Contraception Flashcards

1
Q

Dianette (co-cyprindiol) is licenced for which two conditions?

A

Severe acne
Mod-severe hirsutism

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2
Q

Evra patch - how to use

A

Wear for first three weeks, changing patch every week
Followed by 1 week patch free where bleed will occur

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3
Q

Evra patch
What to do if the patch change is delayed at the end of week 1 or 2

A

< 48 hours
Change immediately
No further precautions

> 48 hours
Change immediately
Barrier method for the next 7 days
If UPSI in the last 5/7 then emergency contraception

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4
Q

Evra patch
What to do if the patch removal is delayed at the end of week 3

A

Remove immediately
New patch on usual cycle start day

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5
Q

Evra patch
Patch application is delayed at the end of a patch free week

A

Barrier contraception for 7/7

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6
Q

Reduced risk of which cancers when taking COCP (3)

A

Ovarian and endometrial and bowel

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7
Q

Increased risk of which cancers with COCP (2)
Other risks (3)

A

Breast and cervical
VTE, stroke, IHD

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8
Q

Missed pill rules for Qlaira
When is the pill classed as late?

If a woman has missed >2 pills then?

A

If it is taken >12 hours late

Emergency contraception

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9
Q

If only 1 pill is missed (Qlaira) then it is dependent on where in the cycle it is missed.
If missed on day 27/28

A

Discard forgotten tablet, continue tablet taking in normal way
No further contraception

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10
Q

If only 1 pill is missed (Qlaira) then it is dependent on where in the cycle it is missed.
Day 25/26

A

Take missed pill and next tab at usual time
No further contraception

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11
Q

If only 1 pill is missed (Qlaira) then it is dependent on where in the cycle it is missed.
Day 18-24

A

Discard packet, start from day 1 again
Additional contraception for 9/7

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12
Q

If only 1 pill is missed (Qlaira) then it is dependent on where in the cycle it is missed.
Day 1-17

A

Take missed pill immediately and next tab at usual time
Additional contraception for 9/7

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13
Q

age < 35 years and smoking
UKMEC

A

UKMEC 2

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14
Q

age > 35 years and smoking > 15 cigarettes/day
UKMEC

A

UKMEC 4

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15
Q

age > 35 years and smoking < 15 cigarettes/day
UKMEC

A

UKMEC 3

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16
Q

COCP
UKMEC 2 and 3 for BMI

A

30-34 UKMEC2
>=35 UKMEC3

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17
Q

COCP
Migraine with aura
Without aura
UKMEC

A

UKMEC 4
UKMEC 3 for continued prescribing
Contraindicated

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18
Q

Epilepsy taking phenytoin,carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine
UKMEC
COCP
POP
Implant
Depo
IUD
IUS

A

COCP
POP
UKMEC 3

Implant UKMEC 2

Depo, IUD, IUS UKMEC 1

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19
Q

Epilepsy on lamtrogine
COCP
POP, implant, depo, IUD, IUS

A

UKMEC 3 COCP
UKMEC 1

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19
Q

Epilepsy on lamtrogine
COCP
POP, implant, depo, IUD, IUS

A

UKMEC 3 COCP
UKMEC 1

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20
Q

norethisterone
levonorgestrel
ethynodiol diacetate
Are all types of?
How late can it be taken?

A

POP second generation
3 hours

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21
Q

Desogestrel (Cerazette) is what type of contraception?
How does it work?
How late can you take it?

A

POP third generation
Inhibits ovulation
Can take the pill up to 12 hours kate

22
Q

POP missed pills explained

A

Take the missed pill as soon as possible (only 1)
Condoms for a further 48 hours

23
Q

POP counselling
SE (1)
Starting the POP (when in the cycle and protection)
Break or no pill break needed

A

Irregular bleeding
If commenced between day 1 and 5 of cycle then immediate protection, otherwise condoms for the first two days
No pill break

23
Q

POP contraindications (UKMEC 4) (2)

A

Pregnancy
Breast ca in last 5 years

24
Q

POP UKMEC 3 (4)

