Week 3 - D - Pathology 2 - PKD, Kidney&Bladder carcinoma Flashcards
What is the absence of one of the kidneys known as?
Kidney agenesis
What level is the right and left kidneys located between?
Right kidney - vertebra L1-L3
Left kidney - vertebra T12-L2
Why does the right kidney sit lower than the left?
Due to the presence of the liver the right kidney sits lower
The spleen is small and does not take up as much space as the liver
fusion at either pole of the kidney, Kidneys usually lie lower ie beneath inferior mesenteric artery WHat is this?
What is a duplex system?
This is a horseshoe kidney
A duplex system means there are two ureters coming from the same kidney and inserting into the bladder
What is the most common polycsytic disease in people?
Autosomal dominant polycystic kidney disease (ADPKD)
What is the most common polycystic disease typically diagnosed in children and infants ?
This autosomal recessive polycystic kidney disease (ARPKD)
ARPKD - how does it present?
Present at birth, first year.
Bilateral flanks masses.
Dilated distal tubes, collecting ducts, enlarged kidneys at birth.
What can ARPKD lead to?
This can lead to kidney failure in children which can result in death
What can result from the poor kidney function in autosomal recessive polycystic kidney disease? It gives rise to a child with poor lung function and deformity of the face and ears
This can lead to oligohydroaminos as kidney function does not work and this causes a syndrome cause Potter’s syndrome
Potter’s syndrome classically occurs due to bilateral renal agenesis but can be seen in ARPKD
How are the kidneys involved in olioghydramnios that can lead to Potter’s syndrome?
Fetal urine production begins in early gestation and comprises the majority of the amniotic fluid in the second and third trimesters of pregnancy - therefore need working kidneys
Oligohydramnios occurs if the volume of amniotic fluid is less than normal for the corresponding period of gestation.
The fetal urine is critical to the proper development of the lungs
Adult Polycystic Disease is of autoosmal inheritance What genes/chromosomes are there mutations?
Chromosome 16 in 90% (ADPKD 1), others
Chromosome 4 (ADPKD 2).
How does adult polycystic disease usually present?
Usually presents in adult life with bilateral abdominal mass, haematuria and chronic renal failure
What are the 4Bs of adult polycystic renal disease?
Big - abdominal mass
Bilateral
Bleeding - haematuria
Berry Aneurysms in the Circle of Willis
What can the Berry Aneurysms lead to?
Berry aneursyms are small weak vessels that cause aneusyms to form and can lead to rupture causing subarachnoid haemorrhage
Due to the chronic renal failure seen in ADPKD, how can this lead to left ventricular hypertrophy?
This causes secondary hypertension which will lead to left ventricular hypertrophy when trying to pump blood around the body
What will ultrasound of the kidneys show? Can the cysts spread? (do they have a functional effect)
Ultrasound shows the large cystic kidneys
In 1/3 – cysts in liver, pancreas, lung.
No functional effect.
Adenoma – yellowish nodules usually less than 2cm in size and are cortical in the kidney
What is the tumour of fat, muscle and blood vessels known as?
This is known as an Angiomyolipoma
What is the common type of renal tumour in adults? It is known as clear cell carcinoma due to its histological appearance
This is renal cell carcinoma
Known as clear cell as the cells are clear on hisstology
Yellow colour, with solid, cystic, necrotic and haemorrhagic areas is how the kidney looks when taken out in renal cell carcinoma What can he renal cell carcinoma extend into? what condition is it associated with?
Can be assoicated with von Hippel-Lindau syndrome
What is squamous cell carcinomas of the urinary tract linked to?
Linked to the parasitic infection via Schistosomiasis found in egypt and other african countries
Can see the schistosomiasis eggs here
Also linked to smoking
