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240 Cards in this Set
- Front
- Back
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an afebrile 22 year old woman develops urinary findings of increased frequency, urgency, dysuria, and suprapubic pain. The urinalysis most likely showed?
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Pyuria and bacteriuria: neutrophils and bacteria
Positive dipstick nitrite/esterase: first reaction due to E. coli conversion of nitrates to nitrites, second due to neutrophils Positive dipstick for blood: invariable findings in LUT infection |
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T/F
there is no fever or cast formation in a lower urinary tract infection. |
true
these would be findings in acute pyelonephritis |
|
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what are dysmorphic RBCs characteristic of?
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nephritic type of acute glomerulonephritis and glomerular origin of hematuria
|
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what type of kidney disease does a type III HSR present in?
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most cases of glomerulonephritis
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what would you see WBC casts present in?
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acute pyelonephritis
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Elderly man with low back pain and an increased serum alkaline phosphatase/
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prostate adenocarcinoma: increased alkaline phosphatase from osteoblastic mets to bone
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Erythematous lesion on the glans of the penis that has an HPV relationship
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Erythroplasia of Queyrat: precursor lesion for squamous cancer
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Patient with Wegner's granulomatosis develops hematuria and abnormal urine cytology.
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Transitional cell carcinoma from cyclophosphamide
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a 2 year old boy has urinary retention and grape like mass protruding from the urethra
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Embryonal rhabdomyosarcoma: MC sarcoma in children.
Rhabdomyoblasts with cross striations are noted on biopsy |
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An egyptian man, with eosinphilia, has microscopic hematuria and an abnormal urine cytology.
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Bladder squamous cell carcinoma from Schistosoma hematobium infection
|
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what is the MC bladder cancer?
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transitional cell carcinoma
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what are some related causes of transitional cell carcinoma of the bladder?
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smoking: MC
aniline dyes cyclophosphamide Schistosoma hematobium painless gross/microscopic hematuria |
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an uncircumcised male has an ulcerative lesion on the undersurface of the glans penis and palpable inguinal adenopathy.
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Penis squamous cell carcinoma with metastasis. Poor hygiene of circumcision is MCC. Smegma is a carcinogen. Also has an association with HPV 16, 18 and smoking
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loss of blood group antigens implies a poor prognosis for this cancer.
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transitional cell carcinoma of bladder
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a man has a white, raised lesion on the shaft of his penis. A biopsy reveals in-situ cancer
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Bowen's disease: precursor for squamous cell carcinoma
Associated with underlying malignancies in other organs |
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a woman with a h/o leakage from the umbilicus as a child develops microscopic hematuria and abnormal urine cytology
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urinary bladder adenocarcinoma from persistent urachal remnants
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a man who has worked with aniline dyes in the past develops microscopic hematuria and abnormal urine cytology
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transitional cell carcinoma from aniline dye
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most common cancer in men and second most common mortality due to cancer in men
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prostate adenocarcinoma
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cancer that most commonly uses Batson venous plexus for metastasis to the vertebral column.
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prostate adenocarcinoma
osteoblastic metastasis with increased serum alkaline phosphatase |
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a 72 year old man has bilateral painless mass in both testicles.
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malignant lymphoma
MC lymphoma in elderly Metastasis not primary testicular cancer |
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Unilateral right testicular mass in patient with a past h/o cryptochidism in the left testicle.
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Seminoma: increased risk for involved and uninvolved tests.
MC testicular cancer in adults Metastasizes to para-aortic nodes not inguinal nodes |
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most common testicular cancer in children with an increased AFP and the presence of Schiller-Duval bodies.
