Sexual

Question 1

Sexual dysfunction

Answer 1

x 6 months

20-50% have biological etiology

Question 2

Premature ejaculation

Answer 2

< 15 seconds = severe
15-30 seconds = moderate
30-60 seconds = mild

Treat with Prozac, Zoloft, TCA, analgesic cream

Question 3

Erectile dysfunction

Answer 3

If no erection during REM sleep = biological

Question 4

Which antidepressant increases sexual desire?

Answer 4

Wellbutrin (dopaminergic)

Question 5

Viagra contraindicated if taking which other Rx?

Answer 5

NITRATES

Question 6

Gender dysphoria

Answer 6

Kids = 6 criteria, F > M
Adolescents = 2 criteria, M > F
x 6 months

Most not identified in childhood
Women usually identified earlier

Most will end up attracted to their birth gender (75% boys evolve to homosexuality/bisexuality)

Most important risk factor = ABSENT MOTHER.
Among many other environmental risk factors.

Give GnRH agonists in ADOLESCENTS (but not pre-pubescent) to delay secondary sex changes

Question 7

By what ages is gender identity usually crystallized?

Answer 7

2-3 years old

Question 8

Voyeurism

Answer 8

MUST BE 18yo

Question 9

Pedophilia

Answer 9

MUST BE 16yo
MUST HAVE 5 YEAR DIFFERENCE WITH VICTIM

3-5% prevalence
Usually 5 acts by the time consult (45%)
95% are HETEROSEXUAL
50% use ALCOHOL during act
Often have been abused themselves in childhood

Question 10

What is not a paraphilia?

Answer 10

Nymphomania

Question 11

Sexuality

Answer 11

Start masturbation at 15-19 months

Boys have refractory period but not women (can have multiple orgasms)

Question 12

Percentage of sexual assault recidivism @ 5 years?

Answer 12

13%