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Author Question: A 55-year-old man has made an appointment to see his family physician because he has been awakening ... (Read 145 times)

Davideckstein7

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A 55-year-old man has made an appointment to see his family physician because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day.
 
  What is the man's most likely diagnosis and possible underlying pathophysiological problem?
  A)
  Stress incontinence due to damage to CNS inhibitory pathways
  B)
  Overactive bladder that may result from both neurogenic and myogenic sources
  C)
  Overactive bladder due to intravesical pressure exceeding urethral pressure
  D)
  Overflow incontinence that can result from displacement of the angle between the bladder and the posterior proximal urethra

Question 2

A 9-year-old boy has been diagnosed with the nephrotic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options.
 
  A) Hypoalbuminemia
  B) Increased glomerular membrane permeability
  C) Decreased colloidal osmotic pressure
  D) Proteins escape from the plasma to the glomerular filtrate
  E) Accumulation of fluid in the interstitial tissue (edema)



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Zebsrer

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Answer to Question 1

Ans:
B

Feedback:

The man's complaints are typical of overactive bladder, a condition that can result from the interaction of both the nervous control of bladder emptying and the muscles of the bladder itself. His symptoms are not characteristic of stress incontinence, and when intravesical pressure exceeds, urethral pressure overflow incontinence results. The angle between the bladder and the posterior proximal urethra is more commonly a factor in the continence of females.

Answer to Question 2

Ans:
B, D, A, C, E

Feedback:

The pathophysiology of the nephrotic syndrome involves damaged glomeruli becoming increasingly permeable to protein, allowing more protein into the glomerular filtrate. Massive proteinuria results, leading to hypoalbuminemia. Generalized edema, which is the hallmark of nephrotic syndrome, results from the loss of colloidal osmotic pressure of the blood with subsequent accumulation of fluid in the interstitial tissues.





 

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