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Genitourinary > Bladder Disorders (Exam 3) > Flashcards

Bladder Disorders (Exam 3) Flashcards

1
Q

The loss of urine that represents a hygienic or social problem to individual

A

Involuntary Urine Incontinence

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2
Q

causation of Urinary incontinence

A

Multifactorial - Etiologies are diverse and not completely understood

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3
Q

Urinary incontinence is _____ times more likely in this sex

A

2 X more likely

Females

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4
Q

Largest single Risk Factor of Urinary Incontinence

A

Age

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5
Q

Higher prevalence in ?

A

Non-Hispanic White Women

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6
Q

What percentage of incontinent individuals actually receive the appropriate medical evaluation / TX

A

5%

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7
Q

Average time a pt will live with urinary incontinence prior to seeking medical attention

A

6-9 years

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8
Q

Pneumonic to remember Reversible causes of Urinary Incontinence

A

Dippers

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9
Q

Dippers stands for what?

A 
Delirium
infection
atrophic
pharmaceutical
psychological disorders
excess
restricted mobility
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10
Q

An increased intra-Abdominal Pressure raises pressure within bladder to the point where it exceeds the Urethra’s Resistance to urinary flow is

A

Stress Incontinence

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11
Q

what causes the urethral hypermobility

A

due to impaired support from pelvic floor

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12
Q

Intrinsic Sphincter Deficiency is usually secondary to what

A

Pelvic Surgeries

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13
Q

Presentation of Stress Incontinence

A

Coughing, Laughing, and Sneezing

worsens during high-impact sports such as golf, tennis, aerobics, trampolines

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14
Q

A lot or Little urine is lost during Stress incontinence

A

Little

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15
Q

what is Urge Incontinence

A

The involuntary loss of urine associated with a feeling of urgency

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16
Q

what is the main cause of urge incontinence

A

Detrusor Overactivity

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17
Q

Presentation of Urge Incontinence

A

Uncontrolled urine loss and a strong desire to void. Often sudden and rapid event. occurs without warning. Cannot be prevented

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18
Q

Combination of stress and urge incontinence is

A

Mixed incontinence

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19
Q

40-60% of females with incontinence have combination

Mixed incontinence is generally defined as

A

Detrusor Overactivity and Impaired Urethral Function

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20
Q

True or false - the detrusor muscle contraction is involved with overflow incontinence

A

False- The pressure exceeds the resting urethral closure pressure and urine overflows despite the absence of detrusor contraction

