(5.1) Renal Pathology IV (Putthoff)

Question 1

Kidney stones become symptompatic when they enter _________

Answer 1

Kidney stones become symptompatic when they enter the ureter

Question 2

What are the symptoms of neprholithiasis? (kidney stones)

Answer 2

Intense pain - renal colic

Ulceration and bleeding of ureter

Obstruction of urinary flow

Question 3

What is the primary composition of kidney stones?

Answer 3

Calcium oxalate and phosphate

Question 4

What are the predisposing factors to kidney stones?

Answer 4

Changes in urinary pH

Decreased urine volume

Presence of bacteria

Question 5

What are examples of benign renal neoplasias?

Answer 5

Renal papillary adenoma

Angiomyolipoma

Oncocytoma

Renal ribroma/hamartoma

Juxtaglomerular cell tumor

Question 6

How do you tell the intensity of various renal papillary adenomas?

Answer 6

Defined by SIZE

Question 7

What are the size distinctions between renal papillary adenomas?

Answer 7

Benign adenomas <1.0 cm or less

Neoplasms >1.0cm or greater

Question 8

Angiomylipomas

genes?

Answer 8

Loss of TSC1 or TSC2 tumor suppressor genes

Question 9

Renal Angiomyolipoma

Clinical significance?

Answer 9

On occasion, these may spontaneously rupture with MASSIVE HEMORRHAGE

Initial presentation may be shock secondary to massive retroperitoneal and/or intra-abdominal hemorrhage

Question 10

Renal cell carcinoma (RCC)

malignant?

population?

risk factors?

Answer 10

Yes

6-8th decade

Cigarette smoking, HTN, obesity, estrogens, asbestos, chronic renal disease, tuberous sclerosis, aquired cystic disease

Question 11

What is the most common form of renal cell carcinoma?

Answer 11

Clear cell carcinoma

Question 12

Clear cell carcinoma are due to a loss of function of:

Answer 12

VHL

Question 13

Both sporadic papillary and heridtary papillary are due to a mutated and activated…

Answer 13

MET

Question 14

Clear cell renal carcinom is related to the deletions on chromosome…

Answer 14

3

Question 15

Sporadic papillary renal cell carcinoma is related to….. (what chromosomal abnormality?)

Answer 15

Trisomy 7, 16, 17

Loss of Y

Question 16

Hereditary papillary renal cell carcinoma is related to….. (what chromosomal abnormality?)

Answer 16

Trisomy 7

Question 17

What is the classic triad of renal cell carcinoma?

Answer 17

Hematuria

Costoverteberal pain

Palpable flank mass

Question 18

Urothelial carcinomas are made of what type of cells?

Found where?

Answer 18

Transitional cells

Renal pelvis

Question 19

What mutations are associated with Wilms tumors?

Answer 19

WT1 mutations

Question 20

NOW ON SLIDE DECK 4

Question 21

What is exstrophy?

Answer 21

A developmental failure in the anterior wall of the abdomen and the bladder

Question 22

What is the vesicoureteral reflux (VUR)?

Answer 22

Urine from the bladder exhibits retrograde flow into the ureter and kidney

usually related to “valve” malfunction

Question 23

Cystitis

Commmon?

Presentation?

Answer 23

VERY! Especially in women

Frequency, dysuria, pelvic/abdominal pain, low grade fever, turbid urine or hematuria

Question 24

What are the most common etologic agents that cause acute cystitis?

Answer 24

E. coli

Proteus

Klebsiella

Enterobacter

Question 25

Sorry he flew through this… look up key concepts testicular tumors p980

Question 26

Wow.