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RDS Test 3 > B8-049 CBCL Adult Incontinence > Flashcards

B8-049 CBCL Adult Incontinence Flashcards

1
Q

involuntary leakage on exertion/physical activity, or on sneezing/coughing

A

stress urinary incontinence (SUI)

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2
Q

involuntary leakage associated with urgency

A

urge urinary incontinence (UUI)

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3
Q

involuntary leakage associated with urgency and with exertion

A

mixed urinary incontinence (MUI)

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4
Q

involuntary leakage associated with incomplete bladder emptying

A

overflow urinary incontinence

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5
Q

incontinence related to underlying neurologic disease

A

neurogenic urinary incontinence

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6
Q

incontinence unrelated to bladder (i.e. mobility, cognitive, etc)

A

functional urinary incontinence

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7
Q

[sympathetic/parasympathetic]
Hypogastric nerve, T10-L2

A

sympathetic

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8
Q

[sympathetic/parasympathetic]
pelvic nerves, S2,3, 4

A

parasympathetic

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9
Q

[sympathetic/parasympathetic]
release NE in the detrusor muscle to promote bladder relaxation

A

sympathetic

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10
Q

originates in Onuf’s nucleus in the sacral spinal cord

A

pudendal nerve

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11
Q

increases tone of the external sphincter to prevent urine leakage while filling

A

pudendal nerve

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12
Q

[sympathetic/parasympathetic]
release ACh on M2 and M3 receptors to contract the detrusor muscle

A

parasympathetics

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13
Q

[sympathetic/parasympathetic]
relaxation of the bladder

A

sympathetic

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14
Q

[sympathetic/parasympathetic]
contraction of bladder outlet

A

sympathetic

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15
Q

[sympathetic/parasympathetic]
storage

A

sympathetic

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16
Q

[sympathetic/parasympathetic]
emptying

A

parasympathetic

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17
Q

[sympathetic/parasympathetic]
detrusor contraction

A

parasympathetic

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18
Q

[sympathetic/parasympathetic]
urethral relaxation

A

parasympathetic

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19
Q

why do babies have spontaneous bladder voiding?

A

lack of guarding reflex

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20
Q

afferent signals inhibit parasympathetic and increase sympathetic activity

A

guarding reflex

(absent in bebès)

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21
Q

during the filling/storage phase, the bladder accomodates increased volume at low pressure via inhibition of […] system

A

parasympathetic

(sympathetic and somatic activity)

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22
Q

spinal reflex pathway that activates the sympathetic and somatic nerve pathways

A

guarding reflex

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23
Q

what keeps the bladder outlet closed during the filing stage?

A

guarding reflex

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24
Q

when ready to empty, the PAG activates the […] which causes micturition via parasympathetic pathways

A

PMC

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25
Q

what type of incontinence is generally seen in women, but can be seen in men after prostate surgery?

A

stress incontinence

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26
Q

what type of incontinence is “overactive bladder” syndrome?

A

urgency

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27
Q

[what type of incontinence]
sensation of abdominal fullness
dribbling of urine
intermittent stream

A

overflow

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28
Q

reversible causes of urinary incontinence

A

Delirium, dementia
Infection
Atrophic vaginitis
Psychosocial (depression)
Pharmacological
Endocrine disorders
Restricted mobility
Stool impaction

DIAPPERS

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29
Q

what is the most accurate way of measuring post void residual?

A

straight cath

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30
Q

what is considered normal for post void residual?

A

less than 50 cc is normal

greater than 200 cc is too high

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31
Q

greater than […] RBCs/hpf should prompt urology referral for hematuria

A

3

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32
Q

[male/female] incontinence should prompt urology referral

A

male

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33
Q

initial treatment options for UUI/SUI

A

behavioral modifications
absorbent products

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34
Q

men with overflow incontinence can be treated with

A

alpha blocker

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35
Q

treatment for overflow incontinence

A

catheterization

urologic eval to determine if obstructive vs inactive detrusor

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36
Q

medication options for UUI

A

anticholinergics
b3 agonists

37
Q

antimuscarinic selective for M3

A

darifenacin

38
Q

most common non-selective for M3 antimuscarinic medication

A

oxybutynin

39
Q

MOA of mirabegron

A

b3 agonist

(stimulates b3 receptors in the detrusor muscle to inhibit contraction)

40
Q

patients with neurogenic incontinence due to suprapontine lesions will have predominately […] symptoms

A

storage

41
Q

patients with neurogenic incontinence due to suprapontine lesions will have detrusor […]

A

overactivity

but normal sphincter activity

42
Q

patients with neurogenic incontinence due to suprapontine lesions will have […] PVR

A

normal

43
Q

patients with neurogenic incontinence due to infrapontine-suprasacral lesions will have […] symptoms

A

both storage and voiding

44
Q

patients with neurogenic incontinence due to infrapontine-suprasacral lesions will have […] PVR

A

increased

45
Q

patients with neurogenic incontinence due to infrapontine-suprasacral lesions will have detrusor […]

