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Genitourinary > Bladder Disorders (Exam 3) > Flashcards

Bladder Disorders (Exam 3) Flashcards

1
Q

The loss of urine that represents a hygienic or social problem to individual

A

Involuntary Urine Incontinence

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2
Q

causation of Urinary incontinence

A

Multifactorial - Etiologies are diverse and not completely understood

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3
Q

Urinary incontinence is _____ times more likely in this sex

A

2 X more likely

Females

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4
Q

Largest single Risk Factor of Urinary Incontinence

A

Age

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5
Q

Higher prevalence in ?

A

Non-Hispanic White Women

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6
Q

What percentage of incontinent individuals actually receive the appropriate medical evaluation / TX

A

5%

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7
Q

Average time a pt will live with urinary incontinence prior to seeking medical attention

A

6-9 years

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8
Q

Pneumonic to remember Reversible causes of Urinary Incontinence

A

Dippers

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9
Q

Dippers stands for what?

A 
Delirium
infection
atrophic
pharmaceutical
psychological disorders
excess
restricted mobility
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10
Q

An increased intra-Abdominal Pressure raises pressure within bladder to the point where it exceeds the Urethra’s Resistance to urinary flow is

A

Stress Incontinence

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11
Q

what causes the urethral hypermobility

A

due to impaired support from pelvic floor

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12
Q

Intrinsic Sphincter Deficiency is usually secondary to what

A

Pelvic Surgeries

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13
Q

Presentation of Stress Incontinence

A

Coughing, Laughing, and Sneezing

worsens during high-impact sports such as golf, tennis, aerobics, trampolines

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14
Q

A lot or Little urine is lost during Stress incontinence

A

Little

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15
Q

what is Urge Incontinence

A

The involuntary loss of urine associated with a feeling of urgency

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16
Q

what is the main cause of urge incontinence

A

Detrusor Overactivity

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17
Q

Presentation of Urge Incontinence

A

Uncontrolled urine loss and a strong desire to void. Often sudden and rapid event. occurs without warning. Cannot be prevented

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18
Q

Combination of stress and urge incontinence is

A

Mixed incontinence

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19
Q

40-60% of females with incontinence have combination

Mixed incontinence is generally defined as

A

Detrusor Overactivity and Impaired Urethral Function

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20
Q

True or false - the detrusor muscle contraction is involved with overflow incontinence

A

False- The pressure exceeds the resting urethral closure pressure and urine overflows despite the absence of detrusor contraction

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21
Q

Overflow Incontinence is often secondary to

A

Bladder Outlet Obstruction

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22
Q

Common Associated Medical conditions to Overflow Incontinence

A

MS

Diabetes

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23
Q

Overflow incontinence has the pt urinating a large or small amount

A

Small

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24
Q

DDX of a pt with urinary incontinence

A 
MS
Prostatitis 
vaginitis
UTI
Spinal Cord Neoplasm/trauma /abscess
Cystitis 
Urinary Obstruction
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25
Q

What needs to be including in a PE for Urinary Incontinence

A 
Neurologic exam 
Pelvic Exam
Pelvic Floor Examination
anal muscle tone 
Prostate examination 
Stress testing
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26
Q

procedure to look into bladder can be diagnostic and treatment in some cases

A

Cystoscopy / Urethroscopy

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27
Q

when is cystoscopy utilized

A
  • pt with persistent irritative voiding symptoms
  • Hematuria
  • Persistent postoperative incontinence
  • Voiding dysfunction
  • obvious causes of bladder overactivity, such as cystitis , stone, and tumor
28
Q

Management techniques for urinary incontinence

A 
Absorbent products
Dietary Modification 
Pelvic Floor Rehabilitation 
Biofeedback
Acupuncture 
Electrical Stimulation
Urethral Occlusion 
Catheterization
Bladder Training 
Pharmacologic therapy
29
Q

Which incontinence is it contraindicated to use catheterization as a management technique

A

Urge Incontinence

30
Q

which incontinence is bladder training known to have decent success

A

Urge Incontinence

31
Q

When is it contraindicated to utilize Anticholinergics as pharmacologic therapy in incontinence management

A

Narrow / Angle glaucoma

32
Q

Pharmacologic treatment options for incontinence

A

Anticholinergics, Antispasmodic agents, and Tricyclic Antidepressants

33
Q

Surgical Tx options for incontinence

A

Bladder Neck Suspension
Periurethral Bulking Therapy
Artificial urinary sphincter placement
Midurethral sling surgery

