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Gynaecology and Obstetrics > Contraception > Flashcards

Contraception Flashcards

1
Q

Contraceptive method that prevents ovulation

A

COCPs
POPs
Lactational Amenorrhea

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2
Q

Contraceptive method that prevents sperms reaching the oocyte

A

Sterilization

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3
Q

Contraceptive method that prevents embryo implantation in the uterus

A

IUDs
LNG-IUS

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4
Q

Contraceptive method that allows sprem in the vagina but prevent further passage

A

Vaginal diaphragm
Cup

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5
Q

Contraceptive method that prevents sperm in the vagina

A

Condom

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6
Q

Contraceptive method that kills the sperm

A

Spermicidal agents

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7
Q

Medical Eligibility criteria (MEC) levels

A

MEC Category I - No restriction
MEC Category II - Benefits > Risk
MEC Category III - Risks > Benefits
MEC Category IV - Unacceptable health risk

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8
Q

What are the absolute contraindications of CHCs?

A

HTN
CVA
DVT
MI
BCA
Migraine w/ Aura
Age >35
Smoker
Liver tumors
Estrogen-dependent tumor

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9
Q

What is the MOA of CHCs?

A

It inhibits ovulation by stopping negative feedback (decreases FSH and LH)

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10
Q

CHCs different forms

A

Pills
Patch
Ring

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11
Q

Pills has

A

low dose estrogen and progestin

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12
Q

Women who get symptomatic during pill free period, what will you advise?

A

Take pill continuously without the 7 day pill-free period

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13
Q

Patch has ____________ and _______________ and used for 21 days

A

ethinylestradiol
norelgestromin

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14
Q

Where is the patch applied?

A

Any skin area - lower abdomen, arm, buttocks
Site CTD -Breast

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15
Q

Ring has _____________ and _______________

A

ethinylestradiol
etonorgestrel

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16
Q

If 1 pill is missed OR if the pill taken 24-48 hours late

A

Take the last missed mill
Continue the pack as usual
Leave the earlier missed pill
NO CONTRACEPTION NEEDED

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17
Q

If >2 pills are missed OR if pill taken >48 hours late then

A

Take the last missed mill
Continue the pack as usual
Leave the earlier missed pill
If 1st week → Use emergency CTC
If 2nd week → No need
If 3rd week → Directly start a new pack after the 21th pill WITHOUT 7 pill free days

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18
Q

If Patch is missed for ______then emergency ctc is needed

A

48 hours

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19
Q

If ring is missed for ________ then emergency ctc is needed

A

3 hours

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20
Q

Risk of venous thromboembolism is greatest during ________ year of use of COCPs

A

1st year

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21
Q

To prevent venous thromboembolism when prolonged immobility >3hrs

A

Exercise and Graded compression stockings

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22
Q

COCPs use decrease the risk of __________ cancers

A

Colorectal
Endometrial
Ovarian

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23
Q

COCP use increases the risk of ____________ cancers

A

Breast
Cervical

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24
Q

POPs are extremely safe to use if a woman has _______________ risk factors

A

Cardiovascular risk factors

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25
Q

Low dose progesterone inhibits ovulation ____________

A

inconsistently

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26
Q

POPs are ideal for a woman who ___________________

A

wants pills but can’t use COCPs

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27
Q

POPs are used in women with

A

Breastfeeding
Old age
CVDs
Diabetes
SCD

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28
Q

Disadvantages of POP

A

Irregular menses
Functional ovarian cysts
Breast tenderness
Mood swings
Acne
Headache

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29
Q

If a POP pill is missed

A
  • take missed POP, use condom and have emergency ctc
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30
Q

Injectable IM

A
  • Depo provera (medroxyprogesterone)
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31
Q

Injectable SC

A

Sayana press (medroxyprogesterone)

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32
Q

Progesterone injection frequency -

A

12-14 weeks

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33
Q

Injectables are a type of ________ ctc

A

long term

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34
Q

Injectables Progesterones are used to treat ______________

A

Dysmenorrhea or Heavy periods

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35
Q

Injectables have _______ return in fertility while Subdermal implants have _________ return in fertility

A

delayed
rapid

36
Q

Injectables are not for those who wish for _________ ctc

A

short term

37
Q

There is increased risk of HIV by using ____________

A

Depo provera

38
Q

Subdermal implants are inserted in ____________ under LA

A

Non dominant arm
8cm above medial epicondyle

39
Q

Nexplanon - 1 rod - _______________ - 3 yr CTC

A

etonorgestrel
(nExplanon - 2nd letter is E and it has 1 L in it)

40
Q

Uniplant - 1 rod - ________________- 1 year CTC

A

nomgesterol (uNiplant - 2nd letter is N and it has 1 L in it) Uniplant - uni means 1 so single rod

