FREE USMLE/COMLEX Question Bank | Question #54

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[ashutoshsharmash]

Very good analysis. Just wanted to add this for your The Bladder is primarily controlled by the action of these 3 receptors- M3, Beta3 in detrusor and Alpha 1 in sphincter. Parasympathetic via Pelvic nerve stimulates M3 causing detrusor contraction and alpha 1 inhibition causing outlet relaxation, and sympathetic via pudendal nerve will cause the opposite. So you have primarily 3-4 drugs- M3 + is Bethanechol, Beta 3 + is Mirabregnon, alpha 1 + is Tamsulosin, M3 - is Oxybutynin, fenacin (Dari and Solifenacin).
This patient clearly has MS, which is an UMN disease, so the parasympathetic outflow is uninhibited, and so we have urge incontinence due to overactive bladder (detrusor contracts, sphincter relax)- so we need to target either M3 - or Beta 3+, either one would do.

PS- Adding mirabegron and Oxybutynin is a good teaching point in terms of cost. Mirabegron costs close to 700 dollars a month and Oxybutynin costs just 60 dollars a month.

[GabrielSocarrasPonce-yhqx]

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[trilliannova]

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[WhyNot-sipj]

5:00 Bethanechol is a medication that can be used to treat overflow incontinence caused by ( neurogenic bladder atony ), but it should not be used for obstructive causes of overflow incontinence .

Of course BPH is NOT a proper indication for the use of bethanechol to treat overflow incontinence .

[HonoreManju]

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[fatimawardah]

Hello are these questions banks for step 1 or step 2?