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Flashcards in Pathology Deck (25):
1

What is glomerulonephritis

Non-infective
glomerular tufts with secondary tubulo-interstitial changes
Usually diffuse, may be focal

2

What usually causes glomerulonephritis

Immunological mechanisms often after an upper respiratory tract infection

3

What is pyelonephritis

A bacterial infection of the renal pelvis, calyces, tubules and interstitial

4

What are the common presenting symptoms of pyelonephritis

Pyrexia, sweating an other GU symptoms

5

What is the commonest organism seen in pyelonephritis

E Coli
Also pseudomonas, strep or fungi

6

Pyelonephritis is more common in who? men or women

women

7

What is the pathogenesis of pyelonephritis

Blood-borne (rare) in septicaemia, post surgery
due to ascending infection from the more distal end of the urinary tract (cystitis)

8

What are some of the risk factors for pyelonephritis

Age and sex:
Females (shorter, wider urethra)
Pregnancy (ureteric dilatation
Instrumentation or surgery carries a risk of UTI
UT Obstruction e.g. calculus, stricture, neoplasm congenitla anomaly, prostatic and urethral pathology (elderly males)
Diabetics
Vesico-ureteric reflex - if ureters are more perpendicular, then infection can travel back up to the kidney

9

What is the main inflammatory cell seen in pyelonephritis

Neutrophil

10

What are the signs and symptoms of chronic pyelonephritis

Often no previous history of UTI
Vague symptoms
Hypertension and / or uraemia (uric acid level)
Large volume of urine
Coarse cortical scarring and distortion of calyces on renal imaging

11

Why is there large volumes of urine passed in a patient with chronic pyelonephritis

The kidney is scarred and so the patient can't concentrate the urine

12

What is lost and in pyelonephritis and what replaces it

Glomerular loss and replaced by a hyaline ball of connective tissue

13

How is tuberculous pyelonephritis spread

Haematologically spread usually from the lung

14

What are the symptoms and signs of tuberculous pyelonephritis

Vague symptoms: weight loss, fever, long pain, dysuria
Sterile pyuria

15

How is TB pyelonephritis diagnosed

PCR

16

What organisms cause cystitis

E Coli
Klebsiella
Proteus
Pseudomonas

17

What can resemble tumours in cystitis

Ureteritis and cystitis Cystica

18

Why does urinary tract obstruction result in hypertrophy of the muscle lining

Prolonged outlet obstruction causes more urine to be held in the bladder for longer which causes an increase in pressure

19

What is hydronephrosis

Dilatation of pelvicalyceal system with parenchymal atrophy

20

What are the 2 main causes of hydronephrosis

Urinary tract obstruction and reflux

21

What structure usually results in bilateral hydronephrosis

The urethra
neurogenic disturbance
VUR
bilateral ureteric obstruction e.g. advanced carcinoma of cervix

22

What usually causes unilateral hydronephrosis

Presence of stones but can also be neoplasms

23

What type of obstruction is more likely to cause hydronephrosis

Gradual, partial or intermittent obstruction compared to a sudden and complete

24

Why does pyonephrosis sometimes occur in hydronephrosis

Secondary infection often follows stasis

25

Describe the typical appearance of detrusor muscle hyperplasia

Typical criss cross pattern