Louisville Lectures Internal Medicine Lecture Series Podcast

Audry Hawkins is back to discuss antimicrobial stewardship in pneumonia. She starts with comparing differences in guidelines and recent primary literature on empiric treatment of pneumonia. Hawkins then evaluates appropriate empiric step-down therapy and durations and after, discusses the nuances in guideline recommendations for pneumonia. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Crystal Heishman presents an introduction on the broad topic of Infection Prevention. Heishman presents how to identify methods to prevent infectious disease transmission and how to implement device related infection prevention strategies for CAUTI and CLABSI. After, she discusses appropriate testing requirements for C.Diff.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Ben Rogers presents a lecture on reflux by discussing a classic presentation of reflux as well as testing. Dr. Rogers emphasizes modifying care and diagnosis towards each patient with their own unique symptoms.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

In this presentation, Dr. Ryan Doster gives an introduction to diagnostic stewardship after last week's discussion on antimicrobial stewardship. After, Audry Hawkins, PharmD, BCIDP, returns to give an overview on blood culture. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

In this introduction to antimicrobial stewardship, Audry Hawkins first lists untoward effects of antibiotic use. She then describes antibiotic stewardship principles, goals, and strategies. After, she recognizes changes in the regulatory roadmap and national landscape of antimicrobial stewardship over the past few years, including requirements for accreditation for stewardship programs. Lastly, she identifies proven benefits of antimicrobial steward ship; and finally, Sarah Moore reviews the available local and state-level resources.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Malika Rawal presents Adrenal Insufficiency by first answering the question: What Is Adrenal Insufficiency? She then reviews its causes as well as some basics of cortisol. After, Dr. Rawal discusses testing and treatment.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Bryan Moffett presents "Sodium Derangements in the Medical Patient" by first differentiating the difference between total body sodium and sodium concentration. The then breaks down the physiology, causes, and treatment of hyponatremia.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. David Armstrong presents Systemic Lupus Erythematosus by first presenting a case. He then discusses the history of SLE as well as the different kinds of lupus. After, he differentiates between systemic lupus erythematosus and drug-induced lupus. And finally, Dr. Armstrong gives examples of treatment and drug induced lupus management.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

In Glomerular Disease Part One, Dr. Dawn Caster begins by discussing the classifications of common renal pathology and after, focuses on nephrotic syndrome. Dr. Caster gives an overview of nephrotic syndrome and its associated abnormalities as well as the mechanisms of the thrombophilic state in nephrotic syndrome. In part two. Dr. Caster will discuss Glomerulophritis.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Alexa Filley, PharmD, delivers a lecture on Common HIV Regimens and Opportunistic Infection Prophylaxis. She first reviews common human immunodeficiency virus treatment regimens and after, discusses patient/medication characteristics to guide therapy selection. Filley concludes her presentation by reviewing and applying Department of Health and Human Services (DHHS) Guidelines on opportunistic infection prophylaxis in patients with HIV.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Malika Rawal gives an overview on Gender-Affirming Hormone Therapy. Dr. Rawal first discusses the different types of transition as well as general definitions and after, lists terms physicians should and should NOT use when treating patients. Dr. Rawal presents what a visit would look like and how to work with the patient, expectations of hormone therapy, and the physical effects of hormone therapy for feminizing hormone therapy along with masculinizing hormone therapy.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. David Armstrong presents Seronegative Spondyloarthropathies and emphasizes these take home points:- HLA-B27 does not diagnose SNSAs- Inflammatory back pain improves with exercise- Red eye with decreased visual acuity needs slit lamp- Nail pitting correlates with psoriatic arthritis - NSAIDs help everything except enteropathic arthritis Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Chris Reed presents an overview of congenital arrhythmogenic pathologies by first focusing on two families of diseases: structural and conduction. He then discusses pathophysiology and cause of disease and after, the diagnostic workup and what to include in a consultation. Finally, Dr. Reed presents management plans and when to pursue intervention.Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Our new Chair of the Department of Medicine, Dr. Kim Williams, presents his first Grand Rounds on the topic of Nutrition, Health Equity, and CV Mortality. First, Dr. Williams discusses some of the main issue in the United States including being its expensive and broken healthcare system. With the expectance of an increase in cardiovascular disease and stroke mortality in the US in the upcoming decades, particularly in minority groups, Dr. Williams believes our poor nutrition promotes and accentuates health inequities and ethnic disparities. Dr. Williams encourages the implementation of education around plant-based diets which are associated with lower rates of of systemic hypertension, hyperlipidemia, obesity, and diabetes. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Laura Bishop presents "Opiate Use Disorder in the Inpatient Setting: To Bup or Not to Bup with Dr. Bishop" by first examining the practice for adjustments to create space of destigmatizing patients with SUDS. She then discusses the symptoms of opiate withdrawal as well as the pharmacology of buprenorphine and its efficacy/safety in treating opiate use disorder. Dr. Bishop then identifies patients who would benefit from buprenorphine and constructs a plan of care for patients with opiate withdrawal, including non-MAT and MAT options. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Regan Wade presents "Heart Failure Pharmacology" by first reviewing heart failure pathophysiology as it relates to pharmacotherapy. She then discusses guideline directed therapy and other agents indicated to optimize HF care. After, Dr. Wade evaluates literature related to new therapies and indications for medications in patients with heart failure. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Sara Ellingwood presents a talk on Asthma starting with its definition and phenotypes. She discusses making a diagnosis, differential diagnosis, and management. After, Dr. Ellingwood ends with a discussion on when to refer. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.   Disclaimers ©2016 LouisvilleLectures.org

