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AY Renal > Renal Pathology > Flashcards

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
Q

What is renal agenesis?

A

Absence of one or both kidneys

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26
Q

Where is the renal system is transitional epithelium present?

A

From the pelvicalyceal system to urethra

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27
Q

What percentage of bladder tumours are transitional cell carcinomas?

A

90%

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28
Q

What are the risk factors for transitional cell carcinoma?

A 
Aniline dyes 
Rubber industry 
Benzidine 
Cyclophosphamide 
Analgesics (renal pelvis) 
Schistosomiasis 
Smoking
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29
Q

What is the commonest symtpoms in transitional cell carcinoma?

A

Haematuria

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30
Q

Where doe stransitional cell carcinoma spread first?

A

Local lymph nodes (obturator)

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31
Q

Is recurrence of transitional cell carcinomas frequent?

A

Yes

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32
Q

What is the commonest malignant bladder tumour in children?

A

Embryonal rhabdomyosarcoma

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33
Q

Which type of blader cancer can longstanding cystitis cystica predispose to?

A

Adenocarcinoma

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34
Q

What would a raised red velvety area on the glans penis indicate?

A

Erthyrpoplasia of Queyrat

35
Q

What would a dry crusy appearance of squaous cell carcinoma on the penis indicate?

A

Bowen’s disease

36
Q

Do squamous carcinoma in situ occur almost exclusively in circumisised or uncircumsised men?

A

Uncircumsised

37
Q

What occupation can predispose to SCC of the scrotum?

A

Chimeny sweeps

38
Q

What is benign nodular porstate hyperplasia (BNPH)?

A

Irregular proliferation of both glandular and stromal prostatic tissue

39
Q

Clinical presentation of prostatism

A

Difficulty starting
Poor stream
Overflow incontinence

40
Q

Complications of urinary retention

A 
Bladder hypertrophy 
Divericulum fornation 
Hydroureter 
Hydronephrosis 
Infection
41
Q

Managemt of BNPH?

A

Alpha blockers
5 alpha reductase inhibitors
Surgery

42
Q

Is BNPH premalignant?

A

NO

43
Q

Where in the prostate does carcinoma tend to arise?

A

Peripheral ducts and glands (particularly posterior lobe)

44
Q

Where can carcinoma of the prostate spread locally?

A 
Urethral obstruction 
Capsular penetration 
Seminal vesicles 
Bladder 
Rectum
45
Q

Which lymph nodes does carcinoma fo the prostate spread to?

A

Sacral
Iliac
Para-aortic nodes

46
Q

Findings of prostate carcinoma on PR exam?

A

Craggy

47
Q

First line imaging for prostate pathology?

A

USS

48
Q

What blood test may indicate prostate carcinoma?

A

PSA

49
Q

Management of prostate carcinoma

A

Anti-androgen treatemnt
radio therapy for bone mets
Radical prostatectomy

50
Q

Main risk factor for testicular tumours?

A

Tsticular maldescent

51
Q

Presentation of testicular tumours

A

Painless tesicular enlargemnt Can be associated with hydrocele
ynaecomastia
General effects of malignant disease

52
Q

Which cell do most testicular tumours arise from?

A

Germ cell

53
Q

What is the most common testicular germ cell tumour?

A

Seminoma

54
Q

Peak incidence of seminoma?

A

30-50 years

55
Q

Appearance of seminoma?

A

‘Potato tumour’

Large cell tumour cells with variable stromal lymphocytic infiltrate

56
Q

Treatment of seminoma

A

Marked radio-sensitivity (95% cure)

57
Q

Where do teratomas arise from?

A

S cell lines (ectoderm, mesoderm, endoderm)

58
Q

What are the classifications of teratome

A

Differential teratome (TD)
Malignant teratome Intermediate (MTI) Malignant Teratome Undifferentiated (MTU)
Malignant Teratome Trophoblasmic (MTT)

59
Q

Which tumour marker is used to monitor seminoma?

A

PLAP

60
Q

Which tumour monitors yolk sac components of testicular tumours?

A

AFP

61
Q

Which marker monitors trophoblastic components of testicular tumours?

A

bHCG

62
Q

Is glomerulonephritis usually diffuse or focal?

A

Diffuse

63
Q

What is pyelonephritis?

A

Bacterial infection of renal pelvis, calyces, tubules and interstitium

64
Q

What is the commonest causative orgaism of pyelonephritis?

A

E. coli

65
Q

Other than E. coli what other organism can cause pyelopnephritis?

A

Pseudomonas

Strep. faeccalis

66
Q

Pathogenesis of pyelonephritis

A

Ascending infection

Blood-borne

67
Q

Risk factors for pyelonephritis

A 
Age & sex 
Pregnancy 
Instrumentalisation 
Urinary tract obstruction 
Vesico-ureteric reflux 
Diabetes
68
Q

Why is pregnancy a risk factor for pyelonephritis?

A

Ureteric diltation - stasis ofyrine due to hormonal & anatomical effects

69
Q

Presentation of chronic pyelonephritis

A

Often no previous history of UTI
Symptoms often vague
Hypertension and/or uraemia
Large volume of urine

70
Q

What would be seen on imaging in chronic pyelonephritis?

A

Coarse cortical scarring

Distortion of calcyces

71
Q

Pathogenesis of tuberculous pyelonephritis

A

Haematogenous spread - usually from lung

72
Q

Symptoms of tuberculous pyelonephritis

A 
Weight loss 
Fever 
Night sweats 
Loin pain 
Dysuria
73
Q

Laboratory findings of tuberculosis pyelonephritis

A

Caseous foci
Granulomatous inflammation
ZN stain for acid fast bacilli

74
Q

Which organisms cause cystitis

A

E. coli
Klebsiella
Proteus
Pseudomonas

75
Q

When would acute cystitis lead to necrosis?

A

When associated with outlet obstruction

76
Q

What is cystitis cystica?

A

Multipl small fluid filled cysts projecting into lumen of bladder - can resemble tumours

77
Q

Causes of urethral obstruction in males

A

Stricture
Posterior urethral valves
Prostatic disease

78
Q

What can reult from prolonged bladder outlet obstruction?

A

Hypertrophy of detrusor muscl

Diverticulum formation

79
Q

What is hydronephrosis?

A

Dilation of pelvicalcyeal system with parenchymal atrophy

80
Q

What are the two most common causes of hydronephrosis?

A

Obstruction

Reflux

81
Q

Causes of bilateral hydronephrosis

A

Urethral obstruction
Neurogenic disturbance
VUR
Bilateral ureteric obstruction (e.g. dvanced carcinoma of the cervix)

82
Q

Causes of unilateral hydronephrosis

A

Calculi
Neoplasms
Pelvi-ureteric obstruction
Strictures

83
Q

Does a sudden or more chronic obstruction cause more dilation?

A

Chronic causes more dilation

AY Renal (15 decks)

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