Pathology Flashcards
describe the endothelial appearance of the glomerular capillary
endothelial cells
basal lamina
podocytes and foot processes
mesangial cells on inside
what epithelia lines bowmans capsule
parietal epithelia
what antibody is present in goodpastures
IgG against alpha 3 subunit of collagen 4
what type of ANCA is GPA associated with
cANCA
what type of ANCA is MPA associated with
pANCA
classic presentation of nephrotic syndrome
hypoalbuminuria
oedema
proteinuria >3g daily
hyperlipidaemia
classic presentation nephritic syndrome
hypertension
haematuria
why are those with nephrotic syndrome at increased risk of thrombosis and immunosuppression
loss of cotting cascade and complement
what three methods can be used to classify GN
light microscopy
electron microscopy
immunofluorescence
what does crescentic GN indicate
rapidly progressive GN
what does the presence of granulomas relative to GN
GPA
sarcoid
a linear pattern IgG on immunofluorescence is indicative of?
goodpastures syndrome
minimal change GN - cause, who is it more common in, nephritic or nephrotic, treatment and prognosis
idiopathic children nephrotic steroids good prognosis
pathological appearance of minimal change GN
not much to see
podocyte foot process effacement
cause of FSGN
obesity
sickle cell
HIV
PWID
who is FSGN more common in, pathology and nephrotic/nephritic
adults
nephritic
glomerular involvement in parts and scarring
causes of membranous GN
hepatitis, SLE, malaria, syphilis
gold, penicillamine, NSAIDs, captopril
cancer
what cancers can lead to membranous GN
lung
colon
melanoma
membraneous GN - nephrotic/nephritic, pathology appearance, prognosis
nephrotic
thick membranes with sub-epithelial immune deposits
variable
causes of IgA nephropathy
nephritic or nephrotic?
prognosis and pathological appearance?
nephritic genetic or acquired post infeciton IgA in mesangium prognosis depends
cause of type 1 membranoproliferative GN
idiopthic
cause of type 2 membranoproliferative GN
infection
malignancy
SLE
who does membranoproliferative GN affect, nephrotic/nephritic, pathological appearance?
children and adults
nephrotic and nephritic
hypercellular glomeruli with tram track membranes
how does diabetic GN appear pathologically
diffuse and nodular glomerulosclerosis
what are diabetic GN nodules referred to as?
kimmel steil wilson lesions
how common are acquired renal cysts
very
describe the local complications of ADPKD
haemorrhage, infarct, rupture
can lead to pain or haematuria
what are the systemic complications associated with ADPKD
liver cysts
cerebral aneurism
true/false - ARPKD is a childhood disease
true
pathological appearance of an oncocytoma. is it benign or malignant?
small, oval, well circumscribed
central scar
it is benign
appearance of a chromophobe tunour
similar to oncocytoma, but have raisin lie nuclei with halo
risk factors for clear cell cancer
obesity
genes
what do clear cell cancers sometimes extend down
the renal vein, to the IVC
what do most sporadic CCC have muitations in
von hippel lindau, Hypoxia inducable factor
histological appearance of papillary cell cancer
finger like projections
prognosis of collecting duct carcinoma
very very poor
common renal tumour of paediatrics
wilms tumour
what types of cancers are VHL syndrome associated with
renal cell epididymal serous cancer tumours of endolymph sac pancreatic serous cystadenoma cerebellar haemangioblastoma
what type of epithelia is the bladder made up of
transitional type
what other parts of the urinary tract are made up of transitional epithelia
bladder, ureters, collecting system
3 types of cystitis
parasitic
aseptic
cather reactivw
features of aseptic cystitis
persistent dysuria
persistent -ve cultures and urinalysis
what is the most likely parasite in parasitic cystitis
schistosomiasis, central africa
what is the natural history of schistosomiasis infection
causes metaplasia due to persistent infection, leading to squamous cell cancer
what is the natural history of catheter reactive cystitis
can lead to inflamamtion, metaplasia and SCC
causes of urinary diverticulae
stones
tunours
infection
what is hydronephrosis
dilation of the collecting system due to urinary obstruction leading to atrophy of renal parenchyma
bilateral hydronephrosis is indicative of?
low down urinary blockage
what is the most common of urinary obstruction in men and its pathophysiology
prostatism
hyperplasia of the bladder muscle due to enlarged prostate, leading to raised back pressure
what are the risk factors for urothelial neoplasia
middle age and elderly age
beta-naphthalene
smoking - biggest risk
how many transitional cell cancer appear in the bladder
flat CIS or finger like projection
what are the risk factors for urinary SCC
any form of persistent inflammation leading to metaplsia
infection, catheters, sometimes aseptic
how can you tell if a urinary adenocarcinoma is secondary to the bowel or primary from persistent inflammation
imaging alone
what is urachal adenocarcinoma
adenocarcinoma in the urachus, patent part of the alantois from dome bladder to umbilicus
why is the prostate smaller in younger age
it is under androgenic stimuli
what sections of the prostate are affected by BPH
central and transitional
where is the transition zone located
anterior to transitional zone but posteroinferior to fibromuscular stroma
where is the peripheral zone located and what does it encircle
posteror and covers back of central zone and inferior prostatic urethra
risk factors for prostate cancer
cadmium batteries
increasing age
where is prostate cnacer normally found
peripheral zone
what histological type is adenocarcinoma
adenocarcinoma
function of PSA
liquifies semen to allow sperm to swim
how sensitive and specific is PSA
not very at all, high grade cancers dont even produce it
false positives in PSA
prostatitis spironolactone cycling DRE big prostate
what is the gleason scoring system
grading for prostate cancer
lowest is 6 and highest 10
histology of urethra
squamous distally and transitional cell more prox
what is BXO and how may it appear
balantitis xerotica obliterans
young present iwht phimosis/paraphimosis
lighen like band of inflammatory cells with hyaloid cartilage
what type HPV causes genital warts
6/11
what type HPV is a red flag
16/18
who is vaccinated for HPV nowadays?
women and men
what is PEiN and describe its differentiation
penile intraepithelial neoplasia
SCC with haematogenous spread
can be differentaited with no HPV
or defifferentiated with HPV
what is a spermatocele
paratesticular cyst in vas deferens
full of sperm
what is a hydrocele
accumulation of fluid in tunica vaginalis
unicystic, smooth, fluid filled
transluminates
what is a varicocele
varicosity of venous plexus
bag of worms
how long before testical is infarcted in tescicular torsion
6 hours
who gets testicular torsion and how does it present
young/adolescents
sleep, present at any time with acute scrotum
what is a bell clapper deformity and what does it predispose
insertion of tunica vaginalis is high so testis can rotate and sit laterally
risk factors for seminoma and blood test
~40yrs
undescended testis
raised LDH
true/false - contralateral testicle of undescended shares risk of seminoma
true
types of non-seminoma
mature teratoma
yolk sac
embronal
trophoblast
what marker is used in trophoblast
HCG
what marker is used in yold sac cancer
AFP
what marker can be used in choriocarcinoma
bHCG
