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29 Cards in this Set
- Front
- Back
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What does the bladder develop from? |
The cloaca |
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Cystitis glandularis |
Colonic type glandular cells that arise in the bladder |
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Urinary tract tumors may have 3 types of epithelium |
1. Urothelium 2. Squamous 3. Glandular |
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Basic function of the kidney |
- Filtration of blood - Production of urine |
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Other functions of the kidney |
Elimination: toxic metabloic wastes from blood Controls fluid balance in body Electrolytes: sodium, potassium, calcium, magnesium, chlorid, sulfate, phosphate, glucose Blood pressure: contributes to normal maintenance of normal blood pressure and oxygen-carrying capacity of blood |
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Label U and G |
U --> Bowmann's Capsule G --> Glomerulus |
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What is the source of Renin? |
The Juxtaglomerular apparatus |
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What are littre glands? |
Small mucous glands located in the lamina propria, open to penile urethra |
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Why do urine cytology? |
To follow patients with known diagnosis of urothelial cell carcinoma (UCC) or TCC of the bladder, ureter, renal pelvis, or urethra
To rule out TCC
Follow high risk groups: aniline dye workers
Diagnose renal transplant patients
Diagnose infections |
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Types of urinary specimens |
Voided urine Cath urine Bladder wash Illeal conduit Retrograde brushing (ureter/renal pelvis) |
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Types of crystals |
Uric acid crystals (lemon/rhomboid shaped, yellow, significant in voided urines: gout) Calcium oxalate crystals (octahedral, signifacant in voided urines: drug toxicity, crohn's) Triple phosphate crystals (little clinical significance) |
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What type of crystals? |
Triple phosphate crystals |
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What is Corpora amylacea? |
Proteinaceous concretions normally present in prostatic secretions Can be seen in urines |
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What are casts? |
Cylindrical structures formed in the renal tubules of the nephron
Have Tamm-Horsefall protein as matrix |
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Types of casts |
Waxy cast Neutrophil cast Epithelial/renal tubular cell cast Hyaline cast Granular cast Red blood cell cast Mixed cast |
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What type of cast is this? |
Waxy cast |
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Acute Tubular Necrosis (ATN) |
Seen in patients with ischemia, heavy metal posioing, drug toxicity, post renal transplant Self limiting Cyto: increased renal tubular cells |
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What are the bacterial infections of the bladder? |
E.coli: most common Others: proteur, klebsiella, enterobactor, strep, staph, pseudomonas, TB (rare) |
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What are the viral infections of the bladder? |
Herpes, CMV, polyoma, HPV |
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What are the fungal infections of the bladder? |
Candida: most common Others: aspergillus, cryptococcus, actino, coccidiodes, blasto, histoplasma, mucor |
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What are the parasitic infection of the bladder? |
Trich Schistosoma haematobium (blood fluke) |
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Cytology of polyoma virus (BK virus) |
"Fish-net" appearing Large inclusions that take up entire nucleus
Seen in immunocompromised patients DNA virus (like herpes, CMV) |
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Malakoplakia |
Due to persisten coliform infection of bladder
Clinically: presents as yellow plaques in bladder
Characterized by histio's w/ Michaelis-Gutman bodies (MG bodies) Classic "bulls-eye" appearance PAS+
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Reactive and atypical changes in urothelium that mimics |
Instrument effect Atypia due to infections Atypia due to lithiasis or stones Atypia due to therapy |
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Cytology of low grade urothelial cell carcinoma |
High N/C ratio Irregular nuclear membranes Homogeneous cytoplasm Cell clusters |
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Cytology of high grade urothelial cell carcinoma |
Higher N/C ratio Coarsely granular irregularly distributed chromatin Macronucleoli Necrosis |
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What is the diagnosis? |
High Grade Urothelial Carcinoma |
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Retrograde brushing |
Method used to sample ureters and renal pelvis with retrograde canulation Less risk than biopsy |
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Biomarkers for TCC |
Bladder Tumor Antigen (BTA) Fibrin/fibrinogen degradation products (FDP) Hyaluronic acid and hyaluronidase Telomerase Blood group related antigens |
