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Special Pops Exam 1 > Contraception -> > Flashcards

Contraception -> Flashcards

1
Q

Definition of contraception?

A

Deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse

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2
Q

What does PATH stand for (PATH questions)?

A

Pregnancy
Attitudes
Timing
How important is prevention
*shared decision making

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3
Q

When counseling on contraception options, what should be considered?

A

Hx and C/I’s, efficacy, ease of use, side effects, risks, benefits, STI protection, plans for future pregnancy, cost

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4
Q

Most effective birth control methods?

A

Sterilization, IUD, implant

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5
Q

Moderately effective birth control options?

A

Injections, pill, patch, ring, diaphragm

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6
Q

Less effective birth control options?

A

Condoms, withdrawal, sponge, fertility awareness-based, spermicides

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7
Q

Behavioral methods of contraception?

A

Abstinence, outercourse, coitus interruptus, post-coital douche, lactational amenorrhea, cervical mucus methods

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8
Q

What is outercourse?

A

Sexual activity with no vaginal penetration or no penetration at all

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9
Q

Examples of outercourse?

A

Kissing, masturbation, mutual touching

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10
Q

Can outercourse pass infections?

A

Yes

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11
Q

What is coitus interruptus?

A

Withdrawal of the penis before ejaculation

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12
Q

What is a post-coital douche?

A

Water or vinegar that is used to flush semen out of the vagina

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13
Q

Is post-coital douche effective/reliable?

A

No, sperm found in cervical mucus w/in 90 sec after ejaculation

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14
Q

What is lactational amenorrhea?

A

Breastfeeding that can postpone ovulation and menstruation

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15
Q

Recommendations for using lactational amenorrhea as contraception method?

A

-must be only source of infant nutrition
-feed at least q4 hrs/day and q6 hrs/night
-at most 6 mos after birth & stop when period returns

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16
Q

Pregnancy rates in the first 6 months of using lactational amenorrhea?

A

0.9-1.2%

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17
Q

What is the cervical mucus method?

A

Cervix produces mucus of different quality/quantity before & during ovulation: when mucus is tacky, cloudy, sticky, slippery –> unsafe days

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18
Q

Pregnancy rates with cervical mucus method?

A

Of 100 couples in 1 year –> 3 pregnancies

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19
Q

What are the fertility based awareness methods of contraception?

A

Tracking ovulation/cycle, standard days method/cycle beads, birth control app, symptothermal method

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20
Q

When are women most fertile?

A

In the days near ovulation

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21
Q

Guidelines for using standard days method?

A

Must have regular cycle, never shorter than 26 days/longer than 32 days, AVOID unprotected sex day 8-19

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22
Q

What do the colors of cycle beads indicate (standard days method)?

A

Brown beads = safe days
White = unsafe days
Red = first day of period
*move rubber ring every day

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23
Q

Pregnancy rates in couples using the standard days method?

A

Of 100 couples in 1 year –> 5 pregnancies

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24
Q

How does the birth control (natural cycles) app work?

A

Tracks basal body temp/menstrual cycle to detect fertile days

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25
Q

How effective is period tracking using a website?

A

92%

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26
Q

Use efficacy of natural cycles app?

A

93%

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27
Q

How does the symptothermal method work?

A

Uses combo of calendar, temp, cervical mucus method to predict ovulation
*increased accuracy

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28
Q

Available modalities to use the symptothermal method?

A

Commercially available fertility monitors (clearblue)

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29
Q

Barrier methods of contraceptive?

A

Condoms, vaginal sponge, cervical cap, diaphragm, spermicide,

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30
Q

How effective are condoms in preventing pregnancy?

A

85%

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31
Q

How effective are internal condoms at preventing pregnancy?

A

79%

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32
Q

What is a vaginal sponge?

A

Round, plastic foam with spermicide 2 in in diameter, covers cervix/kills sperm

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33
Q

Who are sponges/caps more effective in?

A

Women who have never give birth

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34
Q

Do sponges prevent STIs?

A

No

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35
Q

How effective are sponges at preventing pregnancy?

A

76-88%

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36
Q

How long after insertion should sponges be removed?

A

Within 30hrs d/t TSS

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37
Q

What is a cervical cap?

A

Silicone cup that covers cervix (used w/ spermicide

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38
Q

Do cervical caps protect against STIs?

