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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From the Archives: The Prevention of Post-ERCP Pancreatitis

April 25, 2018
From the Archives: The Prevention of Post-ERCP Pancreatitis

Please enjoy this post from the archives dated January 10, 2014

By Shivani K Patel, MD

Peer reviewed

A 61-year old male with chronic epigastric discomfort presented to the emergency room with severe abdominal pain radiating to his back. He had similarly presented and been hospitalized two weeks prior to this admission at an outside hospital, where he underwent endoscopic retrograde cholangiopancreatography (ERCP) with placement of a pancreatic duct stent. His pain initially improved, but quickly recurred after discharge. Admission labs showed only mild leukocytosis …

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Primecuts – This Week in the Journals

April 24, 2018
Primecuts – This Week in the Journals

By Jennifer Whealdon, MD

Peer Reviewed 

Prior to her passing, former First Lady Barbara Bush announced her decision to forego further aggressive interventions for her chronic medical issues and instead elected for “comfort care”, to spend the final days of her life at home with her loved ones(1).  Her courageous decision revitalized discussion about how we approach end of life care in the United States. Particularly, by publicizing her decision to forego further invasive treatment, she exemplified a thoughtful and intentional consideration for what constitutes …

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Are Fasting Lipids Necessary?

April 20, 2018
Are Fasting Lipids Necessary?

By Anthony Marte
Peer Reviewed

It is a common sequence of dialogue in clinic: “I’d like to draw some blood for cholesterol,” says the doctor. “Have you eaten today?” With downcast eyes, the patient replies, “Yes, I had a snack. I just got so hungry.” The well-intentioned physician concedes, “That’s okay. Another time, then.”

Patients requiring lipid panels frequently report to their clinic appointments in the non-fasting state. These patients often leave clinic without having their blood drawn for lipids, with instructions to return early …

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Core IM: 5 Pearls on Chronic Adrenal Insufficiency

April 18, 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. What are signs and symptoms of chronic adrenal insufficiency (AI)? What is the most sensitive? (2:02)
  2. How do we diagnose and differentiate types of adrenal insufficiency? (6:05)
  3. How sensitive and specific are the diagnostic tests for AI  and at what cutoffs? (12:06)
  4. Can we both test and treat adrenal insufficiency at the same time? (16:40)
  5. Throwback: How do hypokalemia and hepatic encephalopathy connected? (24:55)
  6. Dr. Nidhi Agrawal Recap (19:20)

A special thank you to Dr. Nidhi Agrawal 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.

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Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis – A Randomized Clinical Trial

April 6, 2018
Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis – A Randomized Clinical Trial

By Rebecca Lazarus, MD

Peer Reviewed

Why does this matter?
Osteoarthritis (OA) is a leading cause of disability in the United States and is the most common type of arthritis. The pathogenesis involves the progressive destruction of articular cartilage in a joint, which is accompanied by new bone formation and synovial proliferation. On a cellular level, this process is believed to involve mononuclear cells and pro-inflammatory mediators that promote synovitis, as well as the up-regulation of aggrecanases and collagenases that promote cartilage catabolism . Based …

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