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NYCC Visceral Pathology > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

High blood pressure is a common cause of kidney disease (TRUE/FALSE)?

A

t

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2
Q

What is the most important part of the TMN cancer system and the greatest indicator of long term cancer survivability? How is it graded?

A

M (Metastasis) M0 or M1

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3
Q

A cancer grade of T0 indicates what about the lesion?

A

Carcinoma in situ

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4
Q

What is the pathway of urine flow through the kidney?

A

Renal pyramid ——> Renal papilla ——> Minor calyx ——> Major calyx ——> Renal pelvis ——> Ureter

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5
Q

What is diuresis?

A

Increased urine production and flow rate

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6
Q

What is dysuria?

A

Difficulty or painful urination

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7
Q

What is pyuria?

A

Plus in the urine with white blood cells and purulent exudate

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8
Q

What is hematuria?

A

Blood in the urine (RBCs)

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9
Q

What is nocturia?

A

Excessive urination at night

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10
Q

What is oliguria?

A

Decreased urine output

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11
Q

What is proteinuria?

A

Protein in the urine

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12
Q

What is glycosuria?

A

Sugar in the urine

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13
Q

What is bilateral renal agenesis?

A

Complete failure of the development of both kidneys associated with pulmonary hypoplasia and is incompatible with life

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14
Q

What is the mechanism for how amniotic fluid changes can cause congenital anomalies such as renal agenesis and pulmonary hypoplasia?

A

A diminished kidney function will result in less urination into the amniotic sac leading to oligohydramnios (low amniotic fluid). Amniotic fluid pressure is required to make the kidneys and lungs expand and grow.

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15
Q

Unilateral agenesis of the kidneys is asymptomatic (TRUE/FALSE)?

A

t

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16
Q

What molecule markers in the blood and urine may indicate a renal pathology generally?

A

Decreased GFR
Increased BUN
Increased Creatinine

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17
Q

What is a horseshoe kidney?

A

Fusion of the kidneys at the lower poles with a single large midline organ that is normally ASYMPTOMATIC

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18
Q

What is the most common cause of renal ectopia?

A

Kidney transplant

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19
Q

Where does a renal ectopia most commonly occur?

A

Pelvis

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20
Q

What is exstrophy?

A

Urinary bladder everting through the abdominal wall

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21
Q

What is infantile polycystic kidney?

A

Autosomal recessive dysfunction in the polycystin gene in a newborn associated with pulmonary hypoplasia and dilated collecting ducts

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22
Q

What is adult polycystic kidney?

A

Autosomal dominant hereditary disorder characterized by multiple expanding cysts of both kidneys leading to renal failure

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23
Q

When does adult polycystic kidney disease appear in life?

A

4th decade

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24
Q

45 year old male patient presents to your office complaining of pain in his sides and abdomen on both sides. He has a feeling of heaviness in his loins and also complains of peeing blood. A urinalysis confirms this finding as well as the presence of albumin in the urine. The sides of the patient demonstrate tender palpable masses below the 12th rib. The patient has a blood pressure of 155/99. What is the likely diagnosis based on this information?

A

Adult polycystic kidney

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25
Q

What is acute pyelonephritis?

A

Acute suppurative inflammation of the kidney caused by bacterial and/or viral infection

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26
Q

What is the primary etiology of acute pyelonephritis?

A

Escheria coli

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27
Q

What is the hsitological finding present in acute pyelonephritis?

A

Leukocyte casts

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28
Q

34 year old male patients presents to your office with sudden onset of pain below his ribs and fatigue. The patient is febrile at 101.2. The patient also reports painful and frequent urination. A urinalysis shows high amounts of neutrophils. A culture of the urine shows leukocytic casts filled with neutrophils. What is the likely diagnosis?

A

Acute pyelonephritis

29
Q

What is Murphys punch test and what does it help diagnose?

A

Punch at the 12th intercostal margin indicating a renal pathology

30
Q

What is Murphy’s point and what does it help diagnose?

A

Right upper quadrant point indicating a gall bladder pathology

31
Q

What is McBurney’s point and what does it help diagnose?

A

Right lower quadrant point indicating appendicitis

32
Q

What is chronic pyelonephritis?

A

Chronic tubulointerstitial renal disorder in which chronic tubulointerstitial inflammation and renal scarring are associated with pathological involvement of the calyces and pelvis

33
Q

What is the histological finding that is pathognomonic for chronic pyelonephritis?

A

Thyroidization of tubules

34
Q

45 year old male patient presents to your office complaining of painful urination that has come and gone for years with frequent loin pain. The patient is hypertensive at 145/90. Notable in his history is diabetes mellitus type II and a history of UTIs. In the past he notes complaining of frequent urination especially at night that is burning. The patient has a purulent exudate upon urinalysis of his urine. A biopsy of the kidney tissue shows thyroidization of the cortex of the kidneys. What is the likely diagnosis?

A

Chronic pyelonephritis

35
Q

Atrophy and thinning of the cortices of the kidney is seen in what pathology?

A

Chronic pyelonephritis

36
Q

What is analgesic nephritis?

A

Injury to the medulla of the kidney with papillary necrosis caused by aspirin or acetaminophen

37
Q

Analgesic nephritis is clinically distinct from acute kidney injury secondary (TRUE/FALSE)?

A

t

38
Q

37 year old male patient presents to your office complaining of urinating blood and fatigue. Notable in the patients history is multiple muscle tears and ligamentous injuries. The patient reports taking “4 or 5” aspirin daily for the pain. The patient has a positive Murphy’s punch test. What is at the top of your diagnosis list based on this persons history?

A

Analgesic nephritis

39
Q

What is cystitis?

A

Inflammation of the bladder

40
Q

Mercury, lead, and arsenic poisoning can lead to _______________________ necrosis of renal tubules?

A

Coagulative

41
Q

35 year old male patient presents to your office with abrupt onset of pelvic pain just behind his pubic symphysis. He also reports frequently getting up to pee throughout the day for the last few days. The patients urine culture shows the presence of Escheria coli. What is the likely diagnosis?

A

Acute cystitis

42
Q

44 year old female patient presents to your office complaining of frequent urination and painful urination. She also has pain behind her pubic symphysis. The patient has a urine culture that shows no evidence of bacterial infection but high levels of lymphocytes and plasma cells. The patient reports that this has been a problem for years. What is the likely diagnosis?

A

Interstitial cystitis or painful bladder syndrome

43
Q

What is a urolithiasis or nephrolithiasis?

A

Kidney stone

44
Q

What is the most common type of kidney stone?

A

Calcium

45
Q

What kidney stone often presents grossly as a staghorn calculi?

A

Struvite/triple stones

46
Q

Uric acid stones in the kidney are seen with what pathology?

A

Gout

47
Q

Analgesic nephritis affects what part of the kidney?

A

Medulla

48
Q

Metal toxicity affects what part of the kidney?

A

Cortex

49
Q

Papillary necrosis is a finding in what renal pathology?

A

Analgesic nephritis

50
Q

Kidney stones made of cystine are due to what?

A

Error in amino acid metabolism

51
Q

34 year old male patient presents to your office limping due to great toe pain that began this morning. He cannot even put on his shoe. Furthermore the patient is complaining of pain in his right flank. Blood tests show increased levels of ESR and uric acid. X-Ray shows a gray deposition in the patients right kidney. You have counseled the patient in the past on limiting his red meat intake and alcohol consumption. Based on this presentation alone what is at the top of your differential list?

A

Gout resulting in uric acid crystals in the right kidney

52
Q

Tophi are pathognomonic for what pathology?

A

Gout

53
Q

75 year old male patient presents to your office complaining of hip pain that he said began after he fell out of his tractor the other day. The patient has been a farmer for 30 years and has never felt this pain before. X-ray shows a hip fracture with the presence of small punched out lesions in the hip, spine, and skull. Blood test reveals the presence of Bence-Jones proteins and an IgG spike. Furthermore, the patient mentions that he has been urinating blood and has pain in his flanks as well. What is the likely diagnosis and why does the patient have flank pain?

A

Multiple Myeloma with flank pain caused by the kidneys attempting to filter the IgG light chain and Bence-Jones proteins

54
Q

What is hydronephrosis?

A

Dilation of the renal pelvis due to urinary obstruction

55
Q

What is the most common cause of hydronephrosis in males?

A

BPH

56
Q

What are causes of unilateral hydronephrosis?

A

Kidney stones, tumor, Mets, or stricture

57
Q

What are causes of bilateral hydronephrosis?

A

BPH or bladder carcinoma

58
Q

What is a Wilm’s tumor?

A

Pediatric kidney cancer or nephroblastoma involving a mutation in the WTx gene

59
Q

Infant presents to the ER with abdominal pain, high blood pressure, and hematuria. What is at the top of the differentia list?

A

Wilm’s tumor

60
Q

What is the most common primary cancer of the kidney?

A

Renal cell carcinoma

61
Q

Wilm’s tumor often occurs (Unilaterally/Bilaterally)?

A

Bilaterally

62
Q

Renal cell carcinoma often occurs (Unilaterally/Bilaterally)?

A

Unilaterally

63
Q

64 year old male patient presents to your office complaining of pain in his right side and peeing blood. The patient has palpable tender mass under the 12th rib on the right side. The pain started in the last few weeks and has rapidly progressed. Biopsy of the right kidney shows poorly differentiated cells. What is the likely diagnosis?

A

Renal cell carcinoma

64
Q

In what kidney tumor is there a capsule around the neoplasia?

A

Wilm’s tumor

65
Q

Urinary bladder carcinoma is most commonly a ______________________ cell carcinoma?

A

Transitional

66
Q

56 year old male patient presents to your office complaining of peeing blood and painful urination that began suddenly the other day. The patient is an industrial worker with a long history of smoking. A cystoscopy of the area reveals a mass present on the bladder that when biopsied shows cells that are poorly differentiated resembling transitional epithelium. What is the likely diagnosis?

A

Urinary bladder carcinoma

67
Q

19 year old male patient presents to your office complaining of painful urination. The patient claims that the pain began a few days ago. The patient reports a history of unprotected sex. Urine culture shows the presence of E.Coli in the urine. Based on this information alone what is the likely diagnosis?

A

Acute urethritis

68
Q

Most cases of hypercalcemia are due to what?

A

Hyperparathyroidism

NYCC Visceral Pathology (36 decks)

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