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The Curbsiders Internal Medicine Podcast | MedEd | FOAMed | Internist | Hospitalist | Primary Care | Family Medicine

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview national and international experts to bring you clinical pearls and practice changing knowledge. Doctors Matthew Watto, Stuart Brigham, and Paul Williams deliver some knowledge food for your brain hole. No boring lectures here, just high value content and a healthy dose of humor. Fantastic podcast for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine. Topics include heart disease, obesity, diabetes, cardiac imaging, migraines, fibromyalgia, hypertension, cholesterol, osteoporosis, insomnia, testosterone, functional medicine, dementia, and more!
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Now displaying: September, 2017

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview national and international experts to bring you clinical pearls and practice changing knowledge. Doctors Matthew Watto, Stuart Brigham, and Paul Williams deliver some knowledge food for your brain hole.

thecurbsiders@gmail.com

Sep 25, 2017

Solidify your approach to back pain and sciatica with Dr. Chris Miles, Assistant Professor, Family & Community Medicine and Associate Director, Sports Medicine program, Wake Forest Baptist Medical Center. He schools us on red/yellow flags, physical exam maneuvers, when to order imaging, and practical tools and tips for evidence-based management! Correspondent Dr. Shreya Trivedi cohosts!

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Case from Kashlak Memorial: 53 yo M construction worker with a BMI of 29 and PMhx of DM2, HTN, depression presenting with right low back pain. He can't remember any trauma or injury. Denies radiation, no bowel or bladder dysfunction, saddle anesthesia, weakness

Case from Kashlak Memorial: 48 yo F nurse who has had intermittent back pain for years presented with acute flare after helping lift a patient. The pain similar to previous episodes but more severe and also radiates to her left foot. She has tried naproxen and exercises/mindful stress reduction for months without improvement. It is unbearable for her to work.

Time Stamps

00:00 Intro

02:14 Listener feedback

03:44 Announcements

05:14 Picks of the week

08:20 Millenial learners

10:40 Topic intro and guest bio

12:06 Getting to know our guest

17:30 Clinical case of back pain

20:18 How to hand sensory deficits

21:51 Red and yellow flag symptoms

25:44 How to approach patient with yellow flag symptoms

28:00 Physical exam for back pain

30:00 Special testing: Trendelenburg, Slump test, and Straight leg raise

35:48 Classifying types of back pain and a quick recap of teaching points so far

39:28 How to manage patient expectations

40:42 Treatment of non-radicular back pain

46:33 Home exercises and YouTube training

49:31 When to follow up after initial treatment trial

51:35 The patient with severe acute pain

53:33 Some pearls on muscle relaxants

55:22 Clinical case and how to treat radicular pain

59:40 Invasive treatment of back pain

65:04 Back pain treatments that don’t work

66:06 Take home points

67:34 Outro

Tags: back, pain, radicular, radiculopathy, sciatica, lumbar, disk, herniated, facet, arthritis, spine, muscle, relaxant, tramadol, nsaids, exam, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Sep 18, 2017

Summary:

Get a-HEAD of concussions (aka traumatic brain injuries) with tools, tips, and tricks from The Concussion Guy, Dr. Evan Ratner, Medical Director of Gridiron Heroes. Learn to recognize concussions/traumatic brain injury, what questions to ask, physical exam maneuvers, and how to counsel patients and families on safe return-to-learn/play.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Case from Kashlak Memorial: 29F with no significant PMH presents to primary care office less than 24 hours after she accidentally struck her head on the metal of her car door. She experienced temporary altered consciousness lasting about one hour along with a headache. No nausea, vomiting, speech, or vision changes. She rested at home last night, but didn’t feel up to reading, or watching TV. She drove herself to your office today.

Time Stamps

00:00 Intro

02:33 Listener feedback

05:35 Picks of the week

12:15 Getting to know our guest

19:41 Defining and classifying concussion

23:00 What questions to ask your patient

26:34 Physical exam for patient with concussion

28:50 Use of neurocognitive testing in concussion

30:45 Specifics of testing eye movements and balance

35:00 Who needs imaging?

