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Renal > Pathology of urethral tract > Flashcards

Pathology of urethral tract Flashcards

1
Q

What epithelium lines the bladder?

A

Transitional epithelium

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2
Q

What can cause cystitis?

A

Infection
Parasites
Aseptic
Reactive to catheters

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3
Q

How does schistosomiasis infection lead to cancer?

A

Persistent inflammation
Results in keratinizing squamous metaplasia
Eventual squamous cell carcinoma

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4
Q

What can cause persistent inflammation in the bladder?

A

Schistosomiasis

In-dwelling catheters

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5
Q

What is aseptic cystitis?

A

Persistent symptoms of dysuria
Persistently negative cultures and urinalysis
Caused by a hypersensitivity reaction

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6
Q

What is cystitis cystica?

A

Descriptive term of long term inflammation
Infolding of bladder mucosa into cysts
Reactive phenomenon

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7
Q

What can can result for diverticula in the bladder?

A

Stagnant urine
Infection
Stones
Cancer

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8
Q

What will result from bladder obstruction outflow?

A

Prostatism
Bladder muscle works hard and becomes trabeculated
Eventual persistent back pressure
Can undergo hypertrophy or hyperplasia

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9
Q

What is the end point of urinary tract obstruction?

A

Hydronephrosis - dilation of collecting ducts and atrophic parenchyma

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10
Q

What are risk factors for transitional cell carcinoma of the bladder?

A

Smoking ++++

Beta naphthylamine in the dye industry

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11
Q

What does a transitional cell carcinoma look like?

A

Papillary with finger like projections

Carcinoma in situ is flat

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12
Q

What will allow adenocarcinoma of the bladder to occur?

A

Background of metaplasia

Difficult to distinguish from a colon cancer that has invaded through

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13
Q

What does urachal adenocarcinoma result from?

A

Remnant of the allantois

Forms dome of bladder to the umbilicus which usually involutes

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14
Q

What is the function of the prostate gland?

A

Secretes prostatic fluid and fluid from seminal vesicles

Contractile function during ejaculatioin

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15
Q

What part of the prostate gland does the seminal vesicle pass through?

A

Central zone

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16
Q

What part of the prostate does the urethra pass through?

A

Transitional zone (area for PBH)

17
Q

What part of the prostate is prostate cancer most commonly found in?

A

Peripheral zone

18
Q

How can BPH be treated?

A

Transurethral resection of prostate

Alpha blockers

19
Q

How is prostate cancer diagnosed?

A

Transrectal biopsy

PSA

20
Q

What grading system is used for prostate cancer?

A

Gleason grading system - lowest grade is 6, highest is 10

21
Q

What can cause a high PSA?

A 
Big prostate (BPH)
Prostatitis
PR exa
Spironolactone
Vigorous exercise
Ejaculation
22
Q

What is the clinical presentation of prostate cancer?

A 
Lower urinary tract symptoms
Haematuria/ hematospermia
Bone pain
Anorexia
Wt loss
23
Q

What will prostate cancer feel like upon PR exam?

A

Asymmetrical
Nodular
Fixed and craggy

24
Q

What is PSA?

A

Glycoprotein enzyme produced by the secretory epithelial cells of the prostate gland
Involved in liquefaction of semen

25
Q

What type of cancer affects the prostate?

A

Adenocarcinoma

26
Q

Where does prostate cancer commonly spread to?

A

Pelvic lymph nodes

Skeleton - sclerotic lesions

27
Q

What are the broad classifications of prostate cancer?

A

T1-2 N0 M0 = organ confined disease
T3-4 N0 M0 = locally advanced disease
N+ M+ = metastatic disease

28
Q

What is the management for organ-confined disease?

A

Watchful waiting
Active surveillance
Radical surgery
Radical radiotheapy

29
Q

What are complications of radical prostatectomy?

A

ED
Incontinence
Bladder neck stenosis

30
Q

What is the treatment for locally advanced disease?

A

Radiotherapy with neoadjuvant hormonal therapy

31
Q

What hormonal therapy is used in metastatic disease?

A

LHRH analogues

Anti-androgens

32
Q

What is the growth of prostate cancer cells under the influence of?

A

Testosterone and dihydrotestosterone

33
Q

What should you do if someone over 40 present with frank haematuria?

A

Flexible cystoscopy and CT urogram

34
Q

Where will lymph from the ureter drain?

A

Lumbar and iliac nodes

35
Q

Where will lymph from the testes drain?

A

Lumbar nodes

36
Q

Where will lymph from the superior bladder drain to?

A

Lumbar nodes

37
Q

Where will lymph from the kidneys drain to?

A

Para-aortic

Pre-aortic nodes

Renal (22 decks)

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