Renal Flashcards
Likelihood of being a carrier of adult polycystic kidney disease if one parent has disease?
Adult polycystic kidney disease is an autosomal dominant disorder, so if you inherit one diseased allele you have the disease so there is no carrier status.
What has happened to the normal renal parenchyma in response to the formation and growth of the
cysts?
As the cysts form and expand they cause tissue atrophy, the parenchymal cells of the kidney die by
apoptosis leaving just the cysts.
What does the term ‘blast’ denote?
Blast denotes that the cancer started in a cell that was never a normal cell. We don’t know the cell of origin but we know that it was developing into a renal cell hence the prefix nephro- but it sustained
mutations during embryogenesis thus it never became a mature renal epithelial cell.
cancers papillary carcinoma of ureter with (kidney showing hydronephrosis and cysts) and papillary bladder carcinoma are named papillary as they are growing in papillary structure. what would be the appropriate name based on cell of origin?
transitional cell carcinoma/urothelial carcinomas.
why are the names of nephroblastoma (Wilm’s tumour), primary renal cell carcinoma and papillary carcinoma of ureter not the same?
differing cell of origin. in case of nephroblastomas, original cell is unknown but suspected to be a foetal cell from metanephric blastoma that undergoes mutation and gives rise to this tumour of childhood. cancer derived from cells lining renal pelvis, ureter, bladder are transitional cell carcinomas and those of kidney are renal cell carcinomas.
Why are cancers of the kidney, ureter and bladder generally diagnosed late, what signs and symptoms
do patients present with?
Patients with urinary cancers often present with blood in the urine, mild flank pain, an abdominal mass or
obstruction late in the progression of the disease, the early stages are asymptomatic.
Extra information for interest only: Paraneoplastic syndromes may be observed in some individuals who
may display hypertension, hypercalcaemia and polycythemia, related to increased secretion of renin,
parathyroid-related peptide and erythropoietin respectively.
Cancers are usually very large upon diagnosis with many growing along the renal vein into the vena cava
and penetrating the renal capsule and seeding into the peritoneum. At the time of diagnosis, up to one in
five patients have haematogenous metastases most commonly affecting the lungs, bones and brain
Routes of entry for microbes infecting the kidney include haematogenous (descending) and urinary (ascending) spread, what are the most significant differences between these?
Descending infections are likely to affect both kidneys diffusely and so lead to renal failure. Ascending
infections are more likely to affect 1 kidney and usually only a segment of that kidney.
Is pyelonephritis more common in females or males? define pyelonephritis.
bacterial infection of pelvis, tubules, interstitium (medulla) of the kidney. infection reaches kidney by blood or spreading to kidney from lower urinary tract, the latter is an ascending infection and more common in females than males (8:1) aged between 15 to 40 years.
why is pyelonephritis more common in females?
shorter urethra compared to male,
urethral opening close to anus,
absence of antibacterial properties found in prostatic fluid,
hormonal changes affecting adherence of bacterial to mucosa, which assists spread of bacterial along urinary tract epithelial linings, up to kidney pelvis which is continuous with ureter.
urethral trauma during sexual intercourse - accounts for ‘honeymoon cystits’.
