Core IM | Internal Medicine Podcast
by Core IM Team
Core Internal Medicine via following series:5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do?Gray Matters || Management ReasoningHoofbeats || Dissecting clinical reasoningAt the Bedside || Explore everyday challenges
Episodes
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#223 Amyloidosis Presentation: Gray Matters Segment
“Could amyloidosis be the reason behind a patient’s unexplained symptoms?” This episode explores the clinical clues that should prompt clinicians to consider AL amyloidosis and recognize patterns of organ involvement that may otherwise be easy to overlook. Learn how to connect the findings, spot...
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#222 AFib Stroke Prevention: WATCHMAN, DOACs, and the CHAMPION-AF Trial | Beyond Journal Club Segment with NEJM Group
If your patient asks you about a left atrial appendage closure device, what should you tell them? In the latest episode of the Beyond Journal Club podcast from CORE IM and NEJM Group, the hosts will help you: Understand the trade-offs: stroke prevention, bleeding, procedural risks, and…
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#221 Colon Cancer Screening After Age 75 | 5 Pearls Segment Part 3
“Should you stop screening for colorectal cancer (CRC) at 75?” This episode explores how to individualize screening decisions based on life expectancy, prior colonoscopy findings, and procedural risks. Learn how to navigate these nuanced conversations, avoid age-based assumptions, and use...
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#220 Colon Cancer Screening Nuances: 5 Pearls Segment Part 2
“What’s the best way to screen?” This episode breaks down the pros, limitations, and follow-up needs of FIT, Cologuard, CT colonography, and colonoscopy to help you choose the right CRC screening option for your patients. Also learn practical colonoscopy surveillance intervals based on polyp…
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#219 Updates in Triglycerides
“The triglycerides are high. Now what?” This episode breaks down a practical approach to elevated TGs, from knowing when to check ApoB or non-HDL-C to choosing lifestyle changes, lipid-lowering medications, and when to suspect an underlying genetic disorder. 🔹Transcript and Show Notes 02:17 |...
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#218 Early-Onset Colon Cancer: 5 Pearls Segment Part 1
“Too young for colon cancer.” This episode unpacks the red flags of early-onset colorectal cancer (CRC), from blood in the stool and iron deficiency anemia to persistent abdominal pain and changes in bowel habits, and offers practical pearls for closing the clinical loop. Also learn why a...
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#217 Treatment for Alcohol Use Disorder: 5 Pearls Segment
“It didn’t work.” This episode breaks down practical treatment options (dosing options for naltrexone, acamprosate, topiramate, gabapentin) and counseling pearls to help you meet patients where they are and support their recovery. Also discover blind spots in detox and rehab centers. 🔹Transcript...
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#216 Clinician Grief: At the Beside Segment
Have you ever lost a patient and found yourself thinking about them long after the shift ended? This episode explores the grief clinicians can carry after a patient dies, including the losses that aren’t always obvious. We also discuss ways to work through that grief, recognize when it becomes...
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#215 Gallbladder & Biliary Testing: 5 Pearls Segment
How to choose between RUQ ultrasound, CT, HIDA, MRCP, EUS, and ERCP based on the clinical picture? When should you move from diagnostic imaging to therapeutic ERCP, and what should you know about sphincterotomy, stents, and stone removal? Plus, how to interpret bile duct dilation without jumping...
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#214 Hyponatremia Management: A Core IM Classic
Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia...
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#213 Hypertension First-Line Medications Troubleshooting | Bread & Butter Series
Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers,...
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#212 Top 10 Highlights of the New Lipid Guidelines
Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines! Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change statin decisions, why LDL targets are back, and when to use Lp(a), ApoB, and coronary...
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#211 Breaking Down MASLD vs. MASH and the MAESTRO-NASH & ESSENCE Trials: Beyond Journal Club Segment
MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we...
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#210 HTN in Dialysis: 5 Pearls Segment
What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability, antihypertensive selection, and...
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#209 Dialysis and Fluid Management: 5 Pearls Segment
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,...
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#208 AI vs. Human with Post-Op AFib: Bread & Butter Series
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...
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#207 Is There a Doctor on Board? In-Flight Emergencies
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...
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#206 Eosinophilia: 5 Pearls Segment
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...
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#205 Nutrition Studies, Coffee and the CRAVE Trial: Beyond Journal Club with the NEJM Group
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...
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#204 Diabetic Foot Infections & Osteomyelitis: 5 Pearls Segment
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...
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#203 POCUS for AKI & Dialysis | Real Cases That Changed Management
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…
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#202 Dementia Part 2: Gray Matters Segment
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…
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#201: Dementia Part 1: Gray Matters Segment
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...
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#200: Insulin and QWINT-1 Trial in T2DM: Beyond Journal Club Segment with NEJM Group
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…
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#199 Privacy & Confidentiality: At the Bedside Segment
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...
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#198 Microskills for Change That are Big Enough to Matter, Small Enough to Win
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...
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#197 Hypercoagulability Part 2: 5 Pearls Segment
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…
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#196 Stories of Courage and Career Development with Horn Award
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 🔹 Transcript and Shownotes (1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s...
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#195 Antibiotic Duration & BALANCE Trial: Beyond Journal Club with NEJM Group
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? 🔹...
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#194: Severe Hypertriglyceridemia: 5 Pearls Segment
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? 🔹 Transcript and Shownotes (03:19) | Lipoprotein...
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#193 Venous Congestion & VEXUS Interview with Dr. Ross Prager
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? 🔹...
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#192 Debate on First-Line Medications for Diabetes
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: 🔹 Transcript…
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#191 Hepatorenal Syndrome Part 2 on Management: 5 Pearls Segment
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…
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#190: Hepatorenal Syndrome Part 1: 5 Pearls Segment
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 🔹 Transcript & Show Notes Timestamps: (00:57) | Understanding the Pathophysiology of...
