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Functional incontinence — DGM MCQ

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ModerateContinenceFunctional incontinenceDGM

An 88-year-old woman with severe osteoarthritis wets herself on the way to the toilet. She senses the need to void and has no dysuria or urgency. Her toilet is upstairs and she walks slowly with a frame. Current medicines include paracetamol and amlodipine. What is the most likely diagnosis?

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Correct answer: D — Functional incontinence

She recognises bladder filling but cannot reach the toilet because of mobility and environmental barriers, consistent with functional incontinence. Stress incontinence occurs with exertion, overactive bladder has sudden urgency, overflow suggests retention, and fistula causes continuous leakage. Continence management often requires environmental and mobility interventions.

Reference: NICE NG123; BGS CGA guidance