Term
| Best test for measuring urinary incontinence? |
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Definition
| Cystometrogram: assessment of how the bladder fills and empties over time, put a transducer in bladder, vagina, and rectum, have pt cough while filling, see spikes in pressure |
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Term
| Urge incontinence is aka __ __ aka __ __. |
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Definition
- Overactive bladder
- Destrussor instability |
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Term
| Best tmt option for overactive bladder aka urge incontinence? |
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Definition
- bladder training
- pelvic floor exercises
- anticholinergic drugs |
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Term
| Types of urinary incontinence: |
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Definition
- Stress Incontinence
- Urge Incontinence/overactive bladder
- Mixed Incontinence
- Functional Incontinence/overflow incontinence/limited ambulation |
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Term
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Definition
Involuntary loss of urine during physical activity
Small amount of urine lost, spurts. Cessation of activity stop urine loss
Absence of detrusor contraction |
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Term
| Pathogenesis of Stress Incontinence: |
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Definition
| - bladder neck and proximal urethra drop below the pelvic floor during valsalva |
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Term
| Urge Incontinence/Overactive Bladder: |
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Definition
Loss of urine usually preceded by abrupt, strong desire to void
Precipitants include running water, hand washing, cold temperature, and putting a key in the door when returning home
Larger amounts of urine
Detrusor instability/overactivity
May be present with neurologic disease.
May occur after surgery for stress incontinence |
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Term
| During bladder filling __ __ mediated __ of the urethral smooth muscle and ___ of the detrussor bladder muscle allow urine storage. The ___ system initiates voiding with ___mediated destrusor ___ and ___ of the urethral sphincter. |
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Definition
- alpha adrenergic
- contraction of urehtral smooth muscle
- relaxation of the detrussor
- Parasympathetic NS
- acetylcholine
- detrussor contraction
- relaxation of the urethral sphincter |
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Term
| drug tmt for urge incontinence: |
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Definition
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Term
| Urethral ___ is stress incontinence. |
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Definition
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Term
| An immobile urethra suggests __ __ __. |
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Definition
| intrinsic sphincter deficiency |
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Term
| main dx tool for OAB (urge incontinence)? |
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Definition
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Term
| A cystometrogram suggestive of urge incontinence will show __ __ __. |
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Definition
| uninhibited detrussor contractions |
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Term
| Can stress or urge incontinence/overactive bladder be treated surgically? |
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Definition
- Stress- surgically treatable
- Urge/overactive- NOT surgically treatable |
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Term
| Gold standard tmt for stress incontinence: |
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Definition
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Term
| Pharmacotherapy for Urge/Mixed Incontinence: |
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Definition
- Propantheline
- Oxybutynin (muscarinic antagonist)
- Tolterodine (muscarinic antagonist)
- Sympathomimetic agonist
- TCAs
- Dopamine agonists
- Collagen injection |
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Term
| SE of tolterodine or oxybutinin: |
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Definition
- dry mouth
- blurred vision
- constipation
- nausea
- dizziness |
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Term
| Detrusor overactivity usually requires a combinaion of behavioral modification, kegel exercises, +/- medication |
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Definition
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Term
| multiparity increases risk of __ incontinence. |
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Definition
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Term
| splinting and buldge from posterior vaginal wall: |
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Definition
|
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Term
| anterior vaginal prolapse ddx: |
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Definition
- Cystourethrocele
- Cystocele |
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Term
| Apical vaginal prolapse ddx: |
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Definition
- Uterovaginal
- Vaginal apex after hysterectomy |
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Term
| Posterior Vaginal Prolapse: |
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Definition
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Term
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Definition
Grade 0: No descent
Grade 1: descent between normal and ischial spines
Grade 2: descent between ischial spines and hymen
Grade 3: descent within hymen
Grade 4: descent through hymen |
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Term
| Normal bone mineral density: |
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Definition
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Term
| Osteopenia bone mineral density: |
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Definition
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Term
| Osteoporosis bone mineral density: |
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Definition
|
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Term
| guidelines for osteoporosis tmt in post-menopausal women: |
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Definition
A hip or vertebral fracture
T-score ≤ 2.5 at the femoral neck or spine
Low bone mass (T-score between -1.0 and -2.5)
a 10-year probability of a hip fracture ≥ 3%
AND/OR
a 10-year probability of a major osteoporosis-related fracture ≥ 20% |
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Term
| 50 and older calcium and vitamin D recommendation: |
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Definition
- 1200 mg calcium
- 800-1,000 IU Vitamin D3 |
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Term
| Bone mineral density should start in women greater than or equal to 50 y/o with one or more of the following (6): |
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Definition
- Previous fracture after menopause (not skull, face, ankle, finger, or toe)
- Thinness (weight<127lbs, or BMI<21)
- History of hip fracture in parent
- Current smoking
- Rheumatoid arthritis
- Excessive alcohol intake |
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Term
| look up HPDP guidelines for screening tests |
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Definition
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