Week 6- Approach to Urinary Incontinence

Question 1

What is urinary incontinence

Answer 1

unintentional involuntary voiding of urine

Question 2

What phase involves bladder filling and sphincter contraction

Answer 2

storage phase

Question 3

What phase involves bladder contraction and sphincter relaxation

Answer 3

voiding phase

Question 4

What muscle contracts during voiding

Answer 4

detrusor muscle

Question 5

What nervous system controls bladder storage

Answer 5

sympathetic nervous system

Question 6

What nervous system controls bladder voiding

Answer 6

parasympathetic nervous system

Question 7

What nerve contracts the detrusor muscle

Answer 7

pelvic nerve

Question 8

What nerve relaxes the bladder during storage

Answer 8

hypogastric nerve via beta receptors

Question 9

What nerve contracts the internal urethral sphincter

Answer 9

hypogastric nerve via alpha receptors

Question 10

What nerve contracts the external urethral sphincter

Answer 10

pudendal nerve

Question 11

What type of control is the external urethral sphincter under

Answer 11

voluntary control

Question 12

What is the primary cause of decreased outlet pressure

Answer 12

urethral sphincter mechanism incompetence

Question 13

What condition is the most common cause of incontinence in bitches

Answer 13

urethral sphincter mechanism incompetence

Question 14

What is a sign of sacral disease in physical exam

Answer 14

soft easily expressed bladder with neuro signs

Question 15

What is pollakiuria

Answer 15

increased frequency of urination

Question 16

What is enuresis

Answer 16

unconscious leaking of urine while sleeping

Question 17

What is the ideal method for collecting urine for culture

Answer 17

cystocentesis

Question 18

What imaging method is used to detect ectopic ureters

Answer 18

contrast radiography or cystoscopy

Question 19

What is the gold standard for diagnosing ectopic ureters

Answer 19

transurethral cystoscopy

Question 20

What is the purpose of urethral pressure profilometry

Answer 20

measuring urethral closure pressure

Question 21

What treatment increases urethral tone

Answer 21

phenylpropanolamine

Question 22

What hormone therapy is used to treat USMI

Answer 22

oestriol

Question 23

What is one surgical treatment to increase urethral resistance

Answer 23

collagen injection

Question 24

What is the first-line drug for detrusor contraction failure

Answer 24

bethanechol

Question 25

What class of drugs help relax the internal urethral sphincter

Answer 25

alpha blockers like prazosin

Question 26

What class of drugs help relax the external urethral sphincter

Answer 26

diazepam or dantrolene

Question 27

What is a common anatomical cause of incontinence in young bitches

Answer 27

ectopic ureters

Question 28

What is a common breed predisposition for ectopic ureters

Answer 28

labrador retriever

Question 29

What is detrusor overactivity

Answer 29

failure of bladder to relax during storage phase

Question 30

What clinical signs are associated with detrusor overactivity

Answer 30

urgency pollakiuria nocturia

Question 31

What is the mainstay of treatment for detrusor overactivity

Answer 31

antimuscarinic drugs

Question 32

What is a patent urachus

Answer 32

persistent foetal urachus causing urine leakage

Question 33

What is reflex dyssynergia

Answer 33

discoordination between bladder contraction and sphincter relaxation

Question 34

What drug combination may be used for reflex dyssynergia

Answer 34

bethanechol and prazosin

Question 35

What is the prognosis for chronic detrusor atony

Answer 35

guarded

Question 36

What is a key risk factor for developing USMI

Answer 36

early spay in large breed bitches

Question 37

What does USMI stand for

Answer 37

urethral sphincter mechanism incompetence

Question 38

What type of incontinence occurs with ureterovaginal fistulation

Answer 38

continuous incontinence

Question 39

What are the two forms of ectopic ureters

Answer 39

intramural and extramural

Question 40

What imaging finding may support ectopic ureters

Answer 40

hydronephrosis or hydroureter

Question 41

What bladder tone is seen in UMN bladder

Answer 41

high tone and hard to express

Question 42

What bladder tone is seen in LMN bladder

Answer 42

flaccid and easily expressed

Question 43

What clinical sign is typical of UMN bladder

Answer 43

difficult manual expression

Question 44

What clinical sign is typical of LMN bladder

Answer 44

dribbling of urine

Question 45

What nerve damage causes LMN bladder

Answer 45

pelvic or pudendal nerve

Question 46

What drug is a parasympathomimetic

Answer 46

bethanechol

Question 47

What type of drug is phenylpropanolamine

Answer 47

alpha sympathomimetic

Question 48

What is the main effect of oestriol on continence

Answer 48

improves urethral mucosal tone

Question 49

What complication can follow perineal surgery

Answer 49

iatrogenic ureterovaginal fistulation

Question 50

What is functional obstruction

Answer 50

difficulty urinating without physical blockage

Question 51

What is detrusor atony

Answer 51

loss of detrusor muscle tone often after overdistension

Question 52

What should be done if detrusor atony is suspected

Answer 52

catheterise and support contraction

Question 53

What is the initial treatment approach for incontinence

Answer 53

identify and treat underlying cause

Question 54

What is the role of cystoscopy in incontinence

Answer 54

diagnose anatomical causes like ectopic ureters

Question 55

How does obesity affect continence

Answer 55

increases risk of USMI

Question 56

What is a common bacterial complication of incontinence

Answer 56

urinary tract infection

Question 57

Why is history taking important in incontinence cases

Answer 57

to identify pattern and possible cause

Question 58

What is the function of the hypogastric nerve

Answer 58

relax bladder and contract internal sphincter

Question 59

What structure maintains continence during storage phase

Answer 59

urethral sphincter mechanism

Question 60

What phase involves inhibition of sympathetic tone and contraction of detrusor

Answer 60

voiding phase

Question 61

What diagnostic test measures bladder compliance and pressure

Answer 61

cystometrography

Question 62

What is the expected response rate to medical therapy for USMI

Answer 62

75 to 90 percent