1
Q
How do erections normally occur?
A
- Neuronal release of NO which, via cGMP and Ca2+
- Relaxes smooth muscle cells, allowing blood to fill
2
Q
Describe ED?
A
- Common after 50yrs old
- Often multifactorial
- Often psychological facet: times of stress, anxiety
3
Q
What are the organic causes of ED?
A
- Big three: smoking, alcohol, diabetes
- Also endocrine, neurological, organ failure and drug causes
4
Q
Name some endocrine causes of ED?
A
- Hypogonadism
- Hyperthyroidism
- Hyperprolactinaemia
5
Q
Name some neurological causes of ED?
A
- Cord lesions
- Multiple sclerosis
- Autonomic neuropathy
6
Q
Name some drug causes of ED?
A
- Digoxin
- Beta blockers
- Diuretics
- Ostrogens
- Antipsychotics
- Antidepressants
- Finasteride
- Narcotics
7
Q
Describe the work up for ED?
A
- Sexual and psychologial history
- U&Es, LFTs, glucose, TFT, LH, FSH, lipids, tesotsterone
8
Q
Describe the management of ED?
A
- Treat causes
- Counselling
- Oral phosphodiesterase (PDE5) inhibitors
- Increase cGMP
- Sildenafil
- Vardenafil
- Increase cGMP
- Vacuum aids
- Prostheses (inflatable or malleable)
9
Q
Problems with sildenafil?
A
- Food and alcohol upset absorption
- SEs:
- Headache
- Flushing
- Dyspepsia
- Stuffy nose
- Transient blue-green tingeing of vision
10
Q
Contraindications of PD5 inhibitors?
A
- Concurrent use of nitrates
- Tachy/bradycardia
- Degenerative retinal disordeers
- Unstable angina/stroke <6 months ago
11
Q
Interactions of PD5 inhibitors?
A
- Nitrates
- Cytochrome P450 inducers
- Macrolides
- Protease inhibitors
- Theophyllines
- Azole antifungals
- Rifampicin
- Phenytoin
- Carbamazepine
- Phenobarbitol
- Grapefruit juice
12
Q
Most common cause of ED?
A
Vascular
Y4: Urology
flashcards
Decks in class (12)
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