Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 5: Gynaecology > Combined oral contraceptive pill (Complete) > Flashcards

Combined oral contraceptive pill (Complete) Flashcards

1
Q

**

What does the combined oral contraceptive pill contain?

A

Progesterone

Oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Combined oral contraceptive pill is also referred to as?

A

Combined hormonal contraception (CHC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 main routes of administration for CHC?

A

Orally

Transdermally

Intravaginally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mechanisms of action of CHC?

A

Involves:

Thickening the cervical mucus

Thinning the endometrium

Inhibiting ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the contraindictions for taking CHC?

A

Anything that increases risk of venous thromboembolism such as:

Migarine with aura

Less than 6 weeks post-partum for breastfeeding woman

Cardiomyopathy

AF

Active breast cancer

Antiphospholipid antibodies

Age >35 years and smoking >15 cigarettes a day

Hypertension ( ≥160 mmHg systolic or ≥100 mmHg diastolic)

Vascular disease

IHD

Hx of CVA (e.g. TIA)

Hx VTE

Major surgery with prolonged immobilisation

Known thrombogenic disorders (E.g. factor V lieden)

Complex valvular heart disease (e.g. pulmonary hypertension, history of subacute bacterial endocarditis)

Severe liver cirrhosis

Hepatocellular adenoma or carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why is CHC contraindicted in breast-feeding woman less than 6 weeks post-partum?

A

Due to:

Increased risk of thromboembolism post-partum

Reduction in lactation

Can be transferred to milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is migraine with aura a contraindiction for CHC?

A

Migraine with aura involves neurogenic inflammation and activation of thrombotic pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the three main types of combined oral contraceptive pill? (COCP)

A

Monophasic: Each pill contains same dose

Phasic: Pills contain differing amounts of hormones and must be taken in the correct order

Every day pills: contain 21 hormone-containing pills, and 7 hormone-free pills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What regimens are available for CHC?

A

Traditional

Extended

Continuous use

Flexible-extended use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the traditional regiment for CHC?

A

Pill: One pill per day for 3 weeks followed by 7 day hormone free interval (HFI)

Patch: One patch per week for 3 weeks followed by 7 day HFI
Intravaginal: one vaginal ring for 3 weeks followed by 7-day HFI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is extended use regimen for CHC?

A

Used for a period of nine weeks (3 months), followed by a 7-day HFI, also known as “tricycling”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is continous use regimen for CHC?

A

Used continuously without any HFI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is flexible extended use regimen?

A

Method used until breakthrough bleed followed by 4-day HFI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What information needs to be relayed to the patient when starting COCP?

A

If started on first day of period will provide immediate contraceptive protection.

If started at any other time in cycle, need 7 days of additional protection (e.g. condoms).

Postpartum patients can begin 21 days after giving birth unless they are breastfeeding which would be 6 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the advantages of CHC? (8)

A
  • Effective (failure rate < 1 per 100 woman years)
  • Doesn’t interfere with sex
  • Contraceptive effects revisible upon stopping
  • Makes periods regular, lighter and less painful
  • Reduces risk of ovarian and endometrial cancers which can last for decades affter stopping.
  • Reduces risk of colorectal cancer
  • Can protect against PID (pelvic inflammatory disease)
  • Reduces ovarian cysts, benign breast disease and acne vulgaris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are disadvantages of CHC? (5)

A

Increased risk of breast and cervical cancer

Increased risk of stroke and ischaemic heart disease (especially in smokers)

Increased risk of VTE

People may forget to take it

Offers no protection against sexually transmitted infections

17
Q

What are some side effects associated with CHC? (3)

A

Breast tenderness

Headaches

Nausea and vomitting

Mood and libido changes

Irregular menstrual bleeding, spotting or amenorrhoea

Ovarian cysts

18
Q

How should patients who’ve missed one pill at any time of the cycle be managed?

A

Take the last missed pill as soon as you remember. (You might need to take two pills in one day)

Continue taking one pill each day as usual

Do not require any additional protection during sex (E.g. condom)

19
Q

What should be advised to patients who have missed 2 or more pills within the first week (start of pack)?

A

1) Take the last missed pill as soon as you remember. (You might need to take two pills in one day)

2) Leave any earlier missed pills

3) Continue taking one pill each day as usual

Will require additional protection (E.g. condom) up until 7 days of using pill correctly.

If they had sex during missed pill interval or week 1, will require emergency contraception.

20
Q

How should patients who had unprotected sex within pill free interval during week 1 be managed?

A

Require emergency contraception

21
Q

What should be advised to patients who have missed > 1 pill within the 2nd week (day 8-14)?

A

After seven consecutive days of taking the COC there is no need for emergency contraception

22
Q

What should be advised to patients who have missed > 1 pill within the 3rd week (day 15-21)?

A

She should finish the pills in her current pack and start a new pack the next day.

Because of this theyre omitting the pill free interval

23
Q

How should woman on COCP be advised to continue management if experiencing episodes vomitting (e.g. gastroenteritis)?

A

Patients should take another pill straight away if previous COCP taken within 3 hours of vomitting

(2 hours for progesterone only pill)

N.B. Due to vomitting it probably will not have been absorbed by their body.

24
Q

Woman on COCP should be monitored annually for?

A

Hypertension

N.B. Shown to have 2% risk of hypertension when taking so should have BP measured annually

25
Q

What guideline should be referred to when advising children <16 about contraception and sexual health without breaking confidentiality?

A

Fraiser guidelines

26
Q

What criteria from the fraiser guidelines must be met for a child to be deemed ‘Fraiser competent’?

A

Must meet ALL of the following:

1) Sufficienct maturity and intelligence to understand what the treatment is and its implications.

2) Cannot be persuaded to tell their parents or have a doctor tell them

3) Very likely to continue having sexual intercourse even without contraception

4) Physical and/or mental health likely to suffer if advice or treament not initiated.

5) Advice/treatment is in the patients overall best interest

Year 5: Gynaecology (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions