Histopathology 9 - Urological pathology

Question 1

What is the most common composition of urinary calculi?

Answer 1

Calcium oxalate

Question 2

What is the most likely cause of calcium oxalate urinary calculi?

Answer 2

Hypercalciuria

Either due to excessive Ca absorption from gut or impaired absorption in nephron

Question 3

What are magnesium ammonium phosphate urinary calculi also known as?

Answer 3

Triple stones

Question 4

What is the cause of triple stones?

Answer 4

A consequence of infection with urease-producing organisms (often proteus or klebsiella)
Urease –> ammonia increase
Ammonia makes urine alkaline –> triple stone precipitation

Question 5

Why might a small urinary stone become symptomatic?

Answer 5

If it gets out of kidney and gets into the ureter - it will cause colic at any point where the ureter bends

Question 6

What type of urinary calculi are caused by gout?

Answer 6

Uric acid stones

Question 7

What is papillary adenoma of the kidney?

Answer 7

Benign epithelial kidney tumour composed of papillae and/or tubules
Typically < 5mm

Question 8

What is a renal oncocytoma?

Answer 8

Benign epithelial kidney tumour composed of oncocytic cells

Question 9

What syndrome should be considered in a patient with many renal oncocytomas?

Answer 9

Birt-Hogg-Dubé syndrome

Question 10

What is an angiomyolipoma?

Answer 10

Benign mesenchymal kidney tumour composed of thick-walled blood vessels, smooth muscle and fat

Question 11

In what condition are angiomyolipomas most likely to appear?

Answer 11

Tuberous sclerosis

Question 12

What is a renal cell carcinoma?

Answer 12

Malignancy of epithelial cells of proximal convuluted tubule

Question 13

What is the main symptom of renal cell carcinoma?

Answer 13

Painless haematuria

Question 14

What is the most common subtype of renal cell carcinoma?

Answer 14

Clear cell renal cell carcinoma

other types = papillary cell + chromophone

Question 15

What is the genetic association of clear cell carcinoma?

Answer 15

Loss of chromosome 3p

Question 16

What is Nephroblastoma also known as?

Answer 16

Wilm’s tumour

Question 17

What is nephroblastoma?

Answer 17

Triphasic kidney tumour of childhood

Question 18

How does nephroblastoma typically present?

Answer 18

Abdominal mass in children aged 2-5

Question 19

What is the new name for transitional cell carcinoma?

Answer 19

Urothelial carcinoma

Question 20

What are the 2 main treatments of BPH?

Answer 20

5 alpha reductase inhibitors

Alpha blockers

Question 21

What score is used for prostatic adenocarcinoma?

Answer 21

Gleason score

Question 22

What is the most common type of testicular tumour?

Answer 22

90% = germ cell (Typically seminoma)

Question 23

Recall 2 risk factors for testicular germ cell tumours

Answer 23

Undescended testes

Low birth weight

Question 24

What are the histological subtypes of germ cell testicular tumour?

Answer 24

Seminoma
Embryonal carcinoma
Post-pubertal teratoma
Yolk Sac Tumour

Question 25

What is the most useful form of chemo in germ cell testicular tumours?

Answer 25

Platinum based

Question 26

What are the 3 subtypes of non-germ cell testicular tumours?

Answer 26

Lymphoma
Leydig cell
Sertoli cell

Question 27

Which type of testicular tumour can present with precocious puberty?

Answer 27

Leydig cell (non-germ cell testicular tumour)

Question 28

What is flat urothelial carcinoma in situ?

Answer 28

Very high grade lesion with high risk of progression

Question 29

Which testicular germ cell tumour has clear polygonal cells and a lymphocytic inflitrate?

Answer 29

Seminoma

Question 30

Which type of urinary stone is most likely to develop into a massive “staghorn calculus”?

Answer 30

Triple stone

Question 31

What is the typical histological appearance of non-invasive papillary urothelial carcinoma?

Answer 31

Frond-like growths

Question 32

What is the typical histological appearance of a seminoma?

Answer 32

Clear polygonal cells and lymphocytic infiltrate