Question

56-year old male who initially presented weight loss, loin pain, haematuria and painful inflamed joints. he also complained of a persistent unproductive cough that had been worsening over the past 3 months. he had also developed a pronounced wheeze and some chest pains.
precious medical history:
-Exertional angina and hypertension (diagnosed 8 years ago), and appendicitis (6 years ago).
Drug History:
-thiazide diuretics- patient been taking these since hypertension was diagnosed.
-chest x-ray and blood samples taken showed polycythaemia
3 days later the patient arrested, resuscitation was unsuccessful and the patient died.

What was the patients cause of death?
what were the signs and symptoms?

Answer 1

this is a case of renal cell carcinoma. here the patients compliants like recent weight loss , loin pain , heamaturia are indicatives of the disease..it is a fast growing cancer . mostly araise from tubules of kidney,.

his gender , age , history of hypertensions are risk factors fo this disease. this cancer spread very rapidly to the surrounding areas and distant metastasis to orgons like lung , liver ...through blood vessels .

here the patient history not mention about smoking history and the chest symptoms like uncontrolled cough , chest pain .. may be due to these metastasis . these produces cannon ball metastases, which can compress the airways leads to wheezing , cough.

polycythemia is his blood finding , which occur due to overproduction of erythropoietin in kidney by these tumor cells . these can cause other para neoplastic syndromes also.

here most common cause of death of this patient will be cardiac arrest . he already has some cardiac problem like excertional angina, and renal cancer patients cardiovascular reason is most common cause of death. his cardiac disease are ggrevated by renal cancer.

2 . symptoms of patients are hematuria , loin pain , painful joints , uncontrolled cough, chest pain

signs elicited in this patient are loin tenderness , inflamed joints , wheezing