Update on late-onset hypogonadism (LOH) or ADAM: treatment
1. What is the role of androgen replacement thera-
py (ART) to restore bone mass, muscular strength
and body composition?
Increase in fat mass.
Does not affect bone mass.
Increase in muscle mass.
Reduces the testicular volume.
2. What is the role of androgen replacement thera-
py (ART) to restore libido and sexual function?
Testosterone restores libido in men independent of
the hormone’s levels.
Testosterone restores libido in men with low testos-
The combination of testosterone and phosphodies-
terase inhibitors produces no benefit.
Dehydroepiandrosterone (DHEA) improves erectile
3. What is the risk of ART in relation to exacerbat-
ing prostate disease?
Increases the incidence of prostate cancer
Cannot be used in patients treated for prostate cancer.
Patients with a family history of prostate cancer
should not use ART.
Can increase PSA levels.
4. How should ART be administered orally?
50 mg of DHEA orally twice a day, improves sexual
function in men.
Oral testosterone undecanoate (OTU),160 mg/day,
improves sexual function.
Oral mucosa patches (containing 30 mg of testoster-
one), 3 times a day.
It is strongly advised NOT to use oral testosterone
5. What is the best form of ART?
Injectable testosterone undecanoate depot (TUD) is
the most physiologic.
The oral route remains a quick and convenient way
Skin patches at the maximum dose are not very ef-
Subcutaneous testosterone implants can be used in
RAMB 2014; 60(5)]
1. On prophylactic laser iridotomy, in the contralat-
eral eye, in a patient with acute primary angle clo-
sure in one eye, we can affirm that:
It can prevent similar episodes in many cases. (Alter-
2. The differences between prophylactic laser iridot-
omy (PLI) and prophylactic surgical iridectomy
PLI costs less. (Alternative
3. It is not a complication of PLI:
Clinical improvement of cataract. (Alternative
4. Which anatomic situation of the camerular sinus
is an indication for prophylactic laser iridotomy?
All cases diagnosed as primary angle closure. (Alter-
5. Factors involved in the indication of PLI in cases
of suspected primary angle closure include all of
the following, except:
Lack of symptoms. (Alternative