Bladder disorders

Question 1

what part of the ANS moderates urine storage?

Answer 1

sympathetic

Question 2

what nerve keeps the striated external sphincter contracted?

Answer 2

pudendal

Question 3

bladder emptying is mediated by what part of the ANS?

Answer 3

parasympathetic

Question 4

• urge incontinence
• overflow incontinence

these are due to dysfunction at what level?

Answer 4

bladder

Question 5

what are two causes of urge incontinence?

Answer 5

• detrusor overactivity

- poor detrusor compliance

Question 6

• stress incontinence
• intrinsic sphincter deficiency

these are due to dysfunction at what level?

Answer 6

outlet

Question 7

what is the cause of anatomic stress incontinence?

Answer 7

mobility of bladder neck

Question 8

what is the cause of intrinsic sphincter deficiency?

Answer 8

bladder neck dysfunction

Question 9

mixed incontinence is a combination of _______ incontinence and ________ incontinence

Answer 9

urge, stress

Question 10

what are the potentially reversible, transient causes of urinary incontinence?

Answer 10

Delirium 
Infections 
Atrophic vaginitis 
Pharmaceuticals 
Excessive urine output 
Restricted mobility 
Stool impaction

Question 11

• involuntary urine leak accompanied by or immediately preceded by a strong, sudden desire to urinate
• occurs when bladder pressure overcomes sphincter mechanism

Answer 11

urge urinary incontinence

Question 12

• intermittent involuntary bladder contractions

- may be idiopathic or neurologic

Answer 12

detrusor overactivity

Question 13

• incremental rise in pressure as bladder volume increases

- due to loss of viscoelastic properties or disruption of neurogenic regulation

Answer 13

poor compliance

Question 14

what are the medications for OAB / urge incontinence treatment?

Answer 14

• anticholinergics
• beta 3 agonists
• vaginal estrogen therapy

Question 15

anticholinergics are contraindicated if the patient has what condition?

Answer 15

narrow angle glaucoma

Question 16

what is the general cause of overflow incontinence?

Answer 16

bladder outlet obstruction or poor contractility

Question 17

definition: stress incontinence

Answer 17

involuntary urine leak with any sudden increase in abdominal pressure

Question 18

what are the two types of stress incontinence?

Answer 18

• true anatomic

- intrinsic sphincter deficiency

Question 19

is there medication to help stress incontinence?

Answer 19

no

Question 20

what is required for diagnosis of a UTI?

Answer 20

• pathogens

- symptoms and/or inflammatory response

Question 21

infection in a healthy patient with normal GU tract

Answer 21

uncomplicated UTI

Question 22

infection associated with factors that increase chance of acquiring bacteria and decrease efficacy of therapy

Answer 22

complicated UTI

Question 23

what are the causes of a complicated UTI?

Answer 23

• abnormal GU tract (BPG, stone)
• immunocompromised
• MDR bacteria

Question 24

what medications are used for a UTI?

Answer 24

• TMP-SMX

- fluoroquinolone

Question 25

what is the suggested etiology for bladder pain syndrome?

Answer 25

- increased mast cell concentration in bladder (histamine release) - deficiency in protective glycosaminoglycan layer in urothelium

Question 26

how is the significance and diagnosis of UTI made?

Answer 26

urine examination AND clinical picture of illness