This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'A 6 year old girl presents with Recurrent E.coli infection in urine. Ultrasound of abdomen shows Hydroureter and Hydronephrosis. Micturating cysto – urethrogram shows filling defect in urinary bladder. The likely diagnosis is – \nSelect and explain. \nA. Sacrococcygeal Teratoma, B. Vesicoureteric Reflux – grade II, C. Duplication of Ureter, D. Ureterocele', 'role': 'user'}, {'content': "Answer: D \nExplanation: IVP in ureterocele usually shows a round filling defect, sometimes large, in the bladder corresponding to the ureterocele, and characteristic finding of duplication of the collecting system (ureteroceles are nearly always associated with ureteral duplication)\nUreterocele :\n\nIs a cystic dilatation of the terminal ureter, and is obstructive because of a pinpoint ureteral orifice.\nIt is more common in females\nAffected children often are discovered by prenatal sonography or during an investigation of UTI (IVP)\nTreatment : o transurethral incision of ureterocele : effectively relieves the obstruction but it may result in V.U.R. necessitating ureteral reimplantation later, or\n' open excision of ureterocele and reimplantation 'as primary management'. About other options\nAn isolated VUR or Duplication of ureter do not explain the filing defect in the bladder.\nSacrococcygeal Teratoma :\nThe most common presentation here is with an abnormal, obvious protruding mass from the sacral area. Out of the 4 varieties known, only Type IV which contributes 9.8 % ie entirely pre-sacral and not visible externally (90.8% tumors are visible externally).\nBladder and Rectum may be displaced anteriorly but a filling defect is not characteristic as in ureterocele.\nUreters may be partially obstructed resulting in hydro-ureter and hydronephrosis.", 'role': 'assistant'}]