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.
CHAMPION-AF compares WATCHMAN left atrial appendage closure with direct oral anticoagulants for stroke prevention in atrial fibrillation. Its non-inferiority findings require careful consideration of ischaemic stroke rates, procedural complications, bleeding outcomes and continued antithrombotic treatment.
Colorectal cancer screening after 75 should reflect previous screening, health, life expectancy and time to benefit. New rectal bleeding requires diagnostic assessment, while repeated low-risk polyp findings do not automatically justify lifelong surveillance.
FIT, stool DNA testing and CT colonography require colonoscopy after an abnormal result. Sensitivity for precancerous lesions varies, while subsequent surveillance intervals depend on examination quality and the number, size and histology of colorectal polyps.
Persistent hypertriglyceridaemia can reveal atherogenic risk despite reassuring calculated LDL cholesterol. ApoB or non-HDL cholesterol, secondary-cause review and comparable fasting measurements help separate cardiovascular risk management from treatment aimed at preventing pancreatitis.
Blood in the stool, altered bowel habits, unexplained abdominal pain, iron deficiency and anaemia warrant attention in younger adults, with planned follow-up and diagnostic colonoscopy when presumed benign symptoms persist rather than waiting for screening eligibility.
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.
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