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Core IM: 5 Pearls on Contrast-Induced Nephropathy

May 16, 2018

By Daniel Sartori MD, Marty Fried MD, Shreya Trivedi MD; Illustration by Michelle Lo MD and Amy Ou MD. Quiz yourself on the 5 Pearls we will be covering:

  1. Are there diagnostic criteria for contrast-induced nephropathy (CIN)? (2:11)
  2. Is there a difference between exposure to intra-arterial versus intra-venous contrast in terms of risk of CIN? (6:28)
  3. What are the biggest risk factors for CIN? (14:48)
  4. What preventive measures have been shown to best reduce the risk of CIN? (19:41)
  5. Can ESRD patients on hemodialysis still suffer from CIN? (23:32)
  6. Recap (25:49)

A special thank you to Dr. Josh Farkas for peer-reviewing this podcast!

Subscribe to CORE IM on any podcast app! Follow us on Facebook @Core IM || Twitter @COREIMpodcast || Instagram @core.im.podcast. Please give any feedback at COREIMpodcast@gmail.com. Read more »

Primecuts – This Week in the Journals

May 15, 2018
Primecuts – This Week in the Journals

By Michael Tamimi, MD

Peer Reviewed

At a mere 104 years old, famed ecologist and botanist David Goodall, who was frequently touted as Australia’s oldest scientist, ended his own life via assisted suicide in Switzerland with family and friends at bedside. A proponent of Exit International, Dr. Goodall, just prior to his death, spoke about how he “regret reaching that age,” and noted the “sadness” attributed to his wishes, is not sadness in the desire to die, but rather the fact that “one is prevented” …

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Spotlight: A case of Metformin Associated Lactic Acidosis

May 11, 2018
Spotlight: A case of Metformin Associated Lactic Acidosis

By  Jasmine Nee and Martin Fried, MD

Peer Reviewed

LEARNING OBJECTIVES

1. What is metformin-associated lactic acidosis?
2. How does severe acidemia lead to acute kidney injury?
3. How do you treat metformin-associated lactic acidosis?

CASE SUMMARY

The patient is a 40-year-old man with alcohol dependence and type II diabetes who presented to the emergency department for alcohol intoxication. After arriving hemodynamically stable with reassuring labs, he become tachypneic, confused, and lethargic a few hours later. At this point, he admitted that he took “a …

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Insulin in a Pill: Barriers to Development of Oral Insulin

May 8, 2018
Insulin in a Pill: Barriers to Development of Oral Insulin

By Nicolas Gillingham

Peer Reviewed

Over 30 million Americans—9.4% of the population—live with diabetes, six million of whom are at least partially dependent on exogenous insulin. Insulin can be self-administered by subcutaneous injection, either classically via a syringe, an insulin pen, or using an insulin pump. However, patients with diabetes report that these daily injections can feel particularly burdensome, not to mention stigmatizing, when compared to oral medications like metformin, which is one reason why insulin carries a lower rate of adherence. What if our …

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Encephalopathy’s Muse

May 4, 2018
Encephalopathy’s Muse

By Gregory Rubinfeld, MD

The thick and sultry August outside,

The stale ammonia scented inside,

James The Poet, bedridden, writing in a fury,

Charlotte on a chair next to him, yawning.

 

So too have I become…

My whole frame taken, turned,

The very color of my flesh

Yellowed like the pages of an old book.

Moribund, we living antiques,

At the eternal doorway.

The snickering sardonic Footman ever beckoning.

 

The deep blue ink on the napkin ran some

But the words were still clear, burnished.…

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Core IM Hoofbeats: A 36F with weakness

May 2, 2018

By John Hwang MD, Cindy Fang MD, Neha Sathe MD,  Michael P. Janjigian MD || Audio Editing and Graphic by Amy Ou, MD

Time Stamps

  1. Part 1 Case (2:05)
  2. Framing bias (7:07)
  3. Data-driving reasoning  (11:48)
  4. Hypothesis-driven approach (12:38)
  5. Periodic paralysis syndromes (16:08)
  6. Representativeness heuristic (17:26)
  7. Part 2 Case (20:51)
  8. Pivot Points (31:36)
  9. Diagnosis (35:55)
  10. Take aways (37:20)

Subscribe to CORE IM on any podcast app! Follow us on Facebook @Core IM || Twitter @COREIMpodcast || Instagram @core.im.podcast. Please give any feedback at COREIMpodcast@gmail.com.

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Primecuts-This Week in the Journals

May 1, 2018
Primecuts-This Week in the Journals

Mother Spring has arrived in New York this week and she is lovely. Flowers are blooming, birds are tweeting, rodents are merrily scurrying to and fro in full view just as we humble folk have at long last emerged from our musty hovels to share the majesty of this sun-drenched city nestled between the fresh waters of the Hudson and the salty straits of the East.

With this sense of beauty and appreciation in mind, let us now turn our attention to medicine, and to …

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Why We Do What We Do: The Evidence Behind Rapid Response Teams

April 26, 2018
Why We Do What We Do: The Evidence Behind Rapid Response Teams

By Thatcher Heumann, MD

Peer Reviewed

“Rapid Response Team to 7W. Rapid Response Team to 7W.” After switching elevators and waiting for security to buzz you in through the double doors, you see your fellow residents rushing to one of the corner rooms. When you arrive, med consult is calmly delegating various tasks to nursing and residents: vitals, EKG, ABG, CXR, IV access. They quickly review the patient’s history and medications. Depending on the acute condition—respiratory failure, cardiac arrest, septic shock—interventions such as NIPPV, fluids, …

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