The Clinical Problem Solvers

FEBRUARY 9, 2020

Objectives Define likelihood ratios and their utility in diagnostic reasoning Identify how likelihood ratios alter the probability of a diagnosis Apply likelihood ratios in clinical reasoning What are likelihood ratios and how do they work? A LR > 1 increases the probability of a specific diagnosis.

Clinic 52

Clinic Diagnosis Hypertension Patients 52

The Clinical Problem Solvers

MAY 14, 2020

Would I’ve been able to reason my way to his underlying diagnosis from the initial data? I find it awe-inspiring to listen to clinicians pick up on subtle clues and use both intuitive and analytic reasoning to reach a final diagnosis. Parenthetically, the question around CT for the diagnosis of COVID-19 is interesting.

Illness 52

Illness Diagnosis Emergency Room Diagnose 52

PEMBlog

OCTOBER 26, 2023

The most common presentation in children under 5 years of age is rectal bleeding, which may be intermittent or massive. Other complications include obstruction due to intussusception or volvulus, leading to bowel ischemia and shock. It is characterized by a blind-ending true diverticulum that contains all the layers found in the ileum.

Diagnosis 64

Diagnosis Complication Consulting Management 64

PEMBlog

MAY 1, 2025

Well break down the virology, epidemiology, clinical presentation, and complications of Parvovirus B19. Clinical Manifestations and Diagnosis of Parvovirus B19 Infection. So the classic presentation thats on every board exam ever is called erythema infectiosum, or fifth disease. UpToDate , Jun. link] Edwards, Morven S.

Complication 83

Complication Patient-Centered Patients Diagnosis 83

Physician's Weekly

JUNE 11, 2025

CT Imagin g: CT is recommended at diagnosis if lymphadenopathy or splenomegaly is present, or if clinically indicated. Notably, CT imaging is required prior to venetoclax-based therapy to assess the risk of tumor lysis syndrome (TLS), but it is not routinely used for diagnosis, surveillance, or treatment monitoring. ›

Management 52

Management Diagnosis Complication Screening 52

PEMBlog

SEPTEMBER 26, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the last of the four cases.

Routine Screenings 59

Routine Screenings Patient-Centered Diagnosis Clinic 59

GeriPal

JULY 19, 2024

Summary Transcript Summary The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Are there, though, populations that it may be helpful in, or should that change with the advent of the new amyloid antibodies? Should it?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

OCTOBER 13, 2022

How we came about to select these articles or to have interest in this topic is really older adults are unique population that are at risk for both over diagnosis of infections as well as under diagnosis of infections. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations.

Complication 97

Complication Patient-Centered IT Patients 97

PEMBlog

SEPTEMBER 25, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. Post traumatic cataract B.

Patient-Centered 52

Patient-Centered Diagnosis Management Patients 52

PEMBlog

SEPTEMBER 24, 2024

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. What’s the Diagnosis?

Diagnosis 52

Diagnosis Diagnose Patients Asthma 52

PEMBlog

OCTOBER 2, 2024

I’ll dive into the latest clinical practice guidelines and discuss evidence-based approaches to diagnosis and treatment. Understanding dyspepsia and its clinical presentation. Both conditions can present with similar symptoms. And the presentation for GERD varies by age. Now there are some risk factors for GERD.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

JUNE 20, 2024

Incontinence and avoiding issues can present in an older individual, in some cases, just like they do a younger person. But then there is incontinence, which is the same term, same word, but actually presents as a geriatric syndrome. On our last podcast about urinary incontinence the song request was, “Let it go.” I do like that one.

IT 120

IT Patient-Centered Patients Clinic 120

CDOCS

MAY 4, 2021

We need to recognize how clinical dentistry has become intertwined with digital technologies to synergistically assist us in providing enhanced diagnosis with safe and predictable treatment outcomes. & He presented with a high smile line and desired fixed natural appearing teeth.

Patient-Centered 52

Patient-Centered Patients Manufacturing Clinic 52

GeriPal

MAY 11, 2023

And because we can’t resist, we dip into aducanumab and lecanemab at the end. AlexSmithMD Transcript Eric: Welcome to the GeriPal Podcast. Kristine, do you have a song request for Alex? Kristine: Well, I did have a song, but I was negligent at giving it to him. So, he tried to read my mind… Eric: What was your song? Kristine: Yeah, yeah, yeah.

Physicals 85

Physicals IT Hypertension Education 85

Dr. Michael Bazel

AUGUST 8, 2024

Knowing the difference can help you seek the right treatment and avoid unnecessary complications. There’s no bacterial infection present in urine tests. Timely diagnosis and treatment are crucial to prevent complications. Other conditions, ranging from mild to severe, may mimic the symptoms of a UTI. What is a UTI?

IT 130

IT Complication Medical Advice Chronic Condition 130

Rao Doctor

APRIL 3, 2025

In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Understanding the patient’s medical history is crucial for an accurate diagnosis.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

JUNE 27, 2024

Summary Transcript Summary “Anxiety is a lot like a toddler. It never stops talking, tells you you’re wrong about everything, and wakes you up at 3 a.m.” I’m not sure who wrote this quote, but it feels right to me. Brianna is one of UCSF’s palliative care fellows who just completed her psychiatry residency. Alex Gamble, do you have a song?

