Allergy and immunology
Dr. Cindy Owen gives an overview of cutaneous drug reactions and an approach to diagnosis and treatment in this image-driven lecture. She spends time on urticaria, fixed drug eruption, serum-sickness reaction, hypersensitivity vasculitis, morbilliform rash, drug reaction with eosinophilia and systemic symptoms, erythema multiforme, toxic epidermal necrolysis and less familiar drug reactions (acute generalized exanthematous pustulosis, symmetric drug related intertriginous and flexural exanthem).
Dr. Gerald Lee discusses common primary immunodeficiencies using a case-based approach. He introduces the topic of immunodeficiencies by creating broad categories of clinical presentation to assist with pattern recognition. He spends more time on Selective IgA Deficiency and then covers Common Variable Immunodeficiency in depth.
Yes, that Tao Le. Here he discusses types of rhinitis (infectious, allergic, non-infectious and non-allergic rhinitis, chronic rhinitis with and without polyps). Then he delves into epidemiology, complications, and treatment options (including environmental control, antihistamines, nasal steroids, surgery. He touches on chronic sinusitis as well as when to refer to an allergist or ENT.
Dr. Gerald Lee covers the history of allergy and gives a concise overview of allergic disorders. Then he utilizes cases to discuss allergen immunotherapy including definition, major indication, mechanisms and upcoming applications and new forms of immunotherapy.
Dr. Gerald Lee presents interactive, case-based and image driven lecture on anaphylaxis and urticaria. He covers the mechanism of IgE-related hypersensitivities, diagnosis of anaphylaxis (and common mimics), effective history and treatment of allergic reactions, and the workup of chronic urticaria.
Cardiology
Dr. Regan Wade presents "Heart Failure Pharmacology" by first reviewing heart failure pathophysiology as it relates to pharmacotherapy. She then discusses guideline directed therapy and other agents indicated to optimize heart failure care. After, Dr. Wade evaluates literature related to new therapies and indications for medications in patients with heart failure.
Our Chief Medical Resident for Education, Dr. Samuel Reynolds returns to give an introduction on abstract writing. He begins by describing an abstract and its importance and after, he discusses the general process of abstract writing.
Our Chief Medical Resident for Education, Dr. Samuel Reynolds, presents “Basic Science: Molecular Biology in Cardiovascular Disease”. He discusses the basis of Cardiovascular Disease from a molecular standpoint and emphasizes how arrhythmia and cardiac conduction impairment relates to coronary artery disease and how the development of structural heart disease can mean problems for our heart’s ability to conduct electrical signals. Please note: this presentation took place in our Didactics Zoom, so the audio may be harder to hear.
Dr. Lorrel E.B. Toft returns to the University of Louisville to deliver a much needed Boards Review on Cardiology.
Dr. Shahab Ghafghazi presents "Valvular Heart Disease" and focuses mainly on aortic stenosis through various definitions and case reports.
Dr. Chris Migliore presents The Approach to Chest Pain by first discussing the epidemiology of chest pain or cardiac presentations. He then lists and discusses the important symptoms of chest disease. After, he reviews elements of the chest physical exam and finally, he reviews the fundamentals of clinical reasoning concerning chest pain.
Dr. Lorrel Brown is here to present something a little different: CV Prevention. Dr. Brown first lists Life's Simple 7 approach to prevention of cardiovascular disease as well as how to apply appropriate screening methods for LS7 in clinic patients. She then discusses how to properly treat conditions associate with LS7 and and finishes by giving examples of simple recommendations for patients to move towards ideal cardiovascular health.
Louisville Lectures's most requested lecturer is back! Dr. Lorrel Brown presents Cardiac Arrest and her journey to discover whether education can improve the outcomes. First, she explains the postulated reasons for the variability in survival following out-of-hospital cardiac arrest as well as the gaps between the best practices and real world practices with regards to CPR. She then defines CPR skill retention rates under current methods of instruction and finishes with different ways in which ongoing educational efforts seek to improve outcomes following cardiac arrest.
Dr. Mitchell presents Syncope by first discussing the different types of Syncope as well as cost effective evaluations. She then discusses risk stratification along with management and complications.
Dr. Lorrel Brown discusses the Hypertensive Crisis by first defining hypertension. She then defines hypertensive crisis as having severely elevated blood pressure with end-organ damage. After, she discusses the pathophysiology of end organ damage along with the different treatment approaches for hypertensive crisis. Finally, she finishes her presentation with a few case reports.
Dr. Mokshagundam presents Lipid Disorders by going over basic aspects of lipoprotein transport and metabolism and how it can be problematic. He then discusses the recommendations for managing lipid disorders.
Dr. Lorrel Brown presents Aortic Stenosis by first describing how medicine cannot fix a mechanical problem. She then describes the symptoms of aortic stenosis along with the mainstays of treatment: diuresis, after load reduction, and avoiding hemoydynamic shifts.
Dr. Abramov covers acute decompensated heart failure. starting with a review of the underlying pathophysiology and treatment. He then dives into the the roles of diuretics and beta blockers in acute exacerbations. Finally, he discusses indications for referring a patient to a heart failure specialist along with primary prevention measures.
As we welcome a new class of interns this July, our Louisville Lectures team wanted to highlight some of our most-viewed lectures. Our Boot Camp series will cover high-yield, critical topics that are useful to starting interns. We are starting with some basic EKG concepts and arrhythmia emergencies. Dr. Martin Espinoza and Dr. Lorrell Brown deliver two highly-watched videos.
In this lecture, Dr. Lorrel Brown takes time to discuss the indications, mechanics, and physiology of mechanical circulatory support. She provides a great introduction for internists to some of the most advanced ICU therapies. Dr. Lorrel Brown covers evidence and indications for various modalities like IABP (intra-aortic balloon pump), ECMO (extracorporeal membrane oxygenation), and percutaneous VAD (ventricular assist device).
In this concise talk, Dr. Jan Basile covers resistant hypertension including 24-hour ambulatory measurements, workup for secondary causes and evidence for pharmacologic treatments.
In this lecture, Dr. Mitchell discusses the etiology, evaluation, and workup of syncope in different age groups. She goes on to further discuss a guidelines based approach to diagnosis and pursuit of treatment options (including discharge to home, when appropriate).
In this action-packed lecture, Dr. Lorrel Brown covers ACS basics: coronary perfusion, types of myocardial infarction, and how to diagnose MI using history exam and EKG findings. She reviews ACS risk scores, acute treatment of ACS and some common pitfalls.
Dr. Rodrigo Cavallazzi covers the assessment of volume responsiveness including the static exam as well as dynamic markers to aid with treatment of shock without administration of excessive fluids. He spends some time on shock definition and physiologic compensation before discussing physical exam and laboratory findings consistent with tissue ischemia. Then, he delves into methods of determining pre-load responsiveness.
Dr. Lorrel Brown returns to discuss tamponade cardiac physiology (including demystifying pulsus pardoxus). She continues to cover the differentiation of constrictive and restrictive cardiomyopathies. This action-packed lecture concludes with stress cardiomyopathy and HFpEF (heart failure with preserved ejection fraction).
Dr. Lorrel Brown covers the common (and less common) results of MI using cases. She includes papillary muscle rupture and mitral regurgitation, free wall rupture, ventricular septal defects, right ventricular infarct, pseudoaneurysm, aneurysm, pericarditis and bradyarrhythmias. Free Open Access Medical Education for Internal Medicine.
Dr, Lorrel Brown covers the basics of shock including how to recognize cardiac shock from history, physical exam and invasive monitoring. She discusses physiology and interpretation of pulmonary artery catheterization and then covers choice of vasopressors for therapy.
