I posted this tweetorial to Twitter last month and I want to bookmark it here.
The social media and medical education talk at Vanderbilt
Earlier this year I got the opportunity to speak at Brigham and Women’s Nephrology division. I had spent a lot of time and thought in updating my Social Media and Medical Education talk. For the first time I added Podcasts and Tweetorials, two of the most exciting developments in social media medical education.
Then on the day of my presentation I had “technical problems” connecting my MacBook Air to BWH’s projector (what is this 2003?). So I logged into iCloud and ran an older version of the presentation from iCloud using the online version of Keynote on the PC connected to the projector. The idea that I can run my presentation, with fonts, images, animations on a browser version of Keynote on a PC is truly amazing. Hats off to the Apple engineers.
But that meant the newest version of the talk was still “unpublished.” So I was delighted to get a generous invitation from Vanderbilt to speak at medicine grand rounds.
So this past Thursday I traveled to Nashville and I was able to present this presentation. And now that it is “published”, I am offering the presentation for you to present, edit and repurpose in any way you desire (no permission required, go at it):
- Keynote (this is the native format) (1.16 gb)
- Powerpoint (this is an exported version of the native Keynote, so it has questionable fidelity) (744.7 mb)
- PDF (317 mb)
And what an amazing nephrology department. Holy moly what a deep bench. Loved getting a chance to talk with Ray Harris, Anna Burgner, Tom Golper, Jay Bhave, Kerri Cavanaugh, Alp Ikizler, Julie Lewis, Be a Concepcion, Davika Nair, Leslie Gewin. and Edward Gould.
If you are applying to nephrology fellowship and don’t have Vanderbilt on your list, you are doing it wrong.
#NKFClinicals: The Social Media Session
Matt and I had the honor of putting together a session on social media for the NKF. We did not want to do intro to social media. The beginning of social media in medicine is over. We are in the beginning of the middle, and we wanted to deeper look than intro lectures can provide.
We had three talks.
- Teresa Chan spoke about the future of medical education online. Amazing Powerpoint | PDF
- Macey Henderson spoke about using social media in transplant, specifically about finding living donors. PowerPoint | PDF
KIDNEYcon 2019 was awesome
KIDNEYcon is the answer to my post about how ASN’s Kidney Week is facing an existential crisis. John Arthur, Shree Sharma, and Matt Sparks have put together a brilliant two-day conference that offers hands-on work shops, an inspirational keynote, trainee Jeopardy, and state of the art clinical lectures.
The night before the conference a bunch of people met for bowling. Very fun. One of many events organized by Samira Farouk.
You can see the entire schedule here.
This was my third year participating in KIDNEYcon and this year I was invited to re-run the acid-base, fluid, and electrolyte workshop from last year. This year I teamed up with Roger Rodby of Rush (do more people anyone identify Rodby with Rush or ASN Communities, Twitter, ASN Board Review Course, or #NephMadness Blue Ribbon Panel?).
The workshop started with my favorite electrolyte gimmick, the IV fluid tasting party.
University of Arkansas provided 0.9% NS, 3% saline, lactated ringers, and D5W for our gustatory enjoyment. I then presented three cases:
- A case of toluene toxicity and how it looks like a distal RTA (non-anion gap metabolic acidosis), smells like a distal RTA (hypokalemia), and quacks like a distal RTA (positive urinary anion gap), but it’s not a distal RTA (lots of urinary ammonium).
Then I went over a case of hypernatremia and drilled down on how to calculate a water prescription that will actually correct hypernatremia.
And then a case of hypotonic hyperosmolar hyponatremia.
My slides, including a case of hyperkalemia that we didn’t use, are here:
Keynote | Powerpoint | PDF
(I include the Powerpoint for the unenlightened who still use that ancient technology. I do not check if the transitions, animations or images look decent. Use at your own risk)
Then Roger took over and went through a case of MDMA induced hyponatremia.
Then he went through a case of cerebral injury and polyuria. No, it was not a case of cerebral salt wasting. He then presented a really practical case of hyponatremia. Too many electrolyte problems are made up and you can feel the fiction when you hear them. This case of hyponatremia had integrity. Loved it.
Which was a great entry for Ure-Na tasting.
This led to a totally off label discussion of buying food-grade urea from Amazon and making home UreNa. This is not standard of care. Your mileage may vary. Talk to your lawyer before proceeding.
Roger concluded with a great discussion of DKA in an anuric dialysis patient.
After that I finished the workshop by presenting an unknown case of hypokalemia. And then then we tried to simulate those findings by drinking a sample of sodium zirconium cyclosilicate, Lokelma.
After lunch (dosed with extra mentoring, again thanks to Samira Farouk), Roger and I ran it all again.
That night was a dinner. There was an entertaining game of Jeopardy for the trainees. Jeopardy was put together by Samira Farouk (who, if you haven’t noticed is building a compelling case for NephJC Kidney MVP). Steven Coca found a mistake in the otherwise brilliant Jeopardy board.
Then Michelle Rheault gave an inspiring keynote speech about her journey through academic medicine. It was really good.
Saturday was a day of didactic sessions. The best way to catch up on all the tweets is to take a look at the amazing live tweeting by Brent Wagner…
It started with a review of social media and medicine by Sayna Norouzi and Sri Lekha. It was a breakfast session so it was called Hashtags and Hash-browns. Unfortunately no hash-browns were available.
This was followed by a session on hypertension put together by Swapnil which was amazing. Four lectures:
- Office, Automated, Home, or Ambulatory? Which One and Why? by Mathew Luther
- BP Variability: What is It and Why Should We Care? by Jordana Cohen
- Drugs and Devices That Lower BP: A 2019 Update by Steven Coca
- Debate: BP in CKD: How Low Should We Go? Tara Chang and Scott Brimble
The debate might have been the best medical debate I have ever seen. Dr. Chang’s slides were gorgeous and Scott did a beautiful, funny and humble job poking holes in the generalizability of SPRINT.
It was followed by a session on AKI
- Urine Sediment Microscopy to Diagnose and Phenotype AKI: Should We Bother? by Juan Carlos Velez
- TIMP2/IGFBP7 as a Predictor of AKI Outcomes: Are We There Yet? by Nithin Karakala
- Genomic Predictors in AKI by Kevin Rogers
- Using Proteomics to Identify AKI Biomarkers by John Arthur
After lunch there was a session on pediatrics
- C3GN: Pathogenesis and Treatment by Carla Nester
- Pediatric Kidney Stone Disease, Including Genetic Forms by David Sas
- Kidney Development and APOL1 by Kimberly Reidy
- Non-Adherence in Pediatric Kidney Transplant-Practical Strategies for the Pediatric and Adult Nephrologist by Vikas Dharnidharka
The last session of the weekend was on clinical research.
- Fellow Case Report on euglycemic DKA from an SGLT2i
- A Telehealth Study to Improve Outcomes in Patients with CKD by Manisha Singh
- Perplexed About Pragmatic Trials? The Ins and Outs of Different Trial Designs in Clinical Research by Swapnil Hiremath (who has generously made his presentation available)
- SGLT2 Inhibitors: Discovering Their Role in Slowing Progression of Diabetic Nephropathy by myself
- Tolvaptan for ADPKD: From Mechanisms to Treatment by Frederic Rahbari Oskoul
Here is the presentation I gave:
Keynote | Powerpoint | PDF
(I include the powerpoint for the unenlightened who still use that ancient technology. I do not check if the transitions, animations or images look decent. Use at your own risk)
After the lecture the conference moved to John Arthur’s house for a party with delicious hand crafted martinis and gourmet meatballs.
KIDNEYcon is a special conference. It is a great place for trainees. The workshops allow hand-on experiential learning that you can’t get from YouTube. It gives people the opportunity to really drill down and develop biopsy skills, pathology skills, early career development. In the past they have done point of care ultrasound and cooking classes. It is amazing. If you haven’t been it’s time to make a trip to Little Rock.
Here is a sharp top ten list from KIDNEYcon
My thoughts on 2019 #NephMadness
In a series of tweets.
Start here
Metabolic alkalosis and hypokalemia go together like Phineas and Ferb
This is one of my favorite lectures. It starts with Izzy getting fired on Grey’s Anatomy to the metabolic consequences of crack cocaine in dialysis patients to the imaginary monogenic diseases of Ethan Hawke and Denzel Washington. Metabolic alkalosis is a topic that is rarely taught at all. This lecture goes deep tying metabolic alkalosis to potassium handling (as does the kidney). The lecture covers a lot of useful kidney physiology. In addition to metabolic alkalosis it covers some of the salt wasting nephropathies and monogenic causes of hypertension.
PRECISION Trial in 2 minutes
Short video I did for the #NephMadness Pain Region.
Robot price war hits the Fluid and Electrolyte Companion
I remember this story entertaining story from 2011 (or maybe it was is a more recent version of the same events, it’s hard for me to believe I remember anything from 2011):
(CNN) -- Lots of normal people would pay $23 for a book.
But $23.7 million (plus $3.99 shipping) for a scientific book about flies!?
This unthinkable sticker price for "The Making of a Fly" on Amazon.com was spotted on April 18 by Michael Eisen, an evolutionary biologist and blogger.
The market-blind book listing was not the result of uncontrollable demand for Peter Lawrence's "classic work in developmental biology," Eisen writes.
Instead, it appears it was sparked by a robot price war.
Well, take a look at the listing of The Fluid and Electrolyte Companion at Amazon.com today:
Come and step right up and purchase your very own copy of the Fluid and Electrolyte Companion! A bargain at $1,227.31. Don’t cheap out and but a used copy at only $834.75, go all the way and get a new one. Don’t delay there is only one left!
Or you could just download the PDF for free. Your choice.
This means we’re going to need to do another printing. Doesn’t it?
Lecture on hyperosmolar hypotonic hyponatremia
This is a formal lecture on the Tweetorial I posted about a patient with beer drinkers potomania but presented with increased serum osmolality due to ethanol intoxication.
Keynote • PowerPoint • PDF
Note: The presentations are designed to be displayed in KeyNote, the powerpoint version may be weird, especially the animations, and some of the icons maybe jaggy.
Following the lecture Scott and I recorded an episode of the EMCrit podcast, episode number 242! Scott Weingart is a medical education revolutionary. If you are interested in learning about him check out this episode of Explore the Space.