Vesicouretric Reflux

Question 1

Less than 3 months of age it is more common in

Answer 1

Male

Question 2

Grades of vesicouretric reflux

Answer 2

Normal
Grade 1- reflux into non dilated ureter
Grade 2-reflux into the pelvis( no distension)
Grade3-reflux and mild distension
Grade 4-blunting of calyces and tortuos ureter
Grade 5-severe distension of ureter & loss of papillary impressions

Question 3

Reflux predisposed the patient to

Answer 3

Upper uninary infections

Pyelonephritis

Question 4

If pyelonephritis not mx property with adequate antibiotics this can

Answer 4

Chronic pyelonephritis and scarring of renal parenchyma

Scarring starts Day 3– day 5

Question 5

If scarring is present

Answer 5

Renal fuction is affected

10-20% have HTN

Question 6

Chronic pyelonephritis secondary to vesicouretric reflux is the most common cause of

Answer 6

Renal transpalnt in child< 19 years in uk

Question 7

Dx

Answer 7

Micturating cysto urthrogram
Intravenous urethrogram
DMSA ( SCARRING)

Question 8

MX OF VUR

Answer 8

Antibiotic prophylaxis

Grade 1-5 ( 1-10 yrs) )

Question 9

On antibiotic prophylaxis

Answer 9

Grade 1-3 spontaneous resolution

Grade 4-5 they need endoscopic treatment

Question 10

If endoscopic management fails

Answer 10

Reimplant the ureter by open surgery

Question 11

Endoscopic mx

Answer 11

Suburetric teflon injection (STING)
hydodistension implantation technique (HIT)