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Flashcards in Clinical (Week 3) Deck (213)
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1

What are the types of urethral incontinence?

Overflow
Urge
Stress
Mixed

2

What are the types of extraurethral incontinence?

Ectopic ureter
Fistula

3

A huge palpable bladder, often wet at night and renal impairment suggest what kind of incontinence?

Overflow

4

Frequency, urgency provoked by standing up/coughing/laughing and enuresis suggest what kind of incontinece?

Urge

5

What causes urge incontinence?

Detrusor overactivity:
- Contracting during inhibition of voiding

6

How can we diagnose urge incontinence?

Urodynamics

7

How can pelvic surgery or fractures result in urge incontinence?

1. PNS nerves damaged
2. Residual urine
3. Infection
4. Bladder irritation
5. Overstimulation

8

What causes stress incontinence?

Increased intra-abdominal pressure without detrusor contraction

9

What causes stress incontinence?

Damage to the following during childbirth:
- Pelvic floor
- Urethral function

10

How does the bladder appear on abdominal exam in a patient with urinary retention?

Painless
Palpable
Arises in pelvis
Cannot 'get below' it
Dull to percussion

11

How do we treat overflow incontinence?

Assess renal function
Treat obstruction -> Catheterise
Rehabilitate bladder (Teach self-catheterisation)

12

What dietary advice in urge incontinence?

Caffeine

13

What medical therapy can be used to treat urge incontinence?

Antimuscarinics:
- Oxybutynin
- Tolterodine
β3-adrenergics:
- Mirabegran

14

What are some alternative treatments to treating urge incontinence? (Apart from medication)

Botox (unlicensed)
Neuromodulation
Enterocytoplasty

15

What lifestyle advice is given to assist in the treatment of stress incontinence?

Weight loss
Stop smoking

16

What is the first line treatment for stress incontinence?

Physiotherapy

17

What pharmacology treatment is available for stress incontinence?

Duloxetine (SSRI-5HT inhibitor)
Norepinephrin reuptake inhibitor

18

What surgery is available for stress incontinence?

Colposuspension
Minimally invasive 'tape' procedures

19

What can cause a vesico-vaginal fistula?

Prolonged obstructed labour

20

How do we define haematuria?

Presence of >=5 RBCs per high-field power
In 3/3 consecutive centrifuged samples
>=1 week apart

21

A patient with microscopic haematuria due to a lower urinary tract pathology are likely to have what symptoms?

Hesitancy
Frequency
Urgency
Dysuria

22

Symptomatic, microscopic haematuria from an upper urinary tract pathology usually presents with what symptom?

Renal colic

23

If there is profound haematuria what might you suspect?

Malignancy

24

How much blood much be present in 100ml of urine to be seen?

1ml

25

What are some non-pathological causes of red urine?

Menstruation
Food (Beetroot, blackberries, rhubarb)

26

How can myoglobin end up in the urine?

Rhabdomyolysis
McArdle syndrome
Bywaters/Crush syndrome

27

Which of the following drugs does not cause red urine:
- Doxyrubicine
- Furosemide
- Chlorqine
- Rifampicin
- Nitrofurantoin
- Senna

Furosemide

28

What toxins can cause red urine?

Lead
Mercury

29

What can cause brown urine?

Urobillinogen:
- Haemolysis
- Icterus
- Liver dysfunction
Porphyria

30

Patients over what age are at an increased risk of malignancy if they present with microscopic haematuria?

40 years