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pathology Flashcards

1
Q

what happens when there is a glomerular blockage?

A

glomerular sieve stops working
membrane charge is disrupted
can get nephrotic or nephritic syndrome

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2
Q

what 3 modalities are used to assess a renal biopsy?

A

Light microscopy
Electron microscopy
Immunoflouresence

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3
Q

what antibodies can be seen in IMF?

A

IgM
IgA
IgG

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4
Q

what cell deposits are seen in electron microscopy

A

subepithelial (below podocyte)
membranous (on GBM)
subendothelial (below endothelium)
mesangial (around the mesangial cells)

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5
Q

what can be caused by anti-GBM disease?

A

goodpasture’s
nephritic syndrome
rapidly progressive glomerulonephritis

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6
Q

where does IgG bind to?

A

IgG binds to alpha-3 unit of type IV collagen found in basement membrane of glomerulus and lung

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7
Q

what causes membranous GN?

A

infection - hepatitis, malaria, syphilis
Drugs – penicillamine, NSAID, captopril, gold
Malignancy – lung, colon and melanoma
Lupus – 15% of all GMN in lupus
Autoimmune Disease - thyroiditis

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8
Q

what is the histological appearance of membranous GN?

A

thick membranes, sub-epithelial immune deposits

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9
Q

what is the most common cause of nephropathy worldwide?

A

IgA nephropathy

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10
Q

who gets IgA nephropathy?

A

genetic, acquired defect – coeliac

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11
Q

what causes membranoproliferative GN?

A

idiopathic (type 2- infection, lupus, malignancy)
seen in adults and children

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12
Q

what is the appearance of MPGN?

A

big lobulated hypercellular glomeruli with thick membranes – tram tracks

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13
Q

does MPGN cause nephrotic or nephritic syndrome?

A

both

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14
Q

does IgA nephropathy cause nephrotic or nephritic syndrome?

A

nephritic

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15
Q

what is the treatment of minimal change disease?

A

steroids - excellent prognosis

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16
Q

what is the most common cause of nephrotic syndrome in children?

A

minimal change disease

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17
Q

what causes focal segmental glomerulosclerosis (FSGS)?

A

obesity, HIV, sickle cell, IV drug use

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18
Q

does FSGS cause nephrotic or nephritic syndrome?

A

nephritic

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19
Q

does FSGS respond to steroids?

A

sometimes yes, sometimes progresses to renal failure

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20
Q

what do you see on the kidneys in diabetic nephropathy?

A

Diffuse and Nodular Glomerulosclerosis
Nodules – Kimmel Stiel Wilson Lesion

Also microvascular disease – arterial sclerosis

Infection – pyelonephritis, papillary necrosis

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21
Q

what is the bosniak score?

A

score to assess the likelihood of a kidney cyst being cancer

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22
Q

what is the main difference in kidneys in ADPKD and ARPKD?

A

ADPKD - big kidneys, uneven surface with large cysts
ARPKD- normal sized smooth kidneys

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23
Q

what is xanthogranulomatous pyelonephritis?

A

mass in kidney caused by chronic pyelonephritis so associated with infection and not malignancy

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24
Q

decsribe oncocytoma

A

Small, oval and well circumscribed tumour
brown with a central stellate (star shaped) scar

