Male Sexual Dysfunction Flashcards

1
Q

What are the 7 stages of changes in Male Sex organ during intercourse

A

Libido
Arousal
Penile Tumescence
Copulation
Ejaculation
Orgasm
Détumescence

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2
Q

List 3 disorders associated with Erection

A

Erectile Dysfunction
Priapism
Erectile deformity

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3
Q

List 3 disorders associated with Ejaculation

A

-Premature, delayed or retrograde ejaculation
-anorgasmia
- anejaculation

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4
Q

What are two main causes of hypo active sexual disorder

A

Psychogenic
Low Testosterone

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5
Q

What could be elicited from a medical history that could cue the physician to the cause of hypoactive sexual disorder

A

Symptoms of endocrine disorder

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6
Q

At what age do male testosterone levels peak?

A

20years (900ng/dL)

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7
Q

What does the ADAM stand for in the ADAM Questionnaire

A

Androgen deprivation in the aging male

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8
Q

What qualifies a positive result on the ADAM Questionnaire

A

An affirmative response to Q1 (Do you have decreased libido)

Q7 (Are your erections less strong)

Or 3 of any other questions is a positive result

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9
Q

How do you evaluate the suspected hypogonadal patient?

A

Early Morning Total Testosterone
(<12.1 nMol/L or 348.3 ng/dl)

Repeat T levels & Leutinizing Hormone levels

( LH stimulâtes the testes to form testosterone)

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10
Q

What are the normal testosterone values

A

300-1000 ng/dL (348.3 ng/dl)
10-15 nMol/ L (12.1 nMol/L)

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11
Q

List 5 testosterone treatment options

A

Nebido (IM)
Testosterone implant
Depo- Testosterone
Androderm
AndroGel

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12
Q

Based on the IIEF-5 Questionnaire (International Index of Erectile Dysfunction- 5) state what each score represents

A

1-7: severe Erectile dysfunction
8-11: moderate Erectile dysfunction
12-16: mild-mod Erectile dysfunction
17-21: mild Erectile Dysfunction
22-25: No Erectile Dysfunction

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13
Q

What are the 7 main causes of Erectile Dysfunction

A

Vasculogenic
Neurogenic
Structural Abnormality
Drug Induced
Hormone related
Psychogenic
Trauma related

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14
Q

List some vasculogenic causes of Erectile Dysfunction

A

Cardiovascular Disease
Hyperlipidemia
Smoking
DM

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15
Q

List some neurogenic causes of Erectile Dysfunction

A

Central: degenerative disorders, spinal cord trauma, stroke, CNS tumour

Peripheral: DM 1/DM 2, polyneuropathy, chronic renal failure, surgery

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16
Q

List 3 anatomical/structural causes of Erectile dysfunction

A

Hypospadias, Micropenis, Peyronie’s disease

(Peyronie’s disease is a disorder in which scar link tissue, called plaque, forms under the skin of the penis)

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17
Q

List some hormonal causes of Erectile Dysfunction

A

Hypogonadism
Hyperprolactinaemia
Hyper/hypothyroidism
Hyper/hypocortisolism (Cushing’s )

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18
Q

List some drugs that may cause Erectile dysfunction

A

Antihypertensives(thiazide diuretics)
Antidepressants (selective serotonin re-uptake inhibitors)
Antipsychotics
Antiandrogens
Recreational Drugs

19
Q

List 8 risk factors for Erectile Dysfunction

A
  • Age
  • Obesity
  • Smoking
  • sedentary lifestyle
  • hypertension
  • Diabetes
  • hyperlipidemia
  • Depression
20
Q

Based on the Prostate Cancer Prevention Trial

Men with Erectile Dysfunction are how much more likely to experience cardiac event after 5yrs, than men without

A

45% more likely

21
Q

Based on the Olmstead County Study:

Erectile Dysfunction was associated with what percentage higher risk of subsequent coronary artery disease at 10yrs

A

80% higher risk

22
Q

What is used to assess patients or the population for early detection of Erectile Dysfunction?

A

Risk factor identification
Screening high risk populations
Diagnostic questionnaires

23
Q

What laboratory tests are done when investigating Erectile Dysfunction

A

Fasting glucose
Lipid profile
Urinalysis
CBC
TSH
Serum Testosterone

24
Q

Hat is the first line therapy for Erectile Dysfunction Management

A

PDE-5 inhibitors
(viagra)

25
Second line therapy for Erectile Dysfunction
Vacuum Erection Device Intraurethral Pharmacotherapy
26
What is the third line of therapy for erectile dysfunction
Surgical prosthesis
27
List some side effects of PDE Inhibitors
Headaches Flushing Dyspepsia Nasal Congestion Visual Disturbances
28
What are the contraindications of PDE-5 inhibitors
Nitrate therapy Alpha blocker
29
List 2 side effects of vacuum constriction devices for treating Erectile Dysfunction
Genital Ecchymosis Penile “pivoting”
30
List one contraindication for Vacuum constriction devices
Sickle Cell Disease
31
What is the mechanism of action of Alpostadil? (Intraurethral Pharmacotherapy)
Induces corporal smooth muscle relaxant effects
32
List some side effects of Intraurethral Pharmacotherapy (Alprostadil)
Local pain Urethral Bleeding Dizziness Hypotension
33
List one contraindication for Alprostadil
Priapism
34
What is the dosage of Alprostadil that is administered
5-10ug/ml
35
List some indications of Penile Prosthesis Surgery
- Major Penile Injury or Deformity - Medical therapy contraindicated or unsuccessful
36
What are the indications for arterial revascularisation
Age <55 Non-smoker Non-diabetic No venous leakage Radiographie confirmation of stenosis of internal pudendal artery
37
Pre mature Ejaculation can be
Lifelong (Primary) Acquired (Secondary) Transient Chronic
38
Define Premature Ejaculation
A male sexual dysfunction that is typified by ejaculation that always or nearly always occurs prior to or within 1 min of vaginal penetration
39
What is the prevalence of premature ejaculation in the USA
21%
40
List 7 causes of premature ejaculation
Idiopathic Psychological Spinal Cord Injury Inflammation Medications Anxiety Associated Erectile Dysfunction
41
List four oral therapy option for treatment of premature ejaculation
Clomipramine Fluoxetine Paroxetine Sertraline
42
What is the mechanism of Clomipramine
43
What is the mechanism of Fluoxetine, Paroxetine, Sertraline
Selective Serotonin Reuptake Inhibitor
44
List one topical therapy for treatment of Premature Ejaculation
Lidocaine/Prilocaine