41:51 Recap of what we’ve learned so far

43:40 Can you let someone with a concussion go to sleep?

47:08 Return-to-learn protocol

50:30 Return-to-play protocol

52:30 Post-concussive syndrome

53:55 Medications for post-concussive symptoms

58:58 Second impact syndrome

64:40 Counseling the patient with multiple concussions

67:08 Take home points

69:09 The Curbsiders recap their favorite teaching points

71:30 Outro

Tags: concussion, post, concussive, syndrome, tbi, traumatic, brain, injury, return, play, school, cognitive, rest, treatment, diagnosis, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Sep 15, 2017

Improve your prescribing practices with tips from The Curbsiders as Matt, Stuart and Paul “Pwilliams” discuss safe prescribing in frail, older adults with diabetes, chronic kidney disease, hypertension, and/or dementia in this part two episode on polypharmacy and deprescribing.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, diabetes, hypertension, kidney, chronic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

Sep 11, 2017

Avoid common pitfalls, recognize prescribing cascades, and deprescribe like a champ with tips from Clinical Pharmacist, Dr. Sean M. Jeffery, Clinical Professor of Pharmacy at the University of Connecticut School of Pharmacy, and Chair of the Polypharmacy Special Interest Group for the American Geriatrics society. We discuss how to create better medication lists, tools and tips for deprescribing, how to counsel patients on polypharmacy, and safe use of medication in the elderly.

Special thanks to the American Geriatrics Society for setting up this interview.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Time Stamps

00:00 Intro

01:12 Listener feedback

01:56 Picks of the week

06:28 Topic intro and guest bio

07:49 Getting to know our guest

13:05 Defining polypharmacy and related terms

16:30 Clinical Case of polypharmacy

20:34 Making better medication lists

25:01 Clinical Case from Kashlak Memorial

28:40 Beers Criteria

35:41 Statins in frail, elderly patients

38:00 Treating insomnia in the elderly

44:15 Dosing of meds in patients with CKD

45:50 Tool for analysis of drug-drug interactions

48:10 Take home points from Dr. Jeffery

50:00 Outro

Tags: polypharmacy, deprescribing, prescribing, cascade, pharmacist, drug, therapy, medications, side, effects, adverse, reaction, beers, criteria, interaction, disease, anticholinergic, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

 

Sep 4, 2017

Enhance your skills in the identification and management of eating disorders with clinical pearls from Dr. Rosalind Kaplan, Clinical Associate Professor of Medicine at Thomas Jefferson University and a Primary Care Physician in Jefferson Women's Primary Care. We learn who to screen for eating disorders, what questions to ask, criteria for diagnosis, common complications, and how to manage them. This is a must listen if you’re like us and don’t know much about eating disorders specified and not otherwise specified.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Case from Kashlak Memorial Hospital: 24yo F medical student with history of anxiety, weight loss, and restricting food senior year of high school. She regained weight with psychotherapy. Now she is a medical student who is over exercising, and abusing laxatives. She passes out one day after class and is referred to you at Kashlak.

Time Stamps:

00:00 Intro

01:19 Listener feedback

02:43 Picks of the week

06:50 Topic intro and guest bio

09:10 Getting to know our guest

15:18 Clinical case 

20:15 Broad overview of eating disorders

26:40 Eating disorder not otherwise specified

29:19 Underreporting and under diagnosis in men

30:25 Who to screen and how to do it

34:33 Questionnaires: SCOFF, ESP, and Binge Eating Disorder Inventory

38:42 Initial lab workup for eating disorders

42:38 Bone density screening, treatment

45:41 Back to the case: Initial patient counseling 

49:22 Medical therapy

52:20 Can we use bupropion?

54:02 What’s the role for primary care?

58:14 Hyponatremia in eating disorders

60:34 Complications of purging

66:25 How to be an ally for your patient

69:12 Treatment for binge eating

72:51 Take home points

74:30 Outro

Tags: anorexia, nervosa, bulimia, eating, disorder, weight, loss, binge, binging, purge, electrolytes, not, otherwise, specified, ideal, body, image, treatment, screening, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

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