High Yield IM RENAL Review for Step 2 CK & Shelf Exam

This is meant to be a last minute review of high yield topics for your shelf exam or step 2 ck. Its more helpful if you have already studied the material beforehand for maximum comprehension. All the best in your studies! Check out my other videos for other high yield shelf/step 2 ck reviews

[KAST]

Notes:
0:10 WBC casts in urine: AIN or Pyelo
0:17 Uremia, When dialysis: HUS< EHEC, uremic pericarditis, platelet dysfunction, asterixis
1:46 CKD: HTN and DM
1:58 Dialysis indications: Acidosis (refractory), Electrolytes (K!), Ingestions (methanol, aspirin, lithium, ethylene glycol), Overload (from CKD), Uremia
2:33 AIN: Allergic rxn to drugs (NSAIDs, Diuretics, Abx)- Fever, Eosinophilia, Azotemia, Rash, hematuria, WBC casts
3:22 ATN: Hypoxia or toxins (shock> pre-renal azotemia (BUN/Cr>20)) ->muddy brown casts tx: IVF
4:16 RTAs: Non-gap (NAGMA)> diarrhea and RTAs (vs HAGMA->MUD PILES)
5:23 RTA Type I- under excreted H+, kidney stONEs
5:57 RTA Type II- BIcarb not absorbed
6:11 RTA Type IV- HYPO ALDOstreone- Hyponatremia, hyperkalemia, aldosterone causes excretion of H+!
7:22 Metabolic alkalosis >check urine Cl (high? kidney problem, can't reabsorb, low? kidneys are concentrating but you are losing volume, ex. vomiting, give fluids)
7:55 Steatorrhea-> binds Ca in terminal ileum (saponification), oxalate left over, oxalate stones! in kidneys. (better to eat more Ca to have it in terminal ileum)- kidney stones? Diet: low salt, low fat, high Ca, lots of water
9:53 Cancers- Pt1: elderly male w smoking Hx, gross painless hematuria- renal cell Ca or bladder ca
10:03 Renal cell Ca- flank pain, abd mass, get CT abd, tx: nephrectomy
10:25 bladder ca (transitional cell ca due to carcinogens in cigarettes)- cystoscopy
11:01 pt2: young male with irregulaly shaped painless mass in testicle->dx: scrotal US-> may be testicular Ca, if suspicius, DO NOT BIOPSY (may seed!), tx: inguinal orchiectomy (the biopsy after removed)
11:33 Testicular pain (torsion vs. epididymitis) torsion: acute onset, cord not tender, no cremasteric reflex, worse with scrotal elevation-> dx: if unclear get doppler US (decreased blood flow), if very clear>tx: surgery (bilateral orchiopexy); epididymitis: tender cord, better when elevating scrotum, may have fever
13:54- epididymitis vs orchiitis vs prostatitis- young pt: gono/chlamydia (Ceftriaxone and Azithro) ; old pt: e.coli (fluoroquinolone)

[Sachianna-pmdf]

Renal tubular acidosis explanations are short and sweet! Thank you for simplifying it!

[Tasniaaaaaaaa]

How did I just learn more renal physiology in 15 minutes than I did in weeks worth of renal uworld problems 🙃 you're a lifesaver Dr. High Yield 🥰

[aryazand]

You're explanation for RTAs and calcium oxalate stones are gold! These videos have been key part of my step 2 studying. Thanks!!

[digitiminimi]

Thank you so much man, u're awesome!!!!
Here's a mnemonic that I use for rta:
2, 1, 4
Low, low, more (for k+ level)
No, yes, no (for renal stones which means the Ca level is also only high in rta1)
Also ph level is only different in the middle one too (rta1) which is >5.5
In general the different one is rta1 other than K+ level

[suomynonaanonymous]

Omg thank you no one ever explained the calcium oxalate stone mechanism. I never understood why just memorized it thank you !

[swativanaparthy]

I was waiting for a renal video from you before my step 2ck..finished it two weeks back! thanks a bunch for ur videos..gonna keep reviewing them for my step 3 too 🙌🏼

[MFDElk]

Thank you for your videos which I listen to while jogging.

[salahm]

It is a good description for indications of hemodialysis.

[dfmahghd]

Why in type 4 RTA the urine PH is low <5.5 despite Hydrogen iones retention?

[riaghosh]

Thanks for uploading! All your videos are great! Can you please upload one for Haem/Onc too?

[suomynonaanonymous]

Please tell us what specialty you went into