Clinical Quiz Archives - Renal and Urology News

Clinical Quiz

A Left Testicular Mass in a 29-Year-Old Man

A 29-year-old white male patient initially presented with a left solid testicular mass found on self-examination. Per the patient, it is painless and has enlarged over a several month period. He has a remote history of a left undescended testicle and orchiopexy at age 6 years. The patient’s tumor markers (AFP, ß-HCG, LDH) were within…

Addition of irreversible electroporation to conventional chemotherapy and radiation therapy in local

An HIV Patient on Chemotherapy With Rising Creatinine

A 72-year-old man was referred to a nephrology clinic because of an increase in creatinine from 1.2 to 2.2 mg/dL. He has a complicated medical history of neurogenic bladder, benign prostatic hyperplasia (BPH), HIV, and metastatic squamous cell carcinoma of the left mandible post resection. He underwent cisplatin-based chemotherapy and radiation 3 years previously. For the…

AKI and New-Onset Proteinuria

A 64-year-old man with past medical history of pre-diabetes, hypertension, benign prostate hyperplasia (BPH), elevated PSA, gastroesophageal reflux disease (GERD), and degenerative joint disease affecting T11 to L1 after extensive back surgery 1 year previously presented with diffuse joint and bone pain the past few months as well as fatigue. He had a rising serum creatinine…

Figure 1. CT abdomen revealing a large complex 16 x 11 x 12cm right anterior cystic renal mass with a calcified rim abutting the right colon.

A 64-Year-Old Woman With a Renal Cystic Neoplasm

A 64-year-old woman underwent a screening colonoscopy at the direction of her primary care physician. The colonoscopy revealed an infiltrative, polypoid, and ulcerated large non-obstructing mass in the mid ascending colon that was biopsy-proven to be a well to moderately differentiated invasive adenocarcinoma. She underwent staging cross sectional imaging that revealed an incidentally diagnosed 16…

Figure 1. Purpuric erythematous rash on patient’s arm.

Acute Kidney Injury in Patient With a Purpuric Rash

A 62-year-old white man with past medical history of ulcerative colitis presented with purpuric rash and abdominal pain that started 4 weeks previously. The abdominal pain was associated with nausea, bloating, episodes of diarrhea, and hematochezia. He stopped taking mesalamine prior to symptom onset. A week earlier, he presented to a local hospital where computed…

Figure 1. Scrotal ultrasound demonstrates a 5.5 × 5.5cm right intra-testicular mass with peripheral nodularity.

A 58-Year-Old Man Presenting With a Cystic Neoplasm of the Testis

A 58-year-old white man with a history of hypertension presented for urologic evaluation for obstructive voiding symptoms and an elevated PSA (3.1 ng/dL). On physical examination he was noted to have a palpable right testicular mass. He underwent a scrotal ultrasound that revealed a large (5.5 × 4.0 × 5.5cm) intra-testicular cystic mass with at…

Figure 1. Parathyroid scan of the patient shows focal increased activity posterior to the lower pole of the right thyroid lobe.

An ESRD Patient With Uncontrolled Secondary Hyperparathyroidism

This is a case involving a 64-year-old woman with end-stage renal disease (ESRD) due to lupus nephritis who has been on hemodialysis for 7 years. She also has dementia, hypertension, obstructive sleep apnea on CPAP, and stage 1 non-small cell lung cancer post wedge resection. Over the past 12 months, her secondary hyperparathyroidism (SHPT) has…

CT urogram showing a pear-shaped inverted bladder with extensive venous collateralization.

A 54-Year-Old Man With Painless Gross Hematuria and a Fatty Pelvic Tumor

The patient is a 54-year-old Caucasian male with a history of hidroadenitis who presented with a 1-week history of painless gross hematuria. His past medical history is otherwise unremarkable. He underwent a CT urogram in the emergency department that revealed an inverted pear-shaped bladder due to hypertrophy of perivesical and perirectal fat as well as…

Hematoxylin and eosin stain of the kidney showing brown deposits within the tubules of the kidney.

Chronic Kidney Failure in a Woman With a History of Kidney Stones

A 52-year-old woman presented for nephrologic consultation due to progressive chronic kidney failure. One year previously, her estimated glomerular filtration rate (eGFR) was 55 mL/min/1.73m2. She continued to follow up with her primary doctor and was found to have an eGFR of 40 mL/min/1.73m2 6 months later. The patient’s past medical history was significant for…

CT Urogram demonstrating a left upper tract filling defect and a left 1.5 x 1.2cm left para-aortic lymph node

Upper Tract Filling Defect in a Man With Bladder Cancer History

The patient is a 64-year-old Caucasian man with a history of stage I, pT1N0Mx, high grade urothelial carcinoma (nested variant) treated with a radical cystoprostatectomy and creation of an orthotopic, continent, neobladder which was performed in January of 2017. His past medical history is otherwise unremarkable. Surveillance imaging revealed no evidence of disease recurrence until…