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Men's Health Module > Sexuality and Male Sexual Health > Flashcards

Sexuality and Male Sexual Health Flashcards

1
Q

paraphilias

A

sexual arousal and gratification depend on fantasizing about and engaging in sexual behavior that is atypical and extreme

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2
Q

Define “biological sex”

A

anatomy; internal and external sex organs, chromosomes, hormones

female, male, intersex

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3
Q

Define sexual orientation

A

An individual’s physical and/or emotional attraction to a certain gender

lesbian, gay, straight, bi, asexual, queer

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4
Q

Kinsey scale

A

evaluating sexual orientation

0 = exclusively heterosexual
1 = incidental homosexual
3 = equally hetero and homo
6 = exclusively homosexual
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5
Q

Gender identity

A

innate, deeply felt identification as man, woman, or other

may or may not correspond to sex assigned at birth

girl/woman, boy/man, transgender

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6
Q

sexual behavior

A

how and with whom (or what) we have sex

hetero, homo, bisexual, celibate

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7
Q

What are different types of normal?

A 
statistical (majority of people do it)
religious/moral
psych/social (not harmful to self or others)
legal (doesn't violate laws)
phylogenetic (mammals do it)
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8
Q

Phases of the Sexual Response Cycle

A

Phase 1: desire and excitement/arousal; pulse and RR increase, blood flow to genitals

Phase 2: plateau

Phase 3: orgasm

Phase 4: resolution

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9
Q

How does WHO define being sexually health?

A 
A state of well-being
Positive and respectful
Pleasurable  
Consensual 
Respectful of human rights
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10
Q

Refractory period of sexual response cycle

A

window of time after orgasm where a man cannot experience another orgasm

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11
Q

Most likely cause of lack of sexual desire

A

psychosocial issues

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12
Q

Indications to check testosterone level

A

fatigue, depression, libido, erectile dysfunction

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13
Q

Nervous system control of erection

A

Parasympathetic
Sacral nerve roots S2-S4

*P=point

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14
Q

Nervous system control of ejaculation

A

Primarily sympathetic
T10-L2
2 parts: seminal emission, then projectile ejaculation (pudendal nerve, skeletal muscle)

*S=shoot

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15
Q

Define impotence

A

unable to attain or maintain a penile erection

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16
Q

3 etiologies of erectile dysfunction

A

organic
psychogenic
mixed etiologies

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17
Q

Psychological contributors to ED

A

performance anxiety
strained relationship
depression

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18
Q

neurogenic disorders associated with ED

A

Brain lesions - Dementias, Parkinson’s, stroke, etc.

Peripheral neuropathy

Diabetes mellitus

Chronic alcohol abuse, or vitamin deficiency may affect nerve endings

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19
Q

Meds that induce erectile dysfunction

A

**SSRI, beta blockers, H2 blockers, antihistamines, opiates

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20
Q

Effects of alcohol on erection

A

Small amounts improves erection and increases libido (vasodilatory, Suppression of anxiety)

Large amounts can cause central sedation (Decreased libido, transient ED)

Chronic alcoholism (Hypogonadism, Polyneuropathy)

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21
Q

Lifestyle changes to treat ED

A

Regular exercise
Healthy diet
Smoking cessation
Limiting use of alcohol

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22
Q

How should meds be changed to decrease erectile dysfunction?

A

chnage beta blockers to alpha antagonists, CCBs, or ACE

change SSRI to bupropion (wellbutrin) or buspirone (Buspar); can also have drug holiday or reduce dose

23
Q

1st line treatment for ED worldwide

A

Oral PDE-5Is = phosphodiesterase inhibitors

Sildenafil (Viagra), vardenafil (Levitra) tadalafil (Cialis)

24
Q

Transurethral therapy for ED

A

Alprostadil (Synthetic prostaglandin E-1)

Absorption from the urethra to the corpus spongiosum and then corpus cavernosum

25
Q

MOA of intracavernous injection for ED

A

Papaverine and Alprostadil

relax cavernous smooth muscle and vessels

26
Q

How is long-distance cycling a risk factor for ED?

