Which is the most reasonable first step in the treatment of older men with erectile dysfunction?- Skildor

Question 1 of 5

Which is the most reasonable first step in the treatment of older men with erectile dysfunction?

A. Sex therapy B. Testosterone C. Yohimbine D. Sildenafil

Correct Answer: B

Rationale: Testosterone therapy should be considered first if a deficiency is identified, as low testosterone can contribute to erectile dysfunction.

Question 2 of 5

An 82-year-old woman with a history of hypertension and type 2 diabetes mellitus presents after collapsing at home. What diagnostic test should be done first?

A. Complete blood count and basic metabolic panel B. A STAT noncontrast head computed tomography (CT) C. A two-dimensional echocardiogram D. Urinalysis

Correct Answer: B

Rationale: Noncontrast CT is essential for evaluating potential stroke.

Question 3 of 5

This contagious disease causes fever, headache, stiff neck, photophobia, nausea, vomiting, and altered mental status. What immunization prevents this?

A. Meningococcal vaccine B. Pneumococcal vaccine C. Measles, Mumps, and Rubella (MMR) vaccine D. Varicella vaccine

Correct Answer: A

Rationale: The meningococcal vaccine prevents infections that cause meningitis.

Question 4 of 5

Risk factors for elder mistreatment include all except:

A. Physical disability of patient B. Dementia of patient C. Caregiver burden D. Substance abuse of caregiver

Correct Answer: E

Rationale: Financial independence of the caregiver is not a recognized risk factor for elder mistreatment.

Question 5 of 5

On admission to the hospital, an 85-year-old woman was found to have a fungating mass on her right breast. The mass is 9 cm in diameter, partially ulcerated, and associated with edema of the arm and obvious pain. The patient has no children and had lived alone until recently, when a neighbor became concerned for what appeared to be a progressive loss of memory and neglect of the house. A nephew living in another city eventually came to take care of the situation and arranged for the admission. The patient appears confused and withdrawn; her appearance is disheveled, but she seems to be independent in her ADLs. The medical history is negative for any serious illnesses. She was able to drive her own car until shortly before this admission. The nephew does not wish to authorize hospice �right now.� A positron-emission tomography scan was negative for metastatic disease. In addition to determining the cause of her delirium, which of the following is the best way to address the breast mass?

A. Tamoxifen should be initiated immediately. If no response is seen in 3 months, the patient should receive chemotherapy. B. The mass should be biopsied to study hormone receptor and HER2/neu antigen status. C. The patient should undergo surgery as initial treatment. D. The initial treatment should be radiation therapy.

Correct Answer: E

Rationale: Given the patient's age and condition, the best approach is to avoid aggressive treatment and focus on symptom management.