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Yolk sac tumor (endodermal sinus tumor)
MC testicular cancer in children |
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Testicular tumor that is most radiosensitive and metastasizes to the para-aortic lymph nodes
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Seminoma
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Testicular cancer that may have an increase in hCG without it altering the prognosis
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Seminoma
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Testicular cancer most commonly associated with gynecomastia, lung metastasis, and increase in hCG
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choriocarcinoma
hCG is an LH analogue, hence the gynecomastia |
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Unilateral testicular cancer in a 72 year old man
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spermatocytic seminoma
NO lymphoid infiltrate |
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unilateral testicular cancer in a 22 year old man that partially involves the testis, is associated with hemorrhage and necrosis, and commonly mixed with other types of testicular cancer
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Embryonal carcinoma
spreads hematogenous routes first, unlike seminomas |
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Unilateral testicular cancer in a 35 year old man that completely involves the testicle, is not associated with hemorrhage or necrosis, and has a lymphoid infiltrate intermixed with the neoplastic cells
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Seminoma
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Testicular cancer that would most likely be benign in children and malignant in adults
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choriocarcinoma
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Testicular cancer with worst prognosis
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Choriocarcinoma
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the urinary pathogen most often responsible for endotoxic shock, acute pyelonephritis, and acute cystitis is most likely:
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E. coli:
gram negative rod a nitrate reducer |
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what is the most common cancer in adult males?
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prostate cancer
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what hormone is prostate cancer dependent on?
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DHT-dependent
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where are most prostate cancers located at on the prostate?
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periphery of the gland
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T/F
PSA is more sensitive than specific |
true
false positive from BPH |
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T/F
osteoclastic metastasis is common to the vertebra in prostate cancer |
false
osteoblastic mets |
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would the alkaline phosphatase be increased/decreased in prostate caner?
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increased
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what is the greatest risk factor for malignancy associated with painless hematuria in an adult?
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exposure to polycystic hydrocarbons: these chemicals are in cigarette smoke. painless hematuria is seen in renal adenocarcinoma and transitional cell carcinoma
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what is patient with exposure to Schistosoma hematobium at risk for?
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squamous cancer.
uncommon in US |
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what is a patient with a long history of exposure to phenacetin at risk for?
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transitional cell carcinoma
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what is a patient taking cyclophosphamide at risk for developing?
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transitional cell carcinoma
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what is a patient with h/o exposure to aniline dye at risk for?
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transitional cell carcinoma
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T/F matching.
Persistent urachal sinus: newborn with fecal drainage from umbilicus |
false
it drains urine: persistent urachal sinus drains urine since the urachus connects the bladder with the umbilicus fecal drainage is due to persistent vitelline duct |
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T/F matching
anterior abdominal wall/bladder defect: exstrophy of the bladder |
true
increased incidence of adenocarcinoma |
|
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t/f matching
adenovirus and cyclphosphamide: hemorrhagic cystitis |
true
|
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t/f matching
benign prostate hyperplasia: acquired bladder diverticula/stones |
yes due to increased intravescial pressure
|
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t/f matching
malacoplakia: Michaelis-Gutmann bodies |
yes
calcium concretions |
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t/f matching
urethral caruncle: urethral bleeding in women |
true
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faulty closure of urethral folds: hypospadias
|
yes
hole on undersurface of penis or perineum |
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defect in genital tubercle: epidspadias
|
yes
hole on dorsal surface of penis |
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Fibromatosis of penis: Peyronies disease
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yes
|
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penis squamous carcinoma: metastasis to para-aortic nodes
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NO
inguinal nodes testicular cancers metastasize to para-aortic nodes |
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what is hypospadias?
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an abnormal opening on the ventral surface of the penis that is due to faulty closure of the urethral folds. It must be surgically corrected to prevent UTIs
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what is Mullerian inhibiting factor responsible for in the testes
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descent to the inguinal canal
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what is hCG responsible for in the descent of the testis?
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hCG is responsible for the testis descent in the scrotal sac
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T/F
in a torsion of the testicle Prehn's sign is positive. |
False
Torsion fo the testicle will have an absent cremasteric reflex |
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what is Prehn's sign?
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sign of relief by taking pressure off inflamed epididymis by elevating the scrotum
|
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when is the cremasteric reflex absent?
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torsion of the testicle
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what is produced when the tunica vaginalis persists in a male?
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Hydrocele: transiluminate with light
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is epididymitis a sexually transmitted disease?
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in men < 35 years of age MC Chlamydia, GC
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T/F
A varicocele is a common cause of male infertility. |
true
heat inhibits spermatogenesis renal cell carcinoma with invasion of the left renal vein can produce varicocele |
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what is the MCC of varicocele?
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blockage of the left renal vein since the spermatic vein on the left empties into the left renal vein while the one on the right empties into the IVC
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T/F
retroperitoneal fibrosis can produce a right sided varicocele |
true
|
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what is the MCC of scrotal enlargement?
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Hydrocele and is due to persistent tunica vaginalis
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what are the predisposing factors to a torsion of the testicle?
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violent movement or physical trauma, cryptorchid testis, atrophy of testis
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what are the s/s of testicular torsion?
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sudden onset of testicular pain, absent of cremasteric reflex
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what are the MC pathogens in epididymitis in males < 35 yo.
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Neisseria gonorrhoeae
chlamydia trachomatis |
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what are the MC pathogens in epididymitis in males > 35 yo.
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E. coli and Pseudomonas aeruginosa
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what is the MCC of left sided scrotal enlargement?
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Varicocele
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is urethral obstruction an early or late finding in prostate cancer?
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LATE
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what is the key hormone in hyperplasia and cancer of the prostate?
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DHT is responsible for fetal development of the prostate
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what hormones cause prostate hyperplasia?
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DHT and estrogen
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T/F
DHT alone is responsible for prostate cancer. |
true
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T/F
estrogen is used in tx of prostate cancer. |
true
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what does 5-a-reductase inhibitors do?
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increases testosterone because it converts testosterone to DHT
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what is congenital megaloureter associated with?
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hirshsprungs disease
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what is ureteritis cystica a risk factor for?
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bladder adenocarcinoma
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what is the most common complication of retroperitoneal fibrosis?
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hydronephrosis
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what is the MC cancer of the ureter?
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Transitional cell carcinoma
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what is Exstrophy?
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developmental failure of anterior abdominal wall and bladder
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t/f
exstrophy is a risk factor for bladder adenocarcinoma |
true
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what is the most common cause of bladder adenocarcinoma?
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urachal cysts: drainage of urine from the umbilicus
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what is the MCC of sepsis/urinary tract infections in hospitals
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indwelling catheters
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what can cyclophosphamide produce?
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hemorrhagic cysts
prevented with menses |
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what is the most common uropahtogen?
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E. coli
sepsis in the hospital |
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what does Staphylococcus saprophytica cause?
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LUT infection in young, sexually active female
it is coagulase negative |
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gram stain of e. coli
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gram negative rod
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what is the most common cause of acute urethral syndrome in woman and NSU in men
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C. trachomatis
|
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LUT infection signs
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dysuria
increased frequency urgency |
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what is the gold standard for diagnosis of LUT.
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> 10^5 CFUs/mL
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your female patient has asymptomatic bacteriuria. what do you do to treat her?
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treat pregnant woman with amoxicillin
no treatment for healthy elderly woman |
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what is sterile pyruia?
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neutrophils in the urine
negative standard culture |
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what is Malacoplakia associated with?
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chronic E. coli infection of the bladder
Michaelis Gutman bodies: foamy macrophages filled with laminated mineralized concretions |
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what is the MCC of acquired bladder diverticula?
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BPH
chronic E. coli infection |
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what is a cystocele?
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bladder wall protrudes into vagina - creates a pouch that collects residual urine
|
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cystica/cystica/glandularis?
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bladder rendition or ureteritis cystica
risk of bladder adenocarcinoma |
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if your patient is having a problem with retaining urine, what are the possible nervous system causes?
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increased sympathetic activity
- relax detrusor muscle, contract internal sphincter muscle |
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if your patient is having problems with voiding what could be the possible nervous system mechanism causing it?
|
increased parasympathetic activity
contract detrusor muscle relax internal sphincter muscle |
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what is the MC bladder cancer?
|
transitional cell carcinoma
|
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what is the most common cause of transitional cell carcinoma?
|
smoking
|
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what type of cancer is predominately produced by S. hematobium?
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squamous cell carcinoma of the bladder
|
|
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what is the most common sign of transitional cell carcinoma of the bladder?
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painless hematuria is most common sign
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what type of HSR is involved in killing helminth eggs?
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type II HSR involving eosinophils
|
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what is the MC sarcoma in children?
|
embryonal rhabdomyosarcoma
in boys it protrudes through the urethra |
|
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what cancers most commonly invade the bladder?
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cervical and prostate cancer
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|
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what pathogens causes STD urethritis?
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chlamydia trachomatis
neisseria gonorrhoeae |
|
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what is the most common cause of urethra cancer?
|
squamous cell carcinoma
|
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Hypospadias
|
abnormal opening in ventral surface of the penis
|
|
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what is the most common malformation of the urethral grove?
|
Hypospadias
|
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what causes hypospadias?
|
faulty closure of the urethral folds
androgen dysfunction |
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Epispadias
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abnormal opening in the dorsal surface of the penis
defect in genital tubercle |
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Phimosis
|
orifice of prepuce cannot retract over head of penis
|
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Balanoposthitis
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infection of glans and prepuce
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what is Peyronie's disease?
|
fibromastosis, lateral curvature of the penis
may cause infertility |
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what is Priapism
|
persistent painful erection
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what are risk factors for invasive squamous cell carcinoma?
|
Bowen's disease (leukoplakia involving shaft of the penis/scrotum, associated with HPV 16)
Erythroplasia of Queyrat (erythroplakia located on mucosal surface of the glans and prepuce, HPV 16 association) |
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what is Bowenoid papulosis?
|
HPV 16 association
multiple pigmented redish brown papules on external genitalia DOES NOT develop into invasive squamous cell carcinoma |
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MCC of penis cancer?
|
Squamous cell carcinoma
|
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what is a risk factor for squamous cell carcinoma of the penis?
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lack of circumcision > circumcision protects against developing cancer of the penis; HPV 16, 18 relationship
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what is responsible for the testes transabdominal phase?
|
mullerian inhibiting factor
|
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what is responsible for the testis inguinoscrotal phase?
|
androgen and hCG dependent
|
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Cryptorchid testis
|
incomplete or improper descent of the testis into scrotal sac
|
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what is the MC GU disorder of a male child?
|
cryptorchid testis
|
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T/F
Cryptorchid testis is a risk factor for seminoma and infertility of cryptorchid testis and normally descended testis |
True
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what are some causes of Orchitis? (inflammation of the testes)
|
Mumps
HIV syphilis |
|
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what are s/s of epididymitis?
|
scrotal pain with radiation into spermatic cord
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what is Prehn'ssign?
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elevation of scrotum decreases pain
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what is a varicocele most commonly on the left side?
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spermatic vein empties into left renal vein
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patient presents as a smoker with sudden onset of left varicocele.
|
consider renal carcinoma invading renal vein
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what is the most common cause of torsion of testicle
|
violent movement or trauma
|
|
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what is the most common cause of scrotal enlargement?
|
hydrocele
|
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what causes a hydrocele?
|
persistent tunica vaginalis
inguinal hernia may be present |
|
|
what is the most common testicular cancer?
|
seminoma
|
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what is the most common risk factor for testicular cancers?
|
cryptorchidism
|
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a patient presents with unilateral painless testicular mass, what is your top differential?
|
testicular cancer
|
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what are testicular cancer markers?
|
AFP: yolk sac tumor origin
hCG: choriocarcinoma |
|
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where does testicular cancer metastasize to?
|
para-aortic nodes
|
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what is responsible for the embryonal development of the prostate?
|
DHT
|
|
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what is the most common germ cell tumor?
|
seminoma
|
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a patient presents with a bulky tumor with hemorrhage and necrosis of the testis.
|
Embryonal carcinoma
|
|
|
most common testicular cancer in children < 4 years of age.
