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Phys Clinical Casesgeriatric

Phys Clinical Cases · geriatric

Urinary Incontinence in Older Adults — DCE Clinical Case

DCE long-case and short-case station for Urinary Incontinence in Older Adults.

1 min readVerification in progress

Target exams

FRACP DCEMRCP PACES
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Study tools

Target exams

FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Urinary Incontinence in Older Adults.

Urinary Incontinence in Older Adults — Clinical Case

DCE Long Case

Patient brief

Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Urinary Incontinence in Older Adults. [1]

Presenting complaint: Subacute or acute symptoms referable to Urinary Incontinence in Older Adults, with enough detail to force prioritisation. [1] [2]

Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]

Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]

Examination: Key positives and critical negatives for dangerous differentials. [1]

Investigations: A small set of results that change management. [1] [2]

Tasks

  1. Present a prioritised problem list. [1]
  2. Defend investigations and immediate therapy. [1] [2]
  3. Provide safety-net and follow-up advice. [2]

Model discussion points

  • Working diagnosis and acuity. [1]
  • Differentials and discriminators. [2]
  • Treatment sequence and monitoring. [1] [2] [3]
  • Multimorbidity and communication. [2]
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References3ShowHide
  1. [1]Batmani S, Jalali R, Mohammadi M, et al. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies BMC Geriatr, 2021.PMID 33781236
  2. [2]Dumoulin C, Cacciari LP, Hay-Smith EJC Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women Cochrane Database Syst Rev, 2018.PMID 30288727
  3. [3]Gray SL, Anderson ML, Dublin S, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study JAMA Intern Med, 2015.PMID 25621434
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