Path of Ureter, Bladder, + Urethra

Question 1

Hydronephrosis in children/infants

Answer 1

Ureteropelvic junction Obstruction

Question 2

Ureteritis Forms

Answer 2

Follicularis: Lymphocytes w/ Germinal centers

Cystica: Cystic transformation of nests/Brunn

Question 3

Neoplasms of Ureter

Answer 3

• Fibroepithelial Polyps: Most common bening neoplams of Ureter
• Urothelial Carcinoma: Older individuals

Question 4

most common and serious congenital anomaly of the bladder

Answer 4

• Vesicoureteral reflux

- a defect in the valve between ureters and bladder.

Question 5

4 YO child w/ sudden pyelonephritis

Answer 5

Vesiculoureteral reflux

Question 6

Urachal Anomalies

Answer 6

• Open Urachus -> Fistula to umbilicus

- Open Urachus -> Adenocarcinoma

Question 7

Cystitis Clinical Triad

Answer 7

1. Urinary Freq (every 15-20 min)
2. Localized pain over subgastric region
3. Dysuria

Question 8

Forms of Cystitis

Answer 8

1. Bacterial (80% E. Coli)
2. Hemorrhagic
3. Interstitial
4. Malakoplakia
5. Polypoid cystitis

Question 9

Hemorrhagic Cystitis

Path

Answer 9

• Path: Bleeding f/ mucosa related to toxicity of cyclophosphamide (acrolein) or radiotherapy

Question 10

Interstitial cystitis

• EPI
• S/S
• Histo

Answer 10

• EPI: Middle-age women
• S/S: Suprapubic pain, urgency. dysuria, hematuria
• Histo: Transmural inflammation; Hunner Ulcer

Question 11

Malakoplakia

• A/S
• Path
• Other
• Morph

Answer 11

• A/S: Imunosuppressionl E. Coli Infx
• Path: Defects in M0 function
• Other: Rx are ineffective
• Morph: Soft, yellow, raied mucosal plaques; ***Michaelis-Gutman Bodies

Question 12

Metaplastic lesions of Urinary Bladder

Answer 12

Cystitis glandularis and cystitis cystica are common lesions of the urinary bladder in which nests of urothelium(nests of Von Brunn)grow downward into the lamina propria.

Question 13

Nephrogenic adenoma importance

Answer 13

• sheds renal tubule cells

- Can mimic malignant process of infiltration of lamina propria + detrusor

Question 14

Bladder Cancer Risk Factors

Answer 14

• Smoking
• Industrial Aryl Amines
• Schitosoma Heam. -> Squamous Carcinoma
• Long-term Analgesics
• Irradiation
• Immunosuppressants

Question 15

Urothelial Bladder Neoplams Treatment

Answer 15

Ta/T1 -> Tranurethral resection (TURBT)

Recurrent Tumors -> intravesical instillation of attenuated strain of TB

Muscle-invasive -> Radical cystectomy

Advanced -> Chemo; Palliative

Question 16

Bladder Cancer Grading

• T System
• Grades

Answer 16

- Tis - in situ
Ta - non-invasive
T1 - subepithelial CT
T2a - superficial muscle
T2b -  Deep Muscle
T3 - perivesical tissue
T4 - adjacent organs
- Grade 1 -> Up tp Ta
- Grade 2 -> Upt o T2b
- Grade 3: T3

Question 17

Male congenital anomolies in distal urethral tract

Answer 17

Hypospadia: Ventral opening on Penis

Epispadia: Dorsal opening

Question 18

Urethral Stenosis

• Causes
• Tx

Answer 18

• Cause: Intrumentation, STI, hypospadia, trauma, + radiation
• Tx: Urethrotomy

Question 19

Urethritis:

• S/S
• Types

Answer 19

• S/S: discharge, local pain, itching, frequency; Cystitis, prostatitis
• Types: Gonococcal OR Non-gonococcal (Chlamydia or Mycoplasma)

Question 20

Urethral Caruncle

Answer 20

• a small, polypoid,benign vascular growth that usually occurs at the back part of the distal most end of the urethral meatus.
• Women after menopause due to estrogen def
• Tx estrogen cream + Sx

Question 21

Urethral tumor sites/types

Answer 21

• Proximal -> Urothelial Carcinoma like bladder

- Distal: Squamous Cell Carcinoma