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Yolk sac tumor
increased AFP in all cases characteristic Schiller-Duval bodies resemble primitive glomeruli |
|
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patient is in mid-20s, has increased hCG, tumor contains mixed types of other tumors, trophoblastic and syncytiotrophoblast. Patient has gynecomastia
|
Choriocarcinoma
hCH is analogue of LH increased hCG in all cases Poor prognosis aggressive tumor hematogenous spread to lungs |
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this cancer is usually benign in children and malignant in adults. This is the 2nd MC germ cell tumor in children.
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Teratoma
|
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|
this is the most common testicular cancer in men > 60 years of age.
|
Malignant lymphoma
secondary involvement of both testes by diffuse large cell lymphoma Poor prognosis |
|
|
T/F
Chronic prostatitis is more common than acute |
true
|
|
|
what are some causes of chronic prostatitis?
|
majority are abacterial
bicycle riders |
|
|
what is the MCC of enlarged prostate in men > 50 yo.
|
BPH
|
|
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where is BPH found at on the prostate?
|
periurethral/transitional zones
|
|
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what is the primary mediator of BPH?
|
DHT
estrogen is co-mediator |
|
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what is the most common complication of BPH?
|
obstructive uropathy
produces bladder diverticula |
|
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what is the most common cause of bladder diverticula?
|
BPH
|
|
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a patient has pain on DRE and an increased PSA, what is in your differential?
|
prostate infarct
|
|
|
t/f
BPH is not a risk factor for prostate cancer. |
true
|
|
|
how would you treat a patient with BPH?
|
a-adrenergic blockers of smooth muscle
|
|
|
what is the most common cancer in men?
|
prostate cancer
|
|
|
what part of the prostate is prostate cancer normally found?
|
peripheral location
|
|
|
what is the greatest risk factor for prostate cancer?
|
advancing age
|
|
|
T/F
Prostate cancer is DHT dependent. |
true
|
|
|
what does obstructive uropathy indicate in prostate cancer?
|
extension into the bladder
|
|
|
when prostate cancer metastasizes to bone is it osteoblastic/clastic?
|
osteoblastic metastasis
- lumbar spine, pelvis |
|
|
T/F
PSA is more sensitive than specific |
true
|
|
|
Increased free PSA is found in your patient, what should you consider?
|
BPH
|
|
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increased bound PSA is found in your patient, what should you consider?
|
prostate cancer
|
|
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how do you diagnose prostate cancer?
|
transrectal needle core biopsy
|
|
|
what does FSH stimulate in the male?
|
spermatogenesis
|
|
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what does LH stimulate in the male?
|
stimulates testosterone synthesis in Leydig cells
|
|
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where is SHBG synthesized in the male?
|
sertoli cells and liver
|
|
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what enhances spermatogenesis?
|
testosterone and libido
|
|
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if you increase SHBG what happens to testosterone?
|
free testosterone decreases
|
|
|
if your decrease SHBG what happens to free testosterone?
|
free testosterone will increase
|
|
|
what is the most common manifestation of male hypogonadism?
|
impotence
|
|
|
clinical presentation of hypogonadism
|
impotence
female secondary sex characteristics osteoporosis infertility |
|
|
Primary hypogonadism
|
increased LH
decreased testosterone |
|
|
Secondary hypogonadism
|
decreased LH
decreased testosterone |
|
|
PRimary hypogonadism Leydig cell dysfucntion
|
alcohol
renal failure orchitis radiation - decreased testosterone, increased LH, normal FSH |
|
|
Primary hypogonadism: Leydig cell and seminiferous tubule dysfuction
|
decreased testosterone
decreased sperm count increased LH increased FSH |
|
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Causes of secondary hypogonadism
|
constitutional delay
Kallman's syndrome: decreased FSH, LH, testosterone, sperm count Hypopituitarism: decreased FSH, LH, testosterone, sperm count |
|
|
what accounts for 90% of cases of male infertility?
