1. The most severe complications of intracavernosal injections are:

Α. inflammation of the corpora cavernosa

Β. haematoma

C. priapism

D. urethral injury

Ε. penile oedema

 

2. Intracavernosal injections are more effective, when used in men with:

Α. Diabetes Mellitus

Β. fibrosis of the corpora cavernosa

C. mild vasculopathy

D. hypertension

Ε. neurogenic disorder

 

3. The action mechanism of prostagladin:   

Α. is indirect, blocking α-adrenergic receptors

Β. is direct, inducing relaxation of smooth muscle fibers

C. inhibits PDE5 (phosphodiesterase type 5)

D. has central effect

Ε. none of the above  

 

4. To treat priapism after the use of intracavernosal injections, the first step is:

Α. intracavernosal administration of a sympathomimetic agent

Β. bloodletting

C. cold packs

D. invasive manipulation

 

5. The most common adverse event of intracavernosal injections is: 

Α. priapism

Β. haematoma

C. oedema

D. drop of blood pressure

Ε. pain

F. allergic reaction

 

6.  PDE5 inhibitors act by:

Α. reducing cGMP degradation

Β. reducing NO composition

C. reducing cGMP intracellular levels

D. increasing free calcium levels

 

7. A 50-year old hypertensive patient reports that he has tried a PDE5i without result. The next step would be:

Α. replacement with another PDE5i

Β. intracavernosal injections

C. full history taking concerning the route of drug administration and its dosage

D. immediate discontinuation of the anti-hypertensive regimen

 

8. The 3  available  PDE5 inhibitors:

Α. have similar efficacy

Β. have similar pharmacokinetic features

C. have been approved for daily use

D. differ only with regard to the maximum recommended dose

 

9. PDE5 inhibitors:

Α. should be provided with caution to patients taking nitrates

Β. can be administered independently from food intake

C. must be provided to the maximul tolerated dose before characterizing a patient as "non-responsive" to PDEi

D. is contra-indicated when the patient receives alfuzosin at the same time

 

10. A 45-year old diabetic patient responding initially to sildenafil for about 3 years, reports that his erection is no longer sufficient enough to achieve sexual intercourse.  The next step is to:

Α. increase the dose on demand up to 200mg 

Β. test serum testosterone level

C. check diabetes control

D. test serum testosterone level, control diabetes and re-administrate sildenafil (100mg)

 

11. What do shock waves cause to corpora cavernosa?

Α.  Activation of NO

Β. Activation of Cgmp

C. Proliferation of smooth muscle fibers

D. Neovascularisation of the corpora cavernosa

Ε. None of the above

 

12.  Shock wave therapy is used in......

Α. Renolithiasis

Β. Chololithiasis

C. Peyronie's disease

D. Myocardial ischaemia

Ε. all the above

 

13. In a patient who does not respond to PDE5 inhibitors, what do we expect from fhe shock-wave therapy? 

Α. Functional restoration

Β. Improvement, but also need for supplementary use of PDE5i for functional erection

C. There is not rellay any clinically significant improvement

D. All the above are equally possible to occur

 

14. In a patient with moderate insufficiency of the corpora cavernosa, what do we expect from the shock-wave therapy?  

Α. Functional restoration

Β. Improvement, but also need for permanent use of PDE5i for functional erection

C. No clinically significant improvement

D. All the above are equally possible to occur

 

15. A 67-year old hypertensive patient with erectile dysfunction for 5 years, was prescribed with sildenafil 100mg. The patient took tablets at 10 different instances always with empty stomach and at least 1 hour before sexual contact. 5 out of 10 times, his erection was satisfactory with regard to rigidity and duration. Two (2) times his erection was sufficient for penetration, without though satisfactory duration. The other 3 times there was penile tumescence but this was not enough for penetration. This patient is considered:

Α. to respond to sildenafil treatment

Β. not to respond to sildenafil treatment

 

16. According to a prospective, placebo-controlled, crossover clinical study, the add-on therapy with intracavernosal PGE-1 every 2 weeks in patients with partial response even to the maximum sildenafil dose significantly improves IIEF‐EF score by:

Α. 15%

Β. 65%

C. 25%

D. 30%

 

17. Choose the correct answer.

Α. Intrapenile injections are highly effective and result in patients' high satisfaction.

Β. Intrapenile injections may achieve high satisfaction but may also lead to  withdrawal.

C. Priapism occurs in 20% of patients using intrapenile injections.

D. Fibrosis of the corpora cavernosa occurs more often when there is also papaverine in the mixture.

 

18.  Choose the correct answer.

Α. The infection rate in intrapenile prostheses is 20%.

Β. Prosthesis with antiobiotic prophylaxis is absolutely indicated in diabetic patients.

C. The antibiotic prophylaxis does not prevent the formation of biofilm upon the prosthesis. 

 

19. Choose the correct answer

Α. The prosthesis provides the highest satisfaction rate for the sexual partner. 

Β. The prosthesis has a  reintervention rate >30% within the first 5 years.

C. Penile prosthesis is contra-indicated in diabetic patients. 

 

 

20. Which of the following is required in order to have erection achieved?

Α. Sexual arousal

Β. Communication between brain nerves and penile nerves

C. Relaxation of blood vessels supplying the penis

D. All the above

 

21. All medications mentioned below may cause erectile dysfunction, apart from:

Α. antihypertensives

Β. antifungals

C. tranquillizers

D. anithistamines

 

22. Which hormonal factor is not required in order to assess erectile dysfunction?

Α. ACTH

Β. Prolactin

C. TSH

D. Τestosterone

 

23. Pharmaceutical agents for the treatment of erectile dysfunction act by inhibiting the PDE5 action, which is responsible for:

Α. testosterone degradation

Β. degradation of cyclic-GMP  in the penis

C.degradation of NO in the penis

D. None of the above

 

24. A 50-year hypertensive man visits the Urologist due to erectile dysfunction. He tried a PDE5 inhibitor with no result.  The next step should be: 

Α. to use another PDE5 inhibitor

Β. to switch to intracavernosal injections

C. to check thoroughly the drug administration route and dosage

D. to discontinue immediately the antihypertensive regimen

 

25. Which of the factors below contribute to the emergence of erectile dysfunction?

Α. Depression and unemployment

Β. Hypertension and heart diseases

C. Diabetes

D. All the above

 

26. Which of the conditions below may be related to normal erectile function?

A. Mild arterial insufficiency with normal venous closure mechanism

Β. Severe arterial insufficiency with normal venous closure mechanism

C Normal arterial blow with insufficient venous closure mechanism

D. All the above

 

27. Which of the below factors play a role in normal erection?

Α. Haemodynamics of the corpora cavernosa

Β. Biomechanical properties of tissues

C. Geometry of the penis

D. All the above

 

28. Why does the relaxation of a few cavernosous muscle fibres  induce erection?

Α. Because the two corpora cavernosa communicate with each other

Β. Because there are gap junctions among smooth muscle fibers

C. Because the drug diffuses

D. None of the above

 

29. What pO2 values of the penis are required to achieve erection?

Α. <20mmHg

Β. 40-50mmHg

C. 60-70mmHg

D. >80mmHg

                                                                                                                                                                        

Correct answers

1C	9 C	17 D	25 D
2 Ε	10 D	18 Β	26 Α
3 Β	11 D	19 Α	27D
4 Β	12 Ε	20 D	28 Β
5 Ε	13 Β	21 Β	29 D
6 Α	14 D	22 Α
7 C	15 Α	23 Β
8 Α	16 Β	24C