Day 2

Question 1

List the 5 different categories of definitions regarding sexuality….

Answer 1

Gender ID
Gender Role
Sexual Orientation
Sexual behavior 
Sex

Question 2

List examples of each of the 5 definitions regarding sexuality

Answer 2

Gender ID-male/female/transgender
Gender Role-masculine/feminine
sex-M/F/intersex 
SExual orientation-gay/straight/lesbian/bi/asexual
sexual behavior-homo/hetero/bi/celibate

Question 3

what branch of the nervous system controls erection portion of sex

Answer 3

parasympathetic S2-S4

Question 4

what branch of the nervous system controls the ejaculation phase

Answer 4

sympathetic n from T11-L2

• Pudendal n
• Skeletal muscle

Question 5

List a few causes of ED caused by neurogenic problems?

Answer 5

dementia. PD, stroke, diabetes, chronic alcoholics w/ vitamin deficiencies such as thiamine

Question 6

list some meds responsible for ED

Answer 6

SSRI’s, central acting antihypertensives (propranolol the BB), antihistamines (Cimetidine) & Opiates

Question 7

how does the progression of alcohol effect sexual fxn?

Answer 7

small amounts can increase libido w/ vasodilation & decreased anxiety…. large amounts or chronic use can lead to hypogonadism & polyneuopathies.

Question 8

what are some alternative to beta blockers in pt experiencing ED

Answer 8

CCB (diltiazem) ACE-I (lisinopril)

alpha-adrenoreceptor antagonists

Question 9

what are some alternatives to SSRI’s that may lead to increase sexual fxn

Answer 9

Buproprion (Wellbutrin)
Buspirone
Drug holidays, lowering dose of SSRI

Question 10

What would you tx a man who is unable to have an erection or has some ED

Answer 10

PDE-5 inhibitors such as Sildenfail (Viagra) or Tadalafil (Cialis) (longer duration)

Question 11

What is the general onset of action for Sildenafil? Duration?

Answer 11

10 minutes onset, 4-6 hrs duration

Question 12

This is a transurethral injection into the corpus cavernosum that causes vasodilation (Prostaglandin E1)

Answer 12

Alprostadil

Question 13

How would one tx premature ejaculation? (think opposite of ED)

Answer 13

SSRI
Behavior therapy-condition to hold off on ejaculation
Condoms/anesthetizing creams altho undesireable by the pt

Question 14

A pt is experiencing dry orgasms… (retrograde ejaculation) how are u tx

Answer 14

reassure, common after TURP or alpha-blocker for BPH

Question 15

What type of hernia is often associated w/ more complications

Answer 15

femoral

Question 16

why are males more at risk for hernia’s than females

Answer 16

Due to the scrotum descending down the inguinal canal and stretching it out…

Question 17

at what age do groin hernia’s occur most?

Answer 17

< 1 y/o and >50 y/o

Question 18

risk factors for developing groin hernias?

Answer 18

old age, male sex, Caucasian, smoking, cough, constipation, hx of cryptorchidism, family hx

Question 19

Prime sx of hernias

Answer 19

heaviness/dull discomfort worse w/ lifting/coughing/standing

Question 20

when would u want to attempt to manually reduce a hernia?

Answer 20

if it is incarcerated, but not if it’s strangulated (pain out of proportion)

Question 21

Pt presents w/ dome-shaped subcutaneous papule on the srotum, how would u tx?

Answer 21

this is a follicular/sebaceous cyst- reassure unless bothersome

Question 22

Pt in teens presents w/ pearly dome-shaped papules on coronal margin that are circumferential, how would u tx?

Answer 22

reassure although mistaken for STD it is common and self-resolve.

Question 23

pt presents w/ well-demarcated scaly erythematous plaques, how would u tx?

Answer 23

hydrocortisone for sx periods as this is psoriatic in nature… Calcipotriene cream for prevention

Question 24

Pt presents w/ dilated thin-walled venueles after puberty- black, blue, or dark red, dome-shaped papulesa, how do u tx

Answer 24

reassurance as this is angiokeratomas of Fordyce

Question 25

violet, flat-topped lesions usually seen on glans , how do u tx

Answer 25

lichen planus; reassurance; if papular or erosive lesions give steroids.

Question 26

chronic progressive, sclerosing inflammatory dermatosis

Answer 26

lichen sclerosis or balanitis xerotica obliterans BXO

Question 27

how do u tx lichen sclerosis aka BXO

Answer 27

topical or intralesional steroids depending on stage…

Question 28

how do u tx a pt presenting under 5 y/p with uncircumcised, poor hygiene and a swollen, red penis

Answer 28

could be balanitis- abx or antifungal

Question 29

how do u tx smegma

Answer 29

make sure it isn’t fungal by absence of redness/lesions then pull back foreskin and clean regularly