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L14 Urinary incontinence

Deleted user 23 questions Updated 2 Oct 2019

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11 in 4 New Zealanders live with incontinence.
1. ATrue
2. BFalse
2Choose the incorrect statement.
1. A25% of younger women have experienced incontinence.
2. B34% of older women have experienced incontinence.
3. C12% of older women experience daily incontinence.
4. D25% of older men experience daily incontinence.
5. E22% of older men have experienced incontinence.
6. F5% of younger men have experienced incontinence.
3Choose the incorrect statement.
1. A92.5% of two year olds do not have bladder control.
2. B11% of five year olds do not have bladder control.
3. C3.3% of 8 year olds do not have bladder control.
4. DThe percent of children with nocturnal enuresis is always lower than the percent of children of the same age without bladder control.
4Which of these is not a risk factor for incontinence?
1. AObesity
2. BFunctional impairment
3. CDementia
4. DMedications
5. EEnvironmental barriers to toilet access
6. FSmoking
5Incontinence is under-diagnosed and under-treated despite the majority of urinary incontinence being easy to treat and resolve.
1. ATrue
2. BFalse
6Why is Incontinence Important? It has:
• Social stigma - which leads to [blank_start]restricted[blank_end] activities and [blank_start]depression[blank_end]
• Medical complications - [blank_start]skin[blank_end] breakdown, increased urinary tract [blank_start]infections[blank_end]
• Institutionalisation - UI is the second leading cause of [blank_start]nursing home[blank_end] placement
1. Arestricted
2. Bdepression
3. Cskin
4. Dinfections
5. Enursing home
7Red flags
• [blank_start]haematuria[blank_end] (blood in the urine)
• recurrent [blank_start]urinary tract infections[blank_end] (3 or more in last 6 months)
• loin [blank_start]pain[blank_end] (pain in the lower back)
• recurrent catheter [blank_start]blockages[blank_end]
• hydro nephrosis or [blank_start]kidney stones[blank_end] on imaging
• biochemical evidence of [blank_start]renal[blank_end] deterioration.
1. Ahaematuria
2. Burinary tract infections
3. Cpain
4. Dblockages
5. Ekidney stones
6. Frenal
8Micturition/urination:
An autonomic spinal cord reflex controlled by higher brain centres(Pons - [blank_start]facilitates[blank_end]. Cerebral cortex – [blank_start]inhibits[blank_end].) Detrusor muscle constricts to expel urine, relaxes to allow filling. Has an internal sphincter which is [blank_start]involuntary[blank_end] and an external sphincter which is [blank_start]voluntary[blank_end] and deep in pelvic floor muscle. Stretch receptors send signals to the brain and sacral segment.
1. Afacilitates
2. Binhibits
3. Cinvoluntary
4. Dvoluntary
9At 150-300mL you first have the urge to void urine and at about 700mL you can no longer suppress urination.
1. ATrue
2. BFalse
10Potentially Reversible Causes of incontinence:
D- [blank_start]Delirium[blank_end]
I - [blank_start]Infection[blank_end]
A- [blank_start]Atrophic[blank_end] vaginitis or
urethritis
P -[blank_start]Pharmaceuticals[blank_end]
P - [blank_start]Psychological[blank_end] disorders
E - [blank_start]Endocrine[blank_end] disorders
R- [blank_start]Restricted mobility[blank_end]
S - [blank_start]Stool[blank_end] impaction
1. ADelirium
2. BInfection
3. CAtrophic
4. DPharmaceuticals
5. EPsychological
6. FEndocrine
7. GRestricted mobility
8. HStool

