5 - Contraception

Question 1

Who should be screened for intimate partner violence?

Answer 1

• everyone

Question 2

Progestins are derived from what?

Answer 2

• testosterone

Question 3

How does Mifepristone induce medical abortion?

Answer 3

• causes detachment of embryo or further anti-progesterone cascade

Question 4

What is the surgical option for first trimester abortion?

Answer 4

• manual or electric vacuum aspiration

Question 5

How soon does Plan B (levonorgestrel) need to be used compared to Ella (ulipristal acetate)?

Answer 5

• Plan B = within 3 days

- Ella = within 5 days

Question 6

What is the MOA of copper-IUDs?

Answer 6

• releases free copper which prompts inflammatory resposne

Question 7

What is the only contraceptive methods to prevent infection?

Answer 7

• barrier methods (e.g. condoms)

Question 8

What are the 3 side effects with progesterone use?

Answer 8

• thickening of cervical mucous
• thinning of the endometrium
• decreases tubal peristalsis

Question 9

What 2 drugs are used for medical abortion and what is the regimen?

Answer 9

• Mifepristone in office

- Misoprostol taken at home 24-48 hours later

Question 10

What are the 3 screening tool options for evaluating for domestic violence?

Answer 10

• HITS
• STAT
• RADAR

Question 11

Which is more effective: Plan B or Ella?

Answer 11

• Ella

Question 12

When should diaphragms be inserted and removed?

Answer 12

• inserted < 6 hours before sex

- remove > 6 hours but < 24 hours after sex

Question 13

This contraceptive method is 20x more effective than the other competing contraceptive methods.

Answer 13

Long acting reversible contraception (LARC)

Question 14

How long does nexplanon (implant contraception) last?

Answer 14

5 years

Question 15

How does Misoprotsol work to induce medical abortion?

Answer 15

• causes cervical softening and uterine contractions

Question 16

What is the best birth control for each individual patient?

Answer 16

• whatever she is going to use

Question 17

What is the most effective birth control method? (not in terms of adherence)

Answer 17

• Nexplanon (implant contraception)

Question 18

Estrogen prevents formation of a dominant follicle by suppressing what hormone?

Answer 18

• FSH

Question 19

What is the duration of action of copper vs. LNG IUDs?

Answer 19

• copper = 12 years

- LNG = 7 years

Question 20

If a patient is using the periodic abstinence method how many days does she need to remain abstinence per cycle?

Answer 20

17 days

Question 21

What is the MOA of Plan B (levonorgestrel)?

Answer 21

• progesterone blocks LH surge inhibiting ovulation

Question 22

This type of contraception is associated with increase appetite and decreased bone mineral density.

Answer 22

• Depot-medroxyprogesterone acetate (DMPA)

aka Depo-Povera

Question 23

What % of pregnancies are unintended?

Answer 23

nearly 50%

Question 24

T/F: abortions does not increase risk of subsequent infertility, ectopic pregnancy, or preterm delivery.

Answer 24

True

Question 25

What fraction of women have an abortion during their lifetime?

Answer 25

• 1/3 women have an abortion

Question 26

Progesterone prevents ovulation by suppressing what hormone?

Answer 26

• LH

Question 27

What are the benefits of undergoing a salpingectomy for female sterilization?

Answer 27

less failure and reduced risk of ovarian cancer

Question 28

What is the surgical option for second trimester abortion?

Answer 28

• dilation and evacuation

Question 29

What are the 6 absolute contraindications to EE use?

Answer 29

• VTE disorders
• known/suspected breast cancer
• smoker >35 years
• uncontrolled HTN
• migraine with aura
• SLE with antiphospholipid antibodies

Question 30

What type of drug is Phexxi?

Answer 30

• vaginal pH modulator (VMP)