#169 MGUS to Multiple Myeloma Diagnostics and Counseling: 5 Pearls Segment

#169 MGUS to Multiple Myeloma Diagnostics and Counseling: 5 Pearls Segment

Author: Core IM Team January 22, 2025 Duration: 52:23

SPEP vs. UPEP? What does it tell you and not tell you? What is the role for immunofixation and free light chains in diagnosis? Learn about paraneoplastic antibodies with MGCS and its renal, neurologic, and dermatologic manifestations!

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Behind The Scenes Youtube Interview with Dr. Vincent Rajkumar

Transcript and Show Notes

Timestamps:

(01:26) | Pearl 1: What is a monoclonal gammopathy? What is our expected clinical presentation?

(10:12) | Pearl 2: What is our initial workup? Understanding SPEP, Immunofixation, and Free Light Chains

(24:13) | Pearl 3: Do we need urine testing? When urine testing is necessary and when it is not.

(26:26) | Pearl 4: How should we differentiate monoclonal gammopathies? The continuum of MGUS, SMM, and MM.

(41:35) | Pearl 5: Demystifying Monoclonal gammopathy of clinical significance (MGCS)


Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine



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Ever find yourself in the middle of a busy day, wondering about the 'why' behind a common treatment or needing a clear way to think through a complex diagnosis? That's the space where Core IM | Internal Medicine Podcast lives. Created by the Core IM Team, this isn't just a lecture series; it's a practical companion for clinicians, students, and anyone curious about the inner workings of medical practice. Each episode is structured into distinct segments that tackle different facets of the clinical world. You'll hear "5 Pearls" for concise, immediately useful takeaways, and "Mind the Gap" explores the evidence and reasoning behind our everyday decisions. When management gets tricky, "Gray Matters" steps in to untangle the thought process, while "Hoofbeats" focuses on sharpening diagnostic acumen. Finally, "At the Bedside" brings it all together, addressing the real and often nuanced challenges faced in patient care. The conversation throughout this podcast is grounded, thoughtful, and driven by a genuine desire to deepen understanding beyond the textbook. It’s about connecting the dots between knowledge and application, making the intricate landscape of internal medicine a bit more navigable, one discussion at a time.
Author: Language: English Episodes: 100

Core IM | Internal Medicine Podcast
Podcast Episodes
#124 A1c & Glucose Measurements: Mind the Gap Segment [not-audio_url] [/not-audio_url]

Duration: 21:21
What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are th…
#123 Pacemakers & ICDs: 5 Pearls Segment [not-audio_url] [/not-audio_url]

Duration: 47:31
When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devi…
#122 Kidney Transplant Preparation: 5 Pearls Segment [not-audio_url] [/not-audio_url]

Duration: 46:03
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#121 Trach Care: 5 Pearls Segment [not-audio_url] [/not-audio_url]

Duration: 42:58
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#118 "Futility": At the Bedside Segment [not-audio_url] [/not-audio_url]

Duration: 41:56
How do you approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this?Show n…
#117 Atrial Fibrillation: Gray Matters Segment [not-audio_url] [/not-audio_url]

Duration: 37:30
What does the duration of afib tell you about the thromboembolic risk? When do you start anticoagulation for post-op afib? What do the most recent guidelines recommend for perioperative anticoagulation management? How ma…
#116 The Lipid Panel Reimagined: Mind the Gap Segment [not-audio_url] [/not-audio_url]

Duration: 19:52
Is it enough to look at LDL-C? What is Apo-B? How do you use TG/HDL ratio to understand your patients cardiovascular risk? Do you need to get a fasting lipid panel? How does it affect the triglycerides and LDL?Show notes…
#115 Hope: At the Bedside Segment [not-audio_url] [/not-audio_url]

Duration: 35:04
What are some ways you address unrealistic hopes with your patients? How can you build a portfolio of hope with your patients? Can you learn to guide your patients hope?Show notes, Transcript and References: https://www.…