Tired of getting yellow cards from the infectious diseases team for prescribing meropenem for 3 months?
Sick of Scott appearing behind you with a cat o’ nine tails to administer the requisite antibiotic punishment?
Well this episode has it all – what is antimicrobial stewardship? why do so many people care about it? what can you do to avoid being on the pharmacy’s wanted list? Most importantly, we expertly blend in some music and cold openings for the first time. Jump in, the water is warm!
2023 got you feeling out of rhythm? Finding yourself a bit behind the beat when it comes to pacemakers? Pour yourself a frosty, frothy, fibre-filled glass of your favourite plum juice and strap on your electric earmuffs. We’re going charging on an audio adventure from cathode to anode with Scott and Rahul which will help you nail pacemakers with aplomb!
You know that feeling when you find a surprise $100 note in a coat pocket you haven’t worn for a while? Yeah, we don’t either. But we can imagine it feels kind of like discovering we have a MedConversations episode we forgot to publish! Open this 2022 time capsule with us and treat your tympanic membranes to Bec and Scott talking all* things hypothyroidism. We open up a can of worms talking history of the thyroid, and introduce you to our case Nala the poet with enough heavy-handed use of metaphors to make your Grade 6 teacher proud. If you last till the end, please tell us what you think of the surprise concluding performance.
Intimidated about caring for immunosuppressed patients full of mibs, mabs or stem cell jabs? Here is the infection protection guide to investigate and manage your patient’s neutropenic slump – without resorting to well-evidenced super foods like goji berries or sheep placenta extract
Psychiatry registrar Dr Dean Whitty is back on the MedConversational airwaves again to talk with Bec about taming the black dog in our final ep of the three-part depression series. Dean’s soothing voice takes us on a nice guided tour through lifestyle, psychotherapy, antidepressants and ECT. The content is great med school exam fodder but also broadly useful for anyone out there with Doctor on your name badge no matter what your field.
Dean is the only guest we’ve had so far on the show so please shoot us an email or a Facebook message to let us know what you think of the format!
The MedConversations crew may not fly the surgical flag very much but we love flying into the melee of perioperative management. So get peri with Bec and Scott as we dance around and about* the drug chart of the pre-op patient and allay your surgery rotation pager fears.
*We take the scenic route through salmon sperm, bridge championships, dead rats and Romanesco broccoli.
Weary traveller, let Rahul, Bec and Jupiter’s 79 moons be your guides as we haul you up the third and final segment of the hypertension series. At the summit we take you on a high pressure hike through the assessment and secondary causes of the old HTN under the auspices of a curiously one dimensional character called Mountain.
This episode is for everyone who is sick of COVID-19 but needs to finally learn how to diagnosis and manage it, rather than how to out-argue your uncle about whether the plan-demic will end democracy. We go through diagnosis, testing, and all the juicey new therapeutics available – enough mabs and mibs here to level up your wordle game.
Nasty Bugs. You gotta treat ‘em! In this, truly, tremendous second antibiotic episode, Sleepy Scott, Deranged Davor, Crooked Bec (and Obama Zala) cover all the gram negative bacteria – from microbiology to antibiotics and resistance. Believe me, you’ll be tired of winning!
This is part 2 of our series on depression. Davor and Dean chat about how to evaluate someone you think might have depression. As fascinating as part 1 was, this is much more clinically relevant. Filled with Dean’s wisdom and clinical pearls, listen on if you want to smash your psych OSCEs or perhaps even to be a better doctor.
This episode is a bit of new thing we’re trying – interviews with our friends! As we’ve progressed in our careers, we’ve all started specializing and become increasingly unqualified to talk about large swathes of medicine. On the flipside, our mates have done the same thing in all manner of interesting fields, so we’ve decided to start utilizing this amazing resource.
In this episode, Davor talks to senior psychiatry registrar Dean Whitty about depression. This episode is an overview of the Black Dog – definitions, burden of disease and pathophysiology. To be completely honest, only the first 20 minutes or so are directly clinically applicable. If you decide to stay onboard for the whole journey though, you’ll get Dean’s fascinating thoughts on whether you can make epidemiological conclusions across cultures, the different models of depression and how you might be able to unify them, as well the inherent tension between the biological and psychosocial approaches. We’re planning on following this one up with episodes on evaluation and management.
Welcome seeker. All the bacteria. All the antibiotics. Join us on our ambitious multi-episode trek to summarise all bacteria and their treatment starting this episode with gram positives. Your journey will teach the ancient wisdom that tazocin does not fix all problems and that “beta lactamase inhibitor” is not just a mantra ID registrars use to confuse you. At the pinnacle you will meet a new MedConversations member who will share her wisdom that a life well-lived involves hourly breaks for milk and urination.
