pathology of the urinary tract Flashcards
normal microscopy of the kidney
glomerulus
capillary
distal and proximal tubule
bowmans capsule
renal function impairment/failure
decreased ability of the kidney to excrete nitrogenous waste and regulate water and electrolytes
actue renal function impairment
chronic kidney disease (CKD) - stages 1-4 based on GFR
Parameters to assess renal function (Us and Es)
urea
creatinine
Na, K, Cl
eGFR
which excretory compounds are raised in renal failure
urea and creatinine
what test will be abnormal when assessing full blood count in chronic renal failure
GFR and ACR (albumin to creatinine ratio)
causes of acute renal failure
hypovolaemic shock due to bleeding (haemorrhage, pregnancy, burns, vomiting/diarrhoea)
drugs eg gentamicin
congestive cardiac failure
causes of chronic renal failure
glomerulonephritis chromic use of drugs eg aspirin chronic pyelonephritis hypertension DM AI disease eg systemic lupus erythematosus obstruction of urinary tract
what is glomerulosclerosis
glomeruli scarred, can cause renal failure (ass chronic inflammation)
causes of urinary tract obstruction
calculi or stones stricture of ureter stricture of urethra benign prostatic hyperplasia cancer of bladder or prostate
how does renal cell cancer present
haematuria
loin discomfort
60-70
M>F
what does renal cell cancer look like
yellow and pale variegated appearance
epithelial cells, not columnar or squamous
what is the urothelium/transitional cell epithelium
lines bladder, ureters, pelvis-calyceal system
consists of 4 cells or more
acts as a barrier and prevents back diffusion of urine
different from squamous as more cuboidal than flat
symptoms of cystitis
pain when peeing peeing more often constant urge dark, cloudy, smelly pee pain in lower abdomen generally unwell
signs of bladder cancer
present with frank haematuria or microscopic haematuria ( urine dipstick)
investigations for bladder cancer
U/S
Cystoscopy and biopsy or resection cancer
MRI to assess local spread and lymph node status
CT Scan – staging to look for metastasis in other organs
Histology: Transitional cell carcinoma/urothelial carcinoma