MKSAP: 50-year-old man with increasing urinary frequency and urgency

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 50-year-old man is evaluated for a 1-year history of increasing urinary frequency and urgency and occasional urge incontinence. He has no symptoms of urinary hesitancy or incomplete emptying. The patient has primary progressive multiple sclerosis. Medications are dalfampridine and vitamin D. On physical evaluation, temperature is 36.8 °C (98.2 °F), blood pressure is 120/55 mm Hg, and pulse rate is 68/min. Findings of abdominal and digital rectal examinations are normal. Finger-to-nose testing reveals dysmetria bilaterally. Leg tone is increased bilaterally. Muscle strength is 4/5 in both legs. Gait testing reveals spasticity and ataxia. A urinalysis is negative for infection. Which of the following is the most appropriate treatment? A: Finasteride B: Intermittent urinary catheterization C: Oxybutynin D: Prophylactic antibiotics Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Neurology Source Type: blogs