Vesicoureteral Reflux Flashcards Preview

Nelson: Urologic Disorders > Vesicoureteral Reflux > Flashcards

Flashcards in Vesicoureteral Reflux Deck (20)
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1
Q

VUR occurs when

A

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

2
Q

T/F VUR usually is congenital and often is familial

A

T

3
Q

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

A

VCUG

4
Q

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

A

T

5
Q

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

A

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

6
Q

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

A

III or IV

7
Q

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

A

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
Q

Genetic transmission of VUR

A

Autosomal dominant

9
Q

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

A

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

10
Q

Reflux grades

A

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
Q

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

A

25

12
Q

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

A

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

13
Q

Reflux occurring during bladder filling

A

Low-pressure or passive reflux

14
Q

Reflux occurring during voiding

A

High-pressure or active reflux

15
Q

Used as initial study for reflux

A

VCUG

16
Q

Used as follow up study for reflux

A

Radionuclide cystogram scan

17
Q

Mean age of reflux resolution

A

6 years

18
Q

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

A

T

19
Q

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

A

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

20
Q

Surgical therapy for reflux is indicated when

A

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