Urinary and Male Reproductive System Flashcards
Renal papillary necrosis: diabetic vs analgesic cause?
Diabetes: renal artery stenosis
Analgesics: lesions of differing ages
What condition is interstitial cystitis/ Hunner ulcer associated with?
SLE
Malakoplakia in bladder: metaplasia?
No, inflammatory plaque in response to chronic E. Coli infections
Low grade bladder tumour- shape?
Almost always papillary
What causes struvite stones?
These are Mg ammonium phosphate stones
Due to conversion of urea to ammonia by some bacteria (e.g. Proteus mirabilis)
Incidence of APCKD?
1:1000
Which infections affect first epididymis and which one affects testis first?
TB and gonorrhoea always start in epididymis
Syphilis affects testis first
Foamy macrophages, inflammatory and occasional giant cells
XPG
Most common cause of amyloidosis in developed countries?
Haemodialysis
What malignancy arises in urachal remnant?
Adenocarcinoma
Name 2 facial or head/ neck manifestations of TS?
Angiofibroma of face
Retinal hamartoma
Clear cells are not seen in?
Wilms tumour
Usual cell types:
Blastemal (small round blue cell)
Stromal
Epithelial
Most common cause of renal failure in multiple myeloma?
Light chain deposition within the glomeruli
Amyloidosis is only a contributing factor
Colour of oncocytoma vs RCC?
Oncocytoma: tan brown
RCC: yellow
16 year old male with gynaecomastia- likely cause?
Mixed GCT secreting beta-HCG which stimulates oestrogen production in males
Corpora amylacea in prostate gland?
Calcification in LUMEN of acini
NOT stromal
Typical appearance of choriocarcinoma of testis?
Small (less than 5 cm), aggressive vascular mass
Early mets
BPH (nodular hyperplasia)- histology and risk of ca?
Areas of infarction and squamous metaplasia
NO increased risk of ca
Which infectious agent does NOT involve testis?
HPV: causes warts and penile SCC
What is choriocarcinoma composed of?
Syncytiotrophoblast and cytotrophoblast
Less than 1% of all GCT
Testicular tumour- nodal involvement?
NO involvement of inguinal nodes usually
Spreads to para-aortic nodes
What percentage of RCC isoechoic with parenchyma?
40%
Age for leydig cell tumour?
Bimodal 5-10 years and 20-30 years
Name 3 radiolucent renal tract calculi
Urate stones (5-10%): gout/ leukaemia
Cysteine (1-2%): genetic defect in amino acid absorption
Indinavir: AIDS medications
What is gouty nephropathy?
Urate deposition in renal medulla
Death from renal failure in 10-20%
Name 2 features of ischaemic ATN
Focal tubular necrosis with large skip areas
Occlusion of tubules by Tamm-Horsfall protein
Name 2 features of nephrotoxic ATN
Injury to proximal convoluted tubules
Patients usually recover
T staging of RCC
T1: less than 7 cm
T2: more than 7 cm
T3: extension into renal vein or IVC
T4: beyond Gerota fascia or into adrenal gland
Cystitis cystica/ glandularis
Transformation of urothelium due to chronic infection
Cystitis glandularis: change to columnar epithelium
Cystitis cystica: cystic spaces filled with clear fluid
No risk of adenocarcinoma
Autosomal recessive vs dominant PCKD in terms of nephron involvement?
AR: ectatic collecting ducts
AD: involve whole nephron
Name 3 associated anomalies of ADPCKD
Polycystic liver disease (75%)
Berry aneurysms (10-15%)
MV and aortic anomalies (25%)
Most reliable indicator of malignancy in prostate ca?
Invasion (capsular, lymphovascular, perineural)
Name 2 features of spermatocytic seminoma
Age more than 65 years
Excellent prognosis: slow growing and no mets
Tumour markers in NSGCT
Teratoma: neither unless other components present
Yolk-sac: only AFP
Embryonal cell: both
Choriocarcinoma: beta-HCG only
Yolk sac tumour: appearance and Px
Homogeneous, yellow mucinous appearance
Good prognosis in children
Two types of testicular torsion
Extravaginal: neonates within the inguinal canal
Intravaginal: adolescents/ adults and twists around vascular pedicle (bell clapper testis)
Benign vs malignant nephrosclerosis?
Benign: granular appearance and normal nephrogram
Malignant: severe HTN- abnormal nephrogram and petechial haemorrhage
Undescended testes: malignancy in contralateral side and fertility post surgery?
Increased risk of malignancy in contralateral side
Fertility improves but does not resolve post orchidopexy
Most common para-testicular malignancy?
Adults: liposarcoma
Kids: rhabdomyosarcoma