A

Active liver disease
Breast ca > 5yo
Undiagnosed vaginal bleeding
IHD/stroke

25
Q

Postpartum contraception options when?
POP
COCP
IUD

A

POP straight away (if after d21 then will need condoms for first 48 hours)
COCP from 6 weeks
IUD within 48 hours of childbirth or after 4 weeks

26
Q

Copper coil MOA (1)
IUS MOA (2)

A

Decreased sperm motility

Prevents endometrial proliferation, cervical mucous thickening

27
Q

IUS insertion, how long do you need barrier contraception for once inserted versus copper coil

A

7 days, versus immediately effective for copper coil

28
Q

MOA depo
CI (1)

A

Inhibits ovulation
Breast ca current UKMEC 4

29
Q

Emergency contraception options (3) dose, and time has to be taken within (from UPSI)

A
  1. Levonorgestrel 1.5mg (Levonelle) - within 72 hours
  2. Ullipristal (EllaOne) 30mg - within 120 hours
  3. Copper IUD - within 120 hours (5/7) or 5 days after ovulation date
30
Q

Levonorgestrel dose should be doubled in which cases? (2)

Vomiting within how many hours should the dose be repeated?

A

BMI >26
>70kg

3 hours

31
Q

EllaOne caution should be exercised in patients with which condition?

A

Asthma

32
Q

Children under the age of ? are considered unable to give consent for sexual intercourse

A

<13

33
Q

Young people should be advised to have STI tests when and when after an incident of UPSI?

A

2 and 12 weeks

33
Q

Young people should be advised to have STI tests when and when after an incident of UPSI?

A

2 and 12 weeks

34
Q

Nexplanon MOA
Lasts how long?
Needs to be inserted at what point in the cycle otherwise needs condoms for how long

A

Prevent ovulation
3 years
Days 1-5
7 days

35
Q

Contraception of choice in young people

A

Nexplanon (implant)

36
Q

Patients assigned female at birth with a uterus who is on testosterone therapy should be offered what form of contraception?

Emergency contraception

A

Prog only contraception
Any of the three options

37
Q

Patients assigned male at birth who are on oestro/gonadotrophin therapy should use what contraception?

A

Condoms

38
Q

POP MOA

A

thickens cervical mucous

39
Q

IUD MOA

A

decreases sperm motility

40
Q

IUS MOA

A

prevents endometrial prolif

41
Q

COCP, desogestrel, depo, implant MOA

A

Inhibits ovulation

42
Q

Contraception in >40yo
Which type of contraception is
UKMEC 2 >=40 and >=45

Both can be used up until the age of?

A

COCP >= 40yo
Depo >= 45yo

50

43
Q

<50yo stop contraception after how many years of amenorrhoea

> 50yo

A

2 years
1 year

44
Q

UKMEC 3 for COCP (8)

A

> 35yo <15 cigs/day smoker
BMI >35
FH of VTE <45yo in first degree relative
Controlled HTN
Immobility
BRCA carrier
Current gallbladder disease
DM >20yo

45
Q

UKMEC 4 for COCP (9)

A

> 35yo >15cigs/day
Migraine with aura
Hx VTE
Hx stroke/ IHD
Breast feeding <6 weeks
Uncontrolled HTN
Current breast ca
Major surgery
Antiphospholipid antibodies +ve

46
Q

COCP counselling (3)

A

VTE risk
Breast and cervical risk
IHD and stroke risk

47
Q

COCP if started during which days in the cycle do not also need barrier contraception otherwise needs condoms for how many days

A

D1-D5
7 days contraception

47
Q

COCP if started during which days in the cycle do not also need barrier contraception otherwise needs condoms for how many days

A

D1-D5
7 days contraception

48
Q

Missed pills COCP
1 pill

2 or more
Day 1-7
Day 8-14
Day 15-21

A

Take the missed pill
No additional contraception

Take one missed pill
Condoms for 7/7

1-7 - consider emergency contraception if UPSI

8-14 - no need for emergency contraception

15-21 - skip pill free week

49
Q

If vomiting within how many hours should a repeat COCP be taken?

A

3 hours