4. A 21-year-old woman presents to her obstetrician for urinary problems. She states that she has been stressed because she is working hard to do well on her finals at college. Over the last 2 weeks she finds herself continually rushing to the bathroom, “because I feel like I need to go, but I can’t.” This has never happened to her before, and she has begun wearing pads “just in case.” She denies fevers and dysuria. She is otherwise healthy, exercises regularly, and takes a multivitamin daily. Her physical examination is normal, as is her urinalysis. Cystometry is performed, and her detrusor contraction to bethanechol chloride is greatly exaggerated. What is the most likely etiology of this woman’s urinary urgency? (A) Acute cystitis (B) Chronic bladder distention (C) Detrusor muscle inflammation (D) Multiple sclerosis (E) Pelvic floor damage
Vietnamese Forum Senior
Topics: 8 Posts: 150
04/29/08 - 06:35 AM
#2
C - by exclusion from the others as follows:
A- No risk of UTI; B- Overflow incontinence; D- No clue of MS, often eye symptom firstly and middle-age women with many remission and recurrent; E- Pressure incontinence
___________________ Nothing is impossible.
bcell Forum Junior
Topics: 9 Posts: 58
04/29/08 - 01:50 PM
#3
is it "c"
hero Forum Elite
Topics: 23 Posts: 214
04/29/08 - 10:06 PM
#4
detrusor contraction to bethanechol increase - UMN lesion -> MS
to doc 649: what is the source of this q?
smalley Forum Elite
Topics: 42 Posts: 241
04/29/08 - 10:10 PM
#5
will go for c detrussor muscle inflmn..how can it be ms without any other finding and that also acutely? ___________________ But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
hero Forum Elite
Topics: 23 Posts: 214
04/29/08 - 10:12 PM
#6
smalley wrote: will go for c detrussor muscle inflmn..how can it be ms without any other finding and that also acutely?
detrusor inflammation - response to bethanechol decreased
