Kidney & UTI Pathology

Question 1

1,25 dihydroxycholecaliferol is also known as

Answer 1

Vit D

Question 2

What is oliguria?

Answer 2

<400ml/24h

Question 3

What is the reference range for urea?

Answer 3

3-8mmol/L

Question 4

What should not be measured until 8 hours after a meal?

Answer 4

Creatinine

50-140

Question 5

What happens to creatinine as the GFR decreases?

Answer 5

It increases

plotting the plasma creatinine can help estimate when intervention is needed in ESRF

Question 6

Tubular secretion of creatinine can be inhibited by

Answer 6

aspirin and cimetidine

Question 7

eGFR of less than 15 indicates

Answer 7

ESRF

Question 8

Renal hypoperfusuion can lead to

Answer 8

secondary hyperaldosteronism

Question 9

a patient who is unwell with a rapid rise in creatinine and urea has

Answer 9

ARF

Question 10

Proteinuria, hypoalbuminaemia and oedema point to

Answer 10

nephrotic syndrome

Question 11

oedema, proteinuria and haematuria point to

Answer 11

Nephritic syndrome

Question 12

mesangial cells of the renal corpuscle have

Answer 12

contractile and phagocytic properties

Question 13

Immunological causes of glomerular injury include

Answer 13

IgA nephropathy
SLE
Goodpasture’s syndrome

Question 14

Non-immunological causes of glomerular injury include

Answer 14

Hypertension, HUS, DM, Amyloidosis and Alport disease (inherited abnormal type IV collagen causing abnormal basement membranes)

Question 15

What can cause nephrotic syndrome?

Answer 15

Membranous nephropathy (PLA2R on podocytes) 
Focal segmental glomerulosclerosis
Minimal change disease

Question 16

What can cause nephritic syndrome?

Answer 16

IgA nephropathy (Berger's Disease) 
Post-infectious glomerulonephritis 
Vasculitis
SLE
HUS

Question 17

What is IgAN Henoch Schoelein purpura?

Answer 17

IgA nephropathy that follows throat infections and presents in BOYS with

• arthalgia
• abdo pan
• purpuric rash

Question 18

What is a risk factor for chronic pyelonephritis?

Answer 18

Urinary tract reflux

Question 19

What characteristically shows as a ‘flea bitten kidney’?

Answer 19

Hypertensive nephropathy (nephrosclerosis)

Question 20

Kimmelstiel-Wilson lesions are produced as part of

Answer 20

diabetic nephropathy

Question 21

BPH arises from where in the prostate?

Answer 21

Centrally situated TZ and periurethral cells

it is more likely to cause urinary obstruction earlier than carcinomas

Question 22

Urgency 
Hesitancy 
Increased fequency 
Nocturia 
Incomplete bladder emptying 
all point to

Answer 22

BPH

Question 23

DHT (dihydrotestosterone) is involved in the development of

Answer 23

BPH

Question 24

BRCA2 leads to a 20-fold increased risk of

Answer 24

prostate cancer

So can being African

Question 25

How is prostate cancer staged?

Answer 25

Gleason scoring system

Question 26

Does increased PSA always point to prostate canceR?

Answer 26

No

Question 27

Germ cell tumours are most common in

Answer 27

young males Seminomas Teratomas Choriocarcinoma

Question 28

Is a history of an undescended testis important?

Answer 28

Yes, it is a risk factor for testicular cancer.

Question 29

AFP is a tumour marker for

Answer 29

germ cell tumours

Question 30

bHCG points to

Answer 30

a choriocarcinoma it is elevated in testicular cancer

Question 31

VMA in the urine points to a

Answer 31

phaeochromocytoma

Question 32

What are associated with the development of testicular germ cell tumours?

Answer 32

``` Prior TGCT in the contraletral testicle impaired spermatogenesis inguinal hernia hydrocele testicular atrophy ```

Question 33

Hypogonadism can cause

Answer 33

testicular failure

Question 34

What is the most common form or renal calculi?

Answer 34

Calcium stones

Question 35

A large 'staghorn' calculi points to

Answer 35

struvite stones due to urease producing bacterial information

Question 36

Urate stones can be seen in people with

Answer 36

Gout

Question 37

most renal cell carcinomas are

Answer 37

clear cell

Question 38

What is von Hippel-Lindau syndrome?

Answer 38

Most common cancer syndrome observed in RCC VHL gene breaks down HIF-1 oncogene and loss of function leads to tumour development

Question 39

What does clear cell RC look like microscopically?

Answer 39

Clear cytoplasm with a 'nested' appearance

Question 40

Is RCC chemo resistant?

Answer 40

Yes, it tends to be

Question 41

How do urothelial cell carcinomas present?

Answer 41

Haematuria Urinary frequency Pain on urination Urinary tract obstruction

Question 42

What is the most important prognostic factor in bladder carcinoma?

Answer 42

Depth of invasion

Question 43

Urethral syndrome is caused by

Answer 43

abacterial cystitis

Question 44

what is classified using the KASS criteria?

Answer 44

significant bacteriuria

Question 45

pus in the urine with no organisms grown is known as

Answer 45

sterile pyuria

Question 46

What classifies as a 'complicated' UTI?

Answer 46

UTI in males under 65, children under 10, the presence o a foreign body and underlying abnormality

Question 47

causes of sterile pyuria include

Answer 47

'fastidious' organisms: TB, Haemophilus UT inflammation Urethritis that is sexually transmitted

Question 48

MSUs are carried out using what colour of container?

Answer 48

Red top (contains boric acid to preserve)

Question 49

Early morning urine samples are done when

Answer 49

urinary TB is suspected

Question 50

what would you use to treat a UTI?

Answer 50

Nitrofurantoin (not for upper UTIs) | Trimethoprim

Question 51

What would you use to treat upper UTIs?

Answer 51

Cefuroxime, ciprofloxacin | Tazobactam (in over 65s)

Question 52

When changing catheters, what can be given as a 'cover'?

Answer 52

Gentamicin