Renal Disorders 4 Flashcards
Demographics: prostate cancer
Slow growing form of cancer causing microscopic changes in ⅓ of men by age 50
Demographics: carcinoma in situ (prostate cancer)
50-75% of men by age 75
Prostate cancer: early sx
Not likely to have sx early on
Later s/s of prostate cancer are consistent with those of
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
Dx prostate cancer by
- biopsy (only true ex procedure)
- cytological exam
Histological changes with prostate cancer scored using
Gleason scale
Based on lack of cell differentiation
Testicular cancer prevalence
- relatively rare
- occurs most often in young men (15-35)
Testicular cancer: most common finding
- may be asymptomatic
- hard, painless, pea-sized lump
Testicular cancer: curable?
- Almost always curable with early detection
- low chance of metastasis to other testicle if found early
Testicular cancer s/s
- 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
With testicular cancer, why is LBP significant?
Metastases to retroperitoneal lymph nodes
Renal carcinomas: prevalence
Only 3-4% of all cancers
Most common type of Renal carcinomas:
Renal cell carcinoma (RCC)
RCC usually presents with
- flank pain
- hematuria
- pain with urination
- urinary urgency
- palpable abdominal mass
RCC: early stages
- may be silent
- metastatic disease seen in 25-30% of cases at first dx
RCC; intervention and px
- surgical and chemo (ILK-2)
- variable px
Renal cancer risk factors
- smoking
- obesity
- HTN
- long term dialysis
- occupation (iron and steel injury, asbestos exposure)
- male more than female
Renal carcinomas: If working with elderly population, initial screening questions should include
- urinary function
- usual weight loss, fatigue, etc questions
Renal carcinomas: look for
- unexplained abd, flank, or back pain
- cough or pulmonary system concerns (RCC mets to sternum)
Wilm’s tumor aka
Nephroblastoma
Who gets Wilm’s tumor?
- most common in children
- seen in first 6 years of life
- 500 cases/yr
Wilm’s tumor: s/s
- n/v
- abd pain
- malaise
- loss of appetite
- hematuria
Wilm’s tumor may be seen with
Some hereditary syndromes
Wilm’s tumor survival rate
5 year survival is 92%
Most do not metastasize
Urge incontinence
- sudden, compelling desire to pee that’s difficult to defer
- often related to detrusor instability
Stress incontinence
involuntary loss of urine with effort/physical exertion/sneezing/coughing
Mixed incontinence
Combo of urge and stress
Overflow incontinence
- involuntary loss of urine when bladder becomes overly full
- even without feeling the need to urinate
Functional incontinence
Unable to/difficulty with getting to a restroom in time
Reference range for BUN, creatinine
10-20 mg/dL for adults (ish)
BUN increases when
Renal function decreases
What does an increased BUN indicate?
Decreased renal blood flow
