Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Boards > Sexual Dysfunction > Flashcards

Sexual Dysfunction Flashcards

1
Q

What is the key neurotransmitter for creating erections?

A

Nitric oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the key intracellular molecule that leads to erection?

A

cGMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kinds of physical activity is equivalent to sexual activity?

A

Climbing 2 flights of stairs in 10 seconds or walking a mile in 20 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are common SEs of PDE-5i?

A

Headaches, Facial flushing, nasal congestion, visual changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the different half-lives of the PDE-5is?

A

Sildenafil - Viagra - Tmax 1 hr - T1/2 - 4 hrs

Vardenafil - Levitra - Tmax 1 hr - T1/2 - 4 hrs

Tadalafil - Cialis - Tmax 2 hrs - T1/2 - 18 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side effects of alprostadil?

A

penile pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which is the only FDA-approved monotherapy for ICI?

A

Alprostadil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does phentolamine do in ICI?

A

It potentiates the effect of the other medications which increase cyclic AMP. It is commonly used with papaverine as Bimix (which cases less penile pain than trimix because there is no alprostadil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Medical management of stuttering priapism?

A

Lupron, biclutamide, ketoconazole with corticosteroid.

In adolescents can use Sudafed and tech them phenylephrine injections at home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What components of evaluation are required for Peyronie’s disease?

A

Careful history and physical focusing on the deformity, the psychological distress caused by it, any functional issues related to it including a reptile function, as well as intra- cavernosal injection in the office.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are options for treatment of men with Peyronie’s disease in the active phase?

A

Nonsteroidal anti-inflammatory medication, intra-lesional verapamil. No other oral therapy’s should be recommended.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What medication must be inquired about prior to initiating ICI or in a pt with priapism?

A

MAOIs because MAOI+phenylephrine can cause severe hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is the diagnosis of low testosterone made of?

A

Two separate morning testosterones. Levels below 300 would be considered low testosterone.The guidelines say you have to check it twice.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In men who are found to have To low testosterone levels, what other additional tests are warranted?

A

Luteinizing hormone in order to determine if the pituitary is involved. If this is low or normal, prolactin should be measured. If replacement therapy is being considered a hematocrit as well as a PSA should be checked.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risks associated with testosterone replacement?

A
  1. Infertility
  2. Erythrocytosis
  3. Gynecomastia
  4. Voiding difficulties
  5. Obstructive sleep apnea
  6. Increased risk of stroke, DVT, PE, MI (Although this is somewhat controversial)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

For men with ED, What are the components of the initial a valuation?

A
  1. Medical, psychosocial, sexual history
  2. Validated questionnaires
  3. Counseling that ED may be a marker of other systemic disease
  4. Morning total testosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In men who have undergone radical prostatectomy, what should they be counseled about regarding early use of phosphodiesterase inhibitor’s?

A

Early use of phosphodiesterase inhibitor’s may not improve spontaneous erection recovery according to the AUA guidelines

18
Q

What are the two classes of BP meds most likely to cause ED?

A

Thiazides and Beta blockers

19
Q

Which BP meds are less likely to cause ED?

A

ACE-Inhibitors
ARBs (spironolactone)
Calcium channel blockers

20
Q

Does alprostadil need to be administered in the office as a test dose? If so, why?

A

Yes, because there is 3% risk of hypotension

21
Q

What is important to consider when using a vacuum erection device?

A

Needs to be used with a limited to avoid damaging the penis?

22
Q

What are the WHO parameters for semen volume, concentration, motility, morphology?

A

Volume >1.5cc
Concentration 15 million/mL
Morphology <4%
Motility 40%

23
Q

What are the criteria for performing a varicocelectomy for infertility

A

Male with semen abnormalities, a palpable varicocele, and infertility (with normal female evaluation)

24
Q

What is appropriate follow-up for patients who are started on PDE-5is?

A

See them at 3 months to evaluate for efficacy and side effects. Then every 6-12 months to ensure they haven’t been started on nitrates

25
Q

Specific questions to ask patients with premature ejaculation?

A
  • occurs with every partner?
  • occurs with every sexual attempt?
  • lifelong problem or only recently?
  • are erections normal? (if not, then ED could be acquired, which is different)
26
Q

What lab testing is required in eval of premature ejaculation?

A

None

27
Q

First line therapy for premature ejaculation?

A

Sexual counseling

28
Q

What are the oral medications used for premature ejaculation?

A

Prozac - 5 to 20 mg
Paxil - 10 to 40 mg
Zoloft - 25 to 200 mg

29
Q

What are the topical therapies for premature ejaculation?

A

EMLA cream

lidocaine/prilocaine cream

30
Q

What are the two types of premature ejaculation?

A

Acquired PE and lifelong PE

31
Q

What is the general differential diagnosis for ED?

A
  • psychogenic
  • medications
  • arterial insufficiency
  • venous leak
  • hypogonadism
  • performance anxiety
32
Q

How do you use the topical numbing agent for premature ejaculation?

A

Apply to Penis (can use a condom) 20-30 minutes before sex. Then wipe off before intercourse.

33
Q

Causes of ischemic priapism?

A 
Leukemia or blood disorders
Illicit drugs (cocaine)
Medications (pde5is, ICI, Trazodone)
ETOH
Sickle cell
IDIOPATHIC
34
Q

What lab tests would be appropriate in cases of ischemic priapism?

A

CBC
Urine tox screen
HgB electrophoresis
Corporeal blood gas

35
Q

What are the typical blood gas findings in ischemic priapism?

A

pa02 <30
paC02 > 60
Ph <7.25

36
Q

How do you give phenylephrine for priapism?

A

Dilute to 100-500 mcg/ml

Give 1 ml every 3-5 mins for hour
Put patient on the monitors

37
Q

For an infertility work-up in an azospermic male, what labs are indicated?

A

Testosterone, LH, FSH, prolactin, karyotype

38
Q

What are the inherited genetic mutations that can result in azospermia?

A

Cystic fibrosis - need CF mutation assay panel
Kleinfelters syndrome - need karyotype
Translocations - need karyotype
Azf-c microdeletion assay

39
Q

In men with testicular failure, what are medications that can be used to in Hance spermatogenesis to try to improve the chances of fertility?

A

Anastrazole
Clomid
HCG injections

40
Q

What are some methods for retrieving sperm from the testis for use in in vitro fertilization?

A

TESE
microTESE
TESA (sperm aspiration)
mapping biopsies (multiple percutaneous biopsy’s according to a template)

Oral Boards (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions