Core IM | Internal Medicine Podcast
Core Internal Medicine via following series: 5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do? Gray Matters || Management Reasoning Hoofbeats || Dissecting clinical reasoning At the Bedside || Explore everyday challenges
Episodes
Why is fluid management the most important part of dialysis care? This episode explores the fundamentals of hemodialysis, why ESKD patients have unique physiology, and how volume overload, not just hypertension, drives many complications. Learn practical pearls on dry weight, sodium restriction, diuretics, and the strategies that can reduce hospitalizations and improve patient outcomes.
🔹Sponsor: Oakstone CME
Can AI manage post-op atrial fibrillation or does medicine still require human judgment? Using post-op AFib as a case study, we explore where algorithms help, where evidence falls short, and why clinical context still matters. When evidence is incomplete, and every patient is different, can AI truly practice medicine or only assist the clinicians who do? This episode explores the space between algorithms, uncertainty, and human jud...
We start with a gripping story of seizures and use it as a jumping-off point to unpack practical pearls for in-flight emergencies. Along the way: what’s actually in the emergency medical kit, when planes divert, how ground medical support works, altitude physiology, legal protections, and how to stay calm when medicine suddenly happens at 35,000 feet. By the end, you may still sweat a little…but hopefully less than bef...
Can you distinguish benign eosinophilia from a sign of serious disease, and know exactly when to act at the bedside?
In this high-yield episode, test your clinical reasoning as we tackle:
- When eosinophilia becomes dangerous and why it matters
- How to distinguish if its from atopy vs. systemic disease
- Which medications to stop (and which to watch)
- How travel, diet, and exposure history shape your workup
- When to suspect malignancy befor...
Is coffee helping or harming our patients’ hearts?
In this Beyond Journal Club, we unpack the CRAVE trial and use it as a lens to answer a bigger question:
How should clinicians interpret nutrition research, especially when it feels inconsistent or hard to trust?
Listen for a concise, practical framework you can use the next time a patient asks about coffee, diet, or lifestyle.
🔹Sponsor: Oakst...
Why can these infections be tricky? How to diagnose osteomyelitis at the bedside? Do we always need IV vs oral antibiotics? And the best for last: Simple, practical wound care strategies for medical students, residents, and clinicians who want a clear, usable approach.
.🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure call...
A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?
A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?
A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter?
And the classic inpatient dilemma: your heart failure patient looks bett...
Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them.
• Do cholinesterase inhibitors really work?
• What should clinicians know about lecanemab and donanemab before referring patients?
• How much benefit should we expect and for how long?
• When should you deprescrib...
Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI?
🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly insid...
From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden.
🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/
00.58 | ...
Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside, learn how clinicians should act when ethics, law, and trust collide.
🔹 Sponsor: DoxGPT by D...
Baby alligators - those betrayals of purpose , or, death by a thousand paper cuts !
Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:
Regulated curiosity
Strategic empathy
Small, well-chosen moves...
...and change that is big enough to matter, and small enough to win!
🔹 Sponsor: Caraway’s cookware set is a favorite for a reason.
Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?
When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.
🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Gro...
We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.
🔹 Sponsor: Oakstone CME
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP
(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life
(10:28) | How Dr. Carol W...
Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?
🔹 Sponsor: Oakstone CME
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP
How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?
(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast
(05:27) | Triglycerides as a Cardiovascular Risk Marker
(09:28) | Acute Management For Pancreatit...
Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score?
🔹 Sponsor: Oakstone CME
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP
(00:00) | Volume over...
SGLT-2i vs. GLP-1? vs Metformin? How do you balance the cost and coverage of first-line options like metformin, SGLT-2, and GLP-1s? How do you choose between SGLT-2 and GLP-1s for comorbidities like CAD or CKD? And how do you weigh their side effects and practical use?
🔹 Sponsor:
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP
Timestamps:
(01:43) | Case 1: Managing Uncontrolled D...
What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care?
🔹 Sponsor: Oakstone CME
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP
Timestamps:
...
HRS-AKI vs. other causes of AKI in cirrhosis: What do serum or urine sodium clues, albumin challenges, and shifting diagnostic criteria actually reveal about getting the diagnosis right?
🔹 Sponsor: Oakstone CME
Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP
Timestamps:
(00:57) | Understanding the Pathophysiology of HRS
(03:42) | How Portal Hypertensio...
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