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Most common type of UI in men and women? - Correct Answer Men is urgency and
women is stress
What is urge UI? - Correct Answer Feeling of needing to go right away. Rush to the
bathroom.
What is stress UI? - Correct Answer Sneezing, coughing, laughing, pressure.
What is mixed incontinence? - Correct Answer Both stress and urgency
Risk factors for UI? - Correct Answer Female, obesity, dm, depression, stroke,
fecal incontinence, hysterectomy.
What is the first line therapy for most older patients with UI? - Correct Answer
Behavioral therapy
What does behavioral therapy include for UI? - Correct Answer Weightloss, stop
caffeinated beverages and alcohol, minimize fluid intake at night, stop smoking,loop
diuretics should be taken in afternoon. Bladder trainings, kegal exercises, and
prompted voiding.
Which med can be used for OAB? S/e? - Correct Answer Myrbetriq; can cause
high BP.
What medications can be used for urge incontinence and OAB? What are their
class? - Correct Answer Detrol (tolterodine), ditropan (oxybutinin)
These are anticholinergics/antimuscarinics
Antimuscarinics and anticholinergics should be avoided in which patients?according
to BEERS criteria - Correct Answer Patients with dementia or cognitive impairment
What is the gold standard treatment for women with stress incontinence? - Correct
Answer Surgery
What is the only evidenced based lifetsyle intervention for for moderately obese
younger older women with UI? - Correct Answer Weight loss
Treatment of UI in older persons should be be proceeded how? - Correct Answer
Step wise process. Stating with addressing first comorbidities and medications, then
,lifestyle interventions, behavioral treatment, pharmacological treatment, minimally
invasive procedures or surgeries.
Management of UI should focus on what? - Correct Answer The most bothersome
factors
All patients with UI should be screened for?ex? - Correct Answer Functional status
and depression.
Functional impairment can be assessed by timed up and go and minicog test
Urinary frequency may reflect what ? - Correct Answer High fluid intake, and or use
of caffeinated drinks or alcohol.
Acute onset of UI or the presence of Suprapubic, lower abdominal, or pelvic pain are
what kind of symptoms? What should be done? - Correct Answer Red flag
symptoms. For underlying neurologic or neoplastic disease. Requires immediate
referral to neuro, uro, gyno.
What is the key difference between UI in younger and older persons? - Correct
Answer UI may be precipitated or worsened by outside factors of urinary tract,
including meds, mobility, environment, mentation, manual dexterity.
What is an assessment tool for UI bother and quality of life? And can be used to
assess for the effect of treatment? - Correct Answer Urogenital distress index 6,
min dif in score is 5/11
What kind of therapy is most efficacious for UI? - Correct Answer Both behavioral
and drug therapy. Than either alone
Morbidity with UI are? - Correct Answer Skin breakdown, falls. Fractures
Symptoms of UTI? - Correct Answer Dysuria, frequency, urgency, hematuria
UTI is the most common infection seen in who? - Correct Answer Older adults in
nursing homes, or hospitals.
Asymptomatic bacteriuria increases with? - Correct Answer Age and debility
For older adults, treatment should not be initiated only based on symptoms... why? -
Correct Answer Common symptoms can mimic other diseases
Post menopausal women may also complain of? - Correct Answer Low back pain,
nocturia, incontinence, and constipation.
, Why is bacteruria and UTI so common in older adults? - Correct Answer There are
conditions or diseases that lead to alterations in normal flora, urinary stasis and
obstruction as we age.
Shifts in perineal flora and ph bc if estrogen deficiency occurs.
Urinary stasis and obstruction can occur due to normal aging, which can lead to
increased UTI.
Urethra orifice can also be contaminated.
What is the UA results for UTI? - Correct Answer Positive for nitrates and
leukocytes + symptoms present
What are common signs and Symptoms of UTI in LTC? - Correct Answer Change
in mental Status and characteristics of urine
What is not a useful indicator for UTI? - Correct Answer Presence of pyuria >10
WBC
What other diseases can show presence of pyuria ( >10)? - Correct Answer
Nephrolithiasis, IBD, diverticulitis, intro abdominal abscess
Treatment of dirty urine in the older adult population with asymptomatic bacteria is? -
Correct Answer Not beneficial
What is uncomplicated UTI? - Correct Answer A healthy person w/o a catheter and
no Symptoms of polynephritis.it is directed to E. coli
Treatment for uncomplicated UTI? - Correct Answer Bactrim ds BID x 3 days (avoid
if prior UTI in last 3 months or resistance to sulfas)
Nitrofurantoin 100 mg BID x 5 days
Fosfomycin 3g one dose. Has a lower efficacy
Complicated UTI is what? - Correct Answer UTIs in people with Urinary tract
abnormalities, UTIs in men, catheters, symptoms of polynephritis
How are complicated UTIs treated? - Correct Answer Based on urine culture
results
Empiric ATB use, and then narrow down once cultures return
Bactrim DS BID x 14 days
Ciprofloxacin 500mg BID x7 days
Levofloxacin 750mg daily x7 days
After a UTI, follow up samples urine should only be obtained if? - Correct Answer
Symptoms of infection persist or recur to verify if a secondary infection with a new
organism resistant to therapy has emerged during the treatment