Founded in the US in 2017 by Dr Shreya Trivedi and Dr Marty Fried, this podcast offers practical clinical education, expert discussions, and high-yield updates across a broad range of internal medicine topics.
Alcohol use disorder medication should match recovery goals, drinking pattern and comorbidity, with naltrexone, acamprosate, topiramate and other options assessed by meaningful changes in craving and control alongside continuing psychological and addiction support.
Clinician grief is a natural response to loss that differs from burnout and secondary traumatic stress, with adaptive coping involving movement between acknowledging grief and stepping away, alongside reflection, colleague support and organisational recognition.
Gallstone syndromes are separated by the level and persistence of obstruction. Ultrasound, computed tomography, functional gallbladder imaging, magnetic resonance cholangiopancreatography and endoscopic ultrasound answer different questions, while endoscopic retrograde cholangiopancreatography should usually have a therapeutic target.
Hyponatraemia management turns on the balance between free water, solute and antidiuretic hormone rather than the sodium number alone. The discussion links true hypovolaemia to isotonic volume replacement, identifies urine indices predicting fluid-restriction failure in syndrome of inappropriate antidiuretic hormone secretion, and compares protein, urea, salt and loop diuretics.
Primary-care, cardiology and acute medicine clinicians get a practical prescribing review of hypertension confirmation, first-line medication and low-dose combination therapy. Amlodipine-related oedema, ACE inhibitor cough or angioedema, thiazide-associated electrolyte disturbance, gout and medication intolerance are linked to mechanism-based troubleshooting and planned biochemical monitoring.
Primary-care, cardiology and nephrology clinicians get a cardiovascular risk-stratification update involving PREVENT, LDL targets, lipoprotein(a), apolipoprotein B and coronary artery calcium. The episode uses a calculate, personalise and reclassify framework to connect risk enhancers with statin and non-statin treatment decisions.
Gastroenterology, endocrinology and primary-care teams get a metabolic liver disease update. MASLD, MASH, cardiometabolic risk, fibrosis staging, FIB-4, elastography, weight-loss targets, semaglutide and resmetirom trial interpretation are linked to practical risk stratification.
Relevant to nephrology, acute medicine and ward teams managing severe hypertension, breathlessness or fluid overload in haemodialysis. It prioritises interdialytic blood pressure, dry-weight reassessment, sodium and fluid balance, while showing how medication dialysability should influence drug selection and timing.
Relevant to acute medicine, nephrology and ward teams reviewing haemodialysis patients with shortness of breath, severe hypertension, pulmonary oedema or cramps. It separates solute clearance from ultrafiltration and keeps dry weight, sodium intake, residual urine output and dialysis timing in view.
New atrial fibrillation after surgery is not just a rate problem. Confirm stability, symptoms and exertional limits, then look for pulmonary embolism, bleeding, infection, thyroid disease or electrolyte disturbance before deciding on cardioversion, anticoagulation, monitoring or discharge.
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