Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q

What is glomerulonephritis?

A

Non infective iflammation of the glomerulous and nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is pyelonephritis?

A

Bacterial infection of the renal pelvis, calyces, tubules and intersitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common bacterial cause of pyelonephritis

A

E.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does sterile pyuria sugest?

A

Tuberculous pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is cystitis?

A

Inflammation of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What bacteria usually causes cystitis?

A

E.coli

Klebsiella

Proteus

Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does prolonged unrinary tract obstruction cause

A

Hypertrophy of detrusor muscle

Diverticulum formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is hydronephrosis?

A

water in the kidney leading to pelvicalyceal dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What difference do you see in a sudden blockage versus a gradual blockage in hydronephrosis?

A

Sudden - little dilation

Gradual - Large dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define urinary incontinence

A

Involuntary leakage of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the four types of urethral urinary incontinence?

A

Urge

Stress

Mixed

Overflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens in overflow incontinence?

A

Bladder outflow is obstructed

Chronic retention resulting in uncontrolled incontinence

Often at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is urge incontinence?

A

Frequently feeling desperate to go and then voiding small volumes at a time.

Waking up at night to have to go pee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is stress incontinence?

A

Urine leaks during increased intra abdominal pressure usually due to pelvic floor weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What life style changes are involved in the managment of urge urinary incontinance

A

Avoid caffine and alcohol

Bladder training

stop smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What drugs can be usful in urge urinary incontinence?

A

Antimuscarinics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does agenesis mean?

A

Absence of one or both kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does hypoplasia mean?

A

Small kidneys but normal development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Whats the deal with cysts in the kidneys?

A

Simple cysts are very common ad dont cause any problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the prognosis for neonatal polycystic disease?

A

Terminal - few months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is associated with infantile polycystic disease?

A

Congenital hepatic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How i adult polycystic kidney disease aquired?

A

Autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does adult polycystic disease present?

A

mid life - abdominal mass , haematuria , hyperstension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is associated with adult polycystic kidney disease?

A

Berry aneurysms

cysts in liver pancrease and lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does renal cell carcinoma spread?

A

Blood-borne spread to lung and bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most common bladder tumour?

A

Transitional cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common symptom of transitional cell carcinoma?

A

Haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where do you normally find transitional cell carniomas?

A

In the trigone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How does squamous carcinoma of the penis present?

A

Ulcerating tumour at the glans of the penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is benign nodular hyperplasia of the prostate?

A

very common disorder

Irregular proliferation of both glandular and stromal prostatic tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is characterisitc of prostatism?

A

Difficulty starting micturation

poor stream

overflow incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Is bengin nodular hyperplasia pre malignant?

A

NOOOOOO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where does carcinoma of the prostate usually occour ?

A

Mainly in peripheral ducts and glands particulary in the posterior lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How does carcinoma of the prostate spread and where too?

A

Local - urethral obstruction, seminal vesicles, bladder, rectum

lymphatics- sacral, iliac and para-aoritc nodes

Blood- bone ( lumbosacral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What investigations are useful in carcinoma of the prostate?

A

Prostate specific antigen (PSA)

Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How is carcinoma of the prostate managed?

A

Hormonal therapy - anti- androgen

Radiotherapy - bone mets

Surgery - prostatectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the bigest risk factor for testicular tumours?

A

testicular maldescent is a risk factor x10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How do testicular tumours present?

A

Painless testicular enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the most common type of testicular tumour?

A

Germ cell tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When do people get seminomas and what type of tumour are they ?

A

30-50 yrs

Germ cell tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How can seminomas spread?

A

Lyphatic spread to para-aortic lymph nodes

blood spread to lungs and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How do you treat seminoma?

A

Radiotherapy - 95% cure rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What testiclar cancer do young guys get?

A

Teratomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What does hematospermia mean?

A

Blood in the semen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

the symptoms “Debilitating unilater or bilateral flank pain with heamaturia which is otherwise unexplained” are classical of which syndrome?

A

Loin pain haematuria syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is decompression heamaturia?

A

Haematuria following bladder drainage in high pressure chronic urinary retention treatments by decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is pneumaturia?

A

Passage of air bubbles in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is faecaluria?

A

Passage of faecal matter in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What information does the timing of the heamaturia give you?

A

initial voiding - urethral

Total voiding - bladder , kidneys or ureter

Terminal voiding- prostate or bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is acute urinary retention?

A

Inability to urinate.

Urine is still produced but voiding does not occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is a common cause of acute loin pain?

A

Ureteric colic secondary to calculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How do you treat renal calculi?

A

NSAIDs and Opiate

alpha blocker for small stones expected to pass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What size of stone is easily passible ?

A

<4mm:- 80% pass spontaneously

>6mm - 21% pass spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is paraphimosis

A

Painful swelling of the foreskin distal to a phimotic ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

When does paraphimosis usually occour?

A

When the foreskin is retracted for catherterization or cystoscopy and the staff member forgets to put it back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is Priapism ?

A

Prolonged erection, often painful and not associated with sexual arousal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the two classes of priapism?

A

Ischaemia:- venous stasis compartment syndrome

Non-ischaemic :- tramatic distrution of penile vasculature resulting in uregulated blood entry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How do you treat ischaemic priapism?

A

Aspiration

irigation with saline

surgical shunt

59
Q

How do you treat non-ishaemic priapism?

A

Observe- may resolve spontaneously

Selective arterial embolization with non-permanent materials

60
Q

What is fournier’s gangrene?

A

Necrotizing fasciitis around the male genitalia

61
Q

How do you treat Fournier’s gangrene?

A

Surgical deridement + antibiotics

62
Q

What is emphysematous pyelonephritis

A

Acute necrotizing infection caused by gas forming pathogens

63
Q

What organism usually causes emphysematous pyelonephritis?

A

E coli

64
Q

How does bladder injury usually present?

A

Suprapubic tenderness,

lower adominal bruising ,

dimished bowel sounds

65
Q

Where is the apex and where is the base of the prostate?

A

Base is superior portion continous with the bladder neck

Apex is inferior portion continuous with striated sphincter

66
Q

What happens at the verumontanum?

A

Ejaculatory ducts drain to each side of the prostatic urethra

67
Q

From which zone does most of prostate cances arise?

A

Perpheral zone

68
Q

Is FHx important in prostate cancer?

A

Risk is x2 with with one first degree relative and x4 with two first degree relatives

69
Q

What is PSA?

A

Prostatic specific antigen

PSA is a protein produced by the secretory spithelial cells of the prostate gland

70
Q

What is the sensitvity and specificity of PSA?

A

Sensitivity - 90%

Sepcificty - 40%

71
Q

Why does prostatic specific antigen testing have such a low specificty?

A

Catheterization and PR exams can raise PSA

72
Q

What type cancer are the majority of prastatic cancers?

A

Multifocal adenocarcinomas

73
Q

What are the most common types of uroepithelial tumors?

A

90% transitional cell

9% squamous cell

74
Q

What are the two types of transitional cell uroepithelial tumors

A

Papillary type 80%

Nonpapillary type 20%

75
Q

What bacteria is normally found in the upper urinary tact?

A

Usually Sterile!

76
Q

what bacteria is normally found in the urethra?

A

Coliforms and enterococci

77
Q

What are the common bacterial causes of UTI

A

Coliforms

E.coli

Klebsiella

Enterbacter

78
Q

What are the classic symptoms of a UTI?

A

Dysuria

Increased frequency of urination

Nocturia

Haematuria

fever

loin pain

rigors

79
Q

What results from a dipstick test would suggest bacteria in the urine?

A

Leakocyte esterase activity (WBC)

Nitrites

Protein

Blood

80
Q

How do you treat uncomplicated lower UTI in women?

A

3 days of oral amoxicillin

81
Q

What do you do if you detect anysmptomatic bacteriuria in pregnancy?

A

Treat with antibiotics as it could progress to pyelonephritis

82
Q

What is this a buzzword for ?

“UTI symptoms with pus cells present in urine but no significant growth on culture”

A

Urethral syndrome

or

Abacterial cystitis

83
Q

What are the three types of renal failure?

A

Pre-renal

Intrinsic-renal

Post-renal

84
Q

How do you treat hyperkalaemia?

A

Calcium gluconate

Actrapid insulin with glucose

salbutamol

85
Q

How is Chronic kidney disease staged?

A

By looking at the GFR

86
Q

At what GFR do patients start to experiance symptoms?

A

below 20ml/min

87
Q

What is an abnormal protein urea?

A

100-300 mg/day = Heavy proteinuria

>300mg/day = Nephrotic range

88
Q

What is an acute kidney injury?

A

Rapid decline in GFR

89
Q

What do you find in Nephrotic syndrome?

A

Proterinuria >300mg day

Hypoalbuminaemia

Oedema

High cholestrol

90
Q

What do you find in nephritic syndrome?

A

Oliguria

Oedema and fluid retention

hypertension

active urinary sediment

91
Q

What would be a fat containing tumour of the kidney?

A

Angiomyolipoma

92
Q

Are angiomylolipomas premalignant

A

Nope

93
Q

Is a oncocytoma benign or malignant?

A

Benign

94
Q

How does renal cell carcinoma present?

A

Loin pain

Renal mass

Haematuria

95
Q

What are the stages of renal cell carcinoma?

A
  1. within capsule
  2. within perinephric fat
  3. regional lymph nodes and renal vein
  4. metstastases
96
Q

How do you treat renal cell cancer?

A

Surgery - radical nephrectomy

97
Q

What is the 5 year survivial rate of eac cancer stage ?

A
  1. 75%
  2. 50%
  3. 35%
  4. 5%
98
Q

What is this?

A

Balanitis xerotica obliterans

BXO

99
Q

What is Bowen’s disease?

A

Squamous carcinoma in situ of the male genitalia

100
Q

What is CKD?

A

Reduced GFR and/or evidence of kidney damage

101
Q

How is GFR assesed?

A

Measured with nuclear medicine

Estimation by creatinine clearance rate

Can be estimated from serum creatinine

102
Q

How is the GFR over or under estimated in skinny and muscly people?

A

Skinny - GFR better than it looks

Muscly- GFR worse than it looks

103
Q

What are the stages of CKD?

A
  1. GFR 90 with symptoms
  2. GFR 60- 90 with symptoms
  3. GFR 30-60
  4. GFR 15-30

5 GFR less than 15

104
Q

What measures the likely hood of progression of CKD?

A

Patients with proteinuria are more likely to progress

105
Q

What complcations of CKD should you be on the look out for?

A

Anaemia

Hyperparathyoidism

Bone disease

106
Q

Why does anaemia occour in CKD?

A

Decreased erythropoietin produced by kidneys?

107
Q

How do you treat anaemia in patients with CKD?

A

IV iron

Erythropoietin injections weeklly

108
Q

Why do people with CKD get bone disease?

A

Vitamin D is hydroxylated in the kidneys.

This is impaired in CKD

109
Q

How do you treat bone disease in CKD?

A

Alfacalcidol - doesnt need activation by the kidneys

110
Q

What are the clinical features of Autosomal dominant polycystic kidney disease?

A

Reduced urine conc

chronic pain

hypertension

hematuria

cyst infection

renal failure

111
Q

How is autosomal dominant polycystic kidney disease diagnosed?

A

Radiologically - ultrasound

Genetic - Linkage analysis

112
Q

If an individual has ADPKD what is the pecentage chance that the offspring will have the disease?

A

50%

113
Q

How do you treat ADPKD?

A

Tolvaptan

114
Q

What is the distinguishing factor of ATRKD?

A

Cysts are seen appearing from the collecting duct system

115
Q

What is medullary cystic kidney?

A

Morphologically abdnormal renal tubules leading to fibrosis

presents around 28yrs

116
Q

How does the site and type of injury in glomelularnephritis determine clincial presentation?

A

Endothehlial or mesangial - Proliferative lesion with red cells in urine

Podocytes - non proliferative with protein in urine

Proliferative means immune system activation

117
Q
  • 24 year old man incidentally found to have ++ blood and + protein on dip, BP 148/92.
  • Protein quantified at 0.7g/day. Creat 72.
  • What glomerular cells are most likely to be injured?
A

Mesangium cells

Endothelial cells would be much worse

118
Q

What happens when the podocytes are injured?

A

Atrophy

loss of the barrier

119
Q

What happens if the mesangium cells get damaged?

A

Inflammation and proliferation

active inflammatory response

120
Q

What are the layers of the glomelrluous ?

A

Mesangium

Endothelial cell

Podocytes

121
Q

What is classic about the red cells in glomerulonephritis?

A

They are squished

Dysmorphic

122
Q

What is nephritic syndrome?

A

Acute renal failure with fluid retention and hypertension

usually a proliferative process

123
Q

What is nephrotic sydrome?

A

Proteinuria >3g/day

low protein in blood

lots of odema

normal renal function

124
Q

Inslut to podocytes causes nephrotic or nephritic syndrome?

A

Nephrotic - proteinuria

125
Q

does Insult to the mesangium or endothelial cells cause nephrotic or nephritic syndrome?

A

Nephritic

126
Q

How does the presentation of GN differ from a non glomerluar disease like Intersitial ephritis?

A

Look at the urine

Blood

Dysmorphic cells

127
Q

What is the blood pressure target in glomerlulornephritis?

A

120/75

128
Q

How do you treat glomerulonephritis?

A

Treat symptoms

ACE inhibiors

Immunosupression

129
Q

What is minimal change nephropathy?

A

Podocytes are damaged

autoimmune

common in kids

complete remision with oral steroids

130
Q

What is focal segmental glomerulosclerosis?

A

Monst common nephrotic syndrome in adults

more difficult to treat than minimal change

treat with steroids

131
Q

What is the survival rate for dialysis in type 1 diabetes ?

1yr

2yr

5yr

A

1yr- 81%

2yr- 62%

5yr- 24%

132
Q

How can you slow down the progression of diabetic nephropathy?

A

Reduce proteinuria

ACE inhibitor

133
Q

What is ischaemic nephropathy?

A

Reduced GFR associated with reduced renal blood flow blow the level of autoregulatory compensation

134
Q

What causes ischameic nephropathy?

A

Essential hypertension

Secondary hypertension

135
Q

What is important to remember about renal artery stenosis?

A

ACE inbibitors should not be used in bilateral renal artery stenosis

136
Q

What is myeloma ?

A

Cancer of plasma cells

137
Q

How does Myeloma affect the kidneys?

A

Monoclonal immunoglobulin deposistion

138
Q

How do you diagnosis Myeloma in the blood and in the urine?

A

Blood

Serum protein electrophoresis

Serum free light chains

Urine

Bence jones protein

139
Q

How do you treat Myeloma?

A

Chemotherapy

Stem cell transplant

Plasma exchange to remove light chains

140
Q

Whate gives an indication of severity of AKI?

A

risk of death proportional to rise in creatinine

141
Q

How is AKI defined?

A

<48 hrs reduction in kidney function defined as

An absolute increase of serum creatinine by 26.4micromol/L

or Increase in serum creatinine by >50%

or Reduction in urine output

142
Q

What do you see in the ECG of patients with hyperkaleamia?

A

Peked T waves

Wider QRS complexes

143
Q
A

Renal (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions