Dr Kevin And Dr Dimitre Canadian Medical Educators public
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The bulb-like corms of C. autumnale contain colchicine, a useful drug for inflammatory conditions. Dear listeners, Colchicine has been used as an anti-inflammatory medication for centuries. The plant source of colchicine, the autumn crocus, was indeed used in Ancient Egypt as a treatment for rheumatism and swelling. Currently, colchicine is indicat…
 
Dear Listeners, This month, we are very excited to bring you a preview of our upcoming conference for Physician Empowerment. This year, our focus is on personal resilience and practice management. On today’s episode, Kevin shares a remarkably refreshing view on wellness within our profession. The event is being live-streamed from beautiful Banff, A…
 
Dear Listeners, We are very honoured to have Dr. John Crosby join us and share the wisdom he has gained during his lifetime as a Family Doctor in Canada. Dr. Crosby is an author, blogger, consultant, and mentor. He is a regular contributor to the Medical Post and a peer reviewer for the College of Physicians & Surgeons of Ontario. Most remarkably, …
 
Dear Listeners, It is estimated that about 40% of patients with type 1 or type 2 diabetes will have diabetic kidney disease. The suggested progression of this disorder is glomerular hyperfiltration due to a high-pressure state caused by elevated blood sugar, proteinuria due to glomerular damage, and chronic renal failure to renal hypoperfusion. Rec…
 
Dear Listeners, An estimated 10% of school-aged children will have proteinuria. About 0.1% of them will have persistent hematuria requiring further investigation. Transient proteinuria can be caused by stress, exercise, cold exposure, dehydration, and orthostasis. Persistent proteinuria can be caused by Glomerular or Tubular Disease. Glomerular dis…
 
Dear Listeners, The C-Reactive Protein and the Erythrocyte Sedimentation Rate are both lab tests used to measure inflammation in the body. They are usually elevated during infectious, inflammatory, and malignant diseases. The CRP is produced by the liver shortly after the offending process so it is a direct measure of inflammation. The ESR is based…
 
Dear Listeners, As a follow up to podcast 67, Eric Harvey, a 3rd year Mcgill medical student, is joining the Primary Medicine Podcast to go over the treatment approach for male hypogonadism. It is important to consider both benefits and risks of testosterone therapy, before initiating treatment. The clearest benefit is to men with abnormally low se…
 
In podcast 67, Dr. Dimitre will cover the diagnostic approach to late-onset hypogonadism also known as andropause. Late-onset hypogonadism (LOH), causes a gradual yearly decrease in testosterone levels of 1 to 2% in men over the age of 40. While this condition is commonly known as Andropause there is no cessation of hormone production. However, jus…
 
Dear Listeners, Constipation, or decrease in stool frequency and hardening in stool consistency, is a common issue in the elderly and can affect their quality of life significantly. Dr. Kevin has a 4 step approach to constipation in the elderly. Step one is making the diagnosis, remembering that constipation is a symptom with an underlying cause. S…
 
Betty Boop is having a horrid secondary headache! Dear Listeners, A headache is considered secondary when it is related to an underlying medical condition. About 10% of patients presenting with headache are suffering from a secondary cause. Dr. Kevin’s approach to secondary headaches is anatomical in nature. Moving from the outside in, he suggests …
 
Aphthous Ulcers, also known as canker sores, affect about 25% of the population. They are considered benign as long as they are small (less than 1 cm), self-limiting (resolve within 3-4 weeks), and not associated with any additional symptoms (such as fever). Consider the differential for mouth ulcers as being infectious or non-infectious. The most …
 
Endocrine Emergencies are rare but deadly conditions that can be hard to diagnose and manage. This can lead to long treatment delays and potentially life-threatening complications. In podcast 63, Dr Wahid and Dr. Dimitre will cover some of the most common emergencies relating to the thyroid (myxedema coma, thyroid storm, thyroiditis), adrenal gland…
 
