Pathology: Renal and Urology 2 Flashcards
What is the term given to congenital absence of the kidneys?
Renal agenesis
Which condition can occur in utero to a foetus if they have agenesis of both kidneys?
Oligohydramnios
Lack of foetal kidneys and urine production so less amniotic fluid is present
Simple cysts within the kidneys are ________ in the population
Simple cysts within the kidneys are common in the population
How are the kidneys affected in ARPKD?
Bilateral renal enlargent
Enlogated cysts in medullary collecting ducts
Which condition is ARPKD associated with?
Congenital hepatic fibrosis
What is the most common cause of congenital cystic disease of the kidneys?
ADPKD
Where is the genetic abnormality found in ADPKD?
90% chromosome 16 (PKD1 mutation)
10% chromosome 4 (PKD2 mutation)
How do patients with ADPKD present?
Age > 40
Abdominal mass
Haematuria
Hypertension
Chronic renal failure
How are the kidneys affected in ADPKD?
Massive bilateral renal enlargement >1kg
Glomerular, tubular and medullary cysts
Distorted renal shape
Where else may cysts be found besides the kidney in ADPKD?
Liver
Pancreas
Lung
Patients with ADPKD have a high risk of which cerebrovascular condition?
Berry aneurysms (in the circle of Willis)
What is the main risk of a Berry aneurysm?
Subarachnoid haemorrhage
What is the most common benign tumour in the kidneys?
Fibromas
Where are fibromas found in the kidney?
Medullary in origin
Where are adenomas found in the kidneys?
Cortex
What are angiomyolipomas?
Mixture of fat, muscle and blood vessels
(can be uniateral or bilateral)
Angiomyolipomas in the kidney are associated with which condition?
Tuberous sclerosis
What can a Juvenile granulosa cell tumour of the kindeys lead to?
Secondary hypertension
(due to production of renin)
What is the most common intra-abdominal malignant tumour in children?
Nephroblastoma (Wilm’s tumour)
Where do urothelial carcinomas present?
Renal pelvis and calyces
Renal cell carcinomas present from whcih tissue?
Renal tubular epithelium
What is the most common malignant renal tumour in adults?
Renal cell carcinoma
What age range is usually affected by renal cell carcinoma?
Males 55-60
How does a renal cellc carcinoma present?
Abdominal mass,
Haematuria
Flank pain
General features of malignant disease
Renal cell cacinoma has which paraneoplastic manifestations?
Polycythaemia
Hypercalcaemia
How does a renal cell carcinoma appear?
Large apparently well circumscribed mass on cortex
Extentension into which structure is common withe renal cell carcinomas?
Renal vein extension
It is possible for renal cell carcinomas to extend where?
Renal vein
Vena cava
Right atrium (very severe cases)
How can renal cell carcinoma spread?
Haematogenous first
Lymphatic later
Renal cell carcinoma is associated most commonly with which cell type?
Clear cell type
(rich in glycogen and lipid)
Where does renal cell carcinoma most commonly metastasize?
Lung
Bone
Where does the transitonal epithelium extend from?
Pelvicalyceal system to urethra
Bladder tumours are most commonly due to which tumour type?
Transitional cell carcinoma (90%) - Western countries
What are the main risk factors for transition cell carcinoma?
- Aniline dyes (B-naphthylamine)
- Rubber industry
- Benzidine
- Cyclophosphamide
- Analgesics (renal pelvis)
- Smoking
Having problems with your Pee SAC? (P - Phenacetin S - Smoking A - Aniline dyes C - Cyclophosphamide)
What is the most common symptom of transitional cell carcinoma?
Haematuria
Where do the majority of transitional cell carcinomas present?
Trigone
What are the two main variants of transitional cell carcinoma?
Papillary
Solid
Wher can transitional cell carcinomas spread?
Lymph nodes (local)
Lung
Liver
Squamous cell carcinoma can be associated with which two main things?
Calculi
Schistosomiasis
What is the most common urinary tract malignancy in children?
Embryonal Rhabdomyosarcoma (affects bladder)
Longstanding cystitis cystica predisposes to which type of urinary tract tumour?
Adenocarcinoma
Why does extroversion occur with adenocarcinoma?
Glandular metaplasia
