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ESA 3 - Urinary > Session 9 - Pathology Of The Urinary System > Flashcards

Session 9 - Pathology Of The Urinary System Flashcards

1
Q

What are the four main sites of glomerular injury?

A
  • Subepithelial
  • Glomerular Basement Membrane
  • Subendothelial
  • Mesangial / Paramesangial
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2
Q

What is difference between Proteinuria and Nephrotic Syndrome?

A
  • Proteinuria is less severe than Nephrotic Syndrome
  • Proteinuria refers to <3.5g of protein in the urine over 24 hrs
  • Nephrotic Syndrome refers to >3.5g of protein in the urine over 24 hrs
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3
Q

How does Nephrotic Syndrome lead to generalised oedema?

A
  • Protein in urine = less in the blood
  • Decreased oncotic pressure of the blood
  • fluid leaves blood causing oedema
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4
Q

What are the most common causes of Primary Nephrotic Syndrome?

A
  • Minimal Change glomerulonephritis
  • Focal segmental glomerulosclerosis (FSGS)
  • Membranous glomerulonephritis
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5
Q

Describe Minimal Change Nephritis.

When does it present, treatments, progression, microscopic changes?

A
  • Presents in childhood, decreased incidence with age
  • Responds well to steroids
  • Usually doesn’t progress to renal failure
  • Under light microscopy looks normal
  • Under electron microscopy can see damage to podocytes
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6
Q

Describe each part of the name of Focal Segmental Glomerulosclerosis?

A

Focal - Involves <50% of glomeruli on light microscopy
Segmental - Involving part of the glomerular tuft
Sclerosis - Scarring

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7
Q

Describe Focal Segmental Glomerulosclerosis.

When does it present, Treatment, cause, progression?

A
  • Presents in adulthood
  • Less responsive to adulthood
  • Caused by a circulating factor, evidenced by the fact that even with kidney transplants the sclerosis comes back shortly after
  • Can progress to renal failure
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8
Q

Describe Membranous Glomerulonephritis.

Cause, progression, co-morbidities?

A
  • Immune complex deposits in sub-epithelial space
  • Rule of thirds: 1/3 get better, 1/3 stay the same + 1/3 get renal failure
  • Evidence that it may be secondary to other conditions like malignancies
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9
Q

What is Nephritic syndrome in general?

A

Renal failure due to blocking of the filter

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10
Q

Describe IgA nephropathy

Cause, when does it present, how does it present, treatment?

A
  • IgA deposited in glomerulus
  • can occur at any age
  • classically presents with haematuria + has a relationship with mucosal infections
  • no effective treatment
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11
Q

What are the two types of hereditary nephropathies?

A

Thin Glomerular Basement Membrane Nephropathy
+
Alport Syndrome

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12
Q

What anatomical features allow deposits of immune complexes into the mesangium?

A

There are no podocytes or basement membranes to act as a barrier against the deposition

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13
Q

What are the risk factors for Prostate Cancer?

A
  • Age, uncommon is men <50
  • Family history
  • Race: Afro-Caribbeans more at risk than Caucasians who are more at risk than Asians
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14
Q

What factors will affect which treatments we use for someone with prostate cancer?

A
  • Age
  • Stage of cancer
  • PSA levels
  • Biopsies
  • MRI scan and Bone scan
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15
Q

What are some of the treatments available for prostate cancer?

A
  • Radical Prostatectomy
  • Radiotherapy
  • Primary Cyrotherapy (freeze prostate)
  • Hormones
  • High Intensity Focused Ultrasound
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16
Q

What are some of the differential diagnoses for someone with haematuria?

A
  • Various Urinary tract cancers
  • Stones
  • Infection
  • Inflammation
  • Benign prostate hyperplasia
  • Glomerular
17
Q

What are some of the risk factors for bladder cancer?

A
  • Smoking
  • Occupational Exposure (to rubber or plastics, crude oil)
    - painters, mechanics, printers
  • Schistosomiasis
18
Q

Describe the process of a radical cystectomy?

A
  • Removal of urinary bladder
  • Piece of ileum used to make a conduit from ureters to abdomen
  • Urine can be collected from here into a bag
  • May also attempt to reconstruct bladder from a piece of SI
19
Q

What are some of the risk factors for a Renal Cell Carcinoma?

A
  • Smoking
  • Obesity
  • Dialysis
20
Q

What are some of the treatment options available for renal cell carcinomas?

A
  • Radical or partial nephrectomy
  • Immunotherapy
  • Molecular therapies targeting angiogenesis
  • surveillance

ESA 3 - Urinary (9 decks)

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