Core IM | Internal Medicine Podcast

Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?
When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.

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🔹 Transcript & Shownotes
(2:56) - (13:15) | PEARL 1: Managing clots in the “unprovoked”/provoked-irreversible patient
(13:21) - (18:10) | PEARL 2: Managing provoked, “reversible” clots
(18:14) - (25:14) | PEARL 3: DOAC failure: time to step it up?
(25:20) - (37:25) | PEARL 4: APLAS: the exception to everything

Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematology

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We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.
🔹 Sponsor: Oakstone CME
Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP 
🔹 Transcript and Shownotes
(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life
(10:28) | How Dr. Carol Ward Created the Horn Award and Honored Mary Horn’s Legacy
(14:16) | Dr. Hilit Mechaber’s Story of Courage, Vision, and Impact Beyond the Award
(17:55) | Why does the Horn Award Matter?
Tags: CoreIM, Internal Medicine, Career Development Award, Mary O'Flaherty Horn Award, Clinical Care, Scholarship, Teaching, Leadership, Wellness and Care, Family Responsibilities

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Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?
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🔹 Transcript and Shownotes
Timestamp
(02:58) | Host, Organism, Source: The Core Framework Behind Duration
(09:02) | How Evidence Shifted Practice
(11:27) | The BALANCE Trial: Short-Course vs Standard-Course Therapy
(18:55) | Where does this leave us?

Tags: CoreIM, Internal Medicine, Infectious disease, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education

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How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?
🔹 Transcript and Shownotes
(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast
(05:27) | Triglycerides as a Cardiovascular Risk Marker
(09:28) | Acute Management For Pancreatitis induced by Triglycerides
(14:34) | Lifestyle Counseling
(17:31) | Medications That Lower Triglycerides
(25:29) | How to Choose the Right Triglyceride Therapy
(27:56) | Genetic Causes and When to Suspect Familial Disorders

Tags: CoreIM, Internal Medicine, Lipidology, lipid, Cardiology, Metabolic Health, Triglycerides, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education, primary care

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Why is venous congestion not the same as volume overload? How can looking at IVC as well as doppler on the hepatic vein, portal vein, and/or intrarenal vein help? Can venous congestion explain someone's delirium? Or be at play in septic shock? What are the limitations of the VEXUS score?

🔹 Sponsor: Oakstone CME
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🔹Transcript and Shownotes

(00:00) | Volume overload vs. Venous Congestion
(05:49) | Venous Congestion and AKI, mortality, possible delirium
(10:10) | Measuring Venous Congestion and the Role of VEXUS
(15:05) | Common Mistakes and Best Practices of VEXUS score
(23:13) | Assessing Fluid Tolerance and Risks with Venous Doppler in Acute Care
(25:29) | Fluid vs. Vasopressor Strategy Guided by Venous Assessment 

Tags: CoreIM, Internal Medicine, Critical Care, Nephrology, Cardiology, Fluid Management, POCUS, Ultrasound, Doppler, Hospital Medicine, Clinical Reasoning, Medical Education

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