Pathology

Question 1

What is nephritis and what are the two types?

Answer 1

• nephritis is inflammation of the kidney

- types: glomerulonephritis is non-infective and pyelonephritis is infective

Question 2

What are the main features of nephritic syndrome?

Answer 2

haematuria and hypertension

Question 3

What are the main features of nephrotic syndrome?

Answer 3

heavy proteinuria, oedema and hyperlipidaemia

Question 4

What pathologically can diabetes cause in the kidney?

Answer 4

• diffuse and nodular glomerulosclerosis (kimmel stiel wilson lesion)
• microvascular disease ie arterial sclerosis or pyelonephritis or papillary necrosis

Question 5

What is the Bosniak score?

Answer 5

this predicts cancer risk of cysts in the kidneys

Question 6

What is the main benign tumour of the kidneys?

Answer 6

oncocytoma which is small, oval and well-circumscribed and is brown with a central stellate scar

Question 7

What are the features of papillary and collecting duct carcinomas?

Answer 7

• papillary: malignant, finger-like projections

- collecting duct carcinoma: really bad

Question 8

What are the features of a clear cell carcinoma?

Answer 8

• most common malignant tumour
• caused by genetics and obesity
• presents as haematuria, mass and ?hypertension
• bright yellow surface
• can have renal vein involvement and extend into vena cava and grow towards the heart

Question 9

Where is urothelium?

Answer 9

bladder, ureters, collecting system and urethra

Question 10

What does schistosomiasis end up with?

Answer 10

squamous cell carcinomas

Question 11

What is cystitis cystica?

Answer 11

infolding of the bladder mucosa into cysts

Question 12

What can catheters eventually lead to?

Answer 12

metaplasia and then SCC

Question 13

What is the result of urinary tract obstruction?

Answer 13

back pressure so collecting duct system dilates and renal parenchyma becomes atrophic

Question 14

What is the urachus?

Answer 14

this is a remnant of the alantosis which connected bladder to umbilicus which involutes but can form adenocarcinoma inside it

Question 15

What is prostatic hyperplasia treated with?

Answer 15

transurethral resection

Question 16

What are the main benign and malignant renal pathologies?

Answer 16

benign: simple cysts, angiomyolipoma and oncocytoma
malignant: renal cell carcinoma, transitional cell carcinoma and lymphoma

Question 17

What lining is the urethra made of?

Answer 17

proximal it is urothelium

distal it is squamous

Question 18

What is BXO?

Answer 18

balanitis xerotic obliternas which is genital lichen plants which is very common in the young
can lead to phimosis

Question 19

What virus is genital warts cause by?

Answer 19

HPV 6 and 11

Question 20

What are Sertoli cells?

Answer 20

in testes and are stimulated by FSH

control environment in tubules and absorb excess cytoplasm

Question 21

What do the seminiferous tubules contain?

Answer 21

germ cells, Sertoli cells and maturing sperms

Question 22

What are Leydig cells?

Answer 22

in the interstitium of the testes which are under the control of LH to make dihydrorepiandrosterone from testosterone

Question 23

What is a testicular hydrocoele?

Answer 23

accumulation of fluid around the testes between the two layers of the tunica vaginalis

Question 24

What is a spermatocoele?

Answer 24

cystic change within the vas of the epididymus

Question 25

What is a varicocele?

Answer 25

enlargement of the veins in the venous plexus that drains the testes

Question 26

What are the features of a seminoma?

Answer 26

germ cell tumour
common
40y
Rf- undescended testes
good cure rate with radiotherapy

Question 27

What are the features of non-seminomatous tumours?

Answer 27

less common
mixed with seminoma
30y
agressive and can metastasise
treat early

Question 28

What are the types of non-seminomatous tumours?

Answer 28

• teratoma
• yolk sac: alpha feto protein production
• embryonal: aggressive
• trophoblast: positive for hCG

Question 29

What are the risk factors for microscopic haematuria?

Answer 29

smoking
over 40y
occupational exposure
analgesic abuse
H of UTI or UI disease

Question 30

What are the causes of haematuria?

Answer 30

ask when it occurs in one stream

• recent UI intervention eg biopsy, catheter
• BPH
• uteritis
• pyelonephritis
• trauma
• cancer
• glomerulonephritis
• nephrolithiasis
• urolithiasis at PUJ, pelvic ring or UUJ
• PKD
• coagulopathies

Question 31

What are the investigations for haemturia?

Answer 31

• FBC for anaemia and WBC
• urine dipstick for culture and microscopy
• coag studies
• urinary bladder cancer markers
• PSA
• CT/US