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Old 12-31-2015
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Default A Question of internal medicine in USMLE #usmle

A 68 year-old woman presents to her physician with a complaint of urinary incontinence. She is nursing home resident and her staff tells you that the patient feels desire to void but she cannot hold it to the restroom. She has no pain, dysuria or hematuria. She has a long history of hypertension and she takes metoprolol and hydrochlorothiazide.
Which of the following is the most appropriate first step of management?


A - Discontinue metoprolol
B - Discontinue hydrochlorothiazide
C - Try timed voiding
D - Prescribe tolterodine therapy
E - Refer to a urologist

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