Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a > GU > Flashcards

GU Flashcards

(72 cards)

Start Studying
1
Q

Name the two groupings of glomerulonephritis?

Quickly define each of the groupings

A

Nephrotic Syndrome - proteinuria w/ hypoalbuminaemia and oedema (greater than 3.5g/day)

Nephritic Syndrome - haematuria w/ oliguria and HTN (less than 3.5g/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 primary nephrotic syndrome diseases?

What is the normal race associated with each?

A

Minimal change glomerulonephritis (children & adults)

Focal segmental glomerulosclerosis (black)

Membranous glomerulonephritis (Caucasian)

Membranoproliferative glomerulonephritis (Caucasian)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 5 secondary causes for nephrotic syndrome?
What is the characteristic property of urine with high protein?
What biochemical disorder of the blood is common with nephrotic syndrome?

A 
Diabetes
Amyloidosis
SLE
Infections
Malignancy
(DASIM)

Frothy urine

Hypercholesterolaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Minimal change glomerulonephritis:
Association with what disease?
H&E?
EM?
IF?
Note on prognosis
A

Association with Hodgkin’s lymphoma

Normal on H&E
Effacement of foot processes on EM
No immune complexes - no IF stainined

Children generally respond well to steroids, good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q 
Focal segmental glomerulosclerosis:
Association with what 2 diseases and \_\_ use?
H&E?
EM?
Better or worse prognosis than MCD?
A

Association with HIV, sickle cell disease and heroin use

Focal and segmental sclerosis on H&E
Effacement of foot processes on EM
No immune complexes, no IF

Poorer response to steroids, will often progress to CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Membranous glomerulonephritis:
H&E?
EM?
IF?

A

Thick glomerular basement membrane on H&E

Spike and dome on EM

Positive granular IF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Membranoproliferative glomerulonephritis:
H&E?
EM?
IF?

Note on T1 vs T2?

A

Thick glomerular basement membrane on H&E

Tram track on EM

Positive granular IF

T1: “tram-tracks”, HBV & HCV, subendothelial
T2: association with C3 nephritic factor, intramembranous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does RPGN stand for? Associated shape? What are the three possibilities in IF - what does this tell us about the diagnosis?

A

Rapidly progressive glomerulonephritis
Crescent shape on biopsy - macrophages and fibrin

Linear - Goodpasture’s
Granular - glomerulonephritis
Negative (pauci-immune) - ANCA vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Berger disease?
Presents in?
What category of diseases does it come under?

A

IgA nephropathy - deposition of IgA complexes in the mesangium of the kidney

Presents in children

Nephritic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute infections glomerulonephritis:
What is the common bacteria?
What particular protein will these carry?
Treatment is ___?

A

Group A beta-haemolytic strep infection of skin (impetigo) or pharynx

M protein - virulence factor

Treatment is supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which specific cells does a renal cell carcinoma usually arise from?

A

Kidney tubules - specifically, proximal convoluted tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would a renal cell carcinoma look on gross exam and microscopy?

A

Gross - yellow mass

Microscopy - polygonal clear (cytoplasm and lipid filled) cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the two pathways for renal cancer? What population does each present in? What is the presentation in each? Main risk factor in each?

A

HEREDITARY pathway
younger patients, bilateral cancer
Von Hippel-Lindau Disease (also affects the cerebellum) - affecting VHL tumour suppressor gene

SPORADIC pathway
older patients, solitary cancer
Strong association with smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is usual triad in the presentation of renal cell carcinoma?
What other general cancer symptoms could be seen?
What is the staging system in renal cell carcinoma?

A

Haematuria, palpable mass, flank pain - all 3 together is rare

Fever, weight loss and malaise

TNM system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are examples of the paraneoplastic syndromes often seen in renal cell carcinoma?
A varicocele of what can sometimes be seen in renal cell carcinoma?

A

Production of:
EPO, renin, PTHrP, ACTH

LEFT sided varicocele of testicle - left spermatic vein drains into left renal vein (unlike right spermatic vein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a angiomyolipoma?

Comprised of what 3 things?

A

A common benign tumour of kidneys

Blood vessels, smooth muscle and adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Wilm’s tumour? - comprised of mostly ___?
Can also have ___ present? (3)
Normal presentation?
Association with what mutation and syndrome?

A

Malignant kidney tumour often affecting young children

Mostly blastema
Also: stroma, tubules, primitive glomeruli

Association with WT1 mutation and WAGR syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where can a urothelial carcinoma occur? Where does it most commonly occur?
What is the major risk factor? One more risk factor?
Classical presentation?

A

Can occur in urothelial lining of…
BLADDER (most common), RENAL PELVIS, URETER, URETHRA

Major risk factor: cigarette smoke
Also: cyclophosphamide

Classic presentation is haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Two growth pathways in urothelial carcinoma?
Comparitive prognosis of each? p53 involvement?
Why is urothelial carcinoma often multifocal and recurring?