Approximately 60% of women will experience a urinary tract infection if their lifetime. Up to twenty percent of them will experience multiple current episodes on a yearly basis. For the first time, the American Urological Association (AUA) has issued a guideline for the diagnosis and treatment of uncomplicated recurrent urinary tract infections (UT…
 
Clogged Arteries due to LDL deposits For podcast 61, Dr. Wahid makes a comeback to talk about Familial Hypercholesterolemia (FH) while Dr. Dimitre bemoans the weather in Ottawa yet again. Familial Hypercholesterolemia (FH) is a condition that affects about 1 in 500 Canadians and is an important cause of early cardiovascular death yet it is relative…
 
Dear Listeners, After a bit of an unplanned hiatus, we are back with podcast number 60 and with Dr Pabani, rural doc extraordinaire. Aspirin is having a really tough time lately with three studies taking the shine off its role in primary prevention of cardiovascular disease. During the podcast, Dr. Dimitre and Dr. Wahid go over the ASCEND, ARRIVE, …
 
Dear Listeners, For our last podcast of the year, Dr. Dimitre talks about Marfan syndrome. It is an autosomal dominant disorder of the connective tissue that affects three major systems: cardiovascular, muskuloskeletal, and ocular. Most individuals who have Marfan’s are asymptomatic until complications arise. Most commonly they will have aortic dil…
 
Dr. Kevin is back for our 58th podcast to talk about his approach to diagnosing inconsolable infants. Unexplained irritability in the clinic setting needs to be assessed as an urgent medical presentation. Up to 5% of fussy children will have an organic cause to their distress. As Dr. Kevin explains, there are a lot of badnesses lurking in the abdom…
 
Dr. Dimitre is back with the 57th episode of the primary medicine podcast! Acquired long QTc syndrome is a disorder of the rhythm of the heart. It can lead to ventricular arrhythmias, such as Torsades de Pointe, and possibly ventricular fibrillation and death. It is caused by QTc prolonging medications which include antidepressants, antibiotics, an…
 
Dr. Wahid Pabani, rural doctor extraordinaire, is back for our 56th podcast to talk about Nocturnal Leg Cramps! OUCH! This very common and distressing condition has many causes from the mundane (such as muscle fatigue) to the serious (such as peripheral vascular disease, or Parkinson Disease). Thankfully, a focused history and physical exam can hel…
 
Dr. Kevin is back four our 55th podcast and he brought a surprise tiny guest. He will be talking about Intussusception. This is a life-threatening condition which mostly affects children below the age of three. It occurs when one part of the intestine slides into the adjacent part of the intestine. This causes bowel ischemia, obstruction, and possi…
 
After a short hiatus, Dr. Dimitre is back to talk about subclinical hypothyroidism. Sometimes referred to as mild thyroid failure, it is diagnosed when peripheral thyroid hormone (T3 and T4) levels are within the normal range, but thyroid stimulating hormone (TSH) is mildly elevated. It is common, occurring in 10% of the population, and carries a r…
 
Dr. Kevin is back for our 53rd podcast. This time we will be talking about Spondylolisthesis. Spondylolisthesis is anterior displacement of a vertebral body relative to the adjacent inferior vertebral body. It is a common condition of young athletes that can present with intermittent back pain. Diagnosis is based on imaging with lumbar X-Ray being …
 
For our latest podcast, Dr. Dimitre is itching to talk about itching! Pruritus is a challenging presentation for two reasons. Firstly, the differential is broad encompassing conditions both benign and malignant. Secondly, the patient is often suffering and looking for a quick solution to his problem. It is thus important to have a clear and efficie…
 
Its winter yet again in Canada. That means slippery ice, broken bones, and concussions! Rural Doc Extraordinaire Wahid is back to talk about concussions. It is a medical condition that has entered the entered the public consciousness with the recent NFL scandal and the aptly named Will Smith movie. It is most often caused by head trauma experienced…
 
Dr. Dimitre and Dr. Kevin are back after a short holiday break! Our 50th podcast and now more than 5000 listeners monthly! What better way to celebrate than by bringing in someone much cleverer than ourselves to talk… Introducing Dr. Ken Milne – founder of the outstanding Skeptics Guide to Emergency Medicine. Visit SGEMS here at http://thesgem.com/…
 
Episode 49 of our podcast showcases Dr. Kevin’s prowess with children as he presents his approach to syncope while taking care of his grouchy 12 mo! Syncope has many causes from the mundane to the deadly and requires a systematic detailed workup. Dr. Kevin takes the time to review the broad differential of this presentation. Not all syncope is vaso…
 
Dr. Wahid and Dr. Dimitre are back for podcast #48! Giardiasis, also known, as beaver fever is one of the most common parasitic human diseases globally. It usually presents with chronic diarrhea, abdominal pain, and weight loss. Symptoms may begin 2-4 weeks after initial exposure to the parasitic cyst and may last up to 4-6 weeks. It is diagnosed u…
 
Dr. Dimitre survived the plague that is hand foot and mouth disease and he is back to tell the tale. Hand foot and mouth disease is a summertime viral infection that presents with painful lesions on the palms, soles, and the oral cavity. It usually affects children under 10. Thankfully it rarely lasts more than a week and is usually treated with su…
 
Dr Mailo joins is back for our 46th podcast! The topic was inspired by one of our friends having a syncopal episode and breaking his noggin. The nasal bones are the most commonly fractured bony structures of the face. Patients with nasal fractures will often present to the emergency department with bleeding, swelling, and bruising. Furthermore, the…
 
Dr Wahid joins us for our 45th podcast to talk about a challenging case he had at the start of his career. Viral Myocarditis, or inflammation of the heart muscle, can cause arrhythmias, heart failure, and even sudden death in healthy individuals. Patients will often present with dyspnea, chest pain, low endurance and irregular heartbeat. Early reco…
 
Ouch! For our latest podcast, Dr. Dimitre talks about the most common cause of heel pain. Plantar Fasciitis, is an easy clinical diagnosis to make but a rather challenging condition to treat. It tends to affect middle-aged persons, athletes, and individuals who stand for prolonged periods of time during the day. Treatment is often conservative, wit…
 
Dr Wahid is back! During our latest podcast, he and Dr. Dimitre converse about Sudden Sensorineural Hearing Loss. SSNHL presents with unexplained hearing loss, often unilateral, which tends to develop over a period of 3 days. Most cases are idiopathic and self-limiting, but some can be caused by serious and life-threatening conditions. Prompt diagn…
 
During our latest podcast, Dr. Kevin segues masterfully from his daughter’s appendicitis scare to the management of airway foreign bodies in children. This is a potentially life-threatening that should be suspected on the basis of a witnessed choking episode. The presentation of unwitnessed foreign body aspiration is subtle and requires a very thor…
 
In our latest podcast, Dr. Kevin is excited to talk about our upcoming conference and Dr. Dimitre is excited to talk about how to remove corneal foreign bodies in the office. Please visit our membership page to access the podcast. Posted on 02/03/2017 by Dr. Dimitre The post Episode 41: Corneal Foreign Body appeared first on Primary Medicine Podcas…
 
In part 2 of our podcast on Cardiac Risk Stratification, Dr Kevin takes us deeper into the rabbit hole! He talks about his approach to patients presenting with symptoms suggestive of Ischaemic Heart Disease. He finishes off by summarizing the limits of cardiac tests. None of them are 100% sensitive! Please visit our membership page to access the po…
 
Dr Kevin takes us deep into the rabbit hole this week! He talks to us about four different front line modalities available to physicians to preform cardiac risk stratification for ischemic heart disease. He goes over some of their advantages and disadvantages and stops short before getting into the raw numbers and math. We have saved that heady tri…
 
During this week’s podcast, Dr. Pabani and Dr. Dimitre brave the harsh Canadian winter to talk about Frostbite! As the freezing month of February looms for Canadians, the good doctors go over how to manage this limb threatening condition in the office. Please visit our membership page to access the podcast. Posted on 29/01/2017 by Dr. Dimitre The p…
 
