Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obs & Gynae > Incontinence and FGM > Flashcards

Incontinence and FGM Flashcards

1
Q

What is stress UI

A

Involuntary leakage on effort or exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is urge UI

A

Involuntary leakage accompanied by or preceded by urgency due to overactivity of bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What nerve allows storage of urine

A

Hypogastric sympathetic
T10-L2
B-receptor on detrusor relaxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What nerve allows internal sphincter to contract

A

Same

Acts on adrenergic receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What nerve stimulates voiding

A

Pelvic
Parasympathetic S2-S4
Relax internal sphincter
Contract detrusor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What nerve is responsible for voluntary control

A

Pudendal
S2-S4
Contraction of external sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes SUI

A

Increase in intra-ado pressure > urethral
Defect / weakness in pelvic floor
Hammock laxity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are other causes / DDx

A 
DIAPERS
Delerium 
Infection - UTI / cystitis 
Atrophic vagintiis 
Pharamceutic or prolapse 
- Diuretic
- Anticholinergic / cholinergic 
Endocrine
- DM
- DI
- Hypercalcaemia
Restricted mobility
Stool impaction / stones

Other
Excess fluid
Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are symptoms associated with incontinence

A 
Urgency
Frequency
Nocturia
Dysuria
Haematuria
Incontinence
Strain to void
Interrupted flow
Recurrent UTI
Prolapse Sx
Bowel Sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are RF for SUI

A 
Age
Menopause 
Female 
Parity
Instrumental birth 
Obesity 
Hysterectomy
FH
Smoking
Increase in intra-abdominal pressure - cough 
Pelvic floor trauma / surgery 
Connective tissue 
Denervation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are initial investigations

A

VE for prolapse / strength of PFM
Urine dip and MSSU
3 day urine diary with intake, output, volume
U+E / glucose
Post void residual volume
USS renal tract - hydronephrosisi if retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do you do post void residual volume

A

If difficulty voiding

Suggestive of overflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When do you do urodynamics

A

If surgery contemplated or uncertainty over Dx or think prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is important in Hx

A 
Obstetric
Gynae
Medical
Previous PFMT
Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is lifestyle measures

A 
Smoking
Weight loss
Avoid constipation
Stop alcohol and coffee
Oestrogen clream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is 1st line Rx

A

PFMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What else can you do

A

Biofeedback if can’t contract

18
Q

What pharmacological measures

A

Duloxetine - SNRI
Yentreve
If PFMT and surgery not an option

19
Q

What surgery

A

TVT = 1st line

COlposuspension

20
Q

What are risks of TVT

A

Bladder perforation
Vaginal and urethral erosion
Vascular injury

21
Q

What does a vesicle-vaginal fistula present like

A

Continuous dribbling
Prolong labour
Poor access to services e.g. poor country

22
Q

How do you Dx

A

Urinary dye study

23
Q

What causes overactive / urge

A 
Destrusor overactivity = form of urge 
Neurogenic
MS
Parkinson
DM
Stones
24
Q

What are symptoms

A 
Urgency
Incontinence
Frequency
Nocturia 
Small vol
Overflow
25
Q

What are RF

A

Age
DM
UTI
Smoking

26
Q

How do you Dx

A

Bladder diary
Dipstick
VE or DRE in men
Urodynamic study

27
Q

How do you treat

A

Normalise intake
Stop smoking
Weight. loss
Bladder retraining programme

28
Q

What are pharmacological intervention

A 
Anti-muscarininc
- Oxybutynin - never in elderly
- Toldierone 
- Mirebegron if >75 
TCA
Botox
Neuromodulation if refractory
29
Q

What are SE of anti-muscarininc

A

Dry eyes and mouth

CNS

30
Q

When should you caution with anti-muscarininc

A

Narrow angle glaucoma
Myasthenia gravis
Poor contracted bladder

31
Q

Oxybutynin

A

DO NOT USE IN FRAIL as immediate release

Use mirebegron if >75

32
Q

What causes overflow

A

Bladder outlet obstruction usually due to BPH leading to retention
Nerve damage
- Neuropathy
- Pelvic surgery

33
Q

What are Sx

A 
Strain
Poor flow
Incomplete emptying
Overflow
Palpable bladder after urination
34
Q

How do you Dx

A 
Urine dip
VE
Bladder diary
Urodynamic 
Bladder scan for residual
35
Q

What does it look like on urodynamic study

A

High voiding pressure

Low flow rate

36
Q

What is FGM

A 
1 = removal of clitoris
2 = clitoris + labia 
3 = infibulation (narrowing of vaginal) 
4 = any other
37
Q

How do you deal with FGM

A

OFFEENSE IN UK

Reinfibulation = illegal

38
Q

What are shot term complications

A 
Pain
Shock
Bleeding
Infection 
Fatal haemorrhage
39
Q

What are long term complications

A 
Retention
Difficulty menstruation
Infection
Cyst 
Obstructed labour
Fistula
PTSD
Sexual dysfunction
40
Q

What should you always ask in Hx

A

Psychological / QOL

41
Q

If present in acute setting what Ix

A 
DRE men for any urinary Sx
Bimanual for women 
Urine dip - rule out UTI
U+E / glucose 
Post void residual to see if retention and rule out overfllow
Renal USS - hydronephrosis

Obs & Gynae (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions