A 65-Year-Old Man Comes to the Office with a 1-Year

question 584

Multiple Choice

A 65-year-old man comes to the office with a 1-year history of erectile dysfunction and decreased libido.  He has hypertension that was diagnosed 5 years ago and is controlled with diet.  The patient has no history of cardiac problems, unexpected weight loss, visual changes, or symptoms of neuropathy.  Family history is unremarkable.  On examination, there is minimal bilateral gynecomastia without galactorrhea.  Genitourinary examination shows decreased testicular size.  The remainder of the physical examination, including visual fields on confrontation, is unremarkable.  Laboratory results are as follows: Repeat early-morning testosterone level is 162 ng/dL.  Which of the following is the best next step in management of this patient?

• A)Angiography of the deep arteries of the penis
• B)Measurement of serum prolactin level
• C)Measurement of transferrin saturation
• D)Sildenafil treatment
• E)Testosterone therapy

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Definitions:

Cerebellum

A region of the brain that plays an important role in motor control, coordination, and sensory integration.

Mammalian Brain

The complex brain structure found in mammals, characterized by a well-developed neocortex, prefrontal cortex, and various other specialized areas.

Lips

Lips are soft, movable, and serve as the opening for food intake and in the articulation of sound and speech in the human body.