5 Written Questions

1. - hormone replacement therapy with testosterone injections or topical patches
   - for androgen deficiency and do not have prostate cancer
   - relaxes arterioles and smooth muscles of the cavernosum => tumescence (swelling) => erection lasts from 30 mins to 4 hours
2. - selective phosphodiesterase type 5 inhibitor
   - relax smooth muscle => blood flow into penis
   - action lasts for 36 hours but erection only occurs with sexual stimulation
   - should not taken concurrently with nitrates alpha-blockers, erythromycin or rifampicin (antibiotics), ketoconazole, intraconazole (antifungals) or protease inhibitors (HIV)
3. - Revascularization: results often temporary
   - Penile prostheses implant: more common, most satisfied end results, rated inflatable type highest
4. - advancing age
   - diseases: heart disease and diabetes
   - trauma
   - use of prescription or illicit drugs
5. - injectable med that treat ED
   - may be injected into penis or palced in the urethra as a minisuppository

5 Multiple Choice Questions

1. - draws blood into penis with a vaccum => trap it there with a constricting band for intercourse => the device is removed for intercourse
   - an O-ring is left at the base of penis to maintain an erection
   - an o-ring alone is suitable for men that can attain an erection but cannot maintain it
   1. Erectile Dysfunction
   2. Alprostadil (Caverject)
   3. Surgical treatment for ED
   4. Vacuum Constriction Device (VCD)
2. - blood chemistry, testosterone, prolactin, thyroxin and prostate specific antigen (PSA) are measured
   - to identify metabolic and endocrine factors
   1. Clinical manifestation of Erectile Dysfunction
   2. Diagnostic Blood Test for Erectile Dysfunction
   3. Erectile Dysfunction
   4. Risks factors of Erectile Dysfunction
3. - helps differentiate between pyschogenic and organic causes
   1. Nocturnal penile tumescence and rigidity (NPTR) Monitoring
   2. Age-related changes in sexual function in men
   3. Clinical manifestation of Erectile Dysfunction
   4. Cavernosometry and cavernosography of the corpora
4. - testes become less firm
   - less testosterone starting at age 50
   - increase level of FSH and LH
   - cellular and tissue changes in penis, decreased sensory activity and hypogonadism (leads to decreased testosterone levels)
   - penis become less rigid in erection (decreased distensibility) because of changing elastic collagen into more rigid collagen => interferes with the veno-occlusive mechanism => blood leaks from penis into general vasculature prematurely => incomplete erection
   - decrease in vibrotactile sensation over the skin of penis => longer stimulation for erection
   - other issues: chemical substance including prescription drugs => decreases blood flow to penis
   - damage to arteries, smooth muscles and fibrous tissues => impotence
   1. prostaglandin E injections
   2. Erectile Dysfunction
   3. Risks factors of Erectile Dysfunction
   4. Age-related changes in sexual function in men
5. - hormone replacement therapy with testosterone injections or topical patches
   - for androgen deficiency and do not have prostate cancer
   - functions similar to papaverine with relaxes arterioles and smooth muscles of the cavernosum => tumescence (swelling) => erection lasts from 30 mins to 4 hourswith less side effects
   - high attrition rate: lack of spontaneity, loss of interest in sex, physical limitations, cost and occasional pain
   1. papaverine
   2. Alprostadil (Caverject)
   3. prostaglandin E injections
   4. Erectile Dysfunction

5 True/False Questions

1. Impotence → - used synonymously with erectile dysfunction, may involve:
   a. total inability to achieve erection,
   b. inconsistent ability to achieve erection or
   c. the ability to sustain only brief erections

   True        False

2. Erectile Dysfunction → - inability of the male to attain and maintain an erection sufficient to permit satisfactory sexual intercourse
   - may causes, may nor may not associate with a loss of libido
   - incidence of problems increases with age

   True        False

3. Sildenafil citrate (Viagra) and Hydrochloride (Levitra) → - Revascularization: results often temporary
   - Penile prostheses implant: more common, most satisfied end results, rated inflatable type highest

   True        False

4. Cavernosometry and cavernosography of the corpora → - hormone replacement therapy with testosterone injections or topical patches
   - for androgen deficiency and do not have prostate cancer
   - functions similar to papaverine with relaxes arterioles and smooth muscles of the cavernosum => tumescence (swelling) => erection lasts from 30 mins to 4 hourswith less side effects
   - high attrition rate: lack of spontaneity, loss of interest in sex, physical limitations, cost and occasional pain

   True        False

5. Clinical manifestation of Erectile Dysfunction → - advancing age
   - diseases: heart disease and diabetes
   - trauma
   - use of prescription or illicit drugs

   True        False