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Flashcards in Bladder Disorders Deck (28)
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1
Q

What part of the brain is responsible for urination?

A

Afferent activity stim pontine micturation center to initiate voluntary void

2
Q

What is the effect of PNS stimulation of bladder?

A

Bladder outlet and sphincter relaxation

Coordinated contraction of bladder smooth muscle

3
Q

What is urinary incontinence?

A

Invol loss of urine

Bladder/sphincter dysfunction or both

4
Q

What are the types of Bladder dysfunction?

A

Urge incontinence
-detrusor overactivity
-poor detrusorcompliance
Overflow incontinence

5
Q

What are the types of Outlet dysfunction?

A

Anatomic Stress incontinence

Intrinsic Sphincter Deficiency

6
Q

What are the Potentially reversible transient causes of Urinary incontinence?

A
DIAPERS
Delirium/Cog impairment
Infection
Atrophic Vaginitis/urethritis
Pharm/meds
Excessive urine output
Restricted mobility Stool impaction
7
Q

What types of meds Cause transient Urinary incontinence?

A
Sedatives
Diuretics
Anticholinergics
Alpha-Adr
Alpha-Ant
8
Q

What is included in an Incontinence Evaluation?

A
Urinalysis
Urine Culture
Post void residual volume measurement
Voiding Diary
Pelvic exam for urethral hypermobility/prolapse
Urodynamics 
Cystoscopy
9
Q

What constitutes Overactive Bladder?

A

Frequency and urgency w/without urge incontinence

10
Q

What constitutes Urge Urinary Incontinence

A

Involuntary Urine Leak w/ strong sudden desire to urinate

Bladder pressure overcomes sphincter mechanism

11
Q

What constitutes Detrusor Overactivity?

A

Intermittent involuntary bladder contractions

Idiopathic or neurogenic

12
Q

What constitutes Poor Compliance of Bladder?

A

Incremental rise in pressure as bladder vol increases

Loss of viscoelastic properties or disrupt of neuro reg

13
Q

How do Anticholinergics help with incontinence?

A

UUI/OAB

Inhibits invol. detrusor muscle cont. by blocking muscarinic receptors

14
Q

What are SE and Contraindications of Antichol?

A

SE: Dry mouth, Constipation, urinary retention, nausea, blurred vision, drowsiness, Confusion
ContIn: Narrow angle Glaucoma

15
Q

How do Beta 3 Antagonists help with incontinence?

A

Inhibits involuntary detrusor muscle contraction by activating B3 receptors

16
Q

What are the surgeries that treat OAB/Urge incont?

A

Sacral Nerve mod
Intravesical Botox injection
Bladder aug or Diversion

17
Q

What are causes of overflow incontinence?

A

Extreme bladder volumes
Bladder outlet obstruction or poor detrusor contractility
Meds
Constipation
Pelvic Prolapse, prostate, urethral stricture
Pelvic Surgery
Sphincter dysfunct

18
Q

What is Stress urinary incontinence?

A

Invol urine leak with sudden inc in abdominal pressure
MEN: postsurgical
Women: pelvic floor muscles and sphincter tone

19
Q

What is the difference between True anatomic stress incontinence and intrinsic sphincter Def?

A

Urethral Hypermobility or urethra below pelvic floor

Weakness of sphincter
More severe

20
Q

What are indications for urology Referral?

A

Failure to respond to conservative therapy
Hematuria
Recurrent infections
Complicated incontinence

21
Q

What are the different types of UTI?

A

Uncomplicated- healthy Pt
Complicated
Recurrent- occurs after resolution
Reinfection- new event with reintro of bacteria into GU tract
Persistent- Same bacteria from focus of inf

22
Q

What are the causes of Complicated UTI?

A

Inc risk and dec efficacy of therapy
Abnormal GU tract
Immunocompromised host
Multi drug resistant Bacteria

23
Q

What are the Risk factors for UTIs?

A
Poor fluid intake/dehyd
Infrequent Void
Incomp bladder emptying
Constipation
Vaginal Atrophy
Staghorn Calculi
Urinary cath
Abn urinay tract
Underlying dis
Poorhygeine
Sexual activity
24
Q

What are the urine studies done in UTI?

A
Urine Collection
UA- leukocyte est
-nitrite
-Blood, goss or micro
-10 WBCs/HPF
Urine culture
25
Q

What is the Tx of UTI?

A

Empiric Abtx: Sulfamethoxazole/ Trimethoprim or fluoroquinolones
Adjust based on sensitivity
Mod Risk factors
Low dose prophylaxis if recurrent

26
Q

What are the disorders associated with Cystitis?

A
Fibromyalgia
IBS
Endometriosis
Vulvodynia
Multiple allergies
27
Q

What is on the DDx of Cystitis?

A
Recurrent UTI
Endometriosis
Pelvic Mass
OAB or neurogenic Bladder
Bladder Cancer
28
Q

What is the Suggested Etiology of Cystitis?

A

Inc mast Cell Conc in bladder => releases histamine
Def in GAG layer in Urothelium
Neurogenic Hypersense at level of bladder or sacral spinal cord
Pelvic Floor dysfunction
AI disorder
Atypical Inf agents
Bladder wll scarring and fibrosis