Urinary Incontinence ( 5 types)

Question 1

What are the 5 types of urinary incontinence?

Answer 1

Stress

Urge

Overflow

Functional

Secondary to meds

Question 2

Stress Incontinence pathology?

Answer 2

Weak urethral sphincter

Intra-abdominal pressures higher than what the urethra can handle (Coughing, laughing, sneezing)

Question 3

Stress Incontinence in females is cause by ?

Answer 3

poor muscular support of pelvic floor - keagles

Question 4

Stress Incontinence in males is cause by ?

Answer 4

following prostate surgery

Question 5

Stress incontinence History and Physical?

Answer 5

Momentary leakage of small amounts of urine

Not associated with urge to void

Question 6

Urge Incontinence pathology?

Answer 6

Bladder sensitivity – infection or neurologic disorder

Strong detrusor contractions – overcome urethral resistance

Question 7

Urge Incontinence usually have _______ bladders?

Answer 7

small

Question 8

Urge Incontinence has a ___________ urge to void.

Answer 8

moderate

Question 9

Volume sizes with urge incontinence?

Answer 9

small to moderate volume

Question 10

Stress incontinence is _____ associated with urge to to void

Answer 10

NOT

Question 11

Overflow Incontinence pathology?

Answer 11

Detrusor can’t overcome urethral resistance

Question 12

Overflow Incontinence typically have _____ bladders?

Answer 12

large

Question 13

Overflow Incontinence history and physical?

Answer 13

Continuous dripping or dribbling

Decreased stream force

Possibly enlarged, tender bladder

Question 14

Causes of Overflow Incontinence?

Answer 14

BPH

peripheral nerve disease

DM

Question 15

Functional Incontinence causes?

Answer 15

poor health or environment conditions

Question 16

Functional Incontinence: Health issues?

Answer 16

weakness, arthritis, poor vision, etc

Question 17

Functional Incontinence: Environmental issues?

Answer 17

unfamiliar setting, bed rails, restraints

Question 18

Incontinence secondary to meds can contribute to ___ of the incontinence pathologies.

Answer 18

any

Question 19

Medication examples that cause incontinence?

Answer 19

Sedatives, tranquilizers, anticholinergics, diuretics, etc.

Take a history!

Question 20

Acute Urinary Cystitis - UTI sxs?

Answer 20

Dysuria, frequency, urgency

Suprapubic discomfort

Possible hematuria (usually microscopic)

Question 21

Acute Urinary Cystitis - UTI pathology?

Answer 21

Bacteria ascends from urethra – E. coli most common

Much less common in men cause the urethera is longer

Question 22

Acute Urinary Cystitis - UTI diagnostic studies?

Answer 22

Dip UA positive – pyuria, bacteruria, hematuria

Urine C&S positive ( culture and sensitivity)

Educate regarding prevention

Question 23

Acute Urinary Cystitis - UTI diagnostic studies: Dip UA results??

Answer 23

pyuria, bacteruria, hematuria

Question 24

Education on UTI?

Answer 24

hygiene ( from front to back )

urine after intercourse ( get
bacteria away from urethra)

increase fluids to flush out bladder as much a possible

Question 25

Acute Pyelonephritis pathology?

Answer 25

Infection ascends – involves kidney

Question 26

Acute Pyelonephritis history and physical?

Answer 26

Fever, flank pain (CVA tenderness), dysuria, urgency, frequency

Question 27

Acute Pyelonephritis labs?

Answer 27

Dip UA positive

Urine culture positive

CBC

Question 28

Acute Pyelonephritis CBC results?

Answer 28

left shift

Question 29

Acute Pyelonephritis Tx?

Answer 29

ATB’s

If severe – admit!

Question 30

Nephrolithiasis history and physical?

Answer 30

Severe flank pain, radiating to groin (“Loin to groin”)

N/V

Question 31

5 major types of stones so are we going to use contrast?

Answer 31

NO!

some are radiolucent, so non-contrast CT

Question 32

Dx for Nephrolithiasis?

Answer 32

Strain urine – ID stone type

netting to catch the stone - want to see what the stone is made out of and maybe need to adress dietary changes etc.

Question 33

Nephrolithiasis Tx?

Answer 33

Lithotripsy - shock waves pulverize the stone

Extra-Corporeal Shock Wave Lithotripsy - ESWL