Pathology Lectures (All Reading Flashcards
1
Q
What are the sminomatous tumors as part of the germ cell tumors
A
- Seminoma
- Spermatocytic seminoma
2
Q
Alport syndrome will have which other clincal presentations
A
Chronic renal failure with nerve deafness, eye disorders such as lens dislocation, posterior cataracts, and corneal dystrophy
3
Q
What is the most common renal cell carcinoma
A
Clear cell carcinoma (70-80%)
4
Q
What complication is acquired (dialysis-associated) cysts associated with
A
Renal cell carcinoma
5
Q
Patients with analgesic nephropathy are associated with developing which condition
A
Urothelial carcinoma of the renal pelvis
6
Q
Sickle cell nephropathy will usually show which morphological features
A
- Diffuse cortical necrosis
- Cortex is pale due to ischemic necrosis
7
Q
What are the diseases of the renal medulla
A
- Medullary sponge kidney
- Nephronephrothiasis cystic disease
8
Q
What are the tow Major histological findings of the progression to ESRF
A
- Tubulointersitital fibrosis
- FSGS (focal segmental glomerulosclerosis)
9
Q
What are the extrarenal manifestations of The autosomal dominant polycystic kidney disease (ADPKD)
A
- hepatic cysts
- subarachnoid hemorrhages from Berry aneurysms
- Mitral valve prolapse
- Diverticular disease
10
Q
What cell type lines lol blood vessels
A
Endothelial cells
11
Q
Clear cell carcinoma the familial form with which deletions
A
98% have:
Chromosome 3 deletion, which is the VHL suppressor gene
12
Q
What is the the target antigen in Goodpasture
A
No collagenous regions of collagen type 4
13
Q
What is the single most important to ask a patient with suspected renal disease
A
“Have you had this before?”
14
Q
What is the most common cause of vesicourital reflux
A
-Congenital, with partial or complete lack of oblique entry/angle of the intravesical portion of ureter
15
Q
What is the localization of immune complexed in the glomerulus during membranous nephropathy
A
Epimembranous deposits
16
Q
What is the most common genetic cause of ESRD
A
-Nephronopthisis-medullary cystic disease
17
Q
Clear cell carcinoma is most commonly which form
A
Sporadic (95%), but hereditary (4%)
18
Q
Which condition in males is commonly the cause of papillary necrosis
A
Obstruction
19
Q
Tubulointerstital nephritis is generally characterized by which conditions
A
- Azotemia
- Inability to concentrate urine
20
Q
What is the prognosis of anaplastic hisomorphology of Wilms tumors
A
Unfavorable
21
Q
Atypical hemolytic uremic syndrome (HUS) is commonly caused by
A
- Inherited mutations of proteins that regulate complement
- Multiple squired causes of endothelial injury such as chemo
- Antiphospholipid syndrome, pregnancy, systemic sclerosis
22
Q
What is the cause of post renal azotemia
A
Urine flow obstruction distal to the calyces and renal pelvis, which can be fixed with removal of the obstruction
23
Q
What is the cause of prerenal azotemia
A
Hypoperfusion of the kidneys that impairs renal function in the absence of actual parenchymal damage
24
Q
What is the pathogenesis of Membranoproliferative glomerulonephritis (MPGN) type 2 (aka dense Deposition disease
A
Nephritic factor, aka C3NeF, is present and stabilizes the C3 convertase and chronic activation of the alternative pathway
25
What are the characteristics of the neonatal forms of The autosomal recessive polycystic kidney disease (ARPKD)
- 60% of renal collecting ducts are cystic, mild hepatic fibrosis
- Due within months, usually due to renal failure
26
What is the most telling sign for the prognosis of bladder cancer
Depth of muscle invasion
27
What is the definition of acute kidney injury
1. Rapid decline in GFR
2. Severe forms show oliguria or anuria
3. Can be reversible or progress to chronic
28
The large portion on UTIs are due to which bacteria
Enteric
29
What are the common endothelial injury triggers for thrombotic microangiopathies
- Bacterial toxins
- Cytokines
- Viruses
- Captain medications
- Anti-Endothelial antibodies
30
What is the effect on renal function in the case of benign nephrosclerosis
Not usually associated with renal insufficiency
31
What are the histological findings of renal oncocytomas
- Abundant acidophilus, granular cytoplasm
| - Alvelar nesting, tubular or solid pattern
32
What is the histological cell type in interstitial cystitis aka Hunner Ulcer
Mast cells
33
What are the main immune components involved in Membranous glomerulopathy
-IgG4 and MAC complex
34
What is the prognosis of Membranoproliferative glomerulonephritis (MPGN) type 2 (aka dense Deposition disease
Worse than type 1, with recurrence in transplanted patients
35
What type of tumor is a carcinoma in situ (CIS) aka flat non-invasive urothelial
Urothelial tumors
36
What is the effect of the neurological system due to uremia
- Uremic encephalopathy such as fatigue, muscle weakness, malaise, asterisks
- amyloid deposits in medial nerve neuropathy,carpal tunnel
- Peripheral neuropathy
