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HD 202 Exam 3 > Andropause > Flashcards

Andropause Flashcards

1
Q

andropause is a.k.a

A

Late Onset Hypogonadism or partial androgen deficiency of the aging male

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2
Q

Andropause is menopause in men T/F

A

F

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3
Q

When will testosterone start to decline?

A

40 y.o

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4
Q

T/F Osteoporosis, muscle loss and cognitive change is common to andropause and menopause

A

T

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5
Q

What enzyme converts Testosterone to DHT?

A

5-a-reductase

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6
Q

When does testosterone peak?

A

8-11AM

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7
Q

When is testosterone lowest?

A

before waking up

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8
Q

Side effects of anabolic steroids

A

aggression, testicular atrophy

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9
Q

What modulates testosterone synthesis?

A

LH

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10
Q

What secretes testosterone?

A

Leydig Cells

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11
Q

T/F there is decreased Leydig cells in older men, thus decline in testosterone production

A

T

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12
Q

How much of testosterone is bound to SHBG?

A

98%; biologically inactive

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13
Q

[Increase/Decrease]

SHBG in obese

A

increase

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14
Q

When does prostate start to enlarge?

A

age 50

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15
Q

T/F In patients with prostatic cancer, administration of
exogenous testosterone can cause cancer to
metastasize

A

T

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16
Q

The following are true about PADAM except
a. decreased visceral fat
b. ical Manifestations
c. Changes in mood and sleep pattern, decreased
intellectual activity, irritability
d. Decreased lean body mass, muscle volume, and
strength
e. Decreased body hair and skin alterations

A

A

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17
Q

The following are true about PADAM except
a. Development of gynecomastia
b. Decreased bone mineral density  osteoporosis
c. ncreased visceral fat
d. Decreased sexual desire, erectile quality, orgasms,
and ejaculation
e. Lower levels of testosterone always mean PADAM

A

E

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18
Q

When is it best to do testosterone testing?

A

8-11AM

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19
Q

You are hypogonadal when your testosterone levels are

A

<200ng/L

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20
Q

What is best assay for testosterone testing?

A

Equilibrium analysis

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21
Q

How to rule out carcinoma?

A

PSA and DRE

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22
Q

Complex associated abnormalities due to metabolic syndrome (androgen and glucose)

A

Increased risk for CV and DM

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23
Q

3 criminals of andropause

A

Metabolic Syndrome, late onset hypogonadism, erectile dysfunction

24
Q

Testosterone deficiency leads to

A

reduced lipolysis, reduced metabolic rate, visceral fat deposition, and insulin resistance

25
Q

Central obesity: waist circumference: Caucasians, Asians

A

> =94cm, >=90cm

26
Q 
Metabolic Syndrome  Values
Increased triglycerides
Decreased HDL
Systolic:
Diastolic::
Increased fasting plasma glucose:
A

> 1.7 mmol/L (≥150

mg/dL);<40 mg/dL); ≥130 mmHg; ≥85 mmHg;≥5.6 mmol/L (100 mg/dL) or Type II DM;

27
Q

How to treat Hypogonadism?

A 
Hormone supplementation: 
IM 200mg monthly;
Oral prep Testosterone undecanoate (andriol 40 mg); Mesterolone (proviron 25 mg)
Transdermal testosterone
injectable: Nebido®
5α-reductase inhibitors
28
Q

alkylated forms of oral hormone supplementation may cause ________;Large doses can lead to ____________________

A

Liver disease;;hepatitis, cholestatic jaundice possibly hepatoma

29
Q

Effect testosterone on nitrogen retention and protein synthesis

A

increase; thus increase in skeletal muscle mass and strength.

30
Q

Effect of Testosterone Replacement

A
  • Slow bone degradation and increase bone
    mineral density
  • increase in total and LDL cholesterol
  • Improvement in mood and reverse depression
  • More concentration and more positive approach
    to life
31
Q

You may absolutely not undergo testosterone replacement if you have the ff except

a. Prostate Specific Antigen (PSA) > 4 ng/ml
b. Abnormal DRE findings
c. Polycythemia
d. Snoring
e. Severe cardiac insufficiency

A

D

32
Q

You may absolutely not undergo testosterone replacement if you have
Snoring
a. Lower Urinary Tract Syndrome (LUTS)
b. increased red blood cells, hemoglobin (>60)
c. Hyperlipidemia
d. Respiratory difficulties

A

B

33
Q

T/F testosterone supplementation may increase cerebrovascular accident due to thickness of blood

A

T

34
Q

If symptoms persist even after testosterone replacement, what will you do?

A

Stop treatment

35
Q

Which division of the nervous system is responsible for erection?

A

parasympathetic nervous system

36
Q

Erectile dysfunction is related to

A

endothelial dysfunction

37
Q 
True about erection
a. Erectile dysfunction is a CV problem
b. ED may be a sign of atherosclerosis
c. Erection is a neurovascular event
D. AOTA
A

D

38
Q

T/F Erections need testosterone

A

F

39
Q

Most important risk factors for ED

A 
o  Age
o  Cardiovascular disease
o  Hyperlipidemia
o  Diabetes mellitus
o  Drug side-effects
o  Smoking
40
Q

What is most notorious risk for erectile dysfunction

A

Diabetes

41
Q

T/F desire is associated with erection

A

F; it is associated with testosterone

42
Q

True about Sexual Function in the Elderly Except
a. Actual latent period between sexual stimulation and
erection increases
b. no change in erectile turgidity
c. Ejaculation is not as explosive
d. Volume of ejaculate is less
e. Refractory period is longer.

A

B

43
Q

What are aphrodisiacs for?

A

increase appetite for sexual activity, but does not enhance erection

44
Q

Enumerate aphrodisiacs

A

Malunggay, ginseng, ginger, celery, onions, okra,

jackfruit, coconut, milk, durian, avocado

45
Q

Give the reason for gynecomastia

A

decreased testosterone and increase in estradiol and estrone

46
Q

indole alkaloid causing blood vessel dilation and increase

blood flow; α-2 receptor blocker

A

Yohimbine

47
Q

side effects of yohimbine

A

palpitations, tremor, hypertension, anxiety and nausea

48
Q

with antiplatelet property that improves vascular endothelial abnormalities and release of nitric oxide, increases interest in sex, increases performance

A

Ginseng

49
Q

mainly for dementia, no difference between placebo, improves memory

A

Gingkgo biloba

50
Q

precursor of nitric oxide, no addition benefit noted vs. placebo, need high dose (5 g) to show difference

A

L-Arginine

51
Q

effect of zinc on erections

A

none

52
Q

Enumerate Phosphodiesterase-5 Inhibitors

A

Sildenafil (Viagra)
Vardenafil
Tadalafil (Cialis)
Udenafi

53
Q

Mode of action of phosphodiesterase-5-inhibitors

A

blockage of PDE-5 increases cGMP levels, leading to
persistent, continued erection; PDE-5 inhibitor does not increase production of cGMP per se, but only slows down its break down

54
Q

Contraindications of Phosphodiesterase-5 Inhibitors

A

patients taking nitrates, patients with congestive heart failure or previous heart attack, In patients taking alpha-blockers (for BPH), antihypertensive drugs

55
Q

Enumerate treatment options for erectile dysfunction

A 
VCD’s (vacuum constriction devices)
Intraurethral injection (MUSE)  inject vasodilators (Prostaglandin E1, papaverine) into penis, Penile prosthesis Intracavernosal injection, Oral therapy

HD 202 Exam 3 (4 decks)

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