Clinical Experience Week #5

Hello!! Hope everyones clinicals are going well. It has been hectic the last few weeks at the hospital. We launched our new electronic medical record system. Pretty interesting. We all had to go thru several training classes, but to say the least the first day was not very fun. Day by Day there were a lot of corrections made, so now it is a lot easier to use.

Interesting case:

Thirty nine year old male presented to the ER with right flank pain, nausea, and vomiting. This patient had no prior medical history.

The ER doctor ordered Ct abd/Plv with and without contrast.

We used 100 ml Omnipaque 350 and did sagittal and coronal two-dimensional images.

Impression on report:

An 11 centimeter mass involving the upper pole of the right kidney, highly suggestive of renal cell carcinoma.

Mild hydronephrosis without obvious cause. A small amount of heterogenous density with the distal right ureter could conceivably represent hemorrhage.

Tiny indeterminate right middle lobe nodule

A few borderline enlarged retroperitoneal lymph nodes.