Next Step: Make Cards on the Automatic Key Concepts, and Vignettes
Remember, the more you automatically know what each sentence means on your test, the better you will do. There are 4 stages in making interpretation more automatic:
- Stage 1: Unable to Make Pathophysiologic Chronologies in Either Timed or Untimed setting
- Stage 2: Basic Pathophysiologic Chronologies, but with Significant Gaps
- Stage 3: Detailed Pathophysiologic Chronology Without Time, but Unable to Consistently Generate PC During Timed Setting
- Stage 4: Consistent Pathophysiologic Chronologies in Timed Setting
My goal with these vignettes is to help you reach Stage 4. How do you do so?
- With the Automatic Key Concept cards, you can master the underlying information to move past Stages 1 + 2.
- Then, with the Vignette/Pathophysiologic Chronology cards, you can teach yourself to make these connections on your exam.
Summary of key concepts:
Automatic Key Concepts:
Copy + paste these into your cards, to make these key concepts more automatic.
“Pre-renal” kidney injury – what is the mechanism? How could this lead to kidney failure?
Less blood getting to the kidneys to be filtered
“Intra-renal” kidney injury – what is the mechanism? How could this lead to kidney failure?
Problems with the filtration mechanism itself
“Post-renal” kidney injury – what is the mechanism? How could this lead to kidney failure?
Problems with back-up of urine → high Bowman’s space pressure
Pre-renal AKI – use the mechanism to explain what the creatinine levels would be
Kidney failure is defined as decreased GFR below a certain threshold. Recall: creatinine is constantly made as a breakdown product of muscle creatine.
Pre-renal AKI: blood (which contains creatinine) is shunted away from kidneys to vital organs like the brain/heart.
When substances like creatinine can’t be filtered → accumulate in blood → serum creatinine ↑
Intra-renal AKI – how is it related to pre-renal AKI? Why?
Often occurs in prolonged pre-renal AKI. Renal blood flow ↓ → ischemia to proximal tubular cells → sloughing into lumen of proximal tubule → blocking of proximal tubule
Intra-renal AKI – use the mechanism to explain what the creatinine levels would be
Kidney failure is defined as decreased GFR below a certain threshold. Recall: creatinine is constantly made as a breakdown product of muscle creatine.
Intra-renal AKI: there is a problem with filtration originating within the kidneys, often because of blockage of the proximal tubule.
When substances like creatinine can’t be filtered → accumulate in blood → serum creatinine ↑
Post-renal AKI – use the mechanism to explain what the creatinine levels would be
Post-renal AKI: there is a problem with filtration because of a blockage after the kidneys (e.g., ureters).
When substances like creatinine can’t be filtered → accumulate in blood → serum creatinine ↑