Pathology Flashcards
Nonneoplastic epithelial disorders of the vulva are
Lichen sclerosus
Lichen cimolex chronicus
Lichen sclerosus
Atrophic epithelium
Subepithelial dermal fibrosis
Bandlike chronic inflammation
Lichen simplex chronicus
Hyperkeratosis
Hyperplasia
Most common congenital kidney diseases
ADPKD
RENAL DYSPLASIA
ADPKD
10% of patients on maintenance renal dialysis
GENE IS PKD1 95%
Kidneys replaced with fluid filled cysts
Diagnoses only during adulthood
Causes renal failure
What’s is the most important complication of ADPKD
Hypertension
Which disease weights as much as 4 kg for each kidney
ADPKD
Cystic renal dysplasia
It’s a developmental abnormality
Can unilateral and bilateral
Kidney has immature nephrons
Cystic dilatations
Unilateral cystic dysplasia
More common then bilateral
Abdominal palpations
Abnormal mass
Non progressive
Non invasive
Replacement of the renal parenchyma with cluster of cysts
Bilateral cystic dysplasia
Associated with urinary tract abnormalities
Renal failure in neonatal period
Both kidneys don’t developed properly in the womb there are bundles of cysts in the kidney
No working kidneys
Most common abdominal mass in infants
1= cystic renal dysplasia
2= wilms tumor
3= neuroblastoma
ARPKD
Present at birth
Renal failure caused by PKHD1 gene
Fibrocystin protein
What is the most common genetic cause of end stage renal diseases in children and young adults
Familial juvenile nephronophthisis
What is the most common cause of chronic kidney disease in humans
Chronic glomerulonephritis
List primary glomerulonephritis
Acute proliferative glomerulonephritis
Rapidly progressive glomerulonephritis
Membranous nephropathy
Minimal change diseases
List secondary glomerulonephritis
Systemic lupus erythamousus
Henoch schonlein purpura
Diabetes mellitus
What are the 2 non exclusive mechanism of the antibody depositions in the glomerulus
1= deposition of circulating antigen antibody complexes
2= antibodies reacting in situ within the glomerulus either with fixed or planted.
Immune couplex + coupleman leads to inflammation
Nephritic syndrome
Immune couplex no couplaman disrupts glomerular permeability
Nephrotic syndrome
Most important glomerular lesions of diabetic nephropathy are
1- capillary basement membrane
2- diffuse mesangial sclerosis
3- nodular glomerulosclerosis
What’s is nodular glomerulosclerosis also known as
Kimmelsteil Wilson disease
List primary glomerular diseases
Minimal change disease
Focal segmental glomerulosclerosis
Membranous nephropathy
IgA nephropathy
Membranoproliferative glomerulonephritis
Secondary glomerular diseases
Systemic lupus erythematosus
Diabetes mellitus
Henoch schonlein purpura
What is the most common cause of nephrotic syndrome in children
Minimal change disease
What is the unique feature for MCD
Absence of glomerular pathology by the light microscopic evaluation
The pathogens is remain unknown
The most cause of nephrotic syndrome in adult
Membranous nephropathy
Pathogenesis of membranous nephropathy
Immune complexes are formed in situ by PLAR2 autoantibodies binding to endogenous podocyte antigens
Or planted antigens
Autoimmune diseases and unknown
Main histoligical finding for MN
Diffused thickening of the GBM
Formation of spikes
No inflammation
Focal segmental glomerulosclerosis pathogenicity
Segmental sclerosis of glomeruli as a primary diseases secondary hiv infection
Obesity
Heroin abuse
Reduced renal mass
Electron microscopy of FSGS
Reveals diffuse foot process effacement
MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS
Basement membrane thickening
Proliferation of glomerular cells
Caused be immune complex deposition
Trum track splitting of basement
Poststreptococcal glomerulonephritis
Acute glomerular inflammation
Nephritigenic stains of streptococci
Which disease is seen most commonly in children following GAS group A streptococcal tonsillopharyngitis
And skin infections
PSGN
PSGN
Deposition of immmune complex’s within the glomerular basement membrane results in compliment activation and subsequent damage to the glomeruli
Immunfluorescence OF PSGN
Granular staninjng pattern for igG and c3
Electron microscopy of PSGN
Large subepithelial humps of deposited immune complexes
SYSTEMIC LUPUS NEPHRITIS
The body’s own immune system attacks the body’s own cells and organs and when kidneys are affected it’s SLN
Autoimmune disease which antinuclear autoantibodies are produced that form immune complexes with self nuclear antigen
One of the most serious complications of SLE IS
Renal failure
Most common SLE IS
Diffuse lupus nephritis class 4
DIFFUSE SLE is
Extencisive subendothlial immune complex deposition may leas to GBM THICKINING CREATE APPEARANCE OF WIRE LOOps
Diabetes nephropathy pathogenisis
AGES May stimulate the production of cytokines and growth factors that lead to the increased synthesis of matrix protein in the glomerular mesgangium
Hallmark for DN
Deposits of matrix material in the mesangium and capillary wall
Diffuse glomerular basement thickening and progressive scarring
What are the three pathophysiogical mechanisms that lead to RPGN
1= anti glomerular basement membrane disease good postures syndrome
2= immune complex glomerulonephritis
3= pauci immune glomerulonephritis ANCA associated with vascullitides
Which diseases is a frequent cause of recurrent hematuria in children and young adults
IGA NEPHROPATHY
Pathophysiology of IgA nephropathy
Increased no of IgA Antibodies
