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Core IM | Internal Medicine Podcast

#197 Hypercoagulability Part 2: 5 Pearls Segment

Core IM | Internal Medicine Podcast

Core IM Team

Education, Medicine, Health & Fitness, Mental Health

4.81.2K Ratings

🗓️ 7 January 2026

⏱️ 40 minutes

🧾️ Download transcript

Summary

Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?

When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.


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🔹 Transcript & Shownotes

(2:56) - (13:15) | PEARL 1: Managing clots in the “unprovoked”/provoked-irreversible patient

(13:21) - (18:10) | PEARL 2: Managing provoked, “reversible” clots

(18:14) - (25:14) | PEARL 3: DOAC failure: time to step it up?

(25:20) - (37:25) | PEARL 4: APLAS: the exception to everything


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



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Transcript

Click on a timestamp to play from that location

0:00.0

Physicians, let's talk about your strategy for those DEA mate requirements. Every prescriber needs to

0:06.2

complete eight hours of training on pain management and substance use disorders. Here's the good news.

0:11.5

N.EGM Group has a free online course pain management and opioids adaptive learning. It not only

0:17.0

checks the DAA box, but also gives you 10.25 CME credits and ABIM MOC points. The format is

0:23.9

case-based, adaptive, so it feels like you're working through real patient scenarios, not just

0:28.1

cleaning through slides. And you can stop, pick it up at any time on your own schedule. So instead of

0:33.4

scrambling, get it done with something engaging designed by the the N.A.M. group and with the same

0:38.1

rigor, you trust your clinical updates. It's free online certificate ready. We'll link it in the show

0:43.2

notes. It's CME-info.com.org slash core I am. And with that, let's get back to the episode.

0:51.0

Welcome to the Core I.m 5 Pearls podcast, bringing you high-yield, evidence-based

0:55.1

pearls. I'm Dr. Marty Fried, a general internist and addiction doc at the Ohio State University,

1:00.3

Wexner Medical Center. Today, we're back with hyperquaggability, part two, the clot thickens.

1:06.7

That's right. We're back, with even more clot-related nuance and questionable puns.

1:11.7

Hey.

1:13.1

I'm Sam, a he-munk and palliative fellow at the Beth Israel Deaconess Medical Center in Boston Math.

1:18.7

In our last episode, we focused on hypercoagulability testing.

1:22.6

Or rather, lots of reasons not to test, along with a few reasons to maybe test.

1:27.2

But this time, we're going to get our hands dirty.

1:29.9

We're focusing on management today, and we're not alone.

1:32.9

And just like last episode, we're joined by Dr. Rebecca Carp Leaf and Dr. Jean Connors,

1:37.1

who hail from some incredible institutions around Boston.

1:40.7

So hi, everybody.

...

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