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Systems- Repro > Incontinence > Flashcards

Incontinence Flashcards

1
Q

What are the 6 main types of incontience

A

Stress -> incontinence due to an increased intra-abdominal pressure

Urge -> sudden urge to pass urine due to overactivity of the detrussor muscle

Overflow -> urine retention due to an incompatipility for complete voiding

Neurogenic -> incontinence due to a decreased nerve sensitivity controlling urination

Post-coital -> incontinence after penetration or orgasm

Mixed -> just a wee mix of all types of incontinence

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2
Q

What treatment should always be done for incontinence

A

Pelvic floor fucking exercises

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3
Q

What type of incontinence is duloxetine used to treat

A

Stress

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4
Q

What type of incontience is Trans-cutaneous Electrical Nerve Stimulation (TENS) used to treat

A

Overflow

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5
Q

What type of incontinence is neuromodulation used to treat

A

Neurogenic

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6
Q

What type of incontinence can be caused by prolonged catheterisation and therfore treated by removing said cathater

A

Neurogenic

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7
Q

Why can coughing, sneezing and moving cause stress incontinence

A

As they all cause an increased intra-abdominal pressure

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8
Q

What type of drug is duloxetine

A

Serotonin and Norepinephrine Reuptake Inhibitor (SNRI)

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9
Q

Women who have had several pregnancies are at an increased risk of what type of incontinence

A

Stress incontinence

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10
Q

Which type of incontinence have patients that ‘know where every public toliet is’

A

Urge

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11
Q

What type of incontinence is due to involuntary contractions of the detrussor muscle

A

Urge

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12
Q

What type of incontinence can also cause urine retention and why

A

Overflow

The urethra is blocked so you can’t fully voi

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13
Q

What type of incontinence can be caused by benign prostate hyperplasia (BPH) and how can it be treated

A

Type of incontince -> overflow

Treated with -> Trans urethral resection of the porstate (TURP) & a-blockers

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14
Q

What are some of the causes of neurogenic incontinence

A

Prolonged cathertisation

Neurological disease (e.g. stroke or MS)

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15
Q

What is a way of indicating the severity of incontinence

A

How many pads the woman gets through

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16
Q

Urine incontinence can occur during the night, what is the definition of nocturia

A

Waking up on more than 1 occasion to piss

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17
Q

What type of incontience can cause recurrent UTIs and why

A

Overflow incontinence

Due to urine retention

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18
Q

What is the 1st line investigation that you should get all patients who complaining of incontience to kick-off with

A

3-day urine diary

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19
Q

What investigation shoudl you do if haematuria occurs

A

Cystoscopy

20
Q

What are the investigations for incontinence

A

3-day urine diary

Abdominal & pevlic exam

Urinalysis

Mid-stream sample of urine (MSSU)

Cystosocpy

Urodynamics

21
Q

What are some of the risk factors for incontinence

A

Being a woman

High parity

Heavy baby

Induced pregnancy

Old age

Obesity

Pelvic floor trauma

Smoking

Environment

22
Q

What environment can increase your risk of incontinence

A

Being in hopsital

23
Q

If a patient with incontience is obese and has a BMI of over 35, what treatments can you not undergo

A

Surgery

24
Q

What methods of induced labour increases your risk of incontinve

A

Forceps delivery

Vaccuum extraction

25
Q

What sex is most likely to suffer from incontience

A

Females bruh

26
Q

What is the 1st line treatment for incontinence and for how long should they be used for

A

Pelvic floor exercises

Used for 3 months

27
Q

What are some of the causes of incontinence

A

Stressful lifestyle

Pelvic trauma

Detrussor degeneration (old age)

Diuretics

Drinking too much

BPH

Defect in vesico-ureteric valve

28
Q

What medication shoudl you always check that patients with incontinence are on as they may be the cause of it

A

Diuretics

29
Q

What is a very common reason for incontinence that should be discussed with the patient

A

Drinking too much

30
Q

In a history, what should you discuss with patients with incontinence

A

Age

Parity

Mode of deliverly (e.g. foreceps)

Weight of heaviest baby

Smoking history

HRT

PMH

31
Q

What questions should you ask in a patient’s PMH about incontinence

A

Diabetes (can cause a big baby that damages the pelvic floor)

Cardio/liver/renal problems

Hypertension

Glaucoma

32
Q

Why must you ask if patient’s with incontinence have/had glaucoma

A

As they wont be able to be treated with anti-cholinergics

33
Q

What are the treatments for incontinence

A

Lifestyle changes

Pelvic floor exercises

Vaginal cones

a-/B-adrenoreceptor agonists

Anti-cholinergics

Anti-musacrinics

Surgery

34
Q

How do anti-cholinegrics treat incontinence

A

Blocks the action of ACh

Decreases sympathetics tone

Increases parasympathetic tone

35
Q

Which drugs treat incontince by increasing sympathetic tone

A

a-adrenorectpor agonsits

B-adrenoreceptor agonists

Anti-muscarinicns

36
Q

When would you use B-adrenoreceptor agonists to treat incontinence

A

When anti-muscarinics can’t be used

37
Q

What surgical treatments are used for incontinence

A

Burch Colposuspension

Cathaterisation

Trans-vaginal tape

38
Q

What is the name of the CNS centre that controls urination

A

Pontine micturation centre

39
Q

What 2 nerves control the parasymapthetic innervation for urination

A

Pelvic nerve

Pudendal nerve

40
Q

What spinal nerves provide parasympathetic innervatoin for urination

A

S2-S4

41
Q

What 2 type of nerves provide sympathetic innervation for urination and what spinal levels are the following nerve

A

B-adrenoreceptors -> T10-L2

a-adrenoreceptors -> T10-S2

42
Q

What nervous system controls the external urethral sphincter and therefore provides voluntary control over urination

A

Somatic nervous system

43
Q

What are the 3 requirements for urination to occur

A

Involuntary relaxatoin of internal urethral sphincter

Involuntary contraction of bladder

Voluntary relaxation of external urethral sphincter

44
Q

What is the normal bladder capcaity

A

400-600ml

45
Q

After what volume of urine in the bladder causes you to:

a) feel like you need to pee
b) desperate to pee

A

a) 250ml
b) 500ml

Systems- Repro (14 decks)

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