Davor, Bec and Scott sit down and chat about nerve roots. Well, to be honest, it’s more like Davor relentlessly interrogates Bec and Rahul about radiculopathy for an hour. Although ethically questionable, it appears to have worked because by the end they seemed to understand which nerve roots are damaged by which disc, how to differentiate between L5 and other causes of foot drop and lots of other cool stuff. Hopefully you will too!
This is also the first episode we recorded with our new equipment. We saw some of the feedback about audio issues, and we reckon things sound much, much better with our new gear. If you’ve stopped listening because you were sick of it sounding like one of us was in a different room, give this ep a whirl.
We’re back with a mammoth topic. Often consigned to a 1-liner in the past history – it’s time to find out just how little you know about the silent killer. Much like the mounds of hair that accumulate in your drain pipes, hypertension is known for a sudden and unexpected day-wrecking by blocking up your plumbing.
Sit back, grab the saltiest nuts you can find and prepare for part 1 of our bigger than Ben-Hur epic on the mechanisms and pathophysiology of hypertension.
Low back pain! Rahul and Davor discuss one of the most common presentations in medicine. What are the most common causes? What are the most serious causes? Who do you image? What on earth does Rahul mean when he says “test the anal reflex”? Listen in to find out the answers to these eternally-vexing questions and more.
Drugs. Death. Hidden infections. Bad mix tapes.No, you’re not tripping out on LSD at your uncle’s mail-order bride wedding, you’re just listening to MedConversations’ latest educational podcast packed full of infective endocarditis wisdom and copyright infringing references to one of our most beloved fictional drug dabblers.
If you naively thought that part 2 of glomerulonephritis would never come and you could spend the rest of your summer wallowing in glorious ignorance of those confusing glomerulonephritidis then you were wrong. Here are the rest of the nephritic syndromes in all their rosé tinted beauty.
Has your troubled history of pot plant homicide led to legal action over your plant carer registration AND/OR your grandmother giving up on you and gifting all her cuttings to her previously second favourite grandchild? We can’t help you with your congenitally absent green thumb AND/OR unlovable personality but this practical episode on clinical fluid assessment will keep your patients from either wilting away or drowning in bottomless bags of normal saline.
Dust off your ear horn, ruffle up your ruffles and prepare your first-born son for a painful but career-favouring transition. Bec and Scott are back and hitting every high note as they croon, roar and trill their way through hypercalcaemia
Get your amphora ready to catch some of the golden stuff and see if you have the blood and the protein to raise some nephrologist eyebrows. We’ve heard the requests of the people and taken on GN in an epic two-part podcast. This podcast will deal with general approach to glomerulonephritis as well as nephrotic syndromes.
On another note, despite the fact that we are known for our outstanding sound quality we are looking to improve the quality of MedConversations. This means more frequent episodes with better sound.
We’ve started a Patreon page where you can donate as little or as much as you like to help the cause. Any amount at all is super appreciated and all funds will go towards improving the podcast.
Find us on Patreon at https://patreon.com/medconversations
Think you might have what it takes to join the extraordinary league of gentle-people against epilepsy? Well you’ll need some training first. Come join Davor and Rahul for a shake-down of the epilepsy world.
P.S. I tried my best to stop Davor from inflicting another neurology episode on us all, but the man is just so damn charismatic.
Charge your batteries and prepare for a shock to the brain. Today we witness the return of a MedConversations legend, Davor who joins Rahul to get your jumbled signals back in alignment about first seizures.
Join Medconversations for an melodramatic tale of a plucky Siamese fighting fish and one man’s journey to virological purity inspired by his faith in the Good Lord above. Along the way you’ll finally learn how to interpret hepatitis B serology.
Merry Christmas from Medconversations with our long awaited ep on inflammatory bowel disease. Fake a smile and pretend its just the gift you wanted as Scott and Rahul explore the length of the disease from the mouth to the azathioprine. Get into the consumerist holiday spirit and share/comment this status for a chance to win an authentic Santa toilet seat cover to keep your own cheeks rosy this Christmas!
You know when people invite you to dinner and tell you not to bring anything, but actually if you got your act together and brought a salad they’d be really glad? MET calls and interns are kind of like that. This ep is for the interns-in-gestation: we teach you how to make salad.
(Anyone disappointed in the low salad content of this ep should head here afterwards for an unrivalled culinary delight brought to you by MedConversations. And Ottolenghi. You’re welcome.)
Call up your injection crew and gather around the gramophone, it’s time for Scott and Rahul to bring you the good news about Hepatitis C – there’s a cure and we’ve distilled it here ready for an acoustic injection. Keep the naloxone on standby, we’ll be your spiritual guides as we go deep!
Which exposure would NOT be an indication for Post Exposure Prophylaxis (PEP) in an Australian (low HIV prevalence) context?
A man presents after sharing needles with another man who he believes may be HIV positive.
A woman presents following receptive anal intercourse with a HIV + source known to be well controlled on antiretroviral therapy
A lady presents after unprotected vaginal intercourse with a man from a high HIV prevalence country
A healthcare worker presents following a needlestick injury in a patient with poorly controlled HIV’
New evidence from the partner study suggests that the chance of HIV transmission from a viral load suppressed source is negligible. This groundbreaking study of 1166 serodiscordant partners in whom the HIV+ partner had viral suppression reported 0 cases of HIV transmission between the partners, despite 22,000 condomless sex acts among MSM and 36000 among heterosexual partners. The study was powered to give a 95% upper confidence of 0.3/100 couple years of condomless sex, suggesting that the risk is lower than it was previously thought to be a few years ago.
Add in the the weight of new evidence about the morbidity benefits of ART in the SMART and TEMPRANO trials has led to recent changes in WHO and Australian ASHM, which now recommend starting antiretroviral therapy in almost all HIV patients.
A, C, and D would all be indications for PEP by Australian guidelines. B would not be a indication, nor would even unprotected receptive anal sex with a source with unknown HIV status from the standard Australian low prevalence community – although it could be considered if the source was from a higher prevalence group – eg a country with higher prevalence or a subgroup like IVDU. Remember, this more conservative administration of PEP reflects both new evidence and low Australian prevalence, and many countries might have higher prevalence or not have updated older more conservative guidelines yet.
For tons of extra information including probabilities of transmission risks by different exposures and current indications for PEP check out ASHMs great guidelines here.
Dont forget your PrEP and barrier protection for this intimate all-male episode as Scott and Rahul take you through the racey fundamentals of HIV – from virology and antivirals to the unadulterated thrill of municipal libraries.
And keep the knowledge pot simmering with Lucy’s great summary here
Ever pondered whether you might suit the professorial lifestyle? This episode, featuring special guests Dr. Adam Brown and Dr. Nitesh Nerlekar, will run through what the appeals of including research in your career are and some basics on how to get started. Drs. Brown and Nitesh are academic cardiologists from Monash Health in Melbourne and have mentored many medical students, junior doctors and PhD candidates in their nascent careers. So sit back, grab a Pina Colada and get caught in the research rain.
Nitesh, Adam and Rahul (alongside a few other academic doctors) are running a research skills course in Melbourne at the Alfred Hospital over the weekend of May 19-20. This course will provide a more in-depth guide on the skills needed get some publications to your name and avoid some of the traps that many young doctors fall into. You can sign up at www.medcube.com.au
Rahul is temporarily back in our fair island nation, so here’s a cis-pacific podcast on cirrhosis. Part two will follow eventually, but like the course of this chronic disease, you probably know that the natural history of MedConversations can sometimes be slow and unpredictable. Sorry about that.
This one’s a shout out to the new interns, the soon-to-be interns and anyone who needs a refresher. But mostly it’s for the pharmacists, who are worried about using up the national stocks of purple ink.
Benjamin Franklin once wrote a play. The two main characters were himself, and gout, and most of the dialogue is along the lines of “eh! oh! eh!”. If you want to learn about gout, probably just read that. But here’s a podcast episode to supplement your learnings.
Excerpt from Dialogue Between Franklin and the Gout
Benjamin Franklin, midnight, 22nd October, 1780
FRANKLIN. Eh! Oh! Eh! What have I done to merit these cruel sufferings?
GOUT. Many things; you have ate and drank too freely, and too much indulged those legs of yours in their indolence.
FRANKLIN. Who is it that accuses me?
GOUT. It is I, even I, the Gout.
FRANKLIN. What! my enemy in person?
GOUT. No, not your enemy.
FRANKLIN. I repeat it; my enemy; for you would not only torment my body to death, but ruin my good name; you reproach me as a glutton and a tippler; now all the world, that knows me, will allow that I am neither the one nor the other.
GOUT. The world may think as it pleases; it is always very complaisant to itself, and sometimes to its friends; but I very well know that the quantity of meat and drink proper for a man who takes a reasonable degree of exercise, would be too much for another, who never takes any.
An awful disease particularly relevant in cold Melbourne. Promising therapies on the horizon though, and I like to think my scamming of the readathon as a 9 year old to get some sweet loot played a part.