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J Renal > Bladder conditions > Flashcards

Bladder conditions Flashcards

1
Q

incontinence definition

A

any involuntary leakage of urine

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2
Q

types of incontinence (4)

A

stress
urge
overflow
mixed (stress and urge)

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3
Q

what is the problem in stress incontinence

what can cause this (4)

A

insufficient pelvic floor strength

child birth
obesity
smoking (chronic cough)
old age

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4
Q

when does the leakage of urine occur in stress incontinence

A

when coughing/sneezing/exercising/laughing

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5
Q

what is the problem in urge incontinence

A

detrusor/bladder overactivity

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6
Q

when does the leakage occur in urge incontinence

when is it worse

A

when hearing running water/opening a door/standing up/key in the door

worse when drinking alcohol/coffee

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7
Q

which type of incontinence presents with frequency and urgency

A

urge

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8
Q

what is the most common type of incontinence

A

mixed - urge and stress

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9
Q

what can cause overflow obstruction

A

bladder outflow obstruction eg benign prostatic hyperplasia

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10
Q

which type of incontinence presents with constant dribbling

A

overflow incontinence

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11
Q

investigations for incontinence (5)

A 
lower abdo exam 
urinalysis for infection
U&Es for renal impairment 
bladder diary 
urodynamics
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12
Q

what do you want to ask someone that comes in with incontinence

A

does it happen when you cough/sneeze

or

does it happen when you hearing water running/stand up

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13
Q

where are the 2 probes in urodynamics

what else do you need

what are you trying to figure out

A

one in bladder
one in rectum/vagina

catheter in bladder

detrusor muscle pressure in different situations (eg coughing)

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14
Q

conservative treatment for stress incontinence

A

stop smoking
weight loss
pelvic floor exercises
‘learn to hold your pee’

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15
Q

surgical treatment for stress incontinence

A

transvaginal tape

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16
Q

conservative treatment for urge incontinence

A

reduce caffeine
reduce fluids
bladder training

17
Q

surgical treatment for urge incontinence

A

botulinum toxin (botox)

18
Q

drug for stress incontinence

is it used

A

duloxetine

not really only temporary - suicidal thoughts side effects

19
Q

drug for urge incontinence

is it used

A

oxybutynin

yes

20
Q

how does oxybutynin work in urge incontinence

A

antimuscarinic drug = decreases detrusor muscle activity

21
Q

treatment of overflow incontinence

A

catheter to drain urine

fix problem

22
Q

what other symptoms is overflow incontinence associated with

A

nocturia
poor flow
urinary retention (chronic and painless, or acute and painful)

23
Q

examination of someone with overflow incontinence

A

abdo exam (fluid retention) neuro exam (eg spinal cord abnormalities)

males - PR exam for prostate, penis inspection
females - vaginal inspection

24
Q

most common bladder cancer

A

transitional cell carcinoma

25
Q

bladder cancer associated with schistomiasis and catheters

A

squamous cell carcinoma

26
Q

bladder cancer associated with cystitis cystica

A

adenocarcinoma

27
Q

most common part of bladder for transitional cell carcinoma

A

trigone

28
Q

risk factors for transitional cell carcinoma (4)

A

dyes
smoking
men
>50 y/o

29
Q

presentation of bladder cancer

A

painless haematuria

30
Q

investigations for transitional cell carcinoma (2)

A 
CT urogram (can see a half filled bladder) 
flexible cystoscopy
31
Q

what does transitional cell carcinoma of the bladder look like on flexible cystoscopy

A

sea anemone

32
Q

treatment of transitional cell carcinoma of the bladder (3)

A

TURBT (transurethral resection of bladder tumour)
cystectomy (removal of part of bladder if detrusor muscle involved)

stoma for urinary diversion

33
Q

what may happen to the kidneys in someone with a bladder cancer

A

hydronephrosis

34
Q

are bladder cancers likely to reoccur

A

yes

need to give them follow ups

35
Q

what is cystitis

A

inflammation of the bladder

from infectious or non infectious causes

36
Q

where does tuberculosis spread from if it infects the bladder

A

kidneys (from tuberculose pyelonephritis)

37
Q

where do people present with schistomiasis bladder infections

A

Africa (tropical countries)

38
Q

painless frank haematuria

A

bladder cancer

J Renal (12 decks)

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