Brainscape's Knowledge GenomeTM

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


See full index

Foundations III > BPH, Erectile Dysfunction > Flashcards

BPH, Erectile Dysfunction Flashcards

1
Q

Benign Prostatic Hyperplasia: Lower urinary tract symptoms

A
  • Weak stream
  • Hesitancy
  • Stream intermittency
  • Post void dribbling
  • Nocturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

BPH: complications

A
  • urinary retention

- Recurrent UTI

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

What are the 2 scoring measures for BPH?

A
  1. Urinary Symptoms (AUA symptom score 0-35)

2. Impact on quality of life (Bother index 0-6)

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

What exam must be performed for a patient with BPH?

A

DRE (note size, consistency, +/- tenderness)

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

BPH: urologic testing (with expected findings)

A
  1. Urofow study (low flow rate)
  2. Post void residual (high residual)
  3. Cystoscopy (trabeculation, obstructive prostate into lumen)
  4. Urodynamic study (low flow, elevated pressure in bladder)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name some conservative lifestyle modifications that can be done for mild BPH

A
  • Avoid drinking too much water before bed
  • If leg edema, elevate legs to help eliminate fluid before bed
  • Avoid caffiene, and alcohol
  • Double void to completely empty bladder
  • Avoid pseudoephedrine/alpha agonist (causes sphincter to contract more forcefully)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BPH medications: phytotherapy

A

Saw palmetto

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

BPH medications: alpha blockers

A

cause relaxation of smooth muscle that restricts flow of urine

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

Alpha-1 blockers

A

Terazosin

Doxazosin

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

Alpha-1A blockers

A

Tamsulosin
Silodosin
Alfuzosin

(more specific and less likely to cause orthostatic hypotension)

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

Alpha-Blockers: ADEs

A
  • Dizziness
  • Nasal congestion
  • Orthostatic hypotension
  • Retrograde ejaculation
  • Floppy iris syndrome*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

5-alpha reductase inhibitors: MOA

A
  • block conversion of testosterone to DHT
  • Decrease prostate size/volume
  • Increase urinary max flow rates
  • Decrease risk of BPH progression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When would you tell your patient to expect results if you were starting them on a 5-alpha reductase inhibitor?

A

can take 6 months to see effect

alpha blockers are much quicker to give benefit

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

Which medication lowers PSA by 50% and is most beneficial in large prostates with PSA >1.4?

A

5 alpha reductase inhibitors

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

Name 2 examples of 5 alpha reductase inhibitors

A
  1. Finasteride

2. Dutasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

5 alpha reductase inhibitors: ADE

A
  • impotence
  • Decreased libido
  • Lower ejaculatory volume
  • Gynecomastia
17
Q

Which is the only PDE5-inhibitor that is approved for BPH and erectile dysfunction?

A

Tadalafil (cialis)

18
Q

What is the gold standard surgery for BPH?

A

TURP - Transurethral Resection of Prostate

19
Q

TURP complications/side effects

A
  1. Retrograde ejaculation
  2. TUR syndrome (Hyponatremia, confusion, hypertension, visual changes)
  3. Hematuria
20
Q

What is the main benefit or reason why one would elect for a Photoselective Vaporization of Prostate proceedure?

A

-can be done safely on anticoagulation patient

21
Q

Holmium Laser Enucleation of Prostate

A

Good for large prostates that previously could only be done with open surgery

22
Q

What are some endocrine issues that could lead to erectile dysfunction?

A

Hyperprolactinemia*
Thyroid disorder
Hypogonadism

23
Q

Name some medications that can cause ED?

A

Antihypertensives ** (beta blockers, thiazides, clonidine, methyldopa)

Antidepressants and antipsychotics (ex. TCAs, MAo-Is, Lithium)

24
Q

Name the medications that can reduce testosterone (3)

A
  1. Cimetidine
  2. Spironolactone
  3. Ketoconizole
25
Q

What can nocturnal penile tumescence help determine?

A

whether the ED is physiologic or psychologic

26
Q

What is the best test to look for arterial insufficiency?

A

Penile duplex Doppler sonography

27
Q

What is the best test to look for venous leak?

A

Cavernosometry/Cavernosography

28
Q

Name some important initial measures for ED?

A
  • Deterime if heart is healthy enough for sex
  • Stop smoking
  • Lose weight
  • Moderate alcohol
  • Change meds (if indicated)
29
Q

What are contraindicated with phosphodiesterase-5 inhibitors?

A

nitrates

30
Q

PDE-5 Inhibitors MOA

A

block PDE-5, allowing c-GMP to continue vasodilating

31
Q

What is important to remember about using PDE-5 inhibitors and alpha blockers?

A

lowest dose of each, separate doses

32
Q

PDE-5 side effects

A
  • nasal congestion
  • facial flushing
  • headache
  • dyspepsia
  • back pain
  • visual changes/loss of vision
33
Q

What is important to remember about proper use of the VED

A

remove constricting ring after intercourse

34
Q

Medicated urethral system for erection (MUSE)

A

Alprostadil

  • prostaglandin E-1
  • First dose under medical supervision (3% will have hypotension)
35
Q

Penile injection

A
  • Alprostadil or (Prostaglandin E1 + Phenotolamine + Papaverine)
  • MAX of 3 per week
  • First dose under medical supervision
36
Q

Priaprism

A

> 4 hours

  • Pain, stasis, hypoxia to cavernosal tissues, acidosis, fibrosis
  • EMERGENCY!!
37
Q

Priaprism: Tx

A
  • Aspirate with 18 gauge needle

- Inject phenylephrine (vasoconstrictor)

38
Q

Penile Prothesis: non-inflatable

A
  • malleable or semi-rigid

- two rods that can be bent into and out of position of use

Foundations III (34 decks)

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