Dr. Forest Arnold returns to present "COVID-19 Vaccines: Wows and Woes" today on Louisville Lectures. In this presentation, Dr. Arnold gives an overview of COVID-19 and vaccines. He then discusses a case of potential thrombosis due to the Johnson & Johnson vaccine as well as the pathophysiology of vaccine-induced immune thrombotic thrombocytopenia (VITT). After, he presents the CDC Advisory Committee on Immunization Practices and the efficacy of vaccines in light of variants. And finally, Dr. Arnold discusses post acute COVID-19 Syndrome (PACS). Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Our Chief Medical Resident for Education, Dr. Samuel Reynolds returns to give an introduction on abstract writing. He begins by describing an abstract and its importance. After, he discusses the general process of abstract writing. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Nina Vasavada gives an Acid Base Core Lecture by first reviewing dietary sources of acids and alkali. She then reviews renal and non renal mechanisms of maintaining acid/base equilibrium. After, she discusses practice questions.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Our Chief Medical Resident for Education, Dr. Samuel Reynolds, presents “Basic Science: Molecular Biology in Cardiovascular Disease”. He discusses the basis of Cardiovascular Disease from a molecular standpoint and emphasizes how arrhythmia and cardiac conduction impairment relates to coronary artery disease and how the development of structural heart disease can mean problems for our heart’s ability to conduct electrical signals. Please note: this presentation took place in our Didactics Zoom, so the audio may be harder to hear.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Jennifer Olges presents "Health Disparities: Food Insecurity and Food Deserts" by first defining food insecurity and food deserts. She then compares and contrasts hunger and food insecurity and describes the scope of the issue in Louisville/Jefferson County as well as in the clinic population. After, Dr. Olges describes the clinical implications of food insecurity and finally, reviews the process for accessing the food bank in the AIM clinic.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Aaditya Chandramouli presents Part One of Sepsis and Sepsis Shock. In this Little Lecture, Dr. Chandramouli discusses the definitions and diagnosis of Sepsis and Sepsis Shock. Stay tuned for next time when he presents the Part Two - Management of Sepsis Shock. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Christopher Chan presents an Introduction to Mechanical Ventilation by first defining respiratory physiology and indications for mechanical ventilation. He then presents the initial parameters/modes of ventilation as well as supportive care. After, Dr. Chan discusses troubleshooting the vent, weaning, successful liberation from the vent, and finally, the checklist.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Lorrel E.B. Toft returns to the University of Louisville to deliver a much needed Boards Review on Cardiology. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Laura Bishop presents the COVID-19 Series. In part one, she discusses the background of COVID-19 from virology, to epidemiology and symptoms. Stay tuned for Part Two where she discusses clinical care.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Forest Arnold's focuses on summarizing the extent of human coronaviruses, risk factors, and the clinical presentation of patients with coronavirus to the extent known. He then identifies the current infection prevention and control approach, as well as clinical management and future directions. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Rodrigo Cavallazzi presents Part Two of his Critical Care Medicine Board Review with the topics below: - Myxedema Coma - Thyroid Storm - Thyroid Function in Non-Thyroidal Illness - Delirium - Sepsis - Protocolized Sedation and Spontaneous Breathing Trial - ICU-Acquired Weakness - Post-intensive Care Syndrome - Chronic Critical Illness Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Rodrigo Cavallazzi presents Part One of his Critical Care Medicine Board Review with the topics below: - Lactic Acidosis- Hyponatremia - Hypernatremia - Drug Poisoning - Cyanide Toxicity - Carbon Monoxide Toxicity - Methemoglobinemia - Hypothermia Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Mark Burns presents "Ebola" by first discussing the history and transmission of Ebola. He then explains the term "person under investigation" as well as how to control the spread of Ebola. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Gunjan Garg presents an overview on  "Chronic Kidney Disease" by first discussing the definition and staging. She then presents the pathophysiology and epidemiology, screening, and clinical manifestations. After, she discusses hypertension, dyslipidemia, management, and so on. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Khushboo Gala returns with Patterns of Liver Injury and the initial evaluations when encountering them. She first classifies liver disease  and after, discusses patterns of liver injury be degree of transaminase elevation. Don't forget to check out part one: Liver Tests! https://youtu.be/jSTtrVSvR00 Behind the scenes at Louisville Lectures, we have been hard at work on a new series: "Little Lectures." Based on feedback from YOU, our loyal viewers, we are excited to present an under ten-minute video series created by residents for learners. These will focus on delivering just-in-time algorithms, practical clinical knowledge and board tips on high-yield topics. These lectures will be provided by the University of Louisville Internal Medicine residents. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org