37
The acquired diverticula is due to which cause
Prostatic enlargement producing obstruction to urine outflow and thickening of the bladder wall
38
What percentage of patients progress to chronic glomerulonephritis if the have had crescentic GN
90%
39
Renal oncocytomas arise from which cells
Type A intercalated cells of the renal cortical collecting ducts
40
What is the most prognostic element in Wilms tumor
-Absence or presence of the diffuse anaplasia (will decide the prognostic element)
41
What are the common histological findings in membranoproliferative glomerulonephritis (MPGN)
- Alterations to the GBM
- Proliferation of glomerular cells (mesangial cells primarily)
- Leukocyte infiltration (neutrophils)
42
Rahbdomyosarcoma of the bladder is what kind of tumor
Malignant mesenchymal tumor
43
What is the typical findings for when acute proliferative glomerulonephritis presents
1-4 weeks following pharyngitis or skin infection (especially Strep B toxin (SpeB)
44
How is post infectious glomerulonephritis due to staphylococcus different than otherswith regards to the immunoglobulin
IgA commonly, rather than IgG like normal
45
Which tumor is aka hypernephroma
Clear cell
46
The autosomal dominant polycystic kidney disease (ADPKD) Ultimately results in which conditions
Bilateral Multiple expanding cysts of both kidneys that destroy the renal parenchyma and results in renal failure
47
What is the prognosis of membranoproliferative glomerulonephritis (MPGN) type 1 (primary and secondary)
50% develo chonic renal failure over 10 year span
48
Papillary renal cell carcinoma is most commonly related to which condition
Trisomy 7
49
What are the morphological findings of malacoplakia
Cystitis of bladder with inflammatory exudate and broad, flat plaques involving the entire bladder
50
The majority of children with nephrotic syndrome are due to which cause
Primary glomerular disease, with minimal change disease being the highest (95%)
51
What are the usual histological findings in RPGN type 2
Cell proliferation within the glomerular tuft, along with crescent formation, along with granular IF staining
52
What are the collecting duct carcinoma characteristics
-Showing branching tubules lined by highly atypical cuboidal cells
53
What is the diffuse proliferative glomerulonephritis characterized by
Marked hypercellularity, from the simple mesangial to complex endocapillary cell infiltrate
54
What is the prognosis of a primary malignant lymphoma
Good prognosis
55
What are the genetic predispositions to urothelial carcinomas
- Chromosome 9 monosomy or deletion
| - Chromosome 17 deletions
56
Minimal change disease will usually develop and is associated following which events
Respiratory infection or immunization
57
During diabetes, what seems to be the main mechanism of damage to the glomeruli
Persistent hyperglycemia causing glucotoxicity
58
In electrophoresis, what is the most common serum proteins and where is it located on electrophoresis
-Albumin is the most common, and travels the farthest towards the positive electrode since it is negatively charged
59
During the recovery phase of acute kidney injury, what are the clinical issues
- Hypokalemia
| - Susceptibility to infection
60
Goodpasture syndrome is charactertized by which immune components
Anti-GBM Antibodies, linear depositis of IgG, C3 in the GBM
61
Which portion of the kidney is involved in Alpert syndome
* Hereditary
| - Glomerular
62
Neurofibroma of the balder is what kind of tumor
Benign
63
Leiomyosarcoma is what kind of tumor
Malignant mesenchymal tumor
64
What is the process of injury in acute tubular injury
Necrotic tubular epithelial cells will detach and localize in the tubule, resulting in obstruction of flow
65
What are the typical findings in the majority of patients with urothelial carcinoma
-Non invasive, which can be removed with transurethral resection (TUR), or intravesical therapy, chemo or BCG
66
What patient population common has IgA nephropathies
Most common in the 20-30s and white and Asians, male with some family history
67
IgA nephropathy is which disease if there is no systemic disease
Berger disease
68
What is the usual clinical presentation of urothelial carcinoma
-Painless hematuria
| “Dominant clinical finding, as well as typically the only finding
69
What are the histological findings of the kidney in those patients with DM
- Diffuse, general thickened tubular basement membranes
- Massive increased in mesangial matrix (narrows capillary lumen)
- Messangial sclerosis
70
What is the localization of immune complexed in the glomerulus during lupus nephritis
Subendothelial deposits
71
What is malacoplakia generally associated with
Defective phagosome function, usually with chronic infection of E. Coli
72
IN unilateral multicystic renal dysplasia commonly presents as what
Abdominal mass in a child
73
What are the characteristics of acquired (dialysis associated) cysts
