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AGM 2 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Acute incontinence characteristics

A

acute onset, reversible, may have associated dysuria

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2
Q

types of incontinence

A

acute, stress, urge, overflow, functional, mixed

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3
Q

types of persistent incontinence

A

stress, urge, overflow, functional, mixed

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4
Q

stress incontinence

A

small volumes of leakage caused by increased intra-abdominal pressure

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5
Q

causes of stress incontinence

A

sphincter problems, TURP

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6
Q

urge incontinence

A

strong, sudden urge with inability to delay

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7
Q

cause of urge incontinence

A

overactive bladder contractions

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8
Q

overflow incontinence

A

due to urinary retention, may be associated with pelvic/abdominal pain

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9
Q

functional incontinence

A

unwilling or unable to reach toilet

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10
Q

causes of functional incontinence

A

osteoarthritis, dementia etc

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11
Q

mixed incontinence

A

usually stress and urge mixed

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12
Q

how to ask about incontinence

A

do you have bladder problems that are bothersome or do you leak urine

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13
Q

reversible causes of incontinence DISAPPEAR mnemonic

A

Delirium, improper fluid Intake, Stool impaction, Atrophic vaginitis/urethritis, Psychological problems, Pharmaceuticals, Excess urine output, Abnormal lab values, Restricted mobility

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14
Q

what conditions can cause excess urine output

A

DM, hypercalcemia, CHF, other volume overload conditions, venous insufficiency when legs elevate

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15
Q

what medications can cause incontinence

A

diuretics, benadryl, anticholinergics, opioids, calcium channel blockers

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16
Q

what causes atrophic vaginitis

A

decrease in estrogen levels

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17
Q

causes of fixed incontinence

A

age-related weakness in pelvic floor or sphincter, obstruction (BPH or prolapse), neurologic, previous surgery/radiation

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18
Q

causes of neurologic incontinence

A

stroke, spinal cord injury/cauda equina, dementia, Parkinsons? DM, MS

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19
Q

normal bladder capacity

A

300-600 mL

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20
Q

external bladder sphincter is what kind of muscle

A

skeletal

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21
Q

what parts of bladder/sphincter is smooth muscle

A

detrusor, internal sphincter

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22
Q

sympathetic innervation of bladder

A

L1-L3 closes bladder and inhibits parasympathetics to relax bladder and hold urine in

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23
Q

parasympathetic innervation of bladder

A

S2-S4 contracts bladder to void

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24
Q

what carries info on bladder fullness to spinal cord

A

afferent pathways via somatic and autonomic nerves

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25
Q

when does first urge to void bladder occur

A

150-350 mL

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26
Q

what counterbalances bladder pressure

A

urethral pressure

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27
Q

under what circumstances does involuntary bladder contraction occur

A

neurogenic bladder

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28
Q

medications causing incontinence due to reduced control

A

diuretics, sedatives, tamsulosin (alpha adrenergic blockers), ETOH, caffeine

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29
Q

meds causing incontinence due to urinary retention

A

anticholinergics, psych meds, alpha agonists, calcium channel blockers

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30
Q

what is considered urinary retention on post-void residual

A

> 150 mL

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31
Q

Major concern with hematuria

A

cancer until proven otherwise

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32
Q

cutoff for microscopic hematuria

A

3 or more RBCs per hpf in 2 of 3 specimens

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33
Q

problem with urine dip re: hematuria

A

cannot distinguish between myoglobin, hemoglobin, diet

34
Q

major cause of stress incontinence in men

A

removal of prostate

35
Q

causes of hematuria

A

UTI, urolithiasis, BPH, cancer, vaginal bleeding, vigorous exercise, urethral trauma, nephritic syndrome

36
Q

high-risk hematuria

A

smoking, chemical exposure, older than 40, pelvic radiation, analgesic abuse, history of UTIs

37
Q

what suggests kidney etiology of hematuria

A

protein, creatinine, casts

38
Q

upper urinary tract evaluation

A

CT, IV urography, renal ultrasound

39
Q

lower urinary tract evaluation

A

cystoscopy, voided urine cytology

40
Q

only method of reliably detecting transitional cell carcinoma of bladder/urethra

A

cystoscopy

41
Q

definition of asymptomatic bacteriuria

A

2 consecutive counts of over 100K of the same bacteria

42
Q

Primary sleep disorders that increase with age

A

sleep-related breathing disorders, RLS, circadian rhythm disorders

43
Q

age-related changes of total sleep time, slow-wave sleep, REM sleep

A

decrease

44
Q

age-related changes of daytime napping, stages N1 and N2, wake after sleep onset

A

increase

45
Q

neck circumference associated with OSA

A

> 16 inches

46
Q

which questionnaire is used to evaluate OSA

A

STOP-Bang

47
Q

elements of STOP-Bang

A

Snoring, Tiredness, Observed apnea, high blood Pressure, BMI, Age, Neck circumference, Gender

48
Q

predisposition to sleep disordered breathing

A

age over 40, commercial motor vehicle driver, family history, male, obesity, postmenopausal, retrognathia, reduced distance and increased angles from chin to thyroid

49
Q

periodic limb movement disorders

A

repetitive, stereotypic leg movements that occur during non-REM sleep

50
Q

Restless leg syndrome

A

uncontrollable urge to move legs with an unpleasant sensation that improves with movement

51
Q

diagnosis of PLMS, RLS

A

polysomnography for PLMS, RLS is clinical

52
Q

Possible causes or provoking factors for RLS

A

iron deficiency, meds (antiemetics, antipsychotics, SSRIs, tricyclics, diphenhydramine)

53
Q

treatment for RLS

A

dopamine agonist (pramipexole, ropinirole), gabapentin

54
Q

rapid eye movement during sleep is associated with what disorders

A

neurodegenerative

55
Q

cause of insomnia in elderly

A

degeneration of suprachiasmatic nucleus leading to a reduction in melatonin production and decreased external cues

56
Q

first line treatment for chronic insomnia

A

CBT-I

57
Q

some agents used for insomnia in older adults

A

mirtazapine, trazodone, melatonin

58
Q

definition of pulmonary nodule

A

well-defined lesion less than or equal to 3 cm

59
Q

benign pulmonary nodules appearance

A

diffuse, central, popcorn, concentric

60
Q

malignant pulmonary nodules appearance

A

ground-glass, eccentric

61
Q

nodule < 6mm

A

no follow-up

62
Q

solid nodule less than 8 mm

A

repeat CT in 6-12 months

63
Q

solid nodule greater than 8 mm

A

CT in 3 months then 12 months

64
Q

ground glass nodule

A

CT at 6-12 months

65
Q

part solid between 6-8mm

A

CT at 3-6 months

66
Q

part sold >8mm

A

PET/CT with biopsy/resection

67
Q

multiple nodules solid

A

CT 3-6 months

68
Q

multiple nodules subsolid any size

A

CT 3-6 months

69
Q

DDX of benign solitary pulmonary nodule

A

infectious granuloma, hamartoma, AV malformation

70
Q

DDX of malignant solitary pulmonary nodule

A

Adenocarcinoma, SCC, metastatic disease, small cell carcinoma, carcinoid tumor

71
Q

diagnosis of pulmonary HTN

A

right heart cath: mean PA>20, pulmonary artery wedge pressure <15, pulmonary vascular resistance > 3 woods units

72
Q

pathophys changes in PAH

A

arterial remodelling and inflammation, thickening of adventitia and media, proliferation and migration of smooth muscle cells and fibroblasts

73
Q

PH group 1

A

PAH (idiopathic, heritable, drug/toxin-induced)

74
Q

PH group 2

A

left heart-induced

75
Q

PH group 3

A

lung disease/hypoxia related

76
Q

PH group 4

A

chronic thromboembolic

77
Q

PH group 5

A

unclear/multifactorial

78
Q

Pulm HTN EKG

A

RAD, RVH, right atrial enlargement, RV strain

79
Q

Pulm HTN CXR

A

large central pulm arteries, enlarged right heart, could be normal

80
Q

Pulm HTN TTE

A

elevated right systolic ventricular pressure

81
Q

medication treatment for chronic thromboembolic pulmonary htn

A

riocoguat

82
Q

treatment of pulm htn

A

endothelin receptor antagonists (end in -entan), phosphodiesterase 5 inhibitors (sildenafil), treat underlying conditions

AGM 2 (4 decks)

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