Pathology of UT

Question 1

what is renal cell carcinoma and what are the two most common types

Answer 1

renal tubular epithelium cancer
clear cell (75%)
papillary (10%)

Question 2

what is von hippel-lindau syndrome

Answer 2

most common cancer syndrome associated with renal cell carcinoma
VHL mutation
HIF-1 oncogene malfunction
cell growth and increased cell survival

Question 3

what is Wilms tumour

Answer 3

nephroblastoma - cancer from nephroblasts
in children under 5 associated with other genetic syndrome like Beckwith-wideman
mutation in WT1

Question 4

what is the clinical presentation of wilms tumour

Answer 4

abdominal distention, haematuria

rare distant metastasis

Question 5

what is urolithiasis

Answer 5

urinary tract calculi (stones)

Question 6

what are the types of urolithiasis

Answer 6

calcium stones (70%)
urate stones (5%) - can't see on XR
cysteine (1%)
struvite stones (15%) - magnesium ammonium phosphate

Question 7

what are the causes of the different types of urolithiasis

Answer 7

hypercalcaemia
gout (urate)
cystiene (congenital cysteniuria)
struvate - UTI

Question 8

how do a UTI cause kidney stones

Answer 8

UTI with urease - converts urea to ammonia - increased pH - precipitation of magnesium ammonium phosphate salts

Question 9

what are some complications of urolithiasis

Answer 9

obstruction - renal impairment
urinary stasis - infection
local trauma - SCC risk

Question 10

what is vesicourectral reflux,

who does it affect and what is the aetiology

Answer 10

urine flows backwards from the bladder to the ureter - mainly familial or those under 2yo

dysfunction of vesicourectric junction when ureter enters bladder at abnormal angle

Question 11

what are the clinal features of vesicourectral reflux

Answer 11

UTI and renal damage

asymptomatic or grow out of it

Question 12

what is a urothelial carcinoma

Answer 12

transitional cell carcinoma
caused by smoking and dyes/rubber which cause gene mutations
local primary tumour effects with distant metastases

Question 13

what is a neurogenic bladder and what are the two types

Answer 13

inability to properly empty the bladder due to neurological problem
spastic - damage to the brain or spinal cord (stroke, MS, injury)
flaccid - damage to peripheral nerves (pregnancy, diabetes, B12 deficiency)

Question 14

what is the aetiology and clinical features of neurogenic bladder

Answer 14

disruption of stretch receptors in the internal sphincter

urinary retention, urge, frequency
UTI, urinary stones, renal impairment and oedema

Question 15

what is benign prostatic hyperplasia (BPH), who is affected, causes and clinal features

Answer 15

increased number of both stroll and glandular cells in the prostate - enlarged
main
old men mainly, obese,

hormone mediated

compression of the urethra = obstruction of bladder
renal damage, infection, stones
symptoms of lower UTI

Question 16

what is prostatic adenocarcinoma, who is affected, causes

Answer 16

cancer of the glandular epithelium in the prostate
old men, black males, obese, family history of BRCA1/2
environmental factors casing mutations or genetic from BRCA1/2
good prognosis

Question 17

what is cryptochordisim

Answer 17

undefended testicles - tests not in scrotum

Question 18

what are the causes, pathogensis and features of cryptochrodism

Answer 18

premature babies and 3% in normal
failure of descent of tests into scrotum
no cause
may resolve but can cause infertility, hernias, cancer risk or testicular torsion

Question 19

what is seminoma

Answer 19

malignant neoplasm of the tests from the germ cells in the seminiferous tubules = testicular cancer

Question 20

give two testicular cancers with a good vs bad prognosis

Answer 20

good = sex cord stroll tumours

bad = non-seminomatous germ cell tumours

Question 21

where in the urogenital system can you get obstruction

Answer 21

kidney 
renal pelvis 
bladder 
ureter 
prostate 
penis 
urethra