Pathology: Renal and Urology 2

Question 1

What is the term given to congenital absence of the kidneys?

Answer 1

Renal agenesis

Question 2

Which condition can occur in utero to a foetus if they have agenesis of both kidneys?

Answer 2

Oligohydramnios

Lack of foetal kidneys and urine production so less amniotic fluid is present

Question 3

Simple cysts within the kidneys are ________ in the population

Answer 3

Simple cysts within the kidneys are common in the population

Question 4

How are the kidneys affected in ARPKD?

Answer 4

Bilateral renal enlargent

Enlogated cysts in medullary collecting ducts

Question 5

Which condition is ARPKD associated with?

Answer 5

Congenital hepatic fibrosis

Question 6

What is the most common cause of congenital cystic disease of the kidneys?

Answer 6

ADPKD

Question 7

Where is the genetic abnormality found in ADPKD?

Answer 7

90% chromosome 16 (PKD1 mutation)

10% chromosome 4 (PKD2 mutation)

Question 8

How do patients with ADPKD present?

Answer 8

Age > 40

Abdominal mass

Haematuria

Hypertension

Chronic renal failure

Question 9

How are the kidneys affected in ADPKD?

Answer 9

Massive bilateral renal enlargement >1kg

Glomerular, tubular and medullary cysts

Distorted renal shape

Question 10

Where else may cysts be found besides the kidney in ADPKD?

Answer 10

Liver

Pancreas

Lung

Question 11

Patients with ADPKD have a high risk of which cerebrovascular condition?

Answer 11

Berry aneurysms (in the circle of Willis)

Question 12

What is the main risk of a Berry aneurysm?

Answer 12

Subarachnoid haemorrhage

Question 13

What is the most common benign tumour in the kidneys?

Answer 13

Fibromas

Question 14

Where are fibromas found in the kidney?

Answer 14

Medullary in origin

Question 15

Where are adenomas found in the kidneys?

Answer 15

Cortex

Question 16

What are angiomyolipomas?

Answer 16

Mixture of fat, muscle and blood vessels

(can be uniateral or bilateral)

Question 17

Angiomyolipomas in the kidney are associated with which condition?

Answer 17

Tuberous sclerosis

Question 18

What can a Juvenile granulosa cell tumour of the kindeys lead to?

Answer 18

Secondary hypertension

(due to production of renin)

Question 19

What is the most common intra-abdominal malignant tumour in children?

Answer 19

Nephroblastoma (Wilm’s tumour)

Question 20

Where do urothelial carcinomas present?

Answer 20

Renal pelvis and calyces

Question 21

Renal cell carcinomas present from whcih tissue?

Answer 21

Renal tubular epithelium

Question 22

What is the most common malignant renal tumour in adults?

Answer 22

Renal cell carcinoma

Question 23

What age range is usually affected by renal cell carcinoma?

Answer 23

Males 55-60

Question 24

How does a renal cellc carcinoma present?

Answer 24

Abdominal mass,

Haematuria

Flank pain

General features of malignant disease

Question 25

Renal cell cacinoma has which paraneoplastic manifestations?

Answer 25

Polycythaemia Hypercalcaemia

Question 26

How does a renal cell carcinoma appear?

Answer 26

Large apparently well circumscribed mass on cortex

Question 27

Extentension into which structure is common withe renal cell carcinomas?

Answer 27

Renal vein extension

Question 28

It is possible for renal cell carcinomas to extend where?

Answer 28

Renal vein Vena cava Right atrium (very severe cases)

Question 29

How can renal cell carcinoma spread?

Answer 29

Haematogenous first Lymphatic later

Question 30

Renal cell carcinoma is associated most commonly with which cell type?

Answer 30

Clear cell type | (rich in glycogen and lipid)

Question 31

Where does renal cell carcinoma most commonly metastasize?

Answer 31

Lung Bone

Question 32

Where does the transitonal epithelium extend from?

Answer 32

Pelvicalyceal system to urethra

Question 33

Bladder tumours are most commonly due to which tumour type?

Answer 33

Transitional cell carcinoma (90%) - Western countries

Question 34

What are the main risk factors for transition cell carcinoma?

Answer 34

1. Aniline dyes (B-naphthylamine) 2. Rubber industry 3. Benzidine 4. Cyclophosphamide 5. Analgesics (renal pelvis) 6. Smoking Having problems with your Pee SAC? (P - Phenacetin S - Smoking A - Aniline dyes C - Cyclophosphamide)

Question 35

What is the most common symptom of transitional cell carcinoma?

Answer 35

Haematuria

Question 36

Where do the majority of transitional cell carcinomas present?

Answer 36

Trigone

Question 37

What are the two main variants of transitional cell carcinoma?

Answer 37

Papillary Solid

Question 38

Wher can transitional cell carcinomas spread?

Answer 38

Lymph nodes (local) Lung Liver

Question 39

Squamous cell carcinoma can be associated with which two main things?

Answer 39

Calculi Schistosomiasis

Question 40

What is the most common urinary tract malignancy in children?

Answer 40

Embryonal Rhabdomyosarcoma (affects bladder)

Question 41

Longstanding cystitis cystica predisposes to which type of urinary tract tumour?

Answer 41

Adenocarcinoma

Question 42

Why does extroversion occur with adenocarcinoma?

Answer 42

Glandular metaplasia