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21
Q

Overflow Incontinence is often secondary to

A

Bladder Outlet Obstruction

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22
Q

Common Associated Medical conditions to Overflow Incontinence

A

MS

Diabetes

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23
Q

Overflow incontinence has the pt urinating a large or small amount

A

Small

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24
Q

DDX of a pt with urinary incontinence

A 
MS
Prostatitis 
vaginitis
UTI
Spinal Cord Neoplasm/trauma /abscess
Cystitis 
Urinary Obstruction
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25
What needs to be including in a PE for Urinary Incontinence
``` Neurologic exam Pelvic Exam Pelvic Floor Examination anal muscle tone Prostate examination Stress testing ```
26
procedure to look into bladder can be diagnostic and treatment in some cases
Cystoscopy / Urethroscopy
27
when is cystoscopy utilized
- pt with persistent irritative voiding symptoms - Hematuria - Persistent postoperative incontinence - Voiding dysfunction - obvious causes of bladder overactivity, such as cystitis , stone, and tumor
28
Management techniques for urinary incontinence
``` Absorbent products Dietary Modification Pelvic Floor Rehabilitation Biofeedback Acupuncture Electrical Stimulation Urethral Occlusion Catheterization Bladder Training Pharmacologic therapy ```
29
Which incontinence is it contraindicated to use catheterization as a management technique
Urge Incontinence
30
which incontinence is bladder training known to have decent success
Urge Incontinence
31
When is it contraindicated to utilize Anticholinergics as pharmacologic therapy in incontinence management
Narrow / Angle glaucoma
32
Pharmacologic treatment options for incontinence
Anticholinergics, Antispasmodic agents, and Tricyclic Antidepressants
33
Surgical Tx options for incontinence
Bladder Neck Suspension Periurethral Bulking Therapy Artificial urinary sphincter placement Midurethral sling surgery
34
Daytime and Nighttime urinary frequency, urgency, and pelvic pain of unknown etiology
Interstitial Cystitis
35
How do we make the diagnosis of Interstitial Cystitis
Diagnosis of Exclusion
36
what percentage of Interstitial cystitis are white What percentage are female
94% 90%
37
What is the term dedicated to sex-related distress / pain with sex
Dyspareunia
38
Presentation of Interstitial cystitis
Exacerbation followed by variable periods of remission May fluctuate to the ovulatory cycle spontaneous remission occurs in 50% Pain with bladder filling common
39
What are the scorings for possible interstitial cystitis and strongly supported diagnosis of interstitial cystitis
Sore > 6 | Score > 12
40
Diagnostic Evaluation of Interstitial cystitis includes what
UA Urine Culture Cystoscopy
41
During Cystoscopy What are the two distinctive findings to help associate problems with interstitial Cystitis
Hunter's Lesions - Distinctive areas of inflammation on the bladder wall 5-10% of pts willl have this Glomerulations- Pinpoint sized areas of bleeding in the bladder wall
42
Tx of Interstitial Cystitis
Extensive counseling 3-6 month trial of Dietary and fluid management Time and stress management, and behavioral modification -up to 90% of pts report exacerbations with food / beverage
43
Foods that are good for Interstitial cystitis
Water, milk, bananas, blueberries, melon, carrots, broccoli, mushrooms, peas, chicken, eggs, most meats, rice, popcorn
44
Foods that will aggravate Interstitial Cystitis
Coffee, Alcohol, soda, monosodium glutamate (MSG), Tomatoes, vinigar, citrus, spicy foods, chocolate, cranberry juice, particular fruits and vegetables
45
Oral meds for Tx of Interstitial Cystitis
Amitriptyline (first-line oral therapy) Nifedipine Pentosan polysulfate sodium Bladder hydrodistention
46
Good 2nd line therapy added for Interstitial cystitis
Physical therapy
47
Define Nocturnal Enuresis
Voiding urine at night "bedwetting"
48
How many months must a pt have been continent for before it can be considered Nocturnal Enuresis
6 months at minimum prior to onset of bedwetting
49
Punishment is or is not an effective form of nocturnal enuresis
not an acceptable or effective from. Children punished are at a risk of emotional and physical abuse.
50
genetics link to nocturnal enuresis
56% of fathers 36% of mothers and 40% of siblings to pts with nocturnal enuresis also experience nocturnal enuresis
51
Physical Examination of Nocturnal Enuresis includes
BP Inspection of external Genitalia Palpation in renal and suprapubic areas palpation of the abdomen to look for hard, wide stool Thorough neurologic examination of LE's including gait, muscle power, tone, sensation, reflexes, and plantar responses Assessment of the anal wink inspection and palpation of the lumbosacral spine
52
Diagnosis needs for nocturnal enuresis
UA Urine Culture Diagnostic imaging not routinely recommended
53
Management nocturnal enuresis
Behavioral Therapy Alarm Therapy medications
54
Refer nocturnal enuresis when
If no improvement after 2-3 months of good management / treatment
55
pharmacologically decreases urine output
Desmopressin
56
Take Desmopressin when
1 hr before bedtime
57
Take imipramine when
1-2 hrs before bedtime
58
Male to female ratio of bladder tumors
1.9 : 1
59
incredibly large exposure causing bladder cancer
Smoking
60
most common presenting symptom of Bladder tumors
Hematuria
61
are bladder tumors typically benign or malignant
Benign
62
bladder cancer is how many more times likely in which sex
3x more likely in Men
63
Median age of diagnosis of bladder cancer
65 y.o.
64
Transitional cell carcinoma is what percentage of bladder cancers
90%
65
percentage of pts that have painless gross hematuria
80-90 %

Genitourinary (11 decks)

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