Elimination Disorders (Enuresis/Encopresis) Flashcards
A 7-year-old boy with mild to moderate developmental delay presents with a chronic history of wetting his clothes during the day about once weekly, even during school. He is now refusing to go to school for fear of wetting his pants and being ridiculed by his classmates. Which of the following statements accurately describes the diagnostic options regarding enuresis in this case?
A. He should not be diagnosed with enuresis because the frequency is less than twice per week.
B. He should be diagnosed with enuresis because the incontinence is resulting in impairment of age-appropriate role functioning.
C. He should not be diagnosed with enuresis because his mental age is likely less than 5 years old.
D. He should be diagnosed with enuresis, diurnal only subtype.
E. He should not be diagnosed with enuresis because the events are restricted to the daytime.
Correct Answer: C. He should not be diagnosed with enuresis because his mental age is likely less than 5 years old.
Which of the following statements about enuresis is true?
A. Over 60% of children diagnosed with enuresis have a comorbid DSM-5 disorder.
B. Developmental delays are no more common in children with enuresis than in other children.
C. Urinary tract infections are more common in children with enuresis.
D. While embarrassing, enuresis has no effect on children’s self-esteem.
E. Prevalence rates for enuresis at age 10 are similar to those at age 5.
Correct Answer: C. Urinary tract infections are more common in children with enuresis.
Which of the following statements about the diurnal-only subtype of enuresis is true?
A. This subtype is more common in males.
B. This subtype is more common after age 9 years.
C. This subtype is sometimes referred to as monosymptomatic enuresis.
D. This subtype is more common than the nocturnal-only subtype.
E. This subtype includes a subgroup of individuals with “voiding postponement,” in which micturition is consciously deferred because of a social reluctance to use the bathroom or to interrupt a play activity.
Correct Answer: E. This subtype includes a subgroup of individuals with “voiding postponement,” in which micturition is consciously deferred because of a social reluctance to use the bathroom or to interrupt a play activity.
Which of the following statements correctly identifies a distinction between primary enuresis and secondary enuresis?
A. Secondary enuresis is due to an identified medical condition; primary enuresis has no known etiology.
B. Children with secondary enuresis have higher rates of psychiatric comorbidity than do children with primary enuresis.
C. Primary enuresis has a typical onset at age 10, much later than the onset of secondary enuresis.
D. Primary enuresis is never preceded by a period of continence, whereas secondary enuresis is always preceded by a period of continence.
E. Unlike primary enuresis, secondary enuresis tends to persist into late adolescence.
Correct Answer: D. Primary enuresis is never preceded by a period of continence, whereas secondary enuresis is always preceded by a period of continence.
Which of the following statements correctly describes factors related to the etiology and/or onset of enuresis?
A. Enuresis has been shown to be heritable, with a child being twice as likely to have the diagnosis if either parent has had it.
B. Mode of toilet training or its neglect can affect rates of enuresis, as shown by high rates seen in orphanages.
C. In girls with enuresis, nocturnal enuresis is the more common form.
D. Rates of enuresis are much higher in European countries than in developing countries.
E. The development of modern diapers is believed to speed toilet training and reduce enuresis.
Correct Answer: B. Mode of toilet training or its neglect can affect rates of enuresis, as shown by high rates seen in orphanages.
Explanation: Enuresis has etiological sources in both genetics and learned behaviors. There are very high rates of enuresis in orphanages and other residential institutions, likely related to the mode and environment in which toilet training occurs. Heritability has been shown in family, twin, and segregation analyses. The relative risk of having a child who develops enuresis is greater for previously enuretic fathers (odds ratio of 10.1) than for previously enuretic mothers (odds ratio of 3.6). Nocturnal enuresis is more common in males; diurnal incontinence is more common in females. Enuresis has been reported in a variety of European, African, and Asian countries as well as in the United States. At a national level, prevalence rates are remarkably similar, and there is great similarity in the developmental trajectories found in different countries.
A 6-year-old boy with mild to moderate developmental delay presents with a history of passing feces into his underwear during the day about once every 2 weeks, even during school. He is now refusing to go to school for fear of soiling his pants and being ridiculed by his classmates. Which of the following statements accurately describes the diagnostic options regarding encopresis in this case?
A. He should not be diagnosed with encopresis because the frequency is less than twice per week.
B. He should be diagnosed with encopresis because the incontinence is resulting in impairment of age-appropriate role functioning.
C. He should not be diagnosed with encopresis because his mental age is likely less than 4 years old.
D. He should be diagnosed with encopresis.
E. He should not be diagnosed with encopresis because the events are restricted to the daytime.
Correct Answer: C. He should not be diagnosed with encopresis because his mental age is likely less than 4 years old.
Which of the following statements about encopresis is true?
A. When oppositional defiant disorder or conduct disorder is present, one cannot diagnose encopresis.
B. When constipation is present, one cannot diagnose encopresis.
C. Urinary tract infections can be comorbid with encopresis and are more common in girls.
D. Although it is embarrassing, encopresis has no effect on children’s self-esteem.
E. Prevalence rates for encopresis at age 5 are estimated to be 5%.
Correct Answer: C. Urinary tract infections can be comorbid with encopresis and are more common in girls.
Which of the following statements correctly describes clinical aspects of the diagnosis of encopresis?
A. Encopresis with constipation and overflow incontinence is often involuntary.
B. Encopresis with constipation and overflow incontinence always involves well-formed stool.
C. Encopresis with constipation and overflow incontinence cannot be diagnosed if the behavior results from avoidance of defecation that develops for psychological reasons.
D. In encopresis with constipation and overflow incontinence, leakage usually occurs during sleep.
E. Encopresis with constipation and overflow incontinence rarely resolves after treatment of the constipation.
Correct Answer: A. Encopresis with constipation and overflow incontinence is often involuntary.
What is true about Enuresis prevalence:
A. 15 year olds: 1%
B. 10 year olds: 3%-5%
C. Unknown
D. 5 year olds: 5%-10%
Correct Answer: A, B, D
What is true about Encopresis prevalence:
A. Unknown
B. 5 year olds 1%
C. 10 year olds .005%
D. More common in males than females
Correct Answer: B, D
