3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
3 жыл бұрын
4 жыл бұрын
4 жыл бұрын
Пікірлер
@johnkodhek 4 ай бұрын
This is one of those videos that make me grateful for KZbin. Been scratching my head all morning trying to understand this & in just a few minutes it's been made clear. Thanks from Kenya! 🤝🏾
@taniaburgos7123 4 ай бұрын
this is so good!!
@samiramusarath 6 ай бұрын
I love the video. Thankyou soo much. So clearly explained. Wish i found this earlier
@heba_seyh9 8 ай бұрын
Thankssss
@heba_seyh9 8 ай бұрын
Ugh you are very cute and you speak very clearly
@heba_seyh9 8 ай бұрын
Done thank you!
@heba_seyh9 8 ай бұрын
done part 2 thank you!
@heba_seyh9 8 ай бұрын
good start thank you!
@AG-en5y 9 ай бұрын
Bro I hope you tie in urine/serum Ca+ and Cl- in future vids. Thanks for great video. U rock
@AG-en5y 9 ай бұрын
Great vid
@J_L45 9 ай бұрын
THANK YOU. First video I have thumbed up on this topic. I have CRPS & Gastroparesis - recently I started getting dysphagia and then COULD NOT eat for 2 entire weeks. Not from lack of trying. My swallowing got so bad that I couldn't take in water. So my daughter took me to the hospital - where I thought i would be turned away. WRONG. I was admitted with starvation ketoacidosis and hypoglycemia. They pumped me with so many IV bags of gluclose, thiamine, potassium, magnesium, iron infusion, etc etc. I felt water logged. I then got refeeding syndrome as the hospital started FORCING me to eat foods that were not appropriate. I had severe edema and then suffered THREE extravasation injuries to BOTH arms ( which already have CRPS ) suffice to say, I probably will never go near a hospital again. Yes, I had a scope, CT scans and barium swallow. Still awaiting results - the only thing they could tell me was that I have more dysmotility. No shit Sherlock. LOL I am so angry that the hospital didn't know how to care for me, did not have the ability to manage my re-feeding, particularly as I am also VEGAN. Imagine offering a vegan patient (with dysphagia ) who has been clinically starved out - with a meat pie as a re-feed. Seriously - WTF.
@xayenen 10 ай бұрын
Rewatching this clearing concepts Thank you!
@xayenen 10 ай бұрын
Thank YOU!
@xayenen 10 ай бұрын
Spot On Amazing! Thankyou
@hm-eo2gy Жыл бұрын
That was great, thanks 🙏🏻
@Blue-gs5gg Жыл бұрын
🙏🙏🙏🙏
@medlectures47 Жыл бұрын
Thanks
@morgan8 Жыл бұрын
I extremely enjoyed the fun explanation of how insulin causes the intracellular shift. Thank you so much!
@fatimahodumuyiwa8608 Жыл бұрын
Thank you
@nataliaguzman9650 Жыл бұрын
Thanks!
@nataliaguzman9650 Жыл бұрын
Hi😊 the narratin sometimes doesn’t correlate with the images. But liked it anyways!
@nataliaguzman9650 Жыл бұрын
Love it
@mohamedsafwat8390 Жыл бұрын
Thank you for this presentation
@tszlachetka 2 жыл бұрын
Great series on the topic! I have one quick question - why is the phosphate level low in this syndrome? Is it due to vitamin D being suppressed from the high Ca (so intestinal reabsorption of phosphate is minimized)? Low PTH usually means less phosphate excretion by the kidneys - so that would bring phosphate levels up - but are the intestinal loses due to low vitamin D more prominent, so that overall we have low phosphate? Thanks for any info :)
@decodingdx8285 2 жыл бұрын
Actually, PTH causes increased excretion of phosphate in the kidneys! I like to remember this with thinking of PTH as Phosphate Trashing Hormone (got that from the Clinical Problem Solvers!)
@tszlachetka 2 жыл бұрын
@@decodingdx8285 Hello! Thanks for the response! Yes, that's what I thought: PTH = promotes phosphate excretion via kidneys, so a LOW PTH state (like in this syndrome) it would mean LESS phosphate excretion, right? So the low phosphate in this syndrome comes from decreased reabsorption in the GI tract due to low vitamin D, correct?
@decodingdx8285 2 жыл бұрын
@@tszlachetka Thank you for so gently correcting me, as I misread your initial question! Yes, I think your thought process is on the right track. Low PTH = less VitD activation = less absorption of both Ca & Phos from the GI tract. I'm not sure if this pathophys has been studied in detail, but another thing that crosses my mind is that calcium & phos love to stick together. For example, we know that in CKD and tumor lysis syndrome, elevated phos levels lead to hypocalcemia. So in calcium alkali syndrome, the excess calcium would also drive the 3Ca + 2PO4 -> Ca3(PO4)2, thus binding up some phosphate.
@tszlachetka 2 жыл бұрын
Super helpful video and easy to listen to! Reviewing for USMLE and wanted a good in depth explanation of this and this is perfect - listening to part 2 right after this!
@raynernoraschi6975 2 жыл бұрын
my god, you are awesome
@johnstewartvet 2 жыл бұрын
Well explained
@michellearchuleta7881 2 жыл бұрын
Awesome presentation, studying for the RDN exam and this was great for a deeper dive. Thank you guys!
@kuldeepkaur-bq5re 2 жыл бұрын
So you mean when HCL is vomited out then the body how's to the metabolic alkaloid, but then what would be the ph.??
