Pathology

Question 1

what is agenesis

Answer 1

absence of one or both kidneys

Question 2

what is hypoplasia

Answer 2

small kidneys but normal development

Question 3

what is a horse shoe kidney

Answer 3

fusion at either pole of the kidneys, usually is the lower poles

Question 4

what is duplex systems

Answer 4

more than 1 urethra etc

Question 5

do simple kidney cysts cause any bother?

Answer 5

not really- no functional disturbance

Question 6

what size of cysts can affect kidneys?

Answer 6

multiple and large

Question 7

What is infantile polycystic disease

Answer 7

rare, autosomal recessive disorder that causes terminal renal failure in perinatal group.

Question 8

in infantile polycystic disease, is the renal enlargement unilateral or bilateral?

Answer 8

bilateral

Question 9

\what canc ause elongated cysts in infantile polycystic disease?

Answer 9

medullary collecting duct dilatation

Question 10

what is specifically associated with infantile polycystic disease

Answer 10

congenital hepatic fibrosis

Question 11

what type of inheritance is adult polycystic disease

Answer 11

autosomal dominant

Question 12

what chromosome is affected in adult polycystic disease

Answer 12

16, 4 is occasionally

Question 13

when does one get affected by adult polycystic disease

Answer 13

middle adult like

Question 14

what symptoms present with adult polycystic disease

Answer 14

abdominal mass, haematuria, hypertension, CRF

Question 15

can adult polycystic disease change the shape of the kidney?

Answer 15

yes

Question 16

where do cysts arise in the adult polycystic disease

Answer 16

any part of nephron- can be fluid filled, blood filled

Question 17

what type of aneurysm is associated with adult polycystic disease

Answer 17

berry aneurysm in circle of willis

Question 18

is a fibroma benign or malignNT

Answer 18

benign

Question 19

what colour are fibromas normally?

Answer 19

white

Question 20

where do fibromas occur>

Answer 20

medulla usually

Question 21

what is an adenoma

Answer 21

a benign tumour formed by glandular tissue in epithelial cells

Question 22

what colour is an adenoma

Answer 22

yellow

Question 23

where do adenomas arise

Answer 23

cortical

Question 24

what is angiomyolipoma

Answer 24

mixture of fat, muscle, blood vessel tumour.

Question 25

What are angiomyolipomas associated with

Answer 25

tuberose sclerosis

Question 26

what can juxtaglomerular cell tumour lead to

Answer 26

secondary hypertension

Question 27

what is the commonest intra abdominal malignant tumour in children aged 1-10

Answer 27

neuroblastoma

Question 28

what sings would be present in a child with neuroblastoma

Answer 28

an abdominal mass

Question 29

what do urothelial carcinomas come from?

Answer 29

renal pelvis and calyces

Question 30

is renal cell carcinoma benign or malignant?

Answer 30

malignant

Question 31

where does renal cell carcinoma arise form?

Answer 31

renal tubular epithelium

Question 32

what is the commonest primary renal tumour in adults

Answer 32

renal cell carcinoma

Question 33

what do patients present with renal cell carcinoma

Answer 33

abdominal mass, haematuria, flank pain, general features- malaise, WL etc, polycythaemia and hypercalcaemia

Question 34

what do masses look like in renal cell carcinoma

Answer 34

well circumscribed, large on cortex. Yellow in colour, with cystic, haemorrhage, necrotic areas. Renal vein extension is v v common

Question 35

is renal vein extension in renal cell carcinoma an good or bad sing?

Answer 35

BAD BAD BAD

Question 36

what is the commonest type of renal cell carcinoma

Answer 36

clear cell- tumour rich in glycogen and lipid

Question 37

what is the common way of metastases in renal cell carcinoma

Answer 37

haematogenous

Question 38

where does transitional cell carcinoma affect?

Answer 38

transitional epithelium from pelvicalyceal system to urethra

Question 39

where does transitional cell carcinoma most commonly affect?

Answer 39

BLADDER

Question 40

what age group does transitional cell carcinoma affect?

Answer 40

> 50

Question 41

what are the risk factors for getting transitional ell carcinoma

Answer 41

smoking, rubber industry, dyes, analgesics,

Question 42

what is the commonest symptom of transitional cell carcinoma

Answer 42

haematuria

Question 43

where does the transitional cell carcinoma most commonly occur

Answer 43

trigone area

Question 44

is transient cell carcinoma often recurring?

Answer 44

yup- can progress to higher stage

Question 45

what is the commonest malignant bladder tumour in children?

Answer 45

embryological rhabdomyosarcoma

Question 46

what do squamous cell carcinomas look like on histology

Answer 46

eggs and red balls

Question 47

Is glomerulonephritis infective?

Answer 47

no

Question 48

Where is glomerulonephritis based?

Answer 48

glomeruli then secondary changes in interstitial component of kidneys

Question 49

Are all glomeruli affected in glomerulonephritis?

Answer 49

no- usually just a few

Question 50

What is associated with pyelonephritits

Answer 50

bacterial infection of renal pelvis, calyces and tubules

Question 51

Is pyelonephritis more often acute or chronic

Answer 51

chronic

Question 52

what is the commonest cause of pyelonephritis

Answer 52

E Coli

Question 53

does pyelonephritis occur more commonly in women or men?

Answer 53

women

Question 54

How does pyelonephritis spread?

Answer 54

septicaemia states, post surgery, MOST COMMONLY- ascending infection

Question 55

what are the risk factors for pyelonephritis

Answer 55

females, age, pregnancy, ureteric dilatation, instrumentation, urinary tract obstruction- stones, strictures, inflame disorders, tumours, duplex systems, diabetes, vesicle-ureteric reflux

Question 56

what is seen histologically in pyelonephritis

Answer 56

neutrophil infiltrate -in chronic infiltrate- lymphocytes and glomerular loss can be seen

Question 57

what ar symptoms of pyelonephritis?

Answer 57

hypertension/ uraemia, vague symptoms, may present with large volume of urine,

Question 58

what is seen on renal imagine of chronic pyelonephritits

Answer 58

coarse cortical scarring and distortion of calyces, kidneys can become very shrunk!

Question 59

How is tuberculosis pyelonephritis spread?

Answer 59

by blood from a site elsewhere

Question 60

how do patients present with tuberculosis pyelonephritis

Answer 60

weight loss, fever, sweats, loin pain, dysuria, sterile pyuria- pus in urine (initially microbiology doesnt grow anything)

Question 61

how do you diagnosis tuberculosis pyelonephritis these days

Answer 61

PCR

Question 62

what necrotic appearance do tuberculosis pyelonephritis have

Answer 62

caseous foci- granulomatous inflammation. Cheese like appearance. Can rupture and spread into ureter, bladder and other viscera. ZN stain

Question 63

What causes cystitis

Answer 63

E. Coli, klebsiella, pseudomonas, proteus

Question 64

Is cystitis acute or chronic?

Answer 64

acute?

Question 65

what is cystic cystitis

Answer 65

multiple small fluid filled cysts projecting into lumen. Can biopsy- may resemble tumours

Question 66

what is an important cause of bladder infections worldwide?

Answer 66

Schistosomiasis (worms and egg they lay)

Question 67

what can bladder infections predispose a patient to

Answer 67

squamous cell carcinoma

Question 68

who is mostly affected by urethral obstruction

Answer 68

males

Question 69

what can cause an obstruction in the urethra

Answer 69

stricture, posterior urethral valves, prostatic disease

Question 70

what happens to the bladder lining in prolonged bladder outlet obstruction

Answer 70

hypertrophy of detrusor muscle

Question 71

what is hydronephritis

Answer 71

prolonged urinary obstruction- dilated pelvicalyceal system with atrophy

Question 72

what are causes of hydronephritis

Answer 72

urinary tract obstruction and reflux

Question 73

what can cause unilateral hydronephritits

Answer 73

proximal urinary tract, calculi, neoplasms, congenital abnormality, strictures

Question 74

if the obstruction is gradual what will happen to urethra tube;e

Answer 74

dilate- hydronephritis

Question 75

what is it called when there is a secondary infection to hydronephritis

Answer 75

pyonephritis