Terminology
What is hypertension?
High blood pressure
What is patient autonomy?
Patient has the right of a person to make independent decisions about their own medical care
What does SOAP stand for?
Subjective, Objective, Assessment, and Plan
A patient with a recent antibiotic prescription develops a fever and a rash. Urine is positive for eosinophils. What is the diagnosis?
Acute Interstitial Nephritis (AIN)
What is the management for nephrotoxic ATN?
stop the medication + IV fluids
What is polyuria?
Excessive urination (producing an abnormally high volume of urine)
What is implicit bias?
Unconscious “shortcuts” our brains take to make quick judgements based on stereotypes or assumptions
What does OLDCARTS stand for?
Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity
A patient with a history of recurrent urinary tract infections presents with chronic flank pain, hypertension. The imaging shows scarred and shrunken kidneys. What is the diagnosis?
Chronic Pyelonephritis
What is the management for AIN?
Stop the medication + steroid (prednisone)
What is hematuria?
Blood in urine
What is the difference between professional refusal and patient abandonment?
Professional Refusal: a planned, ethical step where a provider steps away from a specific task while ensuring a hand-off
Patient Abandonment: one-way termination of the physician-patient relationship without notice, continuity, or consideration for patient harm
What tools do you need for the heart examination?
Stethoscope, hands, and eyes.
A young toddler is brought in by his parents who noticed a smooth abdominal mass while they were giving him a bath. On physical exam, you notice that the mass does not cross the midline. What is the diagnosis?
Nephroblastoma (Wilms Tumor)
What is the management for renal cell carcinoma?
Partial or radical nephrectomy
What is the difference between an acute condition and a chronic condition?
Acute conditions start fast and last a short time. Chronic conditions start slow and last a long time (months-years).
What is the the hierarchy of peer intervention when you notice that a co-worker needs help?
1. Talk to coworker first (privately)
2. Reach out to a supervisor or trusted mentor for help
3. Physician Health Program (PHP)
4. The Medical Board (last resort)
What is the standard step-by-step sequence doctors use to examine a body system (such as heart and lungs)?
IPAA
A 58-year-old patient comes in with intermittent gross hematuria and persistent right flank pain for several months, along with an unintentional weight loss of 15 pounds and fatigue. Abdominal CT shows a 5-cm solid enhancing mass in the right kidney with no distant metastasis. Which is the most likely diagnosis?
Renal Cell Carcinoma (RCC)
What is the management for minimal change disease?
Steroid (prednisone)
Nephrotic syndrome is a group of symptoms that happen when the kidney's filters are badly damaged. What are those three symptoms?
1. High protein in urine (proteinuria)
2. Low protein in blood
3. Swelling / edema
What is the meaning of each of the following ethical frameworks: Utilitarianism, Egalitarianism, and Prioritarianism?
Utilitarianism: “The greatest good for the greatest number”
Egalitarianism: Believe that all human lives have equal value
Prioritarianism: Argues that we need to prioritize the most disadvantaged or those who have had the least opportunity to live through the stages of life
Abdomen is the exception to the standard physical exam sequence. What is the order for the abdominal exam and why is it the exception?
Inspection, Auscultation, Percussion, and Palpation (IAPP)
Touching or tapping the abdomen can stimulate bowel motility and artificially alter natural bowel sounds
A 4-year-old child presents with sudden swelling, heavy protein in the urine, and low blood protein, but normal blood pressure and normal kidney function. There is also unremarkable light microscopy on renal biopsy. What is the diagnosis?
Minimal Change Disease (MCD)
What is the management for ADPKD?
Tolvaptan