Genito Urinary

Question 1

what is gu medicine

Answer 1

anything that helps with the male and female reproductive systems or urinary systems

Question 2

what are the main concepts to grasp in gu medicine

Answer 2

urinary frequency and incontinence

contraception

erectile dysfunction

benign prostatic hyperplasia

vulvovaginal infections

Question 3

what medications can be used in urinary frequency, incontinency and nocturia

Answer 3

antimuscarinics

beta 3 adrenoreceptor agonists

desmopressin

Question 4

what is frequency

Answer 4

needing to urinate more

Question 5

what is incontinence

Answer 5

involutary leakage of urine

Question 6

what are the risk factors for frequency and incontinence

Answer 6

older age
pregnancy
obesity

smoking

ace inhibitors or alpha blockers

stroke, parkinsons

Question 7

what are the different types of frequency and incontinence

Answer 7

stress

urgency

mixed

overflow

Question 8

what is stress incontinence

Answer 8

leakage on exertion

Question 9

what is urgency incontinence

Answer 9

leakage following a large sudden urge to go

Question 10

what is mixed incontinence

Answer 10

combination of stress and urgency

Question 11

what is overflow incontince

Answer 11

complication of chronic urinary retention

Question 12

what is nocturia

Answer 12

waking up during the night to urinate

Question 13

how common is nocturia

Answer 13

affects 1 - 3 adults over 30

Question 14

what are the causes of nocturia

Answer 14

childbirth
menopause
urgency incontinense

prostate issue

inappropriate use of diuretics
high intake of caffiene or alcohol
overactive bladder
diabetes
congestive heart failure

Question 15

what is another name for antimuscarinic medication

Answer 15

anti-cholinergic

Question 16

what are some examples of antimuscarinics

Answer 16

solifenacin

tolterodine

trospium

oxybutynin

Question 17

what is the moa of antimuscarinics

Answer 17

block muscarinic receptors in the detrusor muscle (a smooth muscle layer located in the wall of the urinary bladder)

Question 18

what are the cautions for antimuscarinics

Answer 18

acute myocardial infarction
arrhythmia
tachycardia
congestive heart failure

ulcerative colitis

prostatic hyperplasia

Question 19

what are the contraindications of antimuscarinics

Answer 19

angle closure glaucoma

gi obstruction

paralytic ileus

toxic megacolon

bladder outflow obstruction

urinary retention

myasthenia gravis

Question 20

what are the side effects of antimuscarinics

bowel 2
head 2
mental 2
heart 2

Answer 20

constipation
urinary retention

dry mouth
blurred vision

sedation
confusion

arrythmias
tachycardia

Question 21

how often should we monitor the use of antimuscarinics

Answer 21

every 4-6 until the symptoms improve and then yearly after

Question 22

can antimuscarinics be used in preg and breast feeding :)

Answer 22

hell no

Question 23

if a patient has renal impairment what is the implication on the dosing of antimuscarinics

Answer 23

reduce

Question 24

what is an example of a beta 3 adrenoreceptor agonist

Answer 24

mirabegron

Question 25

what is mirabegron contraindicated in

Answer 25

severe uncontrolled hypertension

Question 26

what monitoring does mirabegron require

Answer 26

blood pressure

Question 27

does mirabegron have teratogenic properties

Answer 27

shown in animal studies

Question 28

does mirabegron require contraception

Answer 28

contraception is advised but not required

Question 29

what are the side effects of mirabegron

Answer 29

hypertension arrythmias gi upset headaches

Question 30

if a patient is on a cyp3a4 inhibitors such as clarithromycin or diltiazem what is required

Answer 30

dose reduction

Question 31

what is desmopressin

Answer 31

analogue of vasopression that reduces renal water excretion

Question 32

what is an example of an indication for desmopressin

Answer 32

nocturia

Question 33

what is desmopressin contra-indicated in

Answer 33

cardiac insufficiency and any conditions treated with diuretics, siadh and any condition that may cause hyponatremia von willebrands disease type 2b

Question 34

what monitoring is required for desmopressin

Answer 34

sodium levels weight blood pressure

Question 35

what are the signs of hypnonatraemia

Answer 35

confusion nausious headache drowsiness spasms

Question 36

what should a patient be counselled on for desmopressin

Answer 36

signs of hyponatremia fluid intake must be stopped 1 hour before and for 8 hours after dose

Question 37

if a patient is vomitting what should we do with the dose of desmopressin

Answer 37

stop

Question 38

what does the combined oral contraceptive contain

Answer 38

estrogen and protgestogen

Question 39

what is the main ingredient of the combined oral contraceptive

Answer 39

progestogen

Question 40

how does the combined oral contraceptive work to prevent pregnancy

Answer 40

suppress surges of luteinizing hormone and follicle stimulating hormone progestogen thickens cervical mucus creating a hostile environment for sperm

Question 41

describe the term multiphasic

Answer 41

when the contents of the different ingredients of the tablet change day to day

Question 42

what is the traditional regiment for a combined oral contraceptive

Answer 42

21 days of active pills followed by 7 day break

Question 43

is the withdrawal bleed during the 7 day break of combined oral contraceptive considered a period

Answer 43

nope

Question 44

describe a tailored regiment for the contraception

Answer 44

a monophasic form of treatment containing ethinylestradiol only and has only a 4 day withdrawl

Question 45

in a tailored regiment what is tricycling (contraception)

Answer 45

9 weeks then a 4 - 7 day break

Question 46

if a patient has never taken oral contraception what day should they start

Answer 46

1st day of cycle

Question 47

if a patient who has never taken oral contraception starts after day 6 what should be done

Answer 47

use additional contraception for 7 days