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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
How would you treat AKI?
Treat underlying cause Dialysis
26
CKD results from permanently reduced GFR from decreased nephrons. How would the patient present?
HTN Tired/poor appetite (waste) Anaemia Renal bone D
27
The 2 options for managing CKD are...?
Dialysis | Transplant
28
Obstruction in the urinary tract can occur from the renal pelvis --> urethral meatus. What are some causes?
``` Stones Tumour Stricture Prostate enlargement Preg ```
29
Does acute or chronic obstruction in the urinary tract present with PAIN + AKI + anuria?
ACUTE
30
How does chronic urinary obstruction present initially?
Initially asymptomatic --> Cortical atrophy --> Renal function decline
31
List 3 consequences of urinary tract obstruction.
Infection Stone formation Kidney damage
32
For each effect of obstruction state where the obstruction would be: 1. Hydronephrosis 2. Hydroureter 3. Detrusor atrophy
1. Pelvuic-ureter junction (PUJ) obstruction 2. Ureteric 3. Urethral
33
Renal stones affect M > F, esp 20-30 yrs. What are 3 ways that they can develop?
Increased Ca2+ in urine Supersaturation Decreased [citrate] (binds to Ca2+)
34
What is the classic presentation of renal stones?
Loin --> groin pain EXTREMELY PAINFUL
35
The consequences of renal stones are: - obstruction - haematuria - infection - squamous metaplasia - carcinoma How would you diagnose it?
Non-contrast CT USS (preg) IV Urography
36
Classification of renal stones?
Calcium Struvite Urate Cystine
37
Which renal stone displays a staghorn calculi on X-ray?
Struvite
38
Two most common cancers in Kidney/Urinary tract?
Renal Cell Carcinoma (RCC) Urothelial Cell Carcinoma (UCC)
39
Most cancer syndromes in RCC are caused by which syndrome?
Von Hippel-Lindau syndrome | TSG mutation
40
Risk factors for RCC?
``` SMOKING* HTN Obesity Oestrogens Asbestos Accquired cystic kidney D ```
41
This presentation correlates with which cancer? Haematuria Palpable abdo mass Costovertebral pain
RCC
42
Are mets common in RCC?
YES Poor prognosis
43
Where do UCC arise from? Most common one?
Lining of pelvis/ureter/BLADDER/urethra
44
Risk factors of UCC?
Smoking Dyes RT M > F
45
Presentation of UCC?
Haematuria Dysuria Urinary obstruction
46
Whats another name for BPH?
Nodular hyperplasia
47
Whats the phrase for the symptoms experienced in BPH?
LUTS (Lower urinary tract symptoms) - Hesistency - Frequency - Urgency - Nocturia - Incomplete bladder emptying
48
95 % of Prostate cancer is...?
ADENOCARCINOMA
49
What are the risk factors for PC?
``` > 40yrs FH BRCA2 mutation [Androgens] Black ```
50
Which grading system is used in PC?
Gleason scoring system
51
Testes 2 main functions?
Produce sperm | Produce androgens
52
Testicular tumours (TT) can be divided into 3 group..?
1" = within testes 2" = mets Haematopoietic (mimic TT, common)
53
Germ cell TT are a subdivision of 1" TT. State some conditions associated with it.
``` Prior one in other testes Cryptochidism Inguinal hernia Disorders of sex dev Hydrocele Testicular atrophy ```
54
Two commontypes of Germ cell TT?
Seminoma Teratoma
55
Which Germ cell TT is often asymptomatic or has testicular enlargemen +/- pain?
Seminoma 35-45yrs
56
How would diagnose seminoma?
Increased [PLAP] | Increased [hCG]
57
Gradual testicular swelling +/- pain in boys/young men is characteristic of what?
Teratoma
58
List inflammatory conditions of the testes
``` A/C Epididymoorchitis Idiopathic granulomatous orchitis Sarcoidois of testes Malakoplakia of testes Sperm granuloma Tuberculous testes ```
59
List 3 complications of inflammatory conditions of testes.
Testicular atrophy --> failure Infertility Germ cell TT
60
Name 1" causes of testicular failure/hypogonadism.
``` Kleinfelter's syndrome Cryptochidism Orchitis Trauma CF ```
61
What are 2" causes of testicular failure?
Pituitary tumour Glucocorticoids, chemo Obesity Age
62
80% of UTI are caused by Staph Saprophyticus. T/F?
F E.Coli (also Proteus mirabilis in kidney stones)
63
Risk factors for UTI?
``` F > M Urinary stasis: preg, obstructions Sex Congenitl ab Instrumentation ```
64
Common cause of paediatric UTIs is?
VUR | Vescio-ureteric reflux
65
Cystitis = inflamm of bladder. | Symptoms?
``` LUTS: Haematuria Dysuria Frequency Nocturia Supra-pubic tenderness ```
66
Which infection present as LUTS + loin/abdo pain + fever + N/V/diarrhoea
PYELONEPHRITIS
67
Urethral syndrome = ?
Abacterial urethritis | LUTS without infection
68
Significant bacteriuria = ?
> 10^5 cfu/mL more likely to get UTI
69
Significant bacteriuria + no UTI symptoms = ?
Asymptomatic bacteriuria
70
Who does asymptomatic bacteriuria occur in?
Long-term catheter Elderly DM
71
pus in urine BUT no organisms = ?
Sterile pyuria
72
List causes of sterile pyuria
``` Inflammation from non-infectious causes: Stones Trauma Vascultiis renal D ```
73
What are the 4 kinds of investigations that can be done in suspected UTIs?
Urinalysis (Blood, protein, WBC, nitrites) Bloods (pyelonephritis) Microbiology (MSU, CSU, clean, SPA) Imaging
74
When would you use imaging when investigating UTIs?
Recurrent UTI UTI in male UTI in child Pyelonephritis
75
Treatment for UTI in F/M?
Nitrofurantoin Trimethoprim Amoxicillin F: 3 days M: 7 days
76
When would you treat asymptomatic bacteriuria?
Preg Infants Prior to urological procedures

Clinical Pathology (13 decks)

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