Erectile dysfunction (ED) is a common men’s health issue that can significantly impact quality of life and often serves as an early marker for underlying cardiovascular disease. Its management, a key topic in the “Urological Disorders” module of the Patient Care 5 curriculum, revolves around the safe and effective use of pharmacotherapies like PDE-5 inhibitors. This quiz will test your knowledge on the pathophysiology of ED, the pharmacology of its treatments, and the critical counseling points required to ensure patient safety, particularly regarding the absolute contraindication with nitrates.
1. The physiological process of achieving an erection is primarily dependent on the release of what signaling molecule, which leads to smooth muscle relaxation and vasodilation?
- a. Endothelin-1
- b. Angiotensin II
- c. Nitric Oxide (NO)
- d. Norepinephrine
Answer: c. Nitric Oxide (NO)
2. Phosphodiesterase-5 (PDE-5) inhibitors like sildenafil work by:
- a. Directly causing vasodilation without stimulation.
- b. Increasing testosterone levels.
- c. Preventing the breakdown of cyclic GMP (cGMP), thereby enhancing the effect of nitric oxide.
- d. Blocking alpha-1 adrenergic receptors.
Answer: c. Preventing the breakdown of cyclic GMP (cGMP), thereby enhancing the effect of nitric oxide.
3. A patient presents with a new prescription for sildenafil. Which of the following comorbidities is a major risk factor for erectile dysfunction?
- a. Allergic rhinitis
- b. Diabetes and Hypertension
- c. Gout
- d. Migraines
Answer: b. Diabetes and Hypertension
4. The concurrent use of any PDE-5 inhibitor with any form of an organic nitrate is absolutely contraindicated due to the risk of:
- a. Severe, life-threatening hypotension
- b. A hypertensive crisis
- c. Serotonin syndrome
- d. Acute kidney injury
Answer: a. Severe, life-threatening hypotension
5. A key counseling point for a patient starting a PDE-5 inhibitor is that the medication:
- a. Will cause a spontaneous erection.
- b. Requires sexual stimulation to be effective.
- c. Should be taken with a high-fat meal for faster absorption.
- d. Must be taken on a daily basis to work.
Answer: b. Requires sexual stimulation to be effective.
6. The “Management of Erectile Dysfunction” is a specific lecture in which course?
- a. PHA5787C Patient Care 5
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5787C Patient Care 5
7. Which PDE-5 inhibitor is known as “the weekend pill” due to its long duration of action of up to 36 hours?
- a. Sildenafil
- b. Vardenafil
- c. Avanafil
- d. Tadalafil
Answer: d. Tadalafil
8. A patient taking sildenafil reports a transient blue tinge to their vision. This side effect is due to cross-inhibition of which other phosphodiesterase enzyme located in the retina?
- a. PDE-3
- b. PDE-6
- c. PDE-11
- d. PDE-4
Answer: b. PDE-6
9. A patient taking tadalafil is more likely to experience which side effect compared to sildenafil?
- a. Visual disturbances
- b. Headache
- c. Flushing
- d. Myalgia and back pain
Answer: d. Myalgia and back pain
10. Which of the following is an example of a medication class that can cause or worsen erectile dysfunction?
- a. ACE inhibitors
- b. Thiazide diuretics and beta-blockers
- c. Statins
- d. Proton pump inhibitors
Answer: b. Thiazide diuretics and beta-blockers
11. The management of men’s health disorders is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. A patient asks to buy an over-the-counter “herbal Viagra.” The pharmacist’s best response is to:
- a. Recommend the most popular product.
- b. Counsel the patient that these products are not FDA-approved, may be ineffective, and can contain dangerous, undeclared ingredients.
- c. Sell them the product without comment.
- d. Tell them it works better than the prescription versions.
Answer: b. Counsel the patient that these products are not FDA-approved, may be ineffective, and can contain dangerous, undeclared ingredients.
13. Alprostadil is a synthetic version of ______ used as a second-line therapy for ED.
- a. Prostaglandin E1
- b. Nitric Oxide
- c. Testosterone
- d. Dopamine
Answer: a. Prostaglandin E1
14. What is the primary reason for a pharmacist to screen a patient’s medication list before dispensing a PDE-5 inhibitor?
