Urinary Incontinence Questions
(107).jpg "Urinary Incontinence Questions - Quiz")
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- 1.
________ oxybutin is associated with __________ published rates of dry mouth and constipation but the incidence of skin reaction to patch is ~15%.
- A.
Topical; lowest
- B.
IV; lowest
- C.
Topical; highest
- D.
IV; highest
Correct Answer
A. Topical; lowest -
- 2.
________ is better with ________ formulations especially in patients who are already taking multiple daily medications.
- A.
Compliance; once daily
- B.
Tolerance; twice daily
- C.
Efficacy; once daily
- D.
Efficacy; three times daily
Correct Answer
A. Compliance; once daily -
- 3.
Which of the following statements is false?
- A.
Major age-related changes in the bladder include increased involuntary contractions
- B.
Urinary incontinence can be attributed to detrusor overactivity alone
- C.
Diminished detrusor contractile strength is a major age-related change
- D.
Urethral closure pressure decreases with age
Correct Answer
B. Urinary incontinence can be attributed to detrusor overactivity alone -
- 4.
In women, mechanical urethral obstruction is usually due to:
- A.
Pelvic organ prolapse
- B.
Prior surgery
- C.
Prostate disease
- D.
A and B only
Correct Answer
D. A and B only -
- 5.
The major age-related changes in bladder pathophysiology include:
- A.
Decreased involuntary contractions
- B.
Increased voided volume
- C.
Decreased detrusor contractile strength
- D.
All of the above
Correct Answer
C. Decreased detrusor contractile strength -
- 6.
The major age-related changes in urethral pathophysiology
- A.
Increased urethral closing pressure
- B.
The number but NOT density of striated fibers decreases
- C.
Prostate-induced mechanical urethral obstruction is common in females
- D.
None of the above
Correct Answer
D. None of the above -
- 7.
Which is not a predominate factor in drug selection?
- A.
Differences in the incidence of ADEs
- B.
Formulation and manufacturer of the drug
- C.
Avoidance of ADEs to which the patient may be susceptible
- D.
Additional patient-based issues that may complicate the use of the drug
Correct Answer
B. Formulation and manufacturer of the drug -
- 8.
Which agent is currently available as a generic medication?
- A.
Oxybutynin
- B.
Solifenacin
- C.
Darifenacin
- D.
Fesoterodine
Correct Answer
A. Oxybutynin -
- 9.
Drug selection for urinary incontinence is primarily based on which of the following:
- A.
Incidences of ADE’s
- B.
Oxybutynin is always the primary choice
- C.
There is no difference between drug choices
- D.
Patient age
Correct Answer
A. Incidences of ADE’s -
- 10.
Which of the following adverse effects of anti-muscarinics is incorrect:
- A.
Dry mouth
- B.
Constipation
- C.
Alopecia
- D.
Altered cognition
Correct Answer
C. Alopecia -
- 11.
Older populations tend to have all of the following characteristics that lead to urinary incontinence EXCEPT:
- A.
Smaller voided volumes
- B.
Higher urine flow rate
- C.
Smaller bladder capacity
- D.
Increased post-voiding residual volume
Correct Answer
B. Higher urine flow rate -
- 12.
Possible causes in women that cause a decrease in urethral closure pressure includes all of the following except:
- A.
Alterations in the mucosal and submucosal layers
- B.
Alterations in smooth muscle membranes
- C.
Decreased vascular density
- D.
Decreased blood flow
Correct Answer
B. Alterations in smooth muscle membranes -
- 13.
Which if the following statements are FALSE?
- A.
Alpha –Blockers and 5-ARI’s used in men with LUT symptoms from BPH are not very effective in reducing UI or urgency
- B.
Anticholinergic drugs are neither less efficacious nor significantly more likely to cause urinary retention
- C.
Desmopressin acetate is inappropriate for nocturia in older persons because of the risk of hyponatremic
- D.
Amitriptyline has robust evidence of efficacy and is supported by its anticholinergic effects
Correct Answer
D. Amitriptyline has robust evidence of efficacy and is supported by its anticholinergic effects -
- 14.
The correct brand name match for the following generics (tolterodine, solifenacin, darifenacin and fesoterodine) in order are:
- A.
Detrol, Vesicare, Enablex, Toviaz
- B.
Sanctura, Vesicare, Toviaz, Enablex
- C.
Detrol, Enablex, Toviaz, Vesicare
- D.
Sanctura, Oxytrol, Enablex, Evista
Correct Answer
A. Detrol, Vesicare, Enablex, Toviaz -
- 15.
Which pharmalogical intervention below do you think would be the BEST treatment of urinary incontinence?
- A.
Estrogen
- B.
Duloxetine
- C.
Amitriptyline
- D.
Oxybutynin
Correct Answer
D. Oxybutynin -
- 16.
Solitenacin and darifenacin act primarily by:
- A.
Increasing bladder capacity
- B.
Acting at the level of the sacral cord to facilitate sphincter contraction
- C.
Ablating detursor overactivity
- D.
