Help
Options
Question
Define erectile dysfunction
click to flip
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Question
Most cases of male erectile disorders have __ cause
Remaining cards (83)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
DU PA BPH, ED, Prost
Duke PA BPH, ED, Prostatitis
| Question | Answer |
|---|---|
| Define erectile dysfunction | Consistent inability to maintain an erect penis with sufficient rigidity to allow sexual intercourse |
| Most cases of male erectile disorders have __ cause | Organic rather than psychogenic |
| The neurotransmitters that initiate and contribute to male erection include__ | Nitric oxide, vasoactive intestinal peptide, acetylcholine, and prostaglandins |
| A loss of libido may indicate __ | androgen deficiency on the basis of either hypothalamic, pituitary, or testicular disease. |
| Loss of erections may result from __ | Arterial, venous, neurogenic, or psychogenic causes |
| Many medications, especially __ are associated with erectile disorders | Antihypertensives |
| __ medications rarely alter erections | Vasodilators, alpha blockers, and diuretic |
| Centrally acting sympatholytics (methyldopa, clonidine, reserpine) can result in __ | Loss of erection |
| Beta blockers, and spironolactone may result in __ | Loss of libido |
| The gradual loss of erectile function over a period of time is more indicative of __ | Organic causes of erectile dysfunction |
| __ prior to intercourse has been effective in delaying ejaculation | Clomipramine 25 mg |
| A complete recording of drug use should be made, since about __% of all cases of sexual dysfunction may be drug related | 25 |
| What laboratory values should be assessed with erectile/sexual dysfunction | CBC, U/A, lipids, serum testosterone, glucose, prolactin |
| What further labs are needed if a patient has abnormal levels of testosterone or prolactin | LH, and FSH to help localize the site of the disease to the hypothalamus, pituitary, or testes |
| What is the initial point in the pathway leading to penile erection | Sexual stimulation (psychogenic or tactile) |
| Sexual stimulation causes the release of __ by the cavernous nerves into the neuromuscular junctions | Nitric oxide |
| To achieve an erection decreased smooth muscle Ca+ concentration leads to __ | Muscular relaxation, cavernosal artery dilation, and increased blood flow |
| Psychogenic causes of ED are now thought to represent <__% of patients seen by ED specialists | 15 |
| What is the anatomic site now believed to be the most common cause of ED | Neuromuscular junction where the cavernosal nerves meet the smooth muscle and endothelium of the deep cavernous penile arteries |
| Testosterone plays a __ role in erectile dysfunction | Permissive |
| What is the most common endocrine disorder affecting erectile ability | Diabetes mellitus |
| What is the most important effect that diabetes has on erectile ability | Loss of function of long autonomic nerves |
| Because of the uncommon occurrence of __ conditions in persons seeking treatment of ED, testing of theses axes is not part of the routine workup of ED | thyroid and adrenal |
| 90% of patients with ED respond to injected vasodilatory agents indicating that __ is not the cause of most cases of ED | Atherosclerotic arterial narrowing |
| Afferent somatic sensory signals are carried from the penis via the __ | pudendal nerve to S2-S4 |
| The paired cavernosal nerves penetrate the corpus cavernosa and innervate the __ | Cavernous artery and veins |
| Sympathetic innervation originates in the intermediolateral gray matter at what levels | Thoracolumbar levels T10-L2 |
| What is the most effective long term option for impotence treatment | Penile prosthesis |
| >__% of all men will develop histological evidence of BPH during the course of their lifetime | 90 |
| __% of men with BPH will develop symptoms that will lead them to seek treatment | 50 |
| Lower urinary tract symptoms can be divided into what two categories | Obstructive voiding symptoms and irritative voiding symptoms |
| What hormone is believed to be responsible for the development and maintenance of the hyperplastic cell growth characteristics of BPH | Dihydrotestosterone |
| The development of BPH occurs predominantly in the __ | Periurethral prostatic tissue referred to as the transition zone |
| Tissue growth in the transition zone of the prostate leads to what phenomenon | Bladder outlet obstruction |
| What is the American Urological Association (AUA) symptom index for BPH | A self administered validated questionnaire consisting of seven questions related to the symptoms of BPH and BOO |
| An AUA score of __ is considered mild | 0-7 |
| An AUA score of __ is considered moderate | 8-19 |
| An AUA score of __ is considered severe | 20-35 |
| What is the preferred first line treatment option for patients diagnosed with LUTS from BPH | Medical management |
| Medical management is initiated for patients with __ AUA scores | Moderate to severe |
| What are the indications for surgery in a patient with LUTS from BPH | Refractory urinary retention, hydronephrosis with/ without renal impairment, recurrent UTI, recurrent gross hematuria, or bladder calculi; renal insufficiency; large postvoid residual volume |
| What is the driving factor for treatment of LUTS due to BPH | The amount to which the patients symptoms are bothersome to him |
| What are the most common prescribed medication for the treatment of LUTS associated with BPH | Alpha-adrenergic antagonists (doxazosin, terazosin, tamsulosin, and extended release alfuzosin) |
| This regimen is most effective in reducing symptoms and preventing disease progression in patients with large prostate glands (>40g) | 5a reductase inhibition (finasteride and dutasteride) |
| What are the most widely used and studied phytotherapeutic extracts used for the treatment of LUTS associated with BPH | Saw palmetto berry |
| What is considered the gold standard for surgical treatment of BPH | Transurethral Resection of the Prostate (TURP) |
| What does TUMT stand for | Transurethral microwave thermotherapy, one of the most widely studied minimally invasive methods of treating symptomatic BPH |
| What does TUNA stand for | Transurethral Needle Ablation |
| What are the major benefits of the minimally invasive therapies for BPH (TUMT, Tuna) over the more invasive TURP | The reduction in bleeding, fluid absorption, the risks associated with general or spinal anesthesia, decreased rates of incontinence, ED, bladder neck contractures, and urethral strictures, reduce hospital stay |
| What is the success rate for the heat based minimally invasive therapies for BPH | 65-75% of patients with symptomatic reduction and flow rate improvement |
| What procedure produces the greatest improvement in both urinary flow rates and symptom score for BPH | TURP |
| What complications are all higher with TURP than the less invasive therapies for BPH | Urinary incontinence, retrograde ejaculation, and urethral stricture |
| __ is reserved for patients with severely large prostate glands | Open surgical enucleation (prostatectomy) |
| Prostatitis is an extremely common clinical condition resulting in __% of office visits to a urologist | 25 |
| What is the most common urologic diagnosis in men younger than 50 years and is the third most common diagnosis in men older than 50 years | Prostatitis |
| What is the most common symptomatic type of prostatitis and may be the most prevalent of all the prostate disorders | Chronic nonbacterial prostatitis CPPS |
| Patients with acute bacterial prostatitis usually present with what symptoms | Fever, chills, dysuria, perineal and low back pain |
| __ are recommended for the treatment of acute bacterial prostatitis because they reach excellent tissue levels within the prostate | Fluoroquinolones |
| Although bacterial resistance and conversion to CBP is low it is beneficial to obtain __ | Follow up urine culture to document clearance of the infection |
| __ is associated with inflammation of the prostate gland and recurrent urinary tract infections with bacteria localized to the prostate via standardized localization testing | CBP |
| Symptoms of Chronic Bacterial Prostatitis | Nonspecific but include LUTS, pelvic pain and or sexual dysfunction |
| __ are indicated for the treatment of CBP and must be tailored to the specific organism | Trimethoprim-sulfamethoxazole (TMP-SMX) or a fluoroquinolone |
| __ is rarely indicated for patients with CBP | Surgery |
| The NIH category __ makes up the largest percentage of patients with clinical prostatitis | III chronic nonbacterial prostatitis |
| Patients with chronic nonbacterial prostatitis usually exhibit what symptoms | Pain (perineal, low back, suprapubic, groin, scrotal), voiding dysfunction (dysuria, week stream, frequency, urgency, or nocturia), and/or sexual dysfunction (painful ejaculation or low libido) |
| The presence of __ is mandatory for the diagnosis of category III prostatitis | Pelvic pain |
| Noninflammatory CPPS, aka prostadynia is typically seen in __ | Younger males age 20-50 years |
| Patients with prostadynia usually exhibit pelvic pain and voiding symptoms but have __ | Negative urine cultures, normal EPS,, and normal prostate on DRE |
| What is the most common benign tumor in men | Benign prostatic hyperplasia |
| The usual etiologic agents of acute bacterial prostatitis | Gram negative rods such as E. coli and Pseudomonas species |
| How long should antibiotic therapy for acute bacterial prostatitis last | 4-6 weeks |
| Chronic bacterial prostatitis is associated with __ | Recurrent UTI’s |
| DRE findings with chronic bacterial prostatitis | Normal prostate exam |
| What are the symptomatic treatments for chronic bacterial prostatitis | NSAIDS and Sitz baths |
| Acute bacterial prostatitis commonly presents with __ | High fever, severely tender prostate on rectal exam |
| TCA’s can be used to treat pain associated with | Prostatodynia |
| __% of all men suffer from some form of ED | 50 |
| What are the requirements for achieving an erection | Intact penile nervous system, normal musculature, sufficient arterial blood flow (pudendal arteries), adequate resistance to penile venous outflow |
| Considered, by most urologists, as the single most useful tool for diagnosing BPH | AUA symptom index |
| What is the normal size of the adult prostate | 20g |
| The normal prostate is about the size of __ | A walnut |
| Cell proliferation within the __ is the primary cause of prostate gland enlargement | Transition zone |
| The prostate is about __ on the DRE | 2 finger breadths |
| Meares-Stamey 4 glass test is for: | Chronic bacterial prostatitis |
Created by:
bwyche
Popular Medical sets