Vesicoureteral Reflux Flashcards Preview

Nelson: Urologic Disorders > Vesicoureteral Reflux > Flashcards

Flashcards in Vesicoureteral Reflux Deck (20):
1

VUR occurs when

Submucosal tunnel between the mucosa and detrusor muscle at the ureteral attachment to the bladder is short or absent

2

T/F VUR usually is congenital and often is familial

T

3

VUR is graded based on the appearance of the urinary tract on what test

VCUG

4

T/F The higher the VUR grade the greater the likelihood of renal injury

T

5

Observation is the most appropriate management approach for VUR of what grade

I and II, and older children with VUR and normal kidneys who have not experienced clinical pyelonephritis

6

The risk of recurrent UTI is highest in patients with grade ___ reflux

III or IV

7

Antibiotic Prophylaxis in VUR is recommended by the AUA in what population of children (those at greatest risk for VUR-related renal injury)

1) Those younger than 1 yr of age) 2) Children with bowel and bladder dysfunction 3) Children being manage by surveillance and develops a febrile UTI

8

Genetic transmission of VUR

Autosomal dominant

9

The AUA recommended that a VCUG should be performed in neonates with

Grade 3-4 antenatal hydronephrosis (moderate to severe pelvocaliceal dilation), hydroureter, or an abnormal bladder

10

Reflux grades

I: Nondilated ureter, II: Reflux into upper collecting system WITHOUT DILATION, III: Dilated ureter and/or blunting of calyceal fornices, IV: Grossly dilated ureter, V: Tortuosity and loss of papillary impression

11

Reflux is present at birth in ___% of patients with neuropathic bladder

25

12

In siblings of individuals with reflux, a VCUG or cystogram is recommended IF

1) There is evidence of renal cortical abnormalities or renal size asymmetry on sonography 2) The sibling has a history of UTI

13

Reflux occurring during bladder filling

Low-pressure or passive reflux

14

Reflux occurring during voiding

High-pressure or active reflux

15

Used as initial study for reflux

VCUG

16

Used as follow up study for reflux

Radionuclide cystogram scan

17

Mean age of reflux resolution

6 years

18

T/F Reflux does not usually cause renal injury in the absence of infection

T

19

Situtations when reflux can cause significant renal damage even without infection (sterile reflux)

High-pressure reflux: posterior urethral valves, neuropathic bladder, non-neurogenic neurogenic bladder (Hinman syndrome)

20

Surgical therapy for reflux is indicated when

1) Failure of medical therapy 2) high reflux grades that are unlikely to resolve