Journey to DMS | Chapter 5

One week left of our 5-week module in nephrology!

This module has been difficult for many of us. First of all, the cases are much more challenging. In the cardiology module, the cases were structured more like multiple choice questions, and although the cases had more than one part, it was convenient to have options. In nephrology, however, the cases are much more open-ended and multi-faceted. Here’s a simplified example of what a nephrology case might look like:

Collaborative Cases

Your patient has T2DM, HTN, CKD3bA2, and OA of the knees. He takes ibuprofen, lisinopril, atorvastatin, and empaglifozin. He presents to the ED with flank pain and oliguria. His BP is 175/95, Cr is 4, BUN 50, K+ 6, HCO3- 17, etc…

But then instead of being asked to choose A, B, C, or D, we’re asked about the potential diagnosis, the mechanism, diagnostic methods, and treatment.

The second part of the case will usually look something like this:

You treated the patient with X but then Y developed. Explain why and give the next step in his treatment.

We also spent a week on acid-base and electrolyte disorders–it was rough! I work in primary care and I don’t think I’ll ever be in a situation where I’ll have to manage a patient with hyperchloremic acidosis or hypotonic hyponatremia. I have really enjoyed the sections of hypertension, renal stones, and CKD as these are directly pertinent to my practice.

My To-Do List

I’m done with this module’s 75 NEJM nephrology questions but I think I still have 20-30 from MKSAP. Most of these will be completed during week five’s reading on glomerular diseases.

I think I’ve decided on my doctoral project. I had a few leads on conducting some primary research but they both fell through so I’ve decided to do a literature search. I have a topic in mind and I’ve started to collect articles I’d like to cite. We are supposed to use a program for this called Zotero but there is no cloud version–it has to be download to each machine you use. What a pain!

We’ll have our nephrology anatomy and pharmacology quiz next week in addition to the usual quiz on the readings and cases.

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