First and foremost - the title. Sorry. It does beat the alternative - You're number one. Right, now that that is out of the way, here's a look at the Renal block. It's only a five week block, so don't blink or you'll miss it.
Week one has quite a monster of a course pack. Sheesh. As always it will introduce you to some basic principles - acid-base, sodium and potassium imbalances, diuretic use, etc. It sets the tone for the remainder of the block. The lectures... well, the lectures when I was in GEMP I, weren't exactly useful. The lecturer tried to use analogies as she taught, and that simply doesn't work for me. It will probably be very different when you're doing Renal, though.
Week two is, in my opinion, the most important week of the block. Here you will be introduced to acute kidney injury, acute tubular necrosis and how to tell the difference using, for example, spot urine sodium. Just a tip - patients who are oligo- or anuric often go through a phase of polyuria when the renal function is restored. The week flows quite well. Get it? Hmm.
Week three is pretty cool. It's all about nephrotic (protein in the urine) and nephritic (blood in the urine) syndromes. Another tip, don't think of these disease manifestations as isolated entities, but rather as two diseases found on a spectrum of disorders. That should make understanding what's going on much easier. Also, for most of the week you won't actually have an idea of what's going on. They don't give you a nice overview. "Hi, I'm Focal Segmental Glomerulosclerosis" is pretty much where it starts. Make sure you read the course pack ASAP.
Now that all the acute diseases have been covered, week four is all about chronic kidney disease (CKD). Remember that CKD is a manifestation of many other diseases, such as diabetes, HIV, hypertension, autoimmune disorders such as systemic lupus erythematosus (contrary to what House says, it is sometimes Lupus...). Glomerular filtration rate is also explained, and how to calculate it. Make sure you understand how calcium and phosphate metabolism is changed as a result of CKD (the long pathway involving vitamin D and PTH) and how anaemia can come about (decreased EPO production and of course anaemia of chronic disorders).
Ahh the prostate and it's issues. That's week five for you. It really isn't a tough week to get through. Unlike trying to get a urinary catheter passed beyond a prostate the size of a watermelon. Oh how I don't like Urology. Prostate cancer is really very common (in the elderly, at least) and many men will die with it rather than of it. Yay.
A final tip is to stay up to date. If there are any concepts that you don't understand ask someone. Ask a friend, a lecturer, Google, your mum or even me. I really enjoyed the internal medicine component of this block. Nephrology is really fascinating.
Almost done with GEMP I! Just one more block to go, well done!
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