Jonathan Casto, PA-C was recently published in a national medical journal, “The Journal of the American Academy of Physician Assistants.” His article titled “What is causing this patient’s hematuria?” was published in their September 2016 issue.
Hematuria is the term for blood in the urine and can be caused by a urinary tract infection, kidney stones or an injury to the kidney. The patient presented with hematuria, right flank pain and frequent urination. Upon examination, a large mass was felt in the right flank and abdomen prompting further testing. A CAT scan revealed a renal cell carcinoma (kidney cancer) of roughly 6”x5”x4”. The patient was referred to the oncology department where he underwent a right radical nephrectomy (removal of kidney). The fact that renal cancers are aggressive and can be metastatic preclude a cursory examination. A less thorough examination would have led the clinician to assume a common urinary tract infection or kidney stones, resulting in treating the patient and discharging them home. Casto’s main conclusion was to emphasize that a thorough physical examination was necessary to diagnose the kidney cancer.
Casto graduated valedictorian of River Valley High School in 2006, graduated Summa Cum Laude from the University of Rio Grande with an Associate’s Degree in Radiologic Technology in 2008 and a Bachelor’s Degree in Biology/Chemistry in 2011. He worked at Pleasant Valley Hospital as an X-Ray tech for three years until enrolling in the Physician Assistant program at Marietta College. After graduating with honors from Marietta College in 2013, he began working as a PA in Charleston, W.Va. He and his wife, Ashley, also a PA, are currently working in Mountain Home, Idaho. Jonathan is the son of Tim and Trhonda Casto of Vinton, Ohio. They are expecting their first child, a son, in January 2017. Jonathan and his wife enjoy hiking, kayaking, camping and hunting with their dog, Kota.