Urological pathology

Question 1

urinary stones can be made of?

Answer 1

Calcium Oxalate (Weddellite) – 75%

Magnesium Ammonium Phosphate (Struvite) – 15%

Uric Acid – 5%

Question 2

which stones are related to hypercalciuria?

Answer 2

Calcium Oxalate

Question 3

3 sources of hypercalciuria?

Answer 3

GUT - absorptive hyper cal

KIDNEY - proximal tubule

Primary HPTH

Question 4

which are the triple stones?

Answer 4

Magnesium ammonium phosphate stones - struvite

Question 5

what causes the formation of triple stones?

Answer 5

infection with urease-producing organisms

Proteus sp.

Question 6

when triple stones become very large what are they called?

Answer 6

staghorn calculi

Question 7

which stones are the following susceptible to:

Gout
Rapid cell turnover

Answer 7

uric acid stones

due to hyperuricaemia

Question 8

where can small kidney stones become lodged at?

Answer 8

Pelvi-ureteric junction,

pelvic brim,

vesico-ureteric junction

Question 9

Name 3 Benign Renal Neoplasms?

Answer 9

Papillary adenoma (epithelial)

Renal oncocytoma (epithelial)

Angiomyolipoma (mesenchymal) - blood, muscle,fat

Question 10

which Benign Renal Neoplasm has the following:

15mm or less in size
Well-circumscribed

Trisomy 7, Trisomy 17, Loss of Y chromosome

Answer 10

Papillary adenoma

small tumour

the papillary carcinoma has the same genetic cause :)

Question 11

which Benign Renal Neoplasm is:

Usually sporadic
Can be seen in Birt-Hogg-Dubé syndrome

Answer 11

Renal oncocytoma

Question 12

which Benign Renal Neoplasm is:

Derived from perivascular epithelioid cells
Mostly sporadic
Can be seen in tuberous sclerosis

Answer 12

Angiomyolipoma

Question 13

which Benign Renal Neoplasm is:

Larger tumours (> 4cm) may present with flank pain, haemorrhage, shock

Answer 13

Angiomyolipoma

Question 14

Malignant kidney neoplasms are often called?

Answer 14

Carcinomas - they are all epithelial tumours

apart from nephroblastoma

Question 15

most common renal cell carcinoma?

Answer 15

clear cell

Question 16

how does renal cell carcinoma often present?

Answer 16

painless haematuria

Question 17

clear cell RCC is caused by loss of which chromosome?

Answer 17

chromosome 3p

Question 18

clear cell RCC tumour has what colour?

Answer 18

golden-yellow

Question 19

Papillary RCC is of what size?

Answer 19

more than 15mm

Question 20

Papillary RCC tumour has what colour?

Answer 20

fragile, friable (crumbled) brown tumour

Question 21

which malignant Renal Neoplasm has

raisin like nuclei

Answer 21

Chromophobe Renal Cell Carcinoma

Question 22

which malignant Renal Neoplasm is:

composed of sheets of large cells
display distinct cell borders,
reticular cytoplasm
thick-walled vascular network

Shows variable genetic aberrations

Answer 22

Chromophobe Renal Cell Carcinoma

Question 23

how does Chromophobe RCC tumour look?

Answer 23

well-circumscribed solid brown tumour

Question 24

ISUP Nuclear Grade (1-4) applies to which tumours?

Answer 24

clear cell RCC

papillary RCC

Question 25

Leibovich Risk Model applies to which tumours? what is it for?

Answer 25

clear cell RCC for staging

Question 26

which tumour presents as abdominal mass in children aged 2-5 years ?

Answer 26

nephroblastoma aka wilms tumour

Question 27

which is the second most common childhood malignancy?

Answer 27

nephroblastoma aka wilms tumour

Question 28

Transitional Cell Carcinomas arise in which 3 areas?

Answer 28

Bladder Renal Pelvis Ureters

Question 29

which tumours are triphasic - affect 3 different cells in kidney?

Answer 29

nephroblastoma aka wilms tumour

Question 30

which tumours carry a number of genetic aberrations including RB and TP53? tumour protein53

Answer 30

High grade Non-Invasive Papillary Urothelial Carcinoma NIPUC

Question 31

which tumours appear as leaf/ frond-like growths?

Answer 31

Non-Invasive Papillary Urothelial Carcinoma NIPUC

Question 32

how does Benign Prostatic Hyperplasia present?

Answer 32

LUTZ: FUN HIPS Frequency Urgency Nocturia Hesitancy Poor flow Terminal Dribbling or UTI, urinary retention

Question 33

treatment for Benign Prostatic Hyperplasia?

Answer 33

§ 5a-reductase inhibitors - finasteride § Alpha-blockers § Transurethral resection

Question 34

which tumour arises from Prostatic Intraepithelial Neoplasia ?

Answer 34

Prostatic Adenocarcinoma

Question 35

which is the Most common malignant tumour in men?

Answer 35

Prostatic Adenocarcinoma

Question 36

Which is the most powerful prognostic indicator in Prostatic Adenocarcinoma?

Answer 36

Gleason score

Question 37

how is Gleason grading conducted?

Answer 37

x+y = z Calculated by adding the top two most common patterns/grades on histological grading (or most common pattern + worst pattern)

Question 38

name risk factors for Testicular Germ Cell Tumours?

Answer 38

``` Undescended testis (3-5x increased risk) Low birth weight / small for gestational age ```

Question 39

Amplification of i12p consistent finding in ?

Answer 39

testicular germ cell tumours

Question 40

how do Testicular Germ Cell Tumours present?

Answer 40

Present as painless lump | 10% present with symptoms related to metastasis

Question 41

which tumour has on histology: Clear polygonal cells with lymphoid infiltrate

Answer 41

Seminoma

Question 42

Highly sensitive to treatment regimes used for | Testicular Germ Cell Tumours ?

Answer 42

platinum-based chemotherapy - cisplatin, carboplatin

Question 43

prognosis of Testicular Germ Cell Tumours ?

Answer 43

Five year survival is 98%

Question 44

which tumour Can see keratin, cartilage, epithelium – trying to form dermal layers

Answer 44

Post-Pubertal Teratoma a Testicular Germ Cell Tumour

Question 45

name 3 Testicular Non-Germ Cell Tumours?

Answer 45

Lymphoma Leydig Cell Tumour Sertoli Cell Tumour

Question 46

which are more common T GCC or T N-GCC?

Answer 46

T GCC

Question 47

a hydrocele consist of fluid which? tunica vaginalis tunica vasculosa, tunica albuginea

Answer 47

tunica vaginalis

Question 48

which penile disease causes Phimosis?

Answer 48

Lichen sclerosis/ BXO

Question 49

which penile disease associated with HPV 6 and 11?

Answer 49

Condylomas

Question 50

which paratesticular and urethral disease associated with N. gonorrhoeae, C. trachomatis

Answer 50

itis! Epididymitis Urethritis

Question 51

Fournier’s Gangrene occurs where?

Answer 51

scrotum - usually immunocompromised