Renal pathology 1 Flashcards Preview

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Flashcards in Renal pathology 1 Deck (62):
1

List the common congenital abnormalities of the renal abnormalities?

Agenesis
Hypoplasia
Horseshoe kidney
Duplex (ureter, pelvis)

2

What is kidney agenesis?

Absent kidney (or both kidneys)

3

What is kidney hypoplasia?

Normal kidney develops but at a smaller size

4

What is horseshoe kidney?

Kidneys fuse at upper or lower pole (more commonly lower pole)

5

What is the prognosis of kidney agenesis of both kidneys?

Death

6

Kidney agenesis can result in a characteristic facial appearance. Why?

diminished urine production -->
diminished amniotic fluid -->
squished nose, recessed chin & low ears

7

What pathology can horseshoe kidney cause?

Obstruction (rarely)

8

How common are simple cysts?

Common

9

How do simple cysts affect the kidney?

They don't usually have a functional effect

10

What size are simple cysts?

Can be large or small

11

When might simple cysts be secondary?

Long term kidney dialysis

12

Are simple cysts uni or bilobular?

Unilobular (but can have multiple cysts)

13

What are simple cysts filled with?

Fluid (NO blood)

14

How common is infantile type polycystic kidney disease?

Rare (there are varying subtypes but all are rare)

15

How does infantile type polycystic kidney disease cause?

Terminal renal failure (may die immediately or survive for several months)

16

Is infantile type polycystic kidney disease autosomal dominant or recessive?

Recessive (autosomal recessive polycystic kidney disease)

17

How are the kidneys affected in infantile polycystic kidney disease?

Bilateral enlargement. Maintenance of reniform shape. Dilation of medullary collecting ducts

18

What is infantile polycystic kidney disease always associated with?

Congenital hepatic fibrosis

19

How common is adult polycystic kidney disease?

Rare (BUT least rare of all the congenital cystic diseases)

20

Is adult polycystic kidney disease autosomal dominant or recessive?

Dominant

21

Where are the gene mutations of ADPCKD type 1 and type 2 respectively? Which is the most common?

Type 1 - chromosome 16 (most common)
Type 2 - chromosome 4

22

How does adult polycystic kidney disease present?

Middle aged
Abdominal mass
Haematuria
Chronic renal failure --> +/- hypertension

23

How are the kidneys affected in adult polycystic kidney disease?

Huge bilateral enlargement. Cysts of varying size cause distortion of the reniform shape.

24

Where are the cysts in ADPCKD found?

Nephron (any part)

25

What is ADPCKD associated with?

Berry aneurysms at the circle of willis

26

What two types of haemorrhage can be caused by ADPCKD?

Subarachnoid haemorrhage (circle of willis)
Intracerebral haemorrhage (hypertension)

27

What other sites might cysts caused by ADPCKD arise? What problems do they cause?

Liver
Pancreas
Lung

No functional problems

28

List the benign renal tumours

Adenoma
Fibroma
Angiomyolipoma
Juxtaglomerular cell apparatus tumour (JGCT)

29

Describe the features of a renal adenoma

30

Describe the features of a renal fibroma

Common
Found in the medulla

31

Describe the features of a renal angiomyolipoma

Consists of vascular, muscle and fat cells
May be multiple/bilateral

32

What is renal angiomyolipoma associated with?

Tuberous sclerosis

33

What does JGCT cause?

Hypertension through increased renin secretion

34

List the malignant renal tumours

Nephroblastoma/Wilm's tumour
Urothelial/transitional epithelial tumours
Renal cell carcinoma

35

Describe the features of nephroblastoma/wilm's tumour

Arises from residual primitive renal tissue

36

What age group is affected by Wilm's tumour? How common is it?

Children (1-10 y/o)
Commonest intra-abdominal tumour (in children)

37

How might nephroblastoma present?

Abdominal mass

38

Describe the features of renal cell carcinoma

Arises from renal tubular epithelium

39

What other names can renal cell carcinoma go by?

Clear cell carcinoma
Hypernephroma
Grawitz tumour

40

How common is renal cell carcinoma?

Commonest primary renal tumour in adults (overall rare)

41

Which age group is most commonly affected by renal cell carcinoma? Which sex?

55-60 y/o
Males

42

How might renal cell carcinoma present?

Abdominal mass
Haematuria
Flank pain
Systemic symptoms
Paraneoplastic syndrome (hypercalcaemia, polycythemia)

43

What is polycythemia? What is it often a feature off in relation to the renal system?

Increased red cells
Cancer (paraneoplastic)

44

Where does renal cell cancer commonly spread to?

Renal veins & IVC

45

How does renal cancer spread?

Haematogenously
Lymphatic spread late in disease

46

Which type of renal cell carcinoma is the most common? What is unique about these types of cells?

Clear cell
Increased lipids and glycogen

47

Which grading system is used in renal cell carcinoma?

Fuhrman

48

Where can transitional cell carcinomas be found?

Anywhere along the length of the urinary system from the renal pelvis to the urethra

49

Where do most transitional cell carcinomas arise?

Bladder

50

In which age group are transitional cell carcinomas found?

>50 y/o

51

What are the risk factors for transitional cell carcinomas?

Dyes
Rubber
Analgesics (particularly renal pelvis)
Schistosomiasis
Smoking
Cyclophosphamide

52

What is schistosomiasis?

Chronic parasitic kidney infection

53

How does transitional cell carcinoma commonly present?

Haematuria

54

Where in the bladder do most transitional cell carcinomas commonly arise? What is this a risk factor for?

Trigone
Ureteric obstruction (+/- hydroureter & hydronephrosis)

55

Describe the morphology of transitional cell carcinomas

Solid vs papillary

56

Describe the grading system of transitional cell carcinomas

pTa - transitional cell cacner
pT1 - stromal invasion
pT2 - detrusor invasion

57

What is a risk factor for the areas surrounding transitional cell carcinomas?

Carcinoma in situ

58

How does transitional cell carcinoma spread?

Lymphatic (obturator, lung, liver)

59

How common is transitional cell carcinoma recurrence?

Common - tends to be higher grade each time it reoccurs

60

What is renal adenocarcinoma associated with?

Extrovesion (lower abdo wall absent and bladder open)
Urachral remains (dome)
Cystitis cystica (long standing)

61

What is squamous cell carcinoma associated with?

Schistomiasis
Calculi (--> metaplasia)

62

What is the commonest malignant bladder tumour in children?

Embryonal rhabdomyosarcoma

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