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CPR Exam 3 > Renal Pathology Pt. 5 > Flashcards

Renal Pathology Pt. 5 Flashcards

1
Q

what is bladder diverticulae?

A

pouchlike evagination of the bladder wall due to increased intravesicular pressure

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2
Q

what is the cause of congenital diverticulae?

A

due to focal failure of development of the normal musculature
OR
urinary tract obstruction during fetal development

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3
Q

what is the cause of acquired diverticulae?

A

prostatic enlargement producing obstruction to urine flow

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4
Q

which diverticulae is more common?

A

acquired

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5
Q

what is the clinical significance of diverticulae?

A

creates sites of urinary stasis which predisposes the patient to infection and bladder calculi

predisposed to vesicoureteral reflux

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6
Q

what is extrophy?

A

developmental failure in the anterior wall of the abdomen which allows the bladder protrude

subject to infection and increased risk of adenocarcinoma

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7
Q

what predisposes an individual to vesicoureteral reflux?

A

valvular defect

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8
Q

what are the classic symptoms of cystitis?

A 
urinary frequency/uregency
dysuria
pelvic/abd pain
fever
dark or bloody urine
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9
Q

how do you distinguish between acute uncomplicated cystitis and complicated UTI?

A

complicated UTIs typically occur in:
urinary tract abnormalities
disease states that reduce urinary tract defenses
UTIs caused by resistant pathogens

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10
Q

what are the most common organisms causing cystitis?

A

E.coli
Proteus
Klebsiella
Enterobacter

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11
Q

why are women more likely to develop cystitis?

A

shorter urethra

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12
Q

what conditions predispose a patient to cystitis?

A 
bladder calculi
urinary obstruction
DM
instrumentation (catheter)
immune deficiency
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13
Q

what causes hemorrhagic cystitis?

A

cytotoxic anti-tumor drugs (cyclophosphamide)

adenovirus

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14
Q

what is interstitial cystitis/Hunner ulcer?

A

chronic, persistent, painful form of cystitis

symptoms of cystitis without evidence of bacterial infection

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15
Q

who is most commonly affected by interstitial cystitis?

A

women age 30-40

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16
Q

what is seen on histology in interstitial cystitis?

A

mast cells and lymphocytes

inflammation and fibrosis of the bladder wall with fissures

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17
Q

what is malacoplakia?

A

cystitis caused by defective phagosome function which causes chronic infection usually by E.coli

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18
Q

what is seen on morphology in malacoplakia?

A

3-4 cm soft, yellow, slightly raised mucosal plaques

can also be seen in the GU tract

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19
Q

who is most commonly affected by malacoplakia?

A

middle-aged females

immunocompromised patients

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20
Q

what is seen on histology in malacoplakia?

A

foamy macrophages with mineralization and Michalis-Gutmann bodies
multinuclear giant cells
interspersed lymphocytes
granulomas

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21
Q

what is polypoid cystitis?

A

inflammatory condition from irritation of the bladder mucosa

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22
Q

what is the primary cause of polypoid cystitis?

A

indwelling catheters

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23
Q

what is seen on histology in polypoid cystitis?

A

polypoid urothelium from extensive submucosal edema

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24
Q

what is polypoid cystitis often misdiagnosed as?

A

papillary carcinoma

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25
Q

what are cystitis cystica and cystitis glandularis?

A

chronic inflammatory conditions that occur in the setting of chronic irritation

irritants are usually infection, calculi, outlet obstruction or tumor

26
Q

how are CC and CG related?

A

urothelium proliferates into buds which grow into CT beneath the epithelium into the lamina propria

the buds then differentiate into cystic depositions of CC or into intestinal columnar mucin-secreting glands resulting in CG

both forms are usually found on histo

27
Q

what is follicular cystitis?

A

aggregation of lymphoid follicles in the mucosa and underlying wall

typically associated with chronic infection

28
Q

what is eosinophilic cystitis?

A

infiltration of submucosal eosinophils from nonspecific subacute inflammation or systemic allergic reaction, autoimmune disorder, parasitic infection

29
Q

what is rhabdomyosarcoma?

A

malignant mesenchymal tumor typically seen in children

30
Q

what is leiomyosarcoma?

A

malignant mesenchymal tumor typically seen in adults

possibly caused by radiation or chemo

31
Q

what is primary malignant lymphoma?

A

hematologic malignancy seen in adults with chronic cystitis

usually non-hodgkin lymphoma

32
Q

what environmental risk factors are associated with urothelial carcinoma?

A 
smoking
industrial exposure to arylamines
schistosoma hematobium 
analgesics
cyclophosphamide
radiation
33
Q

what genetics risk factors are associated with urothelial carcinoma?

A

Chrom 9 monosomy or deletions

Chrom 17p deletions (p53)

34
Q

what mutations are almost always seen in urothelial carcinoma?

A

TP53 and RB

35
Q

what is the clinical presentation of urothelial carcinoma?

A

painless hematuria

36
Q

what type of urothelial carcinoma has a high rate of recurrence?

A

papillary urothelial carcinoma

37
Q

what are the congenital anomalies of the penis?

A

phimosis - small penis hole
hypospadias - urethral opening on ventral surface
epispadias - urethral opening on the dorsal surface

38
Q

what are the congenital anomalies of the testis/epididymis?

A

cryptorchidism - incomplete descent of the testes

39
Q

what infection predisposes men to penis tumors?

A

HPV

40
Q

what is autoimmune orchitis?

A

idiopathic orchitis that presents in middle age as a tender testicular mass with fever

41
Q

what is testicular torsion?

A

twisting of the spermatic cord that cuts of venous drainage of the testis

if untreated leads to testicular infarction

42
Q

what is the most common benign paratesticular tumor?

A

adenomatoid tumor

43
Q

what are the two classifications of germ cell tumors?

A

seminomatous

nonseminomatous

44
Q

what factors contribute to germ cell tumors?

A

cryptorchidism
hypospadias
poor sperm quality

45
Q

what genetics mutations contribute to germ cell tumors?

A

receptor tyrosine kinase KIT and BAK

46
Q

what is the precursor lesion to germ cell tumors?

A

intratubular germ cell neoplasia (ITGCN)

reduplication of chrom. 12p

47
Q

what is the most common type of germ cell tumor?

A

seminoma

48
Q

what is a spermatocytic seminoma?

A

a rare, slow-growing germ cell tumor that predominately affects older men

49
Q

what are the nonseminomatous tumors?

A 
embryonal carcinoma
yolk sac tumor
choriocarcinoma
teratoma
mixed tumors
50
Q

what biomarkers are associated with germ cell tumors?

A

HCG, AFP and lactate dehydrogenase

51
Q

which germ cell tumor has a poorer prognosis?

A

nonseminomatous GCT

52
Q

what is the clinical presentation of leydig cell tumors?

A

high levels of androgens
testicular swelling
gynecomastia
precocious puberty (children)

53
Q

what is the clinical presentation of sertoli cell tumors?

A

hormonally silent

testicular mass

54
Q

what is gonadoblasoma?

A

rare neoplasm comprised of mixture of germ cells

may give rise to seminoma

55
Q

what is testicular lymphoma?

A

aggressive non-hodgkin lymphoma presenting as a testicular mass

56
Q

what are the common causes of prostatitis?

A

bacterial
abacterial *most common
granulomatous

57
Q

what is the primary cause of BPH?

A

nodular hyperplasia of prostatic stromal and epithelial cells that lead to urinary obstruction

58
Q

what is the most common cancer of men?

A

adenocarcinoma of the prostate

59
Q

what biomarkers can indicate prostate cancer?

A

PSA

PCA3

60
Q

what is the most common acquired genetic lesion in prostate cancer?

A

TPRSS2-ETS fusion genes that activate PI3K/AKT pathway

61
Q

what is the clinical presentation of prostate cancer?

A

often clinically silent and only detected by monitoring PSA concentrations

62
Q

what are typical signs of advanced prostate cancer?

A

osteoblastic bone mets

CPR Exam 3 (15 decks)

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