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The Curbsiders Internal Medicine Podcast

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The Curbsiders Internal Medicine Podcast

#435 Neck Pain with Dr. Anthony Mikula

Mon, 15 Apr 2024
A real pain in the neck (Get it?! We have fun.)



Protect your neck!  Learn how to evaluate a patient with neck pain, and differentiate between mechanical neck pain, radiculopathy, and myelopathy. You’ll learn who should be reassured, who should see a surgeon, and what nonoperative options are available.  We’re joined by Dr. Anthony Mikula @anthony_mikula from Mayo Clinic. 



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Show Segments






  • 00:00 Introduction 

  • 06:14 Anatomy and Pain Generators

  • 09:58 Approach to Neck Pain

  • 22:57 Differentiating Radiculopathy from Non-Specific Neck Pain

  • 24:05 Management of Mechanical Neck Pain

  • 27:36 Indications for Imaging

  • 29:21 Terminology and Explanation of Spondylosis, Spondylolisthesis, and Spondylolysis

  • 30:48 Diffuse Idiopathic Skeletal Hyperostosis (DISH)

  • 32:23 Imaging Terminology and Plain Films

  • 36:19 Pathophysiology of Cervical Radiculopathy

  • 38:34 Physical Examination for Cervical Radiculopathy

  • 44:54 Diagnostic Work-up for Radiculopathy

  • 51:53 Interventions for Cervical Radiculopathy

  • 53:53 Considerations for Surgery

  • 57:49 Recognizing Cervical Myelopathy

  • 01:00:17 Natural History of Myelopathy

  • 01:02:25 Referral and Treatment for Myelopathy

  • 01:09:28 Summary and Takeaways





Credits






  • Written and Produced by: Paul Williams, MD, FACP

  • Show Notes: Paul Williams, MD, FACP

  • Infographic and Cover Art: Paul Williams, MD, FACP

  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   

  • Reviewer: Leah Witt, MD

  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

  • Technical Production: PodPaste

  • Guest: Anthony Mikula, MD





Sponsor: Freed



You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.



Sponsor: Grammarly






#434: Ur-INe for Recurrent UTI?! with Dr. Kellen Choi, DO AKA The Bladder Teacher

Mon, 08 Apr 2024
It’s NOT Always a UTI!



Sounds like another UTI but it could be more than that! Time to explore the entire pelvic floor and see what more you can treat. School’s in session with the Bladder Teacher,  Kellen Choi, DO from the University of Louisville @KellenChoi



Claim CME for this episode at curbsiders.vcuhealth.org!



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Show Segments






  • Intro

  • Rapid fire questions/Picks of the Week

  • Case #1 and Definitions

  • Bowel habits

  • Water intake 

  • Case #2

  • Vaginal Estrogen

  • Non-antibiotic prophylaxis

  • Antibiotic in prophylaxis

  • Pelvic Floor Physical Therapy

  • Take-home points

  • Outro





Credits






  • Producer, Writer & Show Notes: Isabel Valdez, PA

  • Infographic & Covert Art: Edison Jyang

  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   

  • Reviewer: Fatima Syed, MD

  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

  • Technical Production: PodPaste

  • Guest: Kellen Choi DO, FAOCS





Sponsor: Freed



You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.



Sponsor: Locumstory



Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.







#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

Mon, 01 Apr 2024
Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!



Claim CME for this episode at curbsiders.vcuhealth.org!



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Show Segments






  • 00:00 Introduction and Diabetes Puns

  • 01:00 Introduction of Guest and Topic

  • 09:12 Qualifications and Eligibility for CGMs

  • 11:32 Types of CGMs and Sensor Placement

  • 24:47 Interpreting CGM Data and Alarms

  • 34:30 Troubleshooting Patterns and Adjustments

  • 35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses

  • 36:15 The Rule of 15 and Addressing Hypoglycemia

  • 37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia

  • 38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin

  • 39:51 Managing Exercise-Induced Hypoglycemia

  • 41:43 Preventing Exercise-Induced Hypoglycemia with Snacks

  • 43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas

  • 45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin

  • 46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia

  • 51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin

  • 56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin

  • 57:44 Addressing Adherence and Medication Barriers

  • 59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management

  • 01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap

  • 01:05:49 Considering Patient Adherence and Barriers to Treatment





Credits






  • Writer and Producer: Matthew Watto MD, FACP

  • Show Notes: Matthew Watto MD, FACP

  • Cover Art and Infographic: Matthew Watto MD, FACP

  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   

  • Reviewer: Emi Okamoto MD

  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

  • Technical Production: PodPaste

  • Guest: Jeff Colburn MD





Sponsor: Freed





You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.



Sponsor: Panacea Financial





Download the 2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.









#432 Hotcakes: E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, Lidocaine for neck pain, C diff risk by antibiotic type, and “dosing by clicks” for GLP1’s

Mon, 25 Mar 2024
Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).



Claim CME for this episode at curbsiders.vcuhealth.org!



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Credits






  • Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP

  • Cover Art: Matthew Watto MD, FACP

  • Reviewer: Rahul Ganatra MD, MPH

  • Technical Production: Pod Paste

  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP







Show Segments






  • Introduction and disclaimer

  • E-cigarettes for smoking cessation

  • Gabapentinoids and COPD exacerbations

  • Topical lidocaine for neck pain

  • Association between specific antibiotics and C. diff infection

  • Shortage of GLP-1 agonists and “dosing by clicks”





Sponsor: Locumstory



Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.





Sponsor: Freed 



You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. 

#431 Myocarditis and Pericarditis

Mon, 18 Mar 2024

Show description: 

Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter! 



Claim CME for this episode at curbsiders.vcuhealth.org!



Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME



Show Segments






  • Intro, disclaimer

  • A case of pericarditis

  • Diagnosing pericarditis

  • The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis

  • Etiologies of pericarditis and initial testing recommendations

  • Treatment of acute uncomplicated pericarditis

  • Using colchicine to prevent recurrent pericarditis

  • Patient counseling after diagnosing pericarditis

  • A case of myocarditis

  • Interpreting elevated troponin levels

  • Distinguishing between myocardial infarction and myocardial injury

  • Diagnostic testing for suspected myocarditis

  • When to pursue cardiac MRI and endomyocardial biopsy

  • The spectrum of myocarditis presentations

  • Fulminant myocarditis

  • Common etiologies of myocarditis

  • Immune checkpoint inhibitor myocarditis

  • Myocarditis from mRNA vaccines and from SARS-CoV-2 infection

  • Management of patients with myocarditis

  • Activity restrictions for patients with myocarditis

  • Outro





Credits






  • Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP

  • Guest: Vivek Kulkarni, MD, FACC

  • Producer, Script, and Show Notes: Adam Barelski, MD

  • Infographics and Cover Art: Edison Jyang

  • Reviewer: Leah Witt, MD

  • Technical Production: Pod Paste

  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP





Sponsor: Freed



You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.



Sponsor: Panacea Financial



Download the full  2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.



Sponsor: Factor



Head to factormeals.com/curb50 and use code curb50 to get 50% off.

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