For our first podcast of 2017, Dr. Dimitre talks about the different causes of a toothache. Dental pain is a relatively common presentation in the walk in clinic and its important to know that it is not always caused by a cavity and that there are certain things doctors can do to help patients before they are sent to see a dentist. Please visit our…
 
On this week’s podcast, Dr. Pabani makes his triumphant return to talk about broken teeth! Dental Avulsions are an emergency, so knowing how to manage them can make the difference between a nice smile and a horrid smirk. Remember that Time is Teeth! If you are interested about learning more our CFP exam perpetration app and books please visit our w…
 
During this week’s podcast, Dr. Dimitre is itching to talk about Scabies after a harrowing near encounter with this horrid enteroparasitic disorder. Scabies is a highly infectious, highly pruritic condition that can be challenging to treat. Please visit our membership page to access the podcast. Posted on 30/11/2016 by Dr. Dimitre The post Episode …
 
During this week’s podcast, Dr. Kevin trots in from the Western prairies to talk to namby pamby city slicker Dr. Dimitre about his approach to fever in the newborn. This is a fairly common presentation in the office that can be a great challenge for clinicians and caregivers. Please visit our membership page to access the podcast. Posted on 17/11/2…
 
During this week`s podcast, Dr. Dimitre huffs and puffs about the importance of Spirometry in Primary Care. He briefly reviews lung physiology and then goes through a simple and intuitive method for interpreting spirometry results. Dr. Wahid drops by to talk about our new app we made to help Residents with their Certification Examination in Family …
 
This week’s podcast has been inspired by Kevin and Dimitre’s respective confrontations with gastroenteritis! During the episode, Kevin discusses his approach to adult diarrhea covering the four common diagnostic “boxes” that practitioners need to consider in the emergency department and the family doctor’s office. Please visit our membership page t…
 
Dr. Kevin is back for this weeks podcast! He starts by talking about a particularly difficult intubation scenario that he was recently faced with. He then goes over the practical aspects of rhythm control, rate control, and anticoagulation therapy in patients with Atrial Fibrillation. We finish off by talking about common cases of A. fib we see in …
 
During this week’s podcast, Dr. Dimitre lurches along all by himself talking about Legg-Calve-Perthes disease. This condition, while relatively rare, should be considered in children, especially boys between the ages of 4-8, who present with a limp. Please go to our member’s area to access the podcast! Posted on 16/09/2016 by Dr. Dimitre The post E…
 
Due to popular demand, Dr. Wahid comes back to talk about shave biopsies. We talk about which lesions are appropriate for biopsy and which are not. We go over the 4 different ways to do this procedure. And we finish with a step by step of how to preform a shave biopsy. Please go to our member’s area to access the podcast! Posted on 28/08/2016 by Dr…
 
An Abdominal Aortic Aneurysm is a common and potentially deadly condition often seen in men over sixty. During today’s podcast, Dr. Dimitre talks about how to diagnose AAA’s and who should be screened in the family doctor’s office. Dr. Kevin shares with us his experiences with AAA and how its the white whale of many ER docs. Please go to our member…
 
Neither Dr. Dimitre or Dr. Kevin like electrolytes, but talk about them they must. Dr. Kevin starts off with hypocalcemia, covering his approach in the ER department. Dr. Dimitre makes some suggestions about dealing with hypocalcemia in the family doctor’s office. Please go to our member’s area to access the podcast! Posted on 27/07/2016 by Dr. Dim…
 
Dr Wahid joins Dr. Dimitre and they talk about their love of the punch biopsy. Dr. Dimitre is grateful that he can use punch biopsies to diagnose weird rashes. Dr. Wahid is happy that they are so easy to preform. During the episode, they go over the indications, contraindications, and step by step of this essential procedure for physicians who mana…
 
During the last June podcast, Dr. Dimitre talks about what to do when a patient has microscopic hematuria. Please go to our member’s area to access the podcast! Posted on 24/06/2016 by Dr. Dimitre The post Episode 25: Microscopic Hematuria appeared first on Primary Medicine Podcast.By Dr. Kevin and Dr. Dimitre: Canadian Medical Educators
 
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