Dr. Olgres presents a quick overview on “Biostats for Internal Medicine”. In this lecture, Dr. Olges explains how to calculate sensitivity and specificity, as well as how to accurately interpret sensitivity and specificity in regards to test results. She then calculates the likelihood ratios and uses them to determine post test probabilities. After, she discusses the difference between relative and absolute risk. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org

Dr. Joe Rotella presents "From Burnout to Joy- Healing the Healers " by first describing the consequences and causes of clinician burnout as well as the rise of national initiatives to support clinician well-being. He then uses stories and illustrations to trace one physician's journey from burnout to joy and growth as a medical leader. And finally, Dr. Rotella explores how we can help each other thrive in this difficult and important work. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Sally Suliman defines Sepsis and its history. She then presents the guidelines for surviving sepsis as well as the updates in literature. After, she discusses the recognition and diagnosis of sepsis as well as treatment. And finally, bundles and compliance. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Khushboo Gala presents "Liver Tests"  by discussing how liver enzymes can help classify hepatic disease into hepatocellular, obstructive/cholestatic and infiltrative diseases. She then talks about the Degree of Transaminase elevation as well as Alkaline Phosphatase. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org  

***Apologies for the sound quality! The majority of our future lectures will not have this problem. Thank you for your patience!*** Dr. Anthony Fernandez presents "Update in Assessment and Treatment of Patients with Psoriasis Vulgaris" by first reviewing the general features of psoriasis vulgaris. He then discusses the systemic inflammatory nature of psoriasis and select comorbid diseases, and the key aspects of clinical assessment of patients. After, he provides an update in treatment options for moderate-to-severe psoriasis.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org  