Facilitate sphincter contraction through smooth muscle α-1A receptors
Correct Answer
D. Facilitate sphincter contraction through smooth muscle α-1A receptors -
- 17.
Which agent is associated with the lowest rates of dry mouth and constipation?
- A.
Tolterodine
- B.
Darifenacin
- C.
Oxybutynin
- D.
Fesoterodine
Correct Answer
C. Oxybutynin -
- 18.
Which of the antimuscarinic agents is not metabolized by CYP450 enzymes?
- A.
Solifenacin
- B.
Trospium
- C.
Oxybutynin
- D.
Fesoterodine
Correct Answer
B. Trospium -
- 19.
Which of the following may improve urinary incontinence?
- A.
Correcting comorbid disease states
- B.
Correcting functional impairments
- C.
Optimizing medication therapy
- D.
All of the above
Correct Answer
D. All of the above -
- 20.
Which of the following is not associated with UI in elderly patients?
- A.
Elderly patients are at risk for developing adverse effects of UI medications
- B.
Etiology is usually a specific condition of the lower urinary tract
- C.
Concurrent medications should be considered for the cause of UI
- D.
UI is associated with an increase in fall risk
Correct Answer
B. Etiology is usually a specific condition of the lower urinary tract -
- 21.
The major age related changes in the bladder include the following EXCEPT?
- A.
Detrusor overactivity
- B.
Diminished detrusor contractile strength
- C.
Increased number and density of striated and smooth muscle
- D.
Small bladder capacity
Correct Answer
C. Increased number and density of striated and smooth muscle -
- 22.
What is a possible cause of decreased urethral closure pressure?
- A.
Increased vascular density and blood flow
- B.
Diminished detrusor contractile strength
- C.
Alterations in the mucosal and submucosal layers
- D.
"ultra-close abutments" in smooth muscle cells to facilitate
Correct Answer
C. Alterations in the mucosal and submucosal layers -
- 23.
Urethral closure pressure decreases with ____________.
- A.
Gender
- B.
Age
- C.
Physical activity
- D.
Caffeine
Correct Answer
B. Age -
- 24.
Which of these is NOT a major age related related change in the bladder?
- A.
Increased involuntary contractions
- B.
Detrusor overactivity
- C.
Decreased involuntary contractions
- D.
Diminished detrusor contractile strength
Correct Answer
C. Decreased involuntary contractions -
- 25.
Which of the following about bladder biopsies from older person with normal urodynamic tests is correct?
- A.
Elevated caveolae
- B.
“dense bands” in smooth muscle membranes
- C.
Tight spaces between muscle cells
- D.
None of the above
Correct Answer
B. “dense bands” in smooth muscle membranes -
- 26.
Which of the following antimuscarinic agents is NOT metabolized by CYP450?
- A.
Trospium
- B.
Darifenacin
- C.
Oxybutinin
- D.
Solifenacin
Correct Answer
A. Trospium -
- 27.
Which of the following UI therapies had the lowest tolerance for dry mouth?
- A.
Tolterodine
- B.
Oxybutynin
- C.
Darifenacin
- D.
Solifenacin
Correct Answer
B. Oxybutynin -
- 28.
Which of the following UI therapies has been shown to be the most efficacious?
- A.
Oxybutynin
- B.
Tolterodine
- C.
Solifenacin
- D.
There is no difference in efficacy among UI therapies
Correct Answer
D. There is no difference in efficacy among UI therapies -
- 29.
What type of leakage is characterized by an increase in intra-abdominal pressure and is associated with impaired urethral sphincter support?
- A.
Urge UI
- B.
Stress UI
- C.
Explosive UI
- D.
Bladder UI
Correct Answer
B. Stress UI -
- 30.
Which of the following medication class is not associated with causing or worsening incontinence?
- A.
NSAIDS
- B.
Estrogens
- C.
Statins
- D.
TCAs
Correct Answer
C. Statins -
- 31.
Which of the following agents with an indication for stress UI does NOT have robust evidence?
- A.
Duloxetine
- B.
Oxybutynin
- C.
Tolterodine
- D.
Darifenacin
Correct Answer
A. Duloxetine -
- 32.
Which one of the following statements are FALSE about antimuscarinic:
- A.
All antimuscarinics are metabolized by CYP-450 enzymes
- B.
During antimuscarinic therapy with older adults a major drug related ADE of concern is cognitive impairment
- C.
Currently there is insufficient evidence that one agent with in this class is "safer" for all older patients
- D.
Agents within this class prescribed for UI may be associated with drug-disease interactions ie advance diabetes, and parkison's disease
Correct Answer
A. All antimuscarinics are metabolized by CYP-450 enzymes -
- 33.
Older persons tend to have smaller bladder capacity, lower urine flow rate, and which of the following?
- A.
Decreased post-voiding residual volume
- B.
Increased post-voiding residual volume
- C.
Decreased nocturia
- D.
Increased detrusor contractile strength
Correct Answer
B. Increased post-voiding residual volume -
- 34.
What cellular mechanisms are likely responsible for age-related changes in the bladder?
- A.
“dense bands” in smooth muscle
- B.
Decreased axon sensitivity
- C.
Narrowing of spaces between muscle cells
- D.
Acetylcholine accumulation
Correct Answer
A. “dense bands” in smooth muscle -
- 35.
Stress UI is a leakage that is associated with all of the following features EXCEPT:
- A.
Increased intra-abdominal pressure
- B.
Sphincter damage impairing closure
- C.
Detrusor overactivity
- D.
Impaired uretheral support
Correct Answer
C. Detrusor overactivity -
- 36.
Urge UI is thought to be caused by:
- A.
Detrusor overactivity
- B.
Impaired compensatory mechanisms
- C.
Bladder outlet obstruction
- D.
A and B only
Correct Answer
D. A and B only -
- 37.
Stress UI is leakage that occurs with ________ in intra-abdominal pressure and is associated with ________ urethral sphincter support.
- A.
An increase; impaired
- B.
A decrease; impaired
- C.
An increase; improved
- D.
A decrease; improved
Correct Answer
A. An increase; impaired -
- 38.
The major age-related changes in the bladder included increased involuntary contractions of what?
- A.
Detrusor overactivity (DO)
- B.
Detrusor underactivity (DU)
- C.
Pyloric sphincter overactivity (PO)
- D.
None of the above
Correct Answer
A. Detrusor overactivity (DO) -
- 39.
The possible causes in urethral closure (resting) pressure decreases with age in women are:
- A.
Alterations in the mucosal and sub-mucosal layers
- B.
Decreased vascular density and blood flow
- C.
Both A and B
- D.
None of the above
Correct Answer
C. Both A and B -
- 40.
All of the following are factors to consider when selecting an antimuscarinic agent for an older patient with UI EXCEPT:
- A.
ADEs
- B.
Patient-based factors
- C.
Efficacy
- D.
Issues that may complicate use of a drug
Correct Answer
C. Efficacy -
- 41.
Urethral closure (resting) pressure decreases with age possible cause(s) in women include:
- A.
Alterations in the mucosal and sub-mucosal layers
- B.
Increased vascular density
- C.
Decreased blood flow
- D.
A and C only
Correct Answer
D. A and C only -
- 42.
The major age-related change(s) in the bladder for men and women include:
- A.
Detrusor overactivity (DO)
- B.
Diminished detrusor contractile strength
- C.
Obstruction due to the prostate
- D.
A and B
Correct Answer
D. A and B -
- 43.
The major age-related changes in the bladder include all of the following EXCEPT:
- A.
Increased involuntary contractions
- B.
Diminished destructor contractile strength
- C.
Destructor overactivity
- D.
Bladder changes only identified in women
Correct Answer
C. Destructor overactivity -
- 44.
Which one of the following antimuscarinic agents failed to show a difference from placebo in reduction in urge UI episodes, but was superior for patient-based outcomes (e.g., quality of life)?
- A.
Oxybutynin
- B.
Tolterodine
- C.
Solifenacin
- D.
Darifenacin
Correct Answer
D. Darifenacin -
- 45.
Which one of the following has been proven to be the most effective in older persons?
- A.
Oxybutynin
- B.
Tolterodine
- C.
Darifenacin
- D.
None of the above
Correct Answer
D. None of the above -
- 46.
If a patient is using antimuscarinic medications to reduce urge UI, what must a patient experience for therapy to be considered as resulting in "cure"?
- A.
50% reduction in leakage over a period of 3 months
- B.
No leakage recorded in a 3-5 day bladder diary
- C.
No leakage recorded in a 3 month bladder diary
- D.
50% reduction in leakage over a period of 1 month
Correct Answer
B. No leakage recorded in a 3-5 day bladder diary -
- 47.
In persons age >50, tolterodine IR 2mg BID has been shown to produce similar effects to ___________ with respect to reduction in urge UI and frequency, but was tolerated significantly better with respect to ADE's (dry mouth and need for dose reduction).
- A.
Solifenacin
- B.
Darifenacin
- C.
Oxybutinin
- D.
None of the above
Correct Answer
C. Oxybutinin -
- 48.
Based on efficacy, which of the following is an appropriate antimuscarinic drug for the treatment of UI in an elderly patient?
- A.
Ditropan
- B.
Detrol
- C.
Diprivan
- D.
A and B
Correct Answer
D. A and B -
- 49.
Which formulation of oxybutynin has the lowest published rate of dry mouth and constipation?
- A.
Oral syrup
- B.
Gelnique 400mg/gm
- C.
Oral tablet
- D.
Transdermal jelly 100mg/gm
Correct Answer
D. Transdermal jelly 100mg/gm -
- 50.
Desmopressin acetate should not be used for nocturia in older persons because of the risk of:
- A.
Hypokalemia
- B.
Hypocalcemia
- C.
Hyponatremia
- D.
Hypoalbuminemia
Correct Answer
C. Hyponatremia -
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Aug 26, 2020Quiz Edited by
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May 09, 2012Quiz Created by
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