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Chronic Renal Disease

Progressive nephron destruction over time leads to progressive loss of renal function 

chronic renal failure is not reversible due to nephron destruction 

if all nephrons have been irreversibly damaged - known as “end stage kidney”

uraemia, polyuria, biochemical change

however less metabolic disturbance than with acute TRF (total renal failure)

Potential causes:

vascular disease 

glomerulonephritis 

diabetes 

Response of Glomeruli to damage

Endothelial cell proliferation: 

occlusion of capillary; reducing flow through glomeruli - correlates with oliguria and uraemia 

Mesangial cell proliferation: 

associated with increased matrix production

 over many years leads to sclerosis and loss of capillary lumen 

Basement membrane thickening: 

e.g. may be due to immune complexes or amyloid 

(the above are an attempt of regeneration in response to inflammation)

Capillary wall necrosis: 

usually fibrinoid; e.g. necrotising vasculitis, malignant hypertension 

 Crescent formation: 

epithelial cell proliferation; reaction to glomerular capillary damage 

severe glomerular damage only - large numbers = poor prognosis

characterises rapidly progressive disease 

serum proteins and fibrin in Bowman’s capsule cause overgrowth of the epithelial lining 

as crescent enlarges - compresses the glomerular tuft - which shrivels and becomes non-functional

once crescents are established disease type can only be determined by examining unaffected glomeruli

Next up: nephortic and nephritic syndrome

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The sun will rise and we will try again. 2/100

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100 days productivity starts now!

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262/365. -3 day of the 100days of productivity

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Trying to study during a flare

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Saturday

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Doctors Who Are Moms Say They Face Discrimination At Work

“If you become chief resident are you just going to get pregnant and have a baby?” asked the silver-haired male attending physician as I sat interviewing for the prestigious academic position of chief internal medicine resident. “That’s what all the female chiefs do, and I’m tired of it,” he added, shaking his head in clear disgust.

Gobsmacked by the blatant sexism of his interview technique, I laughed nervously and made some lame joke about working so much that I barely had time to see my husband, let alone make babies with him. Feeling absolutely professionally alone, with no good means of reporting the incident, I quietly pulled my application and plowed on through residency and life, eventually giving birth to a son at the very end of my training.

My experience is hardly unique: 4 out of 5 physician mothers say they experience workplace discrimination, according the results of a study published last week in JAMA Internal Medicine.

Continue reading

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Medblr

Please reblog this if you’re still an active Medblr! I’d like to follow more of you, and I feel like a lot of the big medblrs aren’t very active anymore. And say what year in med school you are and maybe country? I know some people prefer to stay mostly anonymous.

NEW FRIENDS!

PS- if I follow you it’ll show up as a-lovely-contradiction bc that’s my main blog

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Dr. Trousseau was the first to describe the association between pancreatic adenocarcinoma and hypercoagulability, venous thrombosis, and migratory thrombophlebitis. He actually later diagnosed Trousseau syndrome in himself.

Dr. Mike McInnis, DIT

Dr. Armand Trousseau (1801-1867) was a French internist who made many contributions to medicine, not in the least his two eponymous signs. I can’t imagine what it would have been like to discover the signs of a malignancy, and then later see them in yourself. He died from his cancer at age 65. 

(via murphysmedical)

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Think. Plan. Execute.  I saw this on reddit and felt so inspired.

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2017: Week 12 | Mar. 19 - Mar. 25

“Those who don’t know how to make love make war.” -The Patience Stone

I’ve been experiencing spontaneous surges of color lately - they come over me in dreams, meditation, or during the transient moments I rest my eyes. In fact, many of my dreams have been purely colorful rather than conceptual; it’s been interesting. Anyway, I tend to feel stuck on these “color visions” until I paint with them, which has inspired me to work with some pretty funky color schemes that I wouldn’t normally feel inclined to use. This one was more or less premeditated, but evolved intuitively. I knew I wanted to include a tribute to Aries season, but I wasn’t feeling the fiery shades typically associated with the fire signs, and so I ended up with this rich burgundy color. Then, somehow, the golden rod transpired; it seemed like a strange addition, but I couldn’t resist including it. These definitely aren’t colors I would think to pair, but it all came together pretty well in my opinion. 

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Pulmology, TBC.

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Pulmology, TBC.

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Ambition is the path to success. Persistence is the vehicle you arrive in.

(via study-aid)

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I never cut class. I loved getting A’s, I liked being smart. I liked being on time. I thought being smart is cooler than anything in the world.

Michelle Obama (via mineoflove)