Vanderbilt Internal Medicine Residency Podcast · Jared Freitas and Terra Swanson

S7: E1 Hemoptysis Morning Report

·41 min·2 clips

Triple-positive antiphospholipid syndrome explains the hemoptysis, aortic valve disease, and the patient’s persistent labs.

The podcast opens with the hosts saying the show is back after a few years away. Braden Vogt, David Ray, and Michael Kaminski are the new second-year resident hosts at Vanderbilt University Medical Center, and they keep things easy from the start. Braden talks about growing up in Portland, Oregon, doing his undergraduate work at Oregon State, training at Brown for medical school, and settling into Nashville, then moves into a pretty serious ranking of local hot chicken. David answers with his own Tennessee background, and the food talk helps keep the room relaxed before the medicine takes over. The case discussion then settles into a classic morning-report rhythm. The team works through a patient history that is unusually detailed and carefully structured. The patient is 24 years old. She lives with her parents in a rural town in northern Tennessee. She has two pets at home, a dog and a cat, and neither has been vaccinated or seen a vet in years. She works in a medical facility in a role the speaker describes as nursing-aide-like, and she has been around many sick people. She has not traveled outside Tennessee recently, has never left the United States, and has never been to the American Southwest. Her life otherwise sounds quiet and home-centered. She does not hike, fish, swim, or spend much time outdoors. She reports no meaningful contact with wild animals, farm animals, reptiles, amphibians, aquariums, bugs, or ticks. She denies alcohol, tobacco, IV drug use, illicit drugs, incarceration, or broad exposure to homelessness. The sexual history is brief but specific, with a boyfriend of a few years and mostly barrier contraception. The hosts pause on what stands out and use those details to guide the differential. The close of the discussion broadens the clinical lens beyond the most obvious infectious explanations. They point out how endocarditis thinking can extend to non-bacterial thrombotic causes, including APLS and tumors, and how non-tuberculous mycobacteria depend on the right host and the right pulmonary pattern.

As heard by us

A resident-led case that makes exposure history feel decisive.

This revived Vanderbilt Internal Medicine podcast follows a resident-led case with a clear point: a careful exposure history can narrow the field before any test result lands.

Read the full review in PlayNext →

Why you'd press play

A revived Vanderbilt Internal Medicine Podcast episode that turns a careful exposure history into the differential.

Read the full recommendation in PlayNext →

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