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Renal Too > Bladder > Flashcards

Bladder Flashcards

1
Q

This is the congenital defect where there are multiple ureters out of the same kidney

A

Double and bifid ureters

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2
Q

This is the obstriction at the junction between the kidney and ureter caused by abnormal organization of smooth muscle bundles or extreinsic compression by polar renal vessels.

A

Uteropelvic junction obstruction

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3
Q

Uteropelvic junction obstruction can cause what disease in kids?

A

Hydronephrosis

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4
Q

These are saccular outpouchings of the uretheral wall.

A

Diverticula

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5
Q

Uretheral diverticula are normally asymptomatic but can be breeding grounds for what?

A

bacterial infeciton

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6
Q

What is the most common mechanism to cause bladder diverticula?

A

Persistnat uretheral obstruction like an enlarged prostate

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7
Q

This is the developmental failure in the anterior wall of the abdomen and bladder so that the bladder is exposed to teh surgace of the body.

A

Exstrophy

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8
Q

Extrophy of the bladder can predispose you to what form of cancer?

A

Adenpcarcinoma

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9
Q

This is the condition where the bladder and umbilicus are connected

A

Patent urachus

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10
Q

This is the accumulation of lymphocytes in the ureters causing subepithelial elevation and a granular mucosal surface.

A

Ureteritis follicularis

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11
Q

This is when 1-5mm cysts sprinkle the mucosa of the ureters.

A

Ureteritis cystica

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12
Q

When do symptoms typically improve in acute cystitis?

A

within 2 days after Tx

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13
Q

What is the triad of Sx for acute cystitis?

A

Frequency
Lower abd pain over bladder region
Dysuria

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14
Q

How long must u have cystitis to be a “chronic”?

A

> 2 wks

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15
Q

This is the persistent, painful form of chronic cystitis that occurs mainly in women and is characterized by severe suprapubic pain, urinary frequency, urgency, hematuria, and dysuria without evidence of bacterial infection.

A

Interstitial cystitis

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16
Q

What 3 things show up on the bladder mucosa in interstitial cystitis?

A

fissues, punctate hemorrhages, and Hunner ulcers

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17
Q

This is a vesical inflammatory rxn characterized macroscopically by soft, yellow, slightly raised mucosal plaques.

A

Malacoplakia

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18
Q

What do you see on histological exam with malacoplakia?

A

Large foamy macrophages, with giant cells, and lymphocytes

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19
Q

What do you see in the macrophages in malakoplakia?

A

mineralized Ca deposition in enlarged lysosomes (Michaelis-Gutmann bodies)

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20
Q

What causes malacoplakia?

A

chronic bacterial infection (E. coli or proteus)

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21
Q

This is an inflammatory condition resulting from irritation to the bladder mucosa, causing marked submucosa edema (looks a lot like papillary urothelial carcinoma)

A

Polypoid cystitis

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22
Q

What typically causes polypoid cystitis?

A

Catheters

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23
Q

These are mestplastic nests of urothelium (brunn nests) that grow into the lamina propria.

A

Cystitis glandularis and cystitis cystica

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24
Q

What does the bladder epithelium undergo metaplasia to form in cystitis glandularis?

A

Cuboidal or columnar epithelium

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25
Q

This is a variant of cystitis glandularis that includes goblet cells as well as epithelium that resembles intestinal mucosa.

A

Intestinal or colonic metaplasia

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26
Q

This is the metaplastic lesion where the epithelium transforms into cystic spaces filled with clar fluid lined by flattened urothelium.

A

Cystitis cystica

27
Q

True or False: metaplastic lesions showing extensive intestinal metaplasia have an increased risk of developing adenocarinoma.

A

FALSE. They do not.

except when assocaited with exstrophy… lol

28
Q

What causes squamous metaplasia in the bladder?

A

Injury

29
Q

Squamous metaplasia should be distinguised from what form of epithelium normally found at the trigone in women?

A

Glycogenated squamous epithelium

30
Q

These is the tumor shed from renal tubular cells that inplant in sites of injured urothelium.

A

Nephrogenic adenoma

31
Q

The overlying urothelium of neprhogenic adenomas may be focally replaced by what epithelium, which can assume a papillary growth pattern?

