Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
54 Cards in this Set
- Front
- Back
3 Morphological features in Wilm's tumor
|
Primitive tubules (epithelium)
Blastema (immature cells) Stroma |
|
Age of patients affected by Wilm's tumor
|
1-3 y/o
|
|
Wilm's cure rate
|
High 80-90%
|
|
Genes affected by Wilm's Tumor
|
WT 1/ WT 2
|
|
highest yield syndrome associated w/ Wilm's
|
Beckwith Wiederman
|
|
most common renal neoplasm in INFANCY
|
Congenital mesoblastic Nephroma
|
|
Congenital mesoblastic Nephroma morphological feature
|
spindle cells that have varying immaturity
|
|
< 0.5cm
> 0.5 cm |
papillary adenoma
papillary renal cell carcinoma |
|
Papillary Adenomas are located where?
|
subcapsular in cortex
|
|
Central stellate scare with mahogany brown appearance
|
Renal Oncocytoma
|
|
solitary tumor with a mixture of adipose, smooth m., and blood vessels?
|
angiomyolipoma
|
|
Most common malignant adult neoplasm?
|
Renal Cell Carcinoma
|
|
A 50 y/o pt presents with a history of flank pain, hematuria, and a unilateral palpable mass. He indicates he has a 50 pack/year smoking history. most likely diagnosis?
|
Renal Cell Carcinoma
|
|
Where does Renal Cell carcinoma commonly metastisize to? whats the best Tx?
|
Lungs, bone, lymph nodes
Surgery....chemo is not effective |
|
Clear Cell RCC gene mutation?
|
VHL (von Hippel Lindau) gene- a tumor suppressor gene
|
|
Papillary RCC size?
gene mutation? commonly known as what? |
> 0.5 cm (malignant)
c-met gene "Dialysis kidney" |
|
Prognosis of Collecting Duct Carcinoma?
|
50-66% die
worst prognosis of typical RCC subtypes. this is b/c collecting system is involved which backs up the urine into the blood thus causing toxicities and all kinds of problems. |
|
African-American or Mediterranean decent, history of sickle cell disease, very rare....describes what?
|
Renal Medullary Carcinoma
|
|
glycogen rich tumor?
|
Clear Cell RCC
|
|
Renal Urothelial Cell carcinomas involve what tissue type?
risk factors associated? |
Transitional Cell epithelium (calyces, renal pelvis, ureters, bladder)
smoking, chemicals, chronic injury/irritation |
|
Common sequels with obstructive uropathy?
|
you block urine, it sits around and brews up infection, and stones can also form. eventually you will lose renal function from hydronephrosis.
|
|
dilated renal pelvis
|
hydronephrosis
|
|
Pt presents with pain, hematuria, and an altered urinary output...you know this is probably a _________.
|
Urolithiasis
|
|
Urolithiasis types of stones?
|
Calcium
Struvite- magnesium, ammonium, phsophate Uric Acid Cystine |
|
tell the etiology of these stones:
1) Calcium 2) Struvite 3) Uric Acid 4) Cystine |
1) Most common 70% of time hypercalcemia/uria
2) bacterial infection (staghorn) 3) Gout 4) genetic defect in reabsortion of amino acids |
|
Layers of visceral bladder? (inside-->out)
|
Mucosa
Lamina propria- incomplete slips of smooth m. Muscularis propria- thick smooth m. Adventitia |
|
1) Out pouching of bladder?
2) Anterior bladder wall and abdominal wall missing? |
1) diverticula
2) exstrophy |
|
whats the deal with a patent urachus?
|
communicating duct from bladd to umbilicus which can set up lots of infection. typically requires surgical closing.
|
|
What causes Cystitis?
|
E.coli
Candida SCHISTOSOMIASIS chemicals can cause hemorrhagic cystitis. |
|
What is Malacoplakia?
Buzz cues associated?? |
whitish, tanish, yellow plaques on the bladder wall
Michaelis- Gutmann bodies within lysosomes of macrophages. |
|
Why would Transitional epithelium replaced with the following epithelia:
1) columnar 2) squamous |
1) chemical environment protection
2) physical stressors protection |
|
Urothelial epithelium cancers are:
Benign Premalignant (KNOW) Malignant (name the associated neoplasm within each class) |
Benign- urothelial papilloma
Premalignant- PUNLMP (Papillary urothelial neoplasm of low malignant potential) & Flat CIS (Flat carcinoma in situ) Malignant- Papillary urothelial Carcinoma (TCC-Transitional Cell Carcinoma) & FLAT (associated w/CIS) |
|
Difference in PUNLMP and TCC histologically
|
PUNLMP- mildly disorganized pattern w/ fibrovascular cores
TCC- less organized, big nuclei, mitotic figures. |
|
Squamous Cell carcinoma associated with?
|
schistosomiasis
|
|
Bladder CA risk factors?
|
smoking
2- naphthylamine (aromatic compounds) Extras: Schistosoma cyclophosphamides |
|
Patient presents with hematuria. Biopsy shows multiple tumors. Dr. Leonard gives this specimen a high grade and notes presence of CIS in surrounding mucosa. What does the pt have?
|
Flat CA of uroepithelia associated with CIS
|
|
Small tumors in uroepithelia can be treated how?
|
TURBT- transurethralresection of bladder tumor
|
|
which stones are not seen on standard X-ray imaging?
|
Uric Acid stones
|
|
Struvite stones associated with what urine pH?
|
struvite is high pH, urine is low pH...salt precipitates.
|
|
most common suprapubic mass palpable mass?
|
urachal cysts. treat these soon b/c they can progress to an adenocarcinoma
|
|
CIS, high grade TCC, multifocal and rapid recurrence tumors are treated how?
T4 grades that invade? |
immunotherapy/chemotherapy.
Cystectomy and/or systemic chemo |
|
Renal Cell Carcinoma that can invade into the renal vein and possibly the IVC?
|
Clear Cell RCC
|
|
being called to the morgue to do an autopsy, you notice you have an african-american corpse in front of you. you start the autopsy and notice an abnormally small kidney with a granular surface. under histological section, you notice hyaline thick capillaries. what did the former pt have?
|
hypertensive nephrosclerosis or benign nephrosclerosis
|
|
a 40 y/o male presents to you with headaches, retinal-vascular changes and progressive renal dysfxn. his BP is 195/125. Dx? and histo expectations?
|
Malignant HTN
histo sections show fibrinoid necrosis of capillary walls that look like onion-skin lesions |
|
Pt presents w/ mild-moderate HTN. a bruit is heard over the L kidney. imaging shows narrowing of L renal artery. dx? and renin expectations? likely cause? other cause?
|
Renal a. Stenosis
L renal vein renin increase likely atherosclerotic other cause may be fibromuscular dysplasia |
|
what does fibromuscular dysplasia look like? most common lesion site?
|
String of beads due to increase in fibrosis of capillary wall
media fibroplasia (not intima not adventitia) |
|
Big deal with thrombic Microangiopathies?
How do i know if i got one? |
can cause ischemia
Schistocytes on CBC. thrombocytopenia b/c clotting is going on, HTN and renal failure b/c kidneys are deprived of blood. |
|
causes of thrombic Microangiopathies?
morphology? |
infection, drugs, autoimmune dz, malignant htn, pregnancy
fibrinoid necrosis, collapsed vessels |
|
Hemolytic Uremic Syndrome
typical? |
kids
diarrhea positive E.coli 0157:H7 (Shiga toxin) Shiga toxin causes vascular damage in glomerulus. |
|
Hemolytic Uremic Syndrome
atypical? |
adults
diarrhea negative inherited or acquired condition some inherited conditions can cause thrombotic events to occur at level of kidney. |
|
A pt presents to you with a fever, acute renal failure. The patient has neurological deficits that you note. CBC shows microangiopathic hemolytic anemia and thrombocytopenia. Dx? due to???
|
Thrombotic Thrombocytopenia Purpura (TTP)
ADAMTS13 gene mutation |
|
medullary interstitium is hypertonic and relatively hypoxic. This promotes what nephropathy?
|
Sickle cell nephropathy pathogenesis
|
|
Sickle cell nephropathy does what to the glomerulus? how do you treat it?
|
occludes it causing hypoxia and papillar necrosis. FSGS may occur in some patients.
improve oxygenation via red cell exchange |
|
Sources of embolic kidney disease?
Result? |
cardiac mural thrombi, cardiac valvular vegetations, atherosclerotic plaques
renal infarct and wedge shaped infarcts |