DSSSB October 2024
Medical & Surgical Nursing
Easy
The acronym 'URGE' summarises the symptoms and diagnostic criteria of:
Appeared in: DSSSB October 2024
Explanation
- The acronym 'URGE' represents the four essential clinical criteria required for the diagnosis of Restless Leg Syndrome (RLS), also known as Willis-Ekbom disease.
- URGE stands for: Urge to move the legs, symptoms are induced or worsened by Rest, symptoms Get better with activity, and symptoms worsen in the Evening or at night.
- The diagnosis is made clinically when a patient's history confirms the presence of all four of these features.
- RLS is a common sensorimotor disorder that causes significant discomfort and sleep disruption.
Why Other Options Were Wrong
- Option A: Alzheimer's disease is a neurocognitive disorder. Its diagnosis is based on progressive memory loss, cognitive decline, and impaired daily functioning, not the criteria represented by URGE.
- Option C: An incomplete spinal cord injury involves damage to the spinal cord that results in partial loss of motor and sensory function below the level of the injury. Diagnosis is based on neurological assessment and imaging, not a specific set of symptoms like URGE.
- Option D: Parkinson's disease is primarily diagnosed using the 'TRAP' mnemonic: Tremor (at rest), Rigidity, Akinesia/Bradykinesia, and Postural instability. While some patients with Parkinson's may also have RLS, URGE is not its primary diagnostic tool.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnostic criteria for Restless Leg Syndrome (RLS) using the 'URGE' mnemonic as background academic context rather than a clinical decision trigger.
- Nurses play a key role in identifying RLS by taking a thorough patient history focused on the four URGE criteria, as the diagnosis is purely clinical.
- Patient education is a critical nursing intervention, focusing on lifestyle modifications such as avoiding triggers (caffeine, alcohol), practicing good sleep hygiene, and performing leg stretches before bed.
- What if? If a patient with RLS reports their symptoms are starting earlier in the day and spreading to their arms after being on a dopamine agonist for years, the nurse should recognize this as potential 'augmentation,' a known complication of long-term dopaminergic therapy, and ensure it is reported to the provider for medication adjustment.
How to Approach the Question
- This is a factual recall question that tests your knowledge of a specific medical acronym.
- First, identify the core of the question: the meaning of the acronym 'URGE' in a diagnostic context.
- Recall or deduce the meaning of each letter: 'U' likely stands for Urge, 'R' for Rest, 'G' for Go/Get better, and 'E' for Evening. These concepts point towards a condition that involves an urge to move, is worse at rest, improves with movement, and has a nighttime pattern.
- Evaluate the options based on this understanding. The symptoms described by the URGE mnemonic are the classic, defining features of Restless Leg Syndrome.
- Rule out the other conditions. Alzheimer's is cognitive, spinal cord injury involves paralysis/sensory loss, and Parkinson's disease is defined by the TRAP mnemonic (Tremor, Rigidity, Akinesia, Postural instability).
Concept Tested & Keywords
- Concept Tested: Diagnostic criteria for Restless Leg Syndrome (RLS) using the 'URGE' mnemonic.
- Stem keywords: acronym, URGE, symptoms, diagnostic criteria
- Lead-in keywords: summarises
- Negative lead-in flag: false
Question ID
QE4pE69IK2F52gvwaU0CNP
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13684-13686
E6 Medicine Davidson Principles Practice 24e p. 1126-1128
E6 Pharmacology Katzung 16e p. 791-793
Practise the full DSSSB October 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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