Wilm’s tumor is the most common primary renal tumor of childhood. Origin: Embryonic nephrogenic (mesodermal) cells Mechanism: Deletion of WT-1 gene on chromosome 11 Pathology: a. Macroscopic (Gross): large, solitary tan to grey color mass; pale on cut section with areas of hemorrhage; 10% are bilateral or multicentric; grossly difficult…
Tag: Renal and Electroloyte
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Most Important Urinary Buffer: Phosphate or Ammonia?
There are multiple choice questions (mcq) which asks: What is the most important urinary buffer? And the choices include both the phosphate and ammonia. Different textbooks on physiology and biochemistry have different opinions. Some say that the most important is Phosphate and the others say Ammonia is more important. So,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Ball-on-Tee, Lobster Claw and Signet Ring Sign – Renal papillary necrosis
Synonym: Necrotizing papillitis In renal papillary necrosis, part or all of necrotic renal papilla sloughs and may fall into the pelvicalyceal system, which may remain there (and get calcified) or may be voided down the ureter (often causing obstruction). The renal medulla and papillae are vulnerable to ischemic necrosis because…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
TNM and staging of Urinary Bladder Cancer Simplified
As discussed earlier in – TNM Classification and Cancer Staging Simplified, Urinary bladder is a hollow organ whose “T” classification resembles that of the gastrointestinal tract. Since, the regional lymph nodes of the urinary bladder also lie beyond the serosa like in colon and rectum, positive regional nodes are usually…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Renal (Kidney) Development – Embryology Made Easy
Kidney development occurs chronologically from cranial to caudal direction from urogenital ridge (intermediate mesoderm) in 3 different phases. Intermediate mesoderm → urogenital ridge (longitudinal elevation along dorsal body wall) → nephrogenic cord → Pronephros, Mesonephros and Metanephric mesoderm/blastema Remember the embryology of brain – from cranial to caudal, the primordial…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Complications of Long Term Dialysis
A) Cardiovascular complications 1. Exacerbation or Precipitation of CHF – Voluminous AV Fistula AV shunting → Decreased TPR → BP fall → Sympathetic stimulation & RAAS activation → Ventricular remodeling → Heart failure Several studies have investigated the cut-off fistula access flow that is associated with a higher risk of high-output cardiac failure, with results ranging…
Clinical Skills and Approaches 
Mnemonic based approach to grading and planning treatment for BPH
MNEMONIC: FUNWISE During the last 1 month, how often/many times you had to – 1. Frequency: Urinate again <2 hours after you finished urinating ? 2. Urgency: Difficulty in postponing the urine ? 3. Nocturia: Get up to urinate from bedtime to wakeup ? 4. Weak stream: Weak urinary stream…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Radiation cystitis : Diagnosis, prevention and management
Cause of radiation cystitis: Bladder in the radiation field (treatment of pelvic malignancies like prostate, cervical, colorectal) Epidemiology of radiation cystitis: Incidence: 23% to 80% (variability due to variability in type and dosing of radiotherapy among different medical subspecialities) Incidence of severe hematuria: 5-8% Mean duration for developing radiation cystitis:…