Histopath - urology

Question 1

Epidermoid cyst - which area does this affect? what is it?

Answer 1

Scrotum

Benign skin cysts filled with keratin

Question 2

Scrotal calcinosis - what is this?

Answer 2

Calcified nodules in scrotal skin

Question 3

Blue/red lesions of scrotal skin?

Answer 3

Angiokeratomas

Question 4

Fournier’s gangrene?

Answer 4

Necrotising fasciitis on scrotum

15-20% mortality

Question 5

Scrotal squamous cell carcinoma - importance?

Answer 5

Assoc with occupational exposure to carcinogens in chimney workers

Question 6

Condylomas?

Answer 6

Warts caused by HPV on penis

Question 7

Inflammatory disease of foreskin –> tightening of foreskin

Answer 7

Lichen sclerosus

Question 8

Inflammatory disease of glans –> red areas

Answer 8

Zoon’s balanitis

Question 9

Which paratesticular disease is associated with STIs in <35yo? what is the causative organism in >35yo?

Answer 9

Epididymitis.

E. Coli in older men

Question 10

What is a hydrocele?

Cause?

Answer 10

Accumulation of fluid between 2 layers of tunica vaginalis

Cause - trauma or other underlying pathology

Question 11

Varicocele

Answer 11

Abnormal dilatation of venous plexus in SPERMATIC CORD

Question 12

A benign paratesticular neoplasm? What is the appearance? Histology?

Answer 12

Adenomatoid tumour

• Small solid grey/white nodules
• Small tubules lined by mesothelial cells

Question 13

3 testicular tumours which are NON-germ cell. Prognoses?

Answer 13

Testicular lymphoma - v poor

Leydig and Sertoli cell tumours - benign

Question 14

Testicular germ cell tumours

• RFs?
• affected age group?

Answer 14

• undescended testis (cryptorchidism). also LBW

- Young men, age 20-45yo

Question 15

Precursor lesion for germ cell tumours?

Answer 15

Intratubular germ cell neoplasia (ITGCN)

Question 16

Presentations of testicular germ cell tumours?

Answer 16

Painless testicular lump - MOST COMMON

Can present with metastatic disease - back pain, resp Sx

Question 17

Prognosis of testicular germ cell tumours? why?

Answer 17

• 98% survival at 5 years

- they are v sensitive to platinum based chemo!

Question 18

Renal stones - are men or women more commonly affected?

Answer 18

Men

Question 19

Renal stones - composition?

Answer 19

most are calcium oxalate

Question 20

2 causes of hypercalciuria –> renal stone formation?

Answer 20

Either GI calcium absorption OR high Ca reabsorption in renal PCT

Question 21

“triple stones” - what are they?and how do they form?

Answer 21

Magnesium Ammonium Phosphate

Question 22

What is the danger of “triple stones?”

Answer 22

Risk of forming huge staghorn calculi

Question 23

Common points of renal stone impaction

Answer 23

VUJ
Pelvic brim
PUJ

Question 24

Removal of larger stones?

Answer 24

Lithotripsy

percutaneous/endocscopic removal

Question 25

benign kidney tumour associated with multiple sclerosis?

Answer 25

Angiomyolipoma

Question 26

Benign mesenchymal kidney tumour - what is it called? composition? Presentation?

Answer 26

Angiomyolipoma - thick walled blood vessels, SM, fat - can present with flank pain

Question 27

Kidney tumour with high fat content

Answer 27

Angiomyolipoma

Question 28

Genetic syndrome associated with renal cell carcinoma?

Answer 28

von Hippel Lindau

Question 29

major RF for renal cell carcinoma

Answer 29

Long term dialysis, smoking

Question 30

3 main histological subtypes of renal cell carcinoma

Answer 30

Clear cell Papillary Chromophobe

Question 31

3 main histological subtypes of renal cell carcinoma

Answer 31

1. Clear cell 2. Papillary 3. Chromophobe

Question 32

Diff in gross appearance between papillary and chromophobe renal carcinomas?

Answer 32

Papillary= | Chromophobe =

Question 33

Most common subtype of renal carcinoma

Answer 33

Clear cell

Question 34

Genetic change in clear cell renal carcinoma

Answer 34

loss of chromosome 3p

Question 35

Golden yellow tumours in haemorrhagic areas

Answer 35

Clear cell

Question 36

Diff in gross appearance between papillary and chromophobe renal carcinomas?

Answer 36

``` Papillary= friable and brown Chromophobe = solid and brown ```

Question 37

Genetic change seen in papillary renal cell carcinoma

Answer 37

Trisomy 7 and 17

Question 38

Histology of renal carcinoma shows sheets of large cells. Which subtype is this?

Answer 38

Chromophobe

Question 39

Grading system of renal cell carcinoma? what is it based on?

Answer 39

Fuhrman system | Based on degree of nuclear atypia

Question 40

Small round blue cells

Answer 40

Wilm's tumour

Question 41

What is a urothelial carcinoma

Answer 41

Any neoplasm affecting renal pelvis --> bladder

Question 42

2 types of urothelial carcinoma (carcinoma is really a misnomer)

Answer 42

Invasive and non-invasive

Question 43

Grading of non-invasive urothelial carcinoma

Answer 43

1-3 | 3 = high risk

Question 44

Tx of non-invasive urothelial carcinoma

Answer 44

Resection of visible tumour with cystoscopy +/- intravesical chemotherapy

Question 45

If invasive urothelial carcinoma goes beyond the detrussor muscle, how is it managed?

Answer 45

Cystectomy +/-radio +/- chemo

Question 46

2 main medication options for BPH

Answer 46

alpha blockers | 5-alpha reductase inhibitors

Question 47

Surgical management of BPH

Answer 47

Transurethral resection of the protstate

Question 48

Precursor lesion to prostatic carcinoma

Answer 48

Prostatic intraepithelial neoplasia

Question 49

Name some genes implicated in prostatic carcinoma

Answer 49

``` PTEN GST-pi AMACR p27 E-Cadherin ```

Question 50

Prognostic indicator of prostatic carcinoma? how is it determined?

Answer 50

Gleason score | - add up the 2 most common gleason patterns

Question 51

Gleason score - highest score? lowest score?

Answer 51

6-10 i.e. 3+3 --> 5+5