Dr. Andrew Defilippis discusses his very practical research into the data behind cardiovascular risk scores. His findings on variations between different cohort studies have been published and debated the Annals of Internal Medicine this spring
Dr. Lorrel Brown recaps the electrical system of the heart then uses cases to discuss AV blocks and reviews many EKGs! This your chance to get inside the brain of a cardiologist!
Dr. Martin Espinoza covers differentiating Afib from Aflutter based on ECG features. Then he delves into therapeutic options including answering some FAQs of house staff officers.
Dr. Lorrel Brown gives a thorough review of aortic stenosis using cases: from making the diagnosis to management for asymptomatic and symptomatic stenosis including TAVR. She finishes with important clinical pearls to safely care for patients with aortic stenosis.
Dr. Michael Stillman covers the history of pre-operative evaluation, the ACC/AHA guidelines, and on optimizing risk of patients with major clinical risk factors.
Dr. Espinoza covers basic cardiac electrophysiology and what happens when it goes awry! He discusses supraventricular tachycardias (sinus tachycardia, atrial tachycardia, AVRT, AVNRT), atrial fibrillation and flutter, Wolff-Parkinson-White syndrome. He discusses recognizing features of ventricular tachycardia to differentiate it from SVT. Finally, he addresses management of tachycardias.
Dr. Glenn Hirsch discusses assessment and initial management of acute aortic syndromes: aortic dissection, intramural hematoma, penetrating aortic ulcer, rapid aneurysm expansion and aortic rupture.
In this lecture, Dr. Amit Dwivedi discusses perspectives on peripheral vascular disease tailored towards internal medicine providers from epidemiology, risk factors, diagnosis and treatment.
Endocrinology
Dr. Malika Rawal presents Adrenal Insufficiency by first answering the question: What Is Adrenal Insufficiency? She then reviews its causes as well as some basics of cortisol. After, Dr. Rawal discusses testing and treatment.
Dr. Malika Rawal gives an overview on Gender-Affirming Hormone Therapy. Dr. Rawal first discusses the different types of transition as well as general definitions and after, lists terms physicians should and should NOT use when treating patients. Dr. Rawal presents what a visit would look like and how to work with the patient, expectations of hormone therapy, and the physical effects of hormone therapy for feminizing hormone therapy along with masculinizing hormone therapy.
Dr. Stephen Winters presents "Klinefelter Syndrome" through multiple cases. He discusses the diagnoses of patients with Klinfelter Syndrome as well as what to look for in men and women. He then explains the quality of life for someone with KS as well as different treatments offered by various authors.
Dr. Sathya Krishnasamy presents an Endocrine Board Review for residents at the University of Louisville through a number of case questions.
Dr. Stephen J. Winters discusses "hypogonadism" in women and men through various photos, studies, and cases. He uses many case questions to discuss different scenarios as well as characteristics of hypogonadism that may not be obvious at first glance.
Dr. Stephen Winters presents the hypothalamus and pituitary by first presenting the clinical manifestations of pituitary disease. He then discusses various cases as well has treatment and management of each disorder.
In this presentation, Dr. Betty Villafuerte discusses complications-based approaches to guide treatment modality of obesity. She them reviews treatment guidelines on lifestyle modifications and the use of pharmacotherapy in managing obesity. Finally, she examines the role of meal frequency, meal timing, lifestyle behavior, and intelligence on obesity.
Dr. Mokshagundam presents Lipid Disorders by going over basic aspects of lipoprotein transport and metabolism and how it can be problematic. He then discusses the recommendations for managing lipid disorders.
Dr. Krishnasamy presents Inpatient Glucose Management by first discussing a case of hospital hyperglycemia. She then reviews current guidelines for glycemic management trends in non-critical care settings. After, she reviews institutional protocols.
In this case-based lecture, Dr. Krishansamy walks through several real-life examples of patients and their indications for novel treatments for diabetes with a focus on mechanisms of action. Included in this lecture is an overview and update on the American Diabetes Association (ADA) guidelines and European Association for the Study of Diabetes (EASD). Finally, she takes a look at new technology to treat type one diabetes.
