IM & Hospital Medicine Recaps
Audio notes for busy internists and hospitalists, built from favorite clinical reviews, cases, trials, and more. These summaries are curated and written by practicing physicians, read-aloud by AI.
Episodes
Antiarrhythmic Drugs for AFib (CardioNerds)
Dive deep into the complex world of antiarrhythmic medications for atrial fibrillation. This episode unravels the crucial mechanisms, efficacy, and serious risks of drugs like Class 1C agents, amiodarone, dofetilide, sotalol, and ibutilide. Learn essential prescribing guidelines, critical contraindications (including in CAD and heart failure), and paramount monitoring protocols to ensure patient s
Menopause Care Review (Curbsiders)
Unpack the modern understanding of Menopause Hormone Therapy (MHT), moving beyond past controversies to embrace a nuanced, individualized approach. This episode re-examines the WHI trial, exploring the critical "timing hypothesis" and the benefits of transdermal estrogen. Learn about the role of micronized progesterone, effective treatments for genitourinary symptoms, and how personalize
Hypertriglyceridemia (Core IM)
Elevated triglycerides pose serious health risks, from acute pancreatitis to long-term cardiovascular disease. In this episode, we dive into severe hypertriglyceridemia, covering its causes, urgent inpatient care strategies, and essential long-term approaches including lifestyle changes and pharmacotherapy. Learn how to protect your heart and pancreas from this complex lipid disorder.Source: https
Superficial Vein Thrombosis: A Review (JAMA)
Superficial Vein Thrombosis (SVT) is often underestimated, but new insights reveal its critical importance. This episode dives into why SVT is far from benign, highlighting its strong link to deep vein thrombosis (DVT) and pulmonary embolism (PE). Learn when D-dimer is useless, how to differentiate upper vs. lower extremity SVT, and the precise criteria for conservative management versus aggressiv
Hypertension Guidelines Update (Curbsiders) - IM and Hospital Medicine Recaps
Navigating the latest hypertension guidelines can be complex, but these crucial updates offer fresh perspectives for clinicians and patients. We delve into the critical importance of accurate blood pressure measurement, expanded screening for conditions like primary aldosteronism, and tailored, often more aggressive, treatment strategies including early dual-drug therapy for Stage Two hypertension
ASCVD Risk & Lipids Update (The Curbsiders) - IM and Hospital Medicine Recap
Navigate the evolving landscape of cardiovascular disease prevention with our expert insights. This episode breaks down updated strategies for assessing ASCVD risk and managing lipids, emphasizing personalized approaches. Discover the game-changing PREVENT calculator, the significance of non-HDL cholesterol, the "triple threat" of Lp(a), and how a CAC score can redefine your risk. Learn
Head and Neck Cancer (JAMA)
Head and neck cancer (HNC) demands a sophisticated approach. This episode breaks down the diverse types of HNC, highlighting the critical divide HPV status creates in oropharyngeal cancer - from distinct patient profiles to vastly different prognoses. We'll explore the essential diagnostic workup, stage-specific treatment strategies, and the revolutionary impact of immunotherapy, featuring pem
Prostate Cancer (The Lancet)
Prostate cancer management is evolving rapidly. This episode explores the cutting-edge advancements transforming diagnosis and treatment. From the precise ISUP Grade Group System and essential multi-parametric MRI, to personalized strategies like active surveillance for low-risk disease, we cover it all. Discover the impact of triplet therapy for metastatic cases, targeted radiotherapy, refined ap
Complex Regional Pain Syndrome (NEJM)
Unlock Complex Regional Pain Syndrome (CRPS), one of medicine's most challenging and often misunderstood conditions. This episode dives deep into CRPS, explaining diagnosis via the Budapest criteria, its nature as a nociplastic pain disorder, and the fascinating phenomenon of distorted limb perception. We cover crucial acute interventions, nuanced chronic pain management strategies (including
Cancer Screening in Older Adults (AAFP)
Navigating cancer screening for older adults is a complex puzzle. This episode explores why life expectancy, not just chronological age, should be the primary factor in making screening decisions. We delve into the crucial "lag time" for mortality benefits, the significant harms of overdiagnosis, and specific, nuanced recommendations for breast, prostate, cervical, colorectal, and lung c
Neutropenia Evaluation and Management (AAFP)
