QuestionSBA
QuestionChoice
Prolactinomas can cause erectile dysfunction, however, vascular causes are more common (especially in a patient with risk factors such as obesity). There is an absence of other symptoms such loss of libido, headaches, or visual changes.
10028355
e
Serum prolactin levels
QuestionChoice
This is unlikely to be helpful in establishing a cause for erectile dysfunction. There is also no mention of symptoms suggestive of anaemia.
10028352
b
Full blood count
QuestionChoice
Whilst this is a recommended investigation for patients with erectile dysfunction, the presence of secondary sexual hair and muscle mass points away from it. Additionally, given the history of obesity, diabetes is a more likely cause for erectile dysfunction in this patient.
10028353
c
Testosterone levels
QuestionChoice
Gradual onset erectile dysfunction in a middle-aged male with risk factors present should raise suspicion of diabetes mellitus. Vascular causes are the most common organic cause of erectile dysfunction.
10028351
a
HbA1c
QuestionChoice
Although prostatic issues can cause erectile dysfunction, this is less common than diabetes as a cause. Additionally, there are no mention of other symptoms associated with prostate cancer (e.g. lower urinary tract symptoms). PSA testing should not routinely be offered to asymptomatic patients.
10028354
d
Prostate specific antigen (PSA)
QuestionComment
poorly written question it says most helpful in establishing the underlying cause. a raised hba1c doesnt rule out other causes of ED
43627
QuestionComment
Nope. In that age group, vascular risk factors are the most common cause. The question doesnt ask for the investigation that rules out, it asks you which one is most likely to establish the underlying cause
43693
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test123
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anon
QuestionComment
Am i right in thinking poorly controlled diabetes cause peripheral hair loss? 
44291
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Jargon Defibrillator
QuestionComment
i dont understand, the question doesnt mention secondary sexual hair and muscle mass. it says theyre both appropriate?
51832
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Hypertension Power
Concept
Chapter
2693
6055
Erectile dysfunction
Topic
143
Urology
18068
Gradual onset erectile dysfunction in middle-aged men may indicate underlying diabetes mellitus, particularly in those with obesity.
A 53-year-old man has erectile dysfunction. He states it occurred gradually and has worsened over time.

He denies any symptoms of anxiety or depression and states he has no loss of libido. On examination, he has appropriate body hair and muscle mass.

He has a past medical history of obesity.

Which blood test would be most helpful in establishing the underlying diagnosis?
a