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Genitourinary > Bladder disorders > Flashcards

Bladder disorders Flashcards

1
Q

What are the four types of urinary incontinence

A

1) stress incontinence
2) urgency incontinence
3) mixed incontinence
4) overflow incontinence

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2
Q

True or false:

Stress incontinence is leakage accompanied by a sudden desire to pass urine that is difficult to delay

A

FALSE

This described urgency incontinence

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3
Q

True or false:

Alpha blocking drugs increase the risk of urinary incontinence

A

TRUE

They relax the bladder muscles

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4
Q

Which drug may be used if nocturia is a problem in those with urinary urgency incontinence

A

Desmopressin

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5
Q

True or false: a vaginal oestrogen can be given to women with signs of vaginal atrophy

A

TRUE

It may help reduce symptoms of urinary incontinence and recurrent UTIs

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6
Q

At what age are children generally expected to stop bed wedding

A

5 years old

It is common practice to consider children for treatment only when they reach 7 years old

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7
Q

At what age can desmopressin be used to treat nocturnal enuresis in children

A

Age 5 +

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8
Q

True or false:

enuresis alarms have a higher relapse rate after discontinuation than drug treatment

A

FALSE

Relapse is more common after discontinuing drug treatment.
Imipramine has a high relapse rate

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9
Q

Antimuscarinics are used to treat urinary incontinence. They are contraindicated in _________ (6 points)

A
  1. myasthenia gravis
  2. toxic megacolon
  3. severe ulcerative colitis
  4. urinary retention
  5. angle closure glaucoma
  6. bladder outflow obstruction
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10
Q

True or false:

Bradycardia is an antimuscarinic side effect

A

FALSE

they cause tachycardia

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11
Q

What is the most common cause of urinary retention in men

A

BPH

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12
Q

1st line drug treatment in BPH

A

An alpha blocker e.g. tamsulosin

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13
Q

What class of drug does finasteride belong to

A

5 alpha reductase inhibitor

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14
Q

True or false:

Finasteride is excreted in semen

A

TRUE

Use of a condom is recommended if sexual partner is pregnant or likely to become pregnant.

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15
Q

Which class of analgesic is first line in renal colic

A

NSAIDs

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16
Q

What drug class does mirabegron (betmiga) belong to?

A

It is a Beta 3 adrenergic agonist

Used for urinary (urge) incontinence

17
Q

True or false:

Duloxetine is first line in stress incontinence

A

FALSE

First line is pelvic floor training.
Duloxetine is second line

18
Q

How long should pelvic floor training be tried for at least

A

16 weeks

19
Q

How long should enuresis alarms be used

A

Until a minimum of 2 weeks of dry nights are achieved

20
Q

True or false:

Acute urinary retention is a medical emergency

A

TRUE

It is acute if there is abrupt development of urinary retention (i.e. over a period of a few hours)

Catheter needed.

21
Q

How long should bladder training last (at least)

A

Minimum of 6 weeks

If ineffective then consider antimuscarinics or mirabegron

22
Q

How long may it take for antimuscarinics to work to alleviate incontinence symptoms ?

A

At least 4 weeks

23
Q

Which antimuscarinics are first line for urgency incontinence ?
(3 points)

A

Oxybutynin (immediate release)

Tolterodine (immediate release)

Darifenacin (once daily)

NICE CKS 2019

24
Q

Red flags in women presenting with urinary incontinence?
(Suspect bladder cancer)

[3 points]

A

Unexplained haematuria without UTI

Haematuria despite treatment of UTI

Over 60 with unexplained non-visible haematuria AND dysuria or raised WCC

25
Q

Desmopressin is contraindicated in:

5 points

A

Hypertension

Use of diuretics

Alcohol abuse

Cardiac insufficiency

History of hyponatraemia

26
Q

Side effects of desmopressin include:

5 points

A

Fluid retention and hyponatraemia (So CI in HF and hx of hyponatraemia)

Convulsions (serious cases. So caution in epilepsy)

Abdominal pain, N & V

Headache

Weight gain

27
Q

Which alpha blocker is used for urinary retention in men?

Note: used in over 65s

A

Alfuzosin MR (10mg daily)

Genitourinary (4 decks)

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