@rdance3 2 жыл бұрын
I'm carnivore and don't eat carbs at all. ZERO carbs. Recently, I was sick with a virus. Just before, what I thought was full recovery, I became very weak. I suddenly needed sugar. I ate three packets of sugar and a Snickers Bar and soon felt better. When I got home, I ate two bowls of icecream. The next day, I was still a little weak so I had a small bowl of icecream and a protein shake. Less than an hour later, I was in the Emergency Room. There, I was given three IV bags and two big Potassium pills. I was told that my Potassium was low, which I found strange because I salt my meat with a 50/50 blend of NaCl and Potassium Citrate. I actually had an electrlyte drink that morning with added dextrose. My discharge papers say Accute Respiratory Alkalosis but I can't help but think that it was metabolic and due to my etreme insulin sensitivity and my sugar intake. I wasn't haveing diarrhea and only vomited once. Potassium being low makes me think that it wasn't Milk-Alkali Syndrome but all that icecream that I consumed makes me wonder. 3 weeks prior, my Potassium was 4.9.
@shail6770 2 жыл бұрын
Just discovered your channel and have now watched a few of your videos. And I just have to say this is some really great content! Thank you for making these videos. I can't believe you guys don't have more subscribers.
@zacklee6348 2 жыл бұрын
This video is so great, been looking everywhere for a good explanation for this
@alirahman3259 2 жыл бұрын
Thankyou was very informative and beautiful lecture Thankyou again from Pakistan.
@137venkateshs7 2 жыл бұрын
Thanks helped a lot!
@johnjjmoon 2 жыл бұрын
Thanks for this overview, and great series overall.
@Aa-ji2yf 3 жыл бұрын
Thank you guys
@nicholasradell4781 3 жыл бұрын
This is so helpful like ?!?!?!? Thank you!!!!
@dobrog1 3 жыл бұрын
Best vid on this topic i've found thx
@eng-tatang1108 3 жыл бұрын
Awesome!
@shivakumarp9817 3 жыл бұрын
Very helpful
@reneekauts6065 3 жыл бұрын
can you please do a series on LFT and types of jaundice?
@reneekauts6065 3 жыл бұрын
thankyou!
@maazarif8903 3 жыл бұрын
wow intern here and i didnt know that about the suppository..ive always ordered it wihtout knowing what it truly was ahah thanks for explaining it
@alikaboosi2172 3 жыл бұрын
👍👍
@Tysteriskians 3 жыл бұрын
Welcome back! Good to see this continuing
@linopango3145 3 жыл бұрын
Great video! I have just a question: is there an exam able to distinguish between chemical pneumonitis and aspiration pneumonia? I suppose that it could be a bronchoscopy with biopsy, but sure it is not a "routine" exam. So, there is in front of me a patient with caugh, fever and typical Rx: i give him antibiotics? Even if i don't know the etiology? thank you
@decodingdx8285 3 жыл бұрын
I think it'd be helpful to take a step back and think about when you would be trying to distinguish chemical pneumonitis from pneumonia. Usually this is in the situation of an opacity on a chest x-ray of patient who you either know or suspect has aspirated but they're *not* overtly having pneumonia symptoms. If it's within 24 hours of the suspected event and the patient *isn't* having pneumonia Sx, then it's reasonable to observe the clinical course without antibiotics because it very well could be pneumonitis. However if your patient has an opacity on CXR PLUS a fever, cough, other Sx of pneumonia... then that's the diagnostic criteria for pneumonia! (And of course, you should treat appropriately)
@linopango3145 3 жыл бұрын
Therefore the differential diagnosis in the clinical setting is based on the type of clinical course (acute or chronic?), on the type of symptoms (type of sputum, presence of cough..) and on the anamnesis? Is it fair to say that coughing is not a symptom of respiratory distress syndrome associated with chemical pneumonitis (but we can find it in the insidious aspiration pneumonia)? is fever instead present in both chemical and aspiration pneumonia? thanks for the answer, your job is great
@decodingdx8285 3 жыл бұрын
@@linopango3145 Sorry for the delay - I'm a resident and thus can't always reply immediately. But in general, yes the order of your differential really depends on the clinical context. This really comes into play when you have a confirmed or suspected aspiration event then find an opacity on CXR. If it's within a day or so and the patient doesn't clinically appear to have overt pneumonia, then it's very reasonable to observe and see if they do well off of antibiotics. However, if they appear septic, have a productive cough, etc then it would likely be appropriate to treat for pneumonia. It's possible to have fever in the presence of chemical pnuemonitis (which could be an inflammatory response or could be due to another source!). A fever alone shouldn't necessarily be a decision-maker. It's always important to take the whole clinical picture together to make the best decisions for our patients.
@linopango3145 3 жыл бұрын
@@decodingdx8285 absolutely no problem with the delay, thank you very much. I wish I had teachers like you. good job! I wish you the best
@maheshaliasboya 3 жыл бұрын
Correct electrolytes before or along with feeding?
@decodingdx8285 3 жыл бұрын
Both! If a patient is deplete in electrolytes prior to re-feeding, they are higher risk for developing full-blown re-feeding syndrome. So it’s very important to start supplementation prior to and continue during the re-feeding process.
@abneyacres 3 жыл бұрын
Former ICU nurse turned pulm/crit APP! 🙋🏼♀️ Tripped on your channel tonight and love this exercise. Also really love how appreciative and respectful you all are of other members of the interdisciplinary team! Looking forward to following along with your channel. 🩺
@JJT03-l2v 3 жыл бұрын
Thank you!
@rickywesleywagner6323 3 жыл бұрын
Thank you for this great video! I am in veterinary school and used this to learn about Refeeding Syndrome because it is mostly the same in dogs and cats!
@decodingdx8285 3 жыл бұрын
Wow, how cool! Glad it was helpful!