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A 34-Year-Old Man Comes to the Office Due to a Persistent

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A 34-year-old man comes to the office due to a persistent, painful erection for 12 hours without sexual stimulation.  He has had no trauma to the perineal region.  Over the past few months, the patient has also had fatigue.  He has no prior medical conditions and takes no medications.  Family history is significant for stroke in his father and hypothyroidism in his mother.  The patient does not use tobacco, alcohol, or illicit drugs.  Temperature is 36.8 C (98.2 F) , blood pressure is 120/78 mm Hg, and pulse is 100/min.  There is no lymphadenopathy.  Cardiopulmonary examination is normal.  The liver and spleen are palpable.  The penis is erect, is tender, and has venous engorgement.  The remainder of the examination shows no abnormalities.  The patient is given appropriate treatment, with reduction of symptoms.  Which of the following is the most appropriate diagnostic test to identify the cause of this patient's symptoms?


Definitions:

Internal Carotid Artery

A principal blood vessel that delivers blood to the brain, eyes, and additional areas of the head.

Radial Artery

A major artery in the forearm that supplies blood to the lateral aspect of the hand and the thumb.

Coronary Artery

An artery supplying blood to the heart muscle itself, essential for providing oxygen and nutrients.

Subclavian Artery

A major artery that supplies blood to the thorax, upper limbs, and head.

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