USMLE Question of the Week

How to Assess Urinary Incontinence in a Woman

In Episode 33 of Med School Question of the Week for USMLE, Alisa Khomutova, MedSchoolCoach expert tutor, answers this medical school question:

A 59-year-old multiparous woman comes to the physician because of a urinary leakage for the past 10 months. She involuntarily loses a small amount of urine after experiencing a sudden cramping sensation in the bladder. She often has difficulty making it to the bathroom in time. She has been woken up several times at night by a strong feeling over her bladder being full. She denies burning, itching, hematuria, abdominal pain, or pelvic pain. Menopause was 9 years ago, and she is not on hormone replacement therapy. She works as a night nurse, and drinks 3-4 cups of coffee at work. Upon physical examination, there is no subrapubic tenderness. Pelvic examination is normal and Q-tip test is negative. Ultrasound of the bladder shows a normal post-void residual urine. Which of the following is the primary underlying etiology for this patient’s urinary incontinence?

  • Stress Incontinence
  • Urinary Tract Infection
  • Decreased pelvic floor muscle tone
  • Increased urine bladder volume
  • Increased detrusor muscle activity

Watch to find out!

Alisa Khomutova

Alisa received her B.S. from University of California, Davis, and attended Oakland University William Beaumont School of Medicine. In 2020, she matched into Stony Brook Teaching Hospital practicing General Surgery for residency.

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