Boss Reflux

Front 1

Most common cause of VUR

Back 1

x

Front 2

Go through grading of reflux

Back 2

x

Front 3

What causes renal scarring?

Back 3

x

Front 4

Where and why does renal scarring occur?

Back 4

x

Front 5

Do you screen siblings with reflux?

Back 5

x

Front 6

How does antibiotics change scarring rates?

Back 6

x

Front 7

Go through chart on management of VUR. How do you great reflux grade I-V for less than 1 y/o?

Back 7

x

Front 8

Go through chart on management of VUR. How do you great reflux grade I-V for >1 y/o? (what 3 things trigger continuous antibiotic prophylaxis?)

Back 8

x

Front 9

How do you treat children wiht breakthrough UTI?

Back 9

x

Front 10

What are the 2 surgical options for reflux? How do you treat G1-5 (succss rates?)

Back 10

x

Front 11

What are the 3 types of intravesical and 1 extravesical reimplants?

Back 11

x

Front 12

What is the most common cause of persistent reflex after surgical repair?

Back 12

x

Front 13

Ch 122

Back 13

x

Front 14

What are two pivital discoveries on reflux?

Back 14

x

Front 15

What percentage of children who have UTI have reflux? Infants?

Back 15

x

Front 16

What is the relationship between gender and reflux? (why?)

Back 16

x

Front 17

What is the relationship between pre and post natal reflux?

Back 17

x

Front 18

What is relationship with age?

Back 18

x

Front 19

What is the relationship with race?

Back 19

x

Front 20

What percentage of siblings have reflux?

Back 20

x

Front 21

How do you screen a sibling with reflux?

Back 21

x

Front 22

Name one gene involved with reflux

Back 22

x

Front 23

Where does the ureter bud from?

Back 23

x

Front 24

What happens if the ureteral bud reaches the UGS too soon? too late?

Back 24

x

Front 25

What is the ideal tunnel length to ureteral diameter in a non-refluxing UVJ versus a refluxing UVJ?

Back 25

x

Front 26

What is the strict definition of primary versus secondary reflux?

Back 26

x

Front 27

What causes primary reflux?

Back 27

x

Front 28

What are two categories of secondary reflux?

Back 28

x

Front 29

What are 3 anatomic abnomrmalities that cause secondary reflux?

Back 29

x

Front 30

What are two functional abnormalities that cause secondary reflux?

Back 30

x

Front 31

What is a major cause of UTIs for children on abx? How does it affect the success of treatment of reflux?

Back 31

x

Front 32

Does reflux cause UTI?

Back 32

x

Front 33

What are the 5 grades of reflux?

Back 33

x

Front 34

What are the two steps of diagnosis and evaluation if VUR?

Back 34

x

Front 35

What type of urine specimen is obtained?

Back 35

x

Front 36

What are 3 indications for VCUG?

Back 36

x

Front 37

What are two categories of assessing the lower urinary tract?

Back 37

x

Front 38

What are two direct methods?

Back 38

x

Front 39

Why are delayed and post-void films necessary?

Back 39

x

Front 40

How do you approach at aptient that has both UPJ obstruction reflux?

Back 40

x

Front 41

What type of reflux is not detected on a RNC?

Back 41

x

Front 42

What is positional of the instillation of contrast cystogram (PIC)

Back 42

x

Front 43

What are two modalities to assess the upper tract?

Back 43

x

Front 44

What do you look for on US? (2)

Back 44

x

Front 45

Where is radiotracer taken for the DMSA scan?

Back 45

x

Front 46

What percentage of patients with 1-3 reflux will scar?

Back 46

x

Front 47

What percentage of patients with 4 reflux will not scar? slight? severe? scare?

Back 47

x

Front 48

What percentage of patients with 5 reflux will not scar? slight? severe? scare?

Back 48

x

Front 49

What causes scarring?

Back 49

x

Front 50

What is association of age and scarring?

Back 50

x

Front 51

What is Big Bang theory?

Back 51

x

Front 52

How does papillary anatomy affect scarring?

Back 52

x

Front 53

What are some other factors (2) that effect scaring?

Back 53

x

Front 54

What are 6 abnormalities that co-exist with reflux?

Back 54

x

Front 55

What is the incidence of UPJ obstruction with reflux?

Back 55

x

Front 56

What is the assocation between grade of reflux and UPJO?

Back 56

x

Front 57

Why relux when pregant?

Back 57

x

Front 58

What percentage of 1-2 reflux will self resolve?

Back 58

x

Front 59

What percentage of 3 reflux will self resolve?

Back 59

x

Front 60

What percentage of 4-5 reflux will self resolve?

Back 60

x

Front 61

How long do you observe for resolution?

Back 61

x

Front 62

What are the 5 princples of reflux management?

Back 62

x

Front 63

What is the first step in managing UTI?

Back 63

x

Front 64

What is continous prophy abx for < 2 month? (2)

Back 64

x

Front 65

What is continous prophy abx for > 2 months?

Back 65

x

Front 66

What 3 factors do you consider in patients when deciding medical management vs surgery? (table 122-6)

Back 66

x

Front 67

What does RIVUR study stand for?

Back 67

x

Front 68

What is the design of RIVUR study?

Back 68

x

Front 69

What was the finding of the RIVUR study?

Back 69

x

Front 70

What are teh 6 surgical princples of fixing reflux?

Back 70

x

Front 71

What are the two categories of reflux surgeries?

Back 71

x

Front 72

What are the two categoreis of how to place the new hiatus?

Back 72

x

Front 73

What are 2 suprahital tunnels and 2 infrahiatal tunnel INTRAVESICAL repairs?

Back 73

x

Front 74

What is the EXTRAVESICAL repair?

Back 74

x

Front 75

What type of incision is made for reimplants?

Back 75

x

Front 76

What are the first two steps in an intervesical repair?

Back 76

x

Front 77

What is the paquin technique?

Back 77

x

Front 78

What is the difference with the glenn anderson technique? the advantage

Back 78

x

Front 79

What is the advantage of the cross trigonal technique?

Back 79

x

Front 80

What is main disadvantage of the lich gregor?

Back 80

x

Front 81

What are 3 early complications of the reimplant?

Back 81

x

Front 82

What is a big cause of persistent reflux?

Back 82

x

Front 83

What is STING?

Back 83

x

Front 84

What is the Gil-vernet procedure?

Back 84

x

Front 85

Name a few non-autlogousl materials for endoscopir correction

Back 85

x

Front 86

Name a few autolgous materials for endoscopic correction

Back 86

x

Front 87

Workup

Back 87

x

Front 88

How do you workup a child with febrile UTI (age 0-2)?

Back 88

x

Front 89

AAP - RUS if hydro, then VCUG

Back 89

x

Front 90

EAU - RUS + VCUG, if reflux DMSA

Back 90

x

Front 91

AUA (see next)

Back 91

x

Front 92

When does AUA recommend DMSA (4)?

Back 92

x

Front 93

What is top-down approach?

Back 93

x

Front 94

How do you work up prenatal hyrdo?

Back 94

x

Front 95

What is timing of RUS for prental hydro?

Back 95

x

Front 96

When screen siblings?

Back 96

x

Front 97

In duplplicated system describe the location, function of ureters

Back 97

x

Front 98

Chapter 120

Back 98

x

Front 99

Do boys or girls get more UPJ obstruction?

Back 99

x

Front 100

What is the most common cause of dilation in collecting system of fetal kidney?

Back 100

x

Front 101

What are the two categories of UPJ obstruction etiologies?

Back 101

x

Front 102

What are two causes of extrinsic UPJO?

Back 102

x

Front 103

What is secondary UPJO?

Back 103

x

Front 104

What causes lower pole obstruction?

Back 104

x

Front 105

What is the size of a megaureter?

Back 105

x

Front 106

Are megaureters obstructing or refluxing?

Back 106

x

Front 107

What is the difference between infants and children in presentation of UPJO?

Back 107

x

Front 108

What is a classic presentation for an older child with UPJO?

Back 108

x

Front 109

What are 3 types of open repairs for UPJO?

Back 109

x

Front 110

When does a dismembered pyleoplasty not work?

Back 110

x

Front 111

When is a foley Y-V plasty used?

Back 111

x

Front 112

When do the intubated ureterotomy?

Back 112

x

Front 113

When do the spiral flap?

Back 113

x

Front 114

What type of insicion is done for a child?

Back 114

x

Front 115

What is another approach for UPJO (endoscopic)?

Back 115

x

Front 116

Where do you put the camera and working port for pyeloplasty?

Back 116

x

Front 117

What is the advantage of both dismembered and nondismembered pyeloplasty?

Back 117

x

Front 118

What is success rate with pyeloplasty?

Back 118

x

Front 119

How do you mange a megaurter?

Back 119

x

Front 120

Read technique for repairing a megaureter

Back 120

x