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Clinical Pathology > Kidney & Urinary Tract > Flashcards

Kidney & Urinary Tract Flashcards

1
Q

Summary of Renal Pathology

A 
Functions of kidney
Presentation of renal D
Mechanisms of glomerular/tubular/vascular damage
AKI, CKD, Nephrotic/Nephritic S
Obstructive Uropathy
Urogenital pathology
UTIs
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2
Q

List the 5 functions of the kidney

A 
Regulate BP
Remove waste
Release hormones: renin, EPO
Fluid & electrolyte balance
Acid-base metabolism
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3
Q

A typical presentation of renal disease would be…?

A 
Increased [creatinine], [urea]
Proteinuria
Hypoalbuminaemia
Oedema
Haematuria
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4
Q

Glomerular damage to the kidneys can occur by immunological mediators such as..?

A

Circulating immune-complexes depositing – Vasculitis, SLE, Endocarditis, post-infective

Anti-GBM Disease

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5
Q

Non-immunological damage to the glomerulus can occur by…?

A

HTN
DM - alters
Desposition of ab proteins - amyloid

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6
Q

Ischaemia and toxins are prone to damaging which part of the kidney?

A

Tubules

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7
Q

Damage to the glomerulus (blood vessel) can also damage what?

A

Tubules

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8
Q

List ways vascular damage can occur in the kidneys.

A 
HTN
Atheroma
DM
Vasculitis
Thrombotic microangiopathy
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9
Q

Glomerular D have unclear aetiology and are often named by microscopic appearence.

Which Glomerular D is a common cause of nephrotic syndrome in adults?

A

Membranous nephropathy

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10
Q

Minimal change disease commonly causes nephrotic syndrome in which group of people?

A

Children

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11
Q

Post-infective Glomerulonephritis occurs weeks after what?

A

Strep throat infection

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12
Q

Anti-GBM Disease is anautoimmune attack on glomerulus. T/F?

A

T

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13
Q

IgA nephropathy has a typical presentation of…?

A

Teens/adult + haematuria

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14
Q

Which subtype of IgA nephropathy is often seen in young male + haematuria + rash?

A

Henoch-Schonlein Purpura

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15
Q

Elderly + AKI = ?

A

Myeloma or Acute Interstitial Nephritis

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16
Q

Young women + haematuria + facial rash = ?

A

Lupus Nephritis

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17
Q

Adult + AKI + Fever + Myalgia

A

Vasculitis

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18
Q

Nephrotic syndrome is always caused by damage to the glomerulus. What acronym is used for its presentation?

A 
HHOP
Hypoalbuminaemia
(Hyperlipidaemia)
Oedema
Proteinuria
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19
Q

2 complications of Nephrotic syndrome?

A

Infection (oedema)

Thrombosis (hyperlipidaemia)

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20
Q

Another phrase for Nephritic syndrome is..?

A

Acute Nephritis

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21
Q

What acronym is used for Nephritic syndrome?

A 
HHOP + AKI
HTN
Haematuria
Oedema
Proteinuria
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22
Q

The causes of AKI are split into which categories?

A

Pre-renal (decreased blood flow)

Renal

Post-renal (obstructive)

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23
Q

Increased [creatinine], [urea] + Anuria/Oliguria is typical of what?

A

AKI

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24
Q

Complications of AKI?

A 
Heart failure   (fluid overload)
Arrythmias
infection
Jaundice
GI bleeding
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25
Q

How would you treat AKI?

A

Treat underlying cause

Dialysis

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26
Q

CKD results from permanently reduced GFR from decreased nephrons. How would the patient present?

A

HTN
Tired/poor appetite (waste)
Anaemia
Renal bone D

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27
Q

The 2 options for managing CKD are…?

A

Dialysis

Transplant

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28
Q

Obstruction in the urinary tract can occur from the renal pelvis –> urethral meatus. What are some causes?

A 
Stones
Tumour
Stricture
Prostate enlargement
Preg
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29
Q

Does acute or chronic obstruction in the urinary tract present with PAIN + AKI + anuria?

A

ACUTE

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30
Q

How does chronic urinary obstruction present initially?

A

Initially asymptomatic

–> Cortical atrophy –> Renal function decline

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31
Q

List 3 consequences of urinary tract obstruction.

A

Infection
Stone formation
Kidney damage

32
Q

For each effect of obstruction state where the obstruction would be:
1. Hydronephrosis

  1. Hydroureter
  2. Detrusor atrophy
A
  1. Pelvuic-ureter junction (PUJ) obstruction
  2. Ureteric
  3. Urethral
33
Q

Renal stones affect M > F, esp 20-30 yrs. What are 3 ways that they can develop?

A

Increased Ca2+ in urine

Supersaturation

Decreased [citrate] (binds to Ca2+)

34
Q

What is the classic presentation of renal stones?

A

Loin –> groin pain

EXTREMELY PAINFUL

35
Q

The consequences of renal stones are:

  • obstruction
  • haematuria
  • infection
  • squamous metaplasia
  • carcinoma

How would you diagnose it?

A

Non-contrast CT

USS (preg)

IV Urography

36
Q

Classification of renal stones?