- a. To check for therapeutic duplications.
- b. To screen for the absolute contraindication with nitrates.
- c. To see if the patient can afford the medication.
- d. To check for adherence to other medications.
Answer: b. To screen for the absolute contraindication with nitrates.
15. Counseling patients on the appropriate use of medications and devices is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. The onset of action of sildenafil and vardenafil can be delayed by:
- a. Taking it with water.
- b. Taking it on an empty stomach.
- c. Consuming a high-fat meal.
- d. Taking it with a low-fat meal.
Answer: c. Consuming a high-fat meal.
17. The “Introduction to Urological Disorders” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
18. A patient is taking tamsulosin for BPH and is prescribed sildenafil. The pharmacist should counsel the patient on the potential for:
- a. A hypertensive crisis.
- b. An increased risk of hypotension.
- c. A drug-drug interaction leading to decreased efficacy of both drugs.
- d. Severe constipation.
Answer: b. An increased risk of hypotension.
19. Erectile dysfunction is often considered an early warning sign for what underlying condition?
- a. Chronic kidney disease
- b. Liver failure
- c. Cardiovascular disease
- d. Asthma
Answer: c. Cardiovascular disease
20. An active learning session on urological disorders is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A patient experiences an erection lasting more than 4 hours after taking a PDE-5 inhibitor. This condition is called:
- a. Tachyphylaxis
- b. Priapism
- c. Paresthesia
- d. Angioedema
Answer: b. Priapism
22. Which of the following is a modifiable risk factor for ED?
- a. Age
- b. Family history
- c. Smoking and a sedentary lifestyle
- d. Race
Answer: c. Smoking and a sedentary lifestyle
23. The management of cardiovascular disease, a risk factor for ED, is a topic in the Patient Care 3 curriculum.
- a. True
- b. False
Answer: a. True
24. An active learning session on men’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. A patient should be counseled to take on-demand sildenafil approximately how long before anticipated sexual activity?
- a. 5 minutes
- b. 15 minutes
- c. 1 hour
- d. 4 hours
Answer: c. 1 hour
26. Testosterone replacement therapy is an appropriate first-line treatment for ED in which patient?
- a. A patient with normal testosterone levels.
- b. A patient with confirmed symptomatic hypogonadism.
- c. All elderly male patients.
- d. A patient who cannot afford a PDE-5 inhibitor.
Answer: b. A patient with confirmed symptomatic hypogonadism.
27. Which of the following is a common side effect of PDE-5 inhibitors?
- a. Hypotension
- b. Drowsiness
- c. Headache and flushing
- d. Bradycardia
Answer: c. Headache and flushing
28. An active learning session on urological disorders is part of which course module?
- a. Module 8: Urological Disorders
- b. Module 1: Diabetes Mellitus
- c. Module 3: Women’s Health
- d. Module 6: Geriatrics
Answer: a. Module 8: Urological Disorders
29. The pharmacist’s role in managing ED includes all of the following EXCEPT:
- a. Screening for contraindications.
- b. Counseling on proper use and side effects.
- c. Making a definitive medical diagnosis of the cause of ED.
- d. Identifying potential drug-induced causes.
Answer: c. Making a definitive medical diagnosis of the cause of ED.
30. The “Management of Erectile Dysfunction” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. Which of the following antidepressant classes is most associated with causing sexual dysfunction, including ED?
- a. Bupropion
- b. Mirtazapine
- c. Selective Serotonin Reuptake Inhibitors (SSRIs)
- d. Trazodone
Answer: c. Selective Serotonin Reuptake Inhibitors (SSRIs)
32. A vacuum erection device is a:
- a. First-line pharmacologic therapy.
- b. Non-pharmacologic, mechanical option for managing ED.
- c. Type of penile implant.
- d. Form of psychotherapy.
Answer: b. Non-pharmacologic, mechanical option for managing ED.
33. Which PDE-5 inhibitor can be taken as a low, once-daily dose?
- a. Sildenafil
- b. Vardenafil
- c. Tadalafil
- d. Avanafil
Answer: c. Tadalafil
34. A patient is taking both doxazosin for BPH and sildenafil for ED. What is a key counseling point?
- a. Take both medications at the exact same time to improve efficacy.
