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Therapeutics > Men's Health > Flashcards

Men's Health Flashcards

1
Q

Male Health Issues

A

-CHD
-Prostate cancer
-LUTS/BPH
-Alopecia
-Testicular cancer
-ED
-HYPOgonadism (delayed puberty)
-Peyronie’s Disease

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2
Q

Role of Testosterone

A
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3
Q

Puberty

A

-bone and muscle growth
-body and facial hair
-penis growth
-testicular growth
-spermatogenesis
-inc libido

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4
Q

Men’s Health issues during puberty/adulthood

A

-Delayed sexual maturity (HYPOgonadism)
-Testicular cancer
-Alopecia

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5
Q

Hypogonadism

A

-incomplete/delayed sexual maturity
-lack of testicular growth at 14
-functional (secondary) or organic/genetic

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6
Q

most common cause of hypogonadism

A

-Constitutional delay of growth and puberty

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7
Q

Hypogonadism treatment

A

-usually requires testosterone supplement
-IM testosterone esters 50mg monthly inc by 25 mg up to 100mg

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8
Q

Testicular cancer prognosis

A

-pretty good even stage 3

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9
Q

Testicular cancer treatment

A

-surgery (orchiectomy)
-radiation
-chemo

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10
Q

Alopecia types

A

-androgenic (most common)
-areata
-universalis
-traction
-drug-induced

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11
Q

Androgenic alopecia

A

-male pattern baldness
-usually by 40
-genes play factor

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12
Q

Alopecia areata

A

-autoimmune
-patchy hair loss
-mAb treatment

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13
Q

Alopecia universalis

A

-complete loss of all body hair

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14
Q

Traction alopecia

A

-over time from tension

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15
Q

Drug-induced alopecia

A

-anabolic steroids
-cancer chemo (reversible)

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16
Q

Alopecia mech

A

-hairs transition from large, thick, pigmented to short, wispy, gray

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17
Q

Alopecia treatment

A

-Finasteride (Propecia)
-Minoxidil (Rogaine)
-both
-hair transplant

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18
Q

Finasteride mech

A

-inhibit type II 5-a reductase
-inhibits conversion of testosterone to DHT
-decreased DHT conc in scalp by 60%
-stopped progression in 86% of men

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19
Q

Finasteride (Propecia) dose

A

-1mg PO qd
-continuous use needed to maintain efficacy

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20
Q

Finasteride side effects

A

-decreased libido
-ED
-dec volume of ejaculate
-low incidence tho
-women of child bearing age should AVOID handling

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21
Q

Minoxidil (Rogaine)

A

-alopecia treatment
-OTC?

22
Q

Minoxidil mech

A

-enlarge mini hair follicles
-may inc blood supply
-stimulate hair follicle

23
Q

Minoxidil dosing

A

-topical 5% foam or solution
-apply BID every day!
-may take 4 months to see results
-apply to dry scalp and hair (wet hair will dilute!)

24
Q

Topical finasteride and minoxidil

A

-treat alopecia
-gel, solution, spray
-5% Minoxidil, 0.25% finasteride

25
Q

HYPOgonadism causes

A

-aging
-diabetes, Aids, arthritis, CKD
-long-term corticosteroid use
-obesity

26
Q

Diagnosis of HYPOgonadism

A

-low testosterone levels WITH symptoms

27
Q

Signs of low testosterone

A

-dec libido
-gynecomastia
-loss of body hair
-reduce muscle bulk and strength

28
Q

Testosterone concentrations

A

-dec with age
-300-1100ng/dL

29
Q

Low testosterone diagnosis

A

-serum testosterone levels measured in pts with specific signs of low T
-test in morning for total testosterone
-<300ng/dl
-confirm w 2nd test = free testosterone < 5ng/dl

30
Q

Treatment of Hypogonadism

A

-hormonal therapy
-ONLY use when hypogonadism is diagnosed

31
Q

Testosterone replacement products

A

-patches
-gels
-solutions
-IM
-buccal
-SC pellets
-capsules

32
Q

IM injection

A

-100mg weekly or 200mg every other week
-enanthat or cypionate
-high concentrations during dosings
-mood swings
-cheapest

33
Q

THT patch

A

-5mg
-1-2 patches nightly
-most similar to normal T levels
-avoid exposure to water for 3 hours

34
Q

THT gel

A

-5-10g
-apply to COVERED area of skin daily
-shoulders, upper arms, ab
-WASH HANDS

35
Q

THT solution

A

-30mg-120mg to armpits qd
-apply deodorant first
-wash hands

36
Q

THT buccal tablet

A

-30mg q 12 hours
-do NOT chew or swallow

37
Q

THT SQ pellet

A

-implanted q3-6 months
-delayed onset (3-4 months)

38
Q

THT oral capsule

A

-158-237mg BID
-undecanoate
-take with food
-draw serum test 6 hours after AM dose

39
Q

OTC hypogonadism treatment

A

-most imply T will inc
-most are hormone precursors from natural products
-efficacy and side effects unknown

40
Q

CONTRAINDICATIONS to THT

A

-prostate cancer
-breast cancer
-hematocrit > 50%
-baseline PSA > 4ng/ml or >3 in men at high risk of prostate cancer
-recent or poorly controlled CVD

41
Q

Black box warning of THT

A

-gel: secondary exposure to children
-maybe cardiac risk
-injection > patch

42
Q

Hypogonadism monitoring

A

-3-6 months after initiating therapy
-testosterone levels should be between 400-700 ng/dl
-if hematocrit >54%, STOP therapy until it lowers

43
Q

Androgen misuse and abuse

A

-athletes
-gynecomastia
-weight gain
-acne
-dec testicles
-mood
-hepatotoxicity

44
Q

Prostate cancer risk factors

A

-age
-african ancestry
-family history

45
Q

Prostate cancer 5-yr survival rate

A

-100% in local and regional
-29% in bone

46
Q

Prostate cancer bits

A

-most common man cancer
-2nd leading cause of cancer deaths in men
-gleason score
-treatment dependent on Gleason score
-most men with dx dont die

47
Q

Prostate cancer screening

A

-Prostate specific antigen (PSA)
-normal ~ 4ng/mL

48
Q

PSA <4

A

-15% chance of cancer

49
Q

PSA 4-10

A

-25% chance of cancer

50
Q

PSA > 10

A

-50% chance of cancer

51
Q

PSA screening

A

-men w PSA < 2.5 only need to be retested every 2 years
-screen yearly is PSA > 2.5

-NOT if older than 70
-consider baseline screening of high risk pt at age 40-45

52
Q

noncancer causes of high PSA

A

-older age
-prostatitis
-UTI
-ejaculation
-BPH
-finasteride

Therapeutics (78 decks)

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