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Focal/Segmental Glumerulosclerosis… and so much more!

Sound interesting enough?!

Actually, it is. I often find a way to remember diseases and processes in a manner that I can relate to… this way, I seem to have long-term retention of the material. As a little scientific tidbit Focal/Segmental Glumerulosclerosis is what is called a NEPHROTIC syndrome (in other words, you have lots of protein in the urine daily.. which is bad). This condition is actually the most common nephrotic syndrome in African American and Latino adult populations and is associated with other conditions such as Sickle Cell Anemia, HIV and IV Heroine use. Microscopically it is characterized by fatty casts and an effacement of Glumerular Basement Membrane podocyte “foot processes”. Finally, as a treatment it is important to know that these conditions respond poorly to Corticosteroids unlike another nephrotic syndrome called Minimal Change Disease.

This is the image our professor used to describe the difference between the INFLAMMATORY Nephritic syndromes compared to the relatively calm Nephrotic syndromes. Clever.

Alright.. I won’t bore you too much, I think it’s just fun to share what goes on in my mind as I begin to think about diseases. For me I like to identify a few things: Who gets it? Why do they get it? Are other conditions associated with it? How do we treat it?

This unit we are taking an in-depth look at the KIDNEY. So that means, kidney physiology (review.. trust me, I need it!), pathology, and pharmacology. As usual, we are continuing to study for USMLE Step 1 in our spare time while having fun and keeping a good perspective. I believe that IUSM is preparing us very well for our board exams and for that, I am grateful.

One of our professors posed a very interesting question to us recently… so I feel compelled to share. Do you know what Cafe-Au-Lait means? It’s French for coffee with warm milk added. Now, this was in the context of a lecture based on dermatologic findings that have systemic implications… this case was Neurofibromatosis Type-1. His question, which most of us didn’t know the actual answer to brought up a bigger idea… Maybe we as a medical school should take a class trip to Europe and expand our knowledge in OTHER ways outside of medicine. Now, he was kidding but don’t we need that global knowledge and understanding? Couldn’t we all benefit from a European Adventure? Sure.. but it’s not happening anytime soon.

The point that he eventually made was clear. You will always have responsibilities, deadlines, expectations and stress. Those that live with those obstacles, IN SPITE of those challenges will be be happiest and perhaps the most successful. He added this

“When will you begin living? Many of you would say TODAY.. and you’d be right but perhaps a better answer to that question would have been YESTERDAY.”


Cafe-Au-Lait (Neurofibromatosis Type-1)