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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
what type of incontinence is generally seen in women, but can be seen in men after prostate surgery?
stress incontinence
26
what type of incontinence is "overactive bladder" syndrome?
urgency
27
[what type of incontinence] sensation of abdominal fullness dribbling of urine intermittent stream
overflow
28
reversible causes of urinary incontinence
Delirium, dementia Infection Atrophic vaginitis Psychosocial (depression) Pharmacological Endocrine disorders Restricted mobility Stool impaction DIAPPERS
29
what is the most accurate way of measuring post void residual?
straight cath
30
what is considered normal for post void residual?
less than 50 cc is normal greater than 200 cc is too high
31
greater than [...] RBCs/hpf should prompt urology referral for hematuria
3
32
[male/female] incontinence should prompt urology referral
male
33
initial treatment options for UUI/SUI
behavioral modifications absorbent products
34
men with overflow incontinence can be treated with
alpha blocker
35
treatment for overflow incontinence
catheterization urologic eval to determine if obstructive vs inactive detrusor
36
medication options for UUI
anticholinergics b3 agonists
37
antimuscarinic selective for M3
darifenacin
38
most common non-selective for M3 antimuscarinic medication
oxybutynin
39
MOA of mirabegron
b3 agonist (stimulates b3 receptors in the detrusor muscle to inhibit contraction)
40
patients with neurogenic incontinence due to suprapontine lesions will have predominately [...] symptoms
storage
41
patients with neurogenic incontinence due to suprapontine lesions will have detrusor [...]
overactivity but normal sphincter activity
42
patients with neurogenic incontinence due to suprapontine lesions will have [...] PVR
normal
43
patients with neurogenic incontinence due to infrapontine-suprasacral lesions will have [...] symptoms
both storage and voiding
44
patients with neurogenic incontinence due to infrapontine-suprasacral lesions will have [...] PVR
increased
45
patients with neurogenic incontinence due to infrapontine-suprasacral lesions will have detrusor [...]
overactivity and detrusor-spinchter dysenergia (bladder contracts against high tone outlet)
46
patients with neurogenic incontinence due to sacral/infrasacral lesions will have [...] symptoms
voiding
47
patients with neurogenic incontinence due to sacral/infrasacral lesions will have [...] PVR
increased
48
patients with neurogenic incontinence due to sacral/infrasacral lesions will have [...] detrusor
hypo or acontractile
49
for cortical lesions, bladder tone will be [...] sphincter tone will be [...]
for cortical lesions, bladder tone will be [spastic] sphincter tone will be [normal]
50
for suprasacral lesions, bladder tone will be [...] sphincter tone will be [...]
for suprasacral lesions, bladder tone will be [spastic] sphincter tone will be [spastic]
51
for sacral lesions, bladder tone will be [...] sphincter tone will be [...]
for sacral lesions, bladder tone will be [flaccid] sphincter tone will be [flaccid]
52
for peripheral lesions, bladder tone will be [...] sphincter tone will be [...]
for peripheral lesions, bladder tone will be [spastic or flaccid] sphincter tone will be [normal]
53
autonomic dysreflexia occurs in patients with SCI above [...]
T6
54
what causes autonomic dysreflexia?
noxious stimuli below level of injury bladder/bowel distension, UTI, ulcers, etc.
55
symptoms of autonomic dysreflexia
HA AMS flushing
56
signs of autonomic dysreflexia
hypertension (40 mmHg above resting) bradycardia
57
does asymptomatic bacteriuria require treatment?
no unless pregnancy, or upcoming bladder surgery
58
urine production at night [increases/decreases] with age
increases
59
[...]% of the adult population experiences urinary incontinence
15-30
60
urinary frequency, dysuria, and nocturia are [...] voiding symptoms
irritative
61
hesitancy, straining to void, slow stream, incomplete emptying are [...] voiding symptoms
obstructive
62
antimuscarinic medications act by blocking receptor binding of
ACh (blocks smooth muscle contraction)
63
a-blockers act by relaxing the smooth muscle of the [...]
prostatic urethra
64
onobotulinum injections act by blocking
presynaptic release of ACh (decreases overactive bladder)
65
stimulation of ACh receptors leads to smooth muscle [...]
contraction
66
caffeine intake is associated with [...] incontinence
urgency
67
one of the most common causes of transient urinary incontinence
UTIs
68
injury at the level of the sacrum would be associated with [...] bladder detrusor and [...] urethral sphincter
flaccid flaccid
69
[...] should be stopped preopervatiely to eye surgery, as it is associated with floppy iris syndrome
tamsulosin
70
which nerves are activated in the "storage" phase?
sympathetic and somatic
71
micturition is activated through the [...] in the sacral spinal cord
parasympathetics
72
what type of incontinence is often caused by intrinsic sphincter deficiency?
stress
73
most common clinical signs of autonomic dysreflexia [2]
hypertension bradycardia
74
common causes of autonomic dysreflexia
bowel/bladder distension
75
common cause of nocturia in younger patients
undiagnosed diabetes
76
mirabegron causes detrusor muscle [...]
relaxation
77
what tests are indicated in patients with urinary retention and progressive voiding symptoms?
evaluation of upper tract via renal US and creatinine
78
cortical brain lesions are most often associated with [...] bladder detrusor and [...] urethral sphincter function
spastic normal
79
a [...] should be performed in all patients as a standard part of the evaluation of urinary incontinence
urinalysis
80
evaluation for hematuria would include what tests?
abdominal/pelvic CT cystoscopy
81
first line therapy for post-prostatectomy stress incontinence
physical therapy with biofeedback training
82
onabotulinum toxin is used to treat [...] incontinence
urgency (treats overactive detrusor)
83
regulates involuntary bladder function via coordination of the sympathetic and parasympathetics
pontine micturition center
84
increased sympathetic tone leads to increased urinary [...]
retention
85
increased parasympathetic tone leads to increased urinary [...]
voiding
86
muscarinic antagonists (oxybutynin) inhibit the [...] receptor
M3 --> relaxation of detrusor --> decrease detrusor activity
87
sympathomimetics (mirabegron) activate the [...] receptor
B3 --> relaxation of detrusor --> increase badder capacity
88
what class of medications causes relaxation of smooth muscle in the bladder neck/prostate?
a-1 blockers (tamsulosin)

RDS Test 3 (15 decks)

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