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.
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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
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- 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]
References3ShowHide
- [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]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]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