Core IM | Internal Medicine Podcast

#187 Orthostatic Hypotension Part 1: Gray Matters Segment

Thu, 11 Sep 2025

Learn specific, practical ways to counsel patients on non-pharmacologic interventions. What is our goal with OH treatment? Is it the blood pressure number that matters? How do we avoid missing neurogenic causes of orthostatic hypotension (OH)?

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🔹 Transcript & Show Notes

Timestamps:

(00:05) | Case Presentation: Urinary Retention → Lightheadedness

(02:37) | Defining Orthostatic Hypotension & Prevalence

(04:10) | Why Diagnosis Is Harder Than It Seems

(06:20) | How (and When) to Measure Orthostatic Vitals

(10:06) | Role of Heart Rate in Narrowing the Differential

(14:41) | Rethinking Treatment Goals: Function > Numbers

(17:52) | Recognizing Orthostatic Intolerance Symptoms

(22:14) | Non-Pharmacologic Strategies in the Hospital

Tags: Primary care, Internal Medicine, Physician Assistant, Nurse Practitioner, Geriatrics, Autonomic Dysfunction, Syncope, Falls, Patient Safety, Medical Education

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#186 Pneumothorax: 5 Pearls Segment

Mon, 25 Aug 2025

Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks!

🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion

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🔹 Transcript & Show Notes

Timestamps:

(02:50) | Xray vs. POCUS vs. CT for Pneumothorax Diagnosis

(07:29) | Do All PTXs Need Chest Tubes?

(11:55) | Explaining Pneumothorax to Patients

(14:58) | Understanding the Pleural Drainage System

(26:11) | Monitoring Air Leaks with the Water Seal Chamber

(32:27) | Managing Persistent Air Leaks

Tags: CoreIM, Internal Medicine, Pulmonology, Critical Care, Medical Education, 3-Chamber Drainage System, Endobronchial Valves and Pleurodesis

#185 Neutropenia: 5 Pearls Segment

Wed, 13 Aug 2025

How do you work up neutropenia? When is neutropenia benign? When do neutrophils recover? How can you diagnose neutropenic fever in the first 15 minutes and start antibiotics in the first 60 minutes? Do you always add MRSA coverages? Only Pseudomonas coverage? When do you add fungal coverage?

🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion

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🔹 Transcript & Show Notes

Timestamps:

(02:24) | Approach to Neutropenia & Duffy Null

(11:38) | Dose and duration-dependent neutropenia vs. immune-mediated neutropenia

(19:46) | When do neutrophils recover?

(29:56) | Classifying Neutropenic Fever Syndromes

(29:53) | Strategies for Managing Low-Risk Neutropenic Fever

(33:02) | Antimicrobial Therapy and Duration in Febrile Neutropenia

Tags: CoreIM, Internal Medicine, Oncology, Hematology, Medical Education, Physician Assistant, Nurse Practitioner, Neutropenic Fever Management, Antibiotics

#184 Stories for the Feels

Mon, 28 Jul 2025

Have a good laugh and reflect deeply with these three stories that hit the feels in different ways.

If you'd love to hear more stories from Dr. Maria Rosasco, check out some of her other appearances on the podcast: July Stories and Handoffs & Contingency Planning.

🔹 Sponsor: Oakstone CME’s ACP MKSAP Audio Companion

Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP

🔹 Transcript and Show Notes

Timestamps:

(01:04) | Story 1: Sharing a Personal Story for Patient Care

(03:42) | Story 2: Leading a Family Meeting

(06:52) | Story 3: Early Days of the COVID-19 Pandemic

(10:22) | What Rituals and Values Guide Your Path in Medicine

Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Narrative Medicine, Humanities

#183 Diagnose the Clinician: Hoofbeats Segment

Mon, 21 Jul 2025

What went wrong? What were the reasoning or contextual missteps that led us astray?

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🔹 Transcript and Show Notes

Timestamps:

(00:02) | Case Presentation and Initial Diagnosis

(02:47) | Tachycardia and Early Impressions

(04:10) | Clinical Deterioration and New Clues

(07:19) | Problem Representation and Reflection

(21:45) | Lessons on Reasoning and Bias

(26:55) | Final Takeaways and Action Steps

Tags: Clinical Reasoning, Internal Medicine, Diagnostic Accuracy, Hoofbeats, Cognitive Bias, Medical Education, Illness Scripts