My two favorite slides were the slides that asked the residents to name the most likely diagnosis for a scenario with hyponatremia and various clinical settings:
Can you name all of them? I'll post my answers in the comments.
|After next Tuesday, all that will be left|
will be to send out the prizes.
For one, the start-treatment threshold of >150/90 mm Hg applies to patients 80 years or older in the ASH/ISH guidelines, as opposed to 60 years or older in JNC 8.AHA/ACC/CDC joins JN8 in not calling for stricter, lower, blood pressure targets in the presence of CKD, diabetes, or proteinuria.
Serum anion gap - out. MUD PILES. if god forbid anyone actually diagnose anything that causes ARF. #Employment #NephMadnessThe serum anion gap was an entry on the electrolyte region of NephMadness. It won it's opening round over urine anion gap and advanced to the Sweet 16 by beating hypertonic saline but failed to win the electrolyte region when it fell to Bicarbonate in CKD.
— Michael Katz (@MGKatz036) March 31, 2014
@kidney_boy Ah yes, correcting the gap for low albumin. #ubergeek
— rob rogers (@EM_Educator) April 1, 2014
@EM_Educator the way to turn the anion gap from an abysmal test for lactic acidosis to merely a bad test for lactic acidosisThe meat of the article is contained in table 3 where the authors review 5 studies that looked at the sensitivity of an increased anion gap for lactic acidosis. It's not a pretty picture.
— Joel Topf (@kidney_boy) April 1, 2014
|Both James and Jean Luc start with normal anion gaps, though James is at the upper limit and Jean Luc is at the lower limit of normal.|
|Both patients develop equivalent and significant lactic acidosis but only James develops an anion gap|
As you can imagine, this created QUITE a stir, as medical students around the country have been waiting, stressed out of their minds, about where they will be assigned to go to residency for the next 4-7 years. A flurry of online activity ensued, as medical students already pushed to the brink took to their browser’s source codes to figure out their futures. Apparently the programmers “preloaded” the match homepage source code with the information of where people match, so that once the magic time hits on Friday, they can easily change everyone’s NRMP homepages to reveal the new result. What they didn’t realize? That there are medical students out there who are combing every detail of the site to figure out anything they can ahead of time. Several took it upon themselves to poll all of their friends to assess the accuracy of this method.So today's match day will have a little less drama, for every fourth year who was not obsessing over the match results.
Intermittent HD superior to CVVHD in removing methanol and formate in methanol poisoning. http://t.co/8sHi23RnLu cc: @kidney_boy
— Bryan D. Hayes (@PharmERToxGuy) March 17, 2014
|See if you can get a few more authors next time.|
|15 years old and this page still stands-up. Some stuff never changes.|
Page 358 of the Fluids Book.
|Canadian Family Physician|
Sitting on the flight deck of #NephMadness One. Note the glom pic the wife got me for Valentines day! pic.twitter.com/iMLgTlidQRI posted on World Kidney Day at Medium but I failed to link to on PBFuids. Sorry.
— Joel Topf (@kidney_boy) March 12, 2014
|My very optimistic post for WKD|
Dear Dr Topf,
I congratulate you on assembling and sharing this very nice presentation and, wisely, connecting it to the problems associated with politicians, supplements and DSHEA. We have written some articles about this connection as well.
I give a similar lecture to medical students and another focussed on BEN [ed: Balkan Endemic nephropathy] and aristolochic acid nephropathy for Medical and Nephrology Grand Rounds as most of the research being done on that subject since 2005 has been done in our lab.
A few comments on the historical sequence:
We continue to work on this fascinating nephrotoxin/carcinogen for which, as you see has a "signature mutation" and is likely to affect tens of millions of people in China. And the road to its recognition started exactly as you said in your talk, with the two
- JP Cosyns is the Belgian pathologist who first recognized the similarity to BEN but did not follow up the lead
- Tjassa Hranjec, a medical student at Stony Brook, doing a summer fellowship conducted the personal interview with the farmer you attributed to me. She
- was doing a pilot epi study, under my direction, to determine how we should investigate BEN
- The first experimental evidence for the role of AA in AAN and UTUC appears in our 2007 PNAS paper
- The Serbs and the Bosnians still believed that their BEN was a different disease, so we expanded the number of cases and included those countries in the cover story paper in KI in 2012. DeBroe wrote a commentary to accompany our paper which convinced any remaining skeptics of the validity of our guiding hypothesis: AAN = CHN = BEN
- Wondering how Aristolochia herbs could have been used throughout the world for 2000 years without one mention of toxicity or urothelial cancer, we conducted the study in Taiwan, where one in three people have ingested the Aristolochia herb according to the prescription database. The results are in our 2012 PNAS paper.
Belgian women in Vanderwegen's clinic. He told me that his own clue came when he walked from his office to the clinic and found a number of women talking to each other which was unusual. He asked them how they knew each other which led immediately to the identification of the spa.
With best regards
Arthur P. Grollman M.D.
Distinguished Professor of Pharmacological Sciences
Evelyn Glick Professor of Experimental Medicine
Director: Laboratory of Chemical Biology
Health Sciences Center BST-8-160
Stony Brook University
|Gorgeous picture of DNA Adducts|