- b. Be aware of the risk of dizziness and hypotension; separate administration times if possible.
- c. Stop taking the doxazosin.
- d. The combination is contraindicated.
Answer: b. Be aware of the risk of dizziness and hypotension; separate administration times if possible.
35. Alprostadil can be administered as an intracavernosal injection or a(n):
- a. Oral tablet
- b. Transdermal patch
- c. Intraurethral suppository (pellet)
- d. Nasal spray
Answer: c. Intraurethral suppository (pellet)
36. A patient asks why they can’t just take a nitric oxide supplement for their ED. The pharmacist should explain that:
- a. Nitric oxide supplements are more effective than PDE-5 inhibitors.
- b. Oral nitric oxide is not an effective way to increase local NO levels in the penis; PDE-5 inhibitors work by enhancing the body’s own NO signaling pathway.
- c. Nitric oxide supplements are prescription-only.
- d. Nitric oxide is a dangerous poison.
Answer: b. Oral nitric oxide is not an effective way to increase local NO levels in the penis; PDE-5 inhibitors work by enhancing the body’s own NO signaling pathway.
37. Which PDE-5 inhibitor has the fastest onset of action?
- a. Sildenafil
- b. Tadalafil
- c. Vardenafil
- d. Avanafil
Answer: d. Avanafil
38. The lecture on ED is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. A patient who does not respond to a PDE-5 inhibitor should be counseled to:
- a. Double the dose on their own.
- b. Try the medication on several different occasions, ensuring adequate sexual stimulation, before being considered a treatment failure.
- c. Stop the medication and try an herbal supplement.
- d. Assume no treatments will work for them.
Answer: b. Try the medication on several different occasions, ensuring adequate sexual stimulation, before being considered a treatment failure.
40. An active learning session covering men’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. Which of the following is NOT a common risk factor for ED?
- a. Obesity
- b. Dyslipidemia
- c. Regular exercise
- d. Depression
Answer: c. Regular exercise
42. The pathophysiology of an erection involves:
- a. Vasoconstriction of penile arteries.
- b. Relaxation of cavernous smooth muscle, allowing blood to flow in.
- c. Contraction of the detrusor muscle.
- d. An increase in PDE-5 activity.
Answer: b. Relaxation of cavernous smooth muscle, allowing blood to flow in.
43. A pharmacist’s role includes identifying medications on a patient’s profile that could be contributing to their ED.
- a. True
- b. False
Answer: a. True
44. Which of the following is a lifestyle modification that can improve erectile function?
- a. Smoking cessation
- b. Weight loss
- c. Regular exercise
- d. All of the above
Answer: d. All of the above.
45. A patient should be advised to seek immediate medical help if they experience what side effect while taking a PDE-5 inhibitor?
- a. Mild headache
- b. Flushing
- c. Dyspepsia
- d. Sudden vision or hearing loss
Answer: d. Sudden vision or hearing loss
46. A patient is taking isosorbide mononitrate daily for angina. They should be told that sildenafil is:
- a. Safe to use.
- b. Absolutely contraindicated.
- c. Safe if they separate the doses by 12 hours.
- d. Only safe at a low dose.
Answer: b. Absolutely contraindicated.
47. The management of BPH is covered in the same module as ED.
- a. True
- b. False
Answer: a. True
48. An active learning session on men’s health is part of which course module?
- a. Module 8: Urological Disorders
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 6: Geriatrics
Answer: a. Module 8: Urological Disorders
49. The overall management of ED should include:
- a. A focus on pharmacotherapy alone.
- b. An assessment and management of underlying cardiovascular risk factors.
- c. A recommendation for an herbal supplement first.
- d. The use of the most expensive medication available.
Answer: b. An assessment and management of underlying cardiovascular risk factors.
50. The ultimate goal of learning about the management of ED is to:
- a. Be able to safely and effectively provide pharmacotherapy and counseling to improve a patient’s quality of life.
- b. Memorize the brand and generic names of all PDE-5 inhibitors.
- c. Pass the final exam.
- d. Convince every male patient they need treatment for ED.
Answer: a. Be able to safely and effectively provide pharmacotherapy and counseling to improve a patient’s quality of life.