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

Use the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 

🔹Transcript and Shownotes:  

02:49 | Pearl 1: Foundations of Dialysis

09:21 | Pearl 2: Distinct Physiology

11:42 | Pearl 3: Why is fluid management so important?

19:43 | Pearl 4: Fluid Management Pro-tips

25:31 | Pearl 5: Diuretics in Patients with Residual Kidney Function

Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, Dialysis, End-stage kidney disease, Hypertension, Kidney Health, Dry Weight, Volume Overload

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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 judgment in modern medical care. 

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🔹Transcript and Shownotes:  

02:51 | Broad workup for reversible causes and other etiologies of AFib that may occur post-op

05:10 | Considerations for management of post-op atrial fibrillation

13:00 | Stroke risk in atrial fibrillation

20:49 | Outpatient management of atrial fibrillation 

25:54 | The role of AI in medical decision-making

Tags: CoreIM, Internal Medicine, Medical Education, Atrial Fibrillation, Cardiology, Open Evidence

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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 before.

🔹Sponsor: Oakstone CME

Use the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 

🔹Transcript and Shownotes:  

04:40 | Emergency Medical Kit (EMK) Standard Contents

08:50 | Role of Ground-Based Medical Support & Flight Diversion Decision-Making

19:35 | Interpreting Hypoxia at Altitude

22:06 | In-Flight Liability

23:35 | Common Chief Concerns & Useful Additional Medications

24:53 | How to Be Resourceful in an Austere Environment

Tags: CoreIM, Internal Medicine, Medical Education, In-flight Care, Medical Emergencies, Clinical Reasoning, Seizure Management, Hypoxia, Airway Management, Cardiac Emergency, Syncope, Respiratory Distress

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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 before giving steroids

🔹Transcript and Shownotes: 

02:34 | Why Do We Care About Eosinophilia? (Pearl 1)

10:24 | Atopy and Eosinophilia (Pearl 2)

18:57 | Drugs and Eosinophilia (Pearl 3)

27:29 | ID and Eosinophilia (Pearl 4)

33:54 | Pearl 5: Eosinophilia, Steroids, and Neoplasms (Pearl 5)

Tags: CoreIM, Internal Medicine, Medical Education, Eosinophilia, Hypereosinophilia, Allergy Immunology, Hematology, Pulmonology, Parasitic Infections, Atopy

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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: Oakstone CME

Use the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 

🔹 Transcript and Show notes

00:00 | Challenges of interpreting nutritional research.

02:22 | Best practices for evaluating studies in nutrition. 

12:35 | Delve into the CRAVE trial as an example of critically appraising nutritional investigations.

26:41 | Applying this to clinical practice for your patients.

Tags: IMCore, Internal Medicine, Medical Education, Epidemiology, Diet and Lifestyle

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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 calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com

🔹Transcript and Shownotes:

02:15 | Pearl 1: Pathophysiology

08:20 | Pearl 2: Diagnosis

16:35 | Pearl 3: Treatment

20:35 | Pearl 4: Antibiotics

27:39 | Pearl 5: Wound Care

Tags: CoreIM, Internal Medicine, Medical Education, Diabetic Foot Infections, Osteomyelitis, Foot Ulcer, Wound Care

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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 better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going?

🔹Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/

See here for Neph Madness details 

See here for the POCUS region of NephMaddness

VOTE here to build your bracket!

🔹Transcript and Shownotes:

00:52 | What is NephMadness?

02:19 | Detecting post-renal obstruction in a patient who reported normal urination

11:26 | POCUS for discharge or continue diurese

17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound

23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis line

Along the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside.

If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question.

Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUS

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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 deprescribe dementia medications?

🔹Sponsor: Caraway’s cookware set is a favorite for a reason.

For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout.

🔹Transcript and Shownotes

02:27 | Deep Dive 1: How do we deliver the news of a diagnosis of dementia?

09:41 | Deep Dive 2: Prescribing medications for cognitive decline

29:30 | Deep Dive 3: Patient-centered management for a patient with cognitive decline

35:46 | Deep Dive 4: Planning for an uncertain future

Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant

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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 inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com

🔹Transcript & Shownotes:

01:12 | Cognitive Concerns During a Routine Follow-Up

03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues?

15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline?

31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline?

Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant

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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/

🔹Transcript and Shownotes:

00.58 | Insulin Hx & Types

06:00 | Indications for Insulin and the Burden on Patients

08:26 | What is the QWINT-1 Trial?

16:18 | Discussion

Tags: CoreIM, Internal Medicine, Evidence-Based Medicine, Insulin Resistance, Clinical Reasoning, Hospital Medicine, Medical Education, Endocrine, Endocrinology

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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 Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com

🔹Transcript and Shownotes:

03:51 | What is the difference between Privacy and Confidentiality?

05:50 | Guidelines and laws

10:06 | Limits/appropriate breaches (competing principles/obligations) 

22:03 | Privacy vs education

35:34 | Conclusion

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