Links To And Excerpts From The Curbsider’s #313 Recap Extravaganza–Thank You, Curbsiders, For Another Great Year!

Note to myself: I reviewed the excellent #313 podcast. I will over the course of the next week or so quickly review the show notes of each of the podcasts linked to below [good old spaced repetition].

In this post I link to and excerpt from The Curbsiders#313 Recap Extravaganza 2021
DECEMBER 30, 2021 By MATTHEW WATTO, MD.

All that follows is from the above outstanding resource.

Summary

We recap the top pearls from 2021, including celiac disease, kidney stones, SGLT2 inhibitors for weight loss & HFpEF, smoking cessation, buprenorphine for acute pain, metabolic alkalosis, nephrotic syndrome, bronchiectasis, obesity hypoventilation syndrome, acute diarrhea, osteoporosis, and diabetes. Plus, Paul and Watto express their gratitude to The Curbsiders family and look forward to 2022. Finally, it’s our annual recap extravaganza 2021 with guest host Chris “the Chiu Man” Chiu (@cjchiu), providing a rapid review of previous Curbsiders episodes for your spaced learning.

Special thanks to the whole Curbsiders team and our listeners for an incredible six years of podcasting!

Show Segments

  • Intro
  • Garbs’ picks: Pelvic pain, smoking cessation
  • Addiction medicine pearls: Nicotine use disorder; Acute pain in OUD
    • #299 Acute Pain Management for the Hospitalist
    • Apply for your x-waiver now! The buprenorphine training requirement has been waived (SAMSHA 2021).
  • Nephrology: Kidney stones, nephrotic syndrome, metabolic alkalosis
    • #298: Kidney Stones.
    • #250 Nephrotic Syndrome vs. Glomerulonephritis
    • #308: Metabolic Alkalosis.
    • #226 Kidney Boy on Acute Kidney Injury: Myths & Musings  [I added this podcast because I wanted to review it.]
  • Cardiology: Peripheral arterial disease (PAD), SGLT2 inhibitors for HFpEF
    • #260: Peripheral arterial disease
    • #307: Spooky Tofurkey Cakes. SGLT2 inhibitors for HFpEF (especially, HFmrEF) reduce heart failure hospitalizations and the rate of renal dysfunction (Anker 2021).
  • Pulmonology: Bronchiectasis, OHS
    • #306: Consider bronchiectasis in patients with chronic cough, multiple bouts of pneumonia, or COPD in a nonsmoker. Patients are rarely treated for MAC unless they have weight loss.
    • #269: OHS is a diagnosis of exclusion (TTE, CXR, PFTs = basic workup). Bicarb under 27 has a good NPV. CPAP monotherapy is adequate for most. Don’t use oxygen monotherapy! Weight loss is critical.
  • Bariatric Medicine: Semaglutide for weight loss; bariatric surgery
    • #306: Consider bronchiectasis in patients with chronic cough, multiple bouts of pneumonia, or COPD in a nonsmoker. Patients are rarely treated for MAC unless they have weight loss.
    • #269: OHS is a diagnosis of exclusion (TTE, CXR, PFTs = basic workup). Bicarb under 27 has a good NPV. CPAP monotherapy is adequate for most. Don’t use oxygen monotherapy! Weight loss is critical.
  • Gastroenterology
    • #293: RAHUL GANATRA’s Pearl: A transient rise in hepatic enzymes in the setting of abdominal pain can signify a gallstone that passed or one that is “ball-valving” and causing temporary obstruction!
    • #300: In Celiac disease, it’s okay to use Deamidated Gliadin Peptide (DGP) Ab or Endomysial Ab if indeterminate tissue transglutaminase (TTG) IgA. A biopsy is necessary for most. Patients shouldn’t be on a gluten-free diet during testing. After diagnosis, screen first-degree relatives, trend titers, repeat biopsy in 2 years, and check a baseline DXA in adult patients!
  • Endocrinology: Osteoporosis; Diabetes FAQ
    • #277: Osteoporosis. Obtain bone mineral density testing after 3-5 years of  IV (zoledronic acid) or oral (alendronate or risedronate) bisphosphonate, respectively, and decide on drug holiday vs. continued therapy (Qaseem, 2017). Beware of the rapid drop in BMD after missing doses or stopping denosumab (Lyu, 2020Tsourdi, 2021).
    • #296: Diabetes FAQ. Check non-fasting glucose and C-peptide to help determine T1DM vs. T2DM (Leighton, 2017). Consider T1DM testing (GAD 65, Beta Islet cell, Insulin Antibodies) for anyone in their 30s or younger because BMI alone is unreliable. Metformin and long-acting insulin (LAI) can be used as a starting regimen since basal-bolus regimens often have complexity, cost, and adherence issues (expert opinion). Further, reevaluate your patients with diabetes. Many could benefit from LAI plus SGLT2i or GLP-1 agonists instead of a basal-bolus regimen!
  • Outro

 

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