-Cortical and medullary locations, with numerous filled clear fluid
74
Which portion of the kidney is involved in wegener granulomatosis
Glomerular
75
What are the characteristics of RPGN or rapidly progressive (crescentic) glomerulonephritis
Collapsed, compacted glomerular tufts resulting in:
- Crescent shaped mass of proliferating visceral and parietal epithelial cells
- Rapid obliteration of urinary space
- Infiltrates of macrophages and leukocytes
76
During diffuse proliferative glomerulonephritis, what is the leukocyte infiltration location
Exudative withing the glomerular tuft
77
What are the characteristics of the minority of patients with urothelial carcinoma
-Invasive, needing segmental cystectomy
78
In the cause of urothelial cell carcinoma, what is the result of deletions on chromosome 9 with regards to the type
-Superficial and non invasive, with some invasive
79
What are the preexisting anatomical defeats that are usually present in pyelonephritis
Vesicoureteral reflux
80
Typical hemolytic uremic syndrome (HUS) is associated with what
-Associated with diarrhea from consuming food with bacteria producing Shiga-like toxin (EHEC)
81
Fibroma of the bladder is what kind of tumor
Benign
82
Which age group is commonly seen to have acute proliferative glomerulonephritis
Children
| -Much more aversive and serious in adults, presenting with sudden hypertension and edema with elevated BUN
83
What percentage of papillary tumors are PUNLMP
Aka Papillary urothelial neoplasia of low malignant potential (PUNLMP)
-15-20%
84
How does acute proliferative glomerulonephritis typically present in a patient
Malaise, fever, nausea, oliguria, hematuria with red cells or RBC casts
- Periorbital edema
- Hypertension
85
Wilms tumor tends to be in which location of the kidney
Lower pole
86
IN ischemic events, what is the pattern of damage to the tubules
Patchy
87
Polypoid cystitis can commonly be misdiagnosed for which condition
Papillary carcinoma
88
TSC and tuberous sclerosis complex is which hereditary form and is associated with which tumors
- Autosomal dominant
| - Tumors or lesions of brain, skin, kidney, heart, lungs, eyes
89
What is the histology of the anaplasitc Wilms tumor
- Focal or diffuse (diffuse is a bad prognosis)
| - Anaplasia tends to be associated with p53 mutations and resistant to chemotherapy
90
What is interstitial cystitis, aka Hunner Ulcer
inflammation and fibrosis of the bladder wall with fissure formation
91
What is polypoid cystitis
Inflammatory condition resulting from irritation of the bladder mucosa
92
Malignant arteriolosclerosis is which kind of disease
Small vessel disease
93
How is the most common benign kidney neoplasms defined
Aka renal papillary adenoma, defined by the size
94
What is the genetic component that is associated with the increased risk for testicular tumors
Reduplication of 12p
95
What are the general characteristics of NSGCT compared to seminomas
-More aggressive and have a poorer prognosis
96
During the maintenance portion of acute kidney injury, what is the often the clincal issue
Hyperkalemia
97
In patients with acute cystitis (pyruria) will show what
WBCs
98
In membranoproliferative glomerulonephritis (MPGN) type 1, what is the location of deposits
-Subendothelial
99
What is the most common cause of polyploid cystitis
Indwelling catheters, and can result in polyploid urothelium resulting from extensive submucosal edema
100
Which portion of the kidney is involved in Henoch-Schonlein purpura
Glomerular
101
What is the prognosis of typical triphasic histomorphology
-Favorable
102
What is the characteristic IF finding in Membranous glomerulopathy
“Lumpy-bumpy” granular IgG deposits along the GBM
103
What age group is commonly affected by fibromusclular dysplasia
Younger age group in women
104
Which percentage of diabetic kidney patients make up those with ESRD
30%
105
In the cause of urothelial cell carcinoma, what is the result of deletions on chromosome 17p with regards to the type, and which factor is particularly a bad prognosis
Invasive and insitu carcinomas
| *P53 deletion is particularly a bad sign
106
What is the characteristic of The autosomal recessive polycystic kidney disease (ADPKD)
-Enlarged kidneys with numerous small, radical arrayed cysts from the dilated collecting ducts
107
Most cases of multicystic renal dysplasia present with what
Absent ureter, ureteropelvic obstruction or lower GU abnormalities
108
During antibody mediated glomerular injury, where is the location of circulating immune complexes depositing
Subendothelial
109
Membranous glomerulopathy shows which characteristics with regards to histology
- Diffuse thickening or capillary walls without the increase in cellularity
- Spikes seen with silver stain
110
What are is the histology of tropical triphasic Wilms tumor
- 3 cell types: blastemal, epithelial (tubules), stromal
| - No significant anaplasia
111
