Urinary tract pathologies Flashcards
What are the two types of urethritis?
Gonococcal and non-gonococcal.
Name three causes of urethral stricture.
Iatrogenic, traumatic, inflammatory/infective.
What controls smooth muscle tone in the prostate?
⍺-1a adrenergic receptors.
What are the three associated sex glands of the prostate?
Seminal vesicles, Cowper’s glands, glands of Littre.
What are the two main cell types in the prostate?
Epithelial cells (90%) and stromal cells (10%).
What is the aetiology of BPH?
Ageing and family history.
What zone of the prostate does BPH typically affect?
Transitional zone and peri-urethral tissue.
What is the pathophysiology of BPH?
Increased cell proliferation and/or decreased apoptosis.
Name 5 factors contributing to BPH development.
Androgens, oestrogens, growth factors, inflammation, genetics.
Name 5 complications of BPH.
Lower urinary tract symptoms, urinary retention, UTIs, bladder stones, bladder failure.
What is the most common cancer in men in the UK?
Prostate cancer.
What is the lifetime risk of developing prostate cancer?
1 in 9.
Which zone is most prostate cancer found in?
Peripheral zone (75%).
What are 4 key risk factors for prostate cancer?
Age, ethnicity (Afro-Caribbean), family history, obesity.
What is the key pathological feature of prostate cancer?
Absence of the basal cell layer.
How does prostate cancer spread locally?
Along autonomic nerves.
Where does prostate cancer metastasize early?
Bone (sclerotic lesions).
What is the Gleason grading system used for?
Prognosis in prostate cancer.
How is the Gleason score calculated?
Sum of the most common and highest grade.
What is PSA and its function?
Prostate specific antigen; liquefies seminal coagulum.
Name 4 causes of false positive PSA levels.
UTI, prostatitis, recent instrumentation, BPH.
What are the three anatomical regions of the bladder?
Dome, body, and trigone.
What is the function of the bladder?
Urine storage and excretion.
Name the four histological layers of the bladder.
Mucosa, submucosa, muscle, adventitia.
What is the most common histological type of bladder cancer?
Transitional cell carcinoma (95%).
What cancer is associated with schistosomiasis?
Squamous cell carcinoma of the bladder.
Name 4 risk factors for bladder cancer.
Smoking, age, aromatic amines, chronic inflammation.
What is the most common bacterial infection?
Urinary tract infection (UTI).
What is the route of infection in most UTIs?
Ascending infection.
Name the types of UTI by location.
Cystitis, prostatitis, orchitis/epididymitis, pyelonephritis.
Name 3 bacterial virulence factors in UTIs.
Fimbriae, polysaccharides, flagellum, toxins.
Name 4 host defenses against UTIs.
Urine flow, glucosamines, Tamm-Horsfall protein, epithelial exfoliation.
What is the length and diameter of the ureter?
25 cm long, 3–4 mm wide.
What are the three natural narrowing sites of the ureter?
PUJ, crossing of iliac vessels, VUJ.
What is the histology of the ureter?
Urothelium, 2 muscle layers, adventitia.
What organs are near the ureters?
Aorta, caecum/sigmoid colon, ovaries/uterus.
What causes congenital PUJO?
Crossing vessels (extrinsic) or hypoplastic PUJ (intrinsic).
What is Dietl’s crisis?
Flank pain after drinking large volumes of fluid.
How is PUJO treated if the kidney is functional?
Pyeloplasty.
What is the lifetime risk of urinary stones in men?
10%.
What is the most common type of urinary tract stone?
Calcium oxalate.
Name 4 intrinsic risk factors for stone formation.
Genetic conditions, Crohn’s disease, PUJO, UTIs, meds.
: Name 3 extrinsic risk factors for stone formation.
High salt/protein diet, dehydration, hot climate.
What are the functions of the testicles?
Sperm production (FSH) and androgen production (LH).
Describe sperm flow from testicle to urethra.
Seminiferous tubules → epididymis → vas deferens.
What is the most common solid cancer in men aged 30–45?
Testicular cancer.
What percentage of testicular cancers are germ cell tumours?
95%.
Name two types of germ cell tumours.
Seminomatous, non-seminomatous.
Name three risk factors for testicular cancer.
Undescended testes, HIV, family history.
What are the two age peaks for testicular torsion?
First year of life and age 12–18.
What is the cause of intravaginal torsion?
Bell-clapper deformity.
What is the treatment for testicular torsion?
Urgent surgical detorsion.
What are the main types of urethritis?
Gonococcal and Non-gonococcal urethritis.
What are common causes of urethral stricture?
Iatrogenic injury, trauma, and infection/inflammation.
What are the zones of the prostate?
Peripheral, central, transitional, and anterior fibromuscular zones.
What adrenergic receptor type controls smooth muscle in the prostate?
α-1a adrenergic receptors.
What are the main histological cell types in the prostate?
Epithelial (90%) and stromal cells (10%).
What causes BPH?
Ageing, family history, and hormonal/metabolic changes.
What zone does BPH primarily affect?
Transitional zone and peri-urethral tissue.
What is the key pathophysiological process in BPH?
Increased cell proliferation and/or decreased cell death.
What factors contribute to BPH pathogenesis?
Androgens, oestrogens, growth factors, inflammation, genetics.
What are complications of BPH?
LUTS, urinary retention, UTIs, bladder stones, bladder failure.
What is the most common type of prostate cancer?
Adenocarcinoma.
Where in the prostate does cancer most commonly originate?
75% in the peripheral zone.
What is a critical histological feature of prostate cancer?
Absence of the basal cell layer and basement membrane invasion.
How does prostate cancer typically spread?
Local: along nerves; Lymph: obturator → iliac → para-aortic; Bone: sclerotic metastases.
What is the most important prognostic indicator in prostate cancer?
Gleason score.
How is the Gleason score calculated?
Sum of the two most dominant histological patterns.
What is the function of PSA?
Liquefies seminal coagulum to aid fertilization.
What conditions can falsely elevate PSA levels?
BPH, UTI, prostatitis, recent instrumentation.
What are the three physiological narrowings of the ureter?
PUJ, crossing iliac vessels, and VUJ.
What is the histology of the ureter?
Urothelium, two muscle layers, adventitia.
What congenital condition can affect the PUJ?
PUJ obstruction from crossing vessels or intrinsic hypoplasia.
What is Dietl’s crisis?
Flank pain after drinking large volumes, seen in PUJO.
What is the typical cause of VUR?
Congenital lateral ureteral insertion into the bladder.
What law explains ureteral insertion anomalies in VUR?
Paquin’s law.
What are the most common types of urinary stones?
Calcium oxalate stones.
What are extrinsic risk factors for stones?
Geography, season, diet (high salt/protein, low fluid).
Which stones are radiolucent?
Uric acid stones.
What is the most common solid cancer in men aged 30–45?
Testicular cancer.
What are risk factors for testicular cancer?
Caucasian race, undescended testes, HIV, family history.
What are the main types of germ cell tumors?
Seminomas and non-seminomas (e.g., embryonal, yolk sac, choriocarcinoma).
What are the two types of testicular torsion?
Extravaginal (neonates), intravaginal (bell-clapper deformity).
What is the management for testicular torsion?
Urgent surgical detorsion—time critical.