A

Calcium
Struvite
Urate
Cystine

37
Q

Which renal stone displays a staghorn calculi on X-ray?

A

Struvite

38
Q

Two most common cancers in Kidney/Urinary tract?

A

Renal Cell Carcinoma (RCC)

Urothelial Cell Carcinoma (UCC)

39
Q

Most cancer syndromes in RCC are caused by which syndrome?

A

Von Hippel-Lindau syndrome

TSG mutation

40
Q

Risk factors for RCC?

A 
SMOKING*
HTN
Obesity
Oestrogens
Asbestos
Accquired cystic kidney D
41
Q

This presentation correlates with which cancer?
Haematuria
Palpable abdo mass
Costovertebral pain

A

RCC

42
Q

Are mets common in RCC?

A

YES

Poor prognosis

43
Q

Where do UCC arise from?

Most common one?

A

Lining of pelvis/ureter/BLADDER/urethra

44
Q

Risk factors of UCC?

A

Smoking
Dyes
RT
M > F

45
Q

Presentation of UCC?

A

Haematuria
Dysuria
Urinary obstruction

46
Q

Whats another name for BPH?

A

Nodular hyperplasia

47
Q

Whats the phrase for the symptoms experienced in BPH?

A

LUTS (Lower urinary tract symptoms)

  • Hesistency
  • Frequency
  • Urgency
  • Nocturia
  • Incomplete bladder emptying
48
Q

95 % of Prostate cancer is…?

A

ADENOCARCINOMA

49
Q

What are the risk factors for PC?

A 
> 40yrs
FH
BRCA2 mutation
[Androgens]
Black
50
Q

Which grading system is used in PC?

A

Gleason scoring system

51
Q

Testes 2 main functions?

A

Produce sperm

Produce androgens

52
Q

Testicular tumours (TT) can be divided into 3 group..?

A

1” = within testes

2” = mets

Haematopoietic (mimic TT, common)

53
Q

Germ cell TT are a subdivision of 1” TT. State some conditions associated with it.

A 
Prior one in other testes
Cryptochidism
Inguinal hernia
Disorders of sex dev
Hydrocele
Testicular atrophy
54
Q

Two commontypes of Germ cell TT?

A

Seminoma

Teratoma

55
Q

Which Germ cell TT is often asymptomatic or has testicular enlargemen +/- pain?

A

Seminoma

35-45yrs

56
Q

How would diagnose seminoma?

A

Increased [PLAP]

Increased [hCG]

57
Q

Gradual testicular swelling +/- pain in boys/young men is characteristic of what?

A

Teratoma

58
Q

List inflammatory conditions of the testes

A 
A/C Epididymoorchitis
Idiopathic granulomatous orchitis
Sarcoidois of testes
Malakoplakia of testes
Sperm granuloma
Tuberculous testes
59
Q

List 3 complications of inflammatory conditions of testes.

A

Testicular atrophy –> failure
Infertility
Germ cell TT

60
Q

Name 1” causes of testicular failure/hypogonadism.

A 
Kleinfelter's syndrome
Cryptochidism
Orchitis
Trauma
CF
61
Q

What are 2” causes of testicular failure?

A

Pituitary tumour
Glucocorticoids, chemo
Obesity
Age

62
Q

80% of UTI are caused by Staph Saprophyticus. T/F?

A

F

E.Coli

(also Proteus mirabilis in kidney stones)

63
Q

Risk factors for UTI?

A 
F > M
Urinary stasis: preg, obstructions
Sex
Congenitl ab
Instrumentation
64
Q

Common cause of paediatric UTIs is?

A

VUR

Vescio-ureteric reflux

65
Q

Cystitis = inflamm of bladder.

Symptoms?

A 
LUTS:
Haematuria
Dysuria
Frequency
Nocturia
Supra-pubic tenderness
66
Q

Which infection present as LUTS + loin/abdo pain + fever + N/V/diarrhoea

A

PYELONEPHRITIS

67
Q

Urethral syndrome = ?

A

Abacterial urethritis

LUTS without infection

68
Q

Significant bacteriuria = ?

A

> 10^5 cfu/mL

more likely to get UTI

69
Q

Significant bacteriuria + no UTI symptoms = ?

A

Asymptomatic bacteriuria

70
Q

Who does asymptomatic bacteriuria occur in?

A

Long-term catheter
Elderly
DM

71
Q

pus in urine BUT no organisms = ?

A

Sterile pyuria

72
Q

List causes of sterile pyuria

A 
Inflammation from non-infectious causes:
Stones
Trauma
Vascultiis
renal D
73
Q

What are the 4 kinds of investigations that can be done in suspected UTIs?

A

Urinalysis (Blood, protein, WBC, nitrites)

Bloods (pyelonephritis)

Microbiology (MSU, CSU, clean, SPA)

Imaging

74
Q

When would you use imaging when investigating UTIs?

A

Recurrent UTI
UTI in male
UTI in child
Pyelonephritis

75
Q

Treatment for UTI in F/M?

A

Nitrofurantoin
Trimethoprim
Amoxicillin

F: 3 days
M: 7 days

76
Q

When would you treat asymptomatic bacteriuria?

A

Preg
Infants
Prior to urological procedures

Clinical Pathology (13 decks)

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