prognosis

Question 1

Acute Proliferative Glomerulonephritis / Post Streptococcal Glomerulonephritis

Answer 1

poor if persistent protienuria/abn GFR

Question 2

RPGN

Answer 2

terrible

Question 3

IgA nephropathy

Answer 3

worse if old, heavy proteinuria, HTN, more GS

Question 4

alport dis

Answer 4

F: just some hematuria; M: ESRD by 40yo

Question 5

thin BM dis

Answer 5

excellent

Question 6

membranous nephropathy

Answer 6

-remissions wo therapy
-women = more benign
-renal fail 10-40y
eventaul segmental sclerosis

Question 7

-minimal change dis

Answer 7

great w corticosteroids (even adults, just slower to respond)

Question 8

FSGS

Answer 8

poor (kids better)

• ESRD i 10y
• worse w: rapid protienuria, renal insufficeincy at dx

Question 9

Dense deposit dis (MPGN T2)

Answer 9

poor

• 50% progress to ESRD
• recurs in transplant pts

Question 10

SLE

Answer 10

worse if decrease in Bowmans space

Question 11

Henoch-Schonlein Purpura

Answer 11

great if dx in first 3-8 yrs life (unless cresents or prolonged nephrotic synd)

Question 12

GN with bacterial endocarditis

Answer 12

progress to RPGN

Question 13

atypical HUS

Answer 13

grave, but can recover if mild

Question 14

MultiCystic Renal Dysplasia

Answer 14

If unilateral: great prognosis if the affected kidney is removed; poor prognosis for b/l involvement

Question 15

papilloma (bladder urothelial tumor)

Answer 15

low incidence of progression or recurrence

Question 16

Urothelial bladder CA

Answer 16

Papillomas or low grade papillary urothelial cancer have a 98% 10y survival rate.
o Less than 10% progress to higher grade lesion, but if they do 25% of those pts die
o Stage is best prognostic factor; grade not so much
♣ Ta, Tis, T1 = low stage
♣ T2-4: m invasion

Pts with primary CIS are less likely to progress to muscle invasive cancer as compared to CIS assoc with infiltrating urothelial carcinoma.

Invasive Urothelial carcinoma has a 30% chance of killing the pt if it invades the propria lamina, but otherwise squamous cell carcinoma and adenocarcinoma are assoc with a worse prognosis.

Question 17

SCC of penis

Answer 17

Metastases to regional (inguinal and iliac) lns, but distant metastases is uncommon
-better if confined

Question 18

spermatocytic seminoma

Answer 18

excellent bc doesnt metastasize

Question 19

germ cell tumors of testes

Answer 19

seminoma: good bc usu stage 1 or 2; NSGCT bad bc radioresistant and met early (worst: choriocarcinoma)

Question 20

wilms tumor

Answer 20

Histo elements and stage at time dx
♣ Worst histo: diffuse anaplasia at dx
P53, 11q, 16q deletions; 1q gain = worse