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STEP 2 Cardio + Renal > Renal. Incontinence + UW elderly incont (08-15) (1) > Flashcards

Renal. Incontinence + UW elderly incont (08-15) (1) Flashcards

1
Q

UW incontinence.
STRESS. what symptoms?

A

leaking with Valsalva maneuver (caughing, sneezing, laughing)

this maneuver leads to increased intraabdominal pressure

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2
Q

UW incontinence.
leaking with Valsalva maneuver (caughing, sneezing, laughing)?

A

stress

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3
Q

UW incontinence.
STRESS. what treatment?4

A

lifestyle modifications

pelvic floor exercise

pessary and Kegel

pelvic floor surgery

FA: urethral sling procedure (WTF)

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4
Q

UW incontinence.

lifestyle modifications
pelvic floor exercise
pessary
pelvic floor surgery

in what?

A

stress

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5
Q

UW incontinence. URGENCY. Symptoms?

A

sudden, overwhelming, or frequent need to void

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6
Q

UW incontinence.
sudden, overwhelming, or frequent need to void?

A

Urgency

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7
Q

UW incontinence.
Urgency. Treatment? 3

A

Lifestyle modification
Bladder training
antimuscarinic drugs

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8
Q

UW incontinence.

Lifestyle modification
Bladder training
antimuscarinic drugs

in what?

A

Urgency

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9
Q

UW incontinence.
MIXED. symptoms?

A

Features of stress and urgency

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10
Q

UW incontinence.
Features of stress and urgency?

A

Mixed

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11
Q

UW incontinence. mixed treatment?

A

variable treatment depending on predominant symptoms

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12
Q

UW incontinence.
variable treatment depending on predominant symptoms

in what?

A

MIXED

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13
Q

UW incontinence.
OVERFLOW. symptoms?

A

Constant involuntary dribbling and incomplete emptying

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14
Q

UW incontinence.

Constrant involuntary dribbling and incomplete emptying

A

Overflow

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15
Q

UW incontinence.
OVERFLOW treatment? 3

A

Identification and correction of underlying cause

Cholinergic agonists

Intermitent self-catheterization

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16
Q

UW incontinence.

Identification and correction of underlying cause

Cholinergic agonists

Intermitent self-catheterization

in what?

A

Overflow

17
Q

FA. incontinence. mechanism?

A

involuntary loss of urine cause by either bladder or urethral sphincter dysfunction.

18
Q

FA. incontinence. Mneumonic of causes?

A

DIAPPERS

Delirium/confusion
Athrophic urethritis/vaginitis
Pharmaceutical
Psychiatric disorders (esp. depression)
Excessive urinary output (hyperglycemia, hypercalcemia)
Restricted mobility
Stool impaction

19
Q

FA. incontinence.
Diagnosis. urine labs

A

Urinalysis - pyuria suggests UTI.
Creatinine - can reveal renal dysfunction if urinary obstruction leading to overflow is suspected.

20
Q

FA. incontinence.
Diagnosis. what patients have to do to follow volume?

A

Voiding diaries - helps to define type of incontinence

21
Q

FA. incontinence.
Diagnosis. instrumental testing?2

A

Urodynamic and radiographic testing - not routinely. used if considered surgery

22
Q

FA. incontinence. Stress mechanism?

A

Urethral sphincter insufficiency caused by laxity of pelvic floor musculature

23
Q

FA. incontinence. Stress in what patients? 2

A

multiparous women or after pelvic surgery

24
Q

FA. incontinence. Urgency. how it happens?

A

unexpected urge to void unrelated to position or activity

25
Q

FA. incontinence. Urgency. mechanism?

A

in bladder outlet obstruction (BPH or drugs that incr. sphrincter tone)
or
detrusor overactivity

26
Q

FA. incontinence. Urgency.

pelvic floor exercise, bladder training

what drugs? 1st and 2nd line

A

Anticholinergic - 1st line

B agonists eg mirabegron - 2nd line

27
Q

FA. incontinence. Overflow. what situation?

A

dribbling after incomplete emptying of bladder

28
Q

FA. incontinence. Overflow. mechanim?

A

chronically distended bladder with intravesical pressure that just exceeds the outlet resistance –> small amount of urine to dribble out

29
Q

FA. incontinence. Overflow. treatment

A

urethral cath in acute setting

treat underlying cause

timed voiding/catheterization

30
Q

FA. incontinence.
Total. what situation?

A

uncontrolled loss and at all times and all positions

31
Q

FA. incontinence.
Total. mechanism? 2

A

loss of sphincter efficiency (previous surgery, nerve damage, cancer infiltration)

Abnormal connection between urinary tract and skin (fistula)

32
Q

FA. incontinence.
Total. treatment?

A

surgery

33
Q

UW. incontinence in elderly. genitourinary causes? 4

A

decr. detrusor musle contractility, detrusor overactivity

Bladder/urethral obstruction (cancer, BPH)

Urethral sphincter/pelvic floow weakeness

Urogenital fistula

34
Q

UW. incontinence in elderly. Neurologic causes? 3

A

Multiple sclerosis
Dementia (parkinson, alzheimer, NP hydrocephalus)
Spinal cord injury/disc herniation

35
Q

UW. incontinence in elderly. Potentially reversible causes?

A

DIAPPERS

Delirium
Infection (UTI)
Pharmaceutical (alfa blockers, diuretics)
Psychological (depression)
Excessive urine output (DM, CHF)
Restricted mobility (post surgery)
Stool impaction

36
Q

UW. incontinence in elderly. most common cause?

A

UTI
Once excluded –> additional tests to rule out other causes

37
Q

UW. incontinence in elderly. 3 groups medications as cause

A

alpha blockers: relaxes urethra

Diuretics: xxcessive urine production

Anticholinergic, opiatres, CCB: urinary retention and overflow

STEP 2 Cardio + Renal (35 decks)

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