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Women's Health > Contraception > Flashcards

Contraception Flashcards

1
Q

when can the POP be started and when is patient protected from

A

up to day 5: immediate protection
day 5 onwards: use condoms for 2 days

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2
Q

how is the patch used

A

change every week for 3 weeks, then one week break

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3
Q

if someone has a patch change delay >48 hours in week one or two, or end of patch free week

A

use condoms for 7 days

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4
Q

the COC pill carries an increased risk of

A

cervical cancer
breast cancer

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5
Q

the COC pill carries a decreased risk of

A

endometrial cancer
ovarian cancer
bowel cancer

OBE

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6
Q

how long is the Mirena Coil licensed for use

A

5 years

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7
Q

how long is the copper coil licensed for use normally

A

5 or 10 year use

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8
Q

how long is the copper coil licensed for use if fitted >40yo

A

until 1 year after LMP

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9
Q

first line COCP for >40

A

<30ug ethinylestradiol (lower risk strokes, VT, CVD)

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10
Q

how long after childbirth can a contraceptive implant be inserted

A

immediately

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11
Q

failure rate of female sterilisation

A

1 in 200

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12
Q

if the POP is late

A

> 3 hours: take missed pill ASAP, continue pack and use condoms for 48 hours

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13
Q

Missed pill rules COCP

A

1 pill: continue as normal
2 pills: condoms for 7 days

in week 1: emergency contracpetion
in week 2: crack on
in week 3: finish the pills and start a new pack immediately (miss pill free interval)

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14
Q

After giving birth, when do women require contraception

A

After day 21

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15
Q

When can women start the POP post party

A

any time, after day 21 normal rules regarding condoms for 2 days

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16
Q

COCP UKMEC score in breastfeeding <6 weeks

A

UKMEC 4 - may reduce breast milk production and cause increased VT risk

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17
Q

COCP UKMEC score in breastfeeding 6 weeks-6months

A

UKMEC 2

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18
Q

When can the IUD or IUS be inserted after childbirth?

A

within 48 hours, or after 4 weeks

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19
Q

UKMEC 1

A

no restriction for the use of the contraception

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20
Q

UKMEC 2

A

benefits outweigh the risks

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21
Q

UKMEC 3

A

risks outweigh the benefits

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22
Q

UKMEC 4

A

unacceptable health risk

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23
Q

UKMEC 3 conditions

A

> 35 and smoke (less than 15 a day)
BMI >35
family hx of thromboembolic disease in 1st degree relative <45
controlled hypertension
immobility
carrier of BRCA gene
current gallbladder disease

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24
Q

UKMEC 4 conditions

A

> 35 and smoke more than 15 a day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding <6 weeks postpartum
uncontrolled hypertension
current breast cancer
positive antiphospholipid antibodies (SLE)

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25
Q

which contraceptive may decrease bone mineral density in women?

A

depo provera

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26
Q

delayed return to fertility after the injection

A

up to 12 months

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27
Q

Levonorgestrel must be taken within __ of unprotected sex

A

72 hours

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28
Q

a single dose of levonorgestrel is ___mg and should be ___x for a BMI of >__ or weight over ___kg

A

1.5
2
26
70

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29
Q

more UPSI can occur within __ hours of levonorgestrel with no need to take more

A

12

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30
Q

how long does nexplanon last for

A

3 hours

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31
Q

management of bleeding after the implant

A

<3 months: add 3 month course of COCP to control bleeding pattern
>3 months: cervix exam and STI screen

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32
Q

depoprovera can be _ weeks late with no extra precaution

A

2 weeks

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33
Q

most suitable contraception for young people

A

Long Acting Reversible Contraception LARCs: nexplanon implant

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34
Q

COCP weight UKMEC scores

A

BMI 30: UKMEC 2
BMI >35: UKMEC 3

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35
Q

Patch becomes less effective in patients over __kg

A

90

36
Q

safest form of contraception for breast cancer or BRCA gene

A

copper coil

37
Q

Ulipristal (EllaOne) can be used up to __ hours post UPSI

A

120 (5 days)

38
Q

Levonorgestrel should be used up to __ hours post UPSI

A

72 hours (3 days)

39
Q

Contraception for patients with epilepsy

A

UKMEC 2: implant
UKMEC 1: depo-provera, IUD, IUS

40
Q

UKMEC 2 conditions

A

being a smoker under 35
first degree relative with VTE aged 45 or above

41
Q

when can COC be started after abortion >24 weeks

A

immediately

42
Q

primary mode of the contraceptive implant

A

inhibition of ovulation

43
Q

time until copper coil effective

A

immediately

44
Q

time until injection and implant effective

A

7 days

45
Q

time until COC effective

A

7 days

46
Q

time until POP effective

A

2 days

47
Q

mechanism of desogestrel (cerazette)

A

inhibits ovulation

48
Q

expulsion rate of IUD (copper coil)

A

occurs in 1 in 20 women and more likely in the first 3 months

49
Q

management of smear test positive for actinomyces organisms with symptoms vs no symptoms

A

symptoms: remove IUD and penicillin therapy
no symptoms: no action needed

50
Q

management of nexplanon if patient is on enzyme-inducing drugs

A

cover with depo-provera

51
Q

how effective is lactational amenorrhoea if woman is fully breastfeeding and under 6 months postpartum

A

98%

52
Q

contraception needed if IUS inserted on day 1-7 of cycle

A

no additional contraception needed

53
Q

COC can be used up to __ years of age

A

50

54
Q

why is migraine with aura contra-indicated?

A

significantly increased risk of ischaemic stroke

55
Q

what is the COCs effect on BMD

A

help maintain

56
Q

how long is Mirena licensed for for endometrial protection in women taking oestrogen only HRT

A

4 years

57
Q

undiagnosed breast mass UKMEC category

A

UKMEC 2

58
Q

does the progesterone implant cause increased risk of VTE, stroke, MI, BMD

A

NO

59
Q

time until mirena coil effective

A

days 1-7: immediately
days 7+: 7 days

60
Q

how long should a woman wait after taking ulipristal acetate (EllaOne) before returning to hormonal contraception

A

5 days (ulipristal acetate can reduce hormonal contraceptive)

61
Q

COCP effect on perimenopausal symptoms

A

may ease

62
Q

What UKMEC is past breast cancer

A

UKMEC 3

63
Q

what age can contraception be stopped without risk of pregnancy?

A

55

64
Q

how many months postpartum does LAM method stop working

A

6 months

65
Q

Which contraceptives must be stopped at 50 years old

A

COCP, depoprovera

66
Q

most common adverse affect of POP

A

irregular vaginal bleeding

67
Q

most common adverse affect of depo provera

A

weight gain

68
Q

BMI 30-35 UKMEC score

A

2

69
Q

best contraceptive option for BMI>35

A

mirena IUS

70
Q

what contraceptive is impacted by enzyme inducing drugs

A

nexplanon, the patch

71
Q

most appropriate place for the implant

A

subnormal, non dominant arm

72
Q

management of bleeding >3 months on COCP

A

cervical exam, STI screen, high vaginal and endocervical swab

73
Q

UKMEC for COCP with positive antiphospholipid antibodies

A

UKMEC 4

74
Q

VTE risk in dianette is around __x that of other COCP

A

twice

75
Q

types of coils hormone content in order

A

Jadess
Kyleena
Mirena

76
Q

which pill is indicated in obesity

A

cerazette

77
Q

difference between nexplanon and implanon

A

implanon less likely to be inserted too deep
radiopaque and so easier to locate

78
Q

IUD and ectopic pregnancy risk

A

overall pregnancy risk decreased, but if a woman gets pregnant, it is more likely to be ectopic

79
Q

how is the copper coil used as emergency contraception

A

must be inserted within 5 days of UPSI or 5 days after ovulation date

79
Q

how is the copper coil used as emergency contraception

A

must be inserted within 5 days of UPSI or 5 days after ovulation date

80
Q

UKMEC BRCA gene carrier

A

UKMEC 3

81
Q

what is the increased risk of PID with an IUD

A

increased risk in first 20 days then back to normal

82
Q

which contraceptives take 7 days to work

A

IUS, injection, COC, implant

83
Q

how much ethinylestradiol is recommended for first time COCP

A

30ug

84
Q

EllaOne is contraindicated in patients with

A

severe athsma

Women's Health (5 decks)

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