From the following list of clients, which ones are at high risk for developing priapism? Select all that apply

Question

A) A teenage cocaine abuser who has been "high" for the past 72 hours
B) An uncircumcised male with poor hygiene habits
C) A sixth grade male returning to school following sickle cell crisis
D) A college student with complete spinal cord injury at T12 level following auto accident
E) A middle-aged adult male with recent history of myocardial infarction

Answer 1

Ans: C, D
Feedback:
Priapism is due to impaired blood flow in the corpora cavernosa of the penis. Priapism is classified as primary (idiopathic) or secondary to a disease or drug effect. Secondary causes include hematologic conditions (e.g., leukemia, sickle cell disease, polycythemia), neurologic conditions (e.g., stroke, spinal cord injury), and renal failure. Two mechanisms for priapism have been proposed: low-flow (ischemic) priapism, in which there is stasis of blood flow in the corpora cavernosa with a resultant failure of detumescence (diminution of swelling or erection), and Peyronie disease, which involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. Circumcision trauma to the penis and abnormal tightening of foreskin are external penile problems associated with phimosis rather than the internal vascular problem of priapism.