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2 - CPR (renal) > Lower Urinary Tract > Flashcards

Lower Urinary Tract Flashcards

1
Q

What 3 things make up the lower urinary tract?

A

Ureters
Bladder
Urethra

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2
Q

Describe the epithelium the lines the lower urinary tract?

A

Transitional (urothelium)

  • 5-6 layers of cells with oval nuclei with linear grooves
  • Umbrella cells on the surface layer (flat)
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3
Q

What is a common congenital ureter anomaly that can result in hydronephrosis?

A

Ureteropelvic junction obstruction

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4
Q

What is a common benign mesenchymal tumor of the ureter and who does it occur in?

A

Fibroepithelial polyp

– children

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5
Q

What is a unique obstructive lesion of the ureters?

A

Retroperitoneal Fibrosis

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6
Q

What is Retroperitoneal Fibrosis?

A

Fibrosis throughout the retroperitoneum

==> traps and obstructs the ureters

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7
Q

Retroperitoneal Fibrosis is an obstructive lesion of the ureters. What 3 things can it be associated with?

A
  1. IgG4 related disease
  2. Meds -“methy”
  3. Autoimmune response to Ceroid (lipid compound)
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8
Q

Retroperitoneal Fibrosis is an obstructive lesion of the ureters. What are 3 possible things it is associated with?

A
  1. IgG4 related disease
  2. Meds -“methy”
  3. Autoimmune response to Ceroid (lipid compound)
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9
Q

What are some predisposing factors for inflammation of the bladder (cystitis)? (4)

A
  • Calculi/obstruction
  • Diabetes Mellitus
  • Instrumentation
  • Immune Deficiency
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10
Q

What are the 4 most common etiologic agents for Cystitis?

A
  1. E. coli
  2. Proteus
  3. Klebsiella
  4. Enterobacter
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11
Q

What defines the morphology of Acute Cystitis?

A

Hyperemia of the mucosa + neutrophils

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12
Q

What defines the morphology of Chronic Cystitis?

A

Mononuclear inflammatory infiltrates

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13
Q

What are the main symptoms of Cystitis?

A

Dysuria
Suprapubic pain
Urinary frequency

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14
Q

What are the 3 special forms of Cystitis?

A
  1. Interstitial Cystitis
  2. Malakoplakia
  3. Polypoid Cystitis
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15
Q

What are the 3 special forms of Cystitis?

A
  1. Interstitial Cystitis
  2. Malakoplakia
  3. Polypoid Cystitis
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16
Q

What is Interstitial Cystitis?

A

Symptoms of a UTI but NO infection with at least a 6 week duration

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17
Q

What are the defining morphologic features of Interstitial Cystitis?

A

Mucosal fissures with punctate hemorrhages

- Increased mast cells

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18
Q

Mucosal fissures with punctate hemorrhages and increased mast cells suggests what type of Cystitis?

A

Interstitial Cystitis

– UTI symptoms with NO infection present

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19
Q

What causes Malakoplakia and when is it seen?

A

Due to acquired defects in phagocyte function

– Seen with chronic infection or immunosuppression

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20
Q

How does Malakoplakia look?

A

Yellow raised plaques

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21
Q

What cells will be present with Malakoplakia and what will be inside them?

A

Foamy macrophages with Michaelis-Gutmann bodies inside

22
Q

What are Michaelis - Gutmann bodies and what are they seen with?

A

Calcium deposits inside enlarged lysosomes

– seen with Malakoplakia

23
Q

This type of Cystitis is due to defects in phagocyte function?

A

Malakoplakia

24
Q

What type of Cystitis is due to bladder mucosa irritation from instrumentation (catheter)?

A

Polypoid Cystitis

25
Q

Broad, bulbous polypoid projections after a catheter placement is consistent with what type of cystitis?

A

Polypoid Cystitis

– irritation of the bladder mucosa

26
Q

Bladder cancers are usually urothelial (epithelial) in origin. Which sex is more often affected and is bladder cancer a single or multifocal malignancy?

A

More common in men

– Multifocal malignancy

27
Q

What are some risk factors for developing Bladder Cancer?

A

Smoking
Exposure to Aryl Amines
Schistosoma infections
Analgesic/Cyclophosphamide use

28
Q

What are some risk factors for developing Bladder Cancer?

A

Smoking
Exposure to Aryl Amines
Schistosoma infections
Analgesic/Cyclophosphamide use

29
Q

What are 2 possible precursor lesions for Bladder Cancer?

A
  1. Non-invasive papillary tumors

2. Flat Non-invasive Urothelial Carcinoma In Situ

30
Q

What is the most common precursor lesion for Bladder Cancer?

A

Non-invasive papillary tumors

31
Q

What mutations take place with the Non-invasive papillary tumor bladder cancer precursor lesion to give rise to cancer?

A

RAS
FGFR3
PI-3 kinase

32
Q

Mutations in RAS, FGFR3 or PI-3 Kinase that give rise to Bladder Cancer indicate that what precursor lesion was present?

A

Non-invasive Papillary Tumors

33
Q

What precursor lesion is associated with decreased survival and why?

A

Flat Non-invasive Urothelial Carcinoma In Situ

– More commonly results in Detrusor Muscle Invasion == poor prognosis

34
Q

What defines a worse prognosis for Bladder Cancers?

A

Detrusor muscle invasion being present

35
Q

What mutations take place with Flat non-invasive Urothelial Carcinoma In Situ bladder cancer precursor lesion in order for bladder cancer to arise?

A

TP53

RB

36
Q

Mutations in TP53 or RB that give rise to bladder cancer indicate that what precursor lesion was present?

A

Flat Non-invasive Urothelial Carcinoma In Situ

37
Q

What is the most common symptom of bladder cancer?

A

Painless hematuria

38
Q

What is the most common symptom of bladder cancer?

A

Painless hematuria

39
Q

If there is a soft, gray, large protruding mass of mesenchymal origin in the bladder, what is it?

A

Leiomyosarcoma

40
Q

Inflammation of the Urethra (urethritis) is due to what 2 general causes?

A
  1. Gonococcal

2. Non-Gonococcal

41
Q

What are the 2 agents that are responsible for the Non-Gonococcal Urethritis?

A

Chlamydia

Mycoplasma

42
Q

What is Urethritis (inflammation of urethra) usually present with in women and in men?

A

Women – cystitis

Men – prostatitis

43
Q

What is a common syndrome and its symptoms when Urethritis is present?

A

Reactive Arthritis (Reiter Syndrome)
= Urethritis, Conjunctivitis, Arthritis
“can’t pee, can’t see, can’t climb a tree

44
Q

What are some symptoms of Urethritis?

A

Pain, itching, urinary frequency

45
Q

What is a small, red and painful lesion that can occur at the external urethral meatus of women?

A

Urethral Caruncle

46
Q

What does a Urethral Caruncle lesion look like in women?

A

Small, red and painful lesion at the external urethral meatus

47
Q

Urethral Caruncles are friable. With even the slightest of trauma, what may they do?

A

Ulcerate and bleed

48
Q

What are benign urethral tumors?

A

Papillomas, even inverted ones

Condylomas

49
Q

A proximal urethral carcinoma is similar to what carcinoma?

A

Bladder type (urothelial)

50
Q

A distal urethral carcinoma is similar to what carcinoma?

A

Squamous and HPV related

2 - CPR (renal) (27 decks)

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