Question 1

Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men?&#10;A) Age-related decrease in cognitive functioning&#10;B) Metabolic syndrome&#10;C) Decreased muscle mass in aging men&#10;D) All of the above&#10;

Accepted Answer

Research supports that testosterone replacement therapy may be indicated in men with age-related decrease in cognitive functioning, metabolic syndrome, and decreased muscle mass in aging men. However, it is important to note that the decision to use testosterone replacement therapy should be based on individualized assessment of benefits and risks, and should only be prescribed by a qualified healthcare provider.

Question 2

When assessing a male for hypogonadism prior to prescribing testosterone replacement, serum testosterone levels are drawn:&#10;A) Without regard to time of day&#10;B) First thing in the morning&#10;C) Late afternoon&#10;D) In the evening&#10;

Accepted Answer

Testosterone levels in males are highest in the morning and lowest in the evening. Therefore, it is recommended to draw serum testosterone levels first thing in the morning, typically between 8-10 am, to obtain the most accurate representation of a patient's testosterone levels.

Question 3

Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include:&#10;A) Diabetics&#10;B) Those who have had an acute myocardial infarction in the past 6 months&#10;C) Patients who are deaf&#10;D) Patients under age 60 years of age&#10;

Accepted Answer

Patients who have had an acute myocardial infarction in the past 6 months should not be prescribed PDE-5 inhibitors due to the potential increased risk of cardiovascular events. Diabetics and patients under age 60 can be prescribed PDE-5 inhibitors if there are no contraindications. Deafness is not a contraindication for PDE-5 inhibitor use.

Question 4

While on testosterone replacement, hemoglobin and hematocrit levels should be monitored. Levels suggestive of excessive erythrocytosis or abuse are:&#10;A) Hemoglobin 14 g/dl or hematocrit 39%&#10;B) Hemoglobin 11.5 g/dl or hematocrit 31%&#10;C) Hemoglobin 13 g/dl or hematocrit 38%&#10;D) Hemoglobin 17.5 g/dl or hematocrit 54%&#10;

Accepted Answer

Hemoglobin levels greater than 17.5 g/dl or hematocrit levels greater than 54% suggest excessive erythrocytosis and may be indicative of testosterone abuse. It is important to monitor these levels to ensure patient safety and prevent potential adverse effects such as thromboembolic events.

Question 5

When prescribing phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil (Viagra) patients should be screened for use of:&#10;A) Statins&#10;B) Nitrates&#10;C) Insulin&#10;D) Opioids&#10;

Accepted Answer

Patients should be screened for use of nitrates when prescribing PDE-5 inhibitors such as sildenafil (Viagra) due to the risk of severe hypotension. Nitrates can be found in various medications used to treat angina and heart disease, such as nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Co-administration of nitrates and PDE-5 inhibitors can result in a dangerous drop in blood pressure.

Question 6

The goal of testosterone replacement therapy is:&#10;A) Absence of all hypogonadism symptoms&#10;B) Testosterone levels in the mid-normal range 1 week after an injection&#10;C) Testosterone levels in the mid-normal range just prior to the next injection&#10;D) Avoidance of high serum testosterone levels during therapy&#10;

Accepted Answer

The answer of The goal of testosterone replacement therapy is:&#10;A)...

Question 7

Monitoring of male patients who are using phosphodiesterase type 5 (PDE-5) inhibitors includes:&#10;A) Serum fasting glucose levels&#10;B) Cholesterol and lipid levels&#10;C) Blood pressure&#10;D) Complete blood count&#10;

Accepted Answer

Monitoring blood pressure is important for patients using PDE-5 inhibitors because these medications can cause a drop in blood pressure, especially in combination with nitrates. Serum fasting glucose levels, cholesterol and lipid levels, and complete blood count are not routinely monitored for patients using PDE-5 inhibitors.

Question 8

Men who are prescribed phosphodiesterase type 5 (PDE-5) inhibitors for erectile dysfunction should be educated regarding the adverse effects of the drug which include:&#10;A) Hearing loss&#10;B) Hypotension&#10;C) Delayed ejaculation&#10;D) Dizziness&#10;

Accepted Answer

The answer of Men who are prescribed phosphodiesterase type 5...

Question 9

The factor that has the greatest effect on males developing male sexual characteristics is:&#10;A) Cultural beliefs&#10;B) Effective male role models&#10;C) Adequate intake of testosterone in the diet&#10;D) Androgen production&#10;

Accepted Answer

Androgen production is the factor that has the greatest effect on males developing male sexual characteristics. Androgens are male sex hormones, such as testosterone, that are primarily produced in the testes. They are responsible for the development of male reproductive organs, secondary sexual characteristics, and sex drive in males. While cultural beliefs and effective male role models may have some influence on males developing male sexual characteristics, they do not have as significant an impact as androgen production. Adequate intake of testosterone in the diet is also not a major factor since most testosterone is produced by the body rather than obtained through food.

Question 10

Monitoring of an older male patient on testosterone replacement includes:&#10;A) Oxygen saturation levels at every visit&#10;B) Serum cholesterol and lipid profile every 3 to 6 months&#10;C) Digital rectal prostate screening exam at 3 and 6 months after starting therapy&#10;D) Bone mineral density at 3 months and 6 months after starting therapy&#10;

Accepted Answer

Testosterone replacement therapy in older males requires monitoring for prostate health, hence digital rectal exams are recommended to check for prostate abnormalities.

Deck 49: Men As Patients