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Endocrine Module > Pathophysiology of Erectile Dysfunction and Benign Prostatic Hyperplasia > Flashcards

Pathophysiology of Erectile Dysfunction and Benign Prostatic Hyperplasia Flashcards

1
Q

What is the definition of an Erectile Dysfunction?

A

Inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse

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2
Q

What qualifies as ED?

A

3 months of failing to achieve erections

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3
Q

What co-morbidities can cause ED?

A
  1. Obesity
  2. Dyslipidemia
  3. Metabolic Syndrome
  4. Tobacco Use
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4
Q

What is the Corpora Cavernosa?

A

Two cylinders of erectile tissue (top of penis)

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5
Q

What is the Corpus Spongiosum?

A

Surrounds the urethra (bottom of penis) and expands to form the glands

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6
Q

What NT helps blood flow into the penis via vasodilation?

A

ACh

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7
Q

What are the steps to achieve an erection?

A
  1. Bloodflow increases and fills the copra sinusoids
  2. Those filled corpora then compress subtunical venules to decrease outflow of blood
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8
Q

What are the 2 possible pathways ACh facilitates erection?

A
  1. Improves NO production
  2. Increases cAMP
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9
Q

What is the primary pathway for an erection?

A

NO activated cGMP = decrease Ca2+ = relaxed muscle

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10
Q

What is the secondary pathway for an erection?

A

Increase cAMP = muscle relaxation

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11
Q

What is the MAIN NT for erections?

A

NO

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12
Q

What metabolizes cGMP?

A

Phosphodiesterase type 5 aka PDE 5 in the corpora cavernosa

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13
Q

Where do the spinal cord cholinergic nerves connect to for sexual stimulation?

A

Corpora Vasculature

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14
Q

What is the role of NE in erections?

A

Vasoconstrictor, = detumescence

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15
Q

Does testosterone help with ED?

A

NO, but it does help with libido

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16
Q

What are the 2 physiologic functions of testosterone?

A

Stimulate Libido and Increase Muscle Mass

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17
Q

What is the normal concentration of testosterone?

A

300-1100 ng/dL

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18
Q

Is testosterone a primary mediatory of erectile dysfunction?

A

NO

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19
Q

What is Secondary ED?

A

Patient has hypogonadism and decreased libido

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20
Q

What is Organic ED?

A

Etiology is vascular, neurologic, and/or hormonal
Main Cause

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21
Q

What is Pyschogenic ED?

A

No organic causes and the patient does not respond to psychogenic stimuli

22
Q

What is one disease that could inhibit blood flow into the corpora cavernosa? (vascular organic)

A

HTN, ASCVD, PVD

23
Q

What is one disease that could impair spinal cord nerve conduction? (neurologic organic)

A

MS, Injury, Stroke, PD

24
Q

What is one disease that could block peripheral nerve conduction? (neurologic organic)

A

DM

25
Q

What are lifestyle factors that can cause ED?

A

Alcohol abuse, smoking, obesity, and physical inactivity

26
Q

What are causes of ED associated with damage?

A

Old age, DM, renal failure, heart disease, HTN, ASCVD, and hypothyroidism

27
Q

How can Antihypertensives cause ED? What are examples?

A

Reduced arterial flow into corpora
Diuretics and BB

28
Q

How can Dopamine Antagonists cause ED?

A

Inhibit prolactin inhibitory factor, increasing prolactin levels

29
Q

How can Anticholinergics cause ED? What are examples?

A

Anticholinergic Activity
Anti-Parkinson’s

30
Q

How can Estrogen or Antiandrogenic Drugs cause ED? What are some examples?

A

Suppress testosterone mediated stimulation of libido
Digoxin and Spironolactone

31
Q

How can CNS Depressants cause ED? What are some examples?

A

Suppresses psychogenic stimuli
Narcotics and Benzos

32
Q

What other drugs cause ED?

A

Lithium
Gemfibrozil
Clofibrate
Finasteride
Dutasteride

33
Q

What is Benign Prostatic Hyperplasia?

A

Enlargement of the prostate gland

34
Q

What is the normal prostate weight?

A

15-20 grams

35
Q

What is the anatomy of the prostate?

A

Small gland located below the bladder that surrounds the urethra

36
Q

What is the primary function of the prostate?

A

To secrete fluids that make up 20-40% of the ejaculate

37
Q

What are the 3 prostate tissues?

A
  1. Epithelial Glandular
  2. Stromal
  3. Capsule
38
Q

What is the function of the epithelial glandular?

A

Produce secretions

39
Q

What is the function of the stromal?

A

Smooth muscle with lots of ALPHA-1 RECEPTORS, activated by NE to cause smooth muscle contraction = decreases bladder emptying

40
Q

What is the function of the capsule?

A

Connective smooth muscle with ALPHA-1 Receptors

41
Q

What metabolizes testosterone?

A

5-alpha-reductase

42
Q

What is DHT and it’s role in the prostate?

A

Dihydrotestosterone an active metabolite of TST, facilitates prostate growth, and much for potent in the prostate

43
Q

What are the two types of Lower Urinary Tract Symptoms LUTS?

A
  1. Obstructive
  2. Irritative
44
Q

What are the Obstructive Symptoms?

A

Reduction in bladder emptying (weak stream, low flow rate, incomplete/slow emptying)
Full Bladder feeling after voiding

45
Q

What are the Irritative Symptoms?

A

Over sensation of bladder muscles from long-standing = Nocturia
Bladder cannot void = retention and UTIs

46
Q

How do you know if a BPH medication is working?

A

If the AUA score improves by 3 points

47
Q

What is the physical exam for BPH?

A

Digital Rectal Exam DRE

48
Q

What is classified as Mild BPH?

A

<7

49
Q

What is classified as Moderate BPH?

A

8-19
LUTS

50
Q

What is classified as Severe BPH?

A

> 20
UTI, Insufficiency, Bladder stones

Endocrine Module (16 decks)

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