Urinary and Male Reproductive System

Question 1

Renal papillary necrosis: diabetic vs analgesic cause?

Answer 1

Diabetes: renal artery stenosis

Analgesics: lesions of differing ages

Question 2

What condition is interstitial cystitis/ Hunner ulcer associated with?

Answer 2

SLE

Question 3

Malakoplakia in bladder: metaplasia?

Answer 3

No, inflammatory plaque in response to chronic E. Coli infections

Question 4

Low grade bladder tumour- shape?

Answer 4

Almost always papillary

Question 5

What causes struvite stones?

Answer 5

These are Mg ammonium phosphate stones

Due to conversion of urea to ammonia by some bacteria (e.g. Proteus mirabilis)

Question 6

Incidence of APCKD?

Answer 6

1:1000

Question 7

Which infections affect first epididymis and which one affects testis first?

Answer 7

TB and gonorrhoea always start in epididymis

Syphilis affects testis first

Question 8

Foamy macrophages, inflammatory and occasional giant cells

Answer 8

XPG

Question 9

Most common cause of amyloidosis in developed countries?

Answer 9

Haemodialysis

Question 10

What malignancy arises in urachal remnant?

Answer 10

Adenocarcinoma

Question 11

Name 2 facial or head/ neck manifestations of TS?

Answer 11

Angiofibroma of face

Retinal hamartoma

Question 12

Clear cells are not seen in?

Answer 12

Wilms tumour

Usual cell types:

Blastemal (small round blue cell)

Stromal

Epithelial

Question 13

Most common cause of renal failure in multiple myeloma?

Answer 13

Light chain deposition within the glomeruli

Amyloidosis is only a contributing factor

Question 14

Colour of oncocytoma vs RCC?

Answer 14

Oncocytoma: tan brown

RCC: yellow

Question 15

16 year old male with gynaecomastia- likely cause?

Answer 15

Mixed GCT secreting beta-HCG which stimulates oestrogen production in males

Question 16

Corpora amylacea in prostate gland?

Answer 16

Calcification in LUMEN of acini

NOT stromal

Question 17

Typical appearance of choriocarcinoma of testis?

Answer 17

Small (less than 5 cm), aggressive vascular mass

Early mets

Question 18

BPH (nodular hyperplasia)- histology and risk of ca?

Answer 18

Areas of infarction and squamous metaplasia

NO increased risk of ca

Question 19

Which infectious agent does NOT involve testis?

Answer 19

HPV: causes warts and penile SCC

Question 20

What is choriocarcinoma composed of?

Answer 20

Syncytiotrophoblast and cytotrophoblast

Less than 1% of all GCT

Question 21

Testicular tumour- nodal involvement?

Answer 21

NO involvement of inguinal nodes usually

Spreads to para-aortic nodes

Question 22

What percentage of RCC isoechoic with parenchyma?

Answer 22

40%

Question 23

Age for leydig cell tumour?

Answer 23

Bimodal 5-10 years and 20-30 years

Question 24

Name 3 radiolucent renal tract calculi

Answer 24

Urate stones (5-10%): gout/ leukaemia

Cysteine (1-2%): genetic defect in amino acid absorption

Indinavir: AIDS medications

Question 25

What is gouty nephropathy?

Answer 25

Urate deposition in renal medulla

Death from renal failure in 10-20%

Question 26

Name 2 features of ischaemic ATN

Answer 26

Focal tubular necrosis with large skip areas

Occlusion of tubules by Tamm-Horsfall protein

Question 27

Name 2 features of nephrotoxic ATN

Answer 27

Injury to proximal convoluted tubules

Patients usually recover

Question 28

T staging of RCC

Answer 28

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

Question 29

Cystitis cystica/ glandularis

Answer 29

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

Question 30

Autosomal recessive vs dominant PCKD in terms of nephron involvement?

Answer 30

AR: ectatic collecting ducts

AD: involve whole nephron

Question 31

Name 3 associated anomalies of ADPCKD

Answer 31

Polycystic liver disease (75%)

Berry aneurysms (10-15%)

MV and aortic anomalies (25%)

Question 32

Most reliable indicator of malignancy in prostate ca?

Answer 32

Invasion (capsular, lymphovascular, perineural)

Question 33

Name 2 features of spermatocytic seminoma

Answer 33

Age more than 65 years

Excellent prognosis: slow growing and no mets

Question 34

Tumour markers in NSGCT

Answer 34

Teratoma: neither unless other components present

Yolk-sac: only AFP

Embryonal cell: both

Choriocarcinoma: beta-HCG only

Question 35

Yolk sac tumour: appearance and Px

Answer 35

Homogeneous, yellow mucinous appearance

Good prognosis in children

Question 36

Two types of testicular torsion

Answer 36

Extravaginal: neonates within the inguinal canal

Intravaginal: adolescents/ adults and twists around vascular pedicle (bell clapper testis)

Question 37

Benign vs malignant nephrosclerosis?

Answer 37

Benign: granular appearance and normal nephrogram

Malignant: severe HTN- abnormal nephrogram and petechial haemorrhage

Question 38

Undescended testes: malignancy in contralateral side and fertility post surgery?

Answer 38

Increased risk of malignancy in contralateral side

Fertility improves but does not resolve post orchidopexy

Question 39

Most common para-testicular malignancy?

Answer 39

Adults: liposarcoma

Kids: rhabdomyosarcoma