→ IgA antibodies form immune complexes that deposit in the renal mesangium → mesangial cell and complement system activation → glomerulonephritis (type III hypersensitivity reaction) [5]
A hereditary nepthritis diseases with thin basement membrane
Alport disease
Mutations affecting the type 4 BM Collagen
Henoch schonlein purpura also known as IGA vasculitis
Acute immune complex mediated small vessel vascutltis
Common in children
Palpable purpura
Arthritis arthralgias
Renal involvement
Characteristics of the benign nephrosclerosis
Hypertension
Hyaline arteriosclerosis
Interstitial fibrosis and tubular atrophy
Characteristics of the malignant nephrosclerosis
Malignant HYPERTENSION
Fibrinoid necrosis of arterioles
Hyperplastic arteriosclerosis
Onion skinning
What is nephrosclerosis
Hypertension causing narrowing of renal arteries resulting in chronic ischemia
Benign nephrosclerosis
Increased systemic blood pressure (e.g., due to chronic hypertension) below the protective autoregulatory threshold → benign nephrosclerosis (sclerosis of afferent arterioles and small arteries) → ↓ perfusion → ischemic damage
malignant nephrosclerosis
In case BP exceeds threshold → acute injury → malignant nephrosclerosis (petechial subcapsular hemorrhages, visible infarction with necrosis of mesangial and endothelial cells, thrombosis of glomeruli capillaries, luminal thrombosis of arterioles, and red blood cell extravasation and fragmentation) → failure of autoregulatory mechanisms → ↑ damage
Morphology of malignant nephrosclerosis
Petechial hemorrhage
Flea bitten appearance
Which disease is responsible for 2-5% of hypertension cases
Unilateral renal artery stenosis
Most common cause of renal artery stenosis
Narrowing of renal artery by an atheronatous plaque
Fibromuscular dysplasia of the renal artery
Which disease patchy papillary necrosis
Sickle cell nephropathy
Uncommon condition that occurs after obstetric emergency
Diffuse cortical necrosis
What is pyelonephritis
When inflammation is the the result of an infection in the renal pelvis
Inflammation of the interstitial tissue
Factor causing p
Acute and chronic pyelonephritis
Infection via hematogenous route
Obstructive lesions
Thyroidization is in acute or chronic pyelonephritis
Chronic
What is a n chronic urate nephropathy or gouty nephropathy
Urate deposits evoke a mononuclear response that contains giant cells
Hydronephrosis means
Dilation of the renal pelvis and calyces
Malakoplakia
Michaelis gutmann bodies
Chronic granulomatous inflammation
Urothelial carcinoma
90% of all bladder tumors
Multifocal
Painless hematuria
In males more
Schistosoma haematobium
Clinical course of bladder cancer
Tendency to developed new tumors
Recurrences may show high grade
Cuz or high grade papillary cancer refractory to BCG
What are the benign neoplasms
Renal papillary adenoma
Angiomyolipomas
Oncocytoma
Malignant tumors of the kidney
Renal cell carcinoma
Wilms tumor
Urothelial carcinomas of the calyces and pelvis
What are the three classification of the renal cell carcinoma
1= clear cell carcinoma
2= papillary carcinoma
3= chromophobe carcinoma
What does a clear cell renal cell carcinoma involve
A tumor suppressor gene VHL
What does a papillary renal cell involve
MET PROTO ONCOGENE
Clinical features is renal cell carcinoma
Sixth to seventh decades
Smoker
Hypertensive
Obese
Chronic dialysis
Paraneoplastic syndromes
Morphology RCC
Usually solitary
Area of necrosis and hemorrhage
Propensity to invade into renal pelvis
Papillary tumors bilateral and multiple
Wilms tumor WAGR
W= wilms tumor
A= aniridia
G= genital abnormalities
R= retardation
Denys- drash syndrome
Beck with- wiednann syndrome
What are the germ cell tumors
Seminomatous tumors
Seminoma
Nonseminomatous tumors
Embryonal carcinoma
Yolk sac
Choriocarcinoma
What’s is the most common germ cell tumor
Seminoma
What is the most common testicular tumor in men older then 60 years
Non-Hodgkin lymphoma
What is the most common form of prostatitis
Chronic a bacterial prostatitis
Thyoes of prostatitis
Acute bacterial
Chronic bacterial
Chronic a bacterial
Granulomatous
Benign prostatic hyperplasia
Very common
Androgen mediated growth
Not a malignant lesion
Central zone proliferation
Nodular growth pattern
Prostatic intraeoithelial neoplasia
A putative precursor lesion
Can lead to cancer
Prostate cancer or adneocarcinoma
70% peripheral zone
Hematogenous spread to the bones
Graded using gleason system
PSA MEASUREMENT
Types of mastitis inflammation of breast
Acute mastitis and breast abscess
Chronic mastitis
Mammary duct ecstasia
Traumatic fat necrosis and galactocele
Describe fat necrosis
Disruption of the regular patterns of lipocytes
Formation of lipid filled inflammatory cells and histocytes
Late stages there is replacement fibrosis and even calcification
What is the most common benign breast condition producing vague lumpy breast rather then palpable lump in the breast
Fibrocyctic change
3rd and 5th decade of life
Important Breast tumors
1- fibrosdenoma
2- phyllodes tumor
3- intraductal papilloma
Types of malignant tumors
Non- invasive carcinoma in situ
Invasive cancer
What is the most common benign tumor of female breast
Fibroadenoma
Tumor suppressor gene mutations
TP53
BRCA1
BRCA2
PROTO oncogenic mutations
PIK3CA
HER2
MYC
CCNDI
Paget’s disease of the nipple
Palpable mass is detected in 50%-60% people
Palpable mass= invasive carcinoma
Molecular test for breast cancer
ER
PR
HER2