A

Papillary growth - low grade, high grade, invasion - often p53 independent
Flat growth - high grade, invasion (no low grade) - often p53 dependent

Field defect - smoking affects numerous cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the two non-urothelial carncers of the lower urinary tract?
Basic description of each?

A

Squamous cell carcinoma - requires squamous metaplsaia
Chronic cystitis, Schistosoma, Chronic kidney stones

Adenocarcinoma - malignant proliferation of glands
Often arising from urachal remnant (dome of bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the three major risk factors for prostate cancer?

A

Increasing Age

Family history - BRCA1 and BRCA2

Ethnicity (Afro-Caribbean increased, Far east uncommon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of cancer is the majority of prostate cancer?

Two other very rare types?

Which are of the prostate does it usually grow in? (3 areas and percentage?)

A

Adenocarcinoma

Transitional cell carcinoma
Small cell prostate cancer

Peripheral (70%), transitional zone (20%), central zone (10%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does prostate cancer usually present?
Generic cancer symptoms? (3)
LUTS? (3)
Metastatic disease? (1)

A

Asymptomatic

Malaise, weight loss, anaemia

LUTS: heistancy, poor flow, dysuria, haematuria

Lower back pain from metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the specific histological grading system for prostate cancer? - briefly describe the scoring

4 basic treatment strategies?

A

Gleason grading system -
2 most common cell patterns are scored from 1-5, and the numbers are added for 2-10 score

Active surveillance - minimise treatment, in low risk patients

Radical prostatectomy - used in fit patients with localised cancer

Radiotherapy - localised and advanced cancer

Hormone therapy (leuprolide) - used to reduce testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Where do most testicular cancers arise from? | How many are seminomas vs non-seminomas?
From germ cell tumours 60% seminomas, 40% non-seminomas
26
How does testicular cancer present? 1 major points, 3 minor points
Mass in testicle +/- pain Dull ache may be present Post-pubertal gynecomastia Impotence
27
Physical exam of testicular cancer would show? Key point to differentiate it from differentials? What scan is used? Two serum markers check for?
Physical examination - suspicious masses are often firm and non-fluctuating Don't transilluminate -differentiate from Torsion, Epididymitis, Hydrocele Ultrasound Serum markers - alphafetoprotein (AFP) and human chorionic gonadotrophin (HCG)
28
Is a biopsy done on testicular cancer? What is the general management timelines for testicular cancer? Prognosis is...?
No - might spread the cancer Radical inguinal orciectomy completed - looked at Cancer is staged then surveillance and chemotherapy may be done Good prognosis (5 year survival rate = 95%)
29
What is the major hormone driving BPH? Is there an increased risk of cancer in BPH? What two components of the prostate are enlarged? What zone is usually enlarged?
Dihydrotestosterone (DHT) No increased risk of cancer Stroma and glands are increased Transitional zone - surrounds urethra
30
Mjaor risk factor for BPH? Explain why this risk factor occurs Another risk factor?
Increasing age 5-alpha-reductase increases with age - more DHT Smoking
31
Using the FUN WISE mneumonic - name the 3 storage symptoms and 4 voiding symptoms of BPH. What other two urine-related symptoms may be present?
Frequency, urgency, nocturia Weak stream, intermittency, straining, emptying incomplete Microscopic haematuria and dysuria may be present
32
3 complications of BPH? Why is urinalayis often done with BPH?
Hydronephrosis, infections, stones Can rule out the main ddx - UTI
33
What is the conservative management of BPH? | What is the name of the surgery done?
Reduce caffiene and alcohol, bladder retraining Transurethral resection of prostate
34
What are the 3 medications that can be used for BPH? Drug name/names? How do they work?
Alpha-1 blockers: relaxes smooth muscle - terazosin, doxazosin 5-alpha-reductase inhibitors: stop DHT formation - finasteride Anticholinergics may be used for overactive bladder
35
``` What are the two major causes of CKD? Name 3 other kidney related causes? Name 3 other non-kidney related causes? What long term medication use? ___ can develop into CKD ```
Hypertension, Diabetes Chronic glomerulonephritis, Cystic disease, Obstructive uropathy SLE, RA, HIV NSAIDs AKI into CKD
36
``` How does early CKD present? Later presentation: General (2) Encephalopathy (1) Haematological (1) ```
Asymptomatic Nausea, loss of appetite Asterixis Anaemia
37
Diagnostic definition of CKD? | What does accelerated CKD mean?
GFR <60ml/minute per 1.73m^2, for 3 months or more | Accelerated - 25% or more decrease in GFR within 12 months
38
What are the stages of CKD and related GFR ranges? | What else is used to determine CKD prognosis?
``` 1 = >90 ml/minute/1.72m^2 2 = 60-90 ml/minute/1.72m^2 3a = 45-60 ml/minute/1.72m^2 3b = 30-45 ml/minute/1.72m^2 4 = 15-30 ml/minute/1.72m^2 5 = <15 ml/minute/1.72m^2 ``` Albuminuria is also considered - placed into 3 stages
39
Main principle in CKD management? | Options if ESRF is reached?
Treat the cause | Dialysis or Kidney transplant
40
Name the 3 most common bacterial STIs. What bacteria causes each? 4 other viral STIs?
Chlamydia - Chlamydia trachomatis Gonorrhoea - Neisseria gonorrhoeae Syphillis - Treponema pallidum Herpes (HSV), Genital Warts (HPV), HIV, Hep B
41
How does chlamydia and gonorrhoea present in males (2) vs females (3)?
Males: Dysuria and urethral discharge Females: Non-specific Dysuria, discharge, menstural irregularity
42
How is chlamydia diagnosed? Samples are from?
Nucleic Acid Amplification Tests (NAAT) e.g, PCR Females - self-collected vaginal swab Males - first void urine
43
Normal population for chlamydia vs gonorrhoea? Which of these commonly has asymptomatic carriage?
Chlamydia is most common in women & young adults Gonorrhoea is more common in men & has a wider age range Asymptomatic carriage of chlamydia is more common than gonorrhoea
44
How is gonorrhoea diagnosed? | Taken from where? (3)
Microscopy of gram-stained smears of genital secretions, looking for gram negative diplococci Male urethra, female endocervix, rectum
45
``` Treatment of bacterial STIs: 2 involved in all of them? Chlamydia? Gonorrhoea? Syphilis? ```
Partner management, test for other STIs Azithromycin or Doxycycline Azithromycin AND Ceftriaxone Penicillin (injecion)
46
What are the 2 major stages of syphilis? | What are the 3 big complications of syphilis?
``` Early infectious syphilis (within 2 years) Late syphilis (over 2 years) ``` Gumma, neurosyphilis, cardiovascular complications
47
What are the 3 stages within EARLY SYPHILIS? | What are the symptoms of syphilis and how do these change within early syphilis?
``` Primary: Primary chancre (painless) often on genitalia, but depends on transmission route ``` Secondary: 6-8 weeks after Non-itchy maculopapular rash Generalised lymphadenopathy Mouth ulcers Latent: (early latent)
48
How can syphilis be transmitted? | What are the diagnosis methods for syphilis?
BODY FLUIDS: Sexual contact, needles, direct contact with lesion VERTICAL TRANSMISSION: Can cause congenital syphilis Diagnosis: Early moist lesions - sample Normal diagnosis - serology and particle agglutination test
49
2 classifications of UTIs? | From there can be either ____ or ____?
Uncomplicated - non-pregnant women Complication - pregnant, men, catheters, children, etc... Asymptomatic or symptomatic
50
``` Name the most common cause of UTIs? Renal stones one? Hospital one? Young women one? 2 others? ```
``` E. coli >50% of cases Proteus - renal stone Klebsiella - hospital/catheter Staph. saprophyticus - young women Staph. aureus and Enterococci ```
51
Symptoms of UTI: 3 lower tract 3 upper tract What would be found on urine dipstick?
Dysuria and frequency, haematuria Fever and haematuria, possible sepsis? Nitrate, Leukocytes, Blood?
52
Management of UTI: Asymptomatic in >65 Uncomplicated - what 2? Complicated - ?
Do not treat Trimethoprim OR Nitrofurantoin - MSU not needed, dipstick only Complicated - send MSU sample, longer antibiotic course
53
Risk factors for UTI: | Can you name 5 out of 8?
``` Female Frequency sex Catheter Pregnancy Circumcision Diabetes Urine retention Obstruction - eg, BPH ```
54
Typical population for pyelonephritis? Triad of symptoms? Normal treatment?
Women younger than 35 Loin pain, fever, pyuria (vomiting?) Co-amoxiclav for 14 days
55
3 categories of AKI aetiology? | Name 3 examples within each category
Pre-renal: Hypovolaemia, Shocks, CHF Post-renal: BPH, Kidney stones, intra-abdominal tumours Intra-renal: Acute Tubular Necrosis, Glomerulonephritis, Acute Interstitial Nephritis
56
Name the two groups of medications you can't give to someone with impaired kidney function. Explain the mechanism behind this
NSAIDs- inhibit COX enzymes, stop prostaglandin synthesis needed for vasodilation of the afferent arteriole ACEi/ARB- stop the RAAS system from maintaining the blood pressure needed to perfuse the kidney
57
Acute Tubular Necrosis: What part of the nephron does it affect most? 2 causes? Examples from one the of the main causes? What happens to the damaged cells?
Affects PCT the most Ischaemia Nephrotoxins - aminoglycosides, lead (heavy metals), anti-freeze, radiocontrast dye Cells slough off - causes blockages in nephrons and brown spots I the urine
58
Diagnosis of AKI: 3 guidelines. How many of these 3 needed?
Any 1 or these 3 * Rise in Creatinine > 26 micromol/L in 48 hrs * Rise in Creatinine < 50% of lowest figure in last 6 months) * Urine output < 0.5ml/kg/hr for >6 consecutive hours
59
What is the major emergency in AKI? ECG findings? How do these progress? 3 different medication managements?
Hyperkalaemia - > 6mmol/L ECG: First - tall, peaked T waves Second - small P waves, prolonged PR and QRS Third - arrhythmia Insulin + Dextrose Calcium gluconate Salbutamol
60
Usual BUN:Cr ratio? How does it change in pre-renal, post-renal and intra-renal AKI?
5-20:1 Pre-renal >20:1 Activation of RAAS - more water and salt reabsorption Intra-renal <20:1 General reabsorption is impaired Post-renal >20:1 initially (fluid build-up) <20:1 later (epithelial cell damage)
61
What is the classic age for kidney stones? But age is getting ____ Males vs Females? Is recurrence common? Main advice after treatment?
Male > Female 2:1 Commonest age is 30-50, but getting younger (teenagers now) Yes - recurrence is common, drink lots of water
62
``` What is the two most common types of renal stones? (how much) Which is most common? Colour? X-ray? Acidic or alkaline? ```
80% are calcium based Calcium oxalate: more common, black/dark brown, radiopaque on X-RAY, acidic Calcium phosphate: less common, dirty white, radiopaque on X-RAY, alkaline
63
Other than calcium stones, name 4 other stones: 10% - name, colour, x-ray 5-10% - name, when, made of, shape, x-ray, colour 1% - name, condition <1% - name
10% uric acid - red-brown, radiolucent 5-10% struvite (infection stones - Mg, Amm, Phos, from urease positive bacteria, staghorn, radiopaque, dirty white) Cystine (congenital condition - COLA) Xanthine stones
64
One line description of how renal stones form? Most common cause of renal stone formation? Rarer cause?
Supersaturation of solutes results in precipitation and crystals forming Most common cause - idiopathic (probably dehydration) Rarely hypercalcaemia via primary hyperparathyroidism
65
Name 4 of 6 risk factors for renal stones?
``` Male, 20-50, Caucasian/Asian, High Protein & Salt, Family History, Oxalate-rich foods ```
66
``` Presentation of renal colic: Often __? Pain - site? onset? radiation? character? severe? 2 other symptoms? Urine may have ____? What 2 LUTS may be present? ```
Often asymptomatic Pain is classically sudden onset, waking up patient, radiation to groin, colicky, severe Fever Nausea and vomiting Haematuria (visible or no visible) LUTS - frequency and urgency
67
What is the gold-standard scan for kidney stones? What other scans may be done? Name 3 complications of renal stones? Main differential to look out for?
Non-contrast CT scan - kidney, ureter, bladder NCCT-KUB Ultrasound, X-rays AKI, hydronephrosis, pyonephrosis (pus) Ruptured AAA
68
4 management stratigies in kidney stone disease?
Conservative - many will pass on their own, pain management and anti-emetic Medical expulsion therapy - CCBs or alpha-blockers Shockwave lithotripsy Surgery or stent placement
69
``` What is hydronephrosis? Difference from hydroureter? General aetiology - hydronephrosis is caused by ___ 4 causes in adults? 2 in antenatal babies? ```
Build-up of urine inside kidney causes swelling Hydroureter - ureter only Hydronephrosis - ureter and kidney Caused by urinary retention Kidney stones, BPH, Urethral strictures, Cancers Vesicouretral reflux, congenital ureterpelvic junctin obstruction
70
Testicular/scrotal lump differential: What is done to confirm diagnosis? 5 differentials w/ description
History, Transilluminate, Ultrasound Scan Testicular cancer - non-tender, from testicle, hard without transillumination, 15-40 Hydrocele - fluid build-up in the tunica vaginalis Varicocele - swollen, pampiniform venous plexus, "bag of worms" Epididymal cyst - sac of fluid at the epidydmis Testicular torsion - emergency, extremely tender, often triggered by activity, needs surgery
71
Two major forms of cystic kidney disease? Population it affects? Associated genes?
Autosomal Dominant Polycystic Kidney Disease - adults, PKD1 and PKD2 (polycystin) ARPKD - children, PKHD1
72
How might someone with ADPKD present? (4)
Screening - affected relative Severe loin pain - cyst haemorrhage Hypertension Gross haematuria following trauma

Phase 2a (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions