Pathology 4: Summary From Tutorial 1 Flashcards
Which lesion is almost pathognomonic for nodular glomerulosclerosis as a result of diabetic nephropathy?
Kimmelstiel-Wilson lesion
How can diabetic nephropathy damage the kidney?
Atherosclerosis of larger renal arteries
Pyelonephritis
Renal papillary necrosis
Renal paillary necrosis is often seen in conjunction with which other condition?
Acute pyelonephritis
What causes renal papillary necrosis?
Combination of vasuclar damage and inflammation
This causes ischaemia of the renal papillae which often slough off into the distal urinary tract
What is a highly important factor which dtermines the degree of renal impairment in diabetes?
Age of onset of diabetes
(it becomes more severe the earlier diabetes occur in life)
Amyloidosis is due to what?
Abnormal protein produced by plasma cells of the bone marrow
How does deposition of amyloid affect the kidneys?
Deposition in the glomeruli particularly around basement membrane increases permeability for protein loss
This can progress to nephrotic syndrome
Which conditions are commonly associated with amyloidosis?
RA/SLE
Bonchiestasis
Myeloma
Which stain is used for amyloid and what is the appearance under polarised light?
Congo red stain
Apple green birefringence under polarised light
Why is there an associated with renal calculi and myeloma?
Myeloma causes bone destruction and hypercalcaemia
Why do myeloma patients have increased risk of UTIs and pyelonephritis?
Immunodeficiency
What is the typical appearance of a seminoma?
Solid, white homogenous macroscopic appearance
Like a potato
What is the commonest primary germ cell tumour of young men?
Seminoma
(very rare in older men)
What is the lymphatic drainage of the testes?
Para-aortic nodes
How does seminoma spread?
Lymphatioc mainly (to para-aortic nodes)
Also haematogenous to liver and lungs
What is the prognosis of seminoma and what is the treatment?
Very good (>95%)
Radiotherapy and also chemotherapy
Which tumour marker is associated with seminoma?
PLAP
(placental alkaline phosphatase)
Which tumour marker is associated with teratoma?
AFP
(alpha-fetoprotein)
Produced by teratomas with yolk sac elements
If a teratoma contains trophoblastic it is very malignant. What tumour marker will it possess?
bHCG
(human chorionic gonadotrophin)
There is overgrowth of which tissues in benign prostatic hyperplasia?
Glandular and stromal elements of the prostate
How does BPH differ from prostate cancer in terms of which location of the gland is affected?
Centreaffected in BPH
How can prostatic carcinoma be diagnosed?
PSA (showing a gradual increase)
Immunohistochemical techniques
What is peculiar about skeletal metastases of prostatic carcinoma?
Typically osteosclerotic (more dense than surrounding bone)
(most metastatic tumours are lytic)
In malignant hypertension, which changes can be seen in the kidneys?
Fibrinoid necrosis in arterioles and glomerular tufts
Name causes of secondary hypertension
Renal artery stenosis
Any renal parenchymal disease
Renin secreting tumours (rare) - e.g. juxtaglomerular cell tumour
Pheaochromocytoma
Cushing’s syndrome
Which condition is involved with hypertension, subarachnoid haemorrhage and bilateral renal enlargement?
ADPKD
Why can subarachnoidal haemorrhage occur with ADPKD?
Associated with Berry aneurysm formation in circle of Willis
Why is LVH a feature of ADPKD?
Hypertension
