Term
| Structures formed by the Urogenital Sinus |
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Definition
Bladder
Urachus
Proximal Urethra |
|
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Term
| What is the embryological origin of Ureters, Distal Urethra, and Bladder Trigone |
|
Definition
Ureters: Mesodermal from Mesonephric Ducts
Trigone: Mesodermal from Mesonephric Ducts
Distal Urethra: Ectodermal |
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Term
| How many cell layers thick is the transitional epithelium @ the Renal Pelvis, Ureters, Bladder |
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Definition
Renal Pelvis: 2-3
Ureters: 3-5
Bladder 3-7 |
|
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Term
| What is the epithelium of the bladder trigone |
|
Definition
Transitional in men and most women
Squamous in some women |
|
|
Term
| What is a common bladder problem in multiparous women? |
|
Definition
| Cystocele from prolapse uterus putting tension on the bladder |
|
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Term
| Do double ureters have separate outflows tracts from the kidney and separate inflow tracts to the bladder? |
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Definition
| Many have separate outfow tracts from the kidney, but most only have one combined inflow tract to the bladder |
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Term
| What is the most common cause of hydronephrosis in children |
|
Definition
| Uretopelvic Junction obstruction |
|
|
Term
| What is congenital hydroureter and what is its probable cause? What is a common cause of non-congenital hydroureter |
|
Definition
Dilation of the ureter caused by problems innervating the ureter musculature
Non-Congenital: Obstruction |
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Term
| What are the complications of Uretitis |
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Definition
| None except chronic can lead to granular mucosa from lyphocytic follicles "Utertitis Granularis" or fine cysts "Uterititis Cystica" |
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Term
| What are the tumors of the ureter |
|
Definition
Benign: Leiomyoma, Fibroepithelial Polyps
Malignant: Transitional Cell Carcinoma
|
|
|
Term
| What are the major sites of ureter obstruction |
|
Definition
Renal Pelvis
Crossing the Iliac Vessels
Entering the Bladder |
|
|
Term
| What is the histology of Sclerosing Retroperitoneal Fibrosis |
|
Definition
| Lymphocytes, plasmas, eosinos, and fibrosis |
|
|
Term
| What are the causes and complications of Sclerosing Retroperitoneal Fibrosis |
|
Definition
Causes: Idiopathic-Ormond disease(most common), Drug or Malignancy Induced
Consequences: Hydronephrosis |
|
|
Term
| What is the lymph drainage of the bladder? |
|
Definition
| External and Internal Iliac Nodes |
|
|
Term
| What are some possible complications from incomplete closure of the urachus |
|
Definition
Patent Uracus: Infection
Urachal Cyst: Adenocarcinomas
|
|
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Term
|
Definition
| Absent Anterior Bladder Wall and lower abdominal wall |
|
|
Term
| What are the most common locations of bladder diverticulosis? |
|
Definition
| Trigone, Above Trigone, Urachus Site |
|
|
Term
| What are some possible complications of bladder diverticulosis |
|
Definition
| Malignancy, Infection, Perforation, Lithiasis |
|
|
Term
| Why do lesions to the bladder most commonly carry a worse prognosis |
|
Definition
|
|
Term
| What is the triad of Cystitis Symptoms |
|
Definition
Dysuria
Increased Frequency of Urination
Lower Abdominal Pain |
|
|
Term
| What patients carry the most risk for cystitis |
|
Definition
| Lower Urinary Obstructions: Lithiasis, Pregnancy, BPH |
|
|
Term
| What are the common bacteria of Cystitis |
|
Definition
| Enterobacter, Klebsiella, Proteus, Candida albicans |
|
|
Term
| What is a complication specific to Proteus Cystitis? |
|
Definition
|
|
Term
| What is Hunner's Ulcer and how is it diagnosed |
|
Definition
Chronic Cystitis
Diagnosis: Linear ulcers with fibrosis seen best when bladder is distended |
|
|
Term
| What is Malacoplakia, what is the most common cause? |
|
Definition
A cystitis with PAS+ Inclusions containing crystalline laminations of bacterial reminants named "Michaelis-Gutmann Bodies"
Cause: Chronic E.coli or Proteus Infection |
|
|
Term
| What is Polypoid cystitis, what is its most likely cause and what malignancy can it be confused with? |
|
Definition
Bladder Mucosal irritation causes polypoid projections
Caused by indwelling catheters mostly
Commonly confused with Papillary Urothelial Carcinoma |
|
|
Term
| What are some metaplastic responses of the bladder to irritation |
|
Definition
Brunn's Buds: Proliferative Invaginations
Cystitis Cystica: Brunn's Buds With Eosinophillic material
Cystitis Glandularis: Brunn's Buds forming Glands
Squamous Metaplasia
Nephrogenic Metaplasia(Adenoma): Polypoid Lesions with small tubules |
|
|
Term
| What are the precursor lesions to Urothelial Carcinoma |
|
Definition
Papillary Urothelial Hyperplasia
Flat Urothelial Carcinoma |
|
|
Term
| What is the major determinant of prognosis in Bladder Carcinoma |
|
Definition
| Spread into the Detrussor Muscle |
|
|
Term
| What are the different Grades of Urothelial Carcinomas and how would you differentiate each? |
|
Definition
Papillary Urothelial Neoplasm of Low Malignant Potential: Umbrella cells, >7 cells thick
Papillary Urothelial Carcinoma Low Grade: No umbrella and Atypical appearance
Papillary Urothelial Carcinoma High Grade: Pleomorphic, Necrosis, Ulceration |
|
|
Term
| Describe the most typical bladder cancer patient |
|
Definition
|
|
Term
| Risk factors for bladder cancer |
|
Definition
Smoking
Radiation
Cyclophosphamide
Aniline Dyes
Schistosoma Haematobium |
|
|
Term
| What are the pathway models of Bladder carcinogenesis? |
|
Definition
Papillary: 9q/9p deletions then p53
Carcinoma In-Situ: P53 then Chromosome 9 deletion |
|
|
Term
| Are bladder Carcinomas mostly Monoclonal |
|
Definition
| Yes, shown by X-inactivation |
|
|
Term
| What is the typical presentation of bladder carcinoma |
|
Definition
Painless Hematuria and Cystitis
|
|
|
Term
| How are Localized Papillary, Multifocal, and High-grade/CIS/Recurrent/Invasive Carcinomas treated differently |
|
Definition
Papillary: resection and monitor
Multifocal: Topical Chemotherapy
High-grade etc. : BCG following Chemo |
|
|
Term
| When is cystectomy necessary for bladder carcinoma? |
|
Definition
Refractory to BCG
Detrussor involvement
CIS in Prostate |
|
|
Term
| Prognostic Factors for bladder carcinoma |
|
Definition
Grade
Lamina Propria Invasion
Carcinoma in Situ
Others: Neck/Dome are worse, Antigen Loss, DNA Ploidy, High P53 Expression
|
|
|
Term
| What are the most common benign and malignant mesenchymal tumors of the bladder |
|
Definition
Benign: Leiomyoma
Malignant: Rhabdomyosarcoma(Children)
Leiomyosarcoma(Adults) |
|
|
Term
| What is the most common pathogens of urethritis |
|
Definition
| Gonococcal, Chlamydia, Mycoplasma |
|
|
Term
|
Definition
| Vascularized Fibroelastic bundle outside or within the External Urethral Meatus |
|
|
Term
| What patients are more likely to get a Angiomyolipoma of the kidney and what is the source cell/marker |
|
Definition
Tuberous sclerosis patients
Pericyte derived-Neural Crest(HMB-45) |
|
|
Term
| Describe the appearance of a Oncocytoma |
|
Definition
Organoid(nest-like) growth with central hylanized scar
Hale's/PAS (-) |
|
|
Term
| What are the classic symptoms of Renal cell carcinoma |
|
Definition
Hematuria
Flank Pain
Abdominal Mass |
|
|
Term
| What is Stauffer Syndrome |
|
Definition
Hepatic dysfunction from non-invading Renal cell carcinoma
|
|
|
Term
| What are the risk factors for renal cancer? |
|
Definition
Tobacco
Obesity
HPTN
Estrogen
Asbestos
CRF/Cystic Disease
Tuberous Sclerosis
Familial: VHL(Clear-Cell), Met(Papillary) |
|
|
Term
| What are the familial diseases associated with Renal Carcinoma |
|
Definition
Von Hippel-Lindau Syndrome (Hemoangioblastomas(Brian/Eye), Renal Cysts, Clear Cell Carcinoma): VHL gene (Tumor Supressor)
Hereditary Clear Cell Carcinoma (Only Renal Clear Cell Carcinoma): VHL gene
Hereditary Papillary Carcinoma: Met protooncogene |
|
|
Term
| How do you differentiate the renal cell carcinomas |
|
Definition
Clear Cell: Clear Cyoplasm, PAS(+), Hale's(-)
Papillary: Papillary growth, PAS/Hales (-), Psammoma Body
Chromophobe: Vegetable-like, PAS(-), Hale's(+) |
|
|
Term
| What renal carcinoma is more common in dialysis patients |
|
Definition
|
|
Term
| What is the pattern of growth of the Collecting duct carcinoma |
|
Definition
|
|
Term
| What are the most common metastatic site of Renal carcinoma |
|
Definition
Lungs 50%
Bones 33%
Nodes
Liver
Adrenal
Brain |
|
|
Term
| Are the Ureters intraperitoneal, retro or both? |
|
Definition
|
|
Term
| Where does the lymph from the bladder neck drain? |
|
Definition
| Sacral and Common Iliac Nodes |
|
|
Term
| How would you differentiate urothelial papillary carcinoma from its precusor lesion? |
|
Definition
Papilloma: <7 Cells thick
Papillary Carcinoma of low Malignant Potential: >7 cell layers thick |
|
|
Term
| What is the precursor lesion to Adenocarcinoma of the bladder? |
|
Definition
|
|
Term
| What are the benign neoplasms of the Kidney |
|
Definition
Renal Papillary Adenoma
Angiomyolipoma
Oncocytoma |
|
|
Term
| What renal carcinoma can invade the IVC and even the heart |
|
Definition
|
|
Term
| What neoplasms are analgesic nephropathy associated with |
|
Definition
| Bladder and renal pelvis urothelial carcinoma |
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