VUR Oct 2024

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Across
  1. 2. Directly instilling contrast material at the ureteric orifices while under anaesthesia would unmask the "occult" VUR, this concept is known as a ____ cystogram. (3) (abbrev)
  2. 3. The functional components of the UVJ were first appreciated in 1812 when ___ noted that extension of the ureteral longitudinal muscle fibers into the trigone (___'s muscle) was important in the preservation of intra- mural ureter obliquity. (4)
  3. 7. Complete destruction of the UVJ occurs, in pregnant sows with urinary infection by_____________ (15)
  4. 9. Spontaneous resolution is more likely, or occurs sooner, the ______ the child is at diagnosis. (7)
  5. 13. Reflux nephropathy in all its forms, was the ________ most common primary diagnosis in nonblack pediatric transplant recipients. (6)
  6. 14. Intra-vesically, the inner muscle of the ureter merges with detrusor muscle to contribute to the superficial trigone. Some of these inner ureteral fibers pass medially to contribute to the intraureteric ridge called _______ bar. (7)
  7. 16. Identify ‘D’ in the image______ ____ urethra. (8,3)
  8. 19. More recently _________ has been found to be effective in mitigating the deleterious psychologic effects of cystography and VCUG. (8)
  9. 20. Intrarenal reflux has rarely been observed in children older than ____ years. (4)
  10. 21. Some authors believe that the presence of ____ ____reflux is an indication for reimplantation surgery, rather than observation on prophylaxis. (5, 5)
  11. 22. average age of onset of renal insufficiency due to VUR is _____ years (6)
  12. 23. VUR was first demonstrated to be a normal finding in dogs and ________ (7)
  13. 24. A recent meta-analysis of sibling reflux studies suggests the prevalence of VUR in siblings to be approximately 32%. However, the prevalence may be as low as 7% in older siblings or as high as __________% in identical twin siblings. (7)
Down
  1. 1. Many children with bladder-spinchter dysynergia demonstrate a staccato voiding pattern on a uroflow study. These children benefit from ________.(11)
  2. 2. In 1893, ____ noted the efflux of urine from the distal segment of a ureter accidentally severed during pelvic surgery (5)
  3. 4. Ureteral duplication is also associated with the presence of VUR, typically into the ____ pole of the duplex system. (5)
  4. 5. In breakthrough infections, one of the alternative therapies is the use '_____ prophylaxis', in which both trimethoprim-sulfamethoxazole and nitrofurantoin are administered daily. (6)
  5. 6. Girls when have sense a sudden bladder contraction, they often cross their legs or squat down on their foot to try to prevent incontinence. Such girls require__________ drugs. (16)
  6. 7. __________must be recognized and eliminated as much as possible in order to establish optimal conditions for successful spontaneous or surgical resolution of reflux. (12)
  7. 8. Infant boys younger than 1 year with reflux and could be recommended ________ along with placement on antibiotic prophylaxis. (12)
  8. 10. The traditional period of observation for spontaneous resolution is ____ years, probably because the greatest proportion of growth and anatomic remodelling of the UVJ is complete. (4)
  9. 11. Cohorts of infants with VUR diagnosed after the antenatal detection of hydronephrosis include a greater number of ____ (4)
  10. 12. The classic explanation proposed by______ and Stephens suggests that the lateral displacement may occur as the result of abnor- mal ureteric bud grigin along the developing mesonephric duct. (6)
  11. 15. Reasonable to recommend surgery if the reflux had not ceased after _____ years of observation, no matter what the age. (4)
  12. 17. The best predictive parameter for the resolution of VUR is ______ (5)
  13. 18. _____________ bladder contraction is the most common urodynamic abnormality associated with reflux in neurologically normal children. (11)