Renal Pathology

Question 1

What is acute pyelonephritis?

Answer 1

• acute bacterial infection of the kidney

- most commonly affect bladder which travels up to infect kidney

Question 2

What is the common cause of pyelonephritis?

Answer 2

E.coli transferred during intercourse or wiping after urination (from back to front)

Question 3

What preventative measure can be taken to stop pyelonephritis?

Answer 3

• Drink lots of fluids
• Urinate as soon as you feel the need (don’t hold urine in)
• Urinate after intercourse

Question 4

What are the predisposing conditions for pyelonephritis?

Answer 4

• abnormality of valve at distal end of ureter which connects to the bladder so get reflux of bladder upward into ureter (will get recurrent episodes of pyelonephritis)
• Prostate disease
• Kidney stones causing obstruction

Question 5

What will pyelonephritis pathology be?

Answer 5

small abscesses filled with pus throughout the kidneys (not used for diagnosis)

Question 6

What will histology of pyelonephritis show?

Answer 6

• elevated neutrophils (inflammatory cell)

- in gram stain can also see E.coli

Question 7

What are glomerulopathies?

Answer 7

Group of conditions in which primary pathology is immunologically mediated injury to the glomeruli

Question 8

What are some examples of glomerulopathies?

Answer 8

• Fibronectin glomerulopathy

- IgA nephropathy

Question 9

What are the two main categories of glomerulopathies?

Answer 9

1) alteration of glomerular filtration barrier without inflammation causing primarily massive proteinuria (nephrotic syndrome)
2) Inflammation of the glomeruli which causes haematuria, proteinuria and hypertension (nephritic syndrome)

Some conditions are both

Question 10

What is a cyst?

Answer 10

Closed cavity or sac, normal or abnormal, lined by epithelium, and especially one that contains liquid or semi-solid material

Question 11

Which type of polycystic kidney disease is more serious?

Answer 11

Autosomal recessive (presents very early on) rather than dominant (which presents much later on, only half require treatment)

Question 12

What is the name of larger kidney stones?

Answer 12

staghorn calculae

Question 13

How should kidney stones be prevented?

Answer 13

• drink lots of fluid
• keep urine clear
• avoid certain foods

Question 14

What are the types of kidney stones?

Answer 14

• calcium oxalate (high serum calcium) can have hyperparathyroid cause or too much calcium in diet
• Struvite cause usually lots of infections
• Uric acid caused by gout
• Cystine caused by cystinuria

Question 15

What are the two common benign renal tumours?

Answer 15

• Angiomyolipoma

- Oncocytoma

Question 16

What are the two common malignant tumours?

Answer 16

• Renal cell carcinoma (clear cell type)
• Renal cell carcinoma (other types)
• transitional cell carcinoma (renal pelvis)

Question 17

What will the histology of a high grade tumour show?

Answer 17

• necrosis of tissue

Question 18

In which tumour would you get cells will keratin production

Answer 18

Squamous cell carcinoma

Question 19

In which tumour would you get signet ring cells with intracytoplasmic mucin?

Answer 19

adenocarcinomas

Question 20

In which tumour would you get cells arranged in glands with mucin production?

Answer 20

Adenocarcinomas

Question 21

In which tumour would you get cells with clear cytoplasm?

Answer 21

renal cell carcinomas

Question 22

In which tumour would you get hyper chromatic cells with scanty cytoplasms and numerous mitoses?

Answer 22

Small cell carcinomas