Microscopic anatomy- urinary tract

Question 1

Parameters tested to asses renal function

Answer 1

Urea

Creatinine clearance

Na+ K+ Cl-

eGFR

Question 2

Excretory compounds raised in renal failure (2)

Answer 2

Urea

Creatinine

Question 3

Abnormal blood test results for chronic renal failure

Answer 3

Low haemoglobin- anaemia

Reduced EPO production causes normocytic normochromic anaemia

Question 4

Causes of acute renal failure

Answer 4

Hypovolemic shock due to:

• Diarrhea/ vomiting
• Chronic congestive heart failure
• Septic shock
• Haemorrhage: trauma, GIT, aortic aneurysm.

Question 5

Causes of acute renal failure

Answer 5

Glomerulonephritits

Chronic drug use like aspirin and NSAIDs

Chronic pyelonephritis

Hypertension

Diabetes

Autoimmune

Urinary tract obstruction

Question 6

Glomerulosclerosis

Answer 6

Scarring of glomeruli

Associated with chronic inflammation

Question 7

Causes of urinary tract obstruction

Answer 7

Kidney stones

Ureter stricture

Urethral stricture

Benign prostatic hyperplasia

Cancer of bladder or prostate

Question 8

Benign prostatic hyperplasia

Answer 8

Increased size of prostate due to increased number of cells.

Affects half of men over 60.

Symptoms (due to urethra obstruction):

• Urinary frequency
• Nocturia
• Poor stream
• Prostatism
• UTIs
• Bladder obstruction

Question 9

Testicular seminoma

- Investigations

Answer 9

Most common type of cancer of the testes- painless testicular mass

Investigations:

• Ultrasound
• CT
• Tumor markers

Question 10

Prostatic cancer

- Investigations

Answer 10

Most common cancer in men

Investigations:

• PSA test (Prostatic specific antigen)- raised
• Need core biopsy with transurethral ultrasound
• Prostate chips (transurethral resection of prostate)
• CT/MRI scan for distal metastasis
• Bone scan for bone metastasis

Question 11

Complications of radical prostatectomy

Answer 11

Urinary incontinence

Impotence/ penile dysfunction

UTIs

Question 12

Cancers that show common bone metastasis

Answer 12

Lung

Breast

Kidney

Thyroid

Question 13

Complication of vertebral bone metastasis

Answer 13

Compression of the spinal cord= lower limb paralysis

Can lead to urinary or faecal incontinence

Question 14

Urothelium

Answer 14

Also known as transitional epithelium.
- Lines the bladder, ureter and pelvic-calyceal system

• Four or more cells: more cuboidal in shape

Function
- Barrier to make wall impermeable to urine

Question 15

Renal cell cancer

Answer 15

Urological cancer
- More common in males and in the 60-70 age group.

Symptoms and signs:

• Haematuria
• Loin discomfort

Question 16

Bladder cancer investigations

Answer 16

Ultrasound scan

Cystoscopy for biopsy

CT/ MRI to look for spreading