A 66-year-old gentleman presents to a new primary care physician to establish care after a recent relocation. His past medical history is significant for gout, erectile dysfunction, osteoarthritis of bilateral knees, mitral stenosis, and diabetic peripheral neuropathy. He denies any past surgeries along with the use of any tobacco, alcohol, or illicit drugs. He has no known drug allergies and cannot remember the names of the medications he is taking for his medical problems. He states that he has recently been experiencing chest pain with strenuous activities. What part of the patient's medical history must be further probed before starting him on a nitrate for chest pain?
AErectile dysfunction
BDiabetic peripheral neuropathy
CGout
DArthritis
EMitral stenosis
A 70-year-old male presents to his primary care provider complaining of decreased sexual function. He reports that over the past several years, he has noted a gradual decline in his ability to sustain an erection. He used to wake up with erections but no longer does. His past medical history is notable for diabetes, hyperlipidemia, and a prior myocardial infarction. He takes metformin, glyburide, aspirin, and atorvastatin. He drinks 2-3 drinks per week and has a 25 pack-year smoking history. He has been happily married for 40 years. He retired from his job as a construction worker 5 years ago and has been enjoying retirement with his wife. His physician recommends starting a medication that is also used in the treatment of pulmonary hypertension. Which of the following is a downstream effect of this medication?
AIncrease cGMP degradation
BIncrease cAMP production
CIncrease PDE5 activity
DDecrease nitric oxide production
EDecrease cGMP degradation
A 70-year-old man presents to an urgent care clinic with bilateral flank pain for the past 2 days. During the last week, he has been experiencing some difficulty with urination, which prevented him from leaving his home. Now, he has to go to the bathroom 4–5 times per hour and he wakes up multiple times during the night to urinate. He also complains of straining and difficulty initiating urination with a poor urinary stream. The temperature is 37.5°C (99.5°F), the blood pressure is 125/90 mm Hg, the pulse is 90/min, and the respiratory rate is 18/min. The physical examination showed bilateral flank tenderness and palpable kidneys bilaterally. A digital rectal exam revealed a smooth, severely enlarged prostate without nodules. A CT scan is obtained. He is prescribed a drug that will alleviate his symptoms by reducing the size of the prostate. Which of the following best describes the mechanism of action of this drug?
A5-alpha reductase inhibitor
BCholinergic agonist
CAnticholinergic
DPhosphodiesterase-5 inhibitors
EAlpha-1-adrenergic antagonists
+ 7 more in the PDF
Browse all chapters