Youtor
Removal of kidney stones URS
>> YOUR LINK HERE: ___ http://youtube.com/watch?v=wHjS9-mx-dU
Want to support the channel? Be a patron at: • / lymed Welcome to LY Med, where I go over everything you need to know for the USMLE STEP 1, with new videos every day. • Follow along with First Aid, or with my notes which can be found here: https://www.dropbox.com/sh/mt1jrikc24... • • This video will wrap up renal pathology and will be on on cysts and neoplasms of the kidneys. The biggest cause of cystic kidneys is polycystic kidney disease. Cystic kidneys lead to flank mass and hematuria and hypertension. This is due to a genetic mutation that leads to bilateral enlarged cystic kidneys. It is broken up into whether it is autosomal dominant or autosomal recessive. Autosomal dominant mutations lead to adult manifestations as well as things like berry aneurysms, hepatic cysts and portal hypertension, diverticulosis, and mitral valve prolapse. Autosomal recessive manifestations lead to polycystic kidneys that are seen in-utero. This leads to renal failure in kids and Potter's sequence due to oligohydramnios. Now not all cysts in the kidneys is polycystic kidneys. Another form is multicystic dysplastic kidneys which is not inherited but instead is due to malformation. You can also have medullary cystic kidneys which causes shrunken kidneys and cysts only in the medulla. You may also have common cysts. These are asymptomatic but may be complex, having solid components or septates. This has a risk of cancer. Lastly, you can have acquired cysts due to dialysis which increase the longer the patient is alive. • Let's move on to our last topic - kidney and bladder cancers! The most common renal cancer is renal cell carcinoma. This is cancer of the cells in the PCT and leaves vacuoalated clear cells. Know that it can invade your renal vein and cause varicoceles and testicular metastasis. If you see RCC on both sides, it's associated with von hippel lindau syndrome. This is due to a deletion of tumor suppressors! Branching off neurocutaneous syndromes, we also have one associated with tuberous sclerosis - angiomyolipomas of the kidney! Next cancer is renal oncocytoma which comes from the collecting ducts and leads to a mass with a central scar. The last kidney cancer is Wilms tumor. The biggest fact you need to know is that it affects children! Any kid with a flank mass that doesn't cross the midline and has hematuria has Wilms! Wilm's tumor is associated with multiple syndromes like WAGR as well as beckwith-wiedemann syndrome. • Now cancer of your bladder is a tad different. Your epithelium of your urinary tract is transitional, which leads to transitional cell carcinoma! Known for it's field effect, in which carcinogens can bathe your bladder and cause different tumors at different sites. Know that chronic inflammation can lead to metaplasia to squamous or glandular epithelium. Thus you can also have squamous cell carcinoma or adenocarcinoma! Risk factors include cystitis, schistosoma haematobium. exstrophy of the bladder and remnants of the allantoin. • Done!
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