We know that reflux refers to the retrograde flow of bladder urine into the ureters, which of the following items are important information in the patient’s history? (Select All that Apply)

A. The fact that the patient is male

Incorrect Explanation: The patient's gender does not directly provide important information about the history of reflux.

Explanation: Vesicoureteral reflux (VUR), which is the retrograde flow of urine from the bladder into the ureters, can affect individuals of any gender. While gender might have some implications for certain conditions, it is not a critical factor in understanding the history of reflux.

B. The fact that the patient is female.

Incorrect Explanation: The patient's gender does not directly provide important information about the history of reflux.

Explanation: Just like with the previous option, the patient's gender does not play a significant role in the history of vesicoureteral reflux. The condition can affect both males and females.

C. Developmental milestones

Correct Explanation: Developmental milestones are important in understanding the history of reflux.

Explanation: Developmental milestones are significant because VUR is more common in infants and young children. Infants and young children have a higher likelihood of developing reflux due to the immaturity of their urinary tract systems. Knowing about the patient's developmental milestones can help assess the risk and potential severity of reflux.

D. The number of urinary tract infections the patient has had

Correct Explanation: The number of urinary tract infections (UTIs) is important in understanding the history of reflux.

Explanation: Repeated urinary tract infections can be a sign of vesicoureteral reflux. The backflow of urine from the bladder into the ureters can contribute to UTIs. Monitoring the frequency of UTIs can provide insights into the presence and severity of reflux.

A) Smokey brown urine:

This finding is not typically associated with nephrotic syndrome. Smokey brown urine might indicate the presence of blood in the urine, which can be seen in conditions such as hematuria or certain kidney infections.

B) Polyuria:

Polyuria refers to excessive urination and is not a primary characteristic of nephrotic syndrome. However, children with nephrotic syndrome may have decreased urine output due to the loss of fluid and proteins through the damaged kidney filters.

C) Facial edema:

Facial edema (swelling of the face) is a hallmark of nephrotic syndrome. The loss of albumin in the urine results in a decrease in oncotic pressure (a force that helps keep fluid in the blood vessels), leading to fluid accumulation in the interstitial spaces, including the face, ankles, and abdomen.

D) Hypertension:

Hypertension (high blood pressure) is not a typical finding of nephrotic syndrome itself. However, it's possible for kidney damage to lead to secondary hypertension. In nephrotic syndrome, low levels of albumin can trigger the renin-angiotensin-aldosterone system, which can contribute to increased blood pressure.