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Old 03-07-2012
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Urine Sample cause of this urine incontinence

A 72-year-old man is brought to the physician by his wife because of a 6-month history of difficulty walking, cognitive decline, and nocturia. His wife says that his short-term memory is decreased and he has had intermittent confusion. On examination, he has a reduction of step height. He is oriented to person and place but not to time. He learns four words with some difficulty and recalls zero.
the most likely explanation for the patient's urinary incontinence?
A) Bladder neck dyssynergia
B) Chronic bladder inflammation
C) Detrusor-sphincter dyssynergia
D) Failure of bladder neck closure
E) Failure to inhibit the voiding reflex

please give expln. correct ans not known.
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Old 03-07-2012
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Correct Answer

Most likely it is Detrusor-sphincter dyssenergy.
Ur.Incntinence in Normal pr.Hydrocephalus is usu. due to increased-urgency type associated with decreased inhibition of bladder contractions and detrusor instability.
Incontinence is usu. a late finding and Gait disturbances are first to appear.Just for your info,though they have mentioned in vignette about reduction of step height,it is usu seen in severe cases.
Life is living on the watch out your every step
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Old 03-07-2012
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Ans is E. there is stretching of the decending fibers and loss of cortical inhibition on the sacral micturition center.. so the incontinence is involuntary the patient has no control over it.
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Internal-Medicine-, Step-2-Questions, Urology-

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