Dr. Omer delivers part two of a GI Board Review. This talk includes various cases as well as questions and answers. Check out part one from last week! Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org

Dr. Omer delivers part one of a GI Board Review. This talk includes various cases as well as questions and answers. Stay tuned for Part Two next week. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org

Dr. Anupama Raghuram presents a review of "HIV Pre-Exposure Prophylaxis (PrEP)" by first discussing the HIV global burden of disease and transmission. She then presents the rationale for HIV PrEP as well as the efficacy and indications of HIV PrEP. Finally, she analyzes the initial barriers in prescribing HIV PrEP. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

*PLEASE READ BEFORE WATCHING* We apologize for the poor audio quality. We've had some hiccups with the microphone we use and are currently working to find a solution. Thank you for your patience! And thanks for watching! -------------------------- In this Grand Rounds, Dr. Jonathan Bernstein discusses chronic cough by first describing the evaluation and differential diagnosis of a patient presenting with chronic cough. He then determines the pathogenesis of chronic cough and defines the approach to diagnosis and treatment of chronic cough.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org

Dr. Sally Suliman presents "Interstitial Lung Disease" by first introducing the classification of ILDs. She then defines the micro-anatomy of the lung as well as clinical signs and symptoms of ILDs. After, she discusses testing and finally, IPF diagnosis and treatment. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org  

Dr. Christine Bridges presents "Advanced Care Planning" by first defining advanced care planning. She then discusses the available documents, billing and coding, as well as clinical pearls. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Gunjan Garg presents "Tubulointerstitial Disease" by first discussing pathophysiology and epidemiology.  She then presents its diagnosis and evaluation as well as various causes. After, she discusses management and Ace Board questions. Dr. Garg does this through case based learning.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org

Dr. Liza Cholin defines Acute Kidney Injury and discusses diagnostic tests. She presents prerenal, intrinsic, and postrenal acute kidney injury and after, the indications for urgent dialysis.   Behind the scenes at Louisville Lectures, we have been hard at work on a new series: "Little Lectures." Based on feedback from YOU, our loyal viewers, we are excited to present an under ten-minute video series created by residents for learners. These will focus on delivering just-in-time algorithms, practical clinical knowledge and board tips on high-yield topics. These lectures will be provided by the University of Louisville Internal Medicine residents.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016LouisvilleLectures.org

Dr. Shahab Ghafghazi presents "Valvular Heart Disease" and focuses mainly on aortic stenosis through various definitions and case reports. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016LouisvilleLectures.org

Dr. Travis Huffman gives a quick overview of Hypertensive Crisis, Hypertensive Urgency vs. Hypertensive Emergency and management of both Markedly elevated BP and HTN Emergency/Crisis.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Dr. Craig McClain presents "Management of Alcohol-Related Hepatitis" through various case studies, as well as an overview and diagnosis. He then discusses research findings related to alcoholic hepatitis and after, Dr. McClain explains the therapies being validated for the treatment of AH, their complications, as well as transplantation. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org    

Dr. Bilal Jalil presents part one of three talks on Point of Care Ultrasound. He first discusses the need to take care of the ultrasound machine by keeping it clean and placing probes onto their side cups. After, Dr. Jalil goes into the history of the ultrasound and then into Point of Care Ultrasound.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org

Dr. Christian Matar is a Medicine and Pediatrics resident at the University of Louisville presenting "Hyperkalemia". Behind the scenes at Louisville Lectures, we have been hard at work on a new series: "Little Lectures." Based on feedback from YOU, our loyal viewers, we are excited to present an under ten-minute video series created by residents for learners. These will focus on delivering just-in-time algorithms, practical clinical knowledge and board tips on high-yield topics. These lectures will be provided by the University of Louisville Internal Medicine residents. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016LouisvilleLectures.org