A

Cuboidal epithelium

32
Q

What are the 2 forms of urothelial/transitional tumors?

A
  1. Non-invasive papillary tumors (most common)

2. Flat non-invasive urothelial carcinoma (carcinoma in situ)

33
Q

In flat urothelial carcinomas, what is the gross morphology of the area?

A

Area of mucosal reddening, granularity, or thickening without producing an evident mass.

34
Q

This is the name of the spread of flat urothelial carcinomas where there is scattered malignant cells in an otherwise normal urothelium.

A

Pagetoid spread

35
Q

This is the type of urothelial cancer wehre there is invasion into muscularis mucosae and spreads.

A

Invasive urothelial cancer

36
Q

What are the 4 high yield risk factors for urothelial carcinoma?

A
  1. SMOKING
  2. Napthylamine
  3. Azo-dyes (hairdressers)
  4. Long term cyclophosphamide or phenacetin use
37
Q

What is the presentation of urothelial carcinomas?

A

Painless hematuria

38
Q

In papillary growths of urothelial carcinomas, what is the progression of the disease?

A

Low grade –> high grade –> invade

39
Q

For flat urotheial carcinomas, what is the progression of the disease?

A

Start HIGH grade –> invade

40
Q

What mutations are assocaited with flat urothelial carcinomas?

A

early p53 mutations

41
Q

What must be ruptured in both papillary and flat urothelial carcinomas to become invasive?

A

The basement membrane

42
Q

Since the bladder doesnt normally have quamous cells, what must occur to have squamous cell carcinoma?

A

Metaplasia to squamous cells –> dysplasia –> cancer

43
Q

What is the high yield infection that predisposes you to squamous cell carcinomas?

A

Shistosoma hematobium

44
Q

What type of person may classically present with squamous cell carcinomas from schistosoma hematobium infections?

A

Middle eastern male

45
Q

What 2 chronic conditions are risk factors for squamous cell carcinomas?

A

Chronic cystitis

Long-standing nephrolithiasis

46
Q

True or False: it is more common in squamous cell carcinoma for have mixed urothelial carcinomas with areas of squamous carcinoma than just pure squamous cell carcinoma.

A

True

47
Q

This is the type of cancer from the malignant proliferation of the glands of the bladder.

A

Adenocarcinoma

48
Q

What are the 3 high yield associations for adenocarcinomas?

A
  1. Urachal remnant
  2. Cystitis glandularis
  3. Exsotrophy
49
Q

Where is the common location in the bladder for adenocarcinomas from urachal remnants?

A

Dome of the bladder

50
Q

Urothelial, suqamous, or adenocarcinomas are assocaited with the formation of what other cancer type in the bladder?

A

Small cell carcinoma

51
Q

What is the most import risk factor for bladder cancer?

A

Smoking

52
Q

30-60% of bladder cancer have what 2 genetic alterations?

A

Chromosome 9 monosomy

Deletions of 9p and 9q (as well as deletions of 17p, 13q, 11p and 14q).

53
Q

Deletion of 9p stops the production of which tumor suppresor gene?

A

p16 (INK4a)

54
Q

Deletion of 17p stops the production of which tumor suppresor gene?

A

p53

55
Q

After tumor removal, what is common in bladder cancers?

A

Recurrence

56
Q

What is the diagnostic tool for bladder cancers?

A

Cystoscopy + biopsy

57
Q

What is the treatment for small, localized, non high grade bladder cancer?

A

transurethral resection

58
Q

What is the Tx for tumors invading muscularis propria, CIS, or high grade papillary cancer?

A

Radical cystectomy

59
Q

In males, what typically obstructs the bladder neck?

A

Prostate

60
Q

In females, what typically obstructs the bladder neck?

A

Cystocele

61
Q

What happens in the early stages of bladder neck obstruction?

A

SM hypertrophy and trabeculations in the bladder

62
Q

What happens in the later stages of bladder neck obstruction?

A

Diverticula

63
Q

What causes markely thinned bladder without trabeculations of the bladder?

A

Acute obstruction or terminal disease

Renal Too (3 decks)

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