A dialysis patient with a chronic cough: is it COPD, or are they still volume overloaded?

A patient with AKI and hyperkalemia says they’re still peeing — does that rule out post-obstructive AKI?

A patient arrives in the ED with uremic symptoms and a newly created AV fistula. Can you safely use it, or do you need to place a temporary dialysis catheter?

And the classic inpatient dilemma: your heart failure patient looks better after diuresis, but the creatinine is rising. Is it time to stop, or should you keep going?

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🔹Transcript and Shownotes:

00:52 | What is NephMadness?

02:19 | Detecting post-renal obstruction in a patient who reported normal urination

11:26 | POCUS for discharge or continue diurese

17:25 | Distinguishing COPD from volume overload in a dialysis patient using lung ultrasound

23:55 | Assessing AV fistula maturity at the bedside to potentially avoid placing a temporary dialysis line

Along the way, we discuss practical ways clinicians can use renal, lung, and venous ultrasound to clarify uncertain clinical situations and make faster decisions at the bedside.

If you’ve ever paused on rounds, wondering “what should we do next?” in a patient with kidney disease, this episode explores how POCUS can help answer that question.

Tags: CoreIM, Internal Medicine, Medical Education, Nephrology, AKI Management, POCUS

Most clinicians see dementia medications on the med rec, but many of us aren’t sure how much they actually help. In this episode we break down donepezil, memantine, and the new anti-amyloid drugs, and when to stop them.

• Do cholinesterase inhibitors really work?

• What should clinicians know about lecanemab and donanemab before referring patients?

• How much benefit should we expect and for how long?

• When should you deprescribe dementia medications?

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🔹Transcript and Shownotes

02:27 | Deep Dive 1: How do we deliver the news of a diagnosis of dementia?

09:41 | Deep Dive 2: Prescribing medications for cognitive decline

29:30 | Deep Dive 3: Patient-centered management for a patient with cognitive decline

35:46 | Deep Dive 4: Planning for an uncertain future

Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant

Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI?

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🔹Transcript & Shownotes:

01:12 | Cognitive Concerns During a Routine Follow-Up

03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues?

15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline?

31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline?

Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant