Contraception

Question 1

Efficacy Definition

Answer 1

The likelihood a pregnancy can occur even though you usi g th bc as prescribed

Question 2

Effectiveness

Answer 2

How well the method works in actual practice

Question 3

Highest effective use of BC (2 of them)

Answer 3

IUD and LARC (Levonorgestrel-Releasing Intrauterine Device)

Question 4

Copper IUD Copper T and ParaGard how long it lasts

Answer 4

-Inhibit sperm migration and viability
-10 year life span/non hormonal

Question 5

LARC (Mirena, Liletta, Kyleena)
How long it last
Menstrual cycle
s/e

Answer 5

-cervical mucous viscous/impermeable to sperm

-Menstrural cycle decrease/amenorrhea/dysmenorrhea/heavy bleeding

-s/e: nausea, h/a, mood change, breast tender, ovarian cyst

-last 5 years .

Question 6

LARC: Nexplanon

Answer 6

Controlled release of etonogestrel over 3 years

• Nexplanon releases PROGESTIN
• Subdermal implant, 4x2. Visualized on X-ray.

-thicken cervical mucous, alter uterine lining Fertility immediately after removal, ovulate in 6 weeks.

Non preggos can use this

s/e: irregular bleeding, amenorrhea, h/a, weight gain, acne, breast tender

Question 7

What is the 4 categories guidelines for contraception

Answer 7

US Medical Eligibility Criteria Categories for Classifying Hormonal Contraceptives and Intrauterine Devices

Question 8

What are the 2 PERMANENT CONTRACEPTION

Answer 8

Sterilization (Tubal Occlusion/Ligation) –> block fallopian tubes and blocks sperm

or

Vasectomy (cuts the right and left vas deferens that carries sperm)

Vasectomy, Vassal occlusion, and vassal injection

Outpatient

Question 9

Combined estrogen and
progestin
*what is the high risk of *

Answer 9

• oral contraceptives
  -patches
  -vaginal ring

Thromboembolic evens and endometrial hyperplasia**

Question 10

Progestin ONLY

Which two primary goal is not for preventing ovulation?

Answer 10

IRREGULAR BLEEDING
Drop Provera
Sub-dermal implants

LNG IUD + POP (protesting only pills) - not primary for preventing ovulation

Question 11

Who cannot get oral contraceptives?

Do you need a pelvic exam?

Answer 11

BP > 140/90
Hx of vascular disease
Migraine
Breast ca
Liver disease
Smoker 15 + cigs/day
>35 y/o
DM
Thrombogenic mutation

No don’t need a pelvic exam

Question 12

Initial Pill Pack

R/t Bleeding and starting >5 days

Answer 12

Prescribe 1 year supply (COC) to help with continuation

If you not preggo you can start at any time

> 5 days since bleeding, no sex and additional contraceptive use

Question 13

What is a late dose

Answer 13

< 24 hours since last dose should have been taken

Question 14

What is missed dose

Answer 14

> 24 hours since last dose should have been taken

Question 15

Benefits of COC, what does It not protect you from

Answer 15

Increase bone density, dc PID risk, Dc endometrial, ovarian, and colorectal cancer

BUT

does not protect against HIV

Question 15

For late and missed dose <48 hours

Answer 15

Take ASAP
COntinue regular regimen
No additional contraception needed

Question 16

For late and missed dose >48 hours

Answer 16

Back up contraception needed (condoms) no sex until 7 days continual pill use
Continue regular regimen
No additional contraception needed

Question 17

POP pills

Answer 17

can use with breastfeeding
Use at any age
Amenorrhea at 12 months
PID Protective

Missed POPor nausea, vomiting : Back up contraception for 2 days

Question 18

Warning signs of COC ACHES

Answer 18

Abdominal pain, Chest pain, Headaches, Eye problems, Severe leg pain.

Discontinue pill and call provider

Question 19

Depo Provera

Answer 19

Self administered IM q 13 weeks
Decrease seizures in epilepsy
2 weeks late maximum.

Question 20

Xulane and Twirla Transdermal

Answer 20

Therapeutic in 24-48 hours

Change q week for 3 weeks then break for 1 week
Wear anywhere in upper torso

Question 21

Vaginal Ring

Answer 21

2 inch diameter Keep in vagina for 21 days
low serum concentration

Increase risk of vaginitis and leukorrhea**

Question 22

Emergency Contraception (3)
(LUI)

Answer 22

PlanB one step –> Levonorgestrel take within 3 days , IUD, UA

1) Copper IUD Implant within** 5** days of unprotected sex

2) Plan B One Step (Pill)
UPA, ELA, After, Contra, Prevents, Option 2

3) Yupze Method

se: bleeding, nausea, headache, vomiting, abdominal pain

Question 23

Only Injectable contraception

BBW

Answer 23

Depo Provera given q 3 months

BBW for bone loss should not be used more than 2 years

Question 24

Who should receive Depo

Answer 24

<6 weeks pp
Breastfeeding
High risk heart dz, >160/100 HTN

Question 25

Common s/e of Depo

Answer 25

AMENORRHEA