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Renal Week 3 2017/18 > 5: Pathology 2 > Flashcards

5: Pathology 2 Flashcards

1
Q

What is agenesis of the kidneys?

A

Complete failure of one or both kidneys to develop

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2
Q

Hypoplasia describes ___ organs with (normal / abnormal) development.

A

smaller

normal development

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3
Q

Which poles of the kidneys usually fuse to cause horseshoe kidney?

A

Inferior poles

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4
Q

Does horseshoe kidney affect renal function?

A

Usually not

but can obstruct ureters

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5
Q

Congenital abnormalities of the kidney predispose you to ___.

A

UTIs

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6
Q

What neurological presentation is associated with renal agenesis?

A

Oligohydramnios

Low volume of amniotic fluid in the placenta

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7
Q

What abnormal facial appearance is associated with oligohydramnios?

Which congenital renal disorder causes it?

A

Potter’s facies - low set ears, small jaw, flattened tip of the nose

Renal agenesis

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8
Q

What type of kidney disease, with a characteristic appearance, is very common?

A

Cystic kidney disease

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9
Q

What can cysts contain?

A

Serous fluid

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10
Q

Why may cystic kidney disease cause abdominal pain?

A

Ruptured cysts

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11
Q

What are the two types of polycystic kidney disease and how are they inherited?

A

a) Autosomal dominant PKD - adults, PKD1 on chromosome 16

b) Autosomal recessive PKD - kids, PKDH1, chromosome 6

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12
Q

Is polycystic kidney disease unilateral or bilateral?

A

Bilateral

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13
Q

What happens to the kidneys in

a) ADPKD
b) ARPKD?

A

a) Hyperplasia, damage to tubules

b) Hypoplasia, damage to collecting ducts, fibrosis

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14
Q

What is a characteristic feature of ARPKD?

A

Hypoplasia due to fibrosis

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15
Q

What are the symptoms of polycystic kidney disease?

A

Haematuria

Polyuria

Chronic loin pain

Hypertension

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16
Q

Because ADPKD causes hyperplasia, what may be seen on examination?

A

Abdominal mass

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17
Q

What neuro presentation is associated with ADPKD?

A

Subarachnoid haemorrhage

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18
Q

What diseases are associated with

a) ADPKD
b) ARPKD?

A

a) Loads - subarachnoid haemorrhage, valve disease, diverticulae and hernia

b) Fibrosis of kidneys

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19
Q

What are the most common benign kidney tumours?

A

Fibromas

20
Q

What do fibromas look like?

A

White

Found in renal medulla

21
Q

What do adenomas look like?

Where in the kidneys are they found?

A

Yellow

Adrenal cortex

22
Q

What benign kidney tumours are found in tuberous sclerosis?

A

Angiomyolipoma

blood vessels, muscles and fat

23
Q

Which benign kidney tumours produce renin?

What systemic disease can this cause?

A

Juxtaglomerular cell tumours

Secondary hypertension

24
Q

What is the commonest malignant kidney tumour in children?

A

Nephroblastoma

arises from embryological tissue

25
Q

What is the commonest malignant kidney tumour found in adults?

A

Renal cell carcinoma

26
Q

(Men / women) are at greater risk of RCC.

A

Men

27
Q

What are the symptoms of RCC?

A

Abdomnal mass

Haematuria

Loin pain

Weight loss, anorexia, fever, fatigue

28
Q

What is polycythaemia?

A

Increased number of red cells

29
Q

Why do patients with RCC develop

a) polycythaemia
b) hypercalcaemia?

A

a) Overproduction of EPO

b) Overproduction of calcitriol (activated Vitamin D)

30
Q

Where do RCCs tend to be found?

A

Renal cortex

31
Q

By which vessels can RCCs spread?

A

Renal vein

32
Q

What specific type of RCC is the most common?

A

Clear cell RCC

33
Q

RCCs tend to spread (haematogenously / lymphatically).

A

haematogenously

34
Q

What is seen on histology in RCC?

A

Cysts

Haemorrhage

Necrosis

35
Q

Which malignant tumour arises from the urothelium?

A

Transitional cell carcinoma

36
Q

Where can transitional cell carcinomas be found?

A

Renal pelvis

to

Urethra

37
Q

Which tumour is most commonly found in the bladder?

A

Transitional cell carcinoma

38
Q

What are major risk factors for transitional cell carcinoma?

A

Industrial - work with dyes, rubber

Smoking

Drugs - cyclophosphamide, analgesia

Schistosomiasis infection

39
Q

What is the biggest risk factor for transitional cell carcinoma?

A

Smoking

40
Q

What is the main presenting complaint of transitional cell carcinoma?

A

Haematuria

41
Q

As transitional cell carcinoma can be found in the bladder, what problem may it cause?

A

Obstruction

42
Q

What do low-grade TCCs look like?

What do high-grade TCCs look like?

A

Papillary - like hairs

Solid

43
Q

How is TCC investigated?

A

Cystoscopy

or urography/USS kidneys, depends on where it is

44
Q

Which lymph nodes may TCCs spread to?

A

Obturator nodes

45
Q

TCC is staged by its invasion of which structures?

A

Muscle

Blood vessels

Lymph nodes

46
Q

Which malignant tumours are associated with

a) glandular metaplasia
b) squamous metaplasia?

A

a) Adenocarcinoma

b) Squamous cell carcinoma

47
Q

What is the commonest malignant urinary tract tumour in children?

A

Rhabdomyosarcoma

malignant tumour of skeletal muscle

Renal Week 3 2017/18 (12 decks)

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