share email twitter ⋅ join discord whatsapp(2ck)
Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 ⋅ Step 2 CK Free 120  Step 2 CK Form 6  Step 2 CK Form 7  Step 2 CK Form 8 
search for anything NEW!score predictor (β€œpredict me!”) NEW!
NBME 21 Answers

nbme21/Block 2/Question#33 (reveal difficulty score)
A 68-year-old man comes to the physician ...
Libido: normal; Nocturnal erections: normal πŸ” / πŸ“Ί / 🌳
tags:

Login to comment/vote.


Tutor box

Members from the Leaderboard offering 1-on-1 help: Want to be listed here? Email us!

 +28 
submitted by βˆ—xxabi(277),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Blie asslt elph iledosvs aglssnelot tath eahv roedmf ni teh aerg,dldlbla esud ni ptsntaei ryerarfotc ot resrguy or epfrre to dvoai .it


 +19 
submitted by βˆ—imgdoc(151),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

I hghuott uoabt ti lkie thi:s ntiPtea si vghain yconpsighec DE - its lla ni hsi ,ahed obdlii si oarmnl nda orntuacnl ecrietsno aer .amrlno

If ish netTrseoetso eellv aws olw - Loidib sdeec.eard If sih nvsoeur ysmste itspmayeappsety/ic)c(rttaahmh aws addagme - otularcnn snecretio cdr.seadee

peoH sith ehpls.

sars  Idk about this. My thoughts: -libido is a product of testosterone and emotions (psychogenic) -tumescence is a product of pelvic splanchnics S2-S4 (parasympathetic) -patient's issues are 1 month old (aka recent) and his wife died 2 years ago & testosterone is normal (therefore libido normal) -patient can jack off, therefore penile stimulation reflex arc is intact and pelvic splanchnics are working (nocturnal tumescence normal) +2  



 +13 
submitted by βˆ—dr_jan_itor(78),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

eH msseis ish ewif a,mn s'nti yarde rof rheto ne.mwo cePoghcysni DE. yliahplsyc seh nief




 +3 
submitted by βˆ—yotsubato(1120),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

hWy si sih ibidLo onr?lam I'ts ttaloyl expdecet htta eh may ahev rduedec iliobd tefar shi ewif ided 2 ysare oag form esmo lorribeh rogploend s.neills

nala_ula  perhaps it's more to do with the fact that he can get erections when masturbating, outside of nocturnal erections which are not mediated by sexual desire. So his libido must be intact since he has sexual desire evident in being able to masturbate. +  
nala_ula  At least, that's the way I saw it. +  
home_run_ball  "Testosterone concentration is within the reference range" and the fact that he has no difficulty masturbating = normal libido. Low testosterone would contribute to low libido And if he had low libido he would have difficulty masturbating +  
thisisfine   The way I made the decision about normal vs. decreased libido is also that he presented to his doctor due to difficulty maintaining an erection while trying to have sex - meaning he has the libido to try to have sex. Does that make sense? +1  
btl_nyc  It also says there are no signs of depression, which would cause the low libido after his wife died. +  
temmy  two years is a enough time to mourn...just saying +  
temmy  thisisfine, it makes absolute sense. That is the same way i saw it +  
dr_jan_itor  He misses his wife man, isn't ready for other women. Psychogenic ED. physically hes fine (can crank his meat) +  



 +3 
submitted by βˆ—haliburton(222),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

rfom FAAP DE fo mxide graicon dan cnpeiogcshy nogrii is o.conmm ceosncygPhi ausesc rea mero eyllki nhew eth ittepna sah lamorn enieotcrs iwth baiustratonm or hwen outncnlar nepeil cetesumenc si mranlo.

yotsubato  Couldnt a psychogenic cause reduce libido? +2  
home_run_ball  "Testosterone concentration is within the reference range" and the fact that he has no difficulty masturbating = normal libido. Low testosterone would contribute to low libido And if he had low libido he would have difficulty masturbating +7  
home_run_ball  whoops meant to comment on the other comment +  



 +1 
submitted by βˆ—basic_pathology(14),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

igaOrcn DE: DE urdgni srniu,tmabtao no otnlanruc ,ioceetsnr /-+ ercsdadee lobiid

Pscgiocyne :DE no ED ridngu o,naibstamrtu sye nlctaruno rcse,tneio no sdreceaed biidlo

80.-geecdtsisncacps/ntftiewb2oaou-ei5c-cegr.rgi9fntepa7sie1rnaughax//dwnyeeenl--hd-ufc/inlfclt4otlrbasC_ynseh_6e:renwiw-t




 +0 
submitted by βˆ—syoung07(42),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

if you aer 86 dna lsilt adtgni Plaaaml aodnrsn,He uyro blodii itsn wol ym indr.esf

drdoom  amen +  



 +0 
submitted by βˆ—jhan17(2),
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

n"eItueadaq or etsban luctoarnn neoescrit tussgge orciang isonfd,tnucy eerhwas a mnoalr tulres iedtiancs a hghi kldoileiho of a spgenccoyhi tolie.ogy"

yletnsrpnfcolcr/e:o-ueo9etunw-ne/tt/onnrm6wi-sha/twiei2m4-sts-k-dctt49-wnnht-g-eeaes2rscdct-fcsloeele.mioe-atf-0d6-hwcp-1-s4pp./aeeeirnwohiuu-




search for anything NEW!