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  • Abdomen Acute
  • Abdominal Infarction
  • Abdominal Pain
  • Abdominal Pain Chronic
  • Abdominal Pain-Lower Abdomen
  • Abdominal Pain-Upper AbdomenAbdominal
  • Absence Seizure
  • Abuse-Psychological, Physical, Or Sexual
  • Acoustic Neuroma
  • Acromegaly
  • Acute Appendicitis, Unspecified
  • Acute Intermittent Porphyria (AIP)
  • Acute Renal Failure
  • Acute Stress Disorder
  • Addison's Disease
  • ADHD Adult
  • ADHD-Sleep Disorder Related To ADHD
  • Adjustment Disorder
  • Adrenal Disease
  • Adrenal Disease-Cushing's
  • Adrenal Insufficiency-Addison's Disease
  • Adult ADHD (ADD)
  • Agoraphobia
  • AIDS-Acquired Immune Deficiency Syndrome
  • Akathisia
  • Akathisia Medication-induced
  • Alcohol Abuse
  • Alcohol Dependence
  • Alcohol Dependence In Remission
  • Alcohol Use Disorder
  • Alcohol-Flush-Aldehyde Dehydrogenase Deficiency
  • Aldehyde Dehydrogenase Deficiency
  • Alopecia Areata
  • Alopecia Secondary To Childbirth
  • Alopecia Universalis
  • Alopecia-Male Pattern Baldness
  • Alopecia-Medication-induced
  • Alopecia-Telogen Effluvium
  • Alopecia-Traction
  • Alport Syndrome
  • Aluminum Toxicity
  • Alzheimer's
  • Alzheimer's Dementia
  • Amnestic Disorder
  • Amphetamine Abuse
  • Amphetamine Dependence
  • Amphetamine Dependence In Remission
  • Amyloidosis
  • Amyotrophic Lateral Sclerosis
  • Amyotrophic Lateral Sclerosis (ALS)
  • Anemia
  • Aneurysmal Subarachnoid Hemorrhage
  • Angina Pectoris
  • Angina Unstable
  • Ankylosing Spondylitis
  • Anorexia Nervosa
  • Anorgasmia
  • Antisocial Personality Disorder
  • Anxiety Disorder
  • Anxiety Disorder Due To Another Medical Condition
  • Anxiety-Agoraphobia
  • Anxiety-Organic
  • Anxiety-PTSD (Post-traumatic Stress Disorder)
  • Anxiety-Specific Phobia
  • Aortic Aneurysm
  • Appendicitis
  • Appendicitis-Acute, Unspecified
  • Arrhythmia
  • Arsenic Toxicity
  • Arthritis
  • Arthritis-Cervical
  • Arthritis-Osteoarthritis
  • Arthritis-Rheumatoid
  • Asperger's Syndrome
  • Asthma
  • Atonic Seizure
  • Atypical Depression
  • Auditory Hallucinations
  • Auriculotemporal Nerve Syndrome
  • Autoimmune Hepatitis
  • Avitaminosis
  • Avoidant Personality Disorder
  • B12 Deficiency
  • Bacterial Preexisting Heart Conditions
  • Balance-Disequilibrium-Benign Positional Vertigo
  • Balance-Disequilibrium-Cerebellar Disease
  • Balance-Disequilibrium-Friedreich's Ataxia
  • Balance-Disequilibrium-Labyrinthitis-Acute
  • Balance-Disequilibrium-Vertigo-Central
  • Balance-Disequilibrium-Vertigo-Medication-induced
  • Balance-Disequilibrium-Vertigo-Peripheral
  • Balance-Disequilibrium-Vertigo-Toxin-induced
  • Balance-Disequilibrium-Vestibular-Neuritis
  • Balding-Alopecia Areata
  • Balding-Alopecia Secondary To Childbirth
  • Balding-Alopecia Universalis
  • Balding-Alopecia-Male Pattern
  • Balding-Alopecia-Medication-induced
  • Balding-Alopecia-Traction
  • Balding-Telogen Effluvium
  • Barbiturate -use
  • Barbiturate Abuse
  • Barbiturate Dependence
  • Benzodiazepine Abuse
  • Benzodiazepine Dependence
  • Benzodiazepine Dependence In Remission
  • Benzodiazepine Use
  • Bereavement
  • Bile Duct Obstruction
  • Binge Eating Disorder
  • Bipolar
  • Bipolar Disorder
  • Bipolar Irritability
  • Bipolar-Atypical Depression
  • Bipolar-Dissociative Disorder
  • Bipolar-Dissociative Identity Disorder
  • Bipolar-Irritability
  • Bipolar-Kleptomania
  • Bipolar-Pathological Gambling
  • Bipolar-SAD (Seasonal Affective Disorder)
  • Bladder Disorder
  • Bladder Disorder, Unspecified
  • Bladder Disorder-Unspecified
  • Bladder-Incomplete Bladder Emptying
  • Bladder-Incontinence-Unaware
  • Bladder-Incontinence-Urge Incontinence
  • Bladder-Incontinence-Urinary Stress Incontinence
  • Bladder-Urinary Urgency
  • Bleeding Disorder
  • Blood In The Urine
  • Blood-Anemia
  • Blood-Bleeding Disorder
  • Blood-Epistaxis
  • Blood-Hematemesis
  • Blood-Hematochezia
  • Blood-Hematuria
