Renal Disorders 4

Question 1

Demographics: prostate cancer

Answer 1

Slow growing form of cancer causing microscopic changes in ⅓ of men by age 50

Question 2

Demographics: carcinoma in situ (prostate cancer)

Answer 2

50-75% of men by age 75

Question 3

Prostate cancer: early sx

Answer 3

Not likely to have sx early on

Question 4

Later s/s of prostate cancer are consistent with those of

Answer 4

Lower urinary tract obstruction

• urinary problems (hesitancy, small amts, dribbling, frequency, nocturia)
• lower abd, back, hip, thigh pain/discomfort
• difficulty having an erection
• blood in urine or semen

Question 5

Dx prostate cancer by

Answer 5

• biopsy (only true ex procedure)

- cytological exam

Question 6

Histological changes with prostate cancer scored using

Answer 6

Gleason scale

Based on lack of cell differentiation

Question 7

Testicular cancer prevalence

Answer 7

• relatively rare

- occurs most often in young men (15-35)

Question 8

Testicular cancer: most common finding

Answer 8

• may be asymptomatic

- hard, painless, pea-sized lump

Question 9

Testicular cancer: curable?

Answer 9

• Almost always curable with early detection

- low chance of metastasis to other testicle if found early

Question 10

Testicular cancer s/s

Answer 10

• lump in either testicle
• any enlargement, swelling, hardness, pain, discomfort
• significant decrease in testicle size
• dull ache in lower abdomen or groin
• sudden collection of fluid in scrotum
• enlargement or tenderness in breasts
• infertility
• unexplained malaise or fatigue
• LBP

Question 11

With testicular cancer, why is LBP significant?

Answer 11

Metastases to retroperitoneal lymph nodes

Question 12

Renal carcinomas: prevalence

Answer 12

Only 3-4% of all cancers

Question 13

Most common type of Renal carcinomas:

Answer 13

Renal cell carcinoma (RCC)

Question 14

RCC usually presents with

Answer 14

• flank pain
• hematuria
• pain with urination
• urinary urgency
• palpable abdominal mass

Question 15

RCC: early stages

Answer 15

• may be silent

- metastatic disease seen in 25-30% of cases at first dx

Question 16

RCC; intervention and px

Answer 16

• surgical and chemo (ILK-2)

- variable px

Question 17

Renal cancer risk factors

Answer 17

• smoking
• obesity
• HTN
• long term dialysis
• occupation (iron and steel injury, asbestos exposure)
• male more than female

Question 18

Renal carcinomas: If working with elderly population, initial screening questions should include

Answer 18

• urinary function

- usual weight loss, fatigue, etc questions

Question 19

Renal carcinomas: look for

Answer 19

• unexplained abd, flank, or back pain

- cough or pulmonary system concerns (RCC mets to sternum)

Question 20

Wilm’s tumor aka

Answer 20

Nephroblastoma

Question 21

Who gets Wilm’s tumor?

Answer 21

• most common in children
• seen in first 6 years of life
• 500 cases/yr

Question 22

Wilm’s tumor: s/s

Answer 22

• n/v
• abd pain
• malaise
• loss of appetite
• hematuria

Question 23

Wilm’s tumor may be seen with

Answer 23

Some hereditary syndromes

Question 24

Wilm’s tumor survival rate

Answer 24

5 year survival is 92%

Most do not metastasize

Question 25

Urge incontinence

Answer 25

• sudden, compelling desire to pee that’s difficult to defer

- often related to detrusor instability

Question 26

Stress incontinence

Answer 26

involuntary loss of urine with effort/physical exertion/sneezing/coughing

Question 27

Mixed incontinence

Answer 27

Combo of urge and stress

Question 28

Overflow incontinence

Answer 28

• involuntary loss of urine when bladder becomes overly full

- even without feeling the need to urinate

Question 29

Functional incontinence

Answer 29

Unable to/difficulty with getting to a restroom in time

Question 30

Reference range for BUN, creatinine

Answer 30

10-20 mg/dL for adults (ish)

Question 31

BUN increases when

Answer 31

Renal function decreases

Question 32

What does an increased BUN indicate?

Answer 32

Decreased renal blood flow