Cardio and NSAIDs don't mix

Just something I picked up from our renal module.

You know how drinking and driving don't mix? Well, the same applies for doing cardio workouts and NSAIDs, or non-steroidal anti-inflammatory drug. 

The reason being is that when you undergo sustained cardio workout, such as running, the blood is shunted, or displaced from your kidneys to tissue with currently higher oxygen needs, such as your leg muscles and heart. Because of this, the blood pressure in your kidneys drop, decreasing its ability to filter your blood. As a regulatory mechanism to maintain sufficient filtration pressure, the vessels in the kidneys constrict to increase the pressure. However, under conditions of excessive vessel constriction, it will essentially cutoff blood flow to the kidneys, and now the kidneys will be oxygen deprived and begin to die.

To prevent this from happening, there is a counter-regulatory mechanism to keep the vessels from closing off too much. A compound called prostaglandins, which causes dilation of the vessels, is produced when there is reduced blood flow to the kidneys. However, NSAIDs inhibit prostaglandin synthesis and therefore adequate blood flow is not able to be reestablished.

Repeated bouts of this kidney abuse, and you can say goodbye kidneys and hope you can get a transplant.

Now, why might you be taking an NSAID? Perhaps, you have some kind of inflammation, such as a tendon which has gotten irritated from repetitive movements, such as sustained running resulting in tendinitis of an ankle tendon. Funny thing is this happened to me in my training for a half-marathon coming up... so it's a good thing I found out about this early enough before serious harm was done.

Friends don't let friends do cardio on NSAIDs...

Final exam grade woes

So yesterday I got my exam grade back for the GI module... and needless to say, I didn't do so hot. I got by but what the heck, I studied for it fairly rigorously and I felt pretty confident that I knew the material, but it didn't amount to anything on the exam...

Am I the only one who feels like this?

It is super discouraging and is telling me that studying has no effect on the outcome, so I would almost be better off not studying as hard and enjoying some time to myself everyday, no? I hope it is not the case that the amount of studying I am doing now is the bare minimum I need to do to just pass the class........

However, in the end, it doesn't matter... honors or just passing. It all comes down to the USMLE anyways. I've been doing qbank questions for the GI module and it isn't too bad, so I hope that is more reflective of the fact that my studying is amounting to something at least... I just hope my downward trend this year doesn't carry over to the boards coming up... yikes.

They say to do well on the boards, you should do WELL in your class... well that is certainly not the case for me. They say, don't study for boards ahead of time, and that what you learn in class is what will be relevant to the boards... Each organ module grade tells me that I have to study harder for the next module, but this time around, my grade for GI just told me that I suck at life. Something isn't working and something has gotta change. At this point, I just hope I crush the step 1.

I have so many goals with my medical career, and I am just afraid that these stats are going to hold me back. lame.