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Z MD1 Practical > renal and cancer peer tute > Flashcards

renal and cancer peer tute Flashcards

1
Q

what is the difference between PCT and DCT when identifying them on histology slid

A

PCT: simple cuboidal, brush border (looks hazy), more densely stained (more organelles - look more pink) DCT: smaller cells, no brush border, paler cytoplasm, larger lumen

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2
Q

causes of pre renal failure

A

shock (septic, cardiogenic, hypovolaemic, haemorrhagic)

dehydration

haemorrhage

renal artery stenosis

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3
Q

causes of post renal failure

A

obstruction!

  • renal calculi
  • prostate englargement
  • tumour
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4
Q

causes of intra renal faiulre

A
  • acute on chronic kidney failure
  • acute renal disease
  • acute tubular necrosis
  • tubulointerstitial disease
  • vascular disease
  • myeloma
  • acute pyelonephritis
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5
Q

what is glomerulonephritis

A

inflammatory injury (mostly immune mediated) to the renal glomeruli

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6
Q

consequences of glomerulonephritis

A

nephrotic syndrome

haematuria

renal impairment

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7
Q

what is nephrotic syndrome

A

leakage of protein –> proteinuria, hypoalbuminaemia and generalised oedema

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8
Q

4 important types of glomerulonephritis

A

IgA nephropathy

post-strep glomerulonephritis

membranous nephropathy

minimal change disease

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9
Q

which types of glomerulonephritis present with nephrotic syndrome and which present with nephritic syndrome

A

nephrotic = membranous nephropathy and minimal change disease

nephritic = IgA nephropathy and post-strep glomerulonephritis

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10
Q

classic presentation of someone with IgA nephropathy

A
  • haematuria
  • renal impairment
  • few days after URTI
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11
Q

what do you see histologically by a light microscope in IgA nephropathy

A

mesangial hypercellularity and increased mesangial matrix formation

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12
Q

what do you see on an electron microscope in someone with IgA nephropathy

A

electron dense IgA deposits in the mesangium

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13
Q

classic presentation of someone with post-strep glomerulonephritis

A
  • haematuria
  • renal impairment
  • 1-4 weeks after Strep pyogenes pharyngitis or impetigo
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14
Q

what mediates post-strep glomerulonephritis

A

IgG and C3 complement

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15
Q

classic presentation of membranous nephropathy

A

proteinuria and nephrotic syndrome

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16
Q

what causes membranous nephropathy

A

deposition of immune complexes on the epithelial side of the BM –> the complexes activate C’ and formation of MAC damages BM and allows protein leakage

17
Q

what do you see histologically via light microscope in someone with membranous nephropathy

A

diffuse thickening of the capillary walls without increased cellularity

18
Q

what do you see in an electron microscope in someone with membranous nephropathy

A
  • thickened glomerular BM
  • electron dense immune complex deposits
19
Q

classic presentation of minimal change disease

A

proteinuria and nephrotic syndrome mostly in children

20
Q

what can you see on light and electron microscopy in someone with minimal change disease

A

light = nothing

electron = fusion and effacement of podocyte foot processes

21
Q

what is the most common cause of interstitial nephritis

A

adverse reaction to drugs

22
Q

what is the classic presentation of interstitial nephritis

A

acute renal failure - sudden drop in urine output over 48 hours

23
Q

what cell infiltrates in interstitial nephritis are indicative of drug allergy or infection

A

drug allergy = eosinophils

infection = lymphocytes

24
Q

3 most common causes of chronic renal failure

A

diabetes

glomerulonephritis

hypertension

25
Q

3 key histological features of diabetic renal failure

A
  • thickened gomerular BM
  • glomerulosclerosis
  • mesangial expansion
26
Q

signs of glomerulosclerosis

A

Kimmelstiel Wilson nodules

diffuse mesangial sclerosis

27
Q

what are the components of the glomerular filtration barrier

A
  • capillary endothelium
  • combined endothelial and epithelial BM
  • podocyte foot processes
28
Q

pathogenesis of hyaline arteriolosclerosis

A

haemodynamic stress over time leads to increased endothelial permeability with deposition of plasma proteins in the wall, increased ECM production and SM atrophy. This causes the arteriole wall to become thickened and the lumen narrowed.

29
Q

what are 4 things that can help you determine an invasive cancer from desmoplasia

A

breach of BM or muscularis mucosae

desmoplastic stroma

necrosis

Lymph node involvement or distant mets

30
Q

signs of squamous cell carcinoma vs adenocarcinoma

A

ssc - keratin pearls, IC bridges

adeno - glandular formation

31
Q

cytological grading = what determines LSIL

A
  • increased N:C ratio
  • hyperchromasia
  • koliocytes!
32
Q

cytological grading = what determines HSIL

A
  • increased N:C ratio
  • prominent hyperchromasia
  • hypersegmentation of the nucleus

Z MD1 Practical (6 decks)

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