What are the primary nephritic syndromes that are associated with protein loss
* Also rarely present with hematuria
- Minimal change
- Membranous glomerulopathy
- Focal Segmental glomerulonephritis
112
In anti GBM, where are the antibodies binding and the location of deposition
-The basement membrane
113
Which patients are at risk for hemorrhagic cystitis
- Receiving cytotoxic anti-tumor drugs
| - Adenovirus infection
114
What are the histological findings in a urothelial neoplasia, particularly the papillary carcinoma
- Severe cytology atypical
- Hyperchormatic huge nuclei
- High nucleus/cytoplasmic ratio
115
In membranoproliferative glomerulonephritis (MPGN), what is the location of deposits
Intramembranous (aka dense deposit disease)
116
What is the most common benign forms of renal neoplasia
-Renal papillary adenoma
117
Membranoproliferative glomerulonephritis (MPGN) type 2 (aka dense Deposition disease occurs as which kind
Primary, there is no secondary form
118
What are the nonseminomatous tumors as part of the germ cell tumors
- Embryonal carcinoma
- Yolk sac tumor (endodermal sinus)
- Choriocarcinoma
119
membranoproliferative glomerulonephritis (MPGN) is classified as nephrotic or nephritis
Nephrotic, but shows microscopic hematuria along with some other nephritic syndrome features
120
What are the risk factors of renal cell carcinoma
Smoking increases by 2x
121
What is a common containing feature of seminomas
Contain syncytiotrophoblasts, which increases the levels of HCG
122
Which specific bacteria is responsible for the large portion of UTIs
E. Coli
123
Wilms tumor is associated with which mutations
-WT1 mutations
124
Papillary necrosis in those patients with DM commonly look like what
Pale, grayish necrosis limited to the papillae
125
Patients with urothelial carcinoma of the kidneys have associated with which conditions
- Concomitant bladder tumors
| - Associated with analagesic and Balkan nephropathy
126
What is the average prognosis of renal cell carcinoma
Papillary and clear cell
127
What is the effect of uremia on the gastrointestinal system
Occult GI bleeding, as nausea and vomiting are common in patients with uremia. Uremic retro (ammonia or urinelike odor to the breath)
128
Which portion of the kidney is involved in Microscopic polyarteritis
Glomerular
129
Membranous glomerulopathy falls under which renal disease
Nephrotic syndrome
130
Urothelial carcinoma of the kidney is originating from which cells
Urothelial of the renal pelvis
131
What is the initial spread of testicular cancer
Lymphatic spread, with the para-aortic nodes being first
132
What is the age group that commonly shows interstitial cystitis
Aka Hunner Ulncer*
| -30-40 year old women
133
The congenital diverticula of the bladder is due to which
-Focal failure of development of the normal musculature or some urinary tract obstructive during fetal development
134
Which portion of the kidney is involved in amyloidosis
Glomerular
135
Papillary necrosis is commonly caused in which 3 conditions
- analgesia nephropathy
- Obstruction
- DM
136
In membranoproliferative glomerulonephritis (MPGN) both type 1 and 2, what is a common result from mesangial proliferation
-Proliferation and increased mesangial matrix cause the dissection and “split” of the GBM
137
IgA nephropathy is which disease if there is systemic dieases
-Nonoch Schonlein purpura (HSP), usually with skin manifestations and abdominal viscera
138
Benign nephrosclerosis is classified as which kind of vascular diease
Small vessel disease
139
Papillary necrosis in those patients with analgesia nephropathy commonly look like what
Necrotic papillae slough into calyces
140
80% of patients with a family history of hematuria or recurrent hematuria during childhood have which disorders
- Alport Syndrome
| - Thin basement membrane disease (aka benign familial hematuria)
141
Which mutation is in renal angiomyolipomas
Loss of TSC1 or TSC2 tumor suppressor genes
142
What is the localization of immune complexed in the glomerulus during membranoproliferative glomerulonephritis
Subendothelial deposits
143
IN toxic events, what is the pattern of damage to the tubules
Continuous, with some patchy in the ascending loop
144
Nephronopthisis-medullary cystic disease is usually caused due to which mutations
MCKD1 and MCKD2
145
What conditions can be found with cryptorchidism
Malformation in the GU tract, such as hypospadias
146
Patients with The autosomal dominant polycystic kidney disease (ADPKD) are at a higher risk of which conditions
- Nephrolithiasis
| - UTI
147
Childhood polycystic kidney disease has what inheritance
Autosomal recessive
148
What is the localization of immune complexed in the glomerulus during IgA nephropathy
Mesangial deposits
149
What is the characteristic of thin basement membrane disease (aka benign familial hematuria)
Hematuria due to thinned glomerular basement membranes
150
What biological factors are curcial in the development of prostate cancers
Androgens, as antiandrogens ias a treatment
151
What does the appearance of the vessel look like in fibromusclar dysplasia
Almost like the trachea rings in the renal artery
152
In children with recurrent UTI, 33% have which condition
Vesicoureteral reflux
153
Urothelial carcinoma of the renal pelvis may lead to which conditions
-Hematuria and hydronephrosis and flank pain
154
Clear cell carcinoma has its histological pattern because of what
-Glycogen and lipid accumulation
155
What is the treatment for RPGN
Treatment of the underlying cause does not respond to plasmaphersis
156
Which type of rapidly progressive glomerulonephritis is characterized in lupus nephritis
Type 2 (immune complex)
157
What is the pathogenesis of unilateral renal artery stenosis
- Stenosis causes sympathetic stimulation and hypotension
- Causes the production of Renin and ACE
- Increased vasoconstriction in retention of water and salt
158
What percentage of patients progress to chronic glomerulonephritis if the have had Poststreptococcal GN
1-2%
159
In a patient with a negative urine culture, what are the exceptions where cystitis can not be ruled out
-Patient on the antimicrobial therapy when culture is obtained
160
What is the most common etiology of the large vessel diseases
70% are atherosclerosis
161
Arteroembolic renal diseases is defined with which conditions
- Trophy, fibrosis, hemorrhage, necrosis
| - Leads to sudden obstruction of blood flow in the renal artery and ischemic kidney infarction with renal failure
162
What is a non renal complication associated with Goodpasture
Cross reaction with lung alveolar BM, resulting in pulmonary hemorrhages
163
What is that pathological morphological features of multicystic renal dysplasia
Extensive multiple cysts with poorly differentiated mesenchym with cartilage formations and immature collecting ducts
164
What is the prognosis of large vessel diseases
Potentially curable form of hypertension
165
Which portion of the kidney is involved in Fabry disease
* Hereditary
| - Glomerular
166
What is the usual clinical presenting sign of Minimal change disease
Edema
167
Exstrophy is due to what
Failure in the anterior wall of the abdomen and the bladder
168
In patients with Nephronopthisis-medullary cystic disease, what is renal failure secondary to
Progressive cortical/tubulointersitial damage
169
During antibody mediated glomerular injury, where is the location of In situ Heymann
Foot processes
170
Patients with a exstrophy are at an increased risk for which condition
-Increased risk for adenocarcinoma
171
What are the typical electron microscopy findings in acute proliferative glomerulonephritis
Subepithelial humps of immune complexes
172
A daily dose of what may slow the decline or renal functions in people with chronic kidney disease
Folic acid
173
What conditions are associated with Minimal change disease
- Hodgkin lymphoma
| - lymphoreticular disease
174
Which portion of the kidney is involved in DM
-Glomerular
175
Lipoma in the bladder are what kind of tumors
Benign
176
Most primary renal diseases assocaited with rapidly progressive glomerulonephritis are which type and what percentage
50% are type 3 (pauci immune) on immunofluorescence
177
Most patients are which with regards to thin basement membrane disease (aka benign familial hematuria)
Heterozygous and therefore carriers
178
What conditions are commonly associated with IgA nephropathy
- Hematuria if there is a significant infection
- Gluten enteropathy
- Liver disease
179
What is the most common tumor in men from age 15 to 34
Testicular germ cell tumor
180
Which factor is present in 95% of prostate cancers
PCA3
181
What is the autoimmune antibody that is the cause of the majority of the Membranous glomerulopathy cases
PLA2 aka phospholipase A2 receptor
182
What percentage of patients progress to chronic glomerulonephritis if the have had membranoproliferative GN
50%
183
What are the morphologies of renal oncocytomas
- Mahogany-brown and well circumscribed with central stellate scar
- Simulate renal cell carcinoma
184
How common is the adenoma of the prostate
Most common form of cancer in men
185
What is the prognosis of acute proliferative glomerulonephritis in adults
Not good, as 60% recover completely
186
What are the pathological effects in malignant arteriosclerosis
- Ischemic kidneys
| - Elevated renin
187
Usually at the time of diagnosis, what is usually present with regards to urothelial carcinomas
-Multiple tumors at the initial diagnosis
188
Which portion of the kidney is involved in bacteria also endocarditis
Glomerular
189
What are the bio markers for germ cell tumors of the testis
- HCG
- AFP
- Lactate dehydrogenase
190
What diseases notible cause chronic antigenemia in secondary membranoproliferative glomerulonephritis (MPGN) type 1
- Hepatitis C with cyroglobulemia
- SLE, endocarditis
- Malignancies
191
What are the characteristics of nephritic syndrome
- Glomerular disease with visible hematuria
- mild to moderate proteinuria
- Hypertension
192
Which type of rapidly progressive glomerulonephritis is characterized in ANCA-associated
Type 3 (pauci-immune)
193
Which condition has the histological appearance of cambium layer, defined as a cluster of tumor cells located directly beneath the epithelium, resulting in a nevoid appearance
Botryoid rhabdomyosarcoma
194
In patients with patent urachus remnant/cysts are at a higher risks of developing which conditions
Infections, and then carcinomas of the cysts
195
Which type of rapidly progressive glomerulonephritis is characterized in microscopic polyangiitis
Type 3 (pauci-immune)
196
What is the most common cause of chronic renal failure/end stage renal disease
Diabetes
197
How does nephronopthsis medullary cystic disease present
With polyuria and polydipsia
198
What type of tumor is inverted papilloma tumor
Urothelial tumor
199
What is the result of acute kidney damage that leads to a GFR reduction to 30-50% of normal
Progression to ESRF at a steady rate, completely independent of all other factors
200
What are the predisposing factors for kidney stone formation
- Increased concentration of stone constitutes
- Changes in urinary pH
- Decreased urine volume
- Presence of bacteria
201
Most spread of renal cell carcinoma is typically which spread
Hematogenous (usually invasion of the renal vein)
202
Which type of rapidly progressive glomerulonephritis is characterized in Goodpastures
```
Type 1 (Anti-GBM antibody)
*Renal limited
```
203
What are the characteristics in the urine cytology in urothelial neoplasia
High specificity (95%) but low sensitivity
204
What is cryptorchidism and what risk does it increase
Complete or partial failure of the testes to descend, and is associated with an increased risk for testicular cancer
205
What is the most frequent presentation of membranoproliferative glomerulonephritis (MPGN)
Combined proteinuria and hematuria
206
What is the most morphology of the bladder cancers
Papilloma aka papillae carcinoma
207
What is type 3 RPGN defined as
Lack of anti-GBM antibodies or immune complexes
208
What type of tumor is a exophytic papilloma
Urothelial tumor
209
In papillary renal cell carcinoma has which histological finding
Papillae and foamy macrophages in stalk
210
Which part of the tubules are exceptionally susceptible to ischemia
Proximal tubular epithelial cells because of the high energy requirements
211
What is the triad of symptoms in renal cell carcinoma
- Hematuria (50%)
- Costovertebral pain (20%)
- Palpable flank mass (10%)
212
Wilms tumors usually arise from which precursor lesions
Nephrogenic rests, 100% bilateral
213
Which type of rapidly progressive glomerulonephritis is characterized in granulomatosis with polyangiitis
Type 3 (Pauci-immune)
214
What are the characteristics of sarcomatoid renal cell carcinoma
- Spindle cells stimulating a mesenchymal neoplasm
| - May arise in part of renal cell carcinoma, which is an even worse prognosis
215
What are the two most commone etiologies in causing nephrotic syndrome in systemic diseases
- DM
| - SLE
216
Which condition is focal segmental glomerulosclerosis (FSGS) associated with
-HIV infection, which may even show the rare “collapsing form”
217
What are the characteristics of rapidly progressive glomerulonephritis
Nephritic syndrome with rapid decline in GFR
218
Lymphoma of the bladder is what kind of tumor
Malignant, usually Non-Hodgkin lymphoma
219
What is the treatment for Minimal change disease
-Dramatic response to corticosteroid treatment, which almost serves as a diagnostic feature
220
What is the prognosis of patients with exstrophy
Surgery will give high long term survival
221
What is the characteristics finding of renal oncocytoma on electronmicrospy
Packed with mitochondria
222
What is the best prognosis in renal cell carcinoma
-Chromophobe
223
What is the epidemiology of urothelial carcinomas
-More common in white males in industrial areas
224
Adult polycystic kidney disease has what inheritance
Autosomal dominant
225
What is the most dominant clinical finding in Membranoproliferative glomerulonephritis (MPGN) type 2 (aka dense Deposition disease
Hematuria with 50% having nephritic syndrome
226
Which form of autosomal dominant polycystic kidney disease (ADPKD), has a better prognosis
PDK2
227
What is the immunofluorescence pattern of staining in all cases of Type 2 RPGN
Granular pattern of staining
228
What is the triggering event that leads to acute proliferative glomerulonephritis
- Immune complex injury triggered by exogenous bacterial, fungal, viral antigen
* Especially Strep B
229
Squamous cell carcinoma of the penis usually due to which factors
Poor hygiene and high HPV risk
230
What is the fluorescent staining pattern in Goodpasture and anti-GBM
Linear with IgG
231
What are the characteristics of the perinatal form of The autosomal recessive polycystic kidney disease (ARPKD)
