Elimination disorders

Question 1

basic definition of enuresis

Answer 1

repeated urinary accidents whether intentional or unintentional that is clinically significant

Question 2

what makes enuretic episodes clinically significant

Answer 2

either at least 2x/week for 3 months or the presence of clinically significant distress

Question 3

how old does the patient have to be to diagnose enuresis

Answer 3

at least developmental age of 5

Question 4

specifiers for enuresis

Answer 4

-nocturnal only
-diurnal only
-nocturnal and diurnal

Question 5

primary enuresis

Answer 5

urinary continence was never established for a period of at least 6 month

Question 6

secondary enuresis

Answer 6

develops after period of dryness for at least 6 months

Question 7

basic definition of encopresis

Answer 7

repeated passage of feces in inappropriate places whether intentional or unintentional

Question 8

how often does inappropriate defecation have to take place for dx of encopresis

Answer 8

at least monthly for at least 3 months

Question 9

how old does the patient have to be before they can have a dx of encopresis

Answer 9

at least a developmental age of 4

Question 10

specifiers for encopresis

Answer 10

-with constipation and overflow incontinence
-without constipation and overflow incontinence

Question 11

stool characteristics when there is constipation and overflow incontinence in encopresis

Answer 11

stools are poorly formed or liquid and there may be intermittent or continuous leakage

Question 12

complications of encopresis

Answer 12

impaction, megacolon, and anal fissures

Question 13

main differential dx for encopresis

Answer 13

Hirschsprung disease

Question 14

what is the frequent medical treatment for encopresis

Answer 14

surgical removal of impaction and maintenance laxatives

Question 15

what are psychotherapeutic treatment approaches to encopresis

Answer 15

CBT
supportive psychotherapy and relaxation techniques
reduce embarassment

Question 16

what is megacolon

Answer 16

when feces is held too long there is a loss of tone to rectal wall and desensitization to pressure further complicating constipation d/t inability to feel need to go

Question 17

bladder training for enuresis

Answer 17

asking child to hold it for progressively longer and longer to increase capacity