A 49-Year-Old Man Comes to the Physician to Discuss Poor

question 253

Multiple Choice

A 49-year-old man comes to the physician to discuss poor sexual performance.  He has been unable to sustain erections for the past year.  In the last 2 months, he has not had any erections at all, including at night or when he wakes up in the morning.  Past medical history is significant for type 2 diabetes mellitus, hyperlipidemia, and chronic exertional buttock and thigh pain.  His medications include insulin detemir and atorvastatin.  The patient works as a truck driver and leads a sedentary lifestyle.  He has smoked 1½ packs of cigarettes daily for the past 30 years.  His blood pressure is 134/68 mm Hg and pulse is 78/min.  His BMI is 32 kg/m².  Heart sounds are normal.  There is no evidence of sensory loss over the lower extremities.  Which of the following is the best next step in management of this patient?

• A)Measure ankle-brachial index
• B)Obtain cystoscopy and pelvic ultrasound
• C)Obtain serum testosterone levels
• D)Prescribe phosphodiesterase-5 inhibitor
• E)Prescribe serotonin reuptake inhibitor

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Definitions:

Total Product

The total output of goods or services produced by a firm in a given period of time.

Marginal Product

The additional output resulting from using one more unit of a particular input, holding all other inputs constant.

Unit of Labor

A measure of labor input, often referred to as one hour of work by an employee or worker.

Marginal Product

The additional output resulting from the use of one more unit of a production input.