01b: Contraception Flashcards
Coitus Interruptus refers to which form of contraception? The “typical use” failure is (X)%.
Withdrawal/pulling out
X = 22%
List the “female barrier” methods of contraception (equivalent to condom for males)
- Diaphragm
- Cervical cap
- Female condom
(X) is a surfactant used for contraception and improve efficacy of barriers if used simultaneously. Failure rates up to (Y)%.
X = spermicide Y = 30
T/F: Spermicide doesn’t prevent HIV transmission
True
Sperm lifespain in F genital tract
1-5d
Ovulatory window is how many days?
3-5d
“Perfect use” failure of Natural Family Planning is (X)%. And “Typical use” failure is (Y)%.
X = 0.4-5 Y = 24
Suppression of ovulation in hormonal contraception is the task of (X) hormone
X = progesterone
List the roles of progestin in hormonal contraception
- Inhibit LH surge (ovary and pituitary inhibition)
- Thicken cervical mucus
- Endometrial atrophy
- Cycle control
List the roles of estrogen in hormonal contraception
- Helps inhibit LH surge
- Thinning of and increase in cervical mucus
- Endometrial proliferation
- Cycle control
List the combined hormonal contraceptive methods, aside from the “pill”.
The ring (NuvaRing) and the patch
Combined hormonal contraceptive methods: Perfect use rate is (X)% and typical use rate is (Y)%.
X = 1-2 Y = 8-9
List two findings in patient history that would prevent you from prescribing COC. She would be at very high risk of (X) because of (progestin/estrogen).
- Smoking over 35y, more than 15/d
- Migraine with aura
- History of DVT, stroke, PE, valve disease (or other CV risk factors)
X = stroke, MI
Estrogen
How long should a woman wait after birth to be put back on COC (combined oral contraceptives/the pill)?
3 weeks at least
T/F: COCs should not be used in breast cancer patients.
True
Progestin-only pills for contraception are taken how often?
Every day - at same time
T/F: Progestin-only pills are contraindicated in women with vascular disease.
False - generally not
Depot medroxyprogesterone acetate (DMPA) is administered via (X) route how often?
X = IM injection (at health care location)
Every 12 weeks
Depot medroxyprogesterone acetate (DMPA) has which key adverse effects/contraindications?
Significant weight gain; very few medical/drug interaction contraindications
Which contraceptive method has the best efficacy (lowest failure rate at 0.01%)?
Subdermal implant (Nexplanon; progestin-only)
Perfect failure of Levonorgestrel IUD is (X)%. Typical failure is (Y)%.
X = Y = 0.2
T/F: Primary mechanism of contraception by Levonorgestrel IUD is preventing LH surge.
False - cervical mucus thickening (via progesterone)
Primary mechanism of contraception by Cu IUD is:
Cu is spermicidal and inhibits fertilization
Perfect failure of Cu IUD is (X)%. Typical failure is (Y)%.
X = Y = 0.8
T/F: Cu IUD can be used by essentially any woman since there are no hormones released.
True
Plan B is a high dose of (X) with (Y)% effectiveness
X = progesterone (levonorgestrel) Y = 60-80 (depending on timing)
In U.S., abortion is legal up until (X) weeks gestation
X = 24
Medical abortion can be performed up until (X) weeks gestation using which medications?
X = 10
Mifespristone (anti-progesterone) and misoprostol (prostaglandin analogue)
2nd trimester abortion can be carried out via:
- Meds (induced labor)
2. Dilation and evacuation
Vaginal ring embedded with which hormones? It’s labeled for (X) day use.
Etonogestrel (progestin) and estrogen;
X = 21
All forms of contraception in (X) category result in menstrual disruption (amenorrhea, spotting, prolonged bleeding).
X = progestin-only
Contraception: Primary reason for discontinuation of Nexplanon
Menstrual disruption (amenorrhea, spotting, prolonged bleeding); progestin-only implant
T/F: Majority of women having abortions are in 20-30yo age range.
True
Approximate gestational sac size at 6 weeks gestation.
Size of dime
Approximate gestational sac size at 8 weeks gestation.
Size of quarter
Approximate gestational sac size at 7 weeks gestation.
Size of nickel
Complications of surg abortion:
- Bleeding
- Infection/Retained products (endometritis)
- Uterine perforation
22 yo woman presents with pelvic pain/pressure and U/S shows massive blood clot in uterus. If this is complication of a recent procedure she had, what is it and which procedure?
Surgical abortion
Hematometra (blood collecting in uterus); Rx is to suction contents
Laminaria is used in abortion procedures for which purpose?
Prep cervix for dilation (slowly expands via moisture absorption over 6+ hours)
Dilapan is used in abortion procedures for which purpose?
Prep cervix for dilation (synthetic)
