Episode 19: Bartter and Gitelman 

The sun rises over the San Joaquin Valley, California, today is July 10, 2020. In case you did not notice, we did not have an episode last week. We were very busy in our residency. We started a new rotation and a new academic year. We welcomed a new group of PGY1s, along with 3rd-year medical students, and Sub-Is. We also said goodbye to our dear graduates: Greg Fernandez, Ronald Gavilan, Yunior Martinez, and Steven Saito. “Spread your wings, it’s time to fly. Make the leap. Own the sky.”(1) Good luck in your careers! 

Those activities kept us busy, and, as if that wasn’t enough, we saw an increase in the incidence of COVID-19 across the nation. In Clinica Sierra Vista, we went from 270 positive cases in May to 700 positive cases in June, we also increased the total tests performed from 1200 in May to 2800 in June. Our positivity rate increased from 21% to 25%. In the county of Kern we have had 5,500 cases and 82 deaths. In California, the total of cases is 260,000 with total deaths of 6,500(2), which may have changed by the time you listen to this episode (numbers were rounded up for easy listening).

Also, on a positive note, last weekend we celebrated Independence Day. We hope you had a Happy 4th of July! Especially during these tumultuous times, may America continue to be “the land of the free and the home of the brave.”

Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing is happening everywhere.

The Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. 

Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971.

“All our dreams can come true if we have the courage to pursue them.” Walt Disney

When you want to reach a goal, dreaming is not enough. At some point, you have to start working to make that dream come true. You may need a little dose of faith, and a big dose of action. What dreams do you have? What kind of doctor do you want to become? Your training in residency is the time to prepare to live that dream. Today we have a resident who is working to reach his goals. Dr Sin is a diligent, trustworthy resident and will participate today for the first time in this podcast. 

1. QUESTION NUMBER 1: Who are you?

My name is Hasaney and I am a second-year resident at Rio Bravo Family Medicine residency program. I was born and raised in Long Beach, California, to parents who emigrated from Cambodia. I went to Long Beach Polytechnic High School, and continued my studies at UC Irvine majoring in Biological Sciences. 

I worked in Quality Assurance for a healthcare manufacturing company for a few years, before deciding to pursue a career in Medicine. I enrolled at Ross University School of Medicine in Dominica where I received my medical degree.

I’m a pretty simple guy. I love spending time with my girlfriend, my family, and my friends. I love to go camping, especially in Mammoth, California. I love watching and rooting for the Dodgers.

1. QUESTION NUMBER 2: What did you learn this week?

I had Nephrology clinic for the first time this past Wednesday and Dr. Moreno gave some little teaching points about different syndromes we may see as family physicians, a couple of them being Bartter Syndrome and Gitelman Syndrome.

Bartter Syndrome

Bartter syndrome is an autosomal recessive disorder associated with metabolic abnormalities: hypokalemia, metabolic alkalosis, hyperreninemia and hyperplasia of the juxtaglomerular apparatus, and hyperaldosteronism; There may also be associated hypomagnesemi