Category: Lectures and Presentations

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Found an old lecture

In 2006 I had to give the fellows a lecture on nocturnal dialysis. I remember being delighted with how it turned out. It was a fellow-level lecture that would have little appeal to non-nephrologists. The lecture goes into the different ways to measure dialysis dose and deep-dives into the National Cooperative Dialysis Study and the HEMO trial.

A month or so after giving the lecture I had a hard drive crash. After that, I couldn’t find the lecture.

Well, today I was mucking through an old external hard drive and found the lecture! Yay me! I backed it up!

If you are interested the lecture is now resting safely under the Lectures Tab.

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second lecture of the year: acute kidney injury

This is a significant upgrade from the version I posted a couple of years ago. I put the lecture together right before the ATN trial was published. I finally got around to updating the presentation to include that data. I also updated the NGAL section and added some data on avoiding volume overload.

I used a number of the posts on the blog to allow me to rapidly update the presentation. I was pleased with how well my ATN commentary/review stood up.

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My Grand Rounds

For the last 6 weeks I have been pounding the computer finishing and perfecting my lecture which I gave at Grand Rounds at both Providence Hospital and St John’s Hospital.

I delivered the second one yesterday.

Here is the lecture with an audio track. My presentations are not self-contained most of the important data comes from me presenting. I hope you like it. (.zip file of native Keynote file)

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Fellow talk on sodium

I was scheduled to give a talk on disorders of sodium and water to the fellows yesterday. We have a particularly clever cohort of fellows this year and I really couldn’t give them a warmed over version of my resident and student sodium lecture so I put together this talk which looks five different issues with hyponatremia and some data regarding them:

  1. mannitol induced pseudohyponatremia
  2. TURP syndrome
  3. uremia and propensity for myelinolysis
  4. exercise induced hyponatemia
  5. differentiation of salt delpetion from SIADH with FENa, FEUrea and FE Uric acid with a couple of slides on treating SIADH with saline

Remember, downloading the native Keynote file will give you animations and a better  looking experience.

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I just gave the world’s greatest lecture on diabetic nephroapthy

It was incredible. The residents, who usually sleep through the second half of noon conference, were completely charged up and by the end of the lecture were holding up lighters and chanting my name. I dove from the stage and was passed around like a Rock God.
Here is the lecture in powerpoint format to download. You can also see the Slideshare but they mangle the animations so if you want to really feel the educational frenzy download the .ppt.
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High osmolar gap and a low anion gap.

Our fellowship director asked me to do a lecture on osmolar gap. At first I thought that this was an odd topic as toxic alcohols, the standard reason for determining an osmolar gap are relatively rare findings and I was worried I’d be able to find enough to talk about for an hour.

I’m really happy how the lecture turned out. Not my best but pretty strong for a first crack at a new topic.

I structured the topic by looking at patients with low, normal and high anion gaps to go along with the high osmolar gap and started with a case of a high osmolar gap paired with a negative anion gap. I have only seen one negative anion gap and that was a case of hyperkalemia and hypoalbuminemia. This case comes from the Canadian Medical Association Journal. The low anion gap is from the unmeasured cation, lithium. The patient had a lithium level of 14.5 mmol/L.

Lithium is an unmeasured cation which expands the red box and decreases the anion gap.
The differential for a decreased anion gap.
The osmolar gap is driven up because the cation lithium is not part of the calculated osmolality but contributes to the measured osmolality. A unifying theme of osmolar gap is that adulterants that increase the osmolar gap always have relatively low molecular weights. Lithium carbonate does not disappoint with a molecular weight of only 74. Other intoxicants associated with an increased osmolar gap, likewise have a low molecular weight.
The case report then deals with the dialytic removal of lithium and the nature of lithium toxicity.
Here are the causes of an osmolar gap divided by anion gap:
Here it is:
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My first two lectures to the IM Intern Class of 2012

On July first I gave a lecture on IV fluids, total body water and hyponatremia. This handout is similar to the lecture I give to the medical students titled sodium and water. It adds a half baked section on potassium but this handout really needs to have th sodium section tightened up and shortened, the potassium section finished and short sections on the treatment of phos, magnesium and calcium disorders.

  • Here is the PDF
  • Here is the native Pages documentin case you use Pages and are interested in finishing this work in progress.

On July 9th I gave a lecture on acute renal failure. The handout is 28 5.5 x 8.5 pages. The book is designed as a workshop with questions and points for discussion throughout.

  • Here is the PDF of the 28 page handout. It is very readable and one of the best handouts I have put together.
  • Here is the native Pages document in case you use Pages and are interested in editing my masterpiece.