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MJ- Patho Exam 3 > Renal 4 > Flashcards

Renal 4 Flashcards

1
Q

Which cancer?

  • Papillary neoplasms of renal pelvis that resemble carcinomas of the urinary bladder
  • Classified as low to high grade lesions
  • Most tumors present w/ hematuria or urinary obstruction early in the course
A

Transitional Cell Carcinoma

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2
Q
  • Surgical removal of Transitional Cell Carcinoma yields good results for which grade?
  • What is the 5 year survival %?
  • Who does grading?
A
  • Grade 1 or 2
  • 70%
  • Pathologist

(grade 3 is less favorable)

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3
Q

Which cancer is more likely to metastasize?

(TCC or RCC)?

A

TCC (looks like meatball in pelvis)

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4
Q
  • The most common solid tumor in infants and children (1 out of 10,000)
  • Is present at birth and manifests clinically between 2nd and 4th yrs of life
  • Grows so big, it compresses abdominal contents to other side of abdomen
A

Wilms Tumor

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5
Q
  • Presents as solitary or multinodular abdominal mass that replaces the kidney and is usually palpable
  • Highly malignant tumors composed of blastic or immature cells
A

Wilms Tumor

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6
Q

What is the prognosis of Wilms Tumor?

A
  • Good w/ surgery and chemo.
  • 85% w/ complete cures

(they are usually taken out before they metastasize)

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7
Q
  • What is the MOST COMMON urinary tract neoplasm?
A

Cancer of Urinary Bladder

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8
Q

Who is bladder cancer most common in?

A

Men 60 -80

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9
Q

Which cancer is 2 times more common than RCC?

A
  • Urinary Bladder Cancer is 2 times more common with the same # of deaths (52,000 new cases/year)
  • RCC had 27,000 cases/ year with same # deaths = silent killer
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10
Q

Which cancer has unknown etiology, but the most imprortant risk factor is smoking and is proportionate to total # of cigarettes smoked?

A

Urinary Bladder Cancer

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11
Q

Azo dyes and chemicals used in rubber industry , and textile printing have been linked to which cancer?

A

Bladder cancer

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12
Q

In Egypt, infection w/ Schistosoma haematobium (a parasite) can lead to what cancer?

A

Urinary Bladder

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13
Q
  • 90% of bladder cancers are _____
  • 7% are ______
  • The other 2 types are what?
A
  • 90% Transitional Cell Carcinomas
  • 7% Squamous Cell Carcinoma
  • Adenocarcinoma and Sarcomas
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14
Q

On gross exam, what cancer tumor is either “papillary or flat” or “invasive or non-invasive” by histologic examination of tissue

A

Urinary Bladder Cancer

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15
Q

Progression of bladder cancer leads to extension of tumor into which 2 places?

A
  • Muscle layers of bladder (3)
  • Adjacent pelvic organs
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16
Q

Bladder Cancer usually metastasizes initially to where?

A

Pelvic lymph nodes

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17
Q
  • Pts with bladder cancer present w/ what 3 sxs?
  • How is dx made?
A
  • Hematuria
  • Dysuria
  • Lower abdominal pain

Dx made by:

  • Cystoscopy
  • Histologic biopsy
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18
Q

The treatment of bladder cancer is based on what 2 things?

A
  • Surgical resection
  • Chemotherapy
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19
Q

The prognosis of bladder cancer is based on what 3 things?

A
  • Histologic grade
  • Histologic type
  • Clinical staging (A-D)
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20
Q
  • 5 year survival rate of Stage A/Grade 1 bladder cancer?
  • Survival rate of Stage D tumors (distant metastasis)?
A
  • 98%
  • 15%
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21
Q
  • Classified on the basis of morphology, pathogenesis, or clinical presentation of disease
A

Glomerular Disease

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22
Q

On the basis of pathogenesis, glomerular diseases are classified into what 3 disorders?

