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Year 4 > Contraception > Flashcards

Contraception Flashcards

1
Q

how does COCP work?

A

inhibits ovulation

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2
Q

risks of COCP?

A

increases VTE risk

increases risk of breast and cervical cancer

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3
Q

how does progesterone only pill work?

A

thickens cervical mucus

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4
Q

side effects of POP?

A

irregular bleeding

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5
Q

how does depot work?

A

primary = inhibits ovulation

also thickens cervical mucus

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6
Q

how long does depot last?

A

12 weeks

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7
Q

how does implant work?

A

primary = inhibits ovulation

also thickens cervical mucus

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8
Q

side effects of implant?

A

irregular bleeding

weight gain

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9
Q

how long does implant last?

A

3 years

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10
Q

how do copper intrauterine device work?

A

decreases sperm motility and survival

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11
Q

how does mirena coil work?

A

primary = prevents endometrial proliferation

also thickens cervical mucus

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12
Q

children under what age are considered unable to consent to sexual intercourse in all cases?

A

under 13

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13
Q

what guidelines are used to assess ability to consent to sexual activity?

A

fraser guidelines

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14
Q

advise for STI testing after unprotected sex?

A

advise young people to have STI test 2 and 12 weeks after intercourse

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15
Q

when can COCP be started?

A

start within first 5 days of cycle

if taken after day 5 then additional contraception such as condoms need to be used for 7 days

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16
Q

how is COCP taken?

A

same time every day for 21 days then a 7 day break

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17
Q

is intercourse safe during pill free week?

A

yes but only if next pack is started on time

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18
Q

when might efficacy of COCP be reduced?

A

vomiting within 2 hrs of taking pill

taking meds causing liver enzyme inducing drugs (eg some anticonvulsants)

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19
Q

advise if 1 pill (COCP) is missed at any time in the cycle?

A

take the last pill (even if that means taking 2 pills in one day) then continue taking pills normally
no additional contraceptive needed

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20
Q

advise if 2 or more pills (COCP) are missed in week one of cycle?

A

take last pill even if it means taking two pills in one day
leave any other missed pills
then continue normal daily pills
need emergency contraception if she had unprotected sex during pill free week or week 1 of cycle

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21
Q

is emergency contraception needed if 2 more COCP are missed in week 2 of cycle?

A

no need for emergency contraception as long as there had been 7 consecutive days of taking the COCP

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22
Q

is emergency contraception needed if 2 or more COCP are missed in week 3 of cycle?

A

not as long as they had taken pills for 7 consecutive days before
should finish pills in current pack then start new pack immediately (omitting pill free week)

23
Q

which is most effective form of contraception?

A

implant (nexplanon)

24
Q

what hormones in implant and how does this affect risks?

A

no oestrogen, only progesterone

so doesnt increase VTE risk so can be used if PMH of thrombosis, migraine etc

25
Q

when should implant be inserted?

A

day 1-5 of cycle
if not inserted within days 1-5 then 7 days additional contraceptive measures are needed
can also be inserted immediately after a termination of pregnancy

26
Q

types of IUD?

A

copper

mirena (levonorgestrel)

27
Q

what else are IUDs used for?

A

menorrhagia

fibroids (if uterus not too distorted)

28
Q

how long does copper IUD last?

A

5-10 years (think its 10 generally)

29
Q

how quickly is copper IUD effective?

A

immediately after insertion?

30
Q

how long does mirena IUD last?

A

5 years

31
Q

how quickly is mirena IUD effective?

A

7 days after insertion (need 7 days of additional contraception)

32
Q

when can copper IUD be inserted?

A

any time in menstrual cycle

33
Q

when can mirena be inserted?

A

within first 7 days of cycle

if inserted after day 7 then extra barrier contraception is required for 7 days

34
Q

when can copper coil be inserted after unprotected sex as emergency contraception?

A

up to 5 days after

35
Q

does either type of coil affect VTE risk?

A

no

therefore can be used in obese people, people at risk of VTE etc

36
Q

which coil helps dysmenorrhoea and pain related to endometriosis?

A

only mirena

37
Q

adverse effects of coils?

A

can cause heavy or intermenstrual bleeding but this usually settles
can increase risk of ectopics
can fall out
no STI protection

38
Q

3 types of emergency contraception?

A

levonorgestrel (ellaOne)
ulipristal acetate
copper coil

39
Q

levonorgestrel must be taken within how long of unprotected intercourse?

A

72 hrs

40
Q

when are two doses of levonorgestrel needed?

A

BMI>26 or weight >70kg

or if vomiting occurs within 3 hrs of taking it

41
Q

how quickly can hormonal contraception be started after levonorgestrel?

A

immediately

42
Q

how quickly must ulipristal acetate be taken after unprotected intercourse?

A

120 hrs

43
Q

how many doses of ulipristal acetate?

A

only 1 generally

44
Q

how quickly can hormonal contraception be started after ulipristal acetate?

A

not until 5 days after ulipristal acetate (as it reduces effectiveness of hormonal contraception)
barrier methods should be used during these 5 days

45
Q

how does emergency contraception affect breastfeeding?

A

levonorgestrel has no effect

should delay breastfeeding for 1 week after ulipristal acetate

46
Q

which emergency contraception can be used more than once in a single cycle?

A

levonorgestrel

47
Q

for how long is it normal to have some intermittent bleeding after insertion of IUD?

A

6 months

48
Q

women require contraception from how many days following birth?

A

21 days

49
Q

when can POP be started after giving birth?

A

anytime postpartum (regardless of whether they are breastfeeding)

50
Q

when can COCP be started after giving birth if breastfeeding?

A

6 weeks after birth at the earliest (if patient requests it) but not really recommended until 6 months after
(would still need barrier contraception from 3 weeks after birth)

51
Q

when can COCP be started after birth if not breastfeeding?

A

3 weeks

52
Q

when can IUD be inserted after birth?

A

immediately after delivery of placenta or within 48 hrs of birth
can be done immediately at time of C-section after delivery of placenta

53
Q

if IUD not inserted within 48 hrs of birth, how long must you wait before inserting it?

A

delay insertion until 4 weeks after birth

54
Q

when can implant be inserted following birth?

A

immediately or anytime really

if inserted before 3 weeks then no extra contraception is needed

Year 4 (83 decks)

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