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Retired NBME 19 Answers

nbme19/Block 1/Question#6 (reveal difficulty score)
A 48-year-old woman comes to physician ...
Blockade of parasympathetic innervation of the detrusor muscle ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: incontinence

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submitted by โˆ—randi(14)
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Urgency incontinence, which presents as an overactive bladder with leaking and an urge to void immediately, is due to detrusor muscle overactivity. Thus, a drug that blocks the parasympathetic activity of the detrusor muscle will affect normal stimulation of bladder contraction. FA2019 p588.

Bonus: drugs that can help with urgency incontinence include muscarinic antagonists oxybutinin, tolterodine, solifenacin (remember turtle and ox closing the water dispenser in Sketchy) FA2019 p241.

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victorlt14  I'm puzzled by the preganglionic parasympathetic blockade. Would that maybe have more side effects? +
killuazoldeg  the drug was either M3 blocker or Beta3 stimulator to decrease bladder contraction (by the parasympathetic )and relieve the urge incontitnence +
surgerydoctorca_sgu  When it comes to feeding tubes, also keep in mind how these play into a DNR order. A patient with a DNR may still consider other life-sustaining measures (e.g. intubation, feeding tube, chemotherapy) - FA 2021, Pg. 272 +



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