Pathology

Question 1

what antibodies can be seen in IMF?

Answer 1

IgM
IgA
IgG

Question 2

how doses goodpastures appear on IMF?

Answer 2

linear IgG

Question 3

what are the features of minimal change disease?

Answer 3

unknown aetiology
affects kids
good prognosis (usually resolves with steroids

Question 4

is minimal change nephrotic or nephritic?

Answer 4

nephrotic

Question 5

what are the features of focal segmental glomerulosclerosis?

Answer 5

caused by obesity, HIV, sickle cell, PWID
affects adults
nephrotic

Question 6

what are the features of anti GBM disease

Answer 6

immune mediated
found in basement membranes and lungs
can cause rapidly progessive disease
crescents in histology

Question 7

what are the features of membranous glomerulonephritis?

Answer 7

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

Question 8

what are the features of IgA nephropathy

Answer 8

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

Question 9

what are the features of membranoproliferative glomerulonephritis?

Answer 9

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

Question 10

what are the nodules in diabetic nephropathy called?

Answer 10

kimmel stiel wilson lesions

Question 11

what is the bosniak score?

Answer 11

a radiological scoring of the likelihood of a cyst being cancer

Question 12

what are acquired cysts associated with?

Answer 12

long term dialysis

Question 13

what are the features of ADPCKD?

Answer 13

uncommon
due to a mutation in nephrin
lots of cysts that develop over time
kidneys can become massive
often secondary changes

Question 14

what is ADPCKD associated with?

Answer 14

liver cysts and cerebral aneurysms

Question 15

what is the difference between ARPCKD and ADPCKD?

Answer 15

ARPCKD has a kidney of normal size and a smooth surface

Question 16

what is Xanthogranulomatous pyelonephritis?

Answer 16

a specific infection - creates a mass but is usually associated with infection

Question 17

what are the common renal tumours

Answer 17

benign-oncocytoma
malignant- chromophobe, clear cell, papillary and collecting duct

Question 18

what is a common paediatric tumour in renal disease?

Answer 18

wilms tumour

Question 19

what are the features of an oncocytoma?

Answer 19

small, oval and well circumscribed
mahogany brown with a central stellate scar
very pink and granular cytoplasm

Question 20

what are the features of a chromophobe?

Answer 20

uncommon
histologically similar to oncocytomas
oncocytic but with raisonoid nuclei and perinuclear haloes

Question 21

what are the features of papillary tumours?

Answer 21

2nd most common
generally low grade
have finger like projections

Question 22

what are the features of a collecting duct carcinoma?

Answer 22

least common
not nice
high grade appearance with a very desmoplastic stroma
poor survival rate

Question 23

what are the features of a clear cell carcinoma?

Answer 23

renal cancer= usually means clear cell carcinoma
common
risk factors are obesity + genetic influence
presenting complaint is usually haematuria, mass and rarely hypertension

Question 24

what is the appearance of a clear cell carcinoma?

Answer 24

often partly cystic and very heterogenous surface
bright yellow tumour surface

Question 25

where does a renal cell carcinoma spread to?

Answer 25

renal vein involvement and can extend into the vena cava and grow up towards the heart

Question 26

what can VHL cause?

Answer 26

Renal Cell Carcinoma Cerebellar haemangioblastoma Pancreatic serous cystadenoma Tumours of the endolymphatic sac Epididymal serous cystadenomas

Question 27

what are the features of the bladder?

Answer 27

collects and expels urine lined by urothelium

Question 28

what is cystitis?

Answer 28

inflammation of the bladder

Question 29

what is schistosomiasis?

Answer 29

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

Question 30

what is the lasting impact of schistosomiasis?

Answer 30

persistant inflammation which can lead to squamous metaplasia significantly increased risk of squamous cell carcinoma of the bladder

Question 31

what are people with long term catheters at risk of?

Answer 31

persistant inflammation > metaplasia >SCC

Question 32

what are the features of aseptic (interstitial) cystitis?

Answer 32

persistant symptoms of dysuria but has persistant negative cultures and urinalysis biopsy to rule out carcinoma

Question 33

what is cystitis cystica?

Answer 33

descriptive term that doesnt identify cause the infolding of bladder mucosa into cysts can mimic a tumour on histology

Question 34

what are the features of bladder tumours?

Answer 34

urothelial neoplasia is relatively common affects the middle aged and elderly very strong correlation with smoking (almost as much as lung cancer)

Question 35

what is urothelial carcinoma in situ (CIS)?

Answer 35

a flat lesion

Question 36

what is papillary urothelial carcinoma?

Answer 36

non invasive but still malignant finger like projections

Question 37

what is urothelial carcinoma?

Answer 37

can develop from both CIS and Papillary

Question 38

what is a bladder adenocarcinoma?

Answer 38

only occurs on a background of metaplasia difficult to distinguish from a colon cancer that has invaded through

Question 39

what is the urachus?

Answer 39

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

Question 40

how does an SCC arise in the lung?

Answer 40

persistant inflammation gives rise to squamous metaplasia

Question 41

what is the function of the prostate?

Answer 41

prostatic fluid and fluid from seminal vesicles supplies some contractile function during ejaculation

Question 42

what is hyperplasia?

Answer 42

an increase in the number of cells

Question 43

how common is prostate cancer?

Answer 43

at 50-30% have it at 70- 70% have it at 90-90% have it

Question 44

what are the risk factors for prostate cancer?

Answer 44

cadmium batteries less hormonal link than BPH cause is unclear tumours tend to occur in the periphery of the gland

Question 45

whats the most common type of prostate cancer?

Answer 45

prostatic acinar carcinoma small cell is the most serious

Question 46

what is PSA?

Answer 46

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

Question 47

how is prostate cancer diagnosed?

Answer 47

core biopsies transanal/rectal core biopsies

Question 48

what grading system is used for prostate cancer?

Answer 48

gleason grading system combination of 2 scores, each out of 5