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25
describe chromophobe renal cell carcinoma?
rare malignant tumours look similar to oncocytomas but have shriveled nuclei and perinuclear halos
26
describe papillary renal cell carcinoma
2nd most common renal cancer generally low grade finger like projections
27
describe collecting duct carcinoma
rare tumour, high grade appearance with very desmoplastic stroma, poor survival
28
describe clear cell carcinoma
most common renal cancer, when people say renal cancer they usually mean this common, risk factors- obesity, genetics presents with haematuria, mass, rarely hypertension bright yellow tumour surface
29
where does clear cell carcinoma normally spread to?
renal vein - can then go --> vena cava --> heart
30
what tumours does VHL cause?
Renal Cell Carcinoma Cerebellar haemangioblastoma Pancreatic serous cystadenoma Tumours of the endolymphatic sac Epididymal serous cystadenomas
31
what type of epithelium lines the bladder?
urothelium
32
what is cystitis?
inflammation of the bladder- usually caused by bacterial infection
33
what is schistosomiasis?
water borne disease caused by larvae penetrating skin presents with haematuria untreated infection can cause hydronephrosis, renal failure and bladder scc
34
how does schistosomiasis cause bladder scc?
persistent infection --> bladder metaplasia --> malignancy even though there is no squamous epithelium!
35
what is the presentation of interstitial cystitis?
middle aged women, persistent symptoms of dysuria but negative cultures
36
what are risk factors for urothelial cancer?
smoking - almost as high risk as lung cancer beta-naphthyline - dye industry
37
describe papillary urothelial carcinoma?
malignant but not invasive, finger like projections
38
what is the appearance of urothelial carcinoma in situ?
flat lesions
39
what are rare types of urothelial bladder tumours?
adenocarcinoma - difficult to distinguish from metastasised colon adenocarcinoma urachal adenocarcinoma
40
describe the urachus
Remnant of the alantois + urogential sinus From dome of bladder to the umbilicus Usually involutes, in some various parts remain patent Rarely – adenocarcinoma arises within it. Isolated to bladder dome
41
what is the function of the prostate?
provides passage for urine, some contractile function during ejaculation
42
describe benign prostatic hyperplasia
prostate gets bigger - hyperplasia in increase in cell number affects central and transitional zones - obstructing flow of urine
43
how common is prostate cancer?
At 50 – 30% of all men have it At 70 – 70% of all men have it At 90 - 90%
44
what are the types of prostate cancer?
prostatic acinar carcinoma - most common small cell carcinoma- most serious
45
what is PSA?
prostate specific antigen - glycoprotein enzyme - kallikrein 3
46
what is the problem with PSA?
If normal prostate epithelium makes PSA then very malignant cells won’t - a lot of cancers will though but can be good in follow ups post tumour removal
47
what is gleason staging of prostatic cancer?
based on histological appearance Combination of 2 numbers Each out of 5 Worst grade and predominant grade Lowest is usually 3+3 (Score 6) Highest is 5+5 (Score 10) 1 & 2 not used
48
what is lichen sclerosus?
same as BXO chronic inflammatory condition affects glans, coronal sulcus and/or foreskin can cause phimosis and paraphimosis association with non-HPV related scc
49
what is the clinical presentation of lichen sclerosus?
white patches with petechia, erosion, ulceration, pearly areas
50
what is a condyloma?
genital wart papillomatous proliferation of squamous epithelium can occur in glans, coronal sulcus, foreskin, meatus caused by HPV - usually 6 & 11 - low risk types
51
what is PeIN?
penile intraepithelial neoplasia can be differentiated - non HPV or dedifferentiated - HPV related
52
what has an association with penile cancer?
lichen sclerosus phimosis smoking
53
what do male germ cells mature into?
spermatozoa
54
what stimulates sertoli cells and what is their function?
FSH function is to control environment within seminiferous tubules to let the sperm mature
55
what are some common causes of testicular lumps?
Hernia Cystocoele Hydrocoele Spermatocoele
56
how do hydroceles form?
Accumulation of fluid around the testes Between the two layers of the tunica vaginalis – mesothelial lining Unicystic, smooth and fluid filled
57
when do lesions transilluminate?
when they are fluid filled solid filled lesions will not
58
what is a spermatocele?
Cystic change within the vas of the epididymis Unknown cause and usually asymptomatic May feel a fullness etc. Often present after self examination
59
what is a varicocele?
Varicosities of venous plexus that drains the testis Usually asymptomatic May again present having felt a lump “Bag of worms”
60
what can cause testicular torsion?
bell clapper deformity The insertion of the tunica vaginalis is high – the testis can rotate and even sit laterally
61
what is the most common type of testicular tumour?
germ cell tumour - malignant several types- seminoma is most common
62
what are the most common testicular tumours in old people?
lymphoma spermatic tumour metastasis
63
what is a risk factor for seminoma?
undescended testes - contralateral testes share risk
64
what type of tumour are non-seminomatous tumours?
usually mixed- seminoma still most common subtype on the mix though
65
what is the prognosis for most testicular cancer?
good - seminoma can be cured even at advanced stage non-seminomatous still good but need to treat early
66
what are the features of a mature teratoma?
can be derived from multiple germs layers all classified as malignant even though might not be
67
what do yolk sac tumours prdocuce?
alpha feto protein
68
what is an embyonal tumour non-seminomatous tumour?
aggressive form. Looks high grade and is associated with freq mets
69
describe trophoblast non-seminomatous tumour
strange looking cells on histology Positive for beta HCG (human chorionic gonadotrophin) Positive pregnancy test!

renal (23 decks)

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