[10.23.2023] Updated content, AnKing Overhaul for Step 1 & 2/AnKingMed, ID 768969

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can see an argument for c1 and c2

Posterior urethral valves or vesicoureteral reflux can be assesed using:

  1. {{c1::Renal & bladder ultrasound}} to screen for bilateral hydroureters and hydronephrosis
  2. Follow-up abnormal US with {{c1::Voiding cystourethrogram}} (best test)

@AnKing-Maintainers - UWS2 QID 15955 says 1st step is RBUS, VCUG is performed with abnormal US. Amboss just lists VCUG as test of choice and mentions prenatal US.

Remember looking at this awhile back - RBUS is generally indicate for suspected hydronephrosis, but is not diagnostic for PUV or VUR. UW Step 3 QID 5793 (tagged) specifically has BOTH of these as answer choices and states that voiding cystourethrogram is necessary due to limited sensitivity of post-natal renal ultrasound. I would add RBUS to extra, but not text.

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Support adding to extra, could change text to best / most sensitive test. Think it depends on presentation though which is addressed with nid:1556463033619 (indications for VCUG)

I believe that NID is specific to UTI workup

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Support adding the extra, not the text. Also think the card would read better:

Posterior urethral valves and vesicoureteral reflux are diagnosed by {{c1::voiding cystourethrogram))

Screening exams may include a renal & bladder ultrasound (RBUS)

Updated to reflect discussion


@AnKing-Maintainers - want to close this out, please vote/give any additional thoughts?


Might just be me but does “confirmatory” suggest that US should always/normally be done before? Amboss just says VCUG = diagnostic study of choice, FAS2 also says “VCUG is diagnostic test of choice”

I think the goal was specifically to imply this ^ because UW Step 2 QID in question says RBUS 1st step in evaluation… if this is too muddy, I am okay just rejecting and keeping it simple

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Will hold off on changing anything until I can get on Step 3 UW again @thomas.holmes - should be tomorrow


Step 3 QID asks for “confirmatory test.” Wrong answer for RBUS says: (Choice D) Renal ultrasound is a quick and noninvasive initial test for suspected genitourinary malformations. Both fetal ultrasound and postnatal renal ultrasound are very sensitive for hydronephrosis. However, postnatal renal ultrasounds are less sensitive for distal obstruction and, as a result, cannot definitively differentiate ureteropelvic junction obstruction, vesicoureteral reflux, and PUVs. Therefore, VCUG is necessary to confirm the diagnosis.

So I think “confirmatory” is probably ideal wording in card text

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Thanks for double checking, support