Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Contraception ! > Flashcards

Contraception ! Flashcards

1
Q

Explain the 4 levels of the UKMEC and what they are used for

A

Guiding the decision to start someone on the combined oral contraceptive pill

  • UKMEC 1 = No restriction in use
  • UKMEC 2 = Benefits generally outweigh risks
  • UKMEC 3 = Risks generally outweight benefits
  • UKMEC = Unacceptable risk (CI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a UKMEC 3 for the COCP?

A
  • More than 35 years old and smoking less than 15 cigarettes/day
  • BMI > 35 kg/m^2*
  • Family history of thromboembolic disease in first degree relatives < 45 years
  • Controlled hypertension
  • Immobility e.g. wheel chair use
  • Carrier of known gene mutations associated with breast cancer (e.g. BRCA1/BRCA2)
  • Current gallbladder disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

UKMEC 4 for the combined contraceptive pill

A
  • Uncontrolled hypertension (particularly ≥160 / ≥100)
  • Migraine with aura
  • History of VTE
  • History of stroke or IHD
  • Aged over 35 smoking more than 15 cigarettes per day
  • Current breast cancer
  • Major surgery with prolonged immobilisation
  • Systemic lupus erythematosus and antiphospholipid syndrome
  • Breast feeding < 6 wks post-partum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mechanismof action of the combined oral contraceptive pill (COCP)

A

Inhibits ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What advice is given if one COCP is missed (less than 72 hrs since last pill)

A

-Take missed pill as soon as possible (even if 2 on same day)
-No extra protection required provided other pills before where taken correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Advice if 2 missed pills when on the COCP

A

-Take most recent missed pill
-Additional contraception needed until pill has been taken for 7 days straight
-If this was missed on day 1-7 of the packet and they have had unprotected sex they will need emergency contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 common regimes for taking the COCP?

A
  • 21 days on and 7 days off
  • 63 days on (three packs) and 7 days off (“tricycling“)
  • Continuous use without a pill-free period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give three risks of the COCP

A
  • Small risk of VTE
  • Small increased risk of breast and cervical cancer (returns to normal 10 yrs after stopping).
  • Small increased risk of MI and stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If started within first 5 days of the cycle , when does the COCP offer protection ?

A

Straight away
No additional contraception needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If the COCP is started after day 5 of the menstrual cycle, how long is barrier contraception required for ?

A

7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Advantages of the COCP

A
  • Reduced risk of ovarian and endometrial cancer
  • Reduced risk of colorectal cancer
  • Often makes periods regular, lighter and less painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the cycle for the combined contraceptive patch

A
  • Worn for 4 weeks
  • First 3 weeks : patch worn every day and changed each week
  • No patch worn in week 4 = withdrawal bleed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain precautions needed if there is a delay to changing the combined contraceptive patch in week 1 or 2

A
  • <48 hr delay : change immediately, no further precautions
  • Delay >48 hrs : chnage and use condoms for 7 days.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain precautions needed if there is a delay to patch removal at end of week three

A
  • The patch should be removed as soon as possible and the new patch applied on the usual cycle start day for the next cycle, even if withdrawal bleeding is occurring.

-No additional contraception is needed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is required if patch application is delayed at the end of a patch-free week

A
  • Additional barrier contraception should be used for 7 days following any delay at the start of a new patch cycle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How doe traditional POPs work ?

A
  • Thickening the cervical mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does desogestrel work (POP) ?

A
  • Inhibiting ovulation
  • Thickening the cervical mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If started on day 1-5 of the menstrual cycle, when does the POP provide protection ?

A

Immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Potential SE of POP

A

Irregular vaginal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If started after day 5 of the cycle, how long is barrier contraception required when on the POP

A

2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain the precautions regarding missed pills with the traditional POP

A
  • If < 3 hours late: continue as normal
  • If > 3 hours : take the missed pill as soon as possible, condoms, should be used until pill taking has been re-established for 48 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Explain the precautions regarding missed pills with desogestrel (Cerazette)

A
  • <12 hrs : take pill & no extra precautions
  • > 12 hrs : use condoms until pill taking has been re established for 48 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mechanism of action of nexplanon

A
  • Primarily inhibits ovulation but ALSO thickens cervical mucus
  • Involves the hormone etonogestrel (progestogen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How long does nexplanon
last

A

3 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Adverse effects of nexplanon

A
  • Irregular/heavy bleeding : sometimes managed with co-prescription of COCP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

UKMEC 4 for nexplanon

A

current breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If not inserted on day 1-5 of cycle, how long is additional contraception needed for with nexplanon

A

7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Contents and mechanism of action of injectable contraceptives

A
  • Inhibits ovulation but ALSO thickens cervical mucus and causes endometrial thinning
  • Contains medroxyprogesterone acetate 150mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How often are injectable contraceptives given

A

Every 12 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How long can fertility be delayed once stopped injectable contraceptives

A

12 mnths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

4 adverse effects of injectable contraceptives

A
  • Irregular bleeding
  • Weight gain
  • Potentially increased risk of osteoporosis
  • Not quickly reversible and fertility may return after a varying time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mechanism of action of IUD

A
  • Prevention of fertilisation by causing decreased sperm motility and survival (possibly an effect of copper ions)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is in the IUS and it’s mechanism of action

A

levonorgestrel prevents endometrial proliferation and causes cervical mucous thickening

34
Q

When do IUD being providing protection and how long dp they last

A

Immediately
5 years

35
Q

When does IUS begin providing protection and how long do they last

A

7 days
5 years

36
Q

SE of IUD

A

Heavier, longer and more painful periods

37
Q

Se of IUS

A

Initial frequent uterine bleeding and spotting.

38
Q

When can the IUD / IUS be inserted following childbirth

A

within 48 hours of childbirth or after 4 weeks.

39
Q

When can the POP be started postpartum

A

Anytime
After day 21 postpartum, condoms should be used for 2 days

40
Q

Explain when the COCP is UKMEC 2 / 4 following childbirth

A
  • UKMEC 4 if breastfeeding <6wks
  • UKMEC 2 if breastfeeding 6wks - 6mnths
41
Q

How long can lactional amenorrhoea act as contraception

A

6 mnths but must be amenorrhoeic and soley breast feeding

42
Q

What form of contraception is UKMEC 3 when on lamotrigine

A

COCP

43
Q

What form of contraception is UKMEC 3 when taking phenytoin,carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine

A

COCP and POP

44
Q

When can the COCP be taken up till and what should be done after this ages

A
  • 50 yrs
  • If >=50 switch to non hormonal or progestogen-only method
45
Q

When can the implant, POP and IUS be taken up till but what should be checked after this age

A
  • Continued up to 50
  • Can continue after this point BUT If amenorrhoeic check FSH and stop after 1 year if FSH >= 30u/l or stop at 55 years
  • If not ammenorrhoeic, investigate why
46
Q

what should be done once >=50 yrs if using depo-provera contraception

A

Switch to a non-hormonal method and stop after 2 years of amenorrhoea

47
Q

what is the dose of levonorgestrel (levonelle) and how long after unprotected sex can it be taken

A
  • 1.5mg
  • 72hrs
48
Q

when would the dose of levonorgestrel need to be doubled

A
  • BMI > 26 or >70kg
49
Q

When would the dose of levonorgestel need to be repeated

A

Vomiting within 3 hrs

50
Q

when can hormonal contraception be started following levonorgestrel

A

Immediately

51
Q

what dose of Ulipristal (Ellaone) is used for emergency contraception and how long after unprotected sex can it be taken

A
  • 30mg
  • 120 hrs
52
Q

How long after takin Ulipristal should you wait to recommence hormonal contraception

A

5 days

53
Q

When should Ulipristal be avoided

A

Asthma

54
Q

How long should breastfeeding be delayed if taking Ulipristal

A

1 wk

55
Q

When can IUD be used for emergency contraception

A

Within 5 days of unprotected sex OR up to 5 days after likely ovulation date

56
Q
A
57
Q

What contraception is avoided in cervical and endometrial cancer

A

Mirena coil

58
Q

what contraception is avoided in Wilson’s disease

A

Copper coil

59
Q

How long before fertility returns afer giving birth ?

A

21 days after birth

60
Q

How long is contraception required in menopausal women ?

A
  • For 2 yrs following last period in women <50
  • For 1 yr following last period in women >50
61
Q

When should the progestogen injection be stopped ?

A
  • Before 50 yrs, due to risk of osteoporosis
62
Q

When switching from a tradition progesterone only pill to a COCP, how many days of extra protection is required

A

7 days

63
Q

When switching from desogestrel to a COCP, how many days of additional contraception is required ?

A

NON

64
Q

When should the COCP be stopped prior to a major operation

A

4 weeks

65
Q

When switching from a COCP to a POP, when isn no additional contraception require ?

A

IF :

  • > Have taken the COCP consistently for more than 7 days (they are in week 2 or 3 of the pill pack)
    -> Are on days 1-2 of the hormone-free period following a full pack of the COCP
66
Q

What are the 2 SE unique to depot injections

A
  • Weight gain
  • Osteoporosis
67
Q

What advice is given to women before removal of the coil ?

A

abstain from sex or use condoms for 7 days, or there is a risk of pregnancy

68
Q

Upon instertion, when does the copper coil become effective

A

Immediately (licensed for 5-10 yrs)

69
Q

What does sterilisation in a female involve ?

A
  • Occlusion of the fallopian tubes with ‘Filshie clips’ or tied and cut or removed all together
70
Q

What does male sterilisation involve ?

A
  • Cutting the vas deferens, preventing sperm travelling from the testes
  • Alternative contraception reuired for 2 mnths before sperm testing 12 wks post procedure
71
Q

Advice regarding 2 missed pills on week 3

A

finish the pills in the current pack and start new pack immediately, omitting pill-free interval

72
Q

what is the most effective method of emergency contraception that should be offered o all women as long as there are no CI ?

A

IUD

73
Q

What contraception is not recommended in pts assigned female at borth and on testosteron therapy

A

COCP

74
Q

what are acceptable options for contraception in transgender pts assigned female at birth

A
  • IUD (however may exacerbate bleeding)
  • POP
  • Injections
75
Q

Where is nexplanon inserted ?

A

Subdermal
Non-dominant arm

76
Q

Explain when the different methods of contraception become effective

A
  • Instant: IUD
  • 2 days: POP
  • 7 days: COC, injection, implant, IUS
77
Q

If wanting to start oral contraception within 21 days of giving birth BUT purely bottle feeding. Would you give the COCP or the POP

A

POP

The COCP should not be used in the first 21 days due to the increased venous thromboembolism risk post-partum

78
Q

what antibiotic can reduce the effectiveness of nexplanon ?

A

Rifampicin

79
Q

Following a surgical abortion, when can an intrauterine contraceptive be inserted?

A

Immediately

80
Q
A

Finals (92 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions