Symptoms

Question 1

What is a symptom?

Answer 1

A subjective indicator of a disease or change in condition as perceived by the patient

Question 2

What three facts are true of a symptom?

Answer 2

1. can be volunteered or elicited
2. Can’t be used to make definitive diagnosis
3. May indicate pathologies other than urinary tract dysfunction

Question 3

What three groups can urinary tract symptoms be divided into?

Answer 3

1. Storage
2. Voiding
3. Post micturition symptoms

Question 4

Name the four storage symptoms

Answer 4

1. Frequency
2. Urgency
3. Nocturia
4. Incontinence

Question 5

What is increased daytime frequency?

Answer 5

patient complains that they void too often by day (equivalent to pollakisuria)

Question 6

What is Nocturia?

Answer 6

the complaint that the patient has to wake at night one or more times to void

Question 7

What is Urgency?

Answer 7

complaint of a sudden compelling desire to pass urine which is difficult to defer

Question 8

What is Urinary incontinence?

Answer 8

The complaint of any involuntary leakage of urine

Question 9

Define stress urinary incontinence

Answer 9

involuntary leakage on effort on effort or exertion, or on sneezing or coughing

Question 10

Define urge urinary incontinence

Answer 10

involuntary leakage accompanied by or immediately preceded by urgency

Question 11

Define mixed urinary incontinence

Answer 11

urgency + stress

Question 12

Enuresis

Answer 12

any involuntary loss of urine

Question 13

nocturnal enuresis

Answer 13

loss of urine during sleep

Question 14

Continuous urinary incontinence

Answer 14

continuous leakage

Question 15

What is normal bladder sensation?

Answer 15

the individual is aware of bladder filling and increasing sensation up to a strong desire to void

Question 16

What is increased bladder sensation?

Answer 16

the individual feels an early and persistent desire to void

Question 17

What is reduced bladder sensation?

Answer 17

the individual is aware of bladder filling but does not feel a definite desire to void

Question 18

What is absent bladder sensation?

Answer 18

no specific bladder sensation but may perceive bladder filling as abdominal fullness, vegetative symptoms, or spasticity

Question 19

What are the 6 Voiding symptoms?

Answer 19

1. Slow stream/poor flow
2. Spraying
3. Intermittency
4. Hesitancy
5. Terminal Dribble
6. Straining

Question 20

Define slow stream

Answer 20

reduced urine flow compared to previous performance or in comparison to others

Question 21

Define intermittent stream

Answer 21

urine flow which stops and stats on one or more occasions during micturition

Question 22

Define hesitancy

Answer 22

difficulty in initiating micturition resulting in a delay in the onset of voiding after the individual is ready to pass urine

Question 23

Define straining

Answer 23

muscular effort used to either initiate, maintain or improve the urinary stream

Question 24

Define terminal dribble

Answer 24

prolonged final part of micturition, when the flow has slowed to a trickle/dribble

Question 25

When are post micturition symptoms experienced?

Answer 25

immediately after micturition

Question 26

What are the 2 post micturition symptoms?

Answer 26

1. Feeling of incomplete emptying 2. Post micturition dribble

Question 27

What is the post micturition dribble?

Answer 27

involuntary loss of urine after leaving the toilet

Question 28

Symptoms associated with sexual intercourse

Answer 28

1. Dyspareunic (pain) 2. Vaginal dryness 3. Incontinence

Question 29

Symptoms associated with pelvic organ prolapse

Answer 29

1. the feeling of a lump 2. low back ache 3. heaviness 4. dragging sensation 5. the need to digitally replace the prolapse in order to defaecate or micturate

Question 30

What is a pelvic organ prolapse?

Answer 30

descent of one or more of the anterior wall, the posterior vaginal wall, and the apex of the vagina (cervix/uterus) or vault (cuff) after hysterectomy. Prolapse can be staged from 1-4

Question 31

What are the 7 types of pain associated with the lut?

Answer 31

1. Bladder pain 2. Urethral pain 3. Vulval pain 4. Vaginal pain 5. Scrotal pain 6. Perineal pain 7. Pelvic pain

Question 32

What is acute retention of urine?

Answer 32

painful or palpable bladder, when the patient is unable to pass urine

Question 33

Chronic retention of urine

Answer 33

non-painful bladder which remains palpable or percussable after the patient has passed urine ( some patients may be incontinent

Question 34

Name three methods of tracking micturition

Answer 34

1. micturition time chart 2. frequency volume chart 3. bladder diary

Question 35

What does IPSS stand for

Answer 35

International Prostate Symptom Score

Question 36

What IPSS score is mild ?

Answer 36

0-7

Question 37

what IPSS score is moderate?

Answer 37

8-19

Question 38

what IPSS score is sever?

Answer 38

20+

Question 39

what is IPSS score expressed as

Answer 39

symptom score + bother score

Question 41

What level of spinal cord injury is autonomic dysreflaxia?

Answer 41

T6

Question 42

How much does blood pressure have to increase by for autonomic dysreflaxia to be suspected

Answer 42

40mmg systolic 20mmg diastolic

Question 43

What is effected in an Infra-sacral spinal cord injury?

Answer 43

-acontractile bladder -lack of sensation - urinary retention

Question 44

What causes a Infra-sacral spinal cord injury?

Answer 44

Cauda equina, pelvic surgery, lumbar disc herniation

Question 45

What is effected in a supra pontine spinal cord injury?

Answer 45

Voiding coordination (like baby, the void will be normal but not control over when DO,DOI

Question 47

What is causes a supra pontine spinal cord injury?

Answer 47

Brain injury, stroke, dementia

Question 48

What does supra-sacral spinal cord damage effect?

Answer 48

Filling + voiding Can't spontaneously void ans can't relax urethral sphincter

Question 49

What type of unjury knocks out higher centers?

Answer 49

Supra-pontine

Question 50

What spinal cord injury knocks out the higher centers and pmc?

Answer 50

Supra-sacral

Question 51

What causes a supra sacral spinal cord injury?

Answer 51

Tumour, ms, spina bifida

Question 52

What spinal cord injury has autonomic dysreflaxia as the complication?

Answer 52

Supra -sacral

Question 53

What are M1 receptors involved in?

Answer 53

Cognition

Question 54

What are M1 and M3 side effects?

Answer 54

Dry mouth

Question 55

What are M2 receptors cause?

Answer 55

Heart rate

Question 56

For what type of catheter is hight of external connection important?

Answer 56

External transducer

Question 57

For what type of catheter is the height of catheter tip in the bladder important?

Answer 57

Catheter tip

Question 58

When testing with cough What a position spike in pdet suggest?

Answer 58

Bubble in abdominal line

Question 59

When testing with cough What a negative spike in pdet suggest?

Answer 59

Bubble in vesical line

Question 60

Why are bubbles a problem?

Answer 60

Delay the pressure signal

Question 61

how to calibrate catheter tipped?

Answer 61

Immersing in known depth of water or by pressuring

Question 62

How to calibrate a flour filled transducer?

Answer 62

Lifting the end of the fluid filled line to known height above transducer or by pressuring

Question 63

Risk of supra sacral spine damage

Answer 63

Upper tract dilation

Question 64

how does botox work?

Answer 64

blocks acetyl choline

Question 66

Name three additional treatments to OAB

Answer 66

Calcium antagonist Potassium channel openers Flavokate Antidepressants

Question 67

is there an issue with high pressure in infra-sacrel?

Answer 67

NO because can't contrct sphincter, can't contract bladder

Question 68

what spinal cord injury is detrusor sphincter dyssynergia

Answer 68

supra-sacral