A

overactivity

and detrusor-spinchter dysenergia
(bladder contracts against high tone outlet)

46
Q

patients with neurogenic incontinence due to sacral/infrasacral lesions will have […] symptoms

A

voiding

47
Q

patients with neurogenic incontinence due to sacral/infrasacral lesions will have […] PVR

A

increased

48
Q

patients with neurogenic incontinence due to sacral/infrasacral lesions will have […] detrusor

A

hypo or acontractile

49
Q

for cortical lesions,
bladder tone will be […]
sphincter tone will be […]

A

for cortical lesions,
bladder tone will be [spastic]
sphincter tone will be [normal]

50
Q

for suprasacral lesions,
bladder tone will be […]
sphincter tone will be […]

A

for suprasacral lesions,
bladder tone will be [spastic]
sphincter tone will be [spastic]

51
Q

for sacral lesions,
bladder tone will be […]
sphincter tone will be […]

A

for sacral lesions,
bladder tone will be [flaccid]
sphincter tone will be [flaccid]

52
Q

for peripheral lesions,
bladder tone will be […]
sphincter tone will be […]

A

for peripheral lesions,
bladder tone will be [spastic or flaccid]
sphincter tone will be [normal]

53
Q

autonomic dysreflexia occurs in patients with SCI above […]

A

T6

54
Q

what causes autonomic dysreflexia?

A

noxious stimuli below level of injury

bladder/bowel distension, UTI, ulcers, etc.

55
Q

symptoms of autonomic dysreflexia

A

HA
AMS
flushing

56
Q

signs of autonomic dysreflexia

A

hypertension (40 mmHg above resting)
bradycardia

57
Q

does asymptomatic bacteriuria require treatment?

A

no

unless pregnancy, or upcoming bladder surgery

58
Q

urine production at night [increases/decreases] with age

A

increases

59
Q

[…]% of the adult population experiences urinary incontinence

A

15-30

60
Q

urinary frequency, dysuria, and nocturia are […] voiding symptoms

A

irritative

61
Q

hesitancy, straining to void, slow stream, incomplete emptying are […] voiding symptoms

A

obstructive

62
Q

antimuscarinic medications act by blocking receptor binding of

A

ACh

(blocks smooth muscle contraction)

63
Q

a-blockers act by relaxing the smooth muscle of the […]

A

prostatic urethra

64
Q

onobotulinum injections act by blocking

A

presynaptic release of ACh

(decreases overactive bladder)

65
Q

stimulation of ACh receptors leads to smooth muscle […]

A

contraction

66
Q

caffeine intake is associated with […] incontinence

A

urgency

67
Q

one of the most common causes of transient urinary incontinence

A

UTIs

68
Q

injury at the level of the sacrum would be associated with […] bladder detrusor and […] urethral sphincter

A

flaccid
flaccid

69
Q

[…] should be stopped preopervatiely to eye surgery, as it is associated with floppy iris syndrome

A

tamsulosin

70
Q

which nerves are activated in the “storage” phase?

A

sympathetic and somatic

71
Q

micturition is activated through the […] in the sacral spinal cord

A

parasympathetics

72
Q

what type of incontinence is often caused by intrinsic sphincter deficiency?

A

stress

73
Q

most common clinical signs of autonomic dysreflexia [2]

A

hypertension
bradycardia

74
Q

common causes of autonomic dysreflexia

A

bowel/bladder distension

75
Q

common cause of nocturia in younger patients

A

undiagnosed diabetes

76
Q

mirabegron causes detrusor muscle […]

A

relaxation

77
Q

what tests are indicated in patients with urinary retention and progressive voiding symptoms?

A

evaluation of upper tract via renal US and creatinine

78
Q

cortical brain lesions are most often associated with […] bladder detrusor and […] urethral sphincter function

A

spastic
normal

79
Q

a […] should be performed in all patients as a standard part of the evaluation of urinary incontinence

A

urinalysis

80
Q

evaluation for hematuria would include what tests?

A

abdominal/pelvic CT
cystoscopy

81
Q

first line therapy for post-prostatectomy stress incontinence

A

physical therapy with biofeedback training

82
Q

onabotulinum toxin is used to treat […] incontinence

A

urgency

(treats overactive detrusor)

83
Q

regulates involuntary bladder function via coordination of the sympathetic and parasympathetics

A

pontine micturition center

84
Q

increased sympathetic tone leads to increased urinary […]

A

retention

85
Q

increased parasympathetic tone leads to increased urinary […]

A

voiding

86
Q

muscarinic antagonists (oxybutynin) inhibit the […] receptor

A

M3

–> relaxation of detrusor –> decrease detrusor activity

87
Q

sympathomimetics (mirabegron) activate the […] receptor

A

B3

–> relaxation of detrusor –> increase badder capacity

88
Q

what class of medications causes relaxation of smooth muscle in the bladder neck/prostate?

A

a-1 blockers (tamsulosin)

RDS Test 3 (15 decks)

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