Dr. Sathya Krishnasamy presents cases to illuminate the physiology of thyroid disease including hypothyroidism, hyperthyroidism and thyroid nodules.
Dr. Eleanor Lederer reviews the balance of calcium in the body and mechanisms of homeostasis in the kidneys and bones. She then covers hypocalcemia and hypercalcemia in a case-based approach.
In this lecture Dr. Villafuerte speaks from experience and research on the myriad complications that can occur with diabetes. She covers all the bases (heart disease, stroke, neuropathy, renal disease, peripheral arterial disease) as well as rarer entities such as necrobiosis lipoidica.
Dr. Betty Villafuerte covers treatments for diabetes stressing utilizing pathophysiology to select the right medication for your patient.
Dr Krishnasamy utilizes cases to present a thorough review of calcium metabolism including: calcium homeostasis, etiology and pathogenesis of hypercalcemia and hypocalcemia, disorders of bone metabolism, and vitamin D deficiency.
Dr. Sri Mokhagundam utilizes cases to discuss Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS). He covers differences between the two, workup of hyperglycemia, treatment with fluids, electrolytes and insulin.
Dr. Stephen Winters discusses diagnosis and management of common adrenal disorders: Cushing's syndrome, primary aldosteronism, pheochromocytoma, and adrenal insufficiency.
Gastroenterology
Dr. Bryan Moffett presents "Sodium Derangements in the Medical Patient" by first differentiating the difference between total body sodium and sodium concentration. The then breaks down the physiology, causes, and treatment of hyponatremia.
Dr. Ben Rogers presents a lecture on reflux by discussing a classic presentation of reflux as well as testing. Dr. Rogers emphasizes modifying care and diagnosis towards each patient with their own unique symptoms.
Dr. Omer delivers part two of a GI Board Review. This talk includes various cases as well as questions and answers. Check out part one from last week!
Dr. Omer delivers part one of a GI Board Review. This talk includes various cases as well as questions and answers.
Stay tuned for Part Two next week.
Dr. Craig McClain presents "Management of Alcohol-Related Hepatitis" through various case studies, as well as an overview and diagnosis. He then discusses research findings related to alcoholic hepatitis and after, Dr. McClain explains the therapies being validated for the treatment of AH, their complications, as well as transplantation.
Dr. Anupama Raghuram discusses "Hepatitis A: An Update in the Context of an Outgoing Multi-state Outbreak" by first reviewing the epidemiology and pathogenesis of hepatits A virus (HAV) infections. She then presents the clinical manifestations and management of HAV infections. After, Dr. Raghuram addresses strategies for prevention of transmission in a variety of clinical settings and finally, reviews data on the ongoing multi-state HAV outbreak in the US.
In this presentation Dr. Craig McClain discusses nonalcoholic fatty liver disease as the #1 cause of liver disease. He then presents various cases and current treatment for patients with NASH as life style modifications, vitamin E, HCC monitoring, and more.
In this presentation, Dr. Michael Wellner discusses Hepatitis by first identifying patients with alcoholic hepatitis who are at high risk for poor outcomes. He then recognizes the different viral hepatitides as well as when and whom should receive treatment. After, he describes autoimmune hepatitis and finally, recognizes acute liver failure and which patients need urgent or emergent GI evaluation.
Dr. Luis S. Marsano presents Variceal Hemorrhage by discussing classification, management, history, and treatment of variceal bleeding. He then discusses the effects of antibiotics as well as rescue treatments and different forms of drug therapy.
Dr. Luis S. Marsano presents Upper Gastrointestinal Hemorrhage by first discussing acute upper non-variceal bleeding. He then explains the signs and causes of GI bleeding as well as initial management. After, he talks about different endoscopies, medical therapy, and indications for surgery.
