Core IM | Internal Medicine Podcast

#214 Hyponatremia Management: A Core IM Classic

Throwback: Should you really fluid-restrict every patient with SIADH? When can IV fluids make hyponatremia better or worse? Are salt tabs actually doing enough? And what can urine studies tell you before you start treatment? Join us for a practical, physiology-driven approach to hyponatremia management, from fluids and solutes to loop diuretics and identifying the underlying cause. 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here.🔹Transcript and Shownotes6:46 | Pearl 1: Key Principles15:13 | Pearl 2: Fluids in hyponatremia26: 03 | Pearl 3: Solutes in hyponatremia management35:49 | Pearl 4: Lasix in hyponatremia management40:05 | Pearl 5: EtiologiesTags: CoreIM, Internal Medicine, Medical Education, SIADH, Fluid Restriction, Nephrology, Hospital Medicine, Urine OsmolalityFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out CovePure and use my code CovePure.com/coreim for a great deal: https://covepure.com* Check out ElevenReader and use my code PODCAST for a great deal: https://elevenreader.io* Check out FIGS: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

#213 Hypertension First-Line Medications Troubleshooting | Bread & Butter Series

Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers, Thiazides) is the preferred first-line framework, and how to personalize medication choices based on comorbidities and side effects.🔹Sponsor: Oakstone CMEUse the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes00:48 | Diagnosing Hypertension 02:00 | When to Start Combination Therapy Instead of Monotherapy 03:40 | Choosing First-Line Therapy Using the ACT Framework 11:03 | Why ARBs Are Often Preferred Over ACE Inhibitors 13:52 | Choosing the Right ARB: Candesartan vs Losartan 16:19 | Comparing Potency & Duration Across First-Line Antihypertensives 18:44 | Amlodipine Edema: Why It Happens and How to Fix It 21:54 | Thiazides: Practical Tips, Electrolyte Problems & Class-Killer Side Effects 27:33 | Managing Patients Who 'Can't Tolerate' Blood Pressure Medications Tags: Hypertension Management, High Blood Pressure, Primary Care, Internal Medicine, Core IMFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out CovePure and use my code CovePure.com/coreim for a great deal: https://covepure.com* Check out ElevenReader and use my code PODCAST for a great deal: https://elevenreader.io* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Get 15% off Branch Basics with the code COREIM at https://branchbasics.com/COREIM #branchbasicspod Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

#212 Top 10 Highlights of the New Lipid Guidelines

Learn from primary care docs what has been practiced and changed from the 2026 ACC/AHA Lipid Guidelines! Learn how the new CPR framework (Calculate, Personalize, Reclassify) and PREVENT risk calculator change statin decisions, why LDL targets are back, and when to use Lp(a), ApoB, and coronary artery calcium (CAC) testing. Discover updated risk-enhancing factors, expanded indications for non-statin therapies, and practical strategies to personalize lipid management for both primary and secondary🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here.🔹Transcript and Shownotes:  01:17 | Highlight #1 & #2: CPR and PREVENT Score03:14 | Highlight #3: Updated ASCVD Risk Categories Using the PREVENT Score05:30 | Highlight #4: LDL Targets Are Back07:20 | Highlight #5: High-Risk Conditions That Bypass the PREVENT Score08:41 | Highlight #6: Lp(a) Screening for Everyone11:51 | Highlight #7: When to Use ApoB Testing13:16 | Highlight #8: Reproductive Risk Factors15:29 | Highlight #9: Using CAC to Guide Statin Therapy19:09 | Highlight #10: Non-Statin TherapiesTags: CoreIM, Internal Medicine, Medical Education, Cholesterol, Statins, LDL, ASCVD, Preventive Cardiology, LpA, ApoB, CAC, ACC2026, Cardiology, PrimaryCare Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out CovePure and use my code CovePure.com/coreim for a great deal: https://covepure.com* Check out ElevenReader and use my code PODCAST for a great deal: https://elevenreader.io* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Get 15% off Branch Basics with the code COREIM at https://branchbasics.com/COREIM #branchbasicspod Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

#211 Breaking Down MASLD vs. MASH and the MAESTRO-NASH & ESSENCE Trials: Beyond Journal Club Segment

MASLD affects nearly one in three adults worldwide, yet many patients remain undiagnosed until advanced fibrosis or cirrhosis develops. So, which patients should clinicians actually be screening? When is a FIB-4 enough, and when should we move to elastography or hepatology referral? And are we finally entering an era where we can meaningfully treat MASH?In this Beyond Journal Club episode, we unpack the evolving language of steatotic liver disease and take a close look at two major trials: MAESTRO-NASH studying resmetirom, the first FDA-approved liver-directed therapy for MASH, and ESSENCE, evaluating semaglutide in biopsy-confirmed disease.Along the way, we explore what these biopsy-based histologic endpoints really mean, why placebo responses were surprisingly high, and whether improvements in steatohepatitis and fibrosis will ultimately translate into better clinical outcomes for patients.This episode is for clinicians trying to understand where the field is headed, which patients deserve closer attention, and how metabolic liver disease is increasingly becoming part of everyday primary care and hospital medicine.🔹Sponsor:  Oakstone CMEUse the code "CORE325" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹Transcript and Shownotes:  01:57 | Understanding MASLD as a Systemic Disease 05:45 | MASLD vs MASH vs Met-ALD: Spectrum Steatotic Liver Disease 08:55 | How to Screen for Fibrosis (FIB-4 & FibroScan) 16:15 | Lifestyle Treatment & Weight Loss Targets 19:00 | ESSENCE Trial: Semaglutide for MASH 21:58 | MAESTRO-NASH Trial: Resmetirom 27:27 | Future Treatments for MASH 30:51 | Key Takeaways for Clinicians Tags: CoreIM, Internal Medicine, Medical Education, Hepatology, Fatty Liver Disease, Metabolic Dysfunction Associated Steatohepatitis, Nonalcoholic Fatty Liver Disease, Liver FibrosisFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics and use my code branchbasics.com/COREIM for a great deal: https://branchbasics.com* Check out ElevenReader and use my code PODCAST for a great deal: https://elevenreader.io* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Quince for high-quality clothes with affordable pricing and use code quince.com/coreim Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

#210 HTN in Dialysis: 5 Pearls Segment

What blood pressure should we target in patients on hemodialysis? Why volume control remains the foundation of treatment? How blood pressure targets differ from the general population. Learn practical pearls on medication timing around dialysis, drug dialyzability, antihypertensive selection, and strategies to prevent intradialytic complications while optimizing long-term outcomes. 🔹Sponsor: Search “Amazon Pharmacy Nationwide Home Delivery" in your EHR to get home delivery (often same-day). Learn more here. 🔹Transcript and Shownotes:  02: 19 | Pearl 1: Blood Pressure Targets 09: 40 | Pearl 2: Timing Medications and Dialyzability 15: 31 | Pearl 3 - Pharmacologic Management Nuances in Dialysis Patients 22: 57 | Putting It All Together: The Medication Hierarchy Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, ESRD, End-Stage Kidney Disease, Hypertension, Kidney Health, Dry Weight, Volume OverloadFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Branch Basics and use my code branchbasics.com/COREIM for a great deal: https://branchbasics.com* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Quince for high-quality clothes with affordable pricing and use code quince.com/coreim Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy