Internal Medicine

0521779407-21 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:59

Urinary Incontinence Urticaria (Dermatology) 1495

➣Neuromodulation (Interstim implant)

➣Supravesical diversion (continent or non-continent urinary con-

duit)

Overflow Incontinence

■Bladder drainage with Foley catheter, suprapubic catheter or, if tech-

nically possible, intermittent catheterization

■Search for etiology (idiopathic, neurogenic, psychogenic, drug-

induced, viral).

■Prognosis dependent on cause and urodynamic findings

Extra Urethral Cause of Incontinence

■Vesico-vaginal fistula (closure transabdominally or transvaginally;

consider tissue interposition [Martius, omentum] to reduce risk of

recurrence)

■Ectopic ureter (excision of upper pole moiety; distal ureteral exci-

sion)

follow-up

n/a

complications and prognosis

n/a

URTICARIA AND ANGIOEDEMA (DERMATOLOGY)

CAROL L. KULP–SHORTEN, MD

history & physical

Classification

■Immunologic

➣Ig-E dependent (Type I hypersensitivity)

Specific antigen sensitivities – e.g., latex, insect sting, medica-

tion, infection

Physical urticarias – e.g., dermatographism, pressure, solar,

cold, cholinergic, aquagenic, vibratory

➣Complement mediated (Type III hypersensitivity)

Hereditary angioedema (qualitative or quantitative C1 esterase

inhibitor deficiency)

Acquired C1 esterase inhibitor deficiency (lymphomas, myelo-

mas, systemic lupus erythematosus)

Serum sickness reaction

Urticarial vasculitis