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MD3002 Pathology > Pathology of the kidney, ureters and bladder 2 > Flashcards

Pathology of the kidney, ureters and bladder 2 Flashcards

1
Q

How does a renal stone present acutely?

A

Colickly pain, back, can cause haematuria

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2
Q

How can you treat kidney stones?

A
  • Pain relief
  • US (lithotripsy)
  • Surgery
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3
Q

What can renal calculi contain?

A
  • Calcium (75%)
  • Uric acid (20+%)
  • Cystine (1%)
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4
Q

What kind of kidney stone is radiolucent?

A

Uric acid

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5
Q

What can the underlying causes of a calcium stone be?

A

Hypercalcaemia

- Sarcoid, renal tubular acidosis, hyperparathyroidism

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6
Q

What can the underlying causes of a uric acid stone be?

A

Gout

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7
Q

What can cause a cystine stone?

A
  • Genetic mutation in PCT cystine transporter

- Dehydration

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8
Q

What can cause bladder disease?

A
  • Inflammation
  • Trauma
  • Infection
  • Calculi (schistosomiasis)
  • Neoplasia
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9
Q

What are the different types of urinary tract neoplasms?

A
  • Bladder - urothelial (transitional cell) carcinoma (1/5)
  • Renal - Clear cell carcinoma (ccRCC) (4/5)
    Less common
  • Transitional cell renal carcinoma
  • Renal nephroblastoma (Wilm’s tumour)
  • Ureter transitional cell carcinoma
  • Renal/bladder sarcoma
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10
Q

Why is bladder cancer a major health burden?

A
  • Ocurs mainly in elderly

- High chance of another tumour (5% chance per anum) due to whole mucosa being exposed to carcinogens

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11
Q

Who is mainly affected by Wilm’s tumour?

A

Children (usually < 3 years)

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12
Q

What is wilm’s tumour due to?

A

Mutation in WT1 tumour suppressor gene

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13
Q

What does the histology of wilm’s tumour look like?

A

Resembles immature or embryonal blastema

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14
Q

What is the survival rate from Wilm’s tumour?

A

90% (after surgery, radio, chemo)

Younger = better prognosis

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15
Q

What does Wilm’s tumour usually present with?

A

Large palpable abdominal mass in achild

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16
Q

Where does Renal cell carcinoma usually originate?

A

In ducts esp PCT

17
Q

What is the commonest type of renal cell carcinoma?

A
  • Clear cell
  • Papillary chromophobe
  • Mostly sporadic
18
Q

What greatly increases the risk of renal cell carcinoma?

A

Smoking and obesity

19
Q

What diseases can increase the risk of renal cell carcinoma?

A
  • Chronic cystic disease
  • Von Hippel-Lindau syndrome
  • Autosomal dominant RCC
  • Hereditary papillary
20
Q

What can renal cell carcinoma present with?

A
  • Loin pain
  • Mass
  • Haematuria
  • Metastases (cannonball lesions along lung)
21
Q

How can renal cell carcinoma typically metastasis?

A

Along renal vein to IVC

22
Q

What can renal cell carcinoma cause?

A
  • Paraneoplastic syndromes eg pyrexia, hormones (EPO)

- Metastases (cannonball lesions along lung)

23
Q

What is the prognosis of urothelial cancer which is muscle invasive?

A

50% death in 5 years

24
Q

What are the major risk factors for bladder cancer?

A
  • Smoking

- Industrial (eg aniline dyes)

25
Q

What type of malignancy is most dangerous in bladder cancer?

A

Muscle invasive

26
Q

What is acute renal failure associated with?

A
  • High K+
  • High creatinine
  • May be oliguria
  • Hypertension
  • (lipids in nephrotic syndrome)
27
Q

What is chronic renal failure associated with?

A
  • High K+
  • High creatinine
  • May be oliguria
  • Hypertension
  • Anaemia
  • Small kidneys
28
Q

WHat can the causes of obstructive uropathy be?

A 
Intrinsic and extrinsic 
Acute or chronic 
- Staghorn calculus 
- Ureteropelvic stricture 
- Transitional cell carcinoma of renal pelvis 
- Blood clot 
- Ureteral stone 
- Transitional cell carcinoma of ureter 
- Retroperitoneal fibrosis 
- Pregnancy (exrinsic)
- Carcinoma of cervix (exrinsic)
- Endometriosis (exrinsic)
- Urothelial carcinoma 
- Neurogenic bladder 
- Benign prostatic hyperplasia 
- Urethral stricture
29
Q

What is hydronephrosis?

A

Kidney swells due to urine failing to properly drain from the kidney to the bladder. Usually unilateral

30
Q

What is involved in renal replacement therapy?

A
  • Electrolyte balance
  • Fluid balance
  • Excretion
  • EPO
31
Q

How can dialysis be done at home?

A
  • Through ambulatory peritoneal dialysis (requires permenant catheter)
  • Peritoneal membrane acts as filter
32
Q

What are the problems associated with kidney transplantation?

A
  • Acute cellular rejection
  • Acute antibody mediated rejection
  • Acute vascular rejection
  • Chronic allograft nephropathy (chronic rejection)
  • BK virus infection
33
Q

What type of stone does proteus mirabilis produce?

A

Ammonium phosphate (can cause staghorn calculi)

MD3002 Pathology (19 decks)

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