Lightnews — Scholar-powered news

Reposted by CORE IM

Will Preston @willpreston.bsky.social · 3h

5 pearls is such a great series because even when it’s covering a topic I think I know well, there’s always something important I learn — many such moments in this excellent episode.

CORE IM @coreimpodcast.bsky.social · 10h

1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣

AKI + portal HTN 🟰hepatorenal syndrome

🖥️: www.coreimpodcast.com/2025/10/15/h...

1 1

Reposted by CORE IM

Zaven Sargsyan @sargsyanz.bsky.social · 9h

Yeeeees can’t wait to listen

CORE IM @coreimpodcast.bsky.social · 10h

1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣

AKI + portal HTN 🟰hepatorenal syndrome

🖥️: www.coreimpodcast.com/2025/10/15/h...

1 3

Reposted by CORE IM

Noah markewitz @noahmarkewitz11.bsky.social · 10h

It has been a dream to be able to be a part of my favorite podcast.
Check out this very fun episode on one of the most interesting diseases, Hepatorenal Syndrome!

CORE IM @coreimpodcast.bsky.social · 10h

1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣

AKI + portal HTN 🟰hepatorenal syndrome

🖥️: www.coreimpodcast.com/2025/10/15/h...

1 2

CORE IM @coreimpodcast.bsky.social · 10h

7/ Thanks to all!

Authors: @shreyatrivedimd.bsky.social @noahmarkewitz11.bsky.social Dr. Yaling Tang

Experts: Dr. Juan Carlos Q. Velez, Dr. Nikhilesh Mazumder, Dr. Marina Serper

Graphic: Dr. Dexter Nwachukwu

Peer Reviewers: Dr. Justin Belcher and @ebtapper.bsky.social

1

CORE IM @coreimpodcast.bsky.social · 10h

6/ Stay tuned for part ✌️

1 1

CORE IM @coreimpodcast.bsky.social · 10h

5/

Avoid albumin if:
🫘 Pt is clinically volume overloaded

Give albumin* if:
🫘 Pt is clinically volume down or you’re unsure of volume status

*1g/kg up to 100g/day

1 1

CORE IM @coreimpodcast.bsky.social · 10h

4/ How to diagnose HRS:

🫘 Absence of strong evidence of another diagnosis
🫘 No need for albumin challenge 🤔
🫘 Use clues from H&P ‼️

1 1

CORE IM @coreimpodcast.bsky.social · 10h

3/ Both serum and urine sodium can be helpful in diagnosing HRS ‼️

🫘 Serum sodium ⬇️ because ⬆️ RAAS & ⬆️ ADH
🫘 FeNa < 0.5%*

*even if patient is on a diuretic

1 1

CORE IM @coreimpodcast.bsky.social · 10h

2/ Use clues from history and physical for your differential ‼️

Pre-renal:
🫘 Increased BMs
🫘 Recent diuretic dose ⬆️
HRS:
🫘 More frequent paras
🫘 SBP
ATN:
🫘 Shock
🫘 Muddy brown casts

2 1

CORE IM @coreimpodcast.bsky.social · 10h

1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣

AKI + portal HTN 🟰hepatorenal syndrome

🖥️: www.coreimpodcast.com/2025/10/15/h...

1 4 9

CORE IM @coreimpodcast.bsky.social · 1d

Answer: YES

Review the REVISE trial w/ @NEJMGroup below ⤵️

www.coreimpodcast.com/2024/12/11/s...

2 2

CORE IM @coreimpodcast.bsky.social · 1d

#TriviaTuesday

Does stress ulcer prophylaxis with a PPI reduce clinically-important bleeding compared to no prophylaxis in mechanically ventilated patients in a contemporary ICU setting?

1 1 1

CORE IM @coreimpodcast.bsky.social · 14d

8/ Thanks to all for breaking (pun-intended) this down!

By: Dr. Sarah Gorey, Dr. Clem Lee Dr. Greg Katz and @shreyatrivedimd.bsky.social
Experts: Dr. Annie Garment and Dr. Ole-Petter R. Hamnvik
Graphic: Dr. Jimin Hwang
Audio: Kathreene Gala RN

1 1 4

CORE IM @coreimpodcast.bsky.social · 14d

7/ 🦴 Guidelines have not yet changed to recommend that we treat all postmenopausal women with one dose of IV zoledronate

🦴 There is huge potential for both cost savings and reduction of important fractures

1 1

CORE IM @coreimpodcast.bsky.social · 14d

6/

🦴 Control was placebo
🦴 Results ➡️LOWER fracture risk in BOTH arms receiving zoledronate (vs control)
🦴 NNT: 21 to prevent 1 vertebral fracture
🦴 NO osteonecrosis of jaw or atypical femoral fractures ‼️

1 1

CORE IM @coreimpodcast.bsky.social · 14d

5/ Can infrequent zoledronate (IV bisphosphonate) be used as primary prevention for osteoporosis in women?

🦴 RCT
🦴 1054 women aged 50-60 from New Zealand
🦴 Intervention: zoledronate: 2 doses, one at baseline and one at 5 yr OR 1 dose at baseline, followed by placebo at 5 yrs

1 1

CORE IM @coreimpodcast.bsky.social · 14d

4/ Some v rare side effects of bisphosphonates:

🦴 Osteonecrosis of the jaw
🦴 Atypical femoral fractures

🤔

1 1

CORE IM @coreimpodcast.bsky.social · 14d

3/ Meds for osteoporosis:

🦴 Bisphosphosphonates
- FIT & HORIZON trials
🦴 Denosumab (Prolia)
- FREEDOM trial
🦴 Romosozumab (Evenity)
- FRAME & ARCH trial
🦴 Teriparatide (PTH analogue)

1

CORE IM @coreimpodcast.bsky.social · 14d

2/
Osteoporosis:

🦴 ⬇️ bone density ➡️ fractures
🦴 Dx w/ DEXA and/or fragility fracture

1 1

CORE IM @coreimpodcast.bsky.social · 14d

1/ 🚨 NEW #BeyondJournalClub w/ @NEJMGroup: The Bolland study

Question: Does infrequent zoledronate therapy in patients without osteoporosis prevent fractures?

Answer: ⤵️

www.coreimpodcast.com/2025/10/01/b...

1 3 6

CORE IM @coreimpodcast.bsky.social · 29d

4/ Thanks to all!!

Atuhors: Dr. Alexa Wilden, Dr. Sean Burke, Dr. Alexandra Sheridan @shreyatrivedimd.bsky.social

CORE IM @coreimpodcast.bsky.social · 29d

3/ Chronic therapies fall into two buckets:

1️⃣ Antifibrotics
- slows decline in fibrosis
2️⃣ Immunosuppressants
- NOT for patients with IPF

1

CORE IM @coreimpodcast.bsky.social · 29d

2/ Think of ILD as PRIME

P- post-infectious
R- rheumatologic
I- idiopathic (IPF, NSIP, COP)
M- medication induced
E- environmental (birds, asbestos, silica, coal, tobacco)

1 1

CORE IM @coreimpodcast.bsky.social · 29d

1/ 🚨 NEW #WhiteboardAnimation: ILD 🫁

Let’s talk ILD classification & management ⤵️

🎥: www.youtube.com/watch?v=GjBg...
🖥️: www.coreimpodcast.com/2025/09/14/i...

1 2 5

Reposted by CORE IM

Zaven Sargsyan @sargsyanz.bsky.social · Sep 11

This episode is good stuff

CORE IM @coreimpodcast.bsky.social · Sep 11

1/ 🚨 NEW #GrayMatters: Orthostatics part 1️⃣

Orthostatic hypotension is VERY common ‼️
✨ 20% of those over 60 years old
✨ 50% in nursing homes

Causes:
✨ Decreased venous return
✨ Neurogenic

🖥️: www.coreimpodcast.com/2025/09/11/o...
Sponsor: Oakstone CME

1 3