Week 3 - Renal and Male genital pathology tutorial Flashcards
What is glomerulonephritis?
Inflammation of the glomerulus of the kidney
Person comes in with a sore throat and is treated sufficiently for it. 3 weeks later presents with headache, oedema and other
The streptococcal sore throat caused the glomerulonephritis
What does minimal change glomerulonephritis cause?
This causes nephrotic syndrome
What is nephrotic syndrome characterised by?
Proteinuria - greater than 3g/day
Oedema
Hypoalbuminaemia (can also have hyperlipidaemia)
What does the urine look like in nephrotic syndrome?
Frothy urine with fatty casts
What is IgA mediated nephropathy usually associated with? Presents in children commonly What predisposes to it?
Henoch Schnolein pupura
Classically after a respiratory or a GI infection
What is pyelonephritis?
Infection of the kidney, causing inflammation (can be acute or chronic as there is inflammation)
What is the most common way a person gets acute pyelonephritis?
infection (retrograde infection from urinary tract, usually from bladder infections, acute cystitis – most commonly due to Ecoli)
– worse form of ascending pyelonephritis could be septicaemia
Hypothetically, if we sliced up the kidneys what would we see in pyelonephritis?
Would see pus due to the neutrophils trying to combat the infection
What effects does hypertension have on the kidney? (ie the astherosclerosis/RAAS cycle)
Damages the renal artery by leading to renal artery atherosclerosis, will cause decreased blood flow to the kidney reducing the GFR and therefore the cycle continues as RAAS system is activated and this causes further hypertension etc
Malignant hypertension – sustained hypertension, medical emergency, BP 180/120 What does this look like on histology of the kidney?
Malignant hypertension on histopathlology has a characterizing lesion of the onion skinning of the interlobular arteries
Can also see the fibrinoid necrosis on histopathology in arterioles and glomerular tufts
What pathological lesions may be found in the kidney in a patient with diabetes mellitus?
Kimmelstiel Wilson nodules - due to the nodular glomerulosclerosis cause by diabetes (due to the direct injuries to the capillaries)
In association with the pyelonephritis caused by renal artery stenosis, what can be seen in the kidneys? (it is referring to
Can cause renal papillary necrosis
What are the 4 main cystic diseases of the kidney?
Simple renal asymptomatic cysts
ARPKD - autosomal recessive PKD (kids)
ADPKD - autosomal dominant PKD (adults)
Renal dialysis associated cyts
Which between ARPKD and ADPKD presents in children?
ARPKD - presents in children
ADPKD - presents in adults
Kidneys are replaced by cysts and cause destruction of the kidney leading to the functional renal parenchyma being destroyed
What is the presentation/complications of polycystic kidney disease?
Big, Bilateral, Bleeding and Berry anuersysm in the circle of willis that can haemorrhage causing a massive sub arachnoid haemorrhage
What is an associated condition with ARPKD?
Associated with congenital hepatic fibrosis
What is hydronephrosis?
This is dilatation of the renal pelvis due to an obstruction leading to the backflow of urine in the kidney
What is the name of the condition where ureteric valves can cause bacflow of urine causing hydronephrosis?
Vesico-uteric reflux
Renal cell carcinoma is a type of adenocarcinoma What is likey to worsen the prognostics of the disease?
If the carcinoma has invaded into the renal vein or perinephric fat
What are aetiological factors for bladder cancer? (for both transitional and squamous)
TCC - dyes, rubber and smoking (also long term cyclophosphamide)
SCC - chronic cystitis and schistosomiasis
What age group do BPH affect vs prostatic carcinoma? What hormones drive both?
BPH and prostatic carcinoma both affect the elderly
BPH is oestorgen dirven
Prostatic carcinoma is androgen driven
Which zone/lobes of the prostate gland does BPH and prostatic carcinoma develop in?
BPH is oestrogen driven and develops in the transitional zone (usually in the middle lobe)
Prostatic carcinoma is androgen drive & develops in the peripheral zone (posterior lobe)
What are the two potential serum markers in prostate cancer?
Prostate specific antigen (PSA)
Prostatic acid phosphatase
What is the commonest and second commonest germ cell tumour? (testes)
Commonest - seminoma
Second commonest - teratoma
What is the peak incidence age group in both seminoma and teratoma?
Seminoma - age 30-50
teratoma - age 20-30
What does the macroscopic view of a seminoma look like?
It looks potato like
What are the treatments for seminoma and teratoma?
Seminoma - orchidectomy with radiotherapy
Teratoma - orchidecotomy with chemotherapy
What are the tumour markers for seminoma?
PLAP -placental alkaline phosphatase
What are the tumour markers for teratoma?
bHCG - 100% in trophoblastic malignancy
AFP - alphafeto protein if there is yolk sac remnants (usually choriocarcinomas)
The serum markers can be checked to follow progression of the disease
