Uro Path

Question 1

these specialized epithelial cells allow the urothelium to expand and contract while staying water tight

Answer 1

umbrella cells

Question 2

name 5 renal cystic diseases

Answer 2

multicystic renal dysplasia, adult polycystic kidney disease, infantile polycistic kidney disease, simple renal cysts, acquired cystic kidney disease

Question 3

pathologic hallmark of renal dysplasia

Answer 3

undifferentiated tubules and ducts surrounded by mesenchyme (may contain muscle or cartilage)

Question 4

renal dysplasia is almost always associated with?

Answer 4

other urinary tract abnormalities and obstruction to urine flow in utero

Question 5

most common cause of abdominal mass in newborn

Answer 5

multicystic renal dysplasia

Question 6

differences between adult and infantile polycystic disease

Answer 6

AD vs AR, midlife vs birth (75% die in utero), distorted vs smooth kidneys, bunch of cysts + normal kidney vs dilated collecting system (big blown up kidney)

Question 7

simple renal cysts are usually found in the?

Answer 7

renal cortex

Question 8

microscopy of simple renal cyst shows?

Answer 8

lined by single layer of flattened epithelium (internal septations can mimic cancer)

Question 9

acquired cystic kidney disease occurs in?

Answer 9

pts with long-term dialysis hx

Question 10

acquired cysts are bad because?

Answer 10

they may turn into RCC

Question 11

intrinsic causes of kidney obstruction

Answer 11

stones, blood clots, tumors of urinary tract, posterior urethral valves, strictures

Question 12

renal cell carcinoma is cancer of what cell type?

Answer 12

adenocarcinoma (clear cell or papillary) that arises from renal tubular epithelium

Question 13

abnormalities in which chromosome are associated with clear cell vs. papillary RCC?

Answer 13

chr 3 with clear cell; 7 and 17 with papillary

Question 14

late stage signs of RCC (tho usually detected before this)

Answer 14

hematuria, flank pain, abdominal mass

Question 15

if you see a solid renal mass, what should you do next?

Answer 15

straight to surgery usually (rather than biopsy)

Question 16

infectous causes of cystitis

Answer 16

coliform bacteria, TB, schistosomiasis

Question 17

non-infectious causes of cystitis

Answer 17

radiation and/or chemo

Question 18

these patients can have severe intractable cystitis from chronic use of indwelling catheter

Answer 18

paraplegics

Question 19

bladder obstruction usually occurs in (men/women) secondary to?

Answer 19

men; BPH

Question 20

90% of bladder cancers are?

Answer 20

urothelial (transitional cell) carcinoma

Question 21

paraplegic’s and people with schistosomiasis infection get this type of bladder cancer

Answer 21

squamous cell carcinoma

Question 22

risk factors for urothelial neoplasms

Answer 22

industrial exposure to carcinogens, tobacco use (big one!), cyclophophamide

Question 23

usual clinical presentation of bladder cancer

Answer 23

hematuria or dysuria

Question 24

diagnosis of bladder cancer is made by?

Answer 24

urine cytology and/or cytoscopy + biopsy

Question 25

adenocarcinoma of the bladder may be associated with?

Answer 25

congenital anomalies or metaplasias

Question 26

the bladder may be home to mets from what primary tumors?

Answer 26

local invasion by tumors of the cervix, prostate, colon; mets from melanoma, stomach, breast, and lung cancer

Question 27

major risk factors for germ cell neoplasms of the testis

Answer 27

cryptorchidism, fam hx, gonadal dysgenesis

Question 28

etiologic agents of orchitis

Answer 28

gram neg bacteria, syphilis, mumps

Question 29

testicle torsion is due to twisting of the?

Answer 29

spermatic cord

Question 30

what happens when a testicle is twisted?

Answer 30

hemorrhagic infarct +/- necrosis with time

Question 31

most primary testicular germ cell tumors present as?

Answer 31

painless, solid masses within the testis

Question 32

this tumor marker is suggestive of yolk sac differentiation

Answer 32

alpha-fetoprotein (AFP)

Question 33

this tumor marker is suggestive of chorionic/trophoblastic differentiation

Answer 33

beta HCG

Question 34

this is a non-specific marker seen of bulky tumors of many types

Answer 34

lactic dehydrogenase

Question 35

this is the most common pure germ cell tumor (40-50%) of the testis

Answer 35

seminoma

Question 36

gross appearance of seminoma

Answer 36

solid, grayish-white mass without necrosis or hemorrhage (mets common)

Question 37

microscopic appearance of seminoma + tumor markers

Answer 37

uniform, large tumor cells and lymphocytes; elevated LDH ONLY

Question 38

peak age for seminoma

Answer 38

4th decade (30-40 years)

Question 39

peak age for embryonal carcinoma

Answer 39

3rd decade (20s)

Question 40

gross appearance of embryonal carcinoma

Answer 40

gray-white solid mass WITH necrosis and hemorrhage (often)

Question 41

tumor markers for embryonal carcinoma of the testis

Answer 41

may be AFP+, usually BHCG -- (also show sheet-like pattern on histo)

Question 42

yolk sac tumors are often characterized by a ____ appearance microscopically

Answer 42

microcystic

Question 43

_____ are pathognomonic for yolk sac tumors

Answer 43

Schiller-Duval bodies

Question 44

classic presentation of choriocarcinoms

Answer 44

tiny hemorrhagic and necrotic primary tumor in testis with widespread mets

Question 45

microscopic appearance of choriocarcinoma + tumor markers

Answer 45

must have both syncytiotrophoblasts and cytotrophoblasts, greatly elevated serum BHCG

Question 46

this testicular tumor has tissues from all 3 germ layers and is more aggressive in adults

Answer 46

teratoma

Question 47

management of mixed germ cell tumors of the testis

Answer 47

based on individual components

Question 48

what is Peyronie disease?

Answer 48

focal asymmetric fibrosis of the shaft of the penis, results in a bent penis when erect

Question 49

cancer of the penis is generally ______ and only occurs in?

Answer 49

squamous cell carcinoma; uncircumcized males