Renal Question

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Renal Question

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DrVirgo
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03/18/07 - 10:57 AM

An 8 year old Caucasian boy is brought to the office for the evaluation of high-grade fever, flank pain and burning micturition for the last two days. He has had two previous episodes of acute pyelonephritis. Physical examination reveals costovertebral angle tenderness. Urinalysis shows pyuria, significant bacteruria, WBC casts, positive nitrite and esterase. The voiding cystourethrogram (VCUG) reveals vesicoureteral reflux. What is the most likely complication of this condition, if left untreated?

A. Hydronephrosis
B. Renal Stones
C. Renal Scarring
D. Renal Abscess
E. Renal Cell carcinoma

Please explain WHY this complication would occur.

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sprint123
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03/18/07 - 11:31 AM

A. Hydronephrosis ??..

I think ..Vesico-ureteral reflux can cause HYDRO-Nephrosis..Though not a mechanical obstruction but it is a functional obstruction...

DrVirgo
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03/18/07 - 12:36 PM

The correct answer is C!
HOW does VUR cause renal scarring???

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robin082006
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03/18/07 - 12:49 PM

DrVirgo wrote:
The correct answer is C!
HOW does VUR cause renal scarring???

Chronic pyelonephritis causes scarring

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sprint123
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03/18/07 - 12:53 PM

Question says...Chronic complication of this condition--I am not sure whether it means VUR or Acute Pyelonephritis...We can still argue that..

Chronic VUR-->Repeated Pyelonephritis--->Renal scarring (or)

Chronic VUR-->Functional obstruction--->Hydronephrosis

I think we should go in for the more common one..repeated attacks of pyelonephritis...

Drvirgo..wat do u think on this? confused

DrVirgo
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03/18/07 - 03:23 PM

Chronic VUR-->Repeated Pyelonephritis--->Renal scarring

sounds like the better explanation.

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Luckyall
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03/18/07 - 05:20 PM

the most common complic of VUR is Chronic pyelonephritis wich is DG on IVP by blunting calyces right underneight the SCARRRRR on the cortex

new_n_lost
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03/18/07 - 06:12 PM

Well Said LuckyAll

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