asymptomatic leukocytosis; Red flags; Repeat the CBC until it’s normal 17:30 The peripheral smear; Leukemoid reaction 20:00 The physical exam; When to send flow cytometry? 22:18 A case of lymphopenia; benign ethnic neutropenia; What to look for in the history 27:10 A case of erythrocytosis; Checking EPO levels; JAK2 mutation; Differential Diagnosis; Therapeutic Phlebotomy; Physical findings of Polycythemia Vera 36:53 A case of thrombocytopenia; Lab workup; Differential diagnosis; Pathophysiology; Culprit meds 45:35 Advice for internists 46:36 Take Home Points 47:46 Dr. Kwok’s disclaimer 48:10 Outro and post credit scene
8/23/202152 minutes, 33 seconds
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#290 Stroke and TIA Triple Distilled

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #164 with Neurologist Dr. Chris Favilla!  This mini episode is not available for CME, but episode #164 on Stroke and TIA is available for CME credit through the ACP! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Ten Thousand tenthousand.cc Head to tenthousand.cc and enter our code CURB at checkout to save 15%.  Show Segments Intro, disclaimer, guest bio Afib prevention Workup for afib Treatment of afib Updates on ablation, Left atrial appendage occlusion Outro
8/18/202123 minutes, 47 seconds
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Reboot #164 Stroke and TIA Deconstructed

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 18, 2021 for a brand new Stroke and TIA Triple Distilled episode. Update your management of stroke and TIA in primary care. Stroke neurologist, Chris Favilla MD (University of Pennsylvania), walks us through the plumbing of the brain, so we can identify ischemic risks in stroke and TIA patients to prevent recurrences.  Learn factors that make a TIA high risk, which imaging studies to order, new research around aspirin dosing, dual antiplatelets, DOACs, cardiac monitoring and more!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders  Credits Producers: Molly Heublein MD; Matthew Watto MD, FACP Writer (including CME questions): Molly Heublein MD Cover Art: Bryan Brown MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto, MD; Matthew Watto MD, FACP Guest: Chris Favilla, MD Sponsor: Indeed indeed.com/internalmedicine Get a $75 sponsored job credit to upgrade your job post at Indeed.com/internalmedicine. Sponsor: Qalo qalo.com/curb Head to qalo.com/curb to get 20% off your purchase today. Time Stamps* Time Stamps refer to ad-free version 00:00 Intro, disclaimer, guest bio, and a bad pun 04:20 Chris’ one-liner, advice as a teacher, book recommendation -The Goldfinch,  07:40 Molly’s pick of the week -Extreme Measures (book) by Jessica Zitter 08:40 A case of TIA; definition of TIA 12:14 Stroke territories 14:24 New definition of TIA 16:00 Differentiation from complex migraine 19:17 Risk stratifying TIA and ABCD2 score 22:00 A bit on tPA 24:01 Workup for TIA; workup for amaurosis fugax 25:36 CNS imaging studies after stroke or TIA; Choice of imaging study 33:15 HINTS exam for posterior circulation stroke 34:48 Is an echo necessary? Bubble study for PFO? 38:32 Duration of afib monitoring 40:24 Echo reports: what to look for in patient with stroke or TIA; “soft markers” 41:55 Blood testing after Stroke and TIA (lipid panel, HbA1C; +/- RPR, coags, CBC) 43:50 Folic acid; Sparkle trial: high dose atorvastatin versus placebo for secondary prevention 47:00 Incidental finding: multiple patchy infiltrates in a patient without stroke or TIA; Is it significant? 48:50 Aspirin therapy after TIA; Dosage adjustment based on weight? 51:10 A case of stroke; TOAST trial and classification of acute stroke; ESUS; aortic arch atheromas 55:58 Large artery strokes (hypoperfusion, acute thrombosis, artery to artery embolization) 57:15 Antiplatelets after stroke and TIA; DAPT and duration of therapy 62:57 Antidiabetic drugs and stroke 63:40 Lightning round: CHA2DS2VASc score and women; how much afib is significant?; 66:32 Are all DOACs created equal?; 68:20 Regaining function after a stroke; 69:47 Silent infarcts on imaging 71:54 Resources for stroke: Decision making in neurology textbook 73:28 Outro
8/16/20211 hour, 17 minutes, 34 seconds
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#289 Afib Triple Distilled

Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #159 with Cardiologist Dr. James Furgerson; Plus, updates on ablation and left atrial appendage occlusion!  This episode is not available for CME, but episode #159 on Atrial Fibrillation is available for CME credit through the ACP! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: FIGS wearfigs.com Head to wearfigs.com and enter our code CURB at checkout to save 15%.  ASN Loan Mitigation Pilot Program: asn-online.org/lmpp The American Society of Nephrology’s Loan Mitigation Pilot Program (LMPP) aims to decrease the loan burden of those entering the field of nephrology, while also increasing interest in the specialty. Year 1 of the program will center on individuals historically underrepresented in medicine. Visit ASN-online.org/lmpp or email [email protected]  Show Segments Intro, disclaimer, guest bio Afib prevention Workup for afib Treatment of afib Updates on ablation, Left atrial appendage occlusion Outro
8/11/202126 minutes, 46 seconds
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Reboot #159 Atrial Fibrillation

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 11, 2021 for a brand new Afib Triple Distilled version. Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD  is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up – This episode is going to send your heart racing! You might even skip a beat!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected]  Credits Writer and Producer: Cyrus Askin MD Infographic: Cyrus Askin MD Cover Art: Cyrus Askin MD Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD Editors: Matthew Watto MD Guest: James Furgerson MD Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 100 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024! Sponsor: Panacea Financial panaceafinancial.com Visit panaceafinancial.com today to open your account and join a bank built with you in mind.  Time Stamps* *Note: Time stamps refer to ad-free version  00:00 Intro, disclaimer and guest bio 03:45 Guest one liner, a bit on physician well-being and some other randomness 08:15 A case of palpitations; risk factors for atrial fibrillation 12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters?  15:08 Case summary and next steps in initial work up 18:48 Counseling patient about atrial fibrillation and its consequences 21:40 Ischemic heart disease and atrial fibrillation 24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation 25:25 Rate versus rhythm control; AFFIRM trial 30:50 Strict versus lenient rate control;  RACE trial 33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy 36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials 40:40 When to refer to cardiology and electrophysiology 42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation 45:22 DOACs in CKD and some other nuances in choice of agent 52:27 Bleeding and anticoagulation 58:38 Cardioversion for atrial fibrillation (initial versus delayed) 63:32 Anticoagulation before and after cardioversion 67:48 Lifestyles measures for atrial fibrillation 70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism 74:12 Aspirin monotherapy is not appropriate for atrial fibrillation 76:42 Take home points 78:50 Outro
8/9/20211 hour, 23 minutes, 18 seconds
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#288 LIVE! Neutropenic Fever featuring Dr. Susan Seo

We’ve got a neutropenic fever and the only cure is...more cowbell? LIVE! It’s neutropenic fever (aka febrile neutropenia) deconstructed with infectious diseases expert, Dr. Susan Seo (Memorial Sloan Kettering Cancer Center). Topics: identifying low vs high risk patients, initial labs & imaging, empiric antibiotic therapy, when to add antifungals, de-escalation, and the G-CSF controversy.  Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer and Producer: Matthew Watto MD, FACP Infographic: Edison Jyang Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Matthew Watto MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Susan Seo MD Sponsor: American College of Physicians acponline.org/100curb ACP CME 100 virtual video package includes 75 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024! Sponsor: BetterHelp betterhelp.com/curb ​​Special offer for Curbsiders listeners: get 10% off your first month at betterhelp.com/curb Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders   CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak; Definitions Initial workup for neutropenic fever  Low risk neutropenic fever High risk neutropenic fever When to add antifungal coverage, G-CSF Audience questions Outro
8/2/20211 hour, 3 minutes, 33 seconds
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#287 Angina, Stable CAD, HMB, Hypercalcemia (TFTC #7)

We recap the top pearls on angina, Stable CAD, Heavy Menstrual Bleeding, and Hypercalcemia. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #279, #280, and #281.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli, Avital O’Glasser, and Nora Taranto Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Amercian College of Physicians acponline.org/100curb ACP’s all-new CME 100 video package is now available at acponline.org/100CURB Use code 100CURB. Sponsor: The Jordan Harbinger Show jordanharbinger.com/subscribe CME Partner: 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. Show Segments Intro, disclaimer Angina and Stable CAD Heavy Menstrual Bleeding and Anticoagulation in Menstruating patients Hypercalcemia and primary hyperparathyroidism Outro
7/28/202132 minutes, 42 seconds
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#286 Mingle with Shingles featuring Dr. Boghuma Titanji

Shaken by a shortage of shingles savvy? Vexed by varicella-zoster imposters? Perplexed by post-herpetic neuralgia? Get ready to sharpen your expertise in varicella vaccines, learn how to tell a zoster from a zebra, and administer infection interventions with an eye towards prevention. We are joined today by special guest and returning Curbsiders expert, Dr. Boghuma Kabisen Titanji MD, M.Sc., DTM&H, PhD. (@Boghuma on Twitter!). Unfortunately, CE credit is NOT YET available for this episode : ( Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Sarah Phoebe Roberts, MPH Show Notes by: Sarah Phoebe Roberts MPH, Kate GrantMBChB MRCGP DipGUMed Cover Art: Kate Grant MBChB MRCGP DipGUMed  Infographic: Sarah Phoebe Roberts  Hosts: Matthew Watto MD, FACP; Sarah Phoebe Roberts MPH   Reviewer: Paul Williams MD, FACP   Editor: Kate Grant MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Boghuma Titanji, MD, M.Sc., DTM&H, PhD Sponsor: BetterHelp betterhelp.com/curb Special offer for listeners: get 10% off your first month at betterhelp.com/curb Sponsor: Grammarly grammarly.com/curb Get 20% off Grammarly Premium by signing up at Grammarly.com/curb CME Partner: 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 . Show Segments Intro, disclaimer Guest bio and one-liner First Kashlak case: Diagnosis of varicella-zoster virus (VZV, aka shingles)  Mimics and atypical presentations Treatment for uncomplicated shingles cases  Second Kashlak case: Post-herpetic neuralgia (PHN) PHN treatment options  Management of complicated shingles cases  VZV prophylaxis and infection control Third Kashlak case: Immunization guidelines for older adults VZV vaccine efficacy, live attenuated vs. recombinant vaccine Varicella (chickenpox) vaccine guidelines Final pearls and Outro 
7/26/20211 hour, 10 minutes, 6 seconds
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#285 Common Skin Complaints in Primary Care (Dermsiders)

Walk with us through common skin complaints in primary care, focusing on the trunk and extremities. Our favorite skinternist, Dr. Helena Pasieka (Chief of Dermatology at Kashlak) schools us on tinea versicolor, the fluff test, treatment of skin tags, how to work up and manage generalized pruritus, venous insufficiency, and how to get ready for sandal season in the face of onychomycosis. #dermismedicine! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers: Maddie “Mad Dog” Morgan, Edison Jyang  Infographic and Cover Art: Edison Jyang  Writer: Beth Garbs Garbitelli  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP  Reviewer: Emi Okamoto MD, FACP  Editor: Emi Okamoto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Dr. Helena Pasieka  Sponsor: Qalo qalo.com/curb Listeners get 20% off at qalo.com/curb (Promo code: CURB20) Sponsor: Green Chef GreenChef.com/curb100 Go to GreenChef.com/curb100 and use code curb100 to get $100 off including free shipping!  Sponsor: Provider Solutions & Development info.PSDConnect.org/curbsiders  Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders   CME Partner: 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 to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* Tinea (pityriasis) versicolor and the fluff test, bumps, and lesions  Generalized Pruritus: clinical features, work-up and supportive care   Lower Extremity Venous Insufficiency and Lipodermatosclerosis Onychomycosis Take-Home Points  Outro
7/19/20211 hour, 15 minutes, 43 seconds
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#284 An Antibiotics Primer with @IDdocAdi

This antibiotics primer will break down the (cell) walls of antibiotic knowledge. Stop feeling silly when you deal with penicillins! We discuss antibiotic classes, common uses, the pathophysiology behind antibiotic mechanisms, and so much more with infectious disease expert, Dr. Adi Shah MBBS (@IDdocAdi)!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Script and Show Notes: Nora Taranto MD Infographic, Cover Art, Show Notes: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto (written materials): Clair Morgan of nodderly.com Reviewer: Victor Kovac MD Guest: Adi Shah MBBS Sponsor: Panacea Financial panaceafinancial.com Panacea Financial is a division of Primis, member FDIC Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders CME Partner: 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 to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* How to approach antibiotics Choosing antibiotics / Framework Dr. Shah’s favorite antibiotics Pneumonia Diabetic Foot Infections Take-home points Outro
7/12/202159 minutes, 18 seconds
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#283 CRC Screening: USPSTF Update with Dr. Michael Barry

Review the 2021 USPSTF Guidelines on Colorectal Cancer (CRC) screening with our guest, Dr. Michael Barry (vice-chair of the U.S. Preventive Services Task Force). Topics include a breakdown of testing modalities (stool tests versus direct visualization), screening ages, what to do for patients older than 75, and more!         Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Elena Gibson MD  Cover Art and Infographic: Elena Gibson MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Reviewer: Matthew Watto MD  Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Michael Barry MD  Sponsor: Indeed indeed.com/internalmedicine CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner Benefits of CRC screening How to choose a testing modality Testing in adults over 75 years old Health disparities in CRC screening Outro
7/5/202144 minutes, 36 seconds
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#282 Bariatric Surgery, Osteoporosis, 2021 Conference Highlights! (TFTC #6)

We recap the top pearls from our SGIM & ACP 2021 highlight shows (including gabapentin for pain, LGBTQ  and Women’s health pearls, CCBs and edema, MRSA swabs, IPMNs, DILI, and more!) plus recent interviews on bariatric surgery and osteoporosis. It’s Tales from the Curbside! (TFTC #6), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #275 Bariatric Surgery and #277 Bone Up on Osteoporosis.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Sarah Roberts, Edison Jyang, and Isabel Valdez Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Qalo qalo.com/curb Head to qalo.com/curb to get 20% off. CME Partner: 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.  Show Segments Intro, disclaimer LGBTQ health, Gabapentin, Care of the Muslim Patient, MRSA swabs IPMNs, DILI, CCB and Prescribing Cascades Bariatric Surgery  Osteoporosis Outro
6/30/202147 minutes, 9 seconds
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#281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais

Absorb all (but not too much) of the Calcium for your brain hole as Dr. Carl Pallais (Brigham and Women’s Hospital) walks us through his approach to Hypercalcemia. We learn about how tightly our body regulates calcium, and what to do when that regulation goes awry.  Not to mention that, at the end of the day, PTH is the name to remember (and phosphorus, if you need a quick stand-in while that PTH is pending). Claim CE credit at curbsiders.vcuhealth.org. It's free for all healthcare professionals! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, Writer, Infographic, Cover Art: Nora Taranto MD  Hosts: Matthew Watto MD, FACP; Nora Taranto MD   Reviewer: Yan Emily Yuan MD, MSc Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest:  Carl Pallais MD, MPH  Sponsor: Grammarly Grammarly.com/CURB Sponsor: Native NativeDeo.com/curb CME Partner: 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 . Show Segments Intro, disclaimer, guest bio Dr. Pallais One-Liner Case from Kashlak Definitions: What’s a Normal Calcium Level, and how to adjust for Albumin Causes of hypercalcemia How Lithium works!  Testing for Hypercalcemia: Get that PTH, and that phos  Symptoms of Hypercalcemia, and Questions on History  Indications for Surgery for Parathyroidectomy  Management of Hypercalcemia and Hypercalcemic Emergency  Outro
6/28/20211 hour, 26 minutes, 43 seconds
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#280 Heavy Menstrual Bleeding, Anticoagulation & Coagulopathy in Menstruating Patients

Explore the intersection of hematology and women’s health as we discuss heavy menstrual bleeding (HMB), gynecologic risks of therapeutic anticoagulation, and prescribing contraception in the setting of venous thromboembolic disease.  Wondering how to expand your women’s health knowledge as an internist? Listen as our insightful guest Dr. Bethany Samuelson Bannow @bsamuelson_md (Oregon Health & Science University) helps us navigate the intersections between non-malignant hematology and menstrual health. This episode will empower you to tackle the stigma and overcome knowledge gaps with regard to abnormal menstrual bleeding, as well as learn treatment, and management pearls.  We also explore the intersection between therapeutic anticoagulation, heavy menstrual bleeding, and thromboembolic disease of different contraceptive options.  Finally, we face the themes of overcoming sexism, and even misogyny, in women’s health head-on throughout this episode. After all, half the population has a uterus. Claim Free CE credit for this episode through VCU Health CE at http://curbsiders.vcuhealth.org/ Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Avital O’Glasser MD, FACP, FHM Infographic: Avital O’Glasser MD, FACP, FHM Cover Art : Kate Grant MBChB MRCGP DipGUMed Show Notes: Kate Grant MBChB MRCGP DipGUMed, Maddie Morgan, and Avital O’Glasser MD, FACP, FHM Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM Reviewer: Carolyn Chan, MD Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Bethany Samuelson Bannow, MD Sponsor: Birch by Helix birchliving.com/curb Sponsor: Green Chef GreenChef.com/curb100 CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Case 1 from Kashlak Definitions related to menstrual health Quantifying/defining heavy menstrual bleeding Overcoming stigma of asking about menstrual history/health Clinical evaluation/management of the patient with heavy menstrual bleeding Case 2 from Kashlak Risk of heavy menstrual bleeding (HMB) in the setting of therapeutic anticoagulation Hormonal and nonhormonal therapy options for HMB while anticoagulated Contraception options for someone who develops VTE Case 3 from Kashlak Counseling about VTE risk of different contraception options Take Home Points; Outro; Bonus clip
6/21/20211 hour, 1 minute, 43 seconds
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#279 Dominate Stable Angina with the CardioNerds

Learn how to dominate stable angina. Coronary artery disease with stable angina is a different beast than acute coronary syndrome.  We deconstruct it’s pathophysiology, diagnosis, and management with Drs. Dan Ambinder and Rick Ferraro. Topics: When to order coronary CT vs Stress testing; An approach to non-obstructive coronary disease; What treatments are life prolonging; Medical therapy vs Stenting; An approach to antianginal therapy; and how to partner with each patient. Listen as we dive deep into the recent literature and recommendations to dominate stable angina. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Molly Heublein, MD Writer: Molly Heublein, MD, Michael Sternberg MD Show Notes: Molly Heublein, MD, Beth Garbitelli Infographic, Cover Art: Beth Garbitelli Hosts: Molly Heublein, MD; Paul Williams MD, FACP    Editor: (written materials); Cyrus Askin MD, Clair Morgan of nodderly.com Guest: Daniel Ambinder, MD; Rick Ferraro, MD Sponsor: Panacea Financial panaceafinancial.com Panacea Financial a nationwide digital bank built for doctors by doctors. Panacea offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com. Panacea Financial is a division of Primis, member FDIC Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders. Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for 30 days. Visit Audible.com/curb or text curb to 500-500. CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week* Case from Kashlak Definitions of stable angina, unstable angina INOCA Assessing risk Treatment - life prolonging vs symptom relief Diagnosis- stress testing vs anatomical studies Angioplasty/stenting- ISCHEMIA trial Take home points Outro
6/14/20211 hour, 22 minutes, 51 seconds
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#278 Neuro Mystery Case with The CPSolvers

Delve into the neuro Ddx with expert diagnosticians the @CPSolvers, Drs. Reza Manesh (@DrRxEdu) and Rabih Geha (@rabihmgeha). Play along as they solve a neurology mystery case, and give us a tour of the neuraxis.  No CME for this episode, but claim it for past episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Matthew Watto MD, FACP Writer (case): Daniel Minter MD (@dminter89) Show Notes: Matthew Watto, MD, FACP Cover Art: Sawyer Watto Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Reza Manesh MD and Rabih Geha MD Sponsor: Panacea Financial panaceafinancial.com Sponsor: Provider Solutions and Development info.PSDConnect.org/curbsiders CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Weakness and Falls Localization on the neuraxis NM junction Lung Mass Cognitive Autopsy Outro
6/7/202149 minutes, 39 seconds
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#277 Bone Up on Osteoporosis in Primary Care with Dr. Carolyn Crandall

Bone up on osteoporosis in primary care! Don’t let osteoporosis sneak up on your patients with a vertebral fracture or a hip fracture! Make no bones about your osteoporosis knowledge, from knowing when to screen your patients to selecting a treatment that matches your patient’s lifestyle. Join us as we discuss these topics and more with osteoporosis expert and internal medicine physician, Dr. Carolyn Crandall (UCLA). Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Isabel Valdez, PA-C Show Notes: Isabel Valdez, PA-C Infographic: Isabel Valdez, PA-C Cover Art: Kate Grant MD Hosts: Isabel Valdez, PA-C; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto MD FACP and Leah Witt, MD  (written materials); Clair Morgan of nodderly.com Guest: Carolyn Crandall MD Sponsor: Indeed indeed.com/internalmedicine Get started RIGHT NOW with a FREE $75 SPONSORED JOB CREDIT to upgrade your job post at indeed.com/internalmedicine. Offer valid through JUNE 30TH. Terms and conditions apply. Sponsor: Native NativeDeo.com/curb Stay fresh, stay clean with Native by going to NativeDeo.com/curb, or use promo code curb at checkout, and get 20% off your first order! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week First Case from Kashlak Definitions of Osteoporosis and Low Bone Density (formerly Osteopenia) Patient Counseling on Treatment Side Effects Frequency of Testing Dental Clearance  CKD and Osteoporosis Treatment  Prevention Vitamin D and Calcium Take-home Points and Outro
5/31/20211 hour, 1 minute, 54 seconds
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#276 Chronic Diarrhea, Dementia, OHS, MSK Pearls (TFTC #5)

Recap the top pearls from recent shows on Chronic Diarrhea, Dementia, OHS, and MSK (Shoulder, Hip, and Knee).. It’s Tales from the Curbside! (TFTC), our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #267 Chronic Diarrhea, #268 Dementia, and #269 OHS, and  #274 MSK Triple Distilled. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Elena Gibson, Emi Okamoto, Cyrus Askin, and Matt Watto Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Grammarly Grammarly.com/CURB Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500. CME Partner: 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.  Show Segments Intro, disclaimer Chronic Diarrhea,  Dementia,  OHS, MSK: Shoulder, Hip, Knee Outro
5/26/202145 minutes, 13 seconds
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#275 Bariatric Surgery for the Internist with Dr. Vivian Sanchez

What if we told you there was a powerful tool that could help promote significant weight loss, correct uncontrolled diabetes, improve quality of life, and even improve patient mortality?  What if we told you it was offered less than 1% of the time to patients who qualify for it?  Listen as our esteemed guest Dr. Vivan Sanchez (Boston University) talks us through the patient selection, preoperative workup, and postoperative considerations for bariatric surgery, and how it might benefit your patients. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Paul Williams MD, FACP Infographic: Edison Jyang Cover Art: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Molly Heublein, MD; Clair Morgan of nodderly.com Guest: Vivian Sanchez, MD Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping! CME Partner: 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.  Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week Case from Kashlak Criteria for bariatric surgery Benefits of bariatric surgery Presurgical workup Postoperative management Complications Outro
5/24/20211 hour, 13 minutes, 45 seconds
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#274 MSK Triple Distilled: Shoulder, Elbow, Hip, Knee

Dominate MSK complaints in primary care! A packed recap from our past musculoskeletal episodes, triple distilled to what you need to know.  Learn some buckets to consider when addressing knee pain, just how simple hip complaints are, when to urgently refer shoulder problems, and easy exam maneuvers to differentiate elbow pain.  Use our simple framework to help with the top diagnoses walking into your primary care clinic.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Molly Heublein, MD Show Notes by: Molly Heublein, MD Cover Art and Infographics: Matthew Watto Hosts: Stuart Brigham MD; Molly Heublein, MD Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Emi Okamoto MD, FACP; Clair Morgan of nodderly.com (audio) Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb   CME Partner: 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.  Show Segments Intro, disclaimer Case from Kashlak- general orthopedic complaints Yellow flags Case from Kashlak Knee 4 buckets of knee pain Ligamentous injury Meniscus Patellofemoral Knee exam Knee Imaging Osteoarthritis treatment Case from Kashlak: hip Three steps to hip diagnosis Case from Kashlak: Shoulder Case from kashlak: elbow Take-home points
5/17/202157 minutes, 49 seconds
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#273 ACP 2021: The Highlight Reel Part 2