A
  • Immunologic diseases
  • Metabolic Disorders
  • Circulatory Disorders
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23
Q

Mediated by antibodies and characterized by deposits of Ig’s in the glomeruli

If the deposition of Ig’s evokes an inflammatory reaction, the disease is classified as _____.

A

Immunologic disease classification of Glomerular Disease

Glomerulonephritis

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24
Q

What is the #1 cause of nephritic syndrome?

A

Strep throat or strep skin infection

(2 weeks after infection, kid urinates cola colored urine)

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25
Q

Glomerular Disease

  • What is the antigen?
  • What is the antibody?
A
  • Antigen: strep
  • Antibody: IgG

(these make up the immune complex and they stick together and get stuck at GFM)

26
Q

CL:

F:

BM:

D:

US:

A

CL: Capillary Loop

F: Fenestrations

BM: Basement Membrane (cream filling)

Podocytes (cookie)

D: Desmosomes (slit pores)

US: Uroniferous Side

27
Q

Occurs in the course of systemic disorders such as DM or Amyloidosis

A

Metabolic Disorder classification of Glomerular Disease

28
Q
  • Atherosclerosis of renal arteries is associated with hypoperfusion which leads to hyalinization of the glomeruli
  • The sudden onset of HTN may cause ___ _____ of the glomerular capillaries.
A

Circulatory Disorders classification of Glomerular Disease

Fibrinoid necrosis

29
Q
  • What are the 4 most common categories of Glomerular Disease?
  • How many are there total?
A
  • Acute Renal Failure
  • Nephrotic Syndrome
  • Nephritic Syndrome
  • Chronic Renal Failure
  • 17
30
Q

What is the #1 cause of Acute Renal Failure?

A

ATN (acute tubular necrosis)

31
Q

Acute Renal Failure

  • Is it reversible?
  • Sudden or gradual onset?
  • Results in what 2 things?
  • Is it pre-renal or post-renal?
A
  • Yes
  • Sudden
  • Oliguria or Anuria
  • Either
32
Q

Acute Renal Failure caused by shock or heart failure caused by an MI

A

Pre-renal

33
Q

Acute Renal Failure caused by sudden obstruction to urine outflow, or renal which is a consequence of glomerular destruction (glomerularnephritis)

A

Post-renal

34
Q

Characterized by:

  • heavy proteinuria
  • hypoalbuminemia
  • edema
  • hyperlipidemia
  • lipiduria
A

Nephrotic Syndrome

35
Q

What is the major pathogenetic abnormality of Nephrotic Syndrome?

A
  • A permeability defect in the glomerular capillaries that allows protein to be lost from plasma into the urine (proteinuria)
  • –> which results in a decreased amt of protein (Albumin) circulating in the blood (hypoproteinemia)
36
Q

Nephrotic Syndrome

  • Proteinuria and Hypoproteinemia causes a decrease in plasma oncotic pressure leading to what?
A
  • This decrease in pressure allows fluid to escape into the tissues causing edema
  • This also lowers plasma volume (kidneys sense this and activate RAS, which further contributes to edema)
37
Q

Which organ produces proteins (including Albumin), which were lost (Ig’s Complement, clotting factors) and also produces ___ which circulate in the blood and urine?

A

Liver

Lipoproteins

38
Q

Minimal Change Disease is also called?

A

Nils Disease

39
Q
  • What is the #1 reason/disease for Nephrotic Syndrome in kids? (70% children) (20% adults)
  • The GFM allows what to pass through?
  • How is this observed?
A
  • Minimal Change Disease (Nils Disease)
  • Large proteins
  • Electron microscopy (not visible on light microscopy)
40
Q

What is responsible for a “considerable portion” of cases of Nephrotic Syndrome in adults? (20-30%)

(this rarely ever causes NS in kids)

A

Systemic diseases that involve the kidney:

  • DM
  • Amyloidosis
  • SLE (Systemic lupus erythematosus)
41
Q

Besides systemic diseases and Nils Disease, what other 3 things are associated w/ Nephrotic Syndrome?

A
  • Malignancies
  • Infections
  • Drugs (Heroin)
42
Q

Characterized by 7 things:

  • hematuria
  • variable degrees of proteinuria
  • decreased GFR
  • elevated BUN & serum creatinine
  • Oliguria
  • Mild edema
  • HTN
A

Nephritic Syndrome

43
Q

Glomerular diseases that cause this syndrome, are characterized by inflammatory changes in the glomeruli, w/ _______ and ______.

A

Nephritic Syndrome

  • Leukocytosis
  • Necrosis
44
Q

Which syndrome?

  • Mild proteinuria
  • Mild hematuria

(Due to injury of glomerular capillaries)

A

Nephritic Syndrome

45
Q

Which syndrome?

  • Classic presentation involved in Acute Post-Streptococcal Glomerulonephritis
A

Nephritic Syndrome

46
Q

T/F

  • All glomerular diseases cause a mixed Nephrotic and Nephritic type pictures
A

False, all EXCEPT: Minimal Change disease

47
Q

What is the only means of DEFINITIVE dx for all glomerular diseases?

A

Renal Biopsy

48
Q

****What 3 things are needed for kidney biopsy to dx any glomerular nephritis?****

A
  • H & E stains
  • Immunofluorescence to light up antibodies which are affected membrane
  • Electron Microscopy
49
Q

An immune mediated inflammatory glomerulopathy that occur 1 to 2 weeks after a strep throat infection OR strep skin infection w/ GABHS (St. pyogenes)

A

Acute Post-Streptococcal GMN

(GMN = glomerulonephritis)

50
Q
  • Reflects the deposition of immune complexes in the glomerular basement membrane.
  • What 2 things make up the immune complex?
A
  • Acute Post-Streptococcal Glomerulonephritis
  • Antigen + Antibody
51
Q
  • Acute Post-Streptococcal Glomerulonephritis affects who mostly?
  • How is it treated?
A
  • Children 6-10 yrs (but can affect adults)
  • Kids do great w/ steroids
52
Q

T/F

  • Acute Post-Streptococcal GMN is common in the US
A

False, we have good abx. Still seen in underdeveloped areas though.

53
Q

The disease is caused by glomerular localization of immune complexes generated by an antibody response to circulating antigens. The antigen-antibody complexes are trapped in GBM where they activate ____ and _____ into the glomeruli.

A

Acute Post-Strep GMN

  • Complement
  • Inflammatory Cells
54
Q

Acute Post Strep GMN

  • The complement activation is so extensive, that over 90% of pts have ________ because of consumption within the glomeruli.
A

Hypo-complementemia

55
Q
  • Inflammatory mediators attract/activate ___ and ____.
  • Stimulate proliferation of _____ and ______

(all resulting in marked hypercellularity of glomerulus)

***Diffuse Process***

A
  • neutrophils & monocytes
  • mesangial & endothelial cells

(Acute Post Strep GMN)

56
Q

Acute Post-Strep GMN

  • What 2 things are seen on this slide?
A
  • Collapsed capillary loops
  • Segmented PMNs
57
Q

Acute Post Strep GMN

  • What does this slide depict?
A

Enlarged Hypercellular Glomeruli

58
Q

What is the #1 way to make dx of Acute Post Strep GMN?

A

Electron Microscopy

59
Q

Subepithelial dense deposits (on podocyte side), that are shaped like Humps on the epithelial side of basement membrane that are the deposits of immune complexes

A

Seen on electron microscopy when diagnosing Acute Post Strep GMN

60
Q

Granular deposits seen on both IgG and Complement C3 along the basement membrane

A

Seen on IF (immunofluorescence) microscopy to dx Acute Post Strep GMN

61
Q

What is uncommon, but a possible complication of Acute Post Strep GMN?

A

Crescent formation

MJ- Patho Exam 3 (15 decks)

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