Miscellaneous 3

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Miscellaneous 3
2014-05-16 12:20:56
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  1. 1. A 1 year old boy presents with a large kidney. Macroscopically, there are solid, fleshy, white lesions. Where is spread most likely to be to?
    Wilm's tumour - lungs (occurs early)
  2. 2. A 31 year old male is taking penicillamine for his Wilson's disease. What kind of kidney injury is it most likely to be?
    membranous nephropathy
  3. 3. A 41 year old male has haemoptysis and oliguria. Chest x ray shows consolidation, which is later diagnosed to be pulmonary haemorrhage. Urea and creatinine are raised. What kind of kidney injury might he have and what is the underlying disease?
    Goodpasture's syndrome - focal segmental proliferative (IgA disease)
  4. 4. A 41 year old man is being followed up for chronic pyelonephritis. uroscopy shows bladder leukoplakia. What does this put him at risk of?
    squamous carcinoma of the bladder
  5. 5. A 45 year old woman presents with unilateraly enlargement of the kidney. What are your 3 differential diagnoses?
    Hydronephrosis, tumour, renal vein thrombosis
  6. 6. A 46 year old female with known lung cancer gets nephrotic syndrome. What kind of kidney injury is it most likely to be?
    membranous nephropathy
  7. 7. A 49 year old female is diagnosed with bladder carcinoma. What are the sites of haematogenous and lymphatic spread?
    Lymph: iliac and para-aortic; haematogenous: liver and lung
  8. 8. A 51 year old man complains of pain on passing water, with nausea and vomiting. Ultrasound shows renal tones. What is the most common composition of this?
    Calcium oxalate
  9. 9. A 67 year old male who is a lifetime smoker presents with dysuria. Cystoscopy shows a warty mass projecting into the lumen with no invasion of the bladder wall. What is this?
    Benign transitional cell carcinoma
  10. 10. Is membranoproliferative membranous glomerulonephritis diffuse or focal? Apart from idiopathic, what 4 secondary causes are there?
    Diffuse and global - Infection: IE, malaria, infected CSF shunt. Immunological: SLE.
  11. 11. Is membranous (not proliferative) glomerulonephritis diffuse or focal, and what is the pathology of disease?
    Diffuse and global - immune complex deposition, causing a 'lacy' basement layer.
  12. 12. o.
    Membranous nephropathy - infections (e.g. hep B), malignancy (e.g. lung cancer, lymphoma), drugs (e.g. gold, penicillamine), SLE
  13. 13. On uroscopy Brunn's nests are visualised. What do these represent?
    Glandular metaplasia - benign
  14. 14. What are the 2 causes of focal segmental glomerulosclerosis?
    IgM deposition (idiopathic) and HIV
  15. 15. What are the two main risk factors for renal cell carcinoma?
    Tobacco, von Hippel Lindau
  16. 16. What is the main cause of crescentic glomerulonephritis?
    Post-streptococcal and other
  17. 17. What is the main cause of focal segmental proliferative glomerulonephritis?
    IgA disease (and Goodpasture's syndrome) - these attach to the basement membrane to cause inflammation
  18. 18. What is the main cause of proliferative diffuse global glomerulonephritis?
    Streptococcal infection - non-streptococcal infections can also do it.
  19. 19. What is the most common cause of hydronephrosis in children?
    Ureteropelvic junction obstruction
  20. 20. What kind of cell is renal cell carcinoma?
    Adenocarcinoma from renal tubules
  21. 21. What kind of glomerulonephritis can involve C3 depletion?
    Membranoproliferative glomerulonephritis - this involves c3 deposition in the endothelium
  22. 22. What kind of kidney disease involved IgM deposition in kidneys of young adults?
    Focal segmental glomerulosclerosis - IgM deposition leads to hyaline material in the mesangium.
  23. 23. What kind of kidney disease is involved in HIV?
    Focal segmental glomerulosclerosis - hyaline enters the mesangium and slowly destroys the glomerulus.