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Repro > Lower Urinary Tract Path (Handorf) > Flashcards

Lower Urinary Tract Path (Handorf) Flashcards

1
Q

What are the layers of the wall of the ureter?

A

mucosa, muscualris, and adventitia

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2
Q

what propels the urine through the ureter?

A

peristaltic contractions

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3
Q

aquired strictures in the ureter are due to ..

A

chronic inflammation or sclerosing retroperitoneal fibrosis

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4
Q

what are the most common tumors in the ureter

A

mets

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5
Q

what are the most common benign primary tumors of the ureter?

A

fibroepithelial polyps and leiomyomas

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6
Q

what is the most common type of malignant tumor of the ureter?

A

transitional cell carcinoma

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7
Q

intrinsic or extrinsic cause of ureter obstruction:

neurogenic causes

A

intrinsic (interruption of neuronal pathways)

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8
Q

what is a the major/serious complication of chronic ureter obstruction?

A

hydronephrosis (which can lead to renal failure)

**due to distention of renal pelvis and increased pressure on the kidney parenchyma

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9
Q

What are causes of periureteral inflammation

A

salpingitis, diverticulitis, peritonitis, sclerosing retroperitoneal fibrosis

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10
Q

a fibrous proliferative inflammatory process thet encases retroperitoneal structures and causes compression of the ureter

A

sclerosing retroperitoneal fibrosis

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11
Q

what are the causes of sclerosing retroperitoneal fibrosis

A

unknown (70%)
drugs
chron’s dz
malignancy (lymphoma and urinary tract carcinoma)

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12
Q

ectopic endometrium is…

A

endometriosis

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13
Q

is the endometrial tissue in endometriosis functional?

A

yes

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14
Q

how can endometriosis lead to ureter obstruction?

A

hormones –> proliferation –> bleeding –> scarring –> compression of uretrer

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15
Q

what are 2 outcomes of chronic ureteritis

A

ureteritis folliculitis and ureteritis cystica

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16
Q

gross difference between ureteritis folliculitis and ureteritis cystica

A

ureteritis folliculitis = fine granularity on mucosal surface

ureteritis cystica = cysts on mucosal surface

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17
Q

produced by the accumulation of lymphocytes in the subepithelial region of the ureter in response to chronic inflammation

A

ureteritis folliculitis

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18
Q

male infant with hydronephrosis on the left side

A

uteropelvic junction obstruction

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19
Q

what is the pathophys of uteropelvic junction obstruction

A

abnormal organization and/or excess STROMAL deposition of COLLAGEN between smooth muscle bundles

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20
Q

saccular outpouchings of ureteral wall

A

diverticula

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21
Q

etiology of diverticula

A

congenital or due to increased pressure secondary to obstruction

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22
Q

what is the complication most assc with diverticula?

A

pockets of stasis = infection

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23
Q

congenital anomalies of the ureter

A

double/bifricated ureters, uteropelvic junction obstruction

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24
Q

describe the changes that occur in the bladder with chronic obstruction

A

increased pressure → hypertrophy → trabeculation → crypts form → diverticula → pyelonephritis or hydronephrosis

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25
Q

congenital cause of bladder diverticuIi

A

focal muscular defect

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26
Q

most common aquired cause of bladder diverticuIi

A

urethral obstruction

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27
Q

developmental defect of the closure of the anterior wall of the abdomen and the bladder

A

exstrophy

*i.e. the bladder communicates with the exterior of the body

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28
Q

vestigial structure that located between the apex of the bladder and the umbilicus and connected the bladder to the allantois

A

urachus

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29
Q

result of a totally patent urachus

A

fistulous urinary tract

30
Q

result of a urachus with only the center obliterated

A

diverticulum (infections)

31
Q

result of a urachus with only the center persists

A

urachal cyst –> adenocarcinoma

32
Q

describe the pathogenesis of a cystocele

A

relaxation of the pelvic support (usually old age/trauma from childbirth) → uterine prolapse → bladder floor pulled downward into vagina = cystocele

33
Q

congenital cause of vesicoureteral reflux

A

defect in the intravesical portion of the ureter such that there is no longer an oblique connection
**without the oblique connection the bladder musculature cannot act like a sphincter

34
Q

how does vesicoureteral reflux present?

A

baby with lots of UTIs, pylonephrosis, or hydronephrosis

35
Q

orgs that commonly cause cystitis

A

E coli, proteus, klebsiella, enterobacter

**presents like a UTI

36
Q

seen in exudate of acute cystitis

A

neutrophils

*these predominate

37
Q

seen in the exudate of chronic cystitis

A

lymphocytes, plasma cells, macrophages

*these predominate

38
Q

non-infectious cuases of cystitis

A

radiation, chemo, trauma

39
Q

lymphoid follicles are formed in the bladder mucosa in …

A

follicular cystitis (a form of chronic cystitis)

40
Q

foamy macropahges (PAS +) and michaelis-gutmann bodies

A

malakoplakia

41
Q

what is the etiology/pathogenesis of malakoplakia

A

defective host response to bacterial infection

42
Q

middle aged woman

suprapubic pain, uirnary frequency, urgency, and hematuria, without evidence of bacterial infection

A

interstitial cystitis

43
Q

related to cystitis cystica and is due to chronic inflammation of the bladder

A

cystitis glandularis

44
Q

90% of bladder tumors originate from

A

urothelium (transitional epithelium)

45
Q

inflammation and fibrosis of all layers of the bladder wall +/- localized mucosal ulcers (Hunner ulcers)

A

interstitial cystitis

46
Q

may predispose people to adenocarcinom

A

cystitis glandularis
exstrophy
urachal remnant

47
Q

morphologic patterns of urothelial bladder tumors

A

papillary and flat

48
Q

what areas of the bladder do most cancers arise? consequence of this?

A

lateral and posterior walls at the base –> commonly causes ureteral obstruction

49
Q

risk factors for bladder carcinomas

A 
aniline dyes
smoking
cylophosphamide
phenacetin
schistosomiasis
50
Q

presenting symptoms of bladder carcinoma

A

painless hematuria

+/- frequency, urgency and dysruia

51
Q

where do bladder carcinomas invade?

A

bladder wall, prostate, seminal vesicles, ureters, retroperitoneum,
**may produce fistuals to the vagina or rectum

52
Q

where do bladder carcinomas metastasize to?

A

regional LN, liver, lungs, bone marrow

*heme spread

53
Q

what tends to happen to urothelial tumors after they are removed?

A

new ones develop and these are typically at a higher grade

54
Q

in general, the higher the grade of the urothelial tumor, the

A

higher the chance of reoccurance

55
Q

assc with schistosomiasis and chronic irriation (i.e. calculi)

A

squamous cell carcinoma of the bladder

56
Q

where to squamous cell carcinomas of the bladder tend to airse?

A

trigone

57
Q

what morphology do squamous cell carcinomas of the bladder commonly have

A

fungating and invasive

58
Q

focal glandualr changes with mucin production

A

adenocarcimona

59
Q

adenocarcimona common morphology

A

solitary and deeply invasive (may ulcerate in center)

60
Q

non-smoker, egyption immigrant with bladder cancer most likely has

A

squamous cell carcinomas of the bladder

61
Q

benign bladder neoplasms

A

leiomyoma
hemangioma
granular cell tumor
neurofibroma

62
Q

schistosoma hematobium

A

squamous cell carcinomas of the bladder

63
Q

malignant mesenchymal bladder neoplasms

A

rhabdomyosarcoma
leiomyosarcoma
**sarcomas

64
Q

grape like projections into lumen of bladder in an infant or child

A

embryonal rhabdomyosarcoma (sarcoma botryoides)

65
Q

arthritis + conjunctivitis + urethritis

A

reiter syndrome

66
Q

structure of the urethra is due to … and causes…

A

due to chronic urethritis and can cause outflow obstruction

67
Q

small, red, painful, friable mass about the external urethral meatus in a female pt

A

urethral caruncle

68
Q

histo of urethral caruncle

A

leukocytes + fibrous CT (vascularized)

69
Q

tumor at the external meatus of the urethra and has a viral origin

A

papilloma

70
Q

____ carcinomas occur in the urethra (typically at the external meatus)

A

squamous cell

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