Interstitial cystitis Flashcards Preview

Anatomy > Interstitial cystitis > Flashcards

Flashcards in Interstitial cystitis Deck (18)
Loading flashcards...
1

IC/BPS may be defined clinically as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than ___ , in the absence of ___ or other identifiable causes. The pain or discomfort usually mounts with ___ and is the factor that typically prompts urinary frequency.

IC/BPS may be defined clinically as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes. The pain or discomfort usually mounts with bladder filling and is the factor that typically prompts urinary frequency. The diagnosis of IC/BPS is one of exclusion because there is no specific test or marker that is diagnostic

2

T/F Current epidemiology suggests approximately 3 million females and 2 million males in the USA with IC/BPS symptoms. A male to female ratio of 5:1 is cited, based upon clinical practice.

false

Current epidemiology suggests approximately 3 million females and 2 million males in the USA with IC/BPS symptoms. A female to male ratio of 5:1 is cited, based upon clinical practice.

3

Sexual dysfunction in female IC/BPS may have a profound effect upon their__ and ___, underscoring the importance of identifying and ultimately treating this problem when present.

Sexual dysfunction in female IC/BPS may have a profound effect upon their physical and mental QoL, underscoring the importance of identifying and ultimately treating this problem when present.

4

t/f Common overlapping functional disorders such as high-tone pelvic floor dysfunction, overactive bladder syndrome, vulvodynia, and IBS may necessitate a multidisciplinary approach to achieve symptom relief.

Common overlapping functional disorders such as high-tone pelvic floor dysfunction, overactive bladder syndrome, vulvodynia, and IBS may necessitate a multidisciplinary approach to achieve symptom relief.

5

two distinct pain phenotypes in the IC/BPS patient: those with pelvic pain only and those with ___ and ___,” the latter group representing over ___ of patients. This suggests that many patients have pain derived from the central nervous system.

d two distinct pain phenotypes in the IC/BPS patient: those with pelvic pain only and those with “pelvic pain and beyond,” the latter group representing over 75% of patients. This suggests that many patients have pain derived from the central nervous system.

6

The ___ is the pathognomonic finding for the “classical form” of IC and represents a minority of the IC/BPS population. Ls.

The Hunner lesion (formerly termed “Hunner ulcer”) is the pathognomonic finding for the “classical form” of IC and represents a minority of the IC/BPS population. HLs are easily identified during office cystoscopy, although bladder distention beyond functional capacity and other imaging strategies have been used to enhance identification. Mounting evidence suggests that BPS is indeed a syndrome and distinct from those patients presenting with HLs.

7

t/f

There are reliable differences in clinical presentation between IC/BPS patients with or without HLs

F

There are no reliable differences in clinical presentation between IC/BPS patients with or without HLs

8

Adult female first-degree relatives of patients with IC/BPS may have a prevalence of IC/BPS ___that found in the general population.

Adult female first-degree relatives of patients with IC/BPS may have a prevalence of IC/BPS 17 times that found in the general population.

9

Although ___ may be seen at any age, the clinician should be especially wary of the young patient who presents with a clinical picture of IC/BPS with or without visible inflammation of the bladder wall.

Although ketamine abuse may be seen at any age, the clinician should be especially wary of the young patient who presents with a clinical picture of IC/BPS with or without visible inflammation of the bladder wall.

10

____ is secreted by bladder epithelial cells, inhibits bladder epithelial cell proliferation, and is used as a marker of the disease. It may be the primary cause of syndrome in some patients. Urine ___ appears to have the highest sensitivity and specificity of the markers studied for this disease.

Antiproliferative factor (APF) is secreted by bladder epithelial cells, inhibits bladder epithelial cell proliferation, and is used as a marker of the disease. It may be the primary cause of syndrome in some patients. Urine APF appears to have the highest sensitivity and specificity of the markers studied for this disease.

11

Current studies suggest that the etiology of IC/BPS symptoms may vary. Local processes such as “__, ___ and ___ may produce symptoms for some patients; however, the presence of co-morbid widespread pain syndromes, regional pain syndromes, and immune-mediated pain in the majority of patients suggest that more global pathologies may also be responsible

Current studies suggest that the etiology of IC/BPS symptoms may vary. Local processes such as “leaky epithelium,” mast cell activation, and neurogenic inflammation may produce symptoms for some patients; however, the presence of co-morbid widespread pain syndromes, regional pain syndromes, and immune-mediated pain in the majority of patients suggest that more global pathologies may also be responsible

12

___ among pelvic structures, that is, bowel and bladder, may contribute to chronic pain syndromes because this may result in alteration in function of adjacent pelvic organs.

Cross-sensitization among pelvic structures, that is, bowel and bladder, may contribute to chronic pain syndromes because this may result in alteration in function of adjacent pelvic organs.

13

Bladder compliance in patients with IC is ___; however, capacity is often _ and pain/discomfort is reproduced with filling.

Bladder compliance in patients with IC is normal; however, capacity is often reduced and pain/discomfort is reproduced with filling.

14

initial treatment of BPS.

Patient education, dietary manipulation, nonprescription analgesics, and pelvic floor relaxation sensation techniques

15

__ (an oral agent) and __(an intravesical agent) are the only two FDA-approved medications for the treatment of IC/BPS symptoms.

Pentosan polysulfate sodium (an oral agent) and dimethylsulfoxide (an intravesical agent) are the only two FDA-approved medications for the treatment of IC/BPS symptoms.

16

__, a tricyclic antidepressant, is not FDA approved for the treatment of IC/BPS. Nevertheless, it remains a staple of oral treatment given its antihistaminic properties, its ability to promote sleep, and reduce neuropathic (central and peripheral) pain

Amitriptyline, a tricyclic antidepressant, is not FDA approved for the treatment of IC/BPS. Nevertheless, it remains a staple of oral treatment given its antihistaminic properties, its ability to promote sleep, and reduce neuropathic (central and peripheral) pain

17

___ and ___ injection of botulinum toxin A are currently considered as fourth-line treatment strategies. Although urinary retention is a relatively rare event with BTX-A, caution should be exercised when considering its use in the patient with obstructive voiding symptoms

Sacral neuromodulation and intradetrusor injection of botulinum toxin A are currently considered as fourth-line treatment strategies. Although urinary retention is a relatively rare event with BTX-A, caution should be exercised when considering its use in the patient with obstructive voiding symptoms

18