Diseases of the Renal System 2 Flashcards Preview

Clinical Pathology > Diseases of the Renal System 2 > Flashcards

Flashcards in Diseases of the Renal System 2 Deck (37):
1

Causes of obstructive uropathy in the pelvis and kidney

Calculi
Tumours
Stictures

2

dilated calyces, dilated pelvis, corticol atrophy

Hydronephrosis

3

A type of obstruction with pain and acute renal failure and anuria

Acute bilateral obstruction

4

A type of obstruction which is asymptomatic initially with corticol atrophy and decreased renal function

Chronic unilateral obstruction

5

A type of obstruction which is initially polyuric with progressive renal scarring and impairment

Bilateral partial obstruction

6

Another name for renal calculi

Urolithiasias

7

Are renal calculi more common in males or females?

Males

8

4 causes of renal calculi

Excess of substances
Change in urine constituents
Supersaturation
Decreased citrate levels

9

Why does decreased citrate levels predispose you to renal calculi?

Citrate combines with Ca2+ and prevents calcification.

10

Not peeing for a long tiem

Supersaturation

11

What conditions can cause renal calculi though precipitation of excess substances?

Bone disease
Increased PTH
Sarcoidosis

12

Name 4 things that renal calculi can be made of

Calcium (70%)
Struvite-produced by bacteria
Urate stones-uric acid
cystine stone

13

Describe the pathogenesis of struvite stones

Urease producing bacterial infection-converts urea to ammonia.
Ammonia increases the urine pH
Precipitation of magnesium ammonium phosphate salts

14

What component are struvite stones made out of?

Magnesium ammonium phosphate salts

15

Describe the calculi that form from struvite

Large 'staghorn' calculi

16

Who is predisposed to developing urate stones?

People with hyperuricaemia (a consequence of gout or patients with a high cell turnover e.g. leukaemia)

17

What kidney stones do you get if you can't reabsorb amino acids?

Cysteine stones

18

3 ways you can investigate for renal calculi

Non-contrast CT scanning
Ultrasound in pregnancy where CT is not possible
IV urography- inject dye

19

4 complications of renal calculi

Obstruction
Haematuria-destroys lining of endothelium
Infection
Squamous metaplasia-chronic irritation. Precursor for squamous cell carcinoma

20

What is the most common type of renal cell carcinoma

Clear cell

21

Apart from clear cell, name 2 other types of renal cell carcinoma

Papillary
chromophobe

22

Is renal cell carcinoma more common in males or females?

Males

23

What are the main risk factors for renal cell carcinoma

Smoking
obesity
hypertension
oestrogens
acquired cystic kidney disease
asbestos exposure

24

A genetic disease associated with renal cell carcinoma, especially clear cell

Von Hippel Lindau Syndrome

25

Von Hippel Lindau syndrome is a malfunction of what gene?

VHL gene required for breakdown of hypoxia-inducible factor 1 (HIF-1) tumour suppressor gene. Loss of gene function causes cell growth and T cell survival (Von Hippel in Hifi)

26

Where do tumours commonly develop in Von Hippel lindae syndrome

Kidneys, blood vessels, pancreas

27

How does renal cell carcinoma present

Haematuria
palpable abdominal mass
costovertebral pain
If late presentation-systemic symptoms or metaplasia
paraneoplastic syndromes

28

what paraneoplastic symptoms are seen in renal cell carcinoma

Cushings-ACTH
Hypercalcaemia-PTH
Polycythaesia-erythropoietin

29

Describe the morphology of clear cell carcinoma

Clear cells- nucleus/cytoplasm are dissolved during processing
Well defined yellow, often with haemorrhagic areas
May extend into perinephric fat or into renal vein

30

Describe the morphology of papillary carcinomas

More cystic, multiple, bilateral
Cuboidal, foamy cells.
Surround fibrovascular cores often containing foamy macrophages or calcium

31

Prognosis with renal cell carcinoma

Chemo-resistant-v.poor prognosis with metastases

32

Where do 95% urothelial cell carcinomas develop

Bladder

33

Risk factors for urothelial cell carcinomas

Age
Male
Carcinogens (smoking, cylamines, radiotherapy)

34

Presentation of urothelial carcinomas

Haematuria
Urinary frequency
Pain on urination
Urinary tract obstruction

35

What are the 2 types of urothelial carcinomas

Papillary (more common)
Flat (usually high grade)

36

If the tumour invades the muscularis propria (T2) of the bladder, what is the treatment

Resect bladder

37

Prognosis for urothelial carcinomas

Recurrences are common
Cytoscopy-regular follow up