34
Q

Daytime and Nighttime urinary frequency, urgency, and pelvic pain of unknown etiology

A

Interstitial Cystitis

35
Q

How do we make the diagnosis of Interstitial Cystitis

A

Diagnosis of Exclusion

36
Q

what percentage of Interstitial cystitis are white

What percentage are female

A

94%

90%

37
Q

What is the term dedicated to sex-related distress / pain with sex

A

Dyspareunia

38
Q

Presentation of Interstitial cystitis

A

Exacerbation followed by variable periods of remission
May fluctuate to the ovulatory cycle
spontaneous remission occurs in 50%
Pain with bladder filling common

39
Q

What are the scorings for possible interstitial cystitis and strongly supported diagnosis of interstitial cystitis

A

Sore > 6

Score > 12

40
Q

Diagnostic Evaluation of Interstitial cystitis includes what

A

UA
Urine Culture
Cystoscopy

41
Q

During Cystoscopy What are the two distinctive findings to help associate problems with interstitial Cystitis

A

Hunter’s Lesions - Distinctive areas of inflammation on the bladder wall 5-10% of pts willl have this

Glomerulations- Pinpoint sized areas of bleeding in the bladder wall

42
Q

Tx of Interstitial Cystitis

A

Extensive counseling
3-6 month trial of Dietary and fluid management Time and stress management, and behavioral modification

-up to 90% of pts report exacerbations with food / beverage

43
Q

Foods that are good for Interstitial cystitis

A

Water, milk, bananas, blueberries, melon, carrots, broccoli, mushrooms, peas, chicken, eggs, most meats, rice, popcorn

44
Q

Foods that will aggravate Interstitial Cystitis

A

Coffee, Alcohol, soda, monosodium glutamate (MSG), Tomatoes, vinigar, citrus, spicy foods, chocolate, cranberry juice, particular fruits and vegetables

45
Q

Oral meds for Tx of Interstitial Cystitis

A

Amitriptyline (first-line oral therapy)
Nifedipine
Pentosan polysulfate sodium

Bladder hydrodistention

46
Q

Good 2nd line therapy added for Interstitial cystitis

A

Physical therapy

47
Q

Define Nocturnal Enuresis

A

Voiding urine at night “bedwetting”

48
Q

How many months must a pt have been continent for before it can be considered Nocturnal Enuresis

A

6 months at minimum prior to onset of bedwetting

49
Q

Punishment is or is not an effective form of nocturnal enuresis

A

not an acceptable or effective from. Children punished are at a risk of emotional and physical abuse.

50
Q

genetics link to nocturnal enuresis

A

56% of fathers 36% of mothers and 40% of siblings to pts with nocturnal enuresis also experience nocturnal enuresis

51
Q

Physical Examination of Nocturnal Enuresis includes

A

BP
Inspection of external Genitalia
Palpation in renal and suprapubic areas
palpation of the abdomen to look for hard, wide stool
Thorough neurologic examination of LE’s including gait, muscle power, tone, sensation, reflexes, and plantar responses
Assessment of the anal wink
inspection and palpation of the lumbosacral spine

52
Q

Diagnosis needs for nocturnal enuresis

A

UA
Urine Culture
Diagnostic imaging not routinely recommended

53
Q

Management nocturnal enuresis

A

Behavioral Therapy
Alarm Therapy
medications

54
Q

Refer nocturnal enuresis when

A

If no improvement after 2-3 months of good management / treatment

55
Q

pharmacologically decreases urine output

A

Desmopressin

56
Q

Take Desmopressin when

A

1 hr before bedtime

57
Q

Take imipramine when

A

1-2 hrs before bedtime

58
Q

Male to female ratio of bladder tumors

A

1.9 : 1

59
Q

incredibly large exposure causing bladder cancer

A

Smoking

60
Q

most common presenting symptom of Bladder tumors

A

Hematuria

61
Q

are bladder tumors typically benign or malignant

A

Benign

62
Q

bladder cancer is how many more times likely in which sex

A

3x more likely in Men

63
Q

Median age of diagnosis of bladder cancer

A

65 y.o.

64
Q

Transitional cell carcinoma is what percentage of bladder cancers

A

90%

65
Q

percentage of pts that have painless gross hematuria

A

80-90 %

Genitourinary (11 decks)

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