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#189 Bisphosphonates and Fracture Prevention Trial: Beyond Journal Club with NEJM Group
Who’s really at risk for fractures, and how should we be treating them? Most fragility fractures occur in patients without osteoporosis. Should we rethink who gets treated? And could just one or two IV infusions (spread years apart) of zoledronate prevent fractures for years? Have the concerns...
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#188 Orthostatic Hypotension Part 2: Gray Matters Segment
Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic hypotension? 🔹...
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#187 Orthostatic Hypotension Part 1: Gray Matters Segment
Learn specific, practical ways to counsel patients on non-pharmacologic interventions. What is our goal with OH treatment? Is it the blood pressure number that matters? How do we avoid missing neurogenic causes of orthostatic hypotension (OH)? 🔹 Sponsor: Oakstone CME’ 🔹 Transcript & Show Notes...
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#186 Pneumothorax: 5 Pearls Segment
Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks! 🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion 🔹 Transcript & Show Notes Timestamps: (02:50) | Xray vs. POCUS vs. CT for Pneumothorax…
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#185 Neutropenia: 5 Pearls Segment
How do you work up neutropenia? When is neutropenia benign? When do neutrophils recover? How can you diagnose neutropenic fever in the first 15 minutes and start antibiotics in the first 60 minutes? Do you always add MRSA coverages? Only Pseudomonas coverage? When do you add fungal coverage? 🔹...
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#184 Stories for the Feels
Have a good laugh and reflect deeply with these three stories that hit the feels in different ways. If you'd love to hear more stories from Dr. Maria Rosasco, check out some of her other appearances on the podcast: July Stories and Handoffs & Contingency Planning. 🔹 Sponsor: Oakstone CME’s ACP...
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#183 Diagnose the Clinician: Hoofbeats Segment
What went wrong? What were the reasoning or contextual missteps that led us astray? 🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply! Due Aug 1, 2025 🔹 Transcript and Show Notes Timestamps: (00:02) | Case Presentation and Initial Diagnosis (02:47) | Tachycardia and…
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#182 Pleural Effusions: 5 Pearls Segment
Imaging Pearls | (01:12) Deciding on Thoracentesis | (04:00) Light’s Criteria and Pseudoexudates | (07:00) Pleural Fluid Studies: pH and Cell Differential | (16:56) Diagnosing and Treating Parapneumonic Effusions | (23:32) Malignant Pleural Effusions: Diagnosis and Management | (30:39) 🔹…
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#181 July Stories 3.0
Listen for some good laughs and relatable stories! In this episode, we share raw and real stories from July — from rapid responses to unexpected kindness — and reflect on the emotional weight of starting out in medicine. 🔹 Sponsor: NEJM Fellowship Program, click here to learn more and/or apply!...
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#180 Beta-Blockers & REDUCE-AMI Trial: Beyond Journal Club Segment with NEJM Group
How much do beta blockers help after a heart attack, even when the heart’s pumping well? In this episode, we revisit the origins of beta blockers in post-MI care, examine how evidence evolved, and explore the REDUCE-AMI trial, which questions whether beta blockers are still needed for all. Listen...
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#179 Invasive Fungal Disease: 5 Pearls Segment
🔹 What is invasive fungal disease, and who is most at risk for developing invasive fungal disease? (~ 02:46) 🔹 What are the main classes of fungi? (~11:35) 🔹 What are the pros and cons of B-D Glucan and Galactomannan (~19:16) 🔹 How to increase the yield of blood cultures? How to interpret…
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#178 Continuous Glucose Monitor (CGM): 5 Pearls Segment
🔹What are clinically relevant limitations of an A1c vs. a CGM (1:40) 🔹What do the different parts of the ambulatory glucose profile tell you? (09:59) 🔹What are common pitfalls, medications, lifestyle patterns that are important to ask your patient about when seeing them for a visit to manage...
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#177 Interventional Radiology (IR) 101: 5 Pearls Segment
🔹When is an U/S vs. CT vs. MRI helpful before consulting Interventional Radiology? 🔹What factors go into an IR pre-op evaluation? 🔹 When do drains go in, and when do they come out? 🔹 When a patient has trouble with a drain, what are things you can do before calling IR? 🔹 What does outpatient...
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#176 Constipation Medications: 5 Pearls Segment
🔹 High-yield reversible causes of constipation? (02:26) 🔹 Which type of fiber is more helpful? And is more hydration really better? And bulk-forming laxatives (9:03) 🔹 Osmotic vs Stimulant Laxatives (15:06) 🔹 Suppositories and enemas? (25:39) 🔹Best practices with opioid induced constipation...
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#175 A Revolution in HIV Prevention & The PURPOSE Trials: Beyond Journal Club Segment with NEJM Group
How good are we at preventing HIV? How do efficacy and effectiveness differ? We journey from oral pre-exposure prophylaxis (PrEP) to long-acting injectables, and then to the PURPOSE trials, which look at the use of long-acting lenacapavir as PrEP — a potential game-changer in the field of HIV....
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#174 Lp(a) and ASCVD Risk: 5 Pearls Segment
What does Lipoprotein(a) tell us that a standard lipid panel doesn’t? Should we be testing everyone for it? Dive into the genetics, clinical implications, and evolving management strategies for Lp(a). Learn how to interpret results, counsel patients, and navigate topics with limited data like...
About this show
Core Internal Medicine via following series:5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do?Gray Matters || Management ReasoningHoofbeats || Dissecting clinical reasoningAt the Bedside || Explore everyday challenges
Hosted by
Core IM Team