Urological histopath

Question 1

What is the most common causative pathogen in cystitis? And name some others (2)

Answer 1

85% of cystitis due to gram -ve, of which most common E. Coli Others: Strep faecalis, enterobacter, Klebsiella

Question 2

Predisposing factors to cystitis (4)

Answer 2

DM, sexually active, female, bladder calculi, cyclophosphamide associated with haemorrhagic cystitis

Question 3

Clinical features of cystitis (4)

Answer 3

suprapubic pain dysuria frequency fever (low grade)

Question 4

Complications of cystitis(1)

Answer 4

ascending infection causing pyelonephritis

Question 5

Treatment of cystitis

Answer 5

Trimethoprim/ Nitrofurantoin

Question 6

What % of bladder tumours are transitional cell? Ratio M:F?

Answer 6

90% 3:1

Question 7

2 risk factors for transitional cell tumours

Answer 7

smoking

exposure to aromatic amines (plastics & dyes)

Question 8

Clinical features of transitional cell tumours (3)

Answer 8

Painless haematuria,

frequency, urgency

Pyelonephritis/ hydronephrosis if uretal orifice involved

Question 9

Diagnosis of transitional cell tumours

Answer 9

cystoscopy & biopsy

Question 10

Where is SCC especially prevalent?

Answer 10

countries with endemic urinary schistosomiasis

Question 11

What hormone mediates BPH? Which cells are affected?

Answer 11

Mediated by dihydrotestosterone, causes hyperplasia of stromal & epithelial cells of prostate resulting in large nodules

Question 12

Symptoms of BPH (4)

Answer 12

freq,

difficulty urinating,

retention,

overflow dribbling

Question 13

What type of cancer is prostate cancer most commonly?

Answer 13

Adenocarcinoma

Question 14

Risk factors for prostate cancer (4)

Answer 14

age,

FH,

environment/ hormonal exposure,

race

Question 15

Where does prostate cancer spread locally? & haematogenously?

Answer 15

Bladder

Bone

Question 16

How is Prostate cancer graded?

Answer 16

Gleason system - based on degree of differentiation & glandular patterns

Question 17

Diagnosis of prostate cancer?

Answer 17

PSA > 4ng/ml is indicative (also from history & exam)

Question 18

What is the most common type of testicular tumour?

Answer 18

Seminoma (peak age 30s & is radiosensitive)

(originates in germinal epithelium of seminiferous tubules)

Question 19

When can a testicular teratoma occur? When is it regarded as malignant?

Answer 19

Any age.

Malignant when occurs post-puberty

Question 20

Name 3 biological markers for germ cell tumours?

Answer 20

AFP,

HCG,

LDH

Question 21

What is the main clinical feature of a testicular tumour?

Answer 21

painless enlargement

Question 22

If a patient has maldescended testis, where are they most likely to be? And is he at increased risk of testicular cancer?

Answer 22

Inguinal canal (95%) yes 10 times increased risk

Question 23

Name 3 types of renal cell carcinomas

Answer 23

Clear cell (well differentiated) ( a renal cortical tumor typically characterized by malignant epithelial cells with clear cytoplasm )

Papillary carcinoma ( commonest in dialysis associated cystic disease)

Chromophobe renal carcinoma (pale, eosinophilic cells)

Question 24

What are some risk factors for renal cell carcinoma? (5)

Answer 24

CKD,

obestiy,

HTN,

smoking,

unopposed oestrogen

Question 25

Clinical features of renal cell carcinoma (3)

Answer 25

**palpable** mass, **haematuria**, **costovertebral** pain

Question 26

Paraneoplastic syndromes in renal cell carcinoma (3)

Answer 26

**polycythaemia, hypercalcemia, Cushing's syndrome**