41
Q

Jedelle - 2 rod - _________________ - 3-5 years

A

Levonorgestrel (jedeLLe - it has 2 Ls and 2 Ls also mean 2 rods so it is longer)

42
Q

_______________ - 1 rod - etonorgestrel - 3 yr CTC
___________- 1 rod - nomgesterol - 1 year CTC
__________ - 2 rods - levonorgesterel - 3-5 yrs CTC

A

Nexplanon
Uniplant
Jedelle

43
Q

Subdermal implants are for those who _____________

A

Who forget to take pills

44
Q

Progesterone releasing IUD (LNG-IUD) types

A

Mirena
Jaydess or Skyla

45
Q

Mirena - ___ years
Jaydess/ Skyla - ____ years

A

Mirena - 5 years
Jaydess/ Skyla - 3 years

46
Q

MOA of LNG-IUD -

A

Makes the endometrium unfavorable for implantation and thickens the cervical mucus

47
Q

LNG-IUDs are used for tx of

A

HMB, dysmenorrhea, pelvic pain (endometriosis and adenomyosis) and prevents endometrial hyperplasia

48
Q

Risk of teratogenicity if pregnancy occurs -

A

LNG-IUD

49
Q

Persistent spotting and irregular bleeding when using early

A

LNG-IUD

50
Q

IUDs are used in ___________

A

long term contraception where regular compliance is not needed

51
Q

IUD ctc duration

A

3-10 years

52
Q

Copper IUD used in women _________ so left in place until menopause

A

> 40 year

53
Q

If hormone IUD is used in women __________ so left in place until menopause

A

> 45 year

54
Q

CTD of IUD

A

Pregnancy, PID, Ectopic preg hx, malformation of uterus, copper allergy

55
Q

IUD types

A

Copper IUD
Hormonal LNG-IUD

56
Q

MOA of Copper IUD -

A

Inflty rxn around uterine lining and inhibits sperm motility

57
Q

Side effects of IUD -

A

Increased menstrual blood loss
Increased dysmenorrhea
IUD expulsion
pregnancy (remove IUD within 12 weeks)
Pelvic infxn (Actinomyces like organism)
Uterine perforation

58
Q

Positive ALO in symptomatic patients -

A

penicillin + remove IUD

59
Q

Tx of IUD complications -

A

Laparoscopy
Laparotomy

60
Q

IUD decrease the risk of __________________

A

Ectopic Pregnancy

61
Q

LARC -

A

Cu-IUD
LNG-IUD
Progesterone Implants

62
Q

____________ is the most effective contraceptive method

A

LARC

63
Q

What is LARC

A

Long acting reversible contraception

64
Q

Most common barrier method is ________

A

condom

65
Q

Failure rate of condom is _________

A

24%

66
Q

Vaginal diaphragm is placed between ________________ and ________________

A

the posterior vaginal fornix and the pubic symphysis

67
Q

Vaginal diaphragm failure rate is _________

A

18%

68
Q

Vaginal diaphragm has ______________ as a spermicidal agent

A

Nonoxynol N-9

69
Q

Fitting by a trained person is required in ____________ (condom/diaphragm)

A

diaphragm

70
Q

Diaphragm is inserted 1 hour prior to intercourse and removed after _________ hours

A

6 hours

71
Q

Emergency CTC is AKA

A

morning after pill
Post coital ctc

72
Q

Two types of Emergency CTC -

A

Hormonal and Copper bearing IUD

73
Q

_______________ is the most effective emergency CTC

A

Copper IUD

73
Q

Copper bearing IUD - MOA

A

inhibit implantation if fertilization has occured

74
Q

Hormonal Emergency Pills - Levonorgestrel (____ hours) Ulipristal acetate (____ hours)

A

Levo - 96 hours
Ulipristal - 120 hours

75
Q

Hormonal Emergency ctc - MOA

A

delay ovulation and sperms lose the ability to fertilize

76
Q

Sterilization is ideal for relatively ______________________

A

older couples

77
Q

Semen analysis should be done at ______ weeks after vasectomy to see if any sperm are still present

A

12

78
Q

Tubal ligation is done by -

A

Laparoscopy, Laparotomy, Hysteroscopy

79
Q

Laparotomy is done during

A

C-section

80
Q

Laparoscopy - Under ____ Use alternative ctc unti ______________

A

GA
menstruation occurs

81
Q

________________ is suitable for patients who cannot tolerate surgery (obese, previous surgery)

A

Hysteroscopy

82
Q

Hysteroscopy uses ______________ and confirmed by Xray or US

A

Micro-inserts

83
Q

What is post-tubal ligation syndrome?

A

Increased menstrual bleeding

84
Q

What are some Miscellaneous Techniques?

A

Calendar method (8-18 days)
Temparature method
Lactational amenorrhea <6months

Gynaecology and Obstetrics (13 decks)

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