  • Blood-Hemochromatosis
  • Blood-Hemoptysis
  • Blood-Melena
  • Blood-Polycythemia
  • Blood-Sickle Cell Anemia
  • Blood-Thrombocytopenia
  • Body Dysmorphic Disorder
  • Body Fluid Change
  • Borderline Personality Disorder
  • Boron Toxicity
  • Bowel-Constipation
  • Bowel-Diarrhea
  • Bowel-Diverticulitis
  • Bowel-Diverticulosis
  • Bowel-Essential Palatal Tremor
  • Bowel-Food Allergy
  • Bowel-Gastritis
  • Bowel-Gastroenteritis
  • Bowel-Hiatal Hernia
  • Bowel-Lactase Deficiency
  • Bowel-Nutrition-Gluten-Celiac Disease
  • Bowel-Nutrition-Lactose Intolerance
  • Bowel-Nutrition-Malabsorption
  • Bowel-Nutrition-Malnutrition
  • Bowel-Nutrition-Tropical Sprue
  • Bowel-Pain-Abdomen
  • Bowel-Pain-Abdomen-Acute
  • Bowel-Pain-Abdomen-Chronic
  • Bowel-Pain-Abdomen-Infarction
  • Bowel-Pain-Abdomen-Lower
  • Bowel-Pain-Abdomen-Upper
  • Bowel-Pain-Abdomen-Visceral
  • Bowel-Pain-Abdomen-Viscus-Perforation
  • Bowel-Pain-Erosive Esophagitis
  • Bowel-Pain-Heartburn-GERD
  • Bowel-Pain-IBS
  • Bowel-Pain-Obstruction
  • Bowel-Pain-Peritonitis
  • Bowel-Pain-PUD (Peptic Ulcer Disease)
  • Bowel-Pain-Regional Enteritis
  • Bowel-Pain-Ulcer
  • Bowel-Pain-Ulcer-Gastric
  • Bowel-Pain-Ulcer-Small Intestine-Duodenal
  • Bowel-Pain-Ulcer-Zollinger-Ellison Syndrome
  • Brain Dementia-Amnestic Disorder
  • Branchial Neuralgia
  • Bronchiectasis
  • Bronchitis
  • Bruxism (teeth Grinding)
  • Bulimia
  • Caffeine Dependence
  • Caffeine Intoxication
  • Caffeine-induced Sleep Disorder
  • Cancer
  • Cancer-Bladder
  • Cancer-Breast
  • Cancer-Cervical
  • Cancer-Colon
  • Cancer-Esophageal
  • Cancer-Gastrointestinal
  • Cancer-Kidney
  • Cancer-Leukemia
  • Cancer-Leukoplakia
  • Cancer-Lung
  • Cancer-Lymphoma
  • Cancer-Malignant Neoplasm: Mouth, Unspecified
  • Cancer-Medullary Thyroid Carcinoma
  • Cancer-Melanoma
  • Cancer-Mouth
  • Cancer-Multiple Myeloma
  • Cancer-Ovarian
  • Cancer-Pancreatic
  • Cancer-Pituitary
  • Cancer-Prostate
  • Cancer-Renal Cell Carcinoma
  • Cancer-Skin
  • Cancer-Stomach
  • Carbon Monoxide Poisoning
  • Carcinoid
  • Cataract
  • Cerebellar Disease
  • Cervical Spondylosis
  • Charcot-Marie-Tooth Disease
  • Charles Bonnet Syndrome
  • Chlamydia Infection
  • Choledocholithiasis
  • Cholesteatoma
  • Chorea Gravidarum
  • Chronic Daily Headache
  • Chronic Fatigue Syndrome
  • Chronic Kidney Failure (CKD)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Chronic Pain
  • Chronic Renal Failure
  • Circadian Rhythm Sleep Disorder
  • Cluster Headache
  • Cocaine Abuse
  • Cocaine Dependence
  • Cocaine Dependence In Remission
  • Coital Cephalgia
  • Coital Cephalgia-dull Type
  • Coital Cephalgia-explosive Type
  • Coital Cephalgia-postural Type
  • Collagen Vascular Disease
  • Conduct Disorder
  • Congestion-Drug-induced
  • Congestive Heart Failure
  • Congestive Heart Failure (CHF)
  • Constipation
  • Conversion Disorder
  • COPD
  • Costochondritis
  • Cranial Nerve Palsy
  • Creutzfeldt-Jakob
  • Creutzfeldt-Jakob Disease
  • Crohn's Disease Or Regional Enteritis
  • Cushing's Disease
  • Cystic Fibrosis
  • Cystitis
  • Cystitis, Unspecified
  • Deep Vein Thrombosis
  • Dehydration
  • Delirium
  • Delirium-Aneurysmal Subarachnoid Hemorrhage
  • Delirium-Lewy Body Dementia
  • Delirium-Postconcussion Syndrome
  • Delirium-Traumatic Brain Injury
  • Delusional Disorder
  • Delusional Disorder-erotomanic
  • Delusional Disorder-jealousy
  • Delusional Erotomania
  • Delusional Jealousy
  • Dementia
  • Dementia Amnestic Disorder
  • Dementia NOS
  • Dementia Vascular
  • Dementia-Alzheimers
  • Dental-Poor Fitting Dentures
  • Dental-Poor Hygiene
  • Dependent Personality
  • Depersonalization Disorder
  • Depression
  • Depression-Bereavement
  • Dermatopolymyositis
  • Diabetes Insipidus
  • Diabetes Mellitus
  • Diarrhea
  • Disease Of The Small Intestine, Unspecified
  • Disease Of Anus And Rectum, Unspecified
  • Disease Of Biliary Tract, Unspecified
  • Disease Of Intestine, Unspecified-Colon Proximal
  • Disease Of Intestine, Unspecified-Small Intestine
  • Disease Of Stomach And Duodenum, Unspecified
  • Disease Of The Proximal Colon, Unspecified
  • Disequilibrium-Benign Paroxysmal Positional Vertigo (BPPV)
  • Disequilibrium-Central Vertigo
  • Disequilibrium-Cerebellar Disease
  • Disequilibrium-Friedreich\'s Ataxia
  • Disequilibrium-Labyrinthitis Acute
  • Disequilibrium-Vertigo-Medication-induced
  • Disequilibrium-Vertigo-Peripheral
  • Disequilibrium-Vertigo-Toxin-induced
  • Disequilibrium-Vestibular Neuritis
  • Disorder Of Brain, Unspecified-Brainstem Or Pons
  • Disorder Of Brain, Unspecified-Hemisphere
  • Disorder Of The Brainstem Or Pons, Unspecified
  • Disorder Of The Cerebral Hemisphere, Unspecified
  • Disorder-Body Dysmorphic
  • Disorder-Impulse Control
  • Disorder-Intermittent Explosive
  • Disruptive Behavior Disorder
  • Disruptive-Conduct Disorder
  • Dissociative Disorder
  • Dissociative Identity Disorder
  • Dissociative-Depersonalization Disorder
  • Diuretic-induced Hypokalemia
  • Diverticulitis
  • Diverticulosis
  • Drug Induced Edema
  • Dry Mouth
  • Dyspareunia
  • Dysthymia
  • Early Morning Awakening
  • Eating Disorder
  • Eating Disorder, Medication-induced
  • Eating Disorder-Binge
  • Eating-Anorexia Nervosa
  • Eating-Bulimia
  • Eating-Laxative/Diuretic Abuse
  • Eating-Obesity
  • Eating-Reactive Hyperphagia
  • Eating-Weight Gain-Drug-induced
  • Edema
  • Edema-Drug Induced
  • Electrolytes-Magnesium-Hypomagnesemia
  • Electrolytes-Potassium Deficiency
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Endocrine Disease-Adrenal
  • Endocrine-Adrenal Disease
  • Endocrine-Adrenal Insufficiency-Addison's Disease
  • Endocrine-Adrenal-Cushing's
  • Endocrine-Adrenal-Hyperaldosteronism
  • Endocrine-Carcinoid
  • Endocrine-Diabetes Mellitus
  • Endocrine-Diabetes Mellitus-Hypoglycemia
  • Endocrine-Gout
  • Endocrine-Hyperparathyroidism
  • Endocrine-Hyperparathyroidism - Primary Type
  • Endocrine-Hyperparathyroidism - Tertiary Type
  • Endocrine-Hypogonadism
  • Endocrine-Hypoparathyroidism-reversable
  • Endocrine-Hypopituitarism
  • Endocrine-Hypothyroidism
  • Endocrine-Metabolic Syndrome
  • Endocrine-Pancreatic Disease
  • Endocrine-Pancreatitis
  • Endocrine-Pheochromocytoma
  • Endocrine-Pituitary Adenoma
  • Endocrine-Porphyria Acute Intermittent
  • Endocrine-Thyroid-Hyper
  • Endocrine-Thyroid-Hypo
  • Enuresis
  • Enuresis/Bedwetting
  • Epilepsy-Seizure-Absence (petit Mal)
  • Epistaxis
  • Erectile Dysfunction
  • Erosive Esophagitis
  • Erythema-Drug Induced
  • Essential Palatal Tremor
  • Essential Tremor
  • Estrogen Related Hair Growth
  • Excessive Daytime Sleepiness
  • Exhibitionism
  • Eye-Cataract
  • Eye-Glaucoma
  • Factitious Disorder
  • Fainting
  • Fatigue
  • Fatigue-Chronic Fatigue Syndrome
  • Fatigue-Myasthenia Gravis
  • Female Orgasmic Disorder
  • Female Pattern Baldness
  • Female Sexual Arousal Disorder
  • Fetishism
  • Fibromyalgia
  • Fluid-Dehydration
  • Fluid-Polydipsia Psychogenic
  • Fluid-Polydipsia Secondary
  • Fluid-Weight Change
  • Flush-Aldehyde Dehydrogenase Deficiency
  • Flushing
  • Flushing Of Skin Due To A Spinal Cord Lesion Above T6
  • Flushing Of The Skin
  • Flushing-Drug Induced
  • Flushing-Gustatory Flushing Syndrome
  • Flushing-Harlequin Syndrome
  • Flushing-Mastocytosis
  • Flushing-VIPoma
  • Folic Acid Deficiency
  • Food Allergy
  • Friedreich\'s Ataxia
  • Frotteurism
  • Gallbladder Disease
  • Gallbladder Disease-choledocholithiasis
  • Gastric Or Peptic Ulcer
  • Gastritis
  • Gastroenteritis
  • Gastroesophageal Reflux Disease (GERD)
  • Gender Identity Disorder
  • Generalized Anxiety Disorder
  • Giant Cell Arteritis
  • Gingivitis
  • Glaucoma
  • Glomus Tumor (paraganglioma)
  • Glomus Tumors
  • Gluten-Celiac Disease
  • Gonorrhea
  • Gout
  • Guillain-Barre Syndrome
  • Gustatory Flushing Syndrome
  • Hair-Alopecia-Male Pattern Baldness
  • Hair-Balding-Alopecia Areata
