Men's Health

Question 1

If you suspect a patient has BPH, what testing should you do first?

Answer 1

UA – looking for hematuria or WBC present, to rule in/out cystitis and the need for cystoscopy.
+DRE – make sure not nodular

Question 2

What are first line medications for BPH?

Answer 2

Alpha-2 Blockers. Inhibit sympathetic blockade of voiding of the bladder.

Question 3

How do 5-alpha reductase (Finasteride) inhibitors work for BPH?

Answer 3

Stop conversion of testosterone into DHT, thus preventing further enlargement of the gland.

Question 4

What is the best surgical option for BPH?

Answer 4

Transuretheral Resection of the Prostate

– Can increase symptom relief more than medications combined.

Question 5

If a man is complaining of difficulty urinating +fever, and on DRE there is a tender boggy prostate, what is like?

Answer 5

If acute onset — Acute Prostatitis

Treatment: Abx for Gram-Negatives, for 4-6 weeks + NSAIDS

Question 6

What is the common cause of prostatitis?

Answer 6

Ascending Infection into Prostate, due to dysfunction generally like underlying BPH

Question 7

If a man is having recurrent UTIs, which are not attributed to catheterizations or anatomical abnormality, what should be thought?

Answer 7

Chronic Prostatitis

• • Low back pain and pelvic pain
• • Dysuria, increased frequency

Question 8

What are the risk factors for prostate cancer?

Answer 8

• Age (45+)
• Black>White>Hispanic
• Men with 1st degree relative
• BRCA mutation
• High in fat / low veggies diet

Question 9

What is considered abnormal and diagnosed with ED?

Answer 9

Unable to acquire or maintain an erection 75% of the time for intercourse

Question 10

Most common causes of ED in 40-70 aged men?

Answer 10

Vascular Dysfunction
Anti-Depressants
Low Testosterone

Question 11

What should be first line therapy for ED?

Answer 11

• Weight Loss
• Smoking Cessation
• Counseling for marital problems

Question 12

What are the differences in the pharmacologic agents for ED?

Answer 12

Sildenafil – 14-30min onset, lasts 4 hours
Tadalafil –16-45min onset, lasts 36 hours
Vardenafil – 20-30min onset, lasts 4 hours

Question 13

What is required for PDE5 medications to work?

Answer 13

They enhance the erection, so you still need sexual stimuation/input from body to initiate

Question 14

What are contraindications for PDE5 medications for ED?

Answer 14

Patients taking Nitrates, or who have hypotension