Questions EMC

1) Regarding finasteride, it is correct to state that:

a) It has a long half-life, which could justify the reports of persistent adverse effects.

b) It is able to dramatically increase serum DHT and testosterone.

c) The occurrence of side effects related to the drug is not dose-dependent.

d) A few years ago, a series of symptoms that appeared and even worsened after finasteride discontinuation have been attributed to the drug.

2) Check the incorrect alternative on adverse sexual effects in post-finasteride syndrome:

a) One of the main complaints is penile sensitivity reduction.

b) Symptoms of this syndrome are considered to be those that persist after three weeks of drug discontinuation.

c) Selection bias is the main limitation of studies that describe a higher incidence of these symptoms.

d) The duration of finasteride use appears to be a risk factor for the onset of the syndrome.

3) Regarding laboratory findings in individuals with post-finasteride syndrome, it is possible to state that:

a) Serum testosterone levels are low and DHT levels are normal.

b) Serum DHT levels are low and testosterone levels are normal.

c) Serum testosterone and DHT levels are normal.

d) Serum testosterone and DHT levels are low.

4) In the pathophysiology of the persistent sexual effects of post-finasteride syndrome, it can be stated that:

a) There is evidence of peripheral insensitivity to androgens.

b) Human studies suggest changes in penile histology and architecture.

c) There are signs of permanent inhibition of androgen receptors.

d) The nocebo effect cannot be ruled out in such cases.

5) Regarding finasteride and infertility, it is correct to state that:

a) The drug is able to temporarily alter the sperm morphology.

b) The decrease in fertility does not appear to be related to the dose used.

c) There is a permanent reduction in the ejaculated volume.

d) There is still insufficient data to state that finasteride interferes with the spermatogenesis of healthy men, without predisposing factors for infertility.

6) The following alterations in the spermogram secondary to the use of finasteride are possible, except:

a) Oligospermia

b) Sperm DNA fragmentation

c) Aberrations in sperm morphology

d) Reduction of sperm motility

7) Regarding neurosteroid hormones, it cannot be said that:

a) By definition, these are hormones exclusively produced in the brain.

b) Examples of neurosteroid hormones are pregnenolone, progesterone, and testosterone.

c) In the central nervous system, progesterone and testosterone are metabolized by the enzyme 5α-reductase into, respectively, dihydroprogesterone and dihydrotestosterone.

d) The levels of brain metabolites of the 5α-reductase enzyme are altered in degenerative and psychiatric diseases..

8) Regarding post-finasteride syndrome it is correct to state that:

a) The possibility of a nocebo effect of the drug has already been ruled out.

b) The risk of depression and anxiety disorder in finasteride users is independent of the presence of a concomitant sexual disorder.

c) In the case of a personal history of underlying psychiatric illness, the use of finasteride is not indicated.

d) Epigenetic mechanisms may explain the occurrence of the syndrome in only a limited number of individuals exposed to finasteride.

9) Regarding the metabolic effects of finasteride, it is incorrect to state that:

a) The drug appears to contribute to peripheral insulin resistance and diabetes.

b) It changes the distribution of body fat and induces hepatic steatosis.

c) Due to its influence on bone metabolism, a periodic bone density assessment in individuals using finasteride is mandatory.

d) Faced with a possible increase in cardiovascular risk, more elaborate clinical studies that analyze countless relevant variables are necessary.

10) When assessing a patient with an indication for the use of finasteride, the physician should consider:

a) Presence of previous psychiatric or sexual disorders

b) Family history of psychiatric illnesses

c) Family history of infertility or subfertility

d) Risk factors for metabolic syndrome