  • Hair-Balding-Alopecia Medication-induced
  • Hair-Balding-Alopecia Secondary To Childbirth
  • Hair-Balding-Alopecia Universalis
  • Hair-Balding-Alopecia-Telogen Effluvim
  • Hair-Balding-Alopecia-Traction
  • Hair-Estrogen Related Hair Growth
  • Hair-Female Pattern Baldness
  • Hair-Tinea Capitis
  • Hair-Trichotillomania
  • Hallucination
  • Hallucination-Gustatory
  • Hallucinations
  • Harlequin Syndrome
  • Head Trauma
  • Head-Trauma To Scalp
  • Headache
  • Headache-Chronic Daily Headache
  • Headache-Cluster Headache
  • Headache-coital Cephalgia
  • Headache-Coital Cephalgia -dull Type
  • Headache-Coital Cephalgia -explosive Type
  • Headache-Coital Cephalgia -postural Type
  • Headache-Hemicrania Continua
  • Headache-Medication Overuse
  • Headache-Migraine
  • Headache-Migraine Probable
  • Headache-Migraine Status
  • Headache-Migraine With Aura
  • Headache-Migraine Without Aura
  • Headache-Migraine-Retinal
  • Headache-Psychogenic
  • Headache-sinus
  • Headache-Tension
  • Hearing
  • Hearing Problem
  • Hearing-Medication-induced Loss
  • Hearing-Meniere's Disease
  • Hearing-Tinnitus
  • Hearing-Traumatic Tinnitus
  • Heart Cardiac
  • Heart Disease
  • Heart-Angina
  • Heart-Angina - Emergency
  • Heart-Arrhythmia
  • Heart-Bacterial Endocarditis
  • Heart-CHF
  • Heart-Claudication-Intermittent
  • Heart-claudication-Neurogenic
  • Heart-HCM
  • Heart-MI
  • Heart-Mitral Stenosis
  • Heart-Pericarditis
  • Heavy Smoker
  • Heavy Tobacco Smoker
  • Hematemesis
  • Hematochezia
  • Hematuria
  • Hemicrania Continua
  • Hemochromatosis
  • Hemoptysis
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis D
  • Hepatitis E
  • Hepatitis G
  • Hepatolenticular Degeneration-Wilson's Disease
  • Heroin Abuse
  • Heroin Dependence
  • Heroin Dependence In Remission
  • Hiatal Hernia
  • Hip Pain
  • Histrionic Personality
  • HIV Infection
  • Homicide
  • Huntington's Disease
  • Hyperaldosteronism
  • Hypercalcemia
  • Hypercholesterolemia
  • Hyperhidrosis-Idiopathic
  • Hyperparathyroidism
  • Hyperparathyroidism - Primary Type
  • Hyperparathyroidism - Tertiary Type
  • Hyperprolactinemia
  • Hypersomnia
  • Hypertension
  • Hyperthyroidism
  • Hypertriglyceridemia
  • Hypertrophic Cardiomyopathy
  • Hypoactive Sexual Desire
  • Hypoactive Sexual Desire Disorder
  • Hypochondriasis
  • Hypoglycemia
  • Hypogonadism
  • Hypokalemia
  • Hypokalemia
  • Hypokalemia-Diuretic-induced
  • Hypomagnesemia
  • Hypoparathyroidism
  • Hypoparathyroidism-reversable
  • Hypopituitarism
  • Hypothyroidism
  • Hypothyroidism
  • Idiopathic Hyperhidrosis
  • Impulse Control Disorder
  • Incomplete Bladder Emptying
  • Incontinence-stress Type
  • Incontinence-unaware Type
  • Incontinence-Urge
  • Incontinence-urge Type
  • Increased Intracranial Pressure
  • Infection-AIDS
  • Infection-Creutzfeldt-Jakob
  • Infection-Gonorrhea
  • Infection-HIV
  • Infection-Lyme Disease
  • Infection-Malaria
  • Infection-Rheumatic Fever
  • Infection-Syphilis
  • Infection-Urinary Schistosomiasis
  • Infection-Viral Infection
  • Inferior Temporal Lobe Seizure
  • Inflammatory Disease Of Uterus, Unspecified
  • Inhalant Abuse
  • Inhalant Dependence In Remission
  • Initial Insomnia
  • Insomnia
  • Insomnial-Early Morning Awakening
  • Intermittent Claudication
  • Intermittent Explosive Disorder
  • Intracranial Pressure - Increased
  • Involuntary Emotional Expression Disorder (IEED)
  • Iron Deficiency
  • Irritable Bowel Syndrome (IBS)
  • Kidney Disease
  • Kidney Stone
  • Kidney-Alport Syndrome
  • Kidney-Chronic Renal Failure
  • Kidney-Diabetes Insipidus
  • Kidney-Pyelonephritis
  • Kidney-Renal Failure
  • Kidney-Renal-Failure-Acute
  • Kidney-Uremia
  • Kleine-Levin Syndrome
  • Kleptomania
  • Knee Pain
  • Labyrinthitis Acute
  • Lactase Deficiency
  • Lactose Intolerance
  • Laxative/Diuretic Abuse
  • Lead Toxicity
  • Learning Disorder
  • Leukoplakia
  • Lewy Body Dementia
  • Liver Cirrhosis
  • Liver Disease
  • Liver Disease - Cirrhosis
  • Liver Disease-autoimmune Hepatitis
  • Liver-Cirrhosis-billary
  • Liver-Common Bile Duct Obstruction
  • Liver-Hepatitis B
  • Liver-Hepatitis C
  • Liver-Hepatitis D
  • Liver-Hepatitis E
  • Liver-Hepatitis G
  • Liver-Hepatolenticular Degeneration-Wilson's Disease
  • Liver-Viral Hepatitis
  • LSD Abuse
  • LSD Dependence
  • LSD Dependence In Remission
  • Lung-Asthma
  • Lung-Bronchiectasis
  • Lung-Bronchitis
  • Lung-COPD
  • Lung-Pleurisy
  • Lung-Pneumonia
  • Lung-Pulmonary Embolism
  • Lung-TB
  • Lupus Erythematosus
  • Lupus Erythematosus-Drug Induced
  • Lyme Disease
  • Magnesium-Hypomagnesemia
  • Malabsorption
  • Malaria
  • Male Orgasmic Disorder
  • Malignant Neoplasm Of Mouth, Unspecified
  • Malnutrition
  • Malnutrition-Gluten-Celiac Disease
  • Manganese Toxicity
  • Marijuana Abuse
  • Marijuana Dependence
  • Marijuana Dependence In Remission
  • Mastocytosis
  • Medication Overuse Headache
  • Medication-induced Eating Disorder
  • Medication-induced Erythema
  • Medication-induced Flushing
  • Medication-induced Hearing Loss
  • Meiges Syndrome
  • Melena
  • Meniere's Disease
  • Menopause
  • Menopause-Drug Induced
  • Menopause-early
  • Menopause-Perimenopause
  • Menopause-Postmenstrual Duress
  • Menopause-surgical
  • Mental Retardation
  • Meprobamate Abuse
  • Meprobamate Dependence
  • Meprobamate Dependence In Remission
  • Meprobamate Use
  • Mercury Toxicity
  • Mescaline Abuse
  • Mescaline Dependence
  • Mescaline Dependence In Remission
  • Metabolic Syndrome
  • Metal Toxicity-Aluminum
  • Metal-Aluminum
  • Metal-Arsenic
  • Metal-Boron
  • Metal-Lead
  • Metal-Mercury
  • Metal-Selenium
  • Metal-Tellurium
  • Metal-Zinc
  • Middle Insomnia
  • Migraine Headache
  • Migraine Headache-probable
  • Migraine Headache-retinal
  • Migraine Headache-status
  • Migraine Headache-with Aura
  • Migraine Headache-without Aura
  • Mitral Valve Stenosis
  • Movement Disorder
  • Movement-Akathisia-Neuroleptic-induced
  • Movement-ALS
  • Movement-Chorea Gravidarum
  • Movement-CTD-Polymyalgia Rheumatica
  • Movement-Dermatopolymyositis
  • Movement-Essential Tremor
  • Movement-Guillain-Barre Syndrome
  • Movement-Huntington's
  • Movement-Myoclonus
  • Movement-Parkinson's
  • Movement-Parkinsonism
  • Movement-Tardive Dyskinesia
  • Movement-Tic Disorder
  • Movement-Tourette's Disorder
  • Movement-Transient Tic Disorder
  • Multiple Sclerosis
  • Myasthenia Gravis
  • Myocardial Infarction
  • Myoclonic Seizure
  • Myoclonus
  • Narcissistic Personality
  • Narcolepsy
  • Nasal Congestion-Rebound Congestion
  • Neurodermatitis
  • Neurofibromatosis
  • Neurofibromatosis-I
  • Neurofibromatosis-II
  • Neurogenic Claudication
  • Neuroleptic Malignant Syndrome
  • Neuropathies
  • Night Eating Syndrome
  • Night Sweats
  • Nightmare Disorder
  • Nocturia
  • Nonadherence
  • Nonne-Milroy's Disease
  • Nose Bleed
  • Nutrition-Iron Deficiency
  • Nutrition-Lactose Intolerance
  • Nutrition-Malabsorption
  • Nutrition-Malnutrition
  • Nutrition-Thiamine B1 Deficiency
  • Nutrition-Tropical Sprue
  • Nutrition-Vitamin-Avitaminosis
  • Nutrition-Vitamin-B12 Deficiency
  • Nutrition-Vitamin-B5-Pantothenic Acid Deficiency
  • Nutrition-Vitamin-B6-Pyridoxine Deficiency
  • Nutrition-Vitamin-B9-Folic Acid Deficiency
  • Nutrition-Vitamin-D Deficiency
  • Obesity
  • Obsessive-compulsive Disorder (OCD)
  • Obstruction Intestinal
  • Obstruction-Common Bile Duct
  • OCD
  • OCD Personality
  • OCD-medication Induced
  • Olfactory Hallucinations
  • Opioid Abuse
  • Opioid Dependence
  • Opioid Dependence In Remission
  • Optic Neuritis
  • Oral Cancer
  • Oral Facial Dystonia
  • Oral-Dry Mouth
  • Oral-Gingivitis
  • Orgasmic Disorder
  • Orgasmic Disorder-Female
  • Orgasmic Disorder-males
  • Orthostasis
  • Osteoporosis
  • Other And Unspecified Lesions Of Oral Mucosa
  • Overactive Bladder
  • Pain Abdominal Chronic
  • Pain Abdominal Infarction