|
semineferous tubule dysfunction
|
|
|
what is the gold standard test for infertility in men?
|
semen analysis
|
|
|
if your patient has impotence + preserved NPT:
|
psychogenic cause of impotence
|
|
|
Primary hypogonadism: Leydig cell and seminiferous tubule dysfuction
|
decreased testosterone
decreased sperm count increased LH increased FSH |
|
|
Causes of secondary hypogonadism
|
constitutional delay
Kallman's syndrome: decreased FSH, LH, testosterone, sperm count Hypopituitarism: decreased FSH, LH, testosterone, sperm count |
|
|
what accounts for 90% of cases of male infertility?
|
semineferous tubule dysfunction
|
|
|
what is the gold standard test for infertility in men?
|
semen analysis
|
|
|
if your patient has impotence + preserved NPT:
|
psychogenic cause of impotence
|
|
|
what is the most common cause of impotence in men > 50 yo.
|
vascular insufficiency
|
|
|
what nerves are responsible for an erection?
|
parasympathetic S2-S4
|
|
|
what nerves are responsible for ejaculation?
|
sympathetic T12-L1
|
|
|
list neurological causes of erectile dysfunction.
|
multiple sclerosis
diabetes mellitus |
|
|
list drugs that can cause erectile dysfunction.
|
Leuprolide
methyldopa Psychotropics |
|
|
how does Sildenafil treat erectile dysfunction?
|
increases cGMP, which causes vasodilation in corpus cavernosum
|
|
|
a 30 year old black man with AIDS has pitting edema, HTN, proteinuria > 3.5 g/24h and fatty casts in the urine.
|
focal segmental glomerulosclerosis
the MC glomerular disease in AIDS and IV heroin abusers. It has a bad prognosis. Now considered the most common adult cause of nephrotic syndrome |
|
|
a 29 year old woman develops generalized pitting edema and HTN. A renal biopsy demonstrates diffuse glomerular disease with increased thickness of basement membranes and hypercellularity. Silver stain exhibits a tram track splitting of basement membranes. An EM demonstrates dense deposits in the GBM. The patient hasa low serum C3
|
Type II MPGN or dense deposti disease
associated with C3 nephritic factor causing low C3. Whole basement membrane is involved |
|
|
A 25 year old man, who initially was admitted to the hospital with hemoptysis has progressed into renal failure. The urine contains RBC casts.
Renal biopsy demonstrates linear immunofluroscence and crescents. The EM is negative. |
Goodpastures syndrome
Rapidly progressive crescenteric glomerulonephritis note how patient usually begin with lung disease before renal failure. Anti-basement membrane antibodies are also directed against pulmonary capillary basement membrane. Type II HSR Crescents are due to proliferation of parietal epithelial cells |
|
|
a 74 year old man with colon cancer develops generalized anasarca. He has proteinuria > 3.5 g/24 h and fatty casts in his urine. A renal biopsy shows diffuse glomerular disease
Silver stain demonstrates epimembranous spikes and the presence of subepithelial deposits on EM |
Diffuse membranous glomerulopathy
note the relationship with cancer It is the second MC adult cause of nephrotic syndrome |
|
|
a 10 year old boy has bilateral sensorineural loss, ocular abnormalities, and glomerulonephritis. Both IF and EM are negative.
Foam cells are noted in visceral epithelial cells. |
Alport's syndrome.
X-linked recessive MC |
|
|
a 12 year old boy has a history of cellulitis ~ 2 weeks ago. He develops periorbital edema, hypertension, and smoky-colored urine. Urinalysis shows RBC casts with mild proteinuria.
