Question Answered step-by-step Urology Office Consultation REASON FOR REFERRAL Right flank mass,… Urology Office Consultation REASON FOR REFERRALRight flank mass, hematuria. HISTORY OF PRESENT ILLNESSThe patient noticed the onset of hematuria following a motorcycle accident 1 week prior to admission. The patient denies dysuria or abdominal pain or distention and did not seek medical care for his symptoms until today. PAST HISTORYMedications: None.Illnesses: None.Operations: Tonsillectomy and adenoidectomy at age 8 years.ALLERGIES: ALLERGIC TO IODINE AND SHELLFISH. REVIEW OF SYSTEMSNoncontributory. PHYSICAL EXAMINATIONGENERAL: The patient is a well-developed 26-year-old Caucasian male in no acute distress who is oriented and cooperative.VITAL SIGNS: Pulse: 80/min. Blood pressure: 116/82. Respiratory rate: 20/min.HEENT: PERRLA. EOMs intact. Funduscopic examination shows no capillary aneurysms, hemorrhages or exudates.NECK: Supple without adenopathy.CHEST: Lungs: Clear to auscultation and percussion. Heart: RRR. S1 and S2 present. No murmurs, bruits or rubs.ABDOMEN: Very tender right CVA. There is a 15 cm palpable mass in the right upper quadrant and periumbilical region. The mass is freely moveable. Bowel sounds are normal. No evidence of hernia. Liver and spleen normal.RECTAL: Deferred.EXTREMITIES: Normal. No clubbing, cyanosis or edema. No ulcers or trophic changes.NEUROLOGIC: Deferred. DATABASEAbdominal sonography reveals a 15 cm mass in the midpole of the right kidney with irregular texture and contour. No discrete fluid collections are seen. An IVP was deferred in view of the patient’s history of iodine allergy. BUN 15, creatinine 23. Urinalysis shows microscopic hematuria, proteinuria and 10-15 WBC. Specific gravity 1.020. ASSESSMENTRight nephroma. Rule out renal cell carcinoma, subcapsular or intrarenal hematoma, or focal xanthogranulomatous pyelonephritis. RECOMMENDATIONSThe patient’s history of trauma is probably unrelated to the mass in the kidney, due to the minor amount of discomfort the patient experienced and the abnormal accompanying laboratory values. It is most likely that this is an incidental finding and due to renal cell carcinoma or adenocarcinoma of the kidney. Renal biopsy is recommended. ICD-10-CM needed & E/M: NEEDED Health Science Science Nursing NUR 332 Share QuestionEmailCopy link Comments (0)