  • Pain Disorder
  • Pain Disorder Due To Anatomical And Psychological Conditions
  • Pain Disorder-Psychiatric
  • Pain Disorder-Psychological & General
  • Pain-Abdomen-Acute
  • Pain-Abdominal
  • Pain-Abdominal-Localized To The Lower Abdomen
  • Pain-Abdominal-Localized To Upper Abdomen
  • Pain-Abdominal-Perforation Of Viscus
  • Pain-Abdominal-Visceral
  • Pain-Bowel-Obstruction
  • Pain-Branchial Neuralgia
  • Pain-Chronic Pain
  • Pain-Costochondritis
  • Pain-Erosive Esophagitis
  • Pain-Gastric Ulcer
  • Pain-Heartburn-Gastroesophageal Reflux Disease
  • Pain-Hip
  • Pain-Irritable Bowel Syndrome (IBS)
  • Pain-Peptic Ulcer Disease (PUD)
  • Pain-Peritonitis
  • Pain-Thalamic Central Pain Syndrome
  • Pain-Ulcer
  • Pain-Ulcer-Duodenal
  • Pain-Ulcer-Zollinger-Ellison Syndrome
  • Pancreatic Disease
  • Pancreatic Disease Unspecified
  • Pancreatitis
  • Panic Attacks
  • Panic Disorder
  • Pantothenic Acid Deficiency
  • Paranoid Personality
  • Paraphilia
  • Parkinson's Disease
  • Partial Seizure
  • Partial Seizures
  • Partialism
  • Pathological Gambling
  • Pathological Gambling-medication Induced
  • PCP Dependence
  • PCP Dependence In Remission
  • Pedophilia
  • Pedophilia Exclusive
  • Pedophilia Limited To Incest
  • Pelvic And Perineal Pain
  • Pelvic Inflammatory Disease
  • Pelvic Inflammatory Disease (PID)
  • Perforation Of Viscus
  • Pericarditis
  • Perimenopause
  • Periodic Limb Movement Disorder
  • Peripheral Neuropathy
  • Peripheral Vascular Disease
  • Peripheral Vascular Disease (PVD)
  • Peritonitis
  • Personality Avoidant
  • Personality Disorder
  • Personality-Antisocial
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  • Restless Leg Syndrome-neuroleptic Induced
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  • Retinal Disorder, Unspecified
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  • Sjogren's Syndrome
  • SLE
  • SLE-Drug Induced
  • Sleep Apnea
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  • Sleep Terror Disorder
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  • Sleep-Kleine-Levin Syndrome
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  • Sleep-poor Sleep Hygiene
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  • Sleep-Related Eating Disorder
  • Sleep-Restless Leg Syndrome Neuroleptic-induced
  • Sleep-Restless Legs Syndrome
  • Sleep-Sleep Apnea
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  • Sleep-Sleep Disorder Related To Down's
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  • Sleep-Sleep Disorder Related To Myopathy
  • Sleep-Sleep Disorder Related To Nocturnal Headaches
  • Sleep-Sleep Disorder Related To Nocturnal Seizures
  • Sleep-Sleep Disorder Related To Spasticity
  • Sleep-Sleep Disorder Related To Tourette's
  • Sleep-Sleep Terror Disorder
  • Sleep-Sleepwalking
  • Sleep-Substance-induced Hypersomnia
  • Sleep-Substance-Substance Induced Sleep Disorder
  • Sleepwalking
  • Social Phobia (Social Anxiety)
  • Somatic-Conversion Disorder
  • Somatization
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  • Spinal Cord Lesions Above T6
  • Stevens-Johnson Syndrome Or Toxic Epidermal Necrolysis
  • Stevens-Johnson Toxic Epidermal Necrolysis
  • Stress
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  • Stroke
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  • Stroke - Lateral Hypothalamus
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  • Stroke-Transient Ischemic Attack (TIA)
  • Stuttering
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  • Substance-Peyote Abuse
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  • Substance-Psilocybin Abuse
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  • Substance-Tobacco Use Disorder
  • Substance-Tobacco-Heavy Smoker
  • Suicide
  • Syncope (Fainting)
  • Syphilis
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  • Systemic Lupus Erythematosus
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  • Renal Cell Carcinoma