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: primary care management of anxiety and depression, insomnia, medical marijuana, venous thromboembolism, COVID-19 and coagulopathy, syncope, diverticulitis, aspirin, and delirium! Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Paul Williams MD, FACP; Chris Chiu MD FACP; Sarah Roberts MPH, Beth “Garbs” Garbitelli Show Notes by: Beth Garbitelli Cover Art: Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial panaceafinancial.com Panacea Financial offers loans just for physicians and medical students with low rates, free checking with no ATM fees nationwide, and 24/7 live customer service. Visit panaceafinancial.com today to open your account and join a bank built with you in mind. Panacea Financial is a division of Primis, member FDIC Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  CME Partner: 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. Show Segments Top Pearls on: Primary care management of anxiety and depression Insomnia Medical Marijuana Venous Thromboembolism COVID-19 and Coagulopathy Syncope Diverticulitis Aspirin Delirium
5/10/20211 hour, 5 minutes, 58 seconds
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#272 ACP 2021: The Highlight Reel Part 1

Binge on some delicious knowledge food fresh from ACP’s Internal Medicine Meeting 2021 #IM2021 with pearls on: Heart Failure, Hypertension, IV vs PO antibiotics, Hepatology, Kiwifruit for constipation, Perioperative Sleep Apnea, Thyroid, Bariatric Surgery, Neurology, Super Gonorrhea, and more! Note: This episode will not be available for CME/MOC credit due to the rapid turnaround time. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Deborah Gorth; Paul Williams MD, FACP; Matthew Watto MD FACP; Avital O’Glasser MD, FACP; Molly Heublein MD Show Notes by: Matthew Watto MD Cover Art: Beth Garbitelli Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial panaceafinancial.com Sponsor: GeriPal GeriPal.org Subscribe on Apple Podcasts, Spotify, or wherever you consume podcasts.  CME Partner: 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. Show Segments Heart Failure Oral vs IV antibiotics for osteomyelitis, bacteremia, and endocarditis Inpatient Blood Pressure Management Perioperative sleep apnea Thyroid pearls (pregnancy and weekly dosing) Bariatric Surgery pearls GI disorders (Cdiff, constipation, diverticulitis) Super Gonorrhea; Sunscreen! Outro
5/3/20211 hour, 2 minutes, 1 second
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#271 PAD, Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea (TFTC #4)

Recap our top pearls from recent shows on peripheral arterial disease (PAD), Abdominal Pain, Iron Deficiency in CKD, and Acute Diarrhea. It’s Tales from the Curbside (TFTC)!, our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #260 PAD, #263 Iron CKD, and #266 Acute Diarrhea. CME is not available for #261-262 Abdominal Pain Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli and Edison Jyang Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.com/Curb.   Sponsor: Indeed Indeed.com/INTERNALMEDICINE Get a $75 credit at Indeed.com/INTERNALMEDICINE. Offer valid through JUNE 30TH. Terms and conditions apply. CME Partner: 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.  Show Segments Intro, disclaimer Peripheral Arterial Disease (Dx and Management) Abdominal Pain and the Abdominal Exam Iron deficiency and Anemia in CKD Acute Diarrhea Outro
4/28/202133 minutes, 58 seconds
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#270 SGIM 2021: The Highlight Reel

It’s SGIM 2021, #SGIM21! LGBTQ health, updates in primary care for patients of all ages, caring for the Muslim patient, periop pearls, MRSA in your nose, and more! It’s the most wonderful time of the year for internists: SGIM and ACP, all in one month!  We’re here to help you make the most out of these action-packed virtual events, starting with our SGIM 2021 conference highlights. We hope you enjoy this grab-bag of clinical pearls, from LGBTQ healthcare to periop medicine to primary care, reproductive health, and beyond. Stay tuned for our upcoming ACP IMM2021 recaps for even more knowledge food! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced, and Hosted by: Sarah Phoebe Roberts MPH; Becca Raymond-Kolker, Paul Williams MD, FACP; Chris Chiu MD, FACP, FAAP; Matthew Watto MD FACP  Show Notes by: Sarah Phoebe Roberts MPH Cover Art and Infographic: Sarah Phoebe Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process. Sponsor: Audible Audible.com/curb New members can always try Audible Plus free for thirty days. Visit Audible.com/curb or text curb to 500-500. CME Partner: 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. Show Segments Top Pearls on: LGBTQ health Gynecological health  Reproductive medicine  Primary Care  Hospital Medicine  Perioperative Medicine  Caring for the Muslim patient  Young adult medicine pearls (including COVID19; and Down Syndrome) Reflections on SGIM 2021 and Outro
4/26/20211 hour, 14 minutes, 43 seconds
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#269 Obesity Hypoventilation Syndrome (OHS) and the Didgeridoo with Dr Aneesa Das

Does obesity hypoventilation syndrome (OHS) give you respiratory distress? Are you baffled by bilevel? The wait is over! Learn all the ins and outs about OHS from Dr. Aneesa Das, @AneesaDas,  a sleep specialist and pulmonologist at The Ohio State University! You’ll learn tips and tricks regarding the diagnosis and management of OHS, the important role PCPs can play, and why on earth we’re discussing the didgeridoo! Free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Cyrus Askin, MD Infographic: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Cyrus Askin, MD; Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Reviewer: Leah Witt, MD Editor: Matthew Watto, MD (written materials); Clair Morgan of nodderly.com Guest: Aneesa Das, MD Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb   Sponsor: HRSA National Health Service Corps NHSC.HRSA.gov Applications will be accepted through May 6. Visit NHSC.HRSA.gov to learn about eligibility and the application process. CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner Picks of the Week Case from Kashlak Basic risk factors for OHS and red flags That pathophysiologic trifecta Physical Exam & History - OHS Surveys and specific testing Labs and other tests (PFTs, Echo, and more) OSA, OHS, and Central Sleep Apnea Treating OSA: CPAP vs Bilevel The importance of weight loss Keys for inpatient management Perioperative considerations Take-home points Outro
4/19/20211 hour, 7 minutes, 4 seconds
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#268 Dementia Made Simple with Dr. Josh Uy

Dust off your dementia playbook and re-evaluate your approach as Dr. Josh Uy walks us through this common (yet perplexing) condition. Dr. Uy (@joshuy) is the geriatric fellowship director at University of Pennsylvania in addition to a nursing home director and shares his skills in simplifying dementia screening, management, and treatment. Set your chairs up for the “triad visit” and prepare to ‘stew in the milieu’ of dementia! Free CME for this episode at curbsiders.vcuhealth.org! Credits Producer, cover art, infographic: Emi Okamoto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Leah Witt MD (written materials); Clair Morgan of nodderly.com Guest: Josh Uy MD Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Sponsor: The American College of Physicians Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping! CME Partner: 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. Show Segments Intro, disclaimer, guest bio Guest one-liner and picks of the Week* Case from Kashlak Definitions of dementia and cognitive impairment Subtyping dementia Cases to refer and basic laboratory testing Potential imaging Management of dementia Take-home points, Outro
4/12/20211 hour, 1 minute, 36 seconds
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#267 Diarrhea Disemboweled Part 2: Chronic Diarrhea with Dr. Iris Wang

Flow with us through Diarrhea Disemboweled Part 2 as Dr. Xiao Jing (Iris) Wang @IrisWangMD  walks us through the differential diagnosis and initial evaluation of chronic diarrhea. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Elena Gibson MD Writer: Elena Gibson MD, Beth Garbitelli Cover Art: Kate Grant, MD  Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Matthew Watto MD (written); Clair Morgan of nodderly.com (audio) Guest: Xiao Jing (Iris) Wang MD Sponsor: Express VPN ExpressVPN.com/curb Protect your online activity TODAY with the VPN rated #1 by CNET and Wired. Visit our exclusive link ExpressVPN.com/curb and you can get an extra 3 months FREE on a one-year package! CME Partner: VCU Health CE The Curbsiders partner 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.  Show Segments Intro, disclaimer, guest bio  Case from Kashlak  Osmotic diarrhea & stool osmotic gap Causes of osmotic Diarrhea Algorithm for evaluating diarrhea workup Testing workup for chronic diarrhea Endoscopic evaluation indications Disorders of the Gut-Brain Axis
4/7/202157 minutes, 5 seconds
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#266 Diarrhea Disemboweled Part 1: Acute Diarrhea with Dr. Iris Wang

Flow with us through Diarrhea Disemboweled Part 1 as Dr. Xiao Jing (Iris) Wang @IrisWangMD  walks us through the evaluation and management of acute diarrhea.  NOTE: CME will not Go LIVE until Wed 4/7/21 for both #266 and #267. Then, claim 2 hours credit in one shot! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Elena Gibson MD Writer: Elena Gibson MD, Beth Garbitelli Cover Art: Kate Grant, MD  Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Editor: Matt Watto MD (written); Clair Morgan of nodderly.com (audio) Guest: Xiao Jing (Iris) Wang MD Sponsor: The American College of Physicians  Join the American College of Physicians today! Post-training physicians can take advantage of a special limited-time $100 dues discount. Visit acponline.org/acp100 and use the code CURBSIDERS. Membership discount is available only until May 31, 2021.  Sponsor: BetterHelp betterhelp.com/Curb This podcast is sponsored by BetterHelp and Curbsiders’ listeners get 10% off their first month at betterhelp.com/Curb.   CME Partner: 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.  Show Segments Intro, disclaimer, guest bio  Picks of the Week  Case from Kashlak  Definitions Small bowel vs. Large bowel pathology Red flags Microbiologic evaluation of acute diarrhea Non-Culture based testing panels Supportive Management Post infectious diarrhea Oral Rehydration Solution  Take-Home points and Outro
4/5/202154 minutes, 34 seconds
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#265 Hypertension Update, Sarcoidosis, Seizures (TFTC #3)

Recap our top pearls from recent shows on hypertension, sarcoidosis, and seizure. It’s Tales from the Curbside (TFTC)!, our monthly series providing a rapid review of recent Curbsiders episodes. Note: No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #254, #256, and #257.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced and Hosted by: Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Beth Garbitelli and Edison Jyang Cover Art: Edison Jyang Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Show Segments Intro, disclaimer Hypertension pearls Sarcoidosis pearls Seizures pearls Outro
3/31/202127 minutes, 12 seconds
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#264 Hotcakes: Semaglutide for Weight Loss, Abx for Diverticulitis, Periop COVID19

Fresh hotcakes! Practice-changing articles that you need to know: semaglutide for weight loss; metronidazole plus a fluoroquinolone versus amoxicillin/clavulanic acid for uncomplicated diverticulitis; and the perioperative risks of COVID19. We’re joined by Dr. Adnan Khan (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced and hosted by: Rahul Ganatra MD, MPH; Adnan Khan MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Cover Art: Matthew Watto MD, FACP Editor: Rahul Ganatra MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial panaceafinancial.com This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com. Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: ACP’s MKSAP 19 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at check out. CME Partner: 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 . Show Segments Intro, disclaimer Pick of the week: Dark (Netflix TV series) Preventive Medicine Updates Semaglutide for weight loss Amox-clav vs FQ-metronidazole for Diverticulitis Perioperative COVID19 infection and timing of surgery Rahul’s take-home points Outro
3/29/202144 minutes, 25 seconds
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#263 Iron Deficiency and Anemia of CKD (NephMadness 2021)

Dominant iron deficiency and anemia of CKD! We discuss how to interpret iron studies, when and how to start treatment with PO vs. IV iron, and ESAs vs. the new HIF-PHIs! Iron deficiency in chronic kidney disease is common but frequently overlooked in primary care.  This episode features Kashlak Memorial’s own Chief of Nephrology, Dr. Joel Topf (@kidney_boy), joined by NephMadness experts, Dr. Matthew Spark (@Nephro_Sparks), and Dr. Pascale Khairallah (@Khairallah_P)!  Our guests lay out an easy-to-follow framework for primary care and give us some inside information to #Nephmadness! Read the Anemia Region scouting report. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Writer, Producer:  Stuart Brigham, MD Cover Art:  Kate Grant MBChB, MRCGP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP  Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Joel Topf MD, Matt Sparks MD, Pascale Khairallah MD Sponsor: Grammarly Grammarly.com/CURB Get 20% off Grammarly Premium by signing up at Grammarly.com/CURB Sponsor: Green Chef GreenChef.com/90curb Go to GreenChef.com/90curb and use code 90curb to get $90 off including free shipping! CME Partner: 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. Segments Intro, disclaimer, guest bio Case from Kashlak Approaching CKD in Primary Care Iron and anemia labs in CKD Ferritin Goals in CKD Oral Replacement of Iron in CKD IV Replacement of Iron in CKD Discussing treatment option for Anemia of CKD Basic information on HIF Stabilizers/ PHIs in CKD Take-home points and Outro
3/22/20211 hour, 10 minutes, 31 seconds
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#262 Subacute and Chronic Abdominal Pain: Physical Exam Series

In this part 2 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of the DX: Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com Guest: Andrew Olson MD Sponsor: Birch by Helix birchliving.com/curb Birch is giving $200 dollars off ALL mattresses and 2 free eco-rest pillows at birchliving.com/curb   CME Partner: 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.
3/17/202137 minutes, 46 seconds
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#261 Acute Abdominal Pain: Physical Exam Series

In this part 1 of 2, learn how the abdominal exam affects our imaging choices, when to call a surgeon, and which classical maneuvers may not be so helpful. You may find it gut-wrenching! In this evidence-based physical exam series, we discuss how to approach abdominal pain with Dr. Andrew Olson (Minnesota), the leader of DX: the Diagnostic Excellence Project. Stay tuned for part 2 with Dr. Olson on subacute and chronic abdominal pain later this week! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Justin Berk MD MPH MBA and Sam Masur MD Writer: Sam Masur MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Justin Berk MD MPH MBA (written materials); Clair Morgan of nodderly.com Guest: Andrew Olson MD Sponsor: Panacea Financial panaceafinancial.com This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: BetterHelp betterhelp.com/Curb  This podcast is sponsored by BetterHelp and Curbsiders listeners get 10% off their first month at betterhelp.com/Curb CME Partner: 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.
3/15/202144 minutes, 50 seconds
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#260 Peripheral Artery Disease with Dr. Vlad Lakhter

A painless walk through the diagnosis and management of peripheral artery disease (PAD). PAD is one of those diagnoses that you know about, but maybe don’t feel comfortable diagnosing and managing.  Listen as our esteemed guest Dr. Vladimir Lakhter @VladLakhter (Temple Health) talks us through its diagnosis and management.  Dr. Lakhter gives us a straightforward framework for categorizing and triaging peripheral artery disease and talks us through the important components of medical management and who benefits from revascularization. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Jake Kieserman and Paul Williams MD, FACP Infographic: Edison Jyang Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Vladimir Lakhter, DO Sponsor: Indeed INDEED.COM/INTERNALMEDICINE CME Partner: 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. Time Stamps* *Note: Time Stamps refer to ad-free version.  Intro, disclaimer, guest bio- 00:33 Guest one-liner- 3:25 Dr. Lakhter book recommendations- 5:36 Case from Kashlak- 8:35 Definition and background for PAD- 10:25 Classification schema for PAD- 12:45 The physical examination- 21:05 ABIs and PVR in the diagnosis of PAD- 33:50 Exercise program for PAD-  46:08 Medication therapy-  52:05 Revascularization- 62:50 Outro- 68:45
3/8/20211 hour, 11 minutes, 58 seconds
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#259 Addiction Medicine Triple Distilled

Let's recap our favorite addiction medicine pearls!  We cover the treatment of alcohol use disorder, opioid use disorder and discuss strategies surrounding the management of long-term opioid therapy.  Please share your favorite addiction medicine pearls with us that we may have forgotten in the comments or by tagging us on Twitter @thecurbsiders.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producers: Carolyn Chan MD; Nora Taranto MD Infographics: Hannah R Abrams; Justin Berk MD, MPH, MBA; Carolyn Chan MD; Nora Taranto MD Writer and Cover Art: Carolyn Chan, MD Hosts: Carolyn Chan MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Justin Berk MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial, you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea is also excited to announce their “Match Day Giveaway.” $500 will be awarded to five medical students entering the match in 2021. Entry is free, and students can enter the giveaway on their website until March 31, 2021. Winners will be selected randomly on April 1st,  2021. No purchase necessary for entry. Go to panaceafinancial.com/matchday today to learn more. Panacea Financial, a Division of Sonabank, Member FDIC Partner: The Cribsiders Pediatric Medicine Podcast A Pediatric Podcast here to feed pediatric knowledge food to your adult-sized brain hole & provide weight-based dosings of fun. New episodes drop every other Wednesday! https://thecribsiders.com/  CME Partner: VCU Health CE The Curbsiders partner with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org to claim credit. Time Stamps Intro, disclaimer 00:00 Alcohol Use disorder (inpatient and outpatient management) 03:50  Sponsor -Panacea Finanicial 24:00 Partner -The Cribsiders Pediatric Medicine Podcast Chronic Pain and  Opioid Therapy (prescribing buprenorphine; microdosing) 25:30 Benzo Tapers 46:11 Outro
3/1/202148 minutes, 53 seconds
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#258 Nephrotic Syndrome, Smoking Cessation, Prev Med Update (TFTC #2)

Recap our top pearls from recent shows on nephrotic syndrome vs nephritic syndrome, smoking cessation and updates in preventive medicine. Tales from the Curbside (TFTC) is a monthly series providing a rapid review of recent Curbsiders episodes. Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #250, #251 and #252.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   Infographics by: Elena Gibson MD, Beth Garbitelli and Carolyn Chan MD Cover Art: Matthew Watto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: Grammary grammarly.com/curb
2/24/202134 minutes, 10 seconds
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#257 Carpe Diem: Seizure Basics for Primary Care

Seize control of your differential for epilepsy! This week, we review the basics of seizure work-up and management with our esteemed guest  Dr. Sara Dawit @DrSaraDawit a board-certified neurologist who is an Assistant Professor of Neurology and Neurophysiology Fellow at  The Mayo Clinic, Scottsdale Campus. Dr. Dawit takes us through rapid response to witnessed seizure, how to approach first-time seizures and adult-onset seizure disorders, gives us some facts about non-epileptic seizure disorders, and describes how to approach medication management in epilepsy!  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Paul Williams MD, Beth Garbitelli          Writer and Infographics: Beth Garbitelli Cover Art: Kate Grant  MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Sara Dawit MD Sponsor: ACP’s MKSAP MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout. Sponsor: Green Chef GreenChef.com/90curb Sponsor: Indeed Indeed.com/INTERNALMEDICINE CME Partner: 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 .
2/22/20211 hour, 11 minutes, 38 seconds
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#256 Sarcoidosis

This grand overview of granulomas will leave you comfortable tackling an often breathtaking disease, sarcoidosis. Listen as our esteemed guests Dr. Mary Beth Scholand (University of Utah) and Dr. Jonathan Boltax (University of Utah) rheum-inate on sarcoidosis. We discuss the pathophysiology, diagnosis, and treatment of this disease, role of the primary care clinician and why sarcoidosis in the chart reminds Paul of Shakespeare.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Cyrus Askin MD and Deborah Gorth Writer: Deborah Gorth Infographic and Cover art: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com Guest: Drs. Mary Beth Scholand & Jonathan Boltax Sponsor: ACP’s MKSAP MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at acponline.org/mksap19 and use promo code CURB2021 at checkout. Sponsor: birch by Helix Visit birchliving.com/curb CME Partner: 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. Time Stamps 00:00 Intro, disclaimer, guest bio, Awful(ly good?) Pun 03:42 Guest one-liners 06:28 Sponsor - ACP’s MKSAP19 07:40 Case from Kashlak 08:40 Explaining sarcoidosis 12:19 Possible drivers of sarcoidosis 13:30 Taking a sarcoidosis history 17:26 Suggestions for catching sarcoidosis 21:44 Sponsor - birchliving.com/curb 23:52 Sarcoidosis physical exam, Diagnosis 33:00 Lofgren’s and Heerfordt’s syndromes; Imaging for sarcoidosis 40:44 Initiating therapy for sarcoidosis; Prognosis; the Treatment team 51:23 Primary care considerations for sarcoidosis  54:55 Diagnosing and treating a sarcoidosis exacerbation 61:20 Take home points and outro
2/15/20211 hour, 4 minutes, 25 seconds
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#255 Hotcakes: Colchicine for CAD, and Gout flares, PT versus Steroids for Knee OA

Fresh hotcakes! Practice changing articles that you need to know: low dose colchicine for stable CAD; colchicine vs naproxen for acute gout flares; and physical therapy vs glucocorticoid injection for chronic Knee osteoarthritis. We’re joined by Michael Sternberg (Chief resident, VCU Internal Medicine Residency) and our fearless leader of critical appraisal, internist/epidemiologist, Rahul Ganatra MD, MPH, @rbganatra (VA Boston).  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Hosts: Rahul Ganatra MD, MPH; Michael Sternberg MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: ACP’s MKSAP18 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021. CME Partner: 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 . Time Stamps Intro, disclaimer 01:45 Fun animal fact; Picks of the Week* 06:33 PT vs steroid injection for chronic knee OA 21:00 Colchicine for stable CAD 33:00 Low dose colchicine vs naproxen for acute gout flares
2/8/202147 minutes, 33 seconds
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#254 Hypertension Update with Dr. Wanpen Vongpatanasin

Listen as our esteemed guest Dr. Wanpen Vongpatanasin, @DrWanpen (UT Southwestern) discusses the nitty-gritty of blood pressure monitoring and hypertension treatment.  We review the thresholds for HTN diagnosis and how to accurately measure blood pressure levels at home and in the office.  Dr Vongpatanasin shares the latest guideline recommendations for first line pharmaceutical therapies as well as her pearls about how to treat special populations. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Produced by: Deborah Gorth and Isabel Valdez, PA Written by: Deborah Gorth  Infographic and Cover Art: Edison Jyang Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; Paul Williams, MD, FACP    Editor: Molly Heublein, MD (written materials); Clair Morgan of nodderly.com Guest: Wanpen Vongpatanasin, MD Sponsor: ACP’s MKSAP18 MKSAP® is the most trusted resource for lifelong learning and Board prep for internal medicine physicians and residents. Learn more at www.acponline.org/curb2021. Sponsor: Provider Solutions and 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. CME Partner: 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. Time Stamps 00:00 Sponsors, Intro, disclaimer, guest bio 03:20 Guest one-liner 05:50 Sponsor - ACP’s MKSAP 18 07:05 Case from Kashlak; Defining hypertension and treatment thresholds 10:43 Measuring blood pressure (at home, in the office, validatebp.org) 16:46 Wrist BP cuff 19:50 Home monitoring and ambulatory BP monitoring; What time to take BP medication 31:23 Sponsor - Provider Solutions and Development 32:10 Approach to treatment; Combo pills; How to titrate meds 42:20 Treating resistant hypertension; hyperaldosteronism; Isolated systolic hypertension 52:04 Take home points and Outro
2/1/202156 minutes, 39 seconds
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#253 COVID-19 Vaccines with Dr Monica Gandhi

Answer all your burning questions (and your patients’ burning questions) about the different COVID-19 vaccines currently authorized in the US. Infectious diseases / HIV expert, Dr Monica Gandhi @MonicaGandhi9 (UCSF) joins us to cover: the Pfizer-BioNTech and Moderna novel mRNA vaccine mechanisms, trial data, and practicalities of who should receive them.  We discuss data around the Oxford-AstraZeneca adenovirus vaccine, which is authorized in the UK and India, and may be available in the US later this year.  Feel confident recommending COVID-19 vaccines to your patients! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and Produced by: Molly Heublein, MD Cover Art: Chris Chiu, MD, FACP, FAAP Infographic: Tima Karginov Hosts: Chris Chiu, MD, FACP, FAAP; Molly Heublein, MD; Paul Williams, MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Monica Gandhi, MD, MPH Sponsor: Panacea Financial  This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC 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. Time Stamps Intro, disclaimer, guest bio - 00:00  Guest one-liner, book recommendation - 3:40 Authorized vaccines in the US - 8:30 AstraZeneca vaccine mechanism- 9:26 mRNA vaccine mechanism - 10:30 Vaccine distribution issues (cold chain) - 16:05 mRNA safety - 18:24 mRNA vaccine efficacy/data from phase 3 trials - 19:40 How did we get this so quickly - 23:40 Vaccine impact on asymptomatic infection - 26:18 AstraZeneca trials - 28:20 Pregnancy - 35:10 Anaphylaxis - 37:10 Prior COVID-19 infection - 39:07 Side effects - 42:05 Pediatric patients - 45:12 Phases of role outs in the US -46:50 Herd immunity - 48:16 Thoughts of how to make this happen - 52:45 Preexisting conditions - 53:40 How long will immunity last - 57:15 Mutant strains - 58:25 Future of mRNA vaccines - 1:00:30 Take home points and Outro - 1:02:12
1/27/20211 hour, 5 minutes, 2 seconds
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#252 Smoking Cessation Unfiltered

Get all the details on varenicline, nicotine replacement therapy, and integrating psychosocial interventions into a comprehensive smoking cessation treatment plan! Smoking cigarettes is the leading cause of preventable death worldwide. Listen as our esteemed guest Dr. Steve Baldassarri (Yale) provides us expert pearls to help our patients quit smoking.  Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written and produced by: Carolyn Chan, MD Infographic: Edison Jyang Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin, MD (written materials); Clair Morgan of nodderly.com Guest: Steve Baldassarri MD MHS Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.   “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org. (Prices shown online at registration pages reflect Discounted Rates.)   Register now—Early Bird savings end January 31st! 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. Time Stamps* *Note: Time Stamps refer to ad free version.  03:02 Intro, disclaimer, guest bio 04:35 Guest one-liner  09:50 Tobacco Use Disorder - Chronic Disease 11:08 Case from Kashlak 11:56 Obtaining a history 13:39 Motivations for Smoking Cessation 15:29 Factors associated with challenges in smoking cessation: 21:40 Gradual Tapers vs Cold Turkey 25:18 Nicotine Replacement 32:40 28:57 Pharmacotherapy - “Controller” Medications 31:05 Pharmacotherapy - Short Acting Medications 33:20 Dosing Medications 38:35 Varenicline 39:00 Nicotine gum dosing  44:40 Duration of therapy 48:08 Bupropion  49:05 Behavioral Interventions 55:24 Vaping and electronic cigarettes  57:03 Vaping for smoking cessation 01:02:35 EVALI 01:05:49 Outro
1/25/20211 hour, 6 minutes, 31 seconds
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#251 What the USPSTF? Preventive Medicine Updates with Dr. Amber-Nicole Bird

What the USPSTF?! It’s time for some preventive medicine updates on: screening for unhealthy drug use, cervical cancer, hepatitis C and draft recs for colorectal cancer; plus how to interpret USPSTF screening recs. Dr. Amber-Nicole Bird @ABirdMD (Penn Medicine) refreshes our love for preventive medicine, with updates on the newest recommendations. She reviews how to appropriately interpret and adopt guidelines for our patients, being cognizant of the source. We shine light on the mechanism of USPSTF, including how their guidelines differ from others, so we can understand the value and context when utilizing the guidance in the clinic. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Produced and Written by: David Madick MD; Peter Wikoff MD; Paul Williams MD, FACP Infographic: Beth Garbitelli Cover Art: Chris Chiu MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto, MD (Show notes); Clair Morgan of nodderly.com Guest: Amber-Nicole Bird, MD Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st! 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.
1/18/20211 hour, 4 minutes, 50 seconds
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#250 Nephrotic Syndrome vs. Glomerulonephritis with Kidney Boy, Dr. Joel Topf

Kashlak’s esteemed Chief of Nephrology, Dr Joel Topf @kidney_boy walks us through the evaluation and differentiation of nephrotic syndrome and glomerulonephritis. Embrace the kidney again as we sort the different diagnostics, managements, and prognosis for these two pathologies. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer, writer, infographic, cover art: Elena Gibson MD Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written); Clair Morgan of nodderly.com (audio) Guest: Joel Topf MD Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st! 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.
1/11/20211 hour, 16 minutes, 17 seconds
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#249 Cellulitis, Bites, Vulvovaginitis, MGUS, SPEP (TFTC #1)

Recap the top pearls from recent shows on vulvovaginitis, cellulitis and bites, MGUS and the SPEP. Tales from the Curbside (TFTC) is pilot project providing a rapid review of recent Curbsiders episodes. Note: There is no CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for #244, #246 and #247. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written, Produced and Hosted by: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Infographics by: Kate Grant MBChb, MRCGP, Beth Garbitelli and Nora Taranto MD Cover Art: Matthew Watto Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years. “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org and use the code IM21CURB. Register now—Early Bird savings end January 31st! Time Stamps* *Note: Time Stamps refer to ad free versions. 00:00 Intro, disclaimer, guest bio 02:35 Vulvovaginitis 05:35 Cellulitis and Bites 09:45 SPEP it Up 15:15 Outro
1/4/202118 minutes, 24 seconds
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#248 Top Pearls of 2020: Curbsiders' Recap Extravaganza

Our team shares the top pearls of 2020 in our annual recap extravaganza featuring guest host, Chris “The Chiu Man” Chiu @cjchiu. Check out the video version at YouTube. Topics: hypothyroidism, women in medicine, hypothermia, diuretics, heart failure, AKI, lipids, post-op fever, refugee health, SGLT2 inhibitors, euglycemic DKA, UTIs, bat bites, rabies, ILD, statins in NAFLD, framework for hair loss, and more! Plus: Our picks of the year and the Curbsiders gift guide! Note: This episode is not available for CME but #208 through #247 are available for CME/MOC at curbsiders.vcuhealth.org for free! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Chris Chiu MD, FACP, FAAP Written by: The Curbsiders Team Show Notes: Matthew Watto MD, FACP Cover Art: Chris Chiu MD, FACP, FAAP Hosts: Chris Chiu MD, FACP, FAAP, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC
12/28/20201 hour, 4 minutes, 6 seconds
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#247 SPEP It Up: MGUS, Myeloma, and Immunology, Oh My!

On this episode, Dr. Jorge Castillo (Harvard, Dana Farber) walks us through some immunology basics, teaches us the limitations of the SPEP, plus some additional tests that complement it (think Immunofixation), shares his clinical gestalt about when to suspect  MGUS, Myeloma, Waldenstrom’s, and Amyloidosis--and finally, how to talk to patients about them. If you, like Stuart, have ever wondered what on earth to do with that pesky free light chain ratio or the SPEP that so often gets inboxed to you without explanation, then fear not, Dr Castillo has your back! Episodes | Subscribe | 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; Stuart Brigham MD, FACP, Nora Taranto MD Editor: Matthew Watto MD, FACP ; Clair Morgan of nodderly.com Reviewer: Jooho Chung MD, PhD Guest: Jorge Castillo MD Sponsor: Panacea Financial This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC Sponsor: VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your account!
12/21/20201 hour, 5 minutes, 1 second
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#246 Take a Bite out of Cellulitis with Dr Boghuma Titanji

Master common skin and soft tissues infections: cellulitis, abscesses, human and animal bites with returning guest, infectious diseases expert, Dr Boghuma Titanji MD, PhD @boghuma (Emory; TED). Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Written (including CME) and Produced by: Matthew Watto MD, FACP Cover Art and Infographic by: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto (written materials); Clair Morgan of nodderly.com Guest: Boghuma Titanji MD, M.Sc., DTM&H, PhD Sponsor: Provider Solutions and 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. 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. Time Stamps* *Note: Time Stamps refer to ad free version. 00:00 Intro, disclaimer, guest bio 02:00 Picks of the Week 06:00 Definitions, Initial Approach to cellulitis 10:35 Nonpurulent cellulitis; antibiotic choice
18:10 Fish handler’s disease 24:30 Recurrent cellulitis 31:30 Purulent cellulitis and MRSA; Antibiotic choice; Step down therapy 47:33 Abscesses; Adjuvant antibiotics; Packing Wounds 53:30 Decolonization for recurrent MRSA infections 56:30 Human Bites (clenched fist injury); Dog bites and Cat bites 67:10 Take home points and Outro
12/14/20201 hour, 11 minutes, 42 seconds
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ADHD: All that Fidgets is Not... (Cribsiders #13)

Diagnosis, Management, and Social Implications of Attention Deficit Hyperactivity Disorder.  Ever gotten overwhelmed by all the categories of ADHD, or interpreting the scores on a Vanderbilt form? Join us with Dr. Sarah Vinson, a triple-boarded clinician in adult  psychiatry, child psychiatry, and pediatrics who helps us optimize a diagnosis and management process for ADHD. What other conditions can masquerade as ADHD? Which type of stimulant should you use? Listen to find out more! Show notes at: https://thecurbsiders.com/cribsiders/13 Subscribe at: Apple , Google, Spotify Credits Writer, Producer, Infographic: Angela Zhang Cover Art: Chris Chiu Hosts: Justin Berk, Chris Chiu Editor:Justin Berk; Clair Morgan of nodderly.com Guest(s): Dr. Sarah Y. Vinson Time Stamps 5:30 Diagnosis of ADHD 6:53 Considering a differential diagnosis of ADHD 8:43 Categories of ADHD 15:02 Ancillary Supports 18:27 Consequences of Misdiagnosis 19:53 Parent Counseling 22:08 Behavioral Interventions Treatment 25:56 Gender Differences in ADHD 28:00 Anaphylaxis Promo 28:39 Alternative Treatments 30:54 Pharmacotherapy for ADHD 37:29 Side Effects of Medical Treatments 44:33 Monitoring Progress 46:19 Treating concurrent mood disorders 49:21 ADHD in Young Adults 55:29 ADHD and Race 1:08:13 Future of ADHD
12/9/202046 minutes, 46 seconds
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#245 COVID Cakes: Masks, Home Testing, Anticoagulation, Vaccines

Learn about the latest in COVID-19: Do masks prevent infection?, SARS-CoV-2 home testing, vaccine advice, and how to prevent and treat VTE in COVID-19. Join us as our tzar-of-clinical-appraisal Curbsider/internist/epidemiologist Rahul Ganatra MD MPH (@rbganatra) talks us through the controversial DANMASK-19 trial, plus Watto reports back on his conversation with Dr Parth Rali @parthrali (Temple Lung Center) who helped write the CHEST anticoagulation guidelines for COVID-19. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Producer: Deb Gorth ScM Show Notes, Cover Art, and CME by: Deb Gorth ScM and Matthew Watto MD Written by: Matthew Watto MD, Paul Williams MD, and Rahul Ganatra MD MPH Hosts: Rahul Ganatra MD MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts. 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, disclaimer, Picks of the week* and Vaccines 08:00 DANMASK-19 25:00 Anticoagulation in COVID-19 35:06 COVID-19 home PCR testing Outro
12/7/202042 minutes, 44 seconds
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#244 Vulvovaginitis for All Ages with Dr. Monica Christmas

Everything you need to know about vulvovaginitis: candidiasis, bacterial vaginosis, and Genitourinary Syndrome of Menopause. Join us on the journey of a lifetime as we learn all about diagnosing, treating and managing vulvovaginal conditions in patients of all ages. Plus, a bit on how to recognize and treat lichen sclerosus. Our brilliant guest for this episode is Dr. Monica Christmas (@drmonicaxmas on Twitter), who is a self-described yoga enthusiast, avid reader, wannabe artist and gynecologist. Dr. Christmas is currently an Assistant Professor at the University of Chicago in the section of Minimally Invasive Gynecologic Surgery where she is the director of the Menopause Program. Monica specializes in gynecologic surgery, abnormal uterine bleeding and menopause management with an interest in sexual dysfunction. Her focus is on helping women live healthy, vibrant, happy lives. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! Credits Produced by: Kate Grant MD; Sarah Phoebe Roberts MPH Written by: Kate Grant MD Show Notes by: Sarah Phoebe Roberts MPH, Kate Grant MD Cover Art and Infographic: Kate Grant MD Hosts: Kate Grant MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Monica Christmas, MD Sponsor: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts. 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.
11/30/202057 minutes, 2 seconds
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#243 Diabetes Triple Distilled

Listen in as we recap four of our favorite diabetes episodes to bring you the pearls you need to stay up to date on type 2 diabetes management in the clinic.  We cover pitfalls of A1c testing, guidelines for A1C targets, when and how to use the newer medications SGLT-2 inhibitors and GLP-1 agonists.  We wrap up with a discussion of managing DM2 in patients with kidney disease and in which patients to consider de-intensifying treatment.  Feel confident managing diabetes with the latest data in 2020! Listeners can claim 4 HOURS of Free CE credit for this episode through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). Show Notes | Spotify | Swag! | Top Picks | Mailing List | [email protected] | CME! Credits Written and Produced by: Molly Heublein, MD Infographic and Cover Art: Isabel Valdez, PA Show Notes: Isabel Valdez, PA; Molly Heublein, MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Molly Heublein, MD Editors: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Sponsors: ACP’s I Raise the Rates Join with other clinicians in working to raise influenza and other adult vaccination rates. Visit acponline.org/ai to access free tools and learn new strategies to support your efforts. 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 0:00 Intro, 2:45 Pitfalls of A1c testing, 7:00 Diabetes goals/A1c guidelines; Macrovascular vs Microvascular benefits, 16:20 Choosing between SGLT2 inhibitors vs GLP1 agonists, 19:10 Stuart rants on insulin for symptomatic hyperglycemia, 22:32 Start your patient on an SGLT2i and counsel them about potential adverse events, 30:30 GLP-1 agonists, 36:50 Deintensification; Diabetes Treatment in CKD, Tags Diabetes, hypoglycemia, SGLT2 inhibitors, GLP-1 agonist, metformin, CKD, primary care, assistant, doctor, education, family, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, physician, resident, student
11/23/202046 minutes, 41 seconds
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#242 Wilderness Medicine: Prepare for Disaster

Explore the essentials of Wilderness Medicine and prepare yourself for austere environments as we discuss Altitude Sickness, Frostbite, Animal Bites, Thermoregulation, Wound Care and the proper way to apply a tourniquet.   Thinking about outdoor escapes and vacations now more than ever? Listen as our esteemed guest Dr. Thomas DeLoughery @Bloodman (Oregon Health & Science University) takes us through the fascinating, and at times chilling, world of Wilderness Medicine. This episode will empower you to explore the great outdoors as safely as possible.  We discuss the breadth of wilderness medicine, multiple unique clinical entities encountered in austere environments, and practical ways to protect yourself and others on your adventures.  This episode is truly wild!   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, Produced, and Infographic by: Avital O’Glasser MD, FACP, FHM Show Notes: Deborah Gorth ScM and Avital O’Glasser MD, FACP, FHM Cover Art: Kate Grant, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Avital O’Glasser MD, FACP, FHM Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Thomas DeLoughery MD, MACP, FAWM   Sponsors:   Provider Solutions and 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ Sponsor - VCU Health CE curbsiders.vcuhealth.org    00:00 Intro, disclaimer, guest bio 03:45 Guest one-liner, advice and Picks of the Week* 08:10 Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ 09:00 Case of mountaineering; What is Wilderness Medicine?
 12:05 What’s in your first aid kit?
 21:36 Altitude sickness: acute mountain sickness, high altitude cerebral edema and High altitude pulmonary edema
 31:25 Hypothermia   39:36 Frostbite 
 47:25 Hyperthermia: Heat exhaustion and Heat stroke; How much water should you drink?
 51:55 Bat bites and rabies
 58:20 Snake bites
 66:03 Wound care and tourniquets
 75:40 Take Home Points; Outro; Bonus clip Sponsor - VCU Health CE curbsiders.vcuhealth.org      Links* De Gaulle by Julian Jackson  Command and Control by Eric Schlosser Auerbach's Wilderness Medicine, 2-Volume Set  Whatever book Paul said he was reading, sounds nerdy (The First Law Trilogy)  Wilderness Medicine Society Stop The Bleed: Home  Into Thin Air: A Personal Account of the Mt. Everest Disaster by Jon Krakauer National Outdoor Leadership School Advanced Wilderness Life Support  Inside the ER at Mt. Everest  Annapurna by Maurice Herzog  K2, The Savage Mountain: The Classic True Story Of Disaster And Survival On The World's Second-Highest Mountain– by Charles Houston and Robert Bates    *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 learn the basics of wilderness medicine and how to approach a few common conditions.    Learning objectives After listening to this episode listeners will…   Appreciate Wilderness Medicine as a medicine subspeciality and understand why or how someone might pursue this clinical focus area Recognize signs and symptoms of high altitude sickness Develop an approach to treating animal bites and injuries Learn high yield tips for administering first aid in the wilderness including field hemostasis   Disclosures Dr DeLoughery reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation O’Glasser AY, Gorth D, Deloughery T, Williams PN, Watto MF. “#242 Wilderness Medicine: Prfor Disaster”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date November 16, 2020.   Tags Wilderness Medicine, Travel medicine, first aid, first aid kit, altitude sickness, acute mountain sickness, high altitude cerebral edema, high altitude pulmonary edema, acetazolamide, dexamethasone, hypothermia, frostbite, frostnip, heat exposure, heat exhaustion, heat syncope, hyperthermia, hyponatremia, animal bites, bats, rabies, snakes, antivenom, wound care, tourniquet, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
11/16/20201 hour, 19 minutes, 34 seconds
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#241 Chronic Cough

Rejoice! as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward. 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). We hope you enjoy learning from this episode as much as we enjoyed producing it!   Show Notes | Subscribe | 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; Stuart Brigham MD; Paul Williams MD, FACP    Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Brad Hayward MD   Sponsors: Panacea Financial  This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com Panacea Financial, a Division of Sonabank, Member FDIC     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 - Panacea Financial panaceafinancial.comSponsor - VCU Health CE curbsiders.vcuhealth.org 00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week* 06:23 Sponsor - Panacea Financial panaceafinancial.com 07:30 Case of Post Infectious Cough; Basic definitions for cough Important aspects of the history Empiric therapies for post-viral cough 22:50 Case of idiopathic chronic cough; Physical exam 29:20 Basic testing and empiric therapy for the common causes of chronic cough 41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds 54:28 Take home message; Outro Sponsor - VCU Health CE curbsiders.vcuhealth.org   Links* 90 Day Fiancé (show)   Below Deck Mediterranean (show) Mastering Communication with Seriously Ill Patients by  Anthony Back, Robert Arnold & James Tulsky (book)    *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 develop a pragmatic approach to evaluating subacute and chronic cough in adult patients.   Learning objectives After listening to this episode listeners will be able to…   ... define sub-acute vs chronic cough ... build a repertoire of history questions geared towards identifying the etiology of cough in a patient ... build a toolbox of diagnostic studies / tests that can be used in the evaluation of cough ... marry history, physical and diagnostic studies into a coherent approach to diagnosing subacute and chronic cough through a tiered/logical approach ... understand empiric therapies for cough that may have an advantageous risk-reward profile, even in the absence of diagnosis  ... educate patients on common causes for subacute cough and chronic cough, as well as how to appropriately set expectations regarding symptoms severity and duration   Disclosures Dr. Hayward reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Askin CA, Hayward B, Williams PN, Brigham SK, Okamoto E, Watto MF. “241: Chronic Cough”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date: November 9, 2020.   Tags Cough, dyspnea, asthma, COPD, eosinophil, IL-5, allergy, ENT, allergist, pulmonary, pulmonologist, PFT, spirometry,  post-nasal drip, GERD, reflux, eczema, rash, atopy, mucus, bronchiectasis, lung, antihistamine, CT, X-Ray,  smoking, vaping, birds, dust, cockroaches, steroids, ICS, inhaled, gabapentin,  primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
11/9/202057 minutes, 41 seconds
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#240 Elbow Pain: Straighten it out

Returning guest expert Dr Ted Parks helps us get the elbow straight with a simple approach to common causes of elbow pain for primary care.  Listen as he guides Stuart through physical exam techniques (or watch them on YouTube) for epicondylitis and learn what the bursa is there for anyways. Find out what fracture you can treat in your office, why you shouldn’t stab straight into the olecranon bursa and when elbow pain should be referred.  Feel confident when your patient comes in with elbow pain! 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] Credits Written and Produced by: Molly Heublein, MD Cover Art and Infographic: Edison Jyang Hosts: Stuart Brigham MD, Matthew Watto MD, FACP; Molly Heublein, MD Editor: Emi Okamoto, MD (written materials); Clair Morgan of Nodderly.com (audio/video) Guest: Ted Parks, MD     Sponsors   Provider Solutions and 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. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ Sponsor - VCU Health CE curbsiders.vcuhealth.org    00:00 Intro, disclaimer, guest bio 04:00 Picks of the Week* Sponsor - Provider Solutions and Development https://curbsiders.vcuhealth.org/ 09:50 Medial and lateral epicondylitis case, Elbow anatomy 13:00 Pathophysiology of epicondylitis, Epicondylitis exam, Epicondylitis treatment 34:11 Olecranon bursitis, Bursitis diagnosis and aspiration 46:12 Radial head fracture diagnosis, Radial head fracture treatment 55:30 Cubital tunnel nerve entrapment 57:45 Platelet rich plasma 60:39 Take home points, Plug and Outro 64:00 Bonus Pick of the Week Sponsor - VCU Health CE curbsiders.vcuhealth.org      Goals Listeners will have a working differential of elbow complaints that commonly present in primary care, and understand how to diagnose these and initiate treatment.   Learning objectives After listening to this episode listeners will... Perform an exam for medial and lateral epicondylitis. Describe treatment options for medial and lateral epicondylitis Identify when further evaluation for clinical olecranon bursitis beyond clinical exam is needed Explain how radial head fractures differ from most other fractures, and why casting or surgery is generally not needed.   Links* Molly’s Pick: The Warmth of Other Suns (book) by Isabel Wilkerson  Stuart’s Pick: The Fringe (TV show), JJ Abrams Practical Office Orthopedics (textbook) by Ted Parks, MD   *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.   References Johnson GW, Cadwallader K, Scheffel SB, Epperly TD. Treatment of lateral epicondylitis. Am Fam Physician. 2007 Sep 15;76(6):843-8. PMID: 17910298. Simental-Mendía M, et al. Clinical efficacy of platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review and meta-analysis of randomized placebo-controlled clinical trials. Clin Rheumatol. 2020 Aug;39(8):2255-2265. doi: 10.1007/s10067-020-05000-y. Epub 2020 Feb 26. PMID: 32103373. Parks, Ted.  Practical Office Orthopedics.   McGraw-Hill Education / Medical; 1st Edition (December 29, 2017).   Khodaee M. Common Superficial Bursitis. Am Fam Physician. 2017 Feb 15;95(4):224-231. PMID: 28290630. Liow RY, Cregan A, Nanda R, Montgomery RJ. Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols. Injury. 2002 Nov;33(9):801-6. doi: 10.1016/s0020-1383(02)00164-x. PMID: 12379391. Boone S, Gelberman RH, Calfee RP. The Management of Cubital Tunnel Syndrome. J Hand Surg Am. 2015 Sep;40(9):1897-904; quiz 1904. doi: 10.1016/j.jhsa.2015.03.011. Epub 2015 Aug 1. PMID: 26243318.   Tags Elbow, orthopedics, olecranon bursitis, bursa, aspiration, septic joint, medial epicondylitis, lateral epicondylitis, radial head fracture, PRP, platelet rich plasma, humerus, olecranon, radius, tendonitis, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student   Disclosures Dr Parks reports is the author of Practical Office Orthopedics (McGraw-Hill 2017) . The Curbsiders report no relevant financial disclosures.    Citation Heublein M, Parks T, Jyang E, Brigham SK, Okamoto E, Watto MF. “#240 Elbow Pain: Straighten it out. A dabble into elbow care  with Dr Ted Parks”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list November 02, 2020.
11/2/20201 hour, 5 minutes, 41 seconds
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#239 Sinusitis: It’s Not That Tricky

A runny nose won’t have you running in circles this cold season with our fantastic overview of rhinosinusitis in all its forms! We discuss etiology and presentation of viral versus bacterial rhinosinusitis, practical counseling tips for guiding patients on nasal irrigation, and working up chronic rhinosinusitis! Our guest is the fabulous Dr. Dink Jardine, a general otolaryngologist, Commander in the US Navy, and Director for Professional Education (DPE) and Designated Institutional Official (DIO) at Naval Medical Center Camp Lejeune (NMCCL).    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: Paul Williams MD, FACP, Beth Garbitelli Cover Art: Kate Grant MBChb, MRCGP  Infographic by:  Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com (audio) Guest: Dink Jardine, MD   Sponsors:   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.     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 – National Internal Medicine Day, The American College of Physicians Sponsor - VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio 03:00 Guest one-liner, Favorite failure, Pick of the Week*:  Still Life by Louise Penny Sponsor – National Internal Medicine Day, The American College of Physicians 09:30 Case 1 - Acute Viral Rhinosinusitis  10:40 Rhinosinusitis vs. Sinusitis  14:20 Physical exam in rhinosinusitis 20:40 Counseling patients about viral vs. bacterial infection 22:56  Sinus regimen/nasal irrigation - “Is there a sinus toilet” 27:10 Intranasal fluticasone and other intranasal medications  29:40 Rhinitis medicamentosa 30:40 Nasal spray positioning 33:50 Case 1 - Double Sickening 37:40 Worst case scenarios from rhinosinusitis 40:40 Antibiotic treatment for bacterial rhinosinusitis 43:20 Failed improvement on antibiotics? Second-line options 49:30 Case 2 - Chronic rhinosinusitis  52:28 Etiology of chronic rhinosinusitis 53:33 Making a diagnosis of chronic rhinosinusitis 55:25 Treating chronic rhinosinusitis  58:40 Vasomotor rhinitis  60:40 Sinus irrigation counseling and tips (YouTube) 65:30 Case 3 - Allergic Rhinitis  70:13 Oral medications for allergic rhinitis; Chronic allergic/non-allergic rhinitis  73:51 Take-home points   Links* Still Life: A Chief Inspector Gamache Novel by Louise Penny,  Chief Inspector Gamache series “Dr. Adappa and Dr. Palmer teach you How to do Nasal Irrigation” https://www.youtube.com/watch?v=Br928VfiC1M   *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 develop an approach to the diagnosis and management of rhinosinusitis.   Learning objectives After listening to this episode listeners will... Classify rhinosinusitis, including acute, chronic, bacterial, and viral. Discuss the microbiology and pathophysiology underpinning rhinitis and sinusitis. Differentiate the presentation and management of acute bacterial and acute viral rhinosinusitis. Develop an approach to the diagnosis and management of allergic rhinosinusitis. Recognize and manage patients with non-allergic rhinitis. Discuss the role of antibiotic therapy and surgery in the management of rhinosinusitis.   Disclosures Dr. Jardine reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Williams PN, Garbitelli B, Jardine D, Heublein M, Watto MF.. “#239 Sinusitis: It’s not that tricky.” The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 26, 2020.   Tags sinus, sinusitis, rhinitis, acute bacterial, rhinosinusitis, bacterial, viral, virus, nose, chronic sinusitis, ENT, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
10/23/20201 hour, 14 minutes, 58 seconds
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#238 DVT / PE Triple Distilled

DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates.    Listeners can claim 2 hours of 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 by: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    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. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps 00:00 Intro, disclaimer 01:40 Making the diagnosis of VTE 09:07 Triage and risk stratify Pulmonary Embolism 14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE 21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight,  advanced CKD and in antiphospholipid syndrome 28:22 IVC filters  30:20 Outro   Links Check out the full show notes from previous Curbsiders’ shows covering VTE.  Dr Oren Friedman #92 Pulmonary Embolism for the Internist  Dr Michael Streiff #154 DVT and PE Master Class   Goals Listeners will feel confident in the diagnosis and management of VTE   Learning objectives After listening to this episode listeners will...   Diagnose (VTE) DVT and PE using imaging, risk scores and clinical gestalt Risk stratify patients with pulmonary embolism Choose the appropriate initial anticoagulant for VTE Decide duration of anticoagulation for VTE Recall real risks and questionable benefits of IVC filters in DVT / PE Determine need for cancer or thrombophilia workup in unprovoked DVT / PE     Disclosures The Curbsiders report no relevant financial disclosures.    Citation Watto MF, Williams PN, Brigham SK, Watto MF. “#238 DVT / PE Triple Distilled”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 22, 2020.   Tags Pulmonary embolism, vte, dvt, pe, heparin, anticoagulation, right ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC filter, TPA, echocardiogram, CT scan, bleed, clot, deep, vein, thrombosis, DOAC, NOAC, anticoagulation, d-dimer, Wells, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
10/22/202030 minutes, 25 seconds
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#237 Ophthalmology for Primary Care

Fun, fluorescein, and fundoscopy unite as our esteemed guest, Dr. Nisha Chadha @iEducatorMD (Mount Sinai School of Medicine) brings us ophthalmology for primary care! Dr. Chadha is a medical educator and the content creator of the med-ed simulation website 20/20 Sim. She teaches us the 3-vital signs of ophthalmology, how to recognize common diabetic eye diseases, how to explain diabetic retinopathy to our patients, how to optimize a patient for cataract surgery and so much more. This episode is truly vision-ary!   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, Produced, and Infographic by: Carolyn Chan, MD Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Carolyn Chan, MD Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Nisha Chadha   Sponsors:   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential. 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 – National Internal Medicine Day, The American College of Physicians Sponsor – VCU Health Continuing Education 00:30 Intro, disclaimer, guest bio   03:21 Guest one-liner, Carolyn’s Pick of the Week  09:05  Picks of the Week* 10:13 Case from Kashlak, 3 - Vital Signs of Ophthalmology  17:09  Ocular complications of diabetes 20:22 Screening for diabetic retinopathy; Reports and Abbreviations 26:07 Counseling Patients: The eye is a camera; Clinical symptoms of ocular complications  32:07 Fluorescein Stain; Treatment Options for Diabetic Eye Disease: NPDR, PDR, VH, and RD  41:16 Eye Vitamins for Macular Edema 43:35 Cataracts  47:22 Missing Glaucoma Drops  50:50 Periop Optimization for Cataract Surgery, Anticoagulation and Other Medical Management  58:14 Take Home Points, Plug: 20/20 Sim; Outro Sponsor – VCU Health Continuing Education     Links* Mindset: The New Psychology of Success by Carol S.  Dwek  Crackdown Podcast 20/20 Sim Site   *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 discuss screening, counseling, and management of common ocular diseases seen within primary care.    Learning objectives After listening to this episode listeners will…   Define and assess the three vital signs of ophthalmology.  List ocular complications of diabetes. Counsel a patient on a new diagnosis of  diabetic retinopathy. Describe treatments for diabetic retinopathy. Define proliferative retinopathy, non-proliferative retinopathy, and macular edema. Compose a perioperative medication management plan for cataract surgery   Disclosures Dr. Chadha reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Chan C., Chadha N., Okamoto E., Watto MF. “#237 Ophthalmology for Primary Care”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date October 19, 2020.   Tags Eye, ophthalmology, ophtho, optometry, glaucoma, diabetes, diabetic retinopathy, macular edema, cataracts, cataract surgery, perioperative management, physical exam,  primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student  
10/19/20201 hour, 1 minute, 56 seconds
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#236 Approach to Shortness of Breath: Physical Exam Series

Learn which exam maneuvers are worthwhile and which ones are worthless in your approach to shortness of breath. In our evidence based series on the physical exam, we discuss the approach to the dyspneic patient with Dr. Brian Garibaldi (Hopkins, SBM), associate professor of pulmonary and critical care medicine at Johns Hopkins, and co-president of the Society of Bedside Medicine. We discuss the physical exam’s effect on our differential diagnosis, maneuvers that are commonly taught, and some simple tests with great data that may go overlooked. Be prepared, this episode may take your breath away!   Credits Written and Produced by: Justin Berk, MD, MPH, MBA and Sam Masur, MD  Infographic: Sam Masur, MD, Beth Garbitelli Cover Art: Beth Garbitelli Hosts: Stuart Brigham, MD; Matthew Watto, MD, FACP; and Paul Williams, MD, FACP Editor:Justin Berk MD; Clair Morgan of nodderly.com Guest(s): Brian Garibaldi, MD   Sponsors:   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.   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 – National Internal Medicine Day, The American College of Physicians Sponsor – VCU Health Continuing Education 00:00 Intro, disclaimer, guest bio Sponsor – National Internal Medicine Day, The American College of Physicians 03:47 Introduction to evidence-based exam, pre-test probability, and likelihood ratios 05:29 Case from Kashlak Memorial  06:51 Dr. Garibaldi’s initial maneuvers for the dyspneic patient 11:33 Recapping the exam maneuvers 14:05 Likelihood ratios for common maneuvers 18:25 Over 6/Under 6 maneuvers 25:30 Recap of Dr. Garibaldi’s go-to maneuvers 28:19 Role of labs and diagnostic imaging 31:03 Role of point-of-care ultrasound (POCUS) 34:10 Friday at 5pm 36:31 Take home points 39:25 Outro Sponsor – VCU Health Continuing Education   Links* Stanford 25: Teaching and promoting bedside exam skills to students, residents and healthcare professionals both in person and online The 5 Minute Moment at the Society of Bedside Medicine The POCUS Atlas: Evidence Based Point of Care Ultrasound   Goal Listeners will feel confident how to optimally use the physical exam to guide clinical decision-making in patients presenting with dyspnea.   Learning objectives After listening to this episode listeners will…   Describe the effectiveness of the exam when it comes to aiding diagnosis in a patient with dyspnea Identify specific exam maneuvers that can aid clinical decision-making  Identify exam maneuvers that may not offer more information compared to imaging such as POCUS   Disclosures This episode was made with assistance from the Society of Bedside Medicine and funding from the New York Academy Medicine.  Dr Garibaldi reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Masur S, Garibaldi BT, Watto M, Williams P, Brigham S, Berk J.  #236 Physical Exam Series: Approach to Shortness of Breath. The Curbsiders Internal Medicine Podcast. https:/www.thecurbsiders.com/episode-list. Original Air Date October 12,  2020.   References Mochizuki K et al. Importance of respiratory rate for the prediction of clinical deterioration after emergency department discharge: a single-center, case-control study. Acute Med Surg. Nov 2016. doi:10.1002/ams2.252 Sarkar M et al. Physical signs in patients with chronic obstructive pulmonary disease. Lung India. 2019. doi:10.4103/lungindia.lungindia_145_18 Fagan TJ. Letter: Nomogram for Bayes theorem. N Engl J Med. 1975;293(5):257. doi:10.1056/NEJM197507312930513 Simel, David, et al. Rational Clinical Examination, McGraw-Hill Professional Publishing, 2009. ProQuest Ebook Central  McGee, Steven. Evidence-based physical diagnosis [4th edition] Elsevier, 2018. Clinical Key Benbassat, J., Baumal, R. Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?. J GEN INTERN MED 25, 865–872 (2010). https://doi.org/10.1007/s11606-010-1327-8 Al Deeb M et al. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843-852. doi:10.1111/acem.12435 Yousefifard et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emerg (Tehran). 2016;4(1):1-10. Martindale et al. Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016;23(3):223-242. doi:10.1111/acem.12878 Caldentey et al. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure). JACC Heart Fail 2014.. doi:10.1016/j.jchf.2013.10.004   Tags Physical exam, dyspnea, shortness of breath, auscultation, PMI, percussion, heart failure, wheeze, POCUS, COPD, JVD, hepatojugular reflux, observation, asymmetry, Brian Garibaldi, practice, pallor, lung, heart, hands.
10/12/202041 minutes, 28 seconds
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#235 Spooky Cakes: Dapa-CKD, Turmeric for Knee Pain, Honey for URTI

Time for spooky cakes with a side of candy corn. We discuss Dapagliflozin (SGLT2i) for CKD, Turmeric for knee pain and Honey for URTI (cough) on this halloween themed hotcakes with Rahul Ganatra MD, MPH @rbganatra   Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (Note: CME for this episode won’t be available until 10/12/20. We apologize for the inconvenience).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!   Credits Producer: Sarah Phoebe Roberts Written by: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH    Cover Art: Matthew Watto MD, FACP Hosts: Rahul Ganatra MD, MPH, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Sarah Phoebe Roberts MPH    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com   Sponsors   National Internal Medicine Day Help ACP celebrate National Internal Medicine Day on October 28th. Visit https://www.acponline.org/NIMD20 to learn how you can show your internal medicine pride. Be sure to tag @ACPInternists and use the hashtags #NationalInternalMedicineDay, #IMProud, and #IMEssential.   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 Sponsor – National Internal Medicine Day, The American College of Physicians 00:25 Sponsor – VCU Health Continuing Education 00:40 Intro, disclaimer, Picks of the Week 07:38 Sponsor – National Internal Medicine Day, The American College of Physicians 08:40 Dapa-CKD 20:00 Turmeric for Knee Osteoarthritis 32:10 Honey for URTI and Cough 46:32 Shout out to @votehealth2020 and PatientVoting.com  48:25 Outro Sponsor – VCU Health Continuing Education   Links* Candy Corn (autumn mix) and (classic) Paul’s Halloween movie marathon: Cabin in the Woods, The Descent, The Witch, Ghostbusters   *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 review and perform critical appraisal of recent articles with the potential to change internal medicine practice   Learning objectives After listening to this episode listeners will…   Review the potential benefits of dapagliflozin for prevent of CKD progression and death Evaluate the utility of turmeric for osteoarthritis with inflammatory synovitis Discuss the efficacy of honey for the treatment of acute upper respiratory tract infection and persistent post-infectious cough   Disclosures The Curbsiders report no relevant financial disclosures.    Citation Watto M, Ganatra R, Williams PN, Brigham SK, Roberts SP. “235 Spooky Cakes”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 5, 2020.   Tags Dapagliflozin, slgt2i, sglt2 inhibitors, ckd, turmeric, curcumin, knee osteoarthritis, knee pain, synovitis, honey, urti, respiratory tract infection, cough, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
10/5/202050 minutes, 28 seconds
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#234 The Breast Lump, and Breast Cancer Screening with Nancy Keating MD, MPH

Master your breast cancer screening spiel, cultivate your approach to the breast mass, and empower your patients with empathetic shared decision-making (which we know you’re all already fabulous at)!  On this fantastic episode, we are joined by Dr. Nancy Keating @NancyKeatingMD, policy wonk and primary care doc extraordinaire at Brigham and Women’s Hospital. This episode is rife with drama, as the ACS butts heads with the USPTF and the ACR, and you have to figure out  what’s right for the patient by talking with them--almost as exciting as that moment on Grey’s when Izzie cuts the...anyway, I won’t ruin a key plot point in the most excellent medical show of all time, all in a day’s work, here at The Curbsiders. Enjoy!    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 Producer and Writer: Nora Taranto MD Show Notes: Nora Taranto MD, Isabel Valdez PA  Infographic: Nora Taranto MD Cover Art: Kate Grant, MD  Hosts: Stuart Brigham MD, FACP; Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Reviewer: Arielle Medford MD  Guest: Nancy Keating MD, MPH   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 & Guest Bio 03:27   Guest one-liner 05:27   Best Advice for Women in Medicine 07:34   Picks of the Week Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. 10:00   Case 1: Brenda Cantwell and Breast Lump DDx 13:39   Clinical Breast Exam vs Self Breast Exam 17:26   Practical Tips for the Clinical Breast Exam 21:50   Imaging to Evaluate the Breast Lump 26:36   Demystifying BIRADS 28:36   Epidemiology Potpourri 33:02   Breast Pain without a Mass 34:30   Case 2: Mammie Gram and Breast Screening 46:03   Average Risk vs High Risk Screening 47:18   Breast Risk Prediction Tools 48:51   Breast Density 53:16   Imaging Modalities 61:28     Shared Decision Making in Screening   68:04    Case 3: Ms Britta Lumpworth and When to Stop Screening Mammograms 74:42    Take Home Points and Outro Sponsor - VCU Health Continuing Education     Links* Evicted: Poverty and Profit in the American City by Matthew Desmond Run The List podcast  ACOG Practice Bulletin 179, 2017 Elmore et al, Ten Year Risk of False Positive Screening Mammograms and Clinical Breast Examinations, N Engl J Med, 1998.  Thomas, et al, Randomized trial of breast self-exam in Shanghai: final results. JNCI, 2002. Semagliazov et al, Results of a prospective randomized investigation [Russia] to evaluate the significance of self-examination for the early detection of breast cancer, Vopr Onkol, 2003.  Fuller, M. S., Lee, C. I., & Elmore, J. G. Breast cancer screening: an evidence-based update. The Medical clinics of North America, 2015. Chan et al, False-negative rate of combined mammography and ultrasound for women with palpable breast masses. Breast Cancer Res Treat, 2015.  ACS Recommendations for the Early Detection of Breast Cancer, 2020. USPTF Breast Cancer Screening Recommendations, 2016.  Henderson et al, Breast Examination Techniques, 2020.  Kolb et al. Comparison of the performance of screening mammography, physical exam, and breast ultrasound and evaluation of factors that influence them: an analysis of 27.825 patient evaluations, Radiology, 2002.  Mammogram Interpretation, Chapter 2. Radiology Key.Com.  Flobbe et al, The Additional Diagnostic Value of Ultrasonography in the Diagnosis of Breast Cancer. Arch Intern Med, 2003.  ACS Understanding Mammogram Readings, 2019.  Bittner, Guide to mammography reports: BIRADS terminology, Am Fam Physician, 2010.  Seer cancer statistics review, 1975-2017. 2020.  Anders CK et al, Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes?. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011  ACS How Common is Breast Cancer?  SEER Lifetime Risk (%) of Dying from Cancer by Site and Race/Ethnicity: Females, Total US, 2014-2016 Garcia et al, Cardiovascular disease in women: clinical perspectives, Circ res, 2017.  Cancer Statistics Center: Breast Statistics.  Independent UK Panel on Breast Cancer Screening, The Benefits and harms of breast cancer screening: an independent review, Lancet, 2012.  CDC Breast Cancer Screening Guidelines 2020  ACS Breast Cancer Screening Guidelines, 2015 USPTF Breast Cancer Screening Recommendations, 2016.  ACR Breast Cancer Screening Update, 2018.  Canadian Task Force Breast Cancer Screening Recommendations  UK-NHS Breast Cancer Screening Recommendations  Biller-Andorno et al. Perspective: Abolishing Mammography Screening Programs? A View from the Swiss Medical Board, N Eng J Med, 2014.  Nelson et al, Effectiveness of Breast Cancer Screening: Systematic Review and Meta-analysis to Update the 2009 US PTF Recommendation, Ann Intern Med, 2016.  Miller et al, Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial, BMJ, 2014.  Breast Cancer Risk Assessment Tool (NCI)   BCSC Breast Cancer Risk Assessment Tool  Health Decision/University of Wisconsin Decision Tool Harding Center for Risk Literacy Fact Box   Keating et al, Breast Cancer Screening in 2018: Time for Shared Decision Making, Jama Insights, 2018.  ePrognosis life expectancy calculator      *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 learn how to evaluate a breast lump in the primary care clinic, what the guidelines recommend for asymptomatic breast cancer screening, and how to engage a patient in shared-decision making given the data available on mammograms.    Learning objectives After listening to this episode listeners will…   Triage and evaluate the Breast Lump  Perform breast cancer risk assessment  Recall the Guideline Recommendations for Breast Cancer Screening and how they vary  Engage patients in conversation about b...
9/28/20201 hour, 17 minutes, 28 seconds
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#233 Giving Effective Feedback with Drs. Abby Spencer and Alia Chisty

Listen to our medical education heroes, Dr. Abby Spencer, @abbyCCim (Cleveland Clinic), and Dr. Alia Chisty, @aliachisty (Penn State Health), school us on how to give effective and meaningful feedback! Topics include: the ADAPT framework, how to give difficult feedback, keywords and phrases when giving feedback, how to avoid gender and racial bias when giving feedback, giving feedback to your peers and how to solicit effective feedback as a team leader.     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 Paul Williams MD, FACP Cover Art: Paul Williams, MD, FACP Infographic: Edison Jyang Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Abby Spencer MD and Alia Chisty MD   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, pun 04:00 Guest one-liners, Picks of the Week* (see links below) 10:25 Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders. 11:00 Case from Kashlak, Feedback definitions 15:00 Addressing perceived barriers to feedback 31:45 ADAPT model of feedback 38:10 Addressing potentially gendered feedback;  42:45 Giving feedback to those who lack insight 48:29 Feedback and racial bias 52:25 Giving peer feedback 58:10 Tips for soliciting feedback as a supervisor 69:05 Does giving difficult feedback mean people won’t like you? 75:10 Take home points and Outro Sponsor - VCU Health Continuing Education   Links* Radical Candor (book) Host (film) Percy Jackson & The Olympians: The Lightning Thief movie  Hamilton on Disney Plus Her (film)    *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 demonstrate effective techniques to deliver and solicit meaningful feedback.   Learning objectives After listening to this episode listeners will…   Discuss the definitions and terms used to discuss feedback. Deliver effective feedback that is concordant with the learning goals of their trainees. Address potential perceived barriers to feedback. Utilize the ADAPT framework to partner with their learners and develop shared goals. Develop strategies to mitigate against using gender- or racially-biased narrative language. Deliver feedback to learners with limited insight by leveraging the impact of perception on achieving goals. Solicit effective and meaningful feedback despite being in a position of authority   Disclosures Drs. Spencer and Chisty report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Williams PN, Spencer A, Chisty A, Brigham SK, Jyang E, Watto MF. “#233 Giving effective feedback with Abby Spencer and Alia Chisty”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 21, 2020.   References  Ende J. Feedback in Clinical Medical Education.  JAMA.  1983. . [https://pubmed.ncbi.nlm.nih.gov/6876333/]  Brown B.  2018.  Dare to Lead.  Random House. Stone D and Heen S.  2014.  Thanks for the Feedback.  Penguin Books. Scott K.  2019.  Radical Candor.  St. Martin’s Press. Fainstad T et al.  Feedback can be less stressful: Medical trainee perceptions of using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) framework.  Cureus.  2018. [https://pubmed.ncbi.nlm.nih.gov/30906679/]  Rojek AE et al.  Differences in narrative language in evaluations of medical students by gender and under-represented minority status.  J Gen Int Med.  2019.  [https://pubmed.ncbi.nlm.nih.gov/30993609/]  Mueller AS et al.  Gender differences in attending physicians’ feedback to residents.  JGME.  2017.  [https://pubmed.ncbi.nlm.nih.gov/29075375/]  Ross, DA et al.  Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations.  PLoS ONE.  2017.  [https://pubmed.ncbi.nlm.nih.gov/28792940/] 
9/21/20201 hour, 19 minutes, 45 seconds
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#232 Skinternship: Scalp & Face with Helena Pasieka MD

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 presentations of psoriasis as a means to differentiate from seborrheic dermatitis.  Review when referral to dermatology for hair loss or skin changes of the face/scalp  is necessary. Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.   Disclosures Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Pasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.
9/14/20201 hour, 13 minutes, 15 seconds
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REBOOT #48 Hyponatremia Deconstructed

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 M, Jyang E, Watto MF. “REBOOT #48 Hyponatremia Deconstructed”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original air date: July 17, 2017; Updated September 7, 2020.
9/7/20201 hour, 28 minutes, 45 seconds
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Become #1 in T1DM (Cribsiders #6)

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)
8/31/20201 hour, 2 minutes, 2 seconds
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#231 U Talkin’ UTIs Re: Me?

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.
8/24/20201 hour, 8 minutes, 21 seconds
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#230 Kittleson Rules Acute Heart Failure

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
8/17/20201 hour, 11 minutes, 56 seconds
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#229 Hotcakes: COVID on steroids, statins over 75, short duration DAPT

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”
8/10/202043 minutes, 28 seconds
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#228 Thyroid on Fire! Hyperthyroidism with Dr. Eve Bloomgarden

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
8/3/20201 hour, 11 minutes, 6 seconds
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Back to School Special - COVID Edition (Cribsiders #3)

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
7/29/202058 minutes, 58 seconds
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#227 Baffled by NAFLD?

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
7/27/20201 hour, 15 minutes, 21 seconds
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#226 Kidney Boy on Acute Kidney Injury: Myths & Musings - Tips and Tricks from Joel Topf MD

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
7/20/20201 hour, 9 minutes, 22 seconds
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#225 Women in Medicine: COVID Edition

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