Pathology Flashcards
what antibodies can be seen in IMF?
IgM
IgA
IgG
how doses goodpastures appear on IMF?
linear IgG
what are the features of minimal change disease?
unknown aetiology
affects kids
good prognosis (usually resolves with steroids
is minimal change nephrotic or nephritic?
nephrotic
what are the features of focal segmental glomerulosclerosis?
caused by obesity, HIV, sickle cell, PWID
affects adults
nephrotic
what are the features of anti GBM disease
immune mediated
found in basement membranes and lungs
can cause rapidly progessive disease
crescents in histology
what are the features of membranous glomerulonephritis?
caused by
:hepatitis, malaria, syphilis
: penicillamine, NSAID, captopril, gold
: malignancy
:lupus
affects adults
causes nephrotic syndrome
thick membranes with subepithelial immune deposits
<40% get ESKD
what are the features of IgA nephropathy
most common cause of glomerulonephritis world wide
occurs after a GI/respiratory infection
genetic or acquired defect of immune regulation
nephritic syndrome
IgA deposition in mesangium
prognosis depends on severity
what are the features of membranoproliferative glomerulonephritis?
idiopathic
affects adults and children
can be nephrotic or nephritic
has big lobular hypercellular glomeruli with thick membranes (tram tracks due to double membrane appearance)
prognosis depends on severity
what are the nodules in diabetic nephropathy called?
kimmel stiel wilson lesions
what is the bosniak score?
a radiological scoring of the likelihood of a cyst being cancer
what are acquired cysts associated with?
long term dialysis
what are the features of ADPCKD?
uncommon
due to a mutation in nephrin
lots of cysts that develop over time
kidneys can become massive
often secondary changes
what is ADPCKD associated with?
liver cysts and cerebral aneurysms
what is the difference between ARPCKD and ADPCKD?
ARPCKD has a kidney of normal size and a smooth surface
what is Xanthogranulomatous pyelonephritis?
a specific infection - creates a mass but is usually associated with infection
what are the common renal tumours
benign-oncocytoma
malignant- chromophobe, clear cell, papillary and collecting duct
what is a common paediatric tumour in renal disease?
wilms tumour
what are the features of an oncocytoma?
small, oval and well circumscribed
mahogany brown with a central stellate scar
very pink and granular cytoplasm
what are the features of a chromophobe?
uncommon
histologically similar to oncocytomas
oncocytic but with raisonoid nuclei and perinuclear haloes
what are the features of papillary tumours?
2nd most common
generally low grade
have finger like projections
what are the features of a collecting duct carcinoma?
least common
not nice
high grade appearance with a very desmoplastic stroma
poor survival rate
what are the features of a clear cell carcinoma?
renal cancer= usually means clear cell carcinoma
common
risk factors are obesity + genetic influence
presenting complaint is usually haematuria, mass and rarely hypertension
what is the appearance of a clear cell carcinoma?
often partly cystic and very heterogenous surface
bright yellow tumour surface
where does a renal cell carcinoma spread to?
renal vein involvement and can extend into the vena cava and grow up towards the heart
what can VHL cause?
Renal Cell Carcinoma
Cerebellar haemangioblastoma
Pancreatic serous cystadenoma
Tumours of the endolymphatic sac
Epididymal serous cystadenomas
what are the features of the bladder?
collects and expels urine
lined by urothelium
what is cystitis?
inflammation of the bladder
what is schistosomiasis?
parasite that infects bladder
water borne- eggs in urine/faeces get into the water>larval stage in snail>penetrate skin>ova deposited in bladder
endemic in the eastern Mediterranean and sub-saharan africa
what is the lasting impact of schistosomiasis?
persistant inflammation which can lead to squamous metaplasia
significantly increased risk of squamous cell carcinoma of the bladder
what are people with long term catheters at risk of?
persistant inflammation
> metaplasia
>SCC
what are the features of aseptic (interstitial) cystitis?
persistant symptoms of dysuria but has persistant negative cultures and urinalysis
biopsy to rule out carcinoma
what is cystitis cystica?
descriptive term that doesnt identify cause
the infolding of bladder mucosa into cysts
can mimic a tumour on histology
what are the features of bladder tumours?
urothelial neoplasia is relatively common
affects the middle aged and elderly
very strong correlation with smoking (almost as much as lung cancer)
what is urothelial carcinoma in situ (CIS)?
a flat lesion
what is papillary urothelial carcinoma?
non invasive but still malignant
finger like projections
what is urothelial carcinoma?
can develop from both CIS and Papillary
what is a bladder adenocarcinoma?
only occurs on a background of metaplasia
difficult to distinguish from a colon cancer that has invaded through
what is the urachus?
a remnant of the alantois
goes from the dome of the bladder to the umbilicus
usually involutes but in some parts remain patent
rarely an adenocarcinoma can rise but is isolated to the bladder dome
how does an SCC arise in the lung?
persistant inflammation gives rise to squamous metaplasia
what is the function of the prostate?
prostatic fluid and fluid from seminal vesicles
supplies some contractile function during ejaculation
what is hyperplasia?
an increase in the number of cells
how common is prostate cancer?
at 50-30% have it
at 70- 70% have it
at 90-90% have it
what are the risk factors for prostate cancer?
cadmium batteries
less hormonal link than BPH
cause is unclear
tumours tend to occur in the periphery of the gland
whats the most common type of prostate cancer?
prostatic acinar carcinoma
small cell is the most serious
what is PSA?
a glycoprotein enzyme-kallikrein 3
liquifies semen in ejaculate and allows sperm to swim
multiple things can raise PSA
- BPH
- prostatitis
- drugs eg spironolactone
- PR exam
high grade cancers may not produce it
useful for monitoring post treatment
how is prostate cancer diagnosed?
core biopsies
transanal/rectal core biopsies
what grading system is used for prostate cancer?
gleason grading system
combination of 2 scores, each out of 5
