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Brilliant Board Review & CME
🎙️ Brilliant Medicine: Your Internal Medicine Edge
Stay sharp, stay current, and stay confident with Brilliant Medicine — the go-to podcast for Internal Medicine and Family Medicine physicians, residents, nurse practitioners, and physician assistants.
Each episode delivers high-yield insights on the latest breakthroughs, practice-changing guidelines, and cutting-edge treatments in Internal Medicine — with just enough board review to keep your clinical reasoning razor-sharp.
We cut through the noise, simplify complex studies, and translate new data into actionable knowledge for your daily practice. Whether you're prepping for boards or staying ahead in clinic, hospital, or telemed — we've got your back.
🩺 Fast. Practical. Evidence-based.
This is the update your medical brain craves.
Episodes
45 episodes
🎙️ Episode 45: Mind the Gap – Perioperative Pearls for Older Adults
🧠 Clinical ContextPatients over 65 undergoing inpatient surgery face unique risks. Cognitive impairment, frailty, and increased vulnerability to delirium demand a proactive and nuanced approach to anesthesia and postoperative care...
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🎙️ Episode 44: Thiazide Throwdown: HCTZ vs Chlorthalidone in Real Life
🧠 Clinical ContextHydrochlorothiazide (HCTZ) vs. Chlorthalidone—a classic cardio debate! ALHAT once hinted at chlorthalidone’s superiority, but did a modern head-to-head trial confirm that? Let's break it down.🧪 Study Snapshot: Th...
🎙️ Episode 43: GLP-1s Under the Knife – A Gut Check on Surgery Risks
🧠 Clinical ContextGLP-1 receptor agonists have taken center stage for both type 2 diabetes and obesity management, but their gastric side effects are giving anesthesiologists pause. The ASA's recent guidance recommen...
🎙️ Episode 42: DOACs Decoded: When to Dabble, When to Dodge
🧠 Clinical ContextDOACs (Direct Oral Anticoagulants) have revolutionized anticoagulation—goodbye routine INRs, hello convenience. But while they’ve made our lives easier, they’re not always a fit for every scenario. Here's how to navigat...
🎙️ Episode 41: Stairway to Surgery: Cardiac Clues Before the Cut
🧠 Clinical Context:You're prepping a patient for non-cardiac surgery—what's their cardiovascular risk? Turns out, it’s not always about echo reports or cath results. It starts with a stairs test (sort of).Duk...
🎙️ Episode 40: Anticoag After Ischemic Stroke: Sooner May Be Safer
🧠 Trial:DOAC started at 3 days vs 8–14 days post-stroke in AF patients.📊 Results:No ↑ bleeding.No ↑ ischemic events.🧩 Clinical Takeaway:Safe to start within 4 days in ...
🎙️ Episode 39: Vitamin K2: The Leg Cramp Secret?
🧪 Study:Vitamin K2 (180 mcg) reduced nocturnal leg cramps in elderly.📉 Results:Cramps/week ↓ from 3.6 → ~1 over 8 weeks.Safe and well-tolerated.🧩 Clinical Takeaway:Consider a...
🎙️ Episode 38: TXA for ICH: Not the Magic Bullet
🧪 Study:TXA within 2 hrs of ICH did not reduce hematoma expansion.No benefit in functional outcome or mortality.⚠️ Note:Slight ↑ in thromboembolic events (3% vs 1%).🧩 Clinical Takeaway:...
🎙️ Episode 37: Transfusions in SAH: 8 or 10? Pick 8
🧠 Study:Compared transfusion thresholds of Hgb <8 vs <10 in subarachnoid hemorrhage.📊 Findings:No difference in modified Rankin Score at 12 months.Fewer transfusions, fewer complicat...
🎙️ Episode 36: Mitral Valve 2.0: Transcatheter Repair Steps Up
🧪 Trials:RESHAPE-HF2: ↓ HF hospitalizations with transcatheter edge-to-edge repair vs medical therapy.MATTR: Transcatheter approach non-inferior to surgical repair.🧩 Clinical Takeaway:...
🎙️ Episode 35: Tirzepatide Tackles HFpEF and Obesity
💊 Study:SURMOUNT-HF trial — patients with obesity and HFpEF.Tirzepatide = ↓ HF hospitalizations and ↑ quality of life.📈 Benefits:Significant weight loss.Better metabolic profiles.GI...
🎙️ Episode 34: MS Meds After 55? Time for a Pause ?
🧪 Study:Patients ≥55 with no relapses in 5 yrs and no new lesions in 3 yrs may stop disease-modifying therapy (DMT).No significant difference in disability progression.🧩 Clinical Takeaway:De-esca...
🎙️ Episode 33: Spot Check: Urinary Sodium and Diuretic Response
🧠 Clinical Tool:Spot urine sodium 2 hours after IV loop diuretic.If <50–70 mmol/L → inadequate response.Consider doubling dose or switching loop agents.💡 Tips:Also assess urin...
🎙️ Episode 32: SGLT2 vs Kidney Stones: A Surprising Win
🧪 Key Findings:Cohort study: SGLT2 inhibitors led to significantly lower rates of nephrolithiasis compared to GLP-1 RAs.Mechanism: increased urinary flow and uric acid excretion.🔢 Stats:
🎙️ Episode 31: Semaglutide and the Eye: NAION Signal in Sight.
🧪 Key Insights:Observational data links semaglutide (GLP-1 RA) to increased risk of non-arteritic anterior ischemic optic neuropathy (NAION).Incidence: ~9–15 cases per 100,000 patient-years.Possible mec...
🎙️ Episode 30: PAD Progress: Low-Dose Rivaroxaban Gets the Green Light
🧪 VOYAGER-PAD Trial:Patients with PAD post lower extremity revascularization.Rivaroxaban 2.5 mg BID + aspirin vs aspirin alone.📈 Results:↓ Major Adverse CV Events (MACE).↓ Major Adverse Li...
🎙️ Episode 29: Restless Leg SOS: Gabapentin and Friends to the Rescue
🧠 Problem:RLS causes chronic sleep disruption, often worsens in hospital or peri-op settings.💊 Management:First-line: Gabapentin or Pregabalin (per American Academy of Sleep Medicine).Avoi...
Episode 28: Warfarin & Brain Bleeds: Restarting After Hemorrhage in Mechanical Valves
🧪 Study:Retrospective look at patients with intracranial hemorrhage (ICH) on warfarin for mechanical valves.Followed for stroke, rebleed, mortality.📈 Findings:Only 2 strokes in first 7 days after...
🎙️ Episode 27: Statin Confusion? Try the PREVENT Calculator
📊 What It Is:A modern CV risk estimator developed from 2.3 million-person dataset.Replaces outdated ASCVD calculator (based on 25k).🧠 Features:Adds BMI, GFR, A1C, and zip code.Om...
🎙️ Episode 26: Radiation Optional? Rethinking Esophageal Cancer Pre-Op
🧪 The EPOC Trial:Compared FLOT chemotherapy alone vs chemo + radiation before surgery in localized esophageal/gastroesophageal adenocarcinoma.📈 Findings:FLOT alone led to better 3-year progres...
🎙️ Episode 25: Methotrexate for OA Pain? Believe It or Not
🧠 Surprising contender:OA is not just wear-and-tear — there's an inflammatory phenotype.🧪 Trial:MTX 10–25 mg/week in knee OA with persistent pain.Significant ↓ pain and improved function vs place...
🎙️ Episode 24: Pretreat or Nah? P2Y12s in NSTEMI Under Fire
🧠 Historical practice:Pre-load clopidogrel (or ticagrelor) before cath.Rationale: reduce thrombotic burden prior to PCI.🧪 New Data:Large observational study: 100k+ NSTEMI patients.No benefit
🎙️ Episode 23: Hot Flash Fix: Fezolinetant Makes Menopause Manageable
🧠 Problem:80% of menopausal women suffer from vasomotor symptoms (hot flashes, night sweats).Many can't take hormone therapy (VTE, CAD, breast CA).💊 Fezolinetant:NK3 receptor antagonist — first i...