Which form of urinary incontinence is present in a patient with Alzheimer’s disease who is unable to reach the toilet in time?

Correct Answer: A

Rationale: Functional incontinence is the correct answer. This occurs when a person has physical or cognitive impairments that prevent them from reaching the toilet in time. In Alzheimer's disease, the patient's cognitive decline may impede their ability to recognize the need to urinate or navigate to the restroom. Overflow incontinence is due to bladder overdistention, urge incontinence is characterized by a sudden and overwhelming urge to urinate, and stress incontinence is associated with physical activities that increase intra-abdominal pressure. Hence, in this scenario, functional incontinence aligns with the patient's inability to reach the toilet promptly due to their Alzheimer's disease-related cognitive limitations.

Correct Answer: D

Rationale: The correct answer is D: Retirement. Retirement is not a known risk factor for suicide in the elderly. Here's the rationale: 1. Chronic pain (choice A) and comorbid physical illness (choice B) are risk factors as they can contribute to feelings of hopelessness and despair. 2. Family history of suicide (choice C) is a significant risk factor due to the genetic and environmental influences. 3. Retirement (choice D) does not directly increase the risk of suicide. In fact, many individuals find purpose and fulfillment in retirement.

Correct Answer: A

Rationale: The correct answer is A: Buspirone (Buspar). Buspirone is not indicated for the treatment of depression; it is primarily used to treat anxiety disorders. SSRIs and TCAs are commonly prescribed for depression due to their ability to increase serotonin levels. Bupropion is an atypical antidepressant that works on norepinephrine and dopamine, making it a suitable option for depression treatment. Buspirone's mechanism of action differs from antidepressants, focusing on serotonin and dopamine receptors rather than directly targeting depression symptoms. Therefore, Buspirone is not a recommended drug class for depression treatment.

Correct Answer: A

Rationale: Step-by-step rationale for why A is correct: 1. Baclofen is a muscle relaxant primarily used for treating muscle spasticity, not muscle spasms. 2. Baclofen acts on GABA receptors in the spinal cord to reduce muscle hyperactivity. 3. Tizanidine, Cyclobenzaprine, and Carisoprodol are all indicated for the treatment of muscle spasms. 4. Tizanidine acts centrally to inhibit excitatory neurotransmitter release, Cyclobenzaprine is a muscle relaxant with sedative effects, and Carisoprodol is a centrally acting skeletal muscle relaxant. Summary: Baclofen is not indicated for the treatment of muscle spasms because it is primarily used for muscle spasticity. Tizanidine, Cyclobenzaprine, and Carisoprodol are more commonly prescribed for muscle spasms due to their mechanisms of action.

Correct Answer: B

Rationale: Step-by-step rationale: 1. The patient is 40 years old, which is within the age range for routine screening mammograms. 2. The description of soft, uneven breasts is typical of normal breast tissue variations. 3. Given the patient's age and the benign characteristics described, no further investigation is needed. Summary of other choices: A: Warrants a mammogram - Not necessary as the breast characteristics described are normal for the patient's age. C: May be suggestive of fibroadenoma - Fibroadenomas typically present as firm, well-defined lumps, not soft and uneven breasts. D: May indicate cystic breast - Cystic breasts may feel lumpy or tender, but the overall texture is not described as soft and uneven.