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Flashcards in Brandau Pediactric 1 Deck (41)
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31

vesicoureteral reflux

UTIs

-urine reflux to kidney

grade 3 - dilation of ureter
grade 4 - worse than 3
grade 5 - even worse

32

imaging for VUR

voiding cystourethrogram

33

dimercaptosiccinic acid renal scan

DMSA
-can show scarring in kidney

34

VCU

bladder filled - child voids

-checks for reflux to ureter
-lots of radiation exposure

can do as nuclear (less exposure), easier to do
-done after initial study

35

reflux

inflammatory process
-cytokines reaks havoc
-typically bilateral

36

prophylactic antibiotics for reflux

possible attempt to get rid of reflux

37

chronic renal disease in child

will not grow
-failure to thrive

always monitor growth over time

38

chronic VUR

options:
-careful watching
-antibiotic prophylaxis
-surgery repair for VUR

39

VUR watchful waiting

-inherited - goes away with time
-patients that develop ESRD - most damage in utero
-antibiotics can cause resistance

40

VUR continuous prophylaxis

-grade 3 VUR - 4-6x more likely to develop renal scarring
-chance of recurrent infection

study looking at >grade 3 VUR nothing vs. prophylaxis vs. surgery
-prophylaxis most effective
-what stat design appropriate?

41

surgical repair VUR

-children with UTI - can get again - ESRD
-prophylaxis - nonadherence
-surgery - turns cost and morbidity of VUR into cure