Trigger - Male sexual dysfunction

Question 1

what contracts during ejaculation

Answer 1

epididymis
vas deferens
seminal vesicles
prostate

bulbocavernosus and ischiocavernoso

Question 2

norepinephrine and endothelin play what role in male sexual function

Answer 2

mediates detumescence (smooth muscle contraction increasing venous outflow, restoring flaccid state)

Question 3

failure to initiate erection can be due to what kind of cause

Answer 3

psychogenic, endocrinologic, neurogenic

Question 4

failure to fill penile tissue is d/t what kind of cause

Answer 4

arteriogenic

Question 5

what disease decreases NO synthesis?

Answer 5

DM

also causes vascular disease and neuropathy. basically kills erections from all three directions

Question 6

this etiology results in inhibition of reflexogenic responses and/or increases in smooth muscle tone

Answer 6

psychogenic

Question 7

relaxation of what allows increased blood flow into the penis and therefore erection

Answer 7

corpora cavernosa

Question 8

what compresses venous return during an erection

Answer 8

trabecular smooth muscle

Question 9

if a patient has no response to direct injection of vasoactive medication, what is suggested and what tests should be done to follow up

Answer 9

• respone = non-intact vasculature

should do duplex US, cavernosography, and arteriography

Question 10

a patient with unstable CHF and untreated OSA is not eligible for what type of ED treatement

Answer 10

testosterone therapy

also not eligible:
- prolatinomas
- erythrocytosis
- any conditions suggesting prostate cancer or BPH
- breast cancer

Question 11

which testosterone replacement therapy is expensive

Answer 11

topical cream

injectable is NOT the expensive type

Question 12

which testosterone replacement therapy causes fluctuations in serum levels of testosterone

Answer 12

testosterone injections

Question 13

spermatogenesis suppression is a SE of what ED treatment

Answer 13

testosterone replacement therapy

Question 14

steroids, GnRH agnonists/antagonists and warfarin are all DDI for what ED med

Answer 14

testosterone replacement therapy

Question 15

what medications MOA is to inhibit the degradation cGMP which allows sustained blood flow to the penis

Answer 15

PDE-5 inhibitors

Question 16

longest acting PDE5 inhibitor

Answer 16

tadalafil - 36 hrs

Question 17

what is the shortest onset of action PDE 5 inhibitor

Answer 17

avanafil - 30 min

Question 18

which med has a SE for anterior optic neuropathy, hearling loss, and vision changes

Answer 18

PDE 5 inhibitors

literally for these just think HEENT

Head - headache, flushing
Ears - hearing loss
Eyes - vision chnages, anterior optic neuropathy
Nose - congestion or rhinitis
Throat - dyspepsia

then add hypotension and priapism

Question 19

what medication is CI for NTG or nitrates of any form AS WELL AS CV disease with risk for CV event with sex

Answer 19

PDE-5 inhibitors

Question 20

DDI for antifungals and alpha blockers

Answer 20

PDE5 inhibitors

also nitrates

Question 21

SE of this med include dizziness, fibrosis, infection, bruising, and pain

and of course… priapism

Answer 21

injectable prostaglandins

Question 22

what ED treatment inhibits ejaculation

Answer 22

Vacuum devices

Question 23

what are surgical procedures that are completed on the proximal artery of the penis

Answer 23

endarterectomy and balloon dilation

Question 24

what are surgeries that are done on the distal artery of the penis

Answer 24

arterial bypass

Question 25

what part of the penis are penile prosthesis implanted into

Answer 25

corpora cavernosa

Question 26

paroxetine is 1st line treatment for what disorder

Answer 26

premature ejaculation

Question 27

what is the most effective treatemnt for premature ejaculation

Answer 27

combo of pharm + counseling

Question 28

imipramine, chlorpheniramine and pseudophedrine are used in the treatment of what disorder

Answer 28

retrograde ejaculation

only treated if fertility is desired!