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Renal Path MC > Renal 7 > Flashcards

Renal 7 Flashcards

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1
Q

morphology of ureteropelvic junction obstruction -> boys more common, left side more common

A

abn organization smooth muscle bundles, excess stromal deposition in smooth muscle bundles

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2
Q

associated findings with ureteropelvic junction obstruction

A

agenesis opposite kidney, high ureter insertion

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3
Q

result of ureteropelvic junction obstruction

A

severe vesicoureteral reflux and hydronephrosis

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4
Q

what occurs in diverticula (uncommon in congenital ureters)

A

stasis and infection

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5
Q

obstruction of ureter causes these conditions

A

hydroureters, hydronephrosis, pyelonephritis

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6
Q

intrinsic lesions of ureter obstruction

A

calculi, blood clots, neurogenic, tumorous masses

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7
Q

extrinsic lesions of ureter obstruction

A

periureteral inflammations, endometriosis, pregnancy, tumors

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8
Q

autoimmune reaction occurring in late/middle life -> inflammation encasing retroperitoneal structures and causing ureteral obstruction; what medication might trigger this?

A

sclerosing retroperitoneal fibrosis; ergots, B-blockers

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9
Q

infiltrate/morphology of scerlosing retroperitoneal fibrosis

A

lymphocyte infiltrate, germinal centers and plasma cells

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10
Q

developmental failure of anterior wall of bladder -> causes communication with exterior

A

exstrophy

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11
Q

exposed portion of bladder in exstrophy undergoes this; condition has increased risk of this

A

colonic glandular metaplasia; adenocarcinoma, infection

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12
Q

most common and serious anomaly of urinary bladder -> major contributor to renal infection and scarring

A

vesicoureteral reflex

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13
Q

developmental membrane in male urethra causing congenital outflow obstruction

A

posterior urethral valves

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14
Q

lining of urachal cysts; what does carcinoma of this tissue resemble?

A

transitional or metaplastic epithelium; colonic adenocarcinoms

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15
Q

can cause bladder obstruction in females -> wall between bladder and vagina is torn so bladder can herniate into vagina

A

cystocele

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16
Q

progression of bladder obstruction

A

hypertrophy smooth muscle/wall thickening -> trabeculation (enlarged muscle bundles) -> diverticula formation (crypts…lead to stasis/infection/stones)

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17
Q

morphology of foamy MP found in malacoplakia; what are specific laminated, mineralized concretions bodies found in them

A

granular cytoplasm, PAS positive, phagosomes w/ bacterial debris; Michelis-Gutmann bodies

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18
Q

condition that has Michaelis-Gutman bodies

A

malacoplakia

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19
Q

persistant/chronic cystitis in women -> inflammation and fibrosis of all layers of bladder wall

A

interstitial cystitis

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20
Q

presentation of interstitial cystitis (autoimmune)

A

severe suprapubic pain, urinary frequency, dysuria w/o infection

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21
Q

morphology of interstitial cystitis

A

mucosal ulcer, granulation tissue/mast cells, inflammatory cells

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22
Q

common lesions of bladder inflammation -> nests of transitional epithelium growing inward toward lamina propria

A

cystitis glandularis/cystica

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23
Q

central epithelial cells of bladder transform to these in cystitis glandularis/cystica

A

cuboidal or columnar lining slitlike spaces (glandularis) or cysts (cystica)

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24
Q

intestinal metaplasia in cystitis glandularis/cystica may give rise to these -> more prominent in inflamed/chronically irritated bladder; what does this increase risk for?

