Question

A 58 year old male with a history of diabetes mellitus and coronary artery disease presents with failure to achieve or sustain an erection. This problem has been persistent for the past year, and has been causing a great deal of stress in his marriage. When questioned regarding nocturnal erections, he states that he cannot recall the last time that he awakened with an erection. Previously, this had been a typical occurrence. Current medications include atorvastatin, glyburide, metformin, isosorbide dinitrate, and metoprolol. Physical examination reveals normal external genitalia. There is diminished sensation to pinprick in the distal lower extremities bilaterally. Which of the following is the most appropriate initial step in the management of this patient?

A. Sertraline
B. Yohimbine
C. Alprostadil
D. Tadalafil
E. Reassurance

Answer 1

The most appropriate initial step in the management of this patient would be reassurance. The patient's symptoms are suggestive of erectile dysfunction (ED), which can be caused by a variety of factors including diabetes and coronary artery disease.

Step-by-step explanation:

The most appropriate initial step in the management of this patient would be Reassurance. The patient's symptoms are suggestive of erectile dysfunction (ED), which can be caused by a variety of factors including diabetes and coronary artery disease. Given his medical history and current medications, it's likely that these conditions are contributing to his ED. Initially, providing reassurance and addressing any concerns or stress related to his condition can be helpful.