Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
What are the normal phases of sexual functioning?
|
Appetitive (desire)
Excitement (erection) Plateau (Incr HR,BP,Resp,Skin Flush, intensification of erection) Orgasm (vaginal/uterine contraction, expulsion semen) Resolution (Men,refractory, Women restim possible) |
|
What happens to sexual functioning with aging?
|
Men - slower erection/ejaculation, longer refractory period
Women - less lubrication, vaginal shortening,thinning,dryness |
|
What is primary sexual dysfunction? Secondary?
|
Primary - orgasm never achieved
Secondary - men - inability to maintain despite past erections |
|
What is the triad associated with hyposexuality?
|
Reduced or absent interest in sex. (Appetitive phase disorder)
Key psych triad: Problems in Relationship, Performance Anxiety, Fear of Consequences(STD,Pain,Etc) Others: Depression Psychotic Disorders Meds Epilepsy Bipolar Mood Disorder |
|
Define paraphilia and name some.
|
Disorders of appetitive phase.
Exhibitionism, etc |
|
Define
Exhibitionism Fetishism Frotteurism |
Exhibitionism - exposing genitals
Fetishism - inanimate objects Frotteurism - rubbing penis against nonconsenting, nonaware woman |
|
Necrophilia
Pedophilia (how define?) Sexual Masochism Sexual sadism |
Children (perpetrator must be at least 16 and 5 years older than victim)
Recieving physical suffering Causing physical suffering |
|
Transvestic Fetishism
Voyuerism Zoophilia |
Wearing women's underclothing
observing sexual activity/undressing animals |
|
Sexual problems in the excitement phase (define and name causes)
|
Inability to maintain erection (40% exp at some time)
Inability to maintain vaginal lubrication, relaxing vagina (60%) Key Triad: Comorbid psychopathology Recreational Drug Use/Meds Fatigue others: Diabetes Peripheral Vasc Disease Perineal surgery/radiation renal failure Aortic occlusion at iliac bifurcation (Leriche syndrome) peripheral neuropathy Multiple Sclerosis Spinal cord transection |
|
What are some treatment for excitement phase disorders?
|
Relaxation training
Education Sensate focus (increase awareness of touch/sens stimuli to decrease pressure for orgasm) Relaxation training Education Hormone injections Prostheses Penile injections Vacuum pump |
|
Plateau phase disorders?
Primary Sexual Pain Disorders |
Dyspareunia - pain during coitus (2nd to endometriosis, tissue trauma, insuff lubrication, hymenal tags, phemosis, meds)
Vaginismus - involuntary muscle spasms before/during coitus, penetration impossible (tx. mech dilation) |
|
Orgasmic Phase Problems
Premature Ejaculation Female Orgasmic Disorder |
Premature ejaculation - Primary due to key triad
Secondary due to meds/drugs Tx-Squeeze technique when ejac. inevitability felt, stops ejaculation and backward conditions. Female Orgasmic Disorder- delayed/absent orgasm. Primary - partner trust Secondary - genital pathology, endocrinopathy, meds, alcohol, drugs |
|
What are the effects of the following substances on sexuality:
Alcohol Amphetamine |
Alcohol: Incr libido acutely, chronic liver damage increases estrogen, decr arousal
Incr libido (direct brain stim) |
|
Cocaine
Heroin/Methadone Marijuana |
Cocaine - Incr libido, priapism
Heroin - Decr libido, inhibits ejaculation (less with methadone) Marijuana - Incr libidio acutely, lowered GnRH/Testosterone with chronic use |
|
What substances are connected with increased aggression?
|
Alcohol
Cocaine Amphetamines PCP High dose Marijuana HEROIN is NOT assoc |
|
At what age do children understand death?
|
Children under 5 do not understand death.
Understand permanence of death at age 8. |
|
What are the Kubler-Ross stages of dying?
|
Death (Denial)
Arrives (Anger) Bringing (Bargaining Grave (Grief/depression) Adjustments (Acceptance) |
|
What are the risk factors for suicide completion?
|
S (Sex-male)
A (Age - elderly, teens) D (Depression) P (Previous Attempt) E (Ethanol) R (Rational Thought) S (Sickness) O (Organized Plan) N (No Spouse) S (Social Support Lacking) |
|
What are exceptions to informed consent?
|
Patient not legally competent
Implied consent in emergency Therapeutic Privilege - withold info when would harm patient or undermine decision-making capacity Waiver by patient of right |
|
What are factors that substantiate decision making capacity?
|
1. Patient makes/communicates choice
2. Patient is informed 3. Decision stable over time. 4. Decision consistent with patient values/goals. 5. Decision not result hallucinations/delusions. |
|
What are two types of written advance directives and which takes precedence?
|
Living will = patient direct witholding life-sustaining tx in terminal disease or vegetative states.
Durable Power of Attorney - patient designates surrogate to make medical decisions (may also specify decisions themselves) Surrogate retains power UNTIL REVOKED BY PATIENT. |
|
Define Beneficence
|
Physicians have ethical responsibility to act in patient's best interest. Patient hold's ultimate decision making power (with informed decisions)
|
|
What are exceptions to confidentiality?
|
1. Likely Harm to others (impaired auto drivers)
2. Possible Harm to self 3. No alternative to warn those at risk 4. Doctor can take steps to prevent harm Tarasoff Rules - patient must warn potential victims of their patients plans |
|
What are the requirements of a civil suit under negligence?
What is the burden of proof in a malpractice suit? |
Dereliction (physician breach of duty to patient)
Damage (patient suffers harm) Direct (breach of duty causes harm) Burden of proof - "more likely than not". |