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

MAY 22, 2025

The ability to appreciate, recognize, and engage with music is preserved even until late stages of dementia, and Theresa is examining how music can be useful from the time of diagnosis, not only for the person with dementia, but their caregivers. This is not highly scripted orchestral music, people, its Jazz. -S Tyler 01:12 AHPM.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JULY 21, 2022

Because I don’t think we think about that so much in palliative care, but we do in geriatrics. But I believe before we start, somebody has a song request for Alex. Is it you, Emmy? Emmy: It is. Eric: What’s the song? Emmy: I just forgot the name of the song… [laughter]. Alex: Pink Cadillac by Bruce Springsteen? I like that song.

IT 102

IT Families Family Diagnosis 102

GeriPal

JULY 11, 2024

Summary Transcript Summary In May we did a podcast on KidneyPal (the integration of palliative care in renal disease) , which made us think, hmmm… one organ right next door is the liver. Maybe we should do a podcast on LiverPal? (or or should we call it HepatoPal?) ABIM MOC credit will be offered to subscribers in November, 2024. Excited to be here.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. It can mean many things, including a specific type of plant, the chemicals in the plant, synthetic analogs, or products that have these components. I am super excited to have you on, Eloise. Eloise 00:59 Thank you so much. Alex 02:23 Terrific. Do you want one? These are vitamins.

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

OCTOBER 20, 2022

How we came about to select these articles or to have interest in this topic is really older adults are unique population that are at risk for both over diagnosis of infections as well as under diagnosis of infections. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 23, 2023

Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. And I’m worried that there may come a time when you have trouble making decisions for yourself.

Families 97

Families Family Patient-Centered IT 97

PEMBlog

JUNE 2, 2025

Hypertensive emergency is a clinical diagnosis characterized by a sudden and severe elevation in blood pressure accompanied by signs of acute end-organ dysfunction. However, the presence of end-organ damage is the defining feature of a hypertensive emergency, rather than the absolute blood pressure value alone.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

OCTOBER 12, 2023

Instead, what if your surgeon told you that the operation she was discussing could help with only 4 things: live longer, feel better, prevent disability, or obtain a diagnosis? And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications?

IT 128

IT Families Family Patient-Centered 128

GeriPal

OCTOBER 19, 2023

Summary Transcript Summary What level of evidence do we need for POLST to use it ourselves, to advocate for wider usage, and for establishing POLST completion as a quality metric? The answers to these questions will vary. Reasonable people will disagree. And today, on our podcast, our guests disagree. But is it a tiny, meaningless, fraction?

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

MARCH 7, 2024

In addition to being a palliative and hospice RN, she is the Executive Director for Goodwin Hospice , a large non-profit hospice that added end-of-life doula care to their services in collaboration with Jane and John’s doula organization, Present for You. Jane, welcome to the GeriPal podcast. Jane: Thank you for having me. John: I do.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

FEBRUARY 16, 2023

Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? As Keri put it in the podcast, we must go beyond “a hammer and a nail” philosophy to approaching anger by developing a toolkit for anger that is vast and varied. Is that you Dani? Dani: It is me. Dani: It’s true.

Patients 109

Patients IT Families Family 109

GeriPal

JANUARY 11, 2024

So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying. Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). Four percent. It is the slippery slope made real. It was amazing.

Illness 144

Illness IT Medical Provider 144

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. What does it look like to take a palliative approach to severe mental illness?

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

MAY 1, 2025

Meredith wore a shirt that said Silence=death. Eric gave me the hook during my live cover of One, by U2, a song released in 1992 whose proceeds went entirely to AIDS research. I couldnt help it, forgive me dear listeners, I had to do a longer than usual cut at the start! But this song was actually a fundraiser for AIDS when it was released.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

JULY 25, 2024

MOC Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. ABIM MOC credit will be offered to subscribers in November, 2024. You got it.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

JUNE 6, 2024

Areej 03:50 So at the state of the science, I was actually presenting a study that was focused on addressing sexual health concerns in transplant survivors, and I actually told the story of the state of the science for those of you who were there. Is that an issue for you? I’m happy to talk about it at any time.” This is Eric Widera.

Illness 130

Illness IT Physicals Patients 130

GeriPal

MARCH 27, 2025

We are delighted to welcome Jennifer Wolf f , who is a health services researcher and gerontologist and professor at Johns Hopkins. Jennifer, welcome to the GeriPal Podcast. Jennifer 00:28 It’s great to be here. But before we dive into the study and the implications it has for the practice that we do, I believe someone has a song request.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

FEBRUARY 24, 2022

Since then there has been a lot of back and forth, with even a couple of podcasts from us, several JAMA viewpoints, and most recently a series of published replies from leaders in the field on why ACP is still valuable (see below for references). . Despite all of these publications, I’m still left at a loss of what to think about it all.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

AUGUST 22, 2024

Why does this issue keep coming up? Why is it unresolved? Today we put these questions to Winston Chiong, a neurologist and bioethicist, and Sean Aas, a philosopher and bioethicist. We’ll have a link to that in our show notes. We’re gonna double up on that subject. Alex 01:07 We haven’t figured it out. Alex 01:48 All right.

IT 113

IT Families Family Patient-Centered 113

PEMBlog

JANUARY 17, 2024

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Complications that you should be aware of include bacteremia, endocarditis, septic arthritis, or osteomyelitis. Clin Infect Dis 2011; 52:e18. Stevens DL, Bisno AL, Chambers HF, et al.

IT 59

IT Patients Diagnosis Clinic 59