Chapter 29 RCC Flashcards
What are constitutional symptoms and what are their bra differential diagnosis?
Fatigue, anorexia, weight loss. Malignancy, infectious disease, auto immune disease
What is the work for anemic patients?
CBC, serum iron, TIBC, ferritin
What labs will be found in anemia of chronic disease?
Normocytic normochromic anemia with low serum iron low TIBC and elevated ferritin
What does the presence of microscopic hematuria on UA with anemia of chronic disease suggest?
Anemia of Chronic disease may be secondary to GU malignancy urinary tract kidney or prostate
What test can be ran to investigate suspected genitourinary tract cancer?
Abdominal CT and cystoscopy
Describe stage one renal cell cancer on abdominal CT scan?
Renal mass without the involvement of renal capsule, renal vein or inferior vena cava
When she does patient be admitted to the hospital?
Suspicious abdominal CT scan for kidney cancer
What orders should be done while patient is admitted to the hospital?
Standard pre-operative orders, pre-surgical parenteral antibiotic prophylaxis, surgery and oncology consultation, chest CT for staging
What is the final treatment that should be ordered for RCC patients after consultations?
Nephrectomy
When shed RCC be suspected
On his plane he materia, flank pain, palpable flake
If abdominal CT provides presumptive diagnosis of renal cell carcinoma then what should be done, images?
Chest CT for for the staging, Bone scan if Bone pain or elevated alkaline phosphatase
What is the final treatment that should be done if isolated renal mass? Suspected metastatic disease diagnosis?
Nephrectomy if isolated, biopsy if metastasize
What should preceed nephrectomy/biopsy?
Oncology/surgery consultation, Standard pre-op orders, prophylactic antibiotics (to cover gram-negative and enterococci i.e. Cefazolin)
What is the diagnostic test that should be ran for this patient
CBC, BMP, LFTs, UA, FOBT, abdominal CT, chest CT, serum iron, TIBC, ferritin PT and PTT/INR, blood type and crossmatch
What is a counseling necessary for this patient?
No smoking, no alcohol, cancer diagnosis
