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PEBC > Urinary Incontinence > Flashcards

Urinary Incontinence Flashcards

1
Q

Urinary incontinence (UI) is the complaint of _________________

A

involuntary leakage of urine

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2
Q

There are a number of types of urinary incontinence:
1.
2.
3.
4.

A

1) Stress 2) Urge 3) Overflow 4) Functional

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3
Q

Impairment in _____ function leads to incontinence

A

urethral

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4
Q

Under normal conditions urethral pressure ______ bladder pressure resulting in urine remaining in the bladder

A

exceeds

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5
Q

Some symptoms of urinary incontinence include:
1.
2.
3.

A
  1. Voiding (small or large volumes)
  2. Nocturia
  3. Dribbling

unable to hold voiding, urine loss with abdominal pressure, dyspareunia (painful intercourse), dysuria

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6
Q

Non-modifable risk factors for urinary incontinence:
1.
2.

A

Female gender, Elderly,

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7
Q

Modifiable risk factors:
1.
2.
3.
4.

A
  1. Caffeine intake
  2. BPH in men
  3. Obesity
  4. Medications

Smoking, Bowel problems, fluid intake, limited physical activity, lower urinary tract conditions, restricted mobility

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8
Q

What is the most common form of UI in women?

A

Stress incontinence

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9
Q

Urine leakage in stress incontinence is the result of __________ causing pressure inside the bladder to overcome the ability of the compromised urethral sphincter to close the urethra

A

increased intra-abdominal pressure (cough, sneeze, laugh)

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10
Q

__________ involves leakage of moderate to large amounts of urine due to inability to delay voiding when an urge is perceived

A

Urge incontinence

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11
Q

__________ is a syndrome that includes urgency and can lead to urge incontinence

A

Overactive bladder

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12
Q

Chronic retention of urine often involves leakage of urine which leads to __________ incontinence when the amount of urine retained produces pressure beyond the sphincter or obstruction pressure.

A
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13
Q

Overflow incontinence presents with ________ (the type of frequency)

A

dribbling

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14
Q

_______________ is the loss of urine caused by the inability to get to or use the toilet, and does not involve changes in the lower urinary tract

A

Functional incontinence

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15
Q

Causes of functional incontinence
1.
2.
3.

A

physical constraints (ex restricted mobility) cognitive factors (dementia, depression) and environmental barriers (access to toilet, positioning)

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16
Q

Examples of drug related causes
1.
2.
3.
4.
5.

A
  1. Antihistamines
  2. Anticholinergics
  3. Sedatives
  4. Narcotics
  5. Cholinergics

Muscle relaxants, caffeine, ethanol, etc

17
Q

First line management involves _______ and ________

A

behavioural therapy lifestyle changes

18
Q

Third line treatment:

A

Botox

19
Q

First line treatment for stress incontinence

A
  1. pelvic muscle exercises

biofeedback, exercise/weight loss if overweight, pessaries, surgical intervention

20
Q

The following medications have low evidence for treatment in stress incontinence

A

vaginal estrogen & duloxetine

21
Q

First line treatment for urge incontinence

A

Behavioural therapy
Bladder retraining
Scheduled toileting
Pelvic muscle exercise

22
Q

_____________ are considered second-line treatment for urge incontinence when nonpharmacologic options fail to provide adequate symptomatic relief

A

antimuscarinics and beta3 agonist mirabegron

23
Q

Treatment for overflow due to obstruction

A

alpha antagonists or surgery

24
Q

Treatment for overflow due to detrusor under activity

A

catheterization, diapers and reassessing medication causes

25
Q

Treatment of urinary incontinence during pregnancy involves ______________

A

pelvic floor rehabilitation

26
Q

Common side effects of the anticholinergic medications (Oxybutinin, Tolterodine, Darfenacin, Solfenacin, Trospium, Fesoterodine)

A

Blurred Vision
Delirium
Constipation (++ common)
Sedation (++ common)
Urinary retention
Dry mouth

27
Q

Anticholinergics should be avoided in patients with
1.
2.
3.

A
  1. Urinary/gastric retention
  2. narrow-angle glaucoma
  3. cardiac patients
28
Q

These two anticholinergics DO NOT cross the BBB and may be better tolerated in the elderly
1.
2.

A
  1. Tolterodine
  2. Trospium
29
Q

The most common adverse effects of mirabegron include:
1.
2.
3.

A

Hypertension
Nasopharyngitis
Urinary tract infections
Headaches

30
Q

Avoid ________ in sever, uncontrolled hypertension

A

Mirabegron (also dont crush/chew)

31
Q

TCA’s may be used in patients with concomitant ____ or ____

A

depression or neuropathy

32
Q

If TCA are required in elderly, consider _____ and _____ due to lower risk of anticholinergic s/e

A

notriptyline and desipramine

33
Q

most common type of incontinence in men?

A

overflow

34
Q

The following anticholinergic is not metabolized by the CYP450 system

A

Torspium

PEBC (35 decks)

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