Neutropenia can be a puzzling and concerning finding, signaling everything from medication side effects to serious autoimmune conditions. This episode, from the AAFP, offers essential insights into its diverse causes and critical management strategies. From navigating the critical window of chemotherapy-induced neutropenia and recognizing febrile neutropenia as an oncologic emergency, to understan
Evaluation of Suspected Dementia (AAFP)
Navigating a suspected dementia diagnosis is complex. This episode offers a comprehensive guide to the systematic evaluation process. From gathering crucial collateral history and utilizing cognitive screening tests like the MoCA, to conducting targeted physical exams, focused lab workups, and essential brain imaging, we break down each critical step. We'll explore the nuances of differentiati
Chronic Pancreatitis (Lancet)
Chronic pancreatitis: a condition often misunderstood, challenging both patients and clinicians. This episode cuts through common misconceptions, revealing how the disease can manifest without prior acute attacks and detailing the synergistic impact of dominant risk factors like alcohol and smoking. We explore the cascade of complications from pancreatic exocrine and endocrine insufficiency – incl
Vaginitis: Diagnosis and Treatment (AAFP)
Source: https://www.aafp.org/pubs/afp/issues/2025/1100/vaginitis.htmlSubscribe to our Substack!https://substack.com/@rokeefemd
Management of Sepsis in Hospitalized Patients (Annals of IM)
Source: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02685Subscribe to our Substack!https://substack.com/@rokeefemd
Peripartum Cardiomyopathy (Lancet)
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01451-5/abstractSubscribe to our Substack! https://substack.com/@rokeefemd
MASLD: A Review (JAMA)
Source: https://jamanetwork.com/journals/jama/article-abstract/2841071Subscribe to our Substack!https://substack.com/@rokeefemd
Iron Deficiency Anemia (AAFP)
Source: https://pubmed.ncbi.nlm.nih.gov/41252836/Subscribe to our Substack!https://rokeefemd.substack.com/
Alcohol Use Disorder (Lancet)
Source:https://www.thelancet.com/article/S0140-6736(25)01496-5/abstractSubscribe to our Substack!https://rokeefemd.substack.com/
When Bicarb is Not Bicarb (Strong Medicine)
This episode demystifies why the “bicarb” on a BMP never quite matches the bicarbonate on a blood gas. We explain how CO₂ exists in three forms (dissolved CO₂, carbonic acid, and bicarbonate), why blood gases calculate bicarbonate using pH and PCO₂ via Henderson–Hasselbalch, and how BMPs instead chemically measure total CO₂ after converting bicarbonate and carbonic acid to gas. You’ll learn why th
Invasive Fungal Infections Explained (Core IM)
I love that the TTS AI voice nailed "coccidioides" but struggled with "candida."This episode gives you a clean mental framework for invasive fungal infections by starting with the drugs. We break down the three main antifungal classes - azoles (ergosterol synthesis blockade), polyenes (direct membrane attack via ergosterol binding), and echinocandins (beta-glucan cell wall inhi
Hepatorenal Syndrome (Core IM)
The TTS AI voices just couldn't seem to get "terlipressin" right. Don't blame them.This episode reframes hepatorenal syndrome as a circulatory problem, not a primary kidney disease. We walk through the core pathophysiology - portal hypertension–driven vasodilation, low effective arterial volume, and intense renal vasoconstriction - and the high-yield labs that separate HRS from A
COPD Update (Curbsiders)
This episode updates your COPD mental model from “FEV₁ and a LABA” to phenotype- and risk-driven care. We review when fixed obstruction in a non-smoker should trigger CT chest and full PFTs, why GOLD 2025 now recommends universal alpha-1 antitrypsin screening, and how to use the ABE classification to choose between single bronchodilator, dual LABA/LAMA, and eosinophil-guided triple therapy. We cov
GERD vs NERD Pearls (Curbsiders)
I love how the TTS AI voices struggle with saying "GERD". This episode breaks reflux down to what actually matters at the bedside: clarifying what patients mean by “heartburn,” screening for true alarm features (dysphagia, bleeding/anemia, weight loss), and understanding when an 8-week PPI trial is appropriate. We walk through the modern workup - PPI washout before endoscopy, which endos
Inflammatory Bowel Disease Pearls (Curbsiders)
Inflammatory bowel disease doesn’t always read like the textbook. In this episode, we walk through high-yield clinical pearls for recognizing atypical presentations (including constipation from Crohn’s), taking rectal bleeding seriously in young patients, and avoiding common diagnostic traps with CRP, fecal calprotectin, and small bowel disease. We cover how to choose and monitor therapy with a “t
Evaluation Of Jaundice In Adults - Review (AAFP)
In this episode, we walk through a practical, pattern-based approach to jaundice. We cover why fractionating bilirubin is the key first step, how to quickly distinguish unconjugated from conjugated hyperbilirubinemia, and the red flags for ascending cholangitis and acute liver failure. You’ll learn how to interpret AST/ALT vs alkaline phosphatase, when to reach for RUQ ultrasound, MRCP, or ERCP, a
Non-Celiac Gluten Sensitivity - Review (Lancet)
Explore the gray zone between celiac disease, wheat allergy, and IBS in this episode on Non-Celiac Gluten Sensitivity (NCGS). We break down how to rigorously rule out celiac and wheat allergy, why gluten and FODMAPs (especially fructans) are so hard to tease apart, and how brain–gut interactions and the nocebo effect shape symptoms. You’ll learn a practical approach to diagnosis, the role of elimi
Lung Cancer In Nonsmoking Individuals: A Review (JAMA)
In this episode, we break down why lung cancer in people who have never smoked is a completely different disease biology than tobacco-related lung cancer. We walk through the dominance of adenocarcinoma in this population, the central role of single oncogenic drivers, and why EGFR, ALK, and other targetable alterations are so much more common in never-smokers.We cover how and why to send broad mol
Syphilis: A Review (JAMA)
This episode walks through how syphilis evolves over time - from the painless primary chancre to systemic secondary disease, silent latent phases, and destructive tertiary complications. We break down how timing and symptoms define “early” vs “late” disease, how to use nontreponemal and treponemal tests (including the prozone phenomenon and early false negatives), and when to suspect or treat neur
Chronic Coronary Artery Disease Review (Annals of Internal Medicine)
In this episode, we walk through the evolving concept of “stable ischemic heart disease” now reframed as Chronic Coronary Artery Disease (CCAD) - a long-term imbalance between myocardial oxygen supply and demand, usually from atherosclerotic coronary obstruction. We break down how to estimate pre-test probability, when to use CAC scoring, CCTA, or functional stress testing (including recognizing I
Hair Loss in Women (NEJM Review)
Get a clear framework for approaching female hair loss in clinic. This episode walks through how to quickly flag scarring alopecia that needs urgent derm, distinguish female-pattern hair loss from chronic telogen effluvium and alopecia areata, choose and monitor treatments like topical and oral minoxidil (with when to add antiandrogens), and support patients through the psychological impact and wh
Tinea Infections (Diagnosis and Management Pearls) - AAFP Review
Get a practical handle on when superficial fungal infections need pills, not creams. This episode covers why terbinafine is first-line for tinea capitis and onychomycosis, how long to treat based on site, when (and how) to confirm the diagnosis before committing to months of therapy, why topical steroids can create tinea incognito, and what to do when standard terbinafine fails.Source: Caplan AS,
Dermatologic Emergencies
Learn how to quickly sort benign drug rashes from true dermatologic emergencies at the bedside. This episode walks through morbilliform eruptions, leukocytoclastic vasculitis, AGEP, phototoxic reactions, erythema multiforme, erythroderma, DRESS, and SJS/TEN - highlighting classic morphology, timing, red-flag features, and what to do next when you’re the first clinician to see the rash.Subscribe to
Hyponatremia for the Hospitalist
This episode reviews hyponatremia through a physiology-first lens, emphasizing that it is primarily a disorder of water balance rather than sodium itself. We discuss how urine sodium helps differentiate hypovolemic, hypervolemic, and euvolemic hyponatremia and why it often provides a more reliable assessment of effective volume status than the physical exam. The episode then focuses on SIADH, expl
Monoclonal Gammopathy of Undetermined Significance (MGUS) - NEJM Review
This episode breaks down what MGUS truly represents and why it’s so often misunderstood. It explains how a small, silent monoclonal protein fits into the spectrum of plasma cell disorders, why most people with MGUS feel completely well, and what actually drives the risk of progression to myeloma or related conditions. The discussion walks through the essential diagnostic labs, the Mayo Clinic risk
Recommended
15 minutes de grâce et de vérité
15 Minutes of Infamy
15 Minutes with Jesus: Christian Meditation, Guided Prayer, Bible Study, Emotional Healing, Devotional, Hear God’s Voice
180Podcast.
1856 Podcast-YMCA of South Hampton Roads
1984
1984, by George Orwell
19 Keys Presents High Level Conversations
19 Observations on mining and refining of critical minerals
1A
1Dime Radio
오늘 미국은