A

No

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39
Q

How effective are cervical caps at preventing pregnancy?

A

71-86%

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40
Q

How long must cervical caps remain in place after sex?

A

6 hrs

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41
Q

Max time a cervical cap should be left in?

A

No longer than 48 hrs (TSS)

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42
Q

How long do cervical caps last?

A

2yrs (needs care)

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43
Q

Those using cervical caps need to be examined to determine what?

A

Size

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44
Q

Are cervical caps available OTC?

A

No, need rx

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45
Q

What is a diaphragm?

A

Shallow flexible dome shaped silicone cup that covers the cervix (must be used w/ spermicide)

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46
Q

Some diaphragm users may develop what?

A

Frequent UTIs

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47
Q

How long should a diaphragm be left in after sex?

A

6 hours

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48
Q

Max time a diaphragm should be left in?

A

No longer than 24 hrs

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49
Q

How long does a diaphragm last?

A

2 yrs (needs care)

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50
Q

Requirements for diaphragm?

A

Exam and fitting

51
Q

Are diaphragms available OTC?

A

No, need Rx

52
Q

ROA for spermicides?

A

Cream, jelly foam, suppositories

53
Q

How effective is spermicide at preventing pregnancy?

A

71%

54
Q

How long after application of spermicide can you have sex?

A

Must wait for 10 minutes after application

55
Q

MOA of birth control pills?

A

Made of hormones that prevent egg from releasing from ovary, also cause thickening of cervical mucus to block sperm

56
Q

Effectiveness of OCPs in preventing pregnancy?

A

91%

57
Q

Hormonal levels for combo pills?

A

monophasic (preferred): same amount
bi-progestin: increases once halfway through
tri-level: changes every 7 days

58
Q

How many days is the regimen for combo pills?

A

21 or 28 day regimen: 21 active pills, 1 wk of reminder pills
*can be taken continuously to bypass period

59
Q

How many days is the regimen for mini pill?

A

Active pills for all 28 days

60
Q

When is the mini pill used?

A

Postpartum or unable to have estrogen

61
Q

S/E of birth control pills?

A

Nausea, breast tenderness, dec. libido
RARE in combo pill: heart attack, stroke, blood clots

62
Q

Who should not take birth control pills?

A

Smokers (15+ cigs/day) 35+

63
Q

Should birth control pills be taken at the same time every day?

A

Yes

64
Q

If the mini pill is not taken within 3 hours of the regular time, what should be done?

A

Use backup contraception for 48 hrs

65
Q

Meds that make birth control pills less effective?

A

Rifampin, griseofulvin, St. Johns wort, certain anti-seizure and HIV meds

66
Q

Regimen for birth control patch?

A

New patch placed on skin same time every week x3wks w/ 1 patch-free week

67
Q

Do birth control pills and the patch have the same amount of hormonal delivery?

A

Yes

68
Q

S/E of birth control patch?

A

Same as BCP but may have skin interactions

69
Q

What meds interfere w/ bc patch?

A

Same as BCP

70
Q

Who are birth control patches contraindicated in?

A

Obese women d/t blood clot risk

71
Q

Where should birth control patches be applied?

A

Upper outer arm, upper torso, abdomen, buttocks
*AVOID: breasts or open/red skin
*DO NOT apply patch to same area 2 wks in a row

72
Q

Does the birth control patch need an Rx?

A

Yes

73
Q

How often is a bc vaginal ring inserted?

A

Once a month

74
Q

Regimen for vaginal ring?

A

Leave in for 3 weeks, remove for 1 week, replace with new ring

75
Q

MOA, S/E, and med interactions of the vaginal ring are the same as what methods of BC?

A

Pill, patch
-may also have vaginal discharge, irritation, infection

76
Q

Use of oil-based yeast infection meds may increase what when using a vaginal ring?

A

Inc. blood levels of hormones

77
Q

What to do if ring slips out of vagina during sex?

A

Wash w/ warm water and reinsert

78
Q

Use backup method of bc if vaginal ring has been left out for how long?

A

3 hrs

79
Q

How long may the annovera vaginal ring be used for?

A

1 year, but should be taken out every 3 weeks for 1 week to allow a period

80
Q

What is depo provera injection?

A

IM injection of progestin q3mos
-also available: SQ version at home w/ lower dose of progestin but off label/more expensive

81
Q

MOA of depo shot?

A

Same as mini pill

82
Q

How effective is the depo shot at preventing pregnancy?

A

94%

83
Q

Can the depo shot be used during breastfeeding?

A

Yes

84
Q

Side effects of the depo shot?

A

Menstrual irregularity, weight gain, headaches, slow return of fertility, diabetes risk (hypo-estrogen state), reduced bone density (recovery when stopped but not 100%)

85
Q

What to advise for pts who have reduced bone density from depo shot?

A

CA & Vit D, exercise, no smoking

86
Q

What options are LARC (long acting reversible contraception)?

A

Nexplanon, IUD

87
Q

What hormone does nexplanon release?

A

Progestin hormone: Etonogestrel w/ same MOA as pill

88
Q

How log does nexplanon prevent pregnancy?

A

Up to 5 yrs

89
Q

How effective is the nexplanon at preventing pregnancy?

A

99%

90
Q

Can nexplanon be used while breastfeeding?

A

Yes, at 4 wks postpartum

91
Q

Proper implantation of nexplanon should result in what?

A

Ability to palpate under skin

92
Q

S/E of nexplanon?

A

Menstrual irreg, mood swings, wt gain, headache, acne

93
Q

Med interactions w/ nexplanon?

A

Anti-seizure and antiretrovirals for HIV

94
Q

Risks with nexplanon?

A

Blood clots, problems at insertion site, ovarian cysts

95
Q

How effective are IUDs at preventing pregnancy?

A

99%

96
Q

Can IUDs be used while breast feeding?

A

Yes

97
Q

How does the copper IUD prevent pregnancy?

A

Copper wire wrapped around stem of IUD (toxic to sperm)

98
Q

How long does the copper IUD stay in place?

A

10-12 years

99
Q

Those with which disease should not use copper IUD?

A

Wilson’s Disease

100
Q

What hormone does the hormonal IUD release?

A

Progestin

101
Q

How long do hormonal IUDs last?

A

3-6yrs

102
Q

Risks of IUD?

A

Can slip from uterus (has to be removed), infection, uterine perf

103
Q

S/E of IUD?

A

Pain w/ insertion, menstrual irreg, acne, headaches, breast tenderness w/ hormonal IUD

104
Q

What must be ruled out before IUD insertion?

A

STIs and pregnancy

105
Q

Follow up how long after insertion of IUD?

A

1-3 mos

106
Q

Permanent methods of contraception?

A

Tubal sterilization, vasectomy,

107
Q

What is tubal sterilization?

A

Closing/blocking fallopian tubes –> stops pathway for eggs to travel to uterus

108
Q

How can tubal sterilization be done?

A

Ligation (tying/cutting tubes), electrocautery, clips, clamps, rings

109
Q

How is TL performed?

A

Sedation and laparoscopy

110
Q

Risks of tubal ligation?

A

those associated w/ ansthesia/surg, tubes can reconnect –> risk for ectopic preg, regret

111
Q

Is tubal reversal/reconnection a guarantee of pregnancy?

A

No

112
Q

What is a vasectomy?

A

Vas deferens blocked so sperm cannot mix with seminal fluid

113
Q

Is vasectomy immediately effective?

A

No, effective in ~3mos *sperm sample will be analyzed

114
Q

Risks of vasectomy?

A

Risks associated w/ surgery, ends of tube may rejoin, regret (can be reversed or sperm bank used)

115
Q

How many days can emergency contraceptive prevent pregnancy after unprotected sex?

A

Up to 5 days after unprotected sex

116
Q

Methods of emergency contraceptive?

A

IUD or morning after pill

117
Q

How does the morning after pill work?

A

Attempts to prevent ovary from releasing egg longer than usual

118
Q

How effective are the morning after pills Plan B and Next choice if taking w/in 3 days?

A

89%, effectiveness decreases as time passes

119
Q

How effective is the morning after pill Ella if taking w/in 5 days?

A

85% for all 5 days

120
Q

How may weight effect emergency contraception?

A

Plan B: must be under 165lb
Ella: under 195lb
If obese, IUD is best emergency contraceptive

121
Q

Serious complications of emergency contraceptives?

A

None reported

122
Q

S/E of emergency contraceptives?

A

N/V, headache, menstrual irreg

123
Q

Which emergency contraceptive pill requires rx?

A

Ella, can get online w/ next day delivery

Special Pops Exam 1 (8 decks)

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