How is TPN and PPN similar and how is it different? When should each be used? How does bacterial overgrowth lead to complications? Does TPN cause diarrhea?

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Timestamps:

(01:35) | PEARL 1: Basics of PN: What makes up parenteral nutrition?

(06:54) | PEARL 2: Indications and Contraindications for TPN and PPN: When should I order parenteral nutrition?

(13:40) | PEARL 3: Complications of parenteral nutrition: What are the common adverse effects of parenteral nutrition?

(19:41) | PEARL 4: Parenteral nutrition myths: What should patients know before they start TPN?

(23:56) | PEARL 5: Recap on Tube Feeds: How do we determine the amount of free water to give out patients on tube feeds?

Transcript and Show notes

Tags: IMCore, CoreIM, parenteral nutrition, TPN, PPN, clinical nutrition, nutritional support, complications, patient safety, gastrointestinal disorders, critical care, internal medicine, fluid management, ICU, Crit Care, GI, gastroenterology

Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?

** Register for 2025 Digital Education & Artificial Intelligence Conference !! **

It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.

Timestamps:

(03:01) | PEARL 1: Basics to Urine Drug Screen (UDS)

(08:03) | PEARL 2: Types of urine drug tests, and what are immunoassays (IA)?

(18:44) | PEARL 3: What are gas chromatography/mass spectrometry (GC/MS)-based tests?

(26:51) | PEARL 4: How do you address unexpected test results on a UDS?

(30:29) | PEARL 5: Throwback to “5 Pearls on Stigma in Opioid Use Disorder” episode

Transcript and Show notes

Tags: IMCore, CoreIM, primary care, urine drug screening, opioid use disorder, substance use, harm reduction, addiction medicine, clinical toxicology, patient safety, compassionate care

What if a patient can't afford hospice? Which medications do you deprescribe when on hospice? What happens when patients who are on hospice return to the hospital or ED?

Behind the Scenes Youtube Interview:

Hospice Music Therapy

Show notes & Transcript

Hospice 101 Episode 1

Sponsor:

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Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant

Can the MINT trial change how we treat anemia in acute MI? The largest trial of its kind compared liberal vs. restrictive transfusion strategies in patients with myocardial infarction.

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Timestamp:

• 01:29 History of Transfusion Guidelines/Studies
• 06:49 Pathophysiology of Anemia in heart disease
• 10:04 Transfusion in MI Studies
• 13:45 MINT Trial
• 22:20 Takeaways/Discussion

Transcript and Show Notes

Tags: Tags: CoreIM, IMCore, cardiology, internal medicine, myocardial infarction, anemia, transfusion, physician assistant, nurse practitioner, pharmacist, clinical trials, MINT trial, transfusion strategies, restrictive vs. liberal transfusion, heart attack

Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!

Timestamps:

(01:07) | Strategies for Addressing Moral Distress

(09:25) | Strategies for Address Moral Injury

(20:52) | Conclusion

Transcript and Show notes

Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethics

What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?

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Timestamps:

(04:59) | Definitions

(6:50) | Moral Distress

(09:01) | Moral Residue

(09:01) | Moral Residue

(11:34) | Moral Injury

(13:32) | Causes of Moral Distress and Moral Injury

(18:18) | Consequences

Transcript and Show notes

Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanism

Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”

Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! 

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Timestamps:

(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension

(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output

(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion Pressure

Transcript and Show notes

Cardiorenal Considerations: 5 Pearls Segment

Tags:

IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical care

Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.

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Timestamps:

(2:44) What makes this patient different from others with similar symptoms or diagnosis?

(7:28) Does your covering team have the tools to follow up on tasks and information they need for success? 

(16:06) Is the handoff updated? 

(18:26) What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients? 

(22:41) What are we still uncertain about? 

(25:30) Closing thoughts 

Show notes & transcripts

Tags:

IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalist

• What is the philosophy of hospice? (3:04)
• Who qualifies for hospice (6:13)
• Who makes up the hospice team (8:17)
• Who pays for hospice (17:24)
• What are the different levels of care (21:31)
• What are some limitations of the hospice medicare benefit? (31:57)

Behind the Scenes Youtube Interview:

Hospice Music Therapy

Show notes & Transcript

Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! 

Use the code CORE50 to get 50% off your first month with Freed

Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant

Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention.

Book by Dr. Adaira Landry, Dr. Resa E. Lewiss:

MicroSkills: Small Actions, Big Impact

Show notes & Transcript

Tags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistant

Does colonoscopy prevent colon cancer, and does it save lives? There has never been a randomized controlled trial on screening colonoscopies before NordICC trial, even though it is a guideline based recommendation for everyone over 45! How did this come to be? What do we tell our patients who are on the fence about undergoing screening colonoscopy? To find out, tune into the sixth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. 

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Timestamp:

• 00:00 Introduction
• 02:28 Pathophysiology of Colorectal Cancer & Why Screening Makes Sense
• 06:15 General Cancer Screening – Observational Studies
• 09:17 General Cancer Screening – Randomized Controlled Trials
• 14:40 NordICC Trial
• 22:36 Implications for Patient Care

Show notes & Transcript

Tags: IMCore, CoreIM, primary care, gastroenterology, nurse practitioner, pharmacist, physician assistant, sigmoidoscopy, per protocol analysis and intention to treat analysis