- 90% of collecting ducts are cystic, with minimal hepatic fibrosis
- Survival is only a few hours, usually with hypoplastic lungs
232
Thrombin microangiopathies are commonly caused by which conditions
Resulting in the over activation of platelets:
- Endothelial cell injury and activation, intravascular thrombosis (HUS)
- Platelet Activation and aggregation (TTP)
233
What is the clinical significance of renal angiomyolipoma
With renal cell carcinoma, but can massive hemmorhage, so there is initial presentation with shock
234
Bence Jones proteinuria primarily affects which location of the kidneys
Tubules
235
Which type of rapidly progressive glomerulonephritis is characterized in postinfetious glomerulonephritis
Type 2 (immune complex)
236
Cystitis of the urinary tract are due to what
Infectious, usually bacteria
237
What is the most common form fo non-epithelial tumors of the bladder and in general, how common are they
Non-epithelial tumors in general are uncommon, with he leiomyoma being the most common
238
What is the prognosis of acute proliferative glomerulonephritis in children
Very good with 95% recovering
239
Type 2 immune complex deposition RPGN are assoacited with which conditions
-Lupus
| IgA nephropathy
240
What is the prognosis of most Wilms tumor in children
>90% survive 4 years
241
What is the effect of uremia on cardiovascular system
Uremic pericarditis is very common, usually cause the conditions such as hypertension, atherosclerosis, CHF, and angina get worse during uremia
242
What is the localization of immune complexed in the glomerulus during acute glomerulonephritis
Subepithelial humps
243
Secondary membranoproliferative glomerulonephritis (MPGN) type 1 presents in which patients
Adults
244
“Wire loops” and deposits in the mesangium are primarily due to which condition
SLE
245
Which resisting conditions predispose a patient to pyelonephritis
Diabetes and pregnancy
246
Angiomyolipomas have a strong association with which condition
-Tuberous sclerosis
247
Thrombotic thrombocytopenia purpura (TTP) is defined by which conditions
Deficiencies in ADAMTS13, which regulates vWF
| -Very prominent neurological involvement *****
248
Which cases of The autosomal dominant polycystic kidney disease (ADPKD) is more aggressive
- African Americans
- Male
- Hypertension
249
The majority of urinary bladder tumors are what origin
Urothial epithelial aka transitional cell tumors
250
What are the known toxins that can lead to urethral neoplasia
- Smoking
- Certain dyes
- phenacetin
- Cyclophosphamide
251
What are the typical immunofluorescence microscopy findings in acute proliferative glomerulonephritis
-Granular depositions of IgG, IgM, C3 along the mesangium leading to “humps”
252
Malacoplakia is which type of condition
Special form of cystitis
253
What is the makeup of the majority of the stones in the kidney
-Calcium oxalate and phosphate (70%)
254
What are the characteristics of the chromophobe renal cell carcinoma
Pale, eosinophilic cells are arranged in solid sheets, well defined cell membranes with granular cytoplasms with perinuclear clear halos, usually around blood vessels
255
Which syndrome is the cause of an electron microscopy of the basement membrane to look “frayed” or “moth eaten”
Alport syndrome
256
What percentage of patients progress to chronic glomerulonephritis if the have had membranous nephropathy
30-50%
257
What is the condition that is characterized histologically by infiltrates of multicellular giant cells, with laminated mineralized concretions in the macrophages, which are the result of deposition in abnormal enlarged lysosomes
Aka Michaelis-Gutmann bodies seen in malacoplakia
258
What percentage of patients progress to chronic glomerulonephritis if the have had focal segmental glomerulosclerosis
50-80%
259
Patients with Klinefelter syndrome are assoaicted with increased risk for which condition
Mediastinal germ cell tumors
260
What are the risk factors for urothelial carcinomas
- Cigarete smoke and industrial exposure to arylamines
- Shistosoma hematobium (squamous cell carcinoma)
- long term use of analgesic and cyclophosphamide (nitrogen mustard)
261
What are the two most common forms of The autosomal recessive polycystic kidney disease (ARPKD)
- Perinatal (most common)
| - Neonatal
262
What percentage of patients progress to chronic glomerulonephritis if the have had IgA nephritis
30-50%
263
Infarcts of the kidney are most commonly due to what
Embolism, usually with mural thrombosis form left side of heart
264
What is a very bad prognosis for renal cell carcinoma
-Histology of collecting duct, sarcomatoid, and medullary
265
What is nephrotic syndrome characterized by
- Severe proteinuria
- Hypoalbuminemia
- Severe edema
- Hyperlipidemia
- Lipiduria
266
Primary membranoproliferative glomerulonephritis (MPGN) type 1 primarily presents in which patients
Young adults and children
