Archive for the Renal Category

Book/blog Review – Fluid, electrolyte and acid-base companion/PB

Posted in Blog Reviews, Book / Article Reviews, Free Free Free, Renal with tags , on April 30, 2010 by The Beaver Medic

The fluid, electrolyte and acid-base companion was written by Sarah Faubel, MD and Joel Topf, MD. Joel writes the very well-produced nephrology blog PB (Precious body) Fluids. More on that later.

The book’s 591 pages describe bodily homeostasis in regards to fluid and electrolyte balance as well as the various pathologies that can arise from imbalances. Included are both theoretical explanations of the anatomy and physiology underlying these concepts as well as clinical assessment and treatment information. What I like most about this book is the organizational approach the authors took, similar to Dale Dubin’s Rapid Interpretation of EKGs. Most pages have a large, very well illustrated, image at the top. After some easy to navigate theory there are short questions at the bottom. For a learner with a poor (I mean really poor) background in chemistry and biology I digested each section very quickly.

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Pathology of the Week – Rhabdomyolysis

Posted in Pathology of the Week, Renal, Technical Rescue with tags , , , on April 22, 2010 by The Beaver Medic

Medicalese: rhabdos – rod shaped; myo – related to muscle cells; lysis – break down of cells (greek for to separate). Short forms: rhabdo.

Rhabdomyolysis occurs when certain types of muscle cells (striated ones) break down allowing their contents to spill out into the bloodstream (the extracellular space). One of the contents of the cell is myoglobin which can damage a sensitive part of the kidneys called the tubules. The blood can handle some myoglobin floating around because it binds it to proteins which are too large to fit through the porous membranes of the glomeruli. When too much myoglobin is floating around in blood plasma not all of it becomes bound to protein and some passes into the sensitive renal tubules. A part of the myoglobin, heme, accumulates in the tubules and creates casts that cause tubule death and resultant acute renal failure. I will reference nephrologist Dr. Joel Topf’s 2009 case study as well as this 2000 Van Holder et al review (free public access). See also this physical therapist oriented video.

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The Kidneys

Posted in Renal with tags , , , , , , on January 19, 2010 by The Beaver Medic

Peeeeeeeee. We all do it. What happens when we do not? Bad things. Very bad things actually. I was astounded to learn the importance of a seemingly tertiary bodily activity. And so I present a quick look at renal function.

As Jeffrey Guy, MD put it, “Our bodies are basically large bags of saltwater”. An adult man, weighing 80 kg, has approximately 48 kg of H2O within his body (ref: IV Therapy Podcast). The human body has two kidneys which produce urine for various homeostatic purposes. These include regulating the amount of saltwater within the body as well as the components of the saltwater.

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