Kidney Bladder Path

Front 1

tubular epithelial necrosis with skip "PATHCY" areas, rupture of BM, occlusion of tubular lumen by casts; cell swelling vacuolization, sloughing of non necrotic tubular cells into tubule lumen.
- EOSINOPHILIC hyaline casts sp in dista tubules and CD. : mostly Tamm Horsfall protein.
- Also evidence of epithelial regeneration: flat epithelial cells w hyperchromatic nucleus and mitotic figures.

Back 1

Acute Tubular Necrosis: ISHCEMIC

Front 2

ethylene glycol shows marked ballooning and vacuolar degeneration of PCT. it usually has a DIFFUSE tubular involvement.

Back 2

Acute Tubular Necrosis: TOXINS

Front 3

No. 1 microorganism that causes UTI.

Back 3

gram - rod: E.Coli #1 others:
- proteus, klebsiella, enterobacter.

Front 4

2 routes how bacteria can reach the kidney

Back 4

- ascening from lower UT
- via bloodstream, less common

Front 5

acute pyelonephritis shows what type od casts

Back 5

WBC casts

Front 6

this nephropathy occurs early childhood from superimposition of UTI on congenital vesicoureteral reflux.
it involves calyces and pelvis
- shows dilated tubules w flattened epithelium filled w colloid casts which make them look like thyroid: "thyroidization" also chronic interstitial inflammation and fibrosis.

Back 6

chronic obstructive pyelonephritis
reflux nephropathy

Front 7

affects small arteries and arterioles of kidney, results is focal ischemia
MEDIAL and intimal thickening: glassy thickening, hyalinization of walls , due to age as response to hemodynamic changes, aging, genetics.
hyaline deposition d/t extravasation of plasma proteins through injures endothelium.
due to the effects of BENIGN hypertension under control
- fine granular cortical surface- subcapsular scars w sclerotic glomeruli and tubular dropout.

Back 7

benign nephrosclerosis

Front 8

damage to the interlobular arteries of the kidne: INTIMAL thickening, proliferation of elongated, concentrically arranged smooth muscle cells and fine concentric layering of collagen; ONION SKIN aka; hyperplastic arteriolitis
- PMN infiltrate
- fibrinoid necrosis

Back 8

malignant neprosclerosis

Front 9

most renal infarts are due to embolism, though severe atherosclerosis of the renal arteries may lead to occlusion via thrombosis.
most infarcts are white or anemic (not hemorrhagic) by 24h the infarcts are well demarcated and have a ringed zone of hyperemia. infarcts are usually wedge shaped with base at the cortex and the apex pointing toward the medulla.
ischemic coagulative necrosis
what is the major source of emboli?

Back 9

mural thrombosis in the left atrium and ventricles resulting from myocardial infarction.

Front 10

dilation of the renal pelvis and calyces associated w progressive atrophy of the kidney due to obstructio of urine flow.
if chronic- cortical tubular atrophy and diffuse interstitial fibrosis

Back 10

hydronephrosis

Front 11

kidney disease a/w mutations in genes located in chromosome 16p(PKD1) and 4q (PKD2), these abnormalities arise from TUBULES
a/w LIVER cysts and BERRY aneurisms. they might not know they have it until they develop ARF

Back 11

Adult Polycystic Disease

Front 12

this autosomal recessive disease p/w mutations on the PKDHD1, chromosome 6p21-23
- kidney enlarged
SPONGE like dilated channels to cortical surface; micro shows saccular dilation of collecting ducts
- hepatic periportal fibrosis, bile duct proliferation

Back 12

Autosomal recessive Polycystic Kidney Disease

Front 13

tumor of the kidney present in up to 50% of patients w tuberous sclerosis

Back 13

angiomyolipoma

Front 14

epithelial tumor thought to arise from intercalated cells of CD, considered bening, rare report of mets. particular "mahogany brown" appearance and it often has a intermediate scar
- nuclei have large nucleoli
-EM shows many mitochondria in cytoplasm, thus eosinophilic cells

Back 14

oncocytoma

Front 15

bright yellow tumor (lipid) to grey white mass which distorts the kidney.
- areas of necrosis and hemorrhage are common

Back 15

renal cell carcinoma

Front 16

70-80 % of renal cell carcinoma are this type

Back 16

clear cell carcinoma
cells w clear or granular cytoplasm, non papillary, loss of sequences on short arm of chromosome 3 (95%) familial or a/w VHL gene.

Front 17

this renal cancer arises frrom PROXIMAL TUBULE epithelium, solitary, unilateral, usually upper pole.
-round polygonal cells with clear granular cytoplasm (lipid and glycogen)
- delicate branching vasculature "CHICKEN WIRE"

Back 17

clear cell carcinoma

Front 18

renal cancer that arises from DCT, often multifocal, hemorrhagic, cystic
- most common tumor in patients who develop DIALYSIS associated cystic disease
- cuboidal or low columnar cells in papillary formations
- foamy macrophages within papillary cores

Back 18

papillary cell carcinoma

Front 19

renal carcinoma with pale eosinophilic cells, perinuclear halo, solid sheets usually w largest cells around blood vessels "VEGETABLE CELL WALL APPEARANCE"

Back 19

chromophobe cell carcinoma,

Front 20

tumor classification used to predict survival and recurrence free in patients w localized conventional renal cell carcinona. it uses nuclear features for classification

Back 20

FUHRMAN grading system

Front 21

3 histological patterns of Wilms tumors

Back 21

blastematous tissue w some differentiated glomerular structures associated w mesenchymal tissue and tubules.
- Blastemal
- Stromal
-Epithelial

Front 22

this condition is most common is women, painful chronic.
- punctate hemorrhage and fissures in later stages, HUNNER ULCERS, chronic mucosal ulcers. histo may show MAST CELLS. you biopsy to rule out carcinoma in situ.
-micro doesnt show bacteria even symps are of chronic painful dysuria

Back 22

interstitial cystitis

Front 23

this class of urothelial carcinoma:
orderly architecture, cyto w minimal/mild nuclear atypia, some hyperchromatic nuclei and some variation in nuclear size and shape. less than 10% invade

Back 23

LOW GRADE papillary urothelial carcinoma

Front 24

this urothelial carcinoma p/w large hyperchromatic, dyscohesive cells w atypia and anaplasia. Mitoses are seen. there is architectural disarray and loss of polarity. 80% show invasion

Back 24

HIGH grade papillary urothelial carcinoma

Front 25

thus grade of papillary urothelial carcinoma is high grade by definition, may be multifocal can shed into urine. it doesnt stick out of the lesion, incact basement membrane.

Back 25

IN SITU urothelial carcinoma

Front 26

once a urothelial high grade carcinoma has become inflitrating pT3a, what tissue has it invaded and whats the mortality rate

Back 26

it has invaded all the way to the muscularis propia, and now it has a 50% 5m year mortality rate.

Front 27

classification of bladder cancer pT1 has invade what structure

Back 27

lamina propia

Front 28

this type of bladder carcinoma is rare in the US but is common in countries endemic for urinary schistosomiasis (S.hematobium)

Back 28

squamous cell carcinoma

Front 29

hyperplastic arteriolitis is a/w

Back 29

malignant hypertension

Front 30

problem a/w ADPKD

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liver cyst

Front 31

a/w ARPKD

Back 31

hepatic periportal fibrosis