Anti-DNase B titers are increased. Renal biopsy demonstrates diffuse increase in cellularity along with neutrophilic infiltrate. IF shows granular deposits. Subepithelial deposits are noted on EM. |
Acute post streptococcal GN: skin can be the initial infection
Chronic renal failure is rare Unlike rheumatic fever it is a type III HSR. |
|
|
a 62 year old woman with a long history of severe rheumatoid arthritis and restrictive cardiomyopathy develops pitting edema and hypercholesterolemia. Urinalysis shows oval fat bodies and fatty casts. Protein dipstick 4+ and SSA 4 +
A renal biopsy demonstrates hyalinization of the glomerular mesangium. A special stain is ordered. |
Systemic amyloidosis
reactive type due to conversion of serum associated with amyloid synthesized by the liver as an acute phase reactant to amyloid. Special stain is a congo red which turns apple green when polarized |
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an 89 year old woman with a h/o chronic HCV hepatitis from a blood transfusion develops generalized puffiness and mild HTN. Urinalysis shows oval fat bodies, fatty casts with Maltese crosses, 4+ protein.
A renal biopsy shows hypercellular glomeruli with an increase in basement membrane thickness and tram-track splitting of the basement membrane. the IF is granular and EM demonstrates subendothelial deposits. the patient has depressed levels of C3. |
type I MPGN with HCV association.
Cryoglobulinemia relationship |
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A 24 year old man with prior history of URI has microscopic hematuria, RBC casts, and mild proteinuria during routine physical exam. He is normotensive.
A renal biopsy shows granular IF with predominately IgA deposition in the mesangium and electron dense deposits in the same area. |
IgA glomerulopathy
MC glomerulonephritis Adults present with microscopic hematuria and children with gross hematuria Many patients present with Henoch-Schonlein purpura with palpable purpura, polyarthritis, GI bleeds, and glomerulonephritis. IgA is often increased. Deposits in mesangium |
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A 29 year old man with a family h/o renal disease develops microscopic hematuria and mild proteinuria. he is normotensive. The serum BUN and Cr are normal. H and E stains of renal biopsy show no glomerular abnormalities. IF is negative. The EM is negative for electron deposits, however the glomerular basement membranes are abnormal.
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Thin membrane disease
normal renal function but have mild proteinuria and hematuria |
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A 48 year old woman has proteinuria > 3.5, HTN, fatty casts in urine. A renal biopsy demonstrates eosinophilic nodular masses in the mesangium of the glomeruli, hyaline arteriolsclerosis of the afferent and efferent arterioles, and increased thickness of the basement membranes of the tubules. IF is negative. EM demonstrates fusion of the podocytes and increased collagen deposition in the mesangium and basement membrane.
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Nodular glomerulosclerosis in Diabetes mellitus
NOTE that any cause of nephrotic syndrome has fusion of the podocytes. Nodules represent type IV collagen and trapped protein |
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A normotensive 10 yo. boy with a previous history of an URI has generalized pitting edema. He has had problems with his allergies since early childhood. Urinalysis demonstrates proteinuria > 3.5 g/24 h, fatty casts, oval fat bodies. His renal findings improve rapidly with high dose cortcosteroids.
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Lipoid nephrosis (minimal change disease)
MCC of nephrotic syndrome in children. Selective proteinuria due to loss of negative charge on the GBM and loss of albumin in the urine |
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what are maltese cross due to in the urine sediment?
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cholesterol
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a 35 year old woman with HTN. A urinalysis demonstrates mild proteinuria, hematuria, and RBC casts. A serum ANA is exhibits a rim pattern. An anti-dsDNA titer is extremely high. A renal biopsy exhibits diffuse proliferative changes, wire looping, hematoxylin bodies. IF demonstrates granular pattern. EM shows subendothelial deposits.
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type IV SLE glomerulonephritis
TYPE III with DNA-anti-DNA immunocomplexes. REnal failure is common cause of death. Anti-dsDNA antibodies are in the peripheral blood as well and are a sign of renal disease |
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X-linked dominant disease with primary defect in the a-chain subtype 5 in type IV collagen.
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Alports syndrome
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Glomerulonephritis with strongest relationship with malignancy, chronic HBV, bilateral renal vein thrombosis
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diffuse membranous glomerulopathy; renal vein thrombosis is due to loss of antithrombin III in the urine. This leads to hypercoaguable state with increased risk of venous thrombi in this case in renal veins
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Glomerular disease associated with C3 nephritic factor against C3 convertase.
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Type II MPGN
has intramembranous deposits (dense deposits disease) ACtivation of C3 convertase causes very low C3 levels |
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Glomerulonephritis associated with anti-DNAase B antibodies.
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ACute streptococcal glomerulonephritis.
Anti-ASO titers are not present because they are degraded by the oil in skin. Group A strep skin infections predate the occurence of this type of glomerulonephritis. Most of these are skin infections, but they can also be pharyngeal infections with different strain of group A strep than what is seen in acute rheumatic fever |
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most common glomerular disease associated with cryoglobulinemia and HCV.
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Type I membranoproliferative GN
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Most common glomerular disease associated with an increase in creatinine clearance in the initial stage of disease
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Nodular glomerulosclerosis in DM.
Due to hyaline arteriolosclerosis of the efferent arteriole. ACE inhibitors relax efferent vessels, because ANG II, is no longer present. This reduces GFR back into the normal range and reduces hyperfiltration injury to GBM and loss of protein. |
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Most common glomerularnephritis with episodic hematuria and overlapping findings associated with Henoch-Scholein purupura/
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IgA glomerulopathy. It is the most common overal glomerulopathy and is usually nephritic in its presentation
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Autosomal dominant disease known as benign familial hematuria
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thin membrane disease
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cancers associated with the lacticferous ducts
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intraductal papiloma
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MCC of bloody discharge women < 50
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intraductal papilloma
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cancer associated with the major duct
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DCIS
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where is sclerosing adenosis found in the breast?
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terminal lobule
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MCC of breast mass < 50
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FCC
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Medullary carcinoma
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large cell/lymphocytic infiltrate
good prognosis |
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Lobular carcinoma
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highest incidence of bilaterality
nonpalpable MC malignancy of terminal lobules Indian file pattern |
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Fibroadenoma
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MC stromal tumor
MC mass in women < 35 |
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Ductal carcinoma in-situ
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microcalcifications demonstrate multifocal areas > ducts filled with neoplastic cells and central areas of necrosis
dystrofic calcification comedocarcinoma variant MC malignant tumor with microcalcifications non-palpable |
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component of FCC
simulates invasive cancer MC benign breast lesion with microcalcifications |
sclerosing adenosis
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Inflammatory carcinoma
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peau d'orange
worst overall prognosis |
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Tubular carcinoma
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terminal ductule
increased incidence bilaterality excellent prognosis |
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serous cystadenocarcinoma
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MC primary ovarian cancer
Ovarian cancer thats bilateral Psammoma bodies |
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Granulosa theca cells tumors
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thecal component secretes estrogen
Call-Exner bodies |
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Endometrial sinus tumor
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MC ovarian tumor in children
Schiller-Duval bodies |
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Leydig cell tumors
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Reinke crystalloids
adrogen screening |
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Dysgerminoma
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MC malignant germ cell tumor
associated with streak gonad of Turner's syndrome Serum LDH increased |
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Theca-fibroma
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Meigs syndrome
Right sided pleural effusion, ascites, solid ovarian tumor |
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Brenners tumor
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Walthards rest
mucinous cystadenoma benign surface derived ovarian tumor |
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Endometrial carcinoma
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malignant surface derived cancer
high incidence of bilaterality associated with endometrial carcinoma |
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Kallmanns syndrome
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poor secondary sex characteristics
absence of menarche color blindness and anosmia absent GnRH > decreased FSH and decreased LH |
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T/F
OCPs are a risk factor for cervical cancer |
True
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Placenta accreta
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requires hysterectomy to stop bleeding
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Trichomonas vaginalis
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frothy green discharge
strawberry vagina treat both partners |
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Actinomyces israeli
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yellow flecks of material attached to IUD
Gram + bacteria filamentous |
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Mycobacterium tuberculosis
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plasma cells in chronic endometriosis
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alopecia
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lymphadenopathy is generalized
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