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Renal Pathology Flashcards

1
Q

What is renal hypoplasia?

A

Small kidneys but normal development

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2
Q

What is “Horseshoe” kidney?

A

Fusion at either pole, usually lower

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3
Q

What condition does duplex systems make you more prone to?

A

Infection

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4
Q

Why do babies born with no foetal urine have a squashed facial appearance?

A

Amniotic fluid made mainly of foetal urine

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5
Q

Is infantile polycystic disease common?

A

No its rare

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6
Q

How is infantile polycystic disease passed on?

A

Autosomal Recessive (ARPKD)

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7
Q

Appearance of kidneys in infantile polycystic kidney disease?

A

Uniform bilateral enlargement

Elongated cysts = dilation of medullary collecting ducts

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8
Q

What other condition is infantile polycystic disease associated with?

A

Congenital Hepatic Fibrosis

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9
Q

How is adult polycystic disease passed on?

A

Autosomal dominant (ADPKD 1 or 2)

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10
Q

Presentation of adult polycystic kidney disease?

A 
Usually middle aged 
Abdominal mass 
Haematuria 
Hypertension 
CRF
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11
Q

Examples of benign renal tumours

A

Fibroma
Adenoma
Angiomyolipoma
JGCT

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12
Q

Appearance of renal fibtoma

A

Medullary origin

White nodular

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13
Q

Appearance of renal adenoma

A

Cortical origin

Yellowish nodules

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14
Q

What is renal angiomyolipoma associated with?

A

Tuberous sclerosis

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15
Q

What condition can a benign JGCT lead to?

A

Secondary hypertension (production of renin)

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16
Q

What os the most common intraabdominal tumour in children?

A

Nephroblastoma (Wilm’s tumour)

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17
Q

Where do urothelial carcinomas arise?

A

Renal pelvis and calyces

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18
Q

Types of renal cell carcinoma

A

Clear cell Ca
Hypernephroma
Grawitz tumour

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19
Q

Group most likely to present with renal cell carcinoma

A

Males (2:1)

55-60 y/o

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20
Q

Presentation of renal cell carcinoma

A

Abdominal mass
Haematuria
Flank pain
General features of malignant disease

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21
Q

What are the paraneoplastic manifestations of renal cell carcinoma?

A

Polycythaemia

Hypercalcemia

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22
Q

Method of spread of renal cell carcinoma

A

Blood-borne spread to lung, bone

Lymphatic soread later

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23
Q

Commonest type of renal cell carcinoma?

A

Clear cell ca

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24
Q

Staging system used in renal cell carcinoma

A

Furman

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25
What is renal agenesis?
Absence of one or both kidneys
26
Where is the renal system is transitional epithelium present?
From the pelvicalyceal system to urethra
27
What percentage of bladder tumours are transitional cell carcinomas?
90%
28
What are the risk factors for transitional cell carcinoma?
``` Aniline dyes Rubber industry Benzidine Cyclophosphamide Analgesics (renal pelvis) Schistosomiasis Smoking ```
29
What is the commonest symtpoms in transitional cell carcinoma?
Haematuria
30
Where doe stransitional cell carcinoma spread first?
Local lymph nodes (obturator)
31
Is recurrence of transitional cell carcinomas frequent?
Yes
32
What is the commonest malignant bladder tumour in children?
Embryonal rhabdomyosarcoma
33
Which type of blader cancer can longstanding cystitis cystica predispose to?
Adenocarcinoma
34
What would a raised red velvety area on the glans penis indicate?
Erthyrpoplasia of Queyrat
35
What would a dry crusy appearance of squaous cell carcinoma on the penis indicate?
Bowen's disease
36
Do squamous carcinoma in situ occur almost exclusively in circumisised or uncircumsised men?
Uncircumsised
37
What occupation can predispose to SCC of the scrotum?
Chimeny sweeps
38
What is benign nodular porstate hyperplasia (BNPH)?
Irregular proliferation of both glandular and stromal prostatic tissue
39
Clinical presentation of prostatism
Difficulty starting Poor stream Overflow incontinence
40
Complications of urinary retention
``` Bladder hypertrophy Divericulum fornation Hydroureter Hydronephrosis Infection ```
41
Managemt of BNPH?
Alpha blockers 5 alpha reductase inhibitors Surgery
42
Is BNPH premalignant?
NO
43
Where in the prostate does carcinoma tend to arise?
Peripheral ducts and glands (particularly posterior lobe)
44
Where can carcinoma of the prostate spread locally?
``` Urethral obstruction Capsular penetration Seminal vesicles Bladder Rectum ```
45
Which lymph nodes does carcinoma fo the prostate spread to?
Sacral Iliac Para-aortic nodes
46
Findings of prostate carcinoma on PR exam?
Craggy
47
First line imaging for prostate pathology?
USS
48
What blood test may indicate prostate carcinoma?
PSA
49
Management of prostate carcinoma
Anti-androgen treatemnt radio therapy for bone mets Radical prostatectomy
50
Main risk factor for testicular tumours?
Tsticular maldescent
51
Presentation of testicular tumours
Painless tesicular enlargemnt Can be associated with hydrocele ynaecomastia General effects of malignant disease
52
Which cell do most testicular tumours arise from?
Germ cell
53
What is the most common testicular germ cell tumour?
Seminoma
54
Peak incidence of seminoma?
30-50 years
55
Appearance of seminoma?
'Potato tumour' | Large cell tumour cells with variable stromal lymphocytic infiltrate
56
Treatment of seminoma
Marked radio-sensitivity (95% cure)
57
Where do teratomas arise from?
S cell lines (ectoderm, mesoderm, endoderm)
58
What are the classifications of teratome
Differential teratome (TD) Malignant teratome Intermediate (MTI) Malignant Teratome Undifferentiated (MTU) Malignant Teratome Trophoblasmic (MTT)
59
Which tumour marker is used to monitor seminoma?
PLAP
60
Which tumour monitors yolk sac components of testicular tumours?
AFP
61
Which marker monitors trophoblastic components of testicular tumours?
bHCG
62
Is glomerulonephritis usually diffuse or focal?
Diffuse
63
What is pyelonephritis?
Bacterial infection of renal pelvis, calyces, tubules and interstitium
64
What is the commonest causative orgaism of pyelonephritis?
E. coli
65
Other than E. coli what other organism can cause pyelopnephritis?
Pseudomonas | Strep. faeccalis
66
Pathogenesis of pyelonephritis
Ascending infection | Blood-borne
67
Risk factors for pyelonephritis
``` Age & sex Pregnancy Instrumentalisation Urinary tract obstruction Vesico-ureteric reflux Diabetes ```
68
Why is pregnancy a risk factor for pyelonephritis?
Ureteric diltation - stasis ofyrine due to hormonal & anatomical effects
69
Presentation of chronic pyelonephritis
Often no previous history of UTI Symptoms often vague Hypertension and/or uraemia Large volume of urine
70
What would be seen on imaging in chronic pyelonephritis?
Coarse cortical scarring | Distortion of calcyces
71
Pathogenesis of tuberculous pyelonephritis
Haematogenous spread - usually from lung
72
Symptoms of tuberculous pyelonephritis
``` Weight loss Fever Night sweats Loin pain Dysuria ```
73
Laboratory findings of tuberculosis pyelonephritis
Caseous foci Granulomatous inflammation ZN stain for acid fast bacilli
74
Which organisms cause cystitis
E. coli Klebsiella Proteus Pseudomonas
75
When would acute cystitis lead to necrosis?
When associated with outlet obstruction
76
What is cystitis cystica?
Multipl small fluid filled cysts projecting into lumen of bladder - can resemble tumours
77
Causes of urethral obstruction in males
Stricture Posterior urethral valves Prostatic disease
78
What can reult from prolonged bladder outlet obstruction?
Hypertrophy of detrusor muscl | Diverticulum formation
79
What is hydronephrosis?
Dilation of pelvicalcyeal system with parenchymal atrophy
80
What are the two most common causes of hydronephrosis?
Obstruction | Reflux
81
Causes of bilateral hydronephrosis
Urethral obstruction Neurogenic disturbance VUR Bilateral ureteric obstruction (e.g. dvanced carcinoma of the cervix)
82
Causes of unilateral hydronephrosis
Calculi Neoplasms Pelvi-ureteric obstruction Strictures
83
Does a sudden or more chronic obstruction cause more dilation?
Chronic causes more dilation

AY Renal (15 decks)

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