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Elderly medicine/Clinical Pharma > Incontinence > Flashcards

Incontinence Flashcards

1
Q

Is urinary incontinence more common in men or women?

A

3x more likely in women

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2
Q

What are some causes of incontinence extrinsic to the urinary system?

A 
Co-morbidities
Confusion
Drinking too much at wrong time
Medications
Constipation
Social circumstances
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3
Q

What is the muscle function for urine storage?

A

Detrusor relaxation

Sphincter contraction

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4
Q

What is the muscle function for voluntary voiding?

A

Voluntary relaxation of external urethral sphincter
Involuntary relaxation of internal sphincter
Contraction of detrusor

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5
Q

What is the innervation of the pelvic floor muscle (urogenital diaphragm)?

A

S2-S4

Somatic

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6
Q

What innervation causes detrusor to relax?

A

Sympathetic

T10-L2

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7
Q

Which parts of CNS are involved in storage and voiding?

A

Pontine micturation centre
Frontal cortex
Caudal spinal cord

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8
Q

What is stress incontinence?

A

Bladder outlet too weak
Leak on movement
Weak pelvic floor muscles

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9
Q

How is stress incontinence managed?

A

Physiotherapy
Oestrogen cream
Duloxetine

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10
Q

What is urinary retention with overflow incontinence?

A

Bladder outlet too strong
Poor urine flow
Blockage to urethra
Older men with BPH

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11
Q

How do we treat urinary retention with overflow incontinence?

A

Alpha blocker to relax sphincter

Anti androgen to shrink prostate

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12
Q

What is tamsulosin used for?

A

Alpha blocker

Relaxes sphincter

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13
Q

What is urge incontinence?

A

Bladder muscle too strong
Detrusor contracts at low volumes
Sudden urge to pass urine

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14
Q

What are some possible causes of urge incontinence?

A

Bladder stones

Stroke

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15
Q

How is urge incontinence treated?

A

Anti-muscarinic to relax detrusor
Oxybutinin
Tolterodine
Solifenacin

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16
Q

What are some causes of underactive (neuropathic) bladder?

A

Neurological disease like MS or stroke
Prolonged catheterisation
No awareness of bladder filling resulting on overflow incontinence

17
Q

What are some last resort options if incontinence treatment fails?

A 
Incontinence pads
Urosheaths 
Intermittent catheterisation 
Long term urinary catheter
Suprapubic catheter

Elderly medicine/Clinical Pharma (5 decks)

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