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Another Hard Question

2927 Views 18 Replies 7 Participants Last post by  dev_ppatel8
A 65 year-old male presents with a 4-6 month history of intermittent production of red-tinged urine. Physical exam
reveals a well nourished patient with slightly enlarged prostate and no other abnormal findings.

Initial laboratory data reveals:

-hemoglobin 18.7 g/dl (normal: 13.0-18.0 g/dL)
-hematocrit 58% (normal: 37-49%)
-BUN 10 mg/dl = urea of 3.6 mmol/L (normal: 8-25 mg/dL or 2.9-8.9 mmol/L)
-creatinine 0.8 mg/dl = 70 μmol/L (normal: 0.6-1.5 mg/dL or 52-132 μmol/L)
-calcium 12.3 mg/dl = 3.1 mmol/L (normal: 8.5-10.5 mg/dL or 2.1-2.6 mmol/L)
-urinalysis: ++ hematuria, + PMN.

The patient's lab results are most consistent with which of the following?

A. Dehydration
B. Paraneoplastic syndrome
C. Renal hematoma
D. Cystitis secondary to E. coli
E. Renal calculi

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it looks like paraneoplastic syndrome....
though its rare in prostate ca.
I think its RCC coz RCC causes polycythemia. Inc. prostate size may be due to age related BPH. should be RCC....
RCC...produces ectopic Erythropoiecin (EPO)...responsible for polycythemia...
PTH related peptide...causing hypercalcemia...n renal stone...
regarding occurs only in 50 to 60% pt....though he is having intermittent production of red-tinged urine...
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