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  #1  
Old 09-11-2012
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Post incontinence

Q) a 44 yr old male come to visit the consultant for further evaluation of his illness..he is known hypertensive and recently switched to a new drug from beta blockers due to his poor compliance and sideeffects...the pt. now presents with increasing his breast size than normal and urinary urgency while he was travelling or at work.. since he started the new drug.his b.p is 140/90 mmhg ..the urgency pt. implicated is due to...?

a) stress incontinence
b) urge incontinence
c) psychological incontinence
d) physiological incontinence
e) urinary retention

Last edited by venky2600; 09-11-2012 at 08:58 PM.
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Old 09-11-2012
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a 44 yr old male come to visit the consultant for further evaluation of his illness..he is known hypertensive and recently switched to a new drug from beta blockers due to his poor compliance and sideeffects...the pt. now presents with increasing his breast size than normal and urinary urgency while he was travelling or at work.. since he started the new drug.his b.p is 140/90 mmhg ..the urgency pt. implicated is due to...?

a) stress incontinence
b)urge incontinence;he was started on spironolactone(increased diuretic urge incontinence???)
c) psychological incontinence
d) physiological incontinence
e) urinary retention
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Old 09-11-2012
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Wink

Quote:
Originally Posted by venky2600 View Post
Q) a 44 yr old male come to visit the consultant for further evaluation of his illness..he is known hypertensive and recently switched to a new drug from beta blockers due to his poor compliance and sideeffects...the pt. now presents with increasing his breast size than normal and urinary urgency while he was travelling or at work.. since he started the new drug.his b.p is 140/90 mmhg ..the urgency pt. implicated is due to...?

a) stress incontinence
b) urge incontinence
c) psychological incontinence
d) physiological incontinence
e) overflow incontinence
change option E as overflow incontinence
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  #4  
Old 09-11-2012
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Default my answer :)

I'll go with e) overflow incontinence
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Old 09-12-2012
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Default e. overflow incontinence

Ya medication would be spironolactones
As more urine is produced
its also an antiadronergic (gynecomastia)
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Old 09-12-2012
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it is overflow incontinence due to diuretic spironolactone evident by gynecomastia

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Old 09-12-2012
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Correct Answer D is the right answer

the most appropriate answer is D) physiological incontinence

as everyone replied...,the pt. is on diuretics(Spironolactone) which is causing gynecomastia

let's learn briefly about all incontinence...

4 types of incontinence------
1) urge incontinence
2) overflow incontinence
3) stress incontinence
4) functional( physiological) incontinence

there is no seperate entity of psychological incontinence----it can be included under subset of stress and physiological incontinence


1) functional/physiological incontinence-------it's most commonly due to inability to reach toilet facilities in time..pt's are normally continent(not a true incontinence)-----caused by taking diuretics and caffeine in daily uses.....here in the question pt. wanted to pee in travel and at work..where he unable to find a washroom..and also he is in diuretics...
Rx---no treatment is necessary ..if it's too severe stopping the drug is beneficial...

2) urge incontinence-------caused by detrusor muscle overactivity due to bladder irritation(infection,urethritis,also BPH etc)......Rx---anticholinergics
if the stem mentions any of voiding small amounts every time,nocturia,increased urinary frequency...then it would be the right one

3) overflow incontinence-----caused by outflow obstruction due to BPH,autonomic neuropathy(D.M)--symptoms are low urine flow and dribbling.....Rx---alpha adrenergic blockers or cholinergics
if the stem clearly mentions abt dribbling,burning during micturition then it would be the right one

4) stress incontinence------common in females.....due to laxity of pelvic floor muscles,lack of bladder support..,may be result of lack of estrogen for maintaining urethro vesical angle.....symptoms are loss of urine by sneezing,laughing,coughing....Rx--increase sphincter tone(by alpha adrenergic agonists),kegel pelvic floor muscle exercises.

BPH can cause both urge(when mild) and overflow(very severe) incontinence..
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Old 09-12-2012
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Wink physiological

sorry guys i meant physiological not overflow
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