Systemic paediatrics: vesicoureteric reflux: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Systemic paediatrics: vesicoureteric reflux

Sample item

A 2-year-old girl after a febrile urinary tract infection has grade III vesicoureteric reflux on micturating cystourethrogram. Which investigation shows renal scarring, and what is the preventive measure?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. DMSA scan; continuous low-dose antibiotic prophylaxis in selected cases

Vesicoureteric reflux is graded I to V on the MCU, and a DMSA scan detects cortical scars. Prophylactic antibiotics such as nitrofurantoin or cotrimoxazole are used in selected children, while surgical correction is for breakthrough infections or high grades.

Option by option

  • A. DMSA scan; continuous low-dose antibiotic prophylaxis in selected cases (correct)

    Correct. DMSA shows scars and prophylaxis may be used.

  • B. DTPA scan; nephrectomy

    DTPA assesses split function and drainage, and nephrectomy is not routine.

  • C. Ultrasound alone; lifelong dialysis

    Ultrasound alone may miss scars and dialysis is not required.

  • D. Plain X-ray; steroids

    X-ray cannot show scars and steroids do not help.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, DMSA scan; continuous low-dose antibiotic prophylaxis in selected cases. Vesicoureteric reflux is graded I to V on the MCU, and a DMSA scan detects cortical scars.

Why is "DTPA scan; nephrectomy" not the answer?

DTPA assesses split function and drainage, and nephrectomy is not routine.

Why is "Ultrasound alone; lifelong dialysis" not the answer?

Ultrasound alone may miss scars and dialysis is not required.

Why is "Plain X-ray; steroids" not the answer?

X-ray cannot show scars and steroids do not help.

What concept does this question test?

It tests Systemic paediatrics: vesicoureteric reflux in Pediatrics. Prophylactic antibiotics such as nitrofurantoin or cotrimoxazole are used in selected children, while surgical correction is for breakthrough infections or high grades.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: vesicoureteric reflux?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.