10-29-2011, 05:28 PM
n4b1q13
13. 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 urinary incontinence. He has not had dysuria or nocturia. His wife says that his short-term memory is decreased and he has had intermittent confusion. On examination, he has a broad-based, short-stepped gait with some 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 after 3 minutes. Which of the following is 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
13. 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 urinary incontinence. He has not had dysuria or nocturia. His wife says that his short-term memory is decreased and he has had intermittent confusion. On examination, he has a broad-based, short-stepped gait with some 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 after 3 minutes. Which of the following is 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