Kidney & UTI Pathology Flashcards
1,25 dihydroxycholecaliferol is also known as
Vit D
What is oliguria?
<400ml/24h
What is the reference range for urea?
3-8mmol/L
What should not be measured until 8 hours after a meal?
Creatinine
50-140
What happens to creatinine as the GFR decreases?
It increases
plotting the plasma creatinine can help estimate when intervention is needed in ESRF
Tubular secretion of creatinine can be inhibited by
aspirin and cimetidine
eGFR of less than 15 indicates
ESRF
Renal hypoperfusuion can lead to
secondary hyperaldosteronism
a patient who is unwell with a rapid rise in creatinine and urea has
ARF
Proteinuria, hypoalbuminaemia and oedema point to
nephrotic syndrome
oedema, proteinuria and haematuria point to
Nephritic syndrome
mesangial cells of the renal corpuscle have
contractile and phagocytic properties
Immunological causes of glomerular injury include
IgA nephropathy
SLE
Goodpasture’s syndrome
Non-immunological causes of glomerular injury include
Hypertension, HUS, DM, Amyloidosis and Alport disease (inherited abnormal type IV collagen causing abnormal basement membranes)
What can cause nephrotic syndrome?
Membranous nephropathy (PLA2R on podocytes) Focal segmental glomerulosclerosis Minimal change disease
What can cause nephritic syndrome?
IgA nephropathy (Berger's Disease) Post-infectious glomerulonephritis Vasculitis SLE HUS
What is IgAN Henoch Schoelein purpura?
IgA nephropathy that follows throat infections and presents in BOYS with
- arthalgia
- abdo pan
- purpuric rash
What is a risk factor for chronic pyelonephritis?
Urinary tract reflux
What characteristically shows as a ‘flea bitten kidney’?
Hypertensive nephropathy (nephrosclerosis)
Kimmelstiel-Wilson lesions are produced as part of
diabetic nephropathy
BPH arises from where in the prostate?
Centrally situated TZ and periurethral cells
it is more likely to cause urinary obstruction earlier than carcinomas
Urgency Hesitancy Increased fequency Nocturia Incomplete bladder emptying all point to
BPH
DHT (dihydrotestosterone) is involved in the development of
BPH
BRCA2 leads to a 20-fold increased risk of
prostate cancer
So can being African
How is prostate cancer staged?
Gleason scoring system
Does increased PSA always point to prostate canceR?
No
Germ cell tumours are most common in
young males
Seminomas
Teratomas
Choriocarcinoma
Is a history of an undescended testis important?
Yes, it is a risk factor for testicular cancer.
AFP is a tumour marker for
germ cell tumours
bHCG points to
a choriocarcinoma
it is elevated in testicular cancer
VMA in the urine points to a
phaeochromocytoma
What are associated with the development of testicular germ cell tumours?
Prior TGCT in the contraletral testicle impaired spermatogenesis inguinal hernia hydrocele testicular atrophy
Hypogonadism can cause
testicular failure
What is the most common form or renal calculi?
Calcium stones
A large ‘staghorn’ calculi points to
struvite stones
due to urease producing bacterial information
Urate stones can be seen in people with
Gout
most renal cell carcinomas are
clear cell
What is von Hippel-Lindau syndrome?
Most common cancer syndrome observed in RCC
VHL gene breaks down HIF-1 oncogene and loss of function leads to tumour development
What does clear cell RC look like microscopically?
Clear cytoplasm with a ‘nested’ appearance
Is RCC chemo resistant?
Yes, it tends to be
How do urothelial cell carcinomas present?
Haematuria
Urinary frequency
Pain on urination
Urinary tract obstruction
What is the most important prognostic factor in bladder carcinoma?
Depth of invasion
Urethral syndrome is caused by
abacterial cystitis
what is classified using the KASS criteria?
significant bacteriuria
pus in the urine with no organisms grown is known as
sterile pyuria
What classifies as a ‘complicated’ UTI?
UTI in males under 65, children under 10, the presence o a foreign body and underlying abnormality
causes of sterile pyuria include
‘fastidious’ organisms: TB, Haemophilus
UT inflammation
Urethritis that is sexually transmitted
MSUs are carried out using what colour of container?
Red top (contains boric acid to preserve)
Early morning urine samples are done when
urinary TB is suspected
what would you use to treat a UTI?
Nitrofurantoin (not for upper UTIs)
Trimethoprim
What would you use to treat upper UTIs?
Cefuroxime, ciprofloxacin
Tazobactam (in over 65s)
When changing catheters, what can be given as a ‘cover’?
Gentamicin