Dr. Luis Marsano delves into providing adequate nutrition for patients with cirrhosis to prevent hepatic encephalopathy and alcoholic hepatitis. He also addresses minimizing morbidity; including preventing refractory ascites and hepatorenal syndrome and spontaneous bacterial peritonitis prevention.
In this lecture, Dr. Craig McClain discusses the pathogenesis of alcoholic liver disease, treatment, and patient cases. Dr. McClain uses his expertise in nutrition to discuss risk factors and advanced pathophysiology that predispose patients to excess harm from alcohol. He closes with a focus on where the research on treatment is and what the most recent evidence tells us about how we might improve clinical management.
Rebecca Redman presents an approach to GI cancers from the perspective of an internist. She covers workup of gastrointestinal cancers, the differences between curative and palliative treatment, and types of treatment. She spends a great deal of time on colorectal cancer then discusses esophageal and gastric cancers, hepatocellular carcinoma, pancreatic cancer and GI neuroendocrine tumors.
Dr. Russ Farmer uses MS Paint to cover basic concepts of colon cancer including epidemiology and clinical decision making (chemo and surgery options). He cements the topics by emphasizing visual points.
Dr. Brian Beauerle covers the basics of cirrhosis including pathophysiology, symptoms and survival of patients with survival. He covers when and how to perform a paracentesis including interpretation of results. He discusses pharmacologic and dietary treatment of ascites and refractory ascites. He closes with complications of ascites including spontaneous bacterial peritonitis and hepatic hydrothorax.
Dr. Kris Krueger reviews the epidemiology and pathogenesis of C.difficile in the U.S. Then, she gives an update on current medical treatments including antibiotic, probiotic and surgical treatment before covering the evidence behind fecal microbial transplant. She also addresses prevention strategies and emerging C.difficile therapies such as immunotherapy and vaccines.
Dr. Mike Hughes discusses innovative medical care of chronic pancreatitis with ground-breaking work on auto-islet cell transplantation. He covers differences in auto vs. allo transplantation, indications of transplantation, evaluation of prospective transplant patients, peri-operative and outpatient management, and observed outcomes post-surgery. The lecture spends time reviewing several ongoing research projects at University of Louisville by several labs researching facets of this topic.
Dr. Luis Marsano delves into providing adequate nutrition for patients with cirrhosis to prevent hepatic encephalopathy and alcoholic hepatitis. He also addresses ascites and hepatorenal syndrome management as well as SBP prevention and GI bleeding.
Dr. Bryan Moffett outlines a practical algorithm to considering both acute diarrhea. He then approaches treatment for acute and chronic diarrhea. Finally, he cements this knowledge by presenting several cases.
Dr. Roberts addresses one of the age-old discussions between medicine and surgery: what to do with an inflamed pancreas? He does a brief review of presentation, etiology, severity assessment, complications of pancreatitis and then spends a good deal of time on endoscopic and surgical treatments for pancreatitis and it's complications.
Dr. Russell Farmer covers the acute abdomen for internists (from a surgeon's perspective). He reviews history and physical findings tailored to an acute abdomen and works through cases to discuss the following: diverticulitis, appendicitis, pancreatitis, peptic ulcer disease, bowel obstruction, cholecystitis, ovarian torsion, testicular torsion.
Dr. Dipendra Parajuli uses a case-based approach to review diagnosis, need for imaging, severity scoring systems, management and complications of acute pancreatitis.
Dr. Marsano discusses evidence regarding diagnosis and management of fulminant hepatic failure. Dr. Marsano is a professor of medicine at the University of Louisville and holds a Distinguished Chair in Hepatology in the department of Gastroenterology and Hepatology.
Dr. Gerry Lee highlights important differences between allergic and non-allergic rhinosinusitis and emphasizes how to evaluate and treat the presentation of rhinitis. He discusses when to refer patients with rhinitis to allergists and how to recognize relationships between upper and lower airway diseases.