Y2 S1 Week 1: Kicking off Renal, Pool Noodles, and Lake Tahoe!
Just like that we are up and rolling again and the first week of year 2 has come to an end! This week we started our renal block which is a short, 4-week block that will cover everything anyone could ever want to learn about the kidneys and urinary tract.
Monday started off with a few lectures on renal anatomy and physiology followed by a few lectures on body fluid distribution and tonicity. These lectures were a nice way to ease into the block while remembering how amazing our kidneys are! Did you know that these little things are only about the size of your fist, yet they filter 150-200 liters of blood per day producing 1-2 liters of urine? Talk about powerhouse! The lectures also brought in some clinical relevance related to fluid therapy which was interesting. After those lectures concluded, I spent some time with Churro and then worked through some fluid distribution case studies. These cases helped solidify the concepts related to intracellular and extracellular fluid distribution and how losing or administering fluids with different osmolalities would affect overall fluid distribution.
In case you weren’t already blown away by the amazing efficiency of the kidneys, here is another fun piece of information that will make you look like a brainiac (or weirdo) at your next dinner party. After eating asparagus urine often has a fetid smell. This is because asparagusic acid is broken down into sulfur-containing small molecules (Me2SO4, Me2S2, Me2SO) that are volatile. They have a low enough boiling point that they are vaporized and enter a gaseous state at room temperature. There is also an ongoing debate as to whether there are differences in production or perception of these vaporized molecules so think about that the next time you chow down on some asparagus.
After a nice run with Churro and some field time with his old friends, Tuesday started off with a lecture on the glomerulus. The glomerulus is basically a cluster of capillaries around the end of the kidney tubule and its job is to filter the blood passing through and turn it into urine, definitely no small feat! After gaining a solid understanding of the glomerulus, we then learned about renal blood flow and glomerular filtration. The lecture block finished off with an “active lecture” this lecture was more of a demonstration that helped solidify concepts from the previous two lectures. The whole class participated in the activity and acted as fluid moving through a capillary (aka the classroom). Once we did an initial run through, and understood how the activity worked, we were then told to select items that would influence our ability to filter through the room, some of these items included pool noodles, ping pong balls, and small books. The larger the item, the lower the chance you would be filtered out. That being said, our friends with the fun pool noodles were unable to filter back to their seats and had to stand at the front of the class representing a key plasma protein, albumin. After that activity was over, we had one more demonstration that emphasized the filtration concept that we had just covered, but on a smaller scale. Our block leaders had created a filtration box with a mesh barrier and we used glitter and Orbeez (small little balls that grow when water is added) to analyze the impact of force and size on filtration.
I then had the opportunity to spend the rest of the afternoon with Dr. Yamate! That afternoon consisted of four appointments with thorough consultations and acupuncture treatments. It is always a blast being in the clinic and learning from such an accomplished integrative veterinarian! Every time I'm in the clinic I learn at least one thing that will not be taught in the traditional veterinary curriculum which broadens my perspective. The afternoon was also filled with the most wonderful patients, especially Moose a beautiful Cane Corso with bilateral partially torn cruciates. Moose was getting an acupuncture treatment and was scheduled for surgery in the near future. It was awesome to see how well Moose responded to her treatment and how much her owner cared about setting her up for success pre- and post-surgery! All of the clients that come into that clinic care so much about their animals and are willing to do anything to improve the lives of their furry companion. It’s truly such a special relationship to witness.
Wednesday began with a lab focusing on the physiology of glomerular filtration and renal blood flow. We had an interesting apparatus that simulated an afferent arterial, glomerulus, and efferent arteriole. After understanding how our apparatus worked, we then ran different solutions through the model and analyzed the pressure at the afferent and afferent arteriole as well as the time that it took to collect 5 mL of solution. My group analyzed the impact of colloids on filtration fraction and glomerular filtration rate. Our first solution was saline (not high in protein) and our second was bovine serum albumin with saline and hetastarch (higher in protein). Our second solution (BSA + saline and hetastarch) had a slower glomerular filtration rate and lower filtration fraction compared to the saline. This is because higher levels of colloid proteins found in the BSA + saline and hetastarch) increase oncotic pressure. Oncotic pressure is a “pulling pressure” initiated by plasma proteins that causes fluids to get pulled back into the capillary. Since more fluid was being pulled back into the capillary, less is being filtered by the glomerulus. Overall, this lab was a great way to solidify concepts that we had previously covered in lecture and to top it off, our board had a mysterious sticky note with the word "good" on it so I guess that is a good sign ;) The rest of the day was spent reviewing lectures and hanging with Churro.
Thursday started off with a nice run with Churro followed by a lecture on radiographic imaging of the upper urinary tract followed by a lecture on the pathology of glomerular disease. We then had an anatomy lab that focused on the upper urinary system. This was a great way to cement the radiology lecture from the morning since we were able to see and touch everything we had previously seen on radiographs. We then transitioned into a histology lab. The focus of this lab was to tie all of the concepts together on a cellular level and understand the anatomy of the renal cortex and medulla. We had the opportunity to visualize the glomeruli and see the proximal and distal convoluted tubules. Seeing these structures in lab made the previous lectures more “real” and helped smooth over any misunderstandings. The rest of the afternoon consisted of time with Churro and some studying for the first exam of the year!
Somehow, I hit the jackpot because on Friday I did not have any classes or labs scheduled! My housemates and I jumped on this opportunity and headed up to Lake Tahoe for the day. We spent the day swimming, paddle boarding, and enjoying the beautiful weather. Churro got to come along for the ride and spent the day barking at new friends, enjoying the water, and riding a paddle board for the first time. I am so fortunate to live with such awesome people that continuously invite me to do fun weekend day-trips and tolerate the chaos (Churro) that comes with me. The rest of Friday consisted of a short anatomy study session and some lecture review.
Saturday started off with a quick three-miler with Churro followed by Steve’s 6:30 am Inferno Pilates class. This class is always a fun, and humbling, way to kick off the weekend. The rest of the day was spent getting some things done around the house and studying for the upcoming exam on Monday! Sunday morning started off with a nice 7 miler with Churro followed by some studying before spending the rest of the afternoon with Dr. Yamate. We had a blast exploring the Rock Mama Gallery and I was amazed by the variety and beauty of all of the crystals! After our gallery adventure we got to spend some quality time catching up and then the rest of the night was filled with some final review.
Quote of the week: “They are having fun out there, we are NOT in here...” -Dr. Genetos as he proceeds to talk about osmolarity, osmolality and fluid distribution while all the new first year students are playing games for orientation.
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