    Renal cell carcinoma, or hypernephroma, is a type of kidney cancer that originates in the the lining of very small tubes (tubules) in the kidney that filter the blood and remove waste products.

    Epidemiology of Renal Cell Carcinoma

    Renal cell carcinoma is responsible for 3% of adult cancers, is the most common type of kidney cancer in adults and is responsible for approximately 90-95% of neoplasms arising from the kidney. It occurs most often in men ages 50-70, but unfortunately it also occurs in women. Renal cell carcinoma is also the most lethal of all the kidney cancers. It effects both kidneys in about 2% of cases, and it spreads easily (most often to the neighboring lymph nodes, the lungs-75%, the soft tissues-36%, the bones-20%, the liver-18%, or the brain-8%).  When the tumor is confined to the renal parenchyma (stage I) the 5-year survival rate is 80-85%; but this is lowered considerably when it grows beyond the confines of the kidney, and is reduced to a 5-year survival rate of less than 5% if the tumor has spread to other organs beyond the local lymph nodes.

     

    [kidney+cancer+stage.gif]

    Renal Cell Carcinoma Staging

    Staging of renal cell carcinoma is generally categorized by the Robson, histological, and genetic classification systems.

    The Robson Staging System of Renal Cell Carcinoma

    The Robson modification of the Flocks and Kadesky system is commonly used in clinical practice. This system was designed to correlate stage at presentation with prognosis. The Robson staging system is as follows:

    • Stage I - Tumor confined within capsule of kidney
    • Stage II - Tumor invading perinephric fat but still contained within the Gerota fascia
    • Stage III - Tumor invading the renal vein or inferior vena cava (A), or regional lymph-node involvement (B), or both (C)
    • Stage IV - Tumor invading adjacent viscera (excluding ipsilateral adrenal) or distant metastases

    The Tumor, Nodes, and Metastases (TNM) Classification System

    The major advantage of the TNM system is that it clearly differentiates between disease with tumor thrombi that spread disease via the blood from those with disease in the local lymph nodes.

    The TNM classification system is as follows:

    • Primary tumor (T)
      • TX - Primary tumor cannot be assessed
      • T0 - No evidence of primary tumor
      • T1 - Tumor 7 cm or smaller in greatest dimension, limited to the kidney
      • T2 - Tumor larger than 7 cm in greatest dimension, limited to the kidney
      • T3 - Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond the Gerota fascia
      • T3a - Tumor invades adrenal gland or perinephric tissues but not beyond the Gerota fascia
      • T3b - Tumor grossly extends into the renal vein(s) or vena cava below the diaphragm
      • T3c - Tumor grossly extends into the renal vein(s) or vena cava above the diaphragm
      • T4 - Tumor invading beyond the Gerota fascia
    • Regional lymph nodes (N) - Laterality does not affect the N classification
      • NX - Regional lymph nodes cannot be assessed
      • N0 - No regional lymph node metastasis
      • N1 - Metastasis in a single regional lymph node
      • N2 - Metastasis in more than 1 regional lymph node
    • Distant metastasis (M)
      • MX - Distant metastasis cannot be assessed
      • M0 - No distant metastasis
      • M1 - Distant metastasis
    • AJCC stages
      • AJCC stage I - T1, N0, M0
      • AJCC stage II - T2, N0, M0
      • AJCC stage III - T1-2, N1, M0 or T3a-c, N0-1, M0
      • AJCC stage IV - T4; or any T, N2, M0; or any T, any N, M1
    • The division of patients with renal cell carcinoma into low-, intermediate-, and high-risk groups with or without metastases may be useful in choosing appropriate therapy for them.

    Renal Cell Carcinoma Histologic Subtypes

    The 5 histological subtypes of renal cell carcinomas include clear cell (75%), chromophilic (15%), chromophobic (5%), oncocytoma (3%), and collecting duct (2%) 

    Genetic Classification of Renal Cell Cancer

    Renal Cell Cancer Genetics

    Renal cancer occurs in both a sporadic (nonhereditary) and a hereditary form, and both forms are associated with structural changes of the short arm of chromosome 3 (3p). In addition, there are at least 4 hereditary syndromes associated with renal cell carcinoma including von Hippel-Lindau (VHL) syndrome, hereditary papillary renal carcinoma (HPRC), familial renal oncocytoma (FRO) associated with Birt-Hogg-Dube syndrome (BHDS), and hereditary renal carcinoma (HRC).

    Genetic studies are commonly used to classify renal cell tumors

    • Clear cell renal carcinoma
    • Papillary renal cell carcinoma
    • Chromophobe renal cell carcinoma
    • Collecting duct carcinoma

    Renal cell carcinoma is more common in people of Northern European ancestry (Scandinavians) and North Americans than in those of Asian or African descent. 

    Signs and Symptoms

    The classic triad of symptoms associated with a person with renal cell carcinoma is blood in the urine (hematuria), flank pain and an abdominal mass. This classic triad only occurs in 10-15% of people with advanced renal cell carcinoma, and now the majority of renal cell tumors are detected accidentally during CT or MRI imaging, usually for an unrelated causes.

    The most common signs at diagnosis include dark, rusty, or brown urine color due to blood in the urine (40% of cases), flank pain (40% cases), weight loss (33% of cases) anemia (30% of cases), abdominal mass (25% of cases). and high blood pressure (20% of cases). 

    Risk Factors for Renal Cell Carcinoma

    Risk factors for renal cell carcinomas can be divided into genetic, modifiable (preventable), and unavoidable causes.

    Genetic Risks for Renal Cell Carcinoma

    Renal cell carcinoma risk factors include a family history of the disease, and nearly 40% of patients with von Hippel-Lindau disease develop renal cell carcinoma. Also, people with the disease Tuberous sclerosis have a high probability of developing angiomyolipomas and renal cysts and can lead to renal cell carcinoma. 

    Unavoidable Risks for Renal Cell Carcinoma

    There is an increased incidence of acquired cystic disease of the kidney in patients undergoing long-term renal dialysis and subsequently predisposes to renal cell cancer.

    Modifiable Risks for Renal Cell Carcinoma

    Smoking tobacco doubles the risk of renal cell carcinoma and contributes to as many as one third of all cases. The risk appears to increase with the amount of tobacco smoked in a dose-dependent fashion.

    Obesity is another risk factor, particularly in women; increasing body weight has a linear relationship with increasing risk.

    Hypertension may be associated with an increased incidence of renal cell carcinoma.

    Phenacetin-containing analgesia taken in large amounts may be associated with increased incidence of renal cell carcinoma, and phenacetin is often used as a cutting agent by illicit drug dealers to increase the size of samples of cocaine they intend to sell.

    Find out if your personal health history puts you at risk for having 'Renal Cell Carcinoma' --> Click Here to Take an Online Assessment.



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