11Which of these is NOT a drug which may cause incontinence?
1. ADiuretics
2. BAnticholinergics - antihistamines, antipsychotics, antidepressants
3. CSedatives/hypnotics
4. DAlcohol
5. ENarcotics
6. FCalcium channel blockers
7. GAntimuscarinics
123 types of incontinence:
1. [blank_start]Overflow[blank_end] - urethral blockage
2. [blank_start]Stress[blank_end] - abdominal pressure and weak pelvic floor
3. [blank_start]Urge[blank_end] - oversensitivity from infection or neuro disorders
1. AOverflow
2. BStress
3. CUrge
13Overactive bladder (OAB) is defined as urgency that occurs with urgency UI and usually with frequency and nocturia.
1. ATrue
2. BFalse
14Men are more likely to experience urge incontinence.
1. ATrue
2. BFalse
15Stress Incontinence
• Most common type in [blank_start]women < 75 years[blank_end] old
• Occurs with increase in abdominal [blank_start]pressure[blank_end]; cough, sneeze, laughing, etc.
• Hypermotility of bladder neck and urethra; associated with aging, hormonal [blank_start]changes[blank_end], trauma of [blank_start]childbirth[blank_end] or pelvic surgery (85% of cases)
• [blank_start]Intrinsic[blank_end] sphincter problems; due to pelvic/incontinence surgery, pelvic radiation, trauma, neurogenic causes (15% of cases)
1. Awomen < 75 years
2. Bpressure
3. Cchanges
4. Dchildbirth
5. EIntrinsic
16Urge Incontinence
AKA detrusor [blank_start]hyperactivity[blank_end], detrusor instability, irritable bladder, spastic bladder.
• Most [blank_start]common[blank_end] cause of UI >75 years of age
• [blank_start]Abrupt[blank_end] desire to void cannot be suppressed
• Usually [blank_start]idiopathic[blank_end]
• Causes: infection, tumor, stones, atrophic vaginitis or urethritis, stroke, Parkinson’s Disease, dementia
1. Ahyperactivity
2. Bcommon
3. CAbrupt
4. Didiopathic
17Overflow Incontinence
• Over distention of bladder
• Bladder outlet [blank_start]obstruction[blank_end]; stricture, BPH, cystocele, fecal [blank_start]impaction[blank_end]
• Non-contractile bladder ([blank_start]hypoactive[blank_end] detrusor or atonic bladder); diabetes, MS, spinal injury, medications
1. Aobstruction
2. Bimpaction
3. Chypoactive
18Functional Incontinence does not involve the lower urinary tract and is the result of psychological, cognitive or physical impairment.
1. ATrue
2. BFalse
19Lifestyle choices
• Reduce or eliminate [blank_start]caffeine and alcohol[blank_end]
• Drink 6 to 8 glasses of water daily
• Quit [blank_start]smoking[blank_end]
• [blank_start]Weight[blank_end] control
• Follow a healthy diet high in [blank_start]fibre[blank_end]
• Reduce physical [blank_start]barriers[blank_end] to toilet
1. Acaffeine and alcohol
2. Bsmoking
3. CWeight
4. Dfibre
5. Ebarriers
20Non-pharmacological Treatment Options:
• Bladder [blank_start]training[blank_end]
• Patient [blank_start]education[blank_end]
• [blank_start]Scheduled[blank_end] voiding (Regular scheduled pattern of voiding where the intervals between voiding are gradually [blank_start]increased[blank_end], reduces irritability of the bladder, reverses bad [blank_start]habits[blank_end])
• Positive reinforcement
• Pelvic floor exercises ([blank_start]Kegel Exercises[blank_end])
1. Atraining
2. Beducation
3. CScheduled
4. Dincreased
5. Ehabits
6. FKegel Exercises
21Pharmacological Interventions:
• Anti[blank_start]cholinergics[blank_end]: These medications can calm an [blank_start]overactive[blank_end] bladder and may be helpful for urge incontinence. Examples include [blank_start]oxybutynin[blank_end], tolterodine
• [blank_start]Alpha[blank_end] blockers: In men with urge or overflow incontinence, these medications [blank_start]relax[blank_end] bladder neck muscles and muscle fibres in the prostate and make it [blank_start]easier[blank_end] to empty the bladder. Examples include [blank_start]tamsulosin, doxazosin, terazosin[blank_end].
• Topical estrogen. For women, applying [blank_start]low[blank_end]-dose, topical estrogen in the form of a vaginal cream, ring or patch may help [blank_start]tone[blank_end] and rejuvenate tissues in the urethra and vaginal areas.
1. Acholinergics
2. Boveractive
3. Coxybutynin
4. DAlpha
5. Erelax
6. Feasier
7. Gtamsulosin, doxazosin, terazosin
8. Hlow
9. Itone
22Interventional therapies:
• Bulking material injections: A synthetic material is [blank_start]injected[blank_end] into tissue surrounding the urethra. The bulking material helps keep the urethra [blank_start]closed[blank_end].
• Botulinum toxin type A (Botox): Injections of Botox into the [blank_start]detrusor[blank_end] muscle may benefit people who have an overactive bladder.
• Nerve stimulators: A device resembling a pacemaker is [blank_start]implanted[blank_end] under your skin to deliver painless [blank_start]electrical[blank_end] pulses to the nerves involved in bladder control (sacral nerves).

Surgical Interventions:
- [blank_start]Sling surgery[blank_end] is reported to “cure” 4 out of 5 cases, but success rate drops to 50% after [blank_start]10[blank_end] years
- [blank_start]Bladder neck suspension[blank_end] adds support to the bladder neck and urethra, reducing the risk of stress incontinence
1. Ainjected
2. Bclosed
3. Cdetrusor
4. Dimplanted
5. Eelectrical
6. FSling surgery
7. G10
8. HBladder neck suspension
23Pessaries -
• Urethral insert: a small, tampon-like [blank_start]disposable[blank_end] device inserted into the
urethra before a specific [blank_start]activity[blank_end], such as tennis, that can trigger incontinence. The insert acts as a plug to prevent [blank_start]leakage[blank_end], and is removed before urination.
• Pessary: a stiff ring that you insert into your vagina and wear all [blank_start]day[blank_end]. The
device is typically used in someone who has a [blank_start]prolapse[blank_end] that is causing
incontinence. The pessary helps hold up your bladder, which lies near the
vagina, to prevent urine leakage.
1. Adisposable
2. Bactivity
3. Cleakage
4. Dday
5. Eprolapse

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Description: User has deleted their subject information Quiz on L14 Urinary incontinence, created by Deleted user on 02/10/2019.
Author: Deleted user
Language: English
Views: 108
History: Created on 2 Oct 2019 · updated on 2 Oct 2019
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L14 Urinary incontinence

Questions in this quiz (23)

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