A

goblet cells; adenocarcinoma

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25
causes of hemorrhagic cystitis
radiation or chemotherapy
26
immunosuppressed patients and those on long-term antibiotic use may have acute cystitis associated with these organisms
candida and cryptococcus
27
common presentation of acute cystitis
urgency, frequency, suprapubic pain
28
morphology of chronic cystitis
heaping of epithelium, red/friable/granular surface, fibrous wall thickening, could have aggregates of lymphoid follicles (in follicular cystitis)
29
tumor cause by Schistosomiasis hematobium (common in Middle East)
squamous cell carcinoma (from metaplasia)
30
conditions that are related to adenocarcinoma cancer of bladder/lower urinary
cystitis glandularis/cystica, exstrophy, urachal remnants
31
genetic alteration in small, low grade tumor of transitional cell carcinoma
deletion 9p and 9q, loss tumor suppressor gene
32
deletion of tumor suppressor gene on chromosome 9 causes this kind of transitional cell carcinoma
papillary or flat tumors
33
genetic alterations in high grade, aggressive tumors -> multiple alterations with aneuploid DNA, loss blood group antigens
deletion 17p and loss p53
34
most common etiology of transitional cell cancer
male, 50-80, industrialized/urban nations
35
morphology of low grade lesions of transitional cell carcinoma
papillary w/ limited cellular and nuclear pleomorphism
36
morphology of high grade lesions of transitional cell carcinoma -> 60% mortality in 10 years
papillary or nodular (or both), pleomorphism, anaplasia, loss blood group antigens
37
most common presentation of transitional cell carcinoma
painless hematuria
38
transitional cell carcinoma may invade these areas
prostate, seminal vesicles, retroperitoneum
39
grade of bladder cancer: papillary or flat (both), more extensive growth and invasion of the muscularis -> HIGH risk of invasive disease
3
40
grade of bladder cancer: papillary and have increased number of TC layers with loss of polarity
2
41
grade of bladder cancer: similar to solitary papillomas, but have some minor atypic -> low malignant potential
1
42
result of persistent urinary obstruction
renal atrophy and hydronephrosis
43
most common causes of urinary obstruction
posterior urethral valves, ureteropelvic junction narrowing, vesicuoreteral reflux
44
causes of extrinsic urinary obstruction
BPH, normal pregnancy, uterine prolapse and cystocele, tumors
45
morphology of medullary dysfunction in hydronephrosis (due to protract obstruction)
interstitial fibrosis, distal tubular acidosis, renal salt wasting, loss GFR (LATE)
46
morphology of chronic hydronephrosis -> due to cortical tubular atrophy
blunting pyramidal apices
47
morphology of advanced cases of hydronephrosis -> due to striking parenchymal atrophy
obliteration pyramids, thinning of cortex
48
complete bilateral obstruction of urinary system causes this -> incompatible with long survival
oliguria or anuria
49
organic matrix of this material makes up 1-2% of all stones by weight
mucoprotein matrix
50
calcium oxalate stones are associated with this condition
calciuria (not necessarily hypercalcemia)
51
enteric hyperoxaluria occurs in these individuals -> leads to urolithiasis
vegetarians
52
condition with calcium oxalate stones in the presence of increased uric acid secretion -> uric acid crystals cause nucleation of calcium oxalate
hyperuricosuric calcium nephrolithiasis
53
staghorn calculi typically create cast of these; what is the formation of these associated with?
renal calyces; chronic pyelonephritis
54
cause of ascending infection leading to pyelonephritis in women
Strep faecalis
55
conditions that can lead to hematogenous route of spread causing pyelonephritis -> non enteric organisms (Staph, TB)
ureteral obstruction, debilitated patients, immunosuppressive thearpy
56
associated condition with ascending infection leading to pyelonephritis
vesicoureteral reflux
57
morphology of acute pyelonephritis
patchy interstitial suppurative inflammation, tubular necrosis, abscess with destruction engulfed tubules (glomeruli resistant to infection) -> scarring, cortical depression
58
complications of acute pyelonephritis
papillary necrosis and pyonephrosis
59
complication of acute pyelonephritis -> obstruction where suppurative exudate can't drain
pyonephrosis
60
area involved in papillary necrosis -> coagulative necrosis
tips or distal 2/3 pyramids
61
chronic inflammation of tubules and interstitium
chronic pyelonephritis
62
morphology of chronic pyelonephritis
tubular hypertrophy, dilated tubules with colloid casts (thyroidization), chronic interstitial inflammation/fibrosis -> irregular scarring
63
infection commonly associated with xanthogranulomatous pyelonephritis -> foamy MP and plasma cells, staghorn calculi formation
Proteus
64
possible presentations of xanthogranulomatous pyelonephritis
renal insufficiency and HTN, FSGN w/ proteinuria (poor prognostic indicator)

Renal Path MC (5 decks)

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