Session 10 - Pathology of the urinary system Flashcards Preview

ESA 3 - Urinary > Session 10 - Pathology of the urinary system > Flashcards

Flashcards in Session 10 - Pathology of the urinary system Deck (23):
1

Define, in relation to glomerular injury, focal

Involves less than 50% of glomeruli on light microscopy

2

Define, in relation to glomerular injury, diffuse

Involves more than 50% of glomeruli on light microscopy

3

Define, in relation to glomerular injury, segmental

Involves part of the glomerular tuft

4

Define, in relation to glomerular injury, global

Involves the entire glomerular tuft

5

Define, in relation to glomerular injury, membranous

Thickening of the entire glomerular tuft

6

Define, in relation to glomerular injury, proliferative

An increased number of cells in the glomerulus; can be inflammatory cells or proliferative glomerular cells

7

Define, in relation to glomerular injury, crescent

Accumulation of cells within the bowman’s space; crescents compress capillary tuft and are associated with more severe disease

8

Define, in relation to glomerular injury, glomerulosclerosis

Segmental or global capillary collapse, presumed to be little filtration across sclerotic area

9

Define, in relation to glomerular injury, glomerulonephritis

Any condition associated with inflammation in the glomerular tuft

10

What 4 things occur clinically in nephrotic syndrome?

• Proteinurea (>3.5 g loss in 24 hrs) – Urine looks frothy

• Hypoalbuminaemia

• Oedema

• Hyperlipidaemia – liver compensates loss of albumin by producing more, but has consequence of producing more lipids

11

What 4 things occur clinically in nephritic syndrome?

• Haematuria – micro or macroscopic

• Small proteinuria

• Mild hypertension

• Low urine volume

12

Give 3 primary causes which result in nephrotic syndrome

• Minimal change Glomerulonephritis (GN)

• Focal Segmental Glomerulosclerosis (FSGS)

• Membranous glomerulonephritis

13

Give 2 secondary causes which result in nephrotic syndrome

• Diabetes Mellitus (Microvascular complications affect kidneys)

• Amyloidosis

14

Describe goodpasture syndrome

• V rapidly progressing glomerular nephritis

• Autoantibody to collagen 4 in BM of glomerulus

• Associated with deafness (collagen 4 found in BM of inner ear)

• Characterised by IgG deposition but no ECM deposit

• Treatable to immunosuppressants

15

Describe vasculitis in the kidney

• Systemic Inflammation of blood vessels affects highly vascularised kidney

• Blood vessels attacked directly in glomerulus by Anti neutrophil cytoplasmic antibody (ANCA)

• Treatable if caught early

16

What are subepithelial deposits in the glomerulus? Give an example disease

Antigen abnormally recognised on podocytes, circulating IgG binds to it, forming immune complexes in the glomerulus (Not circulating immune complexes causing damage). e.g. membranous glomerulonephritis

17

What are mesangial deposits in the glomerulus? Give an example disease

Immune complexes can be deposited directly in the mesangium, as there is no podocytes or basement membrane to act as a barrier. e.g. IgA nephropathy

18

Give the usual and unusual presentation of prostate cancer

Usual presentation:

• Asymptomatic

• Or some urinary symptoms e.g. bladder over activity

• Advanced – bone pone due to metastases

 

Unusual: • Haematuria in advanced prostate cancer

19

How would you diagnose prostate cancer?

• Digital rectal examination (DRE)

• Serum PSA

• If any indication via serum PSA or DRE then biopsy of prostate taken via transrectal ultrasound

20

How would you treat a prostate cancer?

o Radical prostatectomy

o Radiotherapy – external beam or brachytherapy High dose brachytherapy

21

How would you treat a metastatic prostate cancer

hormones and palliation (chemo and radiotherapy)

22

How would you treat bladder cancer?

chemotherapy, radiotherapy, immunotherapy

23

How would you treat a renal cell carcinoma?

Radical / partial nephrectomy Immunotherapy