*SCREEEECH!!* PEP for HIVFrom October 2017, It's Bloody Halloween!
HIV PEP is highly effective and far less cumbersome than it once was. Current regimes used Truvada and an anti-retroviral such as raltegravir. PEP should be initiated within 72 hours of exposure and is typically continued for 1 month. •12min 46Brandon Grove, MD, Mizuho Morrison, DO, and Sanjay Arora, MD
Latent Tuberculosis InfectionFrom September 2017, You Can Do It!!
Latent TB is common in many parts of the world and amongst certain populations in North America. Diagnosis is made by tuberculin skin test or by interferon gamma release assay testing. Treatment gold-standard is nine month of isoniazid (INH). •20min 38Devang Patel, MD and Neda Frayha, MD
Things I Do, But Should I? - ConjunctivitisFrom September 2017, You Can Do It!!
It can be tricky to distinguish bacterial from viral conjunctivitis. In this segment, Adrien and Vanessa review diagnostic tips and the evidence behind different treatments for conjunctivitis. Antibiotic treatment of bacterail conjunctivitis may speed up return to work, though does not …11min 5Adrien Selim, MD and Vanessa Cardy, MD
Sexually Transmitted Infections Update, Part 2From August 2017, Diabetes and Whispered Pectorilo….what???
Miz and Matt discuss approach to patients for STD evaluation. They review most recent CDC guidelines on treatment of common STD’s.20min 59Mizuho Morrison, DO and Matthieu DeClerck, MD
Listener Question Extravaganza!!!!From August 2017, Diabetes and Whispered Pectorilo….what???
Andrew and Heidi answer listener mail and discover that 1) if you’re not doing whispered pectoriloquy as part of your exam, that’s ok. 2) aspirating non-inflamed joints to diagnose gout is not supported in the literature 3) immunotherapy for warts works!! Go ahead and inject some yeast or mumps …12min 36Heidi James, MD and Andrew Buelt, DO
Sexually Transmitted Infections Update, Part 1From August 2017, Diabetes and Whispered Pectorilo….what???
Miz and Matt discuss approach to patients for STD evaluation. They review most recent CDC guidelines on treatment of common STD’s. •26min 14Matthieu DeClerck, MD and Mizuho Morrison, DO
Paper Chase 3 - Effect of Oral Steroids on Acute Sore ThroatFrom July 2017, Be Kind and Enjoy Life
This article adds to the body of literature discussing the role of oral steroids in treating pharyngitis. The paperchase guys are split on wether or not this will change their practice. •3min 41Andrew Buelt, DO and Joe Weatherly, DO
HPV VaccinationFrom June 2017, Legions of Lesions
Andrew and Jake give us an update on all that’s new in the land of HPV vaccination. Makers of the mono and quadri-valent will be shortly withdrawing them from the market, leaving the nine-valent vaccine as the only option. Increased valency means broader coverage for wart and cervical causing …9min 56Andrew Buelt, DO and Jake Anderson, DO
Paper Chase 5 - Costs of Misdiagnosed CellulitisFrom June 2017, Legions of Lesions
Many conditions can be mistaken for lower extremity cellulitis including deep vein thromobosis, peripheral vascular disease, dermatitis. Misdiagnosis can lead to unecessary admission to hospital, medication treatment, and failure to treat real cause of presentation. This studies quantifies these …6min 18Andrew Buelt, DO and Joe Weatherly, DO
Steroids and PneumoniaFrom May 2017, My Gut Biome Told Me So
Andrew and Jake review the body of evidence and conclude that there is a role for corticosteroids as an adjunctive treatment for patients hospitalized because of pneumonia. •11min 14Andrew Buelt, DO and Jake Anderson, DO
Tympanostomy TubesFrom May 2017, My Gut Biome Told Me So
Review the indication for tympanostomy tubes as well as trouble-shooting potential complications. •18min 14Heidi James, MD, Ann Dietrich, MD, and Kris Jatana, MD
Lyme DiseaseFrom April 2017, Antibiotics in the Lyme-Light
Lyme disease is the most common tick-borne illness in North America. Infections peak in the spring and summer months. Preventing tick-bites and checking oneself for ticks after time spent outdoors in endemic areas is key. Prophylaxis should be given (doxcycyline 200 mg x 1 dose) if patient had a …21min 54Neda Frayha, MD, Mizuho Morrison, DO, and Heidi James, MD
The Necessary Evils of Primary Care: Plantar WartsFrom April 2017, Antibiotics in the Lyme-Light
Plantar warts are a frequently seen in the primary care office. Drs. Buelt and Anderson review the literature around the more common place, and the obscure, treatment options. From doing to nothing, to duct tape, to topical immunomodulators, options are varied and broad. •11min 47Andrew Buelt, DO and Jake Anderson, DO
Paper Chase 4: Effect of Cranberry Capsules on Bacteriuria Plus PyuriaFrom March 2017, The Benzos & Fungus Among Us
In this nursing home population, the use of cranberry supplements was not associated with a decrease in either bacteriuria or pyuria. •4min 50Andrew Buelt, DO and Joe Weatherly, DO
OnychomycosisFrom March 2017, The Benzos & Fungus Among Us
Onychomycosis is most commonly a dermatophytic or yeast infection of the nails complex. Confirmation of diagnosis by nail culture is recommended prior to treatment. Topical treatments include ciclopirox and efinaconazole. Terbinafine is the preferred oral agent. •16min 40Jake Anderson, DO and Andrew Buelt, DO
Things I Do But Should I: Post-Viral CoughFrom February 2017, Sweat Puddled, Brains Muddled
Post-viral coughs are a common cause of visits to health care providers. While there is little evidence to direct treatment, many recommend short acting beta agonists and inhaled corticosteroids. The study reviewed in this chapter shows the superiority of nebulized ipatropium and salbutamol in …7min 22Vanessa Cardy, MD and Adrien Selim, MD
Bad Rashes in NewbornsFrom February 2017, Sweat Puddled, Brains Muddled
Herpes simplex, Blueberry Muffin Baby caused by TORCH infections and varicella, ichthyosis, and epidermolysis bullosa are the “do not miss” rashes in newborns.17min 44Solomon Behar, MD and Danelle Fisher, MD
The Primary Care RAP Hot Sheet: January 2017From January 2017, The Primary Care RAP Hot Sheet: January 2017
What do Princess Leia, peanut butter, price-gouging and Ebola have in common? This Month’s Hot Sheet, of course! •5min 9Heidi James, MD and Andrew Buelt, DO
Adult VaccinationFrom January 2017, Bones Lose Their Autonomy
An in depth look at the who, why, what, and when of adult vaccinations with focus on: MMR, Tdap, varicella, pneumococcus, hepatitis, and meningococcus.24min 40Heidi James, MD and Dan Smyth, MD
Paper Chase 1: Prescription Strategies for Respiratory InfectionsFrom December 2016, Ear Pain is but a Memory
Delayed prescriptions were associated with slightly greater but clinically similar symptom burden and duration. Compared to an immediate prosecution strategy, delayed prescriptions had substantially reduced antibiotic use. •6min 47Andrew Buelt, DO and Joe Weatherly, DO