Pathology

Question 1

Glomerulonephritis is non-infective. True/False? What is glomerulonephritis?

Answer 1

True

Glomelular tufts with secondary tubulointerstitial changes - diffuse/ focal

Question 2

What is the usual mechanism of disease that causes glomerulonephritis??

Answer 2

Autoimmunity - autoantibody formation or deposition of immune complexes
Can follow URTI but not common

Question 3

What is pyelonephritis?

Answer 3

Bacterial infection of the renal pelvis/calyces, extending into tubules and interstitium

Question 4

Acute pyelonephritis is more common than chronic. True/False?

Answer 4

False

Usually chronic presentations

Question 5

What is the commonest organism cause of pyelonephritis?

Answer 5

E. coli

Can also get Pseudomonas, Strep. faecalis

Question 6

Is pyelonephritis commoner in males or females?

Answer 6

Females since urethra is shorter and wider

Question 7

How is pregnancy a risk factor for pyelonephritis?

Answer 7

Ureteric dilation occurs with stasis due to hormonal and anatomical effects

Question 8

Vesico-ureteric reflux can cause pyelonephritis. What is this?

Answer 8

Congenital/acquired defect where ureter entrance into bladder isn’t closed off, so when bladder contracts there is reflux

Question 9

What is cystitis and which organisms usually cause it?

Answer 9

Inflammation of the bladder

E. coli, Klebsiella, Proteus, Pseudomonas

Question 10

Which tropical infection can predispose to urethelial malignancy?

Answer 10

Schistosomiasis (particularly squamous cell carcinoma)

Question 11

Urethral obstruction is more common in males. True/False?

Answer 11

True

Question 12

What effect does prolonged bladder outlet obstruction have on detrusor muscle?

Answer 12

Hypertrophy and diverticulum formation

Question 13

What is hydronephrosis?

Answer 13

Dilation of pelvicalyceal system with parenchymal atrophy

Question 14

What is the main cause of hydronephrosis?

Answer 14

Urinary tract obstruction

Reflux

Question 15

List risk factors for pyelonephritis

Answer 15

Female
UTI
Pregnancy
Instrumentation
UT obstruction
Vesico-ureteric reflux
Diabetes

Question 16

What is tuberculosis pyelonephritis? State the characteristic distinguishing feature

Answer 16

Haematogenous spread of infection from lung to urinary tract
Sterile pyuria (no positive culture)

Question 17

What is Potter’s syndrome?

Answer 17

Pressure of reduced amniotic fluid causes a distinct facial appearance leading to abnormal kidneys in baby

Question 18

Outline the pathological appearance of the kidneys in polycystic kidney disease

Answer 18

Uniform bilateral renal enlargement
Multiple cysts
Dilatation of medullary collecting ducts
Congenital hepatic fibrosis

Question 19

Outline the pathological appearance of renal fibroma

Answer 19

White nodules in medulla

Question 20

Outline the pathological appearance of renal adenoma

Answer 20

Yellow nodules in cortex

Question 21

Outline the pathological appearance of renal angiomyolipoma

Answer 21

Fat, muscle, blood vessels

Question 22

Outline the pathological appearance of renal oncoytoma

Answer 22

Mahogany, central scar

Question 23

What is the common sites of metastates of renal cell carcinoma?

Answer 23

Blood borne (lung, bone)
Later lymphatic spread

Question 24

What is the common sites of metastates of bladder carcinoma?

Answer 24

Local lymph nodes (obturator)
Lungs
Liver

Question 25

What is the common sites of metastates of prostate carcinoma?

Answer 25

LYMPHATIC: Sacral, iliac paraortic nodes
BLOOD: Lumbosacral nodes, lung, liver

Question 26

Outline the pathological appearance of seminoma

Answer 26

Solid homogenous pale ‘potato’ tumour

Question 27

What is the best management for seminoma?

Answer 27

Radiotherapy

Question 28

What is the best management for teratoma?

Answer 28

Chemotherapy

Question 29

What is the common sites of metastates of seminoma?

Answer 29

LYMPHATIC: paraortic nodes
BLOOD: lungs, liver