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module 104 - theme 3 > pathology of urinary tract & kidney > Flashcards

pathology of urinary tract & kidney Flashcards

1
Q

what is renal function impairment?

A

decreased ability of the kidney to excrete nitrogenous waste and regulate of water and electrolytes

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2
Q

what 6 parameters need to be looked at to asses renal function?

A

1) urea
2) creatinine
3) Na+
4) K+
5) Cl-
6) estimated glomerular filtrate rate (eGFR)

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3
Q

what causes acute renal failure?

A
  • hypovolaemic shock
  • drugs
  • congestive cardiac failure
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4
Q

what causes chronic renal failure?

A
  • several types of glomerulonephritis
  • chronic use of some drugs such as aspirin
  • chronic pyelonephritis
  • hypertension
  • diabetes mellitus
  • autoimmune disease
  • obstruction of urinary tract
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5
Q

what causes urinary tract obstruction?

A

1) calculi or stones
2) stricture in the ureter
3) stricture in the urethra
4) bengin prostatic hyperplasia
5) cancer of the bladder or prostate

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6
Q

what do patients usually present with, with renal cell cancer?

A
  • haematuria

- loin discomfort

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7
Q

when is renal cell cancer more common?

A
  • 60-70 years

- males

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8
Q

what is the appearance of large renal cell cancer?

A

yellow and pale variegated

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9
Q

what is the histology of renal cell carcinoma?

A

the cells are not epithelial but not columnar or squamous

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10
Q

what does the urothelium line?

A
  • bladder
  • ureters
  • pelvi-calyceal system
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11
Q

what is the function of the urothelium?

A

acts as a barrier and prevent back diffusion of urine

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12
Q

what are the symptoms of cystitis?

A
  • pain, burning or stinging when urinating
  • needing to urinate more often and urgently than usual
  • feel like you need to urinate shortly after going to the toiet
  • urine that is dark, cloudy or strong smelling
  • pain low down in tummy
  • feeling generally unwell, achy, sick and tired
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13
Q

what investigations are done for bladder cancer?

A
  • ultrasound scan
  • cystoscopy and biopsy or resection cancer
  • MRI to assess local spread and lymph node status
  • CT scan: for staging to look for metastasis to other organs
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14
Q

what is the histology of bladder cancer?

A

transitional cell carcinoma/urothelial carcinoma

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15
Q

how or bladder cancers often removed?

A

Transurethral Resection of Bladder Tumour

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16
Q

what are the symptoms due to urtheral obstruction?

A
  • frequency in micturition
  • nocturia
  • poor stream
  • difficulty in starting and stopping stream (prostatism)
  • urinary tract infections
  • bladder outlet obstruction leads to hydronephrosis
17
Q

what is the most common cancer in men?

A

prostate cancer

18
Q

what is a key indication of prostate cancer?

A

raised prostatic specific antigen (PSA)

19
Q

what are the 3 cancers that are routinely screened for in the UK?

A
  • breast
  • cervical
  • bowel
20
Q

what are the 3 types of specimens from the prostate?

A

1) needle core biopsies for diagnosis of Ca prostate in patients with raised PSA; biopsies taken per rectum under ultrasound guidance
2) transurethral resection of prostate for treatment of benign prostatic hyperplasia or palliation in Ca prostate if patient presents with obstructive symptoms
3) radical prostatectomy for early prostatic cancer

21
Q

what is an MRI used for in prostatic cancer?

A

to identify the cancer and assess for local spread

22
Q

what is a CT used for in prostatic cancer?

A

to seek for distal metastasis

23
Q

why is a bone scan used in prostatic cancer?

A

prostate cancer spreads to the bones

24
Q

what cancers spread to the bones?

A
  • breast
  • kidney
  • lung
  • lymphomas
  • multiple myeloma
  • prostate
  • thyroid
25
Q

what is a needle core biopsy used for and how is it done?

A
  • used for prostate cancer

- done under guidance of trans-rectal ultrasound

26
Q

what are the complications of vertebral bone metastasis?

A
  • if it goes into spinal chord itself it can cause cord compression
  • weakness
  • paralysis in parts of body
  • unusual sensations
  • problems with urination or bowel function

module 104 - theme 3 (13 decks)

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