267
What is the major histological finding of PUNLMP
Thickened epithelial covering the papillary projections
268
“Flea bitten” appearance of the kidneys is the result of which condition
Malignant arteriolosclerosis
269
What are the typical renal lesions seen in diabetic nephropathy
- Glomerular lesions
- Vascular lesions (arteriolosclerosis)
- Pyelonephritis (necrotizing papillitis)
270
Most patients with type 3, aka pauciimmune, RPGN have which circulating antibody
ANCA
271
Which type of rapidly progressive glomerulonephritis is characterized in Henoch-Schonlein purpura
Type 2 (immune complex)
272
Which portion of the kidney is involved in thin basement membrane disease
* Hereditary
| - Glomerular
273
Xanthogranulomatous pyelonephritis is commonly caused by which pathogen
Proteus
274
What is the classical type of seminoma
Spermatocytic seminoma
275
What is the characteristics and prognosis of a stage 1 bladder cancer
-high survival rate (95%), with high recurrence following treatment, but will not cause death
276
What is the second most common cause of chronic renal failure/end stage renal disease
High blood pressure
277
Most testicular germ cell tumors originate from which precursor lesion
-Intratubular germ cell neoplasia (ITGCN)
278
Alport syndrome will show which characteristic in electron microscopy
Orregualr thickening of the basement membrane, lamination of the lamin densa, and foci of rarefacttion, giving a “moth eaten” or “frayed”look
279
What is the result of steroid therapy for membranous glomerulopathy
Not very good, with high recurrence in transplanted patients
280
What is the pathogenesis of thin basement membrane disease (aka benign familial hematuria)
Mutations in the genes for alpha3 or 4 in type 4 collagen
281
In nephronopthsis, aka medullary cystic disease, where are the cysts localized to
Corticomedullary junction and medulla
282
What commonly results in polar scarring of the kidneys
VUS with chronic pyelonephritis
283
During antibody mediated glomerular injury, where is the location of in situ Deposition
Basement membrane
284
What is the definition of benign nephrosclerosis and what is the effects
Hyaline sclerosis of the renal arterioles and small arteries, leading ot multifocal ischemia
285
What is the result of toxic injury in acute kidney injury (ATN) due to ethylene glycol
Widespread proximal tubule epithelial injury, especially with the PCT showing swelling and vacuilization
286
Which portion of the kidney is involved in Goodpastures syndome
Glomerular
287
What kind of disease is fibromusclar dysplasia
Large vessel disease
288
What is the result of a silver stain in Membranous glomerulopathy
-Showing “spikes” that produce a dome like protrusion
289
What is the gene in autosomal dominant polycystic kidney disease (ADPKD)
- PKD1, which is a integral membrane glycoprotein (85% of cases)
- PKD2, with is a calcium channel (15% of cases)
290
Pyelonephritis is almost causes which which infection
Ascending infection of the bladder
291
What is the most common overall cause of nephrotic syndrome in adults
Focal segmental glomerulosclerosis
292
Which type of rapidly progressive glomerulonephritis is characterized in IgA nephropathy
Type 2 (immune complex
293
What characteristics can be used to differentiate between FSGS and MCD
- Higher incidence of hematuria, reduced GFR, and hypertension
- Proteinuria is nonselective
- Poor response to steroids
- significant progression to ESRD
294
What type of proteinuria is shown in Minimal change disease
Highly selective
295
Most Wilms tumor patients are due to what
90% are Sporadic in normally healthy children with no congenital abnormalities or genetic syndromes
296
What percentage of urothelial neosplasias are papillary and what is the characteristics
30%, usually with a high recurrence rate and high grade
297
What are the effects of uremia seen in the cutaneous tissue
Fluid retention, pruritis associated with calcium phosphate depositions and nail atrophy
298
Which portion of the kidney is involved in SLE
-Glomerular
299
What is the azotemia
Biochemical abnormality that is due to elevation of the blood urea nitrogen (BUN) and creatinine levels as a result of decreased GFR
300
What are the characteristics of the majority of benign renal neoplasms
- Rarely clinical problems
| - Small, but can cause oncocytomas or angiomyolipomas
301
What is the localization of immune complexed in the glomerulus during Heymann glomerulonephritis
Epimembranous deposits
302
What conditions is commonly associated with secondary membranoproliferative glomerulonephritis (MPGN) type 1
Chronic antigenemia leading to immune complex deposition
303
How does a bladder presentation fo a flat lesion compare to that of a papillary lesions
Flat will just provide discomfort while the papilloma with cause hematuria
304
In SLE, which antibody deposits and in which locations
IgG, usually in the mesangial and capillary wall
