MB2: Renal > Pathology > Flashcards

Pathology Flashcards

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1
Q

describe the endothelial appearance of the glomerular capillary

A

endothelial cells
basal lamina
podocytes and foot processes
mesangial cells on inside

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2
Q

what epithelia lines bowmans capsule

A

parietal epithelia

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3
Q

what antibody is present in goodpastures

A

IgG against alpha 3 subunit of collagen 4

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4
Q

what type of ANCA is GPA associated with

A

cANCA

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5
Q

what type of ANCA is MPA associated with

A

pANCA

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6
Q

classic presentation of nephrotic syndrome

A

hypoalbuminuria
oedema
proteinuria >3g daily
hyperlipidaemia

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7
Q

classic presentation nephritic syndrome

A

hypertension

haematuria

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8
Q

why are those with nephrotic syndrome at increased risk of thrombosis and immunosuppression

A

loss of cotting cascade and complement

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9
Q

what three methods can be used to classify GN

A

light microscopy
electron microscopy
immunofluorescence

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10
Q

what does crescentic GN indicate

A

rapidly progressive GN

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11
Q

what does the presence of granulomas relative to GN

A

GPA

sarcoid

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12
Q

a linear pattern IgG on immunofluorescence is indicative of?

A

goodpastures syndrome

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13
Q

minimal change GN - cause, who is it more common in, nephritic or nephrotic, treatment and prognosis

A 
idiopathic 
children 
nephrotic 
steroids 
good prognosis
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14
Q

pathological appearance of minimal change GN

A

not much to see

podocyte foot process effacement

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15
Q

cause of FSGN

A

obesity
sickle cell
HIV
PWID

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16
Q

who is FSGN more common in, pathology and nephrotic/nephritic

A

adults
nephritic
glomerular involvement in parts and scarring

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17
Q

causes of membranous GN

A

hepatitis, SLE, malaria, syphilis
gold, penicillamine, NSAIDs, captopril
cancer

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18
Q

what cancers can lead to membranous GN

A

lung
colon
melanoma

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19
Q

membraneous GN - nephrotic/nephritic, pathology appearance, prognosis

A

nephrotic
thick membranes with sub-epithelial immune deposits
variable

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20
Q

causes of IgA nephropathy
nephritic or nephrotic?
prognosis and pathological appearance?

A 
nephritic 
genetic or acquired 
post infeciton 
IgA in mesangium
prognosis depends
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21
Q

cause of type 1 membranoproliferative GN

A

idiopthic

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22
Q

cause of type 2 membranoproliferative GN

A

infection
malignancy
SLE

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23
Q

who does membranoproliferative GN affect, nephrotic/nephritic, pathological appearance?

A

children and adults
nephrotic and nephritic
hypercellular glomeruli with tram track membranes

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24
Q

how does diabetic GN appear pathologically

A

diffuse and nodular glomerulosclerosis

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25
what are diabetic GN nodules referred to as?
kimmel steil wilson lesions
26
how common are acquired renal cysts
very
27
describe the local complications of ADPKD
haemorrhage, infarct, rupture | can lead to pain or haematuria
28
what are the systemic complications associated with ADPKD
liver cysts | cerebral aneurism
29
true/false - ARPKD is a childhood disease
true
30
pathological appearance of an oncocytoma. is it benign or malignant?
small, oval, well circumscribed central scar it is benign
31
appearance of a chromophobe tunour
similar to oncocytoma, but have raisin lie nuclei with halo
32
risk factors for clear cell cancer
obesity | genes
33
what do clear cell cancers sometimes extend down
the renal vein, to the IVC
34
what do most sporadic CCC have muitations in
von hippel lindau, Hypoxia inducable factor
35
histological appearance of papillary cell cancer
finger like projections
36
prognosis of collecting duct carcinoma
very very poor
37
common renal tumour of paediatrics
wilms tumour
38
what types of cancers are VHL syndrome associated with
``` renal cell epididymal serous cancer tumours of endolymph sac pancreatic serous cystadenoma cerebellar haemangioblastoma ```
39
what type of epithelia is the bladder made up of
transitional type
40
what other parts of the urinary tract are made up of transitional epithelia
bladder, ureters, collecting system
41
3 types of cystitis
parasitic aseptic cather reactivw
42
features of aseptic cystitis
persistent dysuria | persistent -ve cultures and urinalysis
43
what is the most likely parasite in parasitic cystitis
schistosomiasis, central africa
44
what is the natural history of schistosomiasis infection
causes metaplasia due to persistent infection, leading to squamous cell cancer
45
what is the natural history of catheter reactive cystitis
can lead to inflamamtion, metaplasia and SCC
46
causes of urinary diverticulae
stones tunours infection
47
what is hydronephrosis
dilation of the collecting system due to urinary obstruction leading to atrophy of renal parenchyma
48
bilateral hydronephrosis is indicative of?
low down urinary blockage
49
what is the most common of urinary obstruction in men and its pathophysiology
prostatism | hyperplasia of the bladder muscle due to enlarged prostate, leading to raised back pressure
50
what are the risk factors for urothelial neoplasia
middle age and elderly age beta-naphthalene smoking - biggest risk
51
how many transitional cell cancer appear in the bladder
flat CIS or finger like projection
52
what are the risk factors for urinary SCC
any form of persistent inflammation leading to metaplsia | infection, catheters, sometimes aseptic
53
how can you tell if a urinary adenocarcinoma is secondary to the bowel or primary from persistent inflammation
imaging alone
54
what is urachal adenocarcinoma
adenocarcinoma in the urachus, patent part of the alantois from dome bladder to umbilicus
55
why is the prostate smaller in younger age
it is under androgenic stimuli
56
what sections of the prostate are affected by BPH
central and transitional
57
where is the transition zone located
anterior to transitional zone but posteroinferior to fibromuscular stroma
58
where is the peripheral zone located and what does it encircle
posteror and covers back of central zone and inferior prostatic urethra
59
risk factors for prostate cancer
cadmium batteries | increasing age
60
where is prostate cnacer normally found
peripheral zone
61
what histological type is adenocarcinoma
adenocarcinoma
62
function of PSA
liquifies semen to allow sperm to swim
63
how sensitive and specific is PSA
not very at all, high grade cancers dont even produce it
64
false positives in PSA
``` prostatitis spironolactone cycling DRE big prostate ```
65
what is the gleason scoring system
grading for prostate cancer | lowest is 6 and highest 10
66
histology of urethra
squamous distally and transitional cell more prox
67
what is BXO and how may it appear
balantitis xerotica obliterans young present iwht phimosis/paraphimosis lighen like band of inflammatory cells with hyaloid cartilage
68
what type HPV causes genital warts
6/11
69
what type HPV is a red flag
16/18
70
who is vaccinated for HPV nowadays?
women and men
71
what is PEiN and describe its differentiation
penile intraepithelial neoplasia SCC with haematogenous spread can be differentaited with no HPV or defifferentiated with HPV
72
what is a spermatocele
paratesticular cyst in vas deferens | full of sperm
73
what is a hydrocele
accumulation of fluid in tunica vaginalis unicystic, smooth, fluid filled transluminates
74
what is a varicocele
varicosity of venous plexus | bag of worms
75
how long before testical is infarcted in tescicular torsion
6 hours
76
who gets testicular torsion and how does it present
young/adolescents | sleep, present at any time with acute scrotum
77
what is a bell clapper deformity and what does it predispose
insertion of tunica vaginalis is high so testis can rotate and sit laterally
78
risk factors for seminoma and blood test
~40yrs undescended testis raised LDH
79
true/false - contralateral testicle of undescended shares risk of seminoma
true
80
types of non-seminoma
mature teratoma yolk sac embronal trophoblast
81
what marker is used in trophoblast
HCG
82
what marker is used in yold sac cancer
AFP
83
what marker can be used in choriocarcinoma
bHCG
MB2: Renal
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