Male Genital System

Question 1

Mention drugs which can exacerbate BPH symptoms

Answer 1

Testosterone, a-adrenergic agonists

Question 2

Lsit side effects of tamsulosin

Answer 2

1. Orthostatic hypotension with dizziness (minimal)
2. Retrograde ejaculation but no effect libido
3. Floopy iris syndrome esp tamsulosin

Question 3

Desctibe mech of action amd uses of tadalafil

Answer 3

It is PDE5 inhibitor relax urinary smooth muscle amd bladder detrusor and therefore improve LUTS by inc conc of intracellular cGMP though NO pathway, ALSO inhibit PDE5 in cavernousal body thus mainatin VD.
Used in ED and pulmonary HTN & BPH

Question 4

List side effects of tadalafil

Answer 4

1. VD and hypotension used cautiously in cardiac patients and with nitrates
2. Flushing, headache, nasal congestion, back pain
3. Affect cardiac contractility (PDE1)
4. Loss of G/B vision discrimination (PDE6)

Question 5

Describe mech of action of tolterodine

Answer 5

M3 R blocker in bladder smooth muscle dec bladder smooth muscle contract.

Question 6

The most seriois side effect of oxybutinien is…….
Side effect are dec by adding….

Answer 6

Acute urinary retention due to their effect on the bladder
Pilocarpine

Question 7

Mirabegron is a……, its side effects include…….

Answer 7

B3 agonist
Headache, constipation, nasopharyngitis, HTN, tachycardia, UTI

Question 8

Finasteride is a…….., its indications include……., a more potent member is……

Answer 8

5-a-reductase inhibitor
If prostate is more than 40 gm effects appear after 6 months
Dutasteride

Question 9

Side effects of dutasteride include……

Answer 9

Impotence, dec libido and ejaculate volume and gynecomastia

Question 10

Flutamide is a……..

Answer 10

Competetive inhibitors at androgen receptors

Question 11

Describe role of phototherapy in treatment of BPH

Answer 11

1. Inhibit 5-a-reducatse
2. Anti-inflammatory and scavenges free radicals
3. Protection of bladder and detrusor function
4. Anti-androgenic effect
5. Modulation of prolactin-induced prostate growth

Question 12

Describe MOA, disadv & route of gonadoeelin

Answer 12

-It is GnRH analog given continuously to inhibit gonadotrophin release
-It causes an initial stimulation of androgen release
-Parenteral

Question 13

List uses of GnRH analogs

Answer 13

1. Cancer prostate
2. Endometriostis
3. IVF

Question 14

List side effects of GnRH analog in males & females

Answer 14

Males: gynecomastia, breast tenderness, sexual dysfunction, dec muscle mass, depression, feminization, hepatotoxcity
Females: osteoporosis, vaginal dryness, hot flushes, ovarian cyst, CVS mortality, depression

Question 15

Describe MOA, adv & side effects of Degarelix

Answer 15

-Irreversible inhibitor of GnRH receptor & inhibit release of gonadotrophind
-Not associated with initial stimualtion
-As GnRH analogs

Question 16

List medications causing ED

Answer 16

AntiHTN, antipsychotics, antidepressants, antiandrogen, anticovulsants, narcotics, H2 blockers, lipid lowering agents

Question 17

Ideal therapy for ED should have:

Answer 17

Minimal side effects, rapid onset of action, have few or no drug interactions

Question 18

PDE5I are 1st choice in ED in……

Answer 18

Young patients

Question 19

List precautions of Sildebafil

Answer 19

CI: with nitrates, a-blockers, cardiac patients
1. Taken cautiously in liver/kidney impairment
2. Stop the drug if loss of vision or hearing occurred (FDA warning)

Question 20

MOA of Alprostadil

Answer 20

Prostaglandin E1 analog stimlate adenyl cyclase inc cAMP cauing smooth muscle relaxation of arterial blood vessels & sinusoidal tissues in the corpora

Question 21

List routes of administration & uses of alprostadil

Answer 21

-Intracavernosal injection, intraurethral insert (penile suppository), topical cream (more convenient)
-ED & maintain patency of ductus arteriosus in congenital pulmonary stenosis till surgery

Question 22

List side effects of alprostadil

Answer 22

1. Local: penile pain, cavernosal areas of fibrosis, hematoma, bruising & vaginal itching in partner
2. Priapism
3. Dizziness & tachycardia (reabsorbe systemically)

Question 23

List precautions of alprostadil

Answer 23

Use cautiosly in patients with thrombocytopenia, or on anticoagulants, patients with poor quality injection technique as obese patients & patients with psychiatric conitions. Not to be given more than 3 times per week.

Question 24

List indications of testosterone replacement therapy

Answer 24

1. 1ry or 2ry hypogonadism
2. ED associated with hypoprolactinemia
3. Cancer breast

Question 25

List adverse effects of testosterone replacement therapy

Answer 25

1. Sodium retention may exacerbate edema, CHF & HTN 2. Gynecomastia due to conversion by aromatase 3. Abnormal lipid profile 4. Polycythemia 5. Hepatotoxity (with oral) 6. Topical testosterone patches cause contact dermatitis (topical CCS)

Question 26

List indications of stanozolol

Answer 26

1. Chronic debilitating diseases 2. Osteoporosis in elderly men & postmenopausal women 3. Prolonged immobilization 4. Promote growth in boys with delayed puberty

Question 27

List adverse effects of stanozolol

Answer 27

1. Virilization/acne in females, azoospermia/inc libido in males 2. Short stature in children 3. Cholestatic jaundice - cancer liver

Question 28

…….could be added to anabolic steroids to inhibit -ve effects on LH & FSH

Answer 28

Tamoxifen

Question 29

Between the labia majora there is…..

Answer 29

Pudendal cleft

Question 30

The labia minus anteriorly split into 2 smaller folds, ant pair forms…..while post pair forms…… Posteriorly it forms…….

Answer 30

Prepuce of clitoris, frenulum of clitoris Fourchette

Question 31

Clitoris is formed of………, its end is called…..

Answer 31

2 corpora cavernosa Glans of clitoris

Question 32

Mention orifices found in