A

perineal compression on penile arteries

27
Q

Surgeries for ED

A

penile pump implant

28
Q

Primary care approach to ED treatment

A
  1. oral PDE-5I if not contraindicated (Viagra, Levitra)
  2. Consider Transurethral therapy (Alprostadil=MUSE)
  3. Offer referral for penile pump or injection
  4. Surgery referral for select patients
29
Q

Contraindications for prescribing Viagra?

A

nitrates

30
Q

Treatment of premature or rapid ejaculation

A

Behavioral therapy
SSRI
Reduce penile sensitivity with condom or topical anesthetizing cream

31
Q

Retrograde ejaculation

A

back flow of semen into bladder during ejaculation

32
Q

Causes of retrograde ejaculation

A

common after TURP

alpha-blockers used for BPH

33
Q

Treatment of retrograde ejaculation

A

Alpha-sympathomimetics (pseudophedrine)

Elimination of alpha-blockers

34
Q

What causes delayed orgasm?

A

most commonly SSRIs

also opiates

35
Q

Pathophysiology behind ED

A
  • overinhibition of spinal erection center by the brain
  • inadequate NO release
  • sympathetic overactivity
36
Q

PDE-5Is do not work if patient does not experience what?

A

sexual stimulation and NO release into tissues

37
Q

3 categories of preventative services

A

Primary

  • reduce risk of getting a dz
  • Immunizations, Diet & Exercise, Tobacco & Alcohol, Safety, etc…

Secondary

  • early dz detection
  • DRE, FOBT, Colonoscopy, etc…

Tertiary

  • limiting impact of a dz once already present
  • Meds, Surgery, Rad/Chemo, etc…
38
Q

How is the life expectancy of men different than women?

A

6 years less than women

higher death rates for each of 10 leading causes of death

39
Q

CDC leading causes of death in men in U.S?

A
  1. Heart Disease
  2. Cancer
  3. Unintentional injury
  4. COPD
40
Q

Screening recommendations for cardiovascular disease risk assessment?

A

Patients ≥ 20 yo should have CV risk assessment (Framingham risk score) done every 3-5 years

41
Q

How to screen for obesity, diet, and physical activity?

A

BMI

Diet/Exercise log

42
Q

Screening recommendations of USPSTF for diabetes

A

Who? All adults with HTN and hyperlipidemia

When? every 3 years, more freq if increased risk factors

How? fasting plasma glucose preferred; A1c acceptable

43
Q

Who should be rx’d aspirin based on his cardiovascular screening?

A

All adults with a 5-year risk ≥ 3% for CV dz

ASA (81-325 mg/d) daily

44
Q

Easiest way to prevent cancer

A

discuss tobacco cessation at each visit

45
Q

Methods to help with smoking cessation?

A

Chantix, Bupropion, nicotine patch

Smoking cessation programs

46
Q

________ is leading cause of cancer-related death among men.

A

lung cancer

47
Q

What tests are done to screen for cardiovascular disease?

A 
Framingham risk score
BP
Total cholesterol and HDL
BMI
Fasting plasma glucose
48
Q

Who gets screened for colorectal cancer? how often?

A

all adults >= 50
stop when 75 or < 10 yr life expectancy

annual fecal occult blood testing
colonoscopy q 10 yrs (5 yrs if increased risk)

49
Q

Who gets screened for prostate cancer? how often?

A

Average-risk men: 50yo
High-risk men: 40-45yo (Fam Hx, Black)
Stop screening at age 70

PSA and DRE(?) every 2-4 yrs

50
Q

Cancers to screen for in men

A

Colorectal
Prostate
Testicular (controversy)
Melanoma

51
Q

When and who to screen for chlamydia and gonorrhea?

A

annual screening in high risk groups, including all sexually active women <25 years

52
Q

CAGE questionaire

A

used to screen for alcoholism

53
Q

Who and how to screen for AAA?

A 
males 65-75 yo 
who smoke(d) or have 1st degree relative who smokes

get abdominal US just 1 time

54
Q

How to assess for fall and bone fracture risk?

A

“get up & go” test

bone mineral density to check for osteopenia/porosis

Men's Health Module (10 decks)

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