Nocturnal enuresis

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Nocturnal enuresis

Psychological disorders

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Major depressive disorder

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Seasonal affective disorder

Premenstrual dysphoric disorder

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Tobacco dependence

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Nocturnal enuresis

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Enuresis

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Psychological disorders review

Mood disorders: Pathology review

Amnesia, dissociative disorders and delirium: Pathology review

Personality disorders: Pathology review

Eating disorders: Pathology review

Psychological sleep disorders: Pathology review

Psychiatric emergencies: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Malingering, factitious disorders and somatoform disorders: Pathology review

Anxiety disorders, phobias and stress-related disorders: Pathology Review

Trauma- and stress-related disorders: Pathology review

Schizophrenia spectrum disorders: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

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Developmental and learning disorders: Pathology review

Childhood and early-onset psychological disorders: Pathology review

Assessments

Nocturnal enuresis

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Nocturnal enuresis

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USMLE® Step 1 style questions USMLE

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A 6-year-old boy is brought to the pediatrician by his parents due to recent bedwetting. He was toilet-trained at the age of 3 and has been able to stay dry during the day. However, he continues to have nighttime “accidents” 3-4 times per week. The patient consumes fluids in the morning and afternoon, but not prior to bed. The family recently moved from their home in the city to a suburban neighborhood, and he has experienced difficulty making new friends at school. Temperature is 37.2°C (99.0°F), blood pressure is 107/68 mmHg, and pulse is 79/min. A complete physical examination is noncontributory. The patient is subsequently trialed on scheduled timed voids overnight and a bedwetting alarm, both of which fail to control his symptoms. The patient is subsequently initiated on a medication that acts as an antidiuretic hormone analog. Which of the following medications was most likely prescribed?  

External References

First Aid

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Bedwetting p. 340

Nocturnal enuresis p. 340

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Summary

Nocturnal enuresis or nighttime urinary incontinence is involuntary urination while asleep, after the age at which bladder control usually occurs, typically above 5 years old. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis is when a child or adult begins wetting again after having stayed dry. The most common cause is a neurological-developmental delay. Other causes include low ADH levels, infections, and psychological issues.

Treatment for nocturnal enuresis may involve a combination of approaches, such as behavior modification techniques, medication, and lifestyle changes. Behavioral interventions may include setting a schedule for using the bathroom before bed, limiting fluid intake in the evening, and using an alarm to wake the child when they start to wet the bed. Medications such as desmopressin and imipramine may be used to help control bedwetting.

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