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GK F3E5 > Contraception 2 > Flashcards

Contraception 2 Flashcards

1
Q

What exam should be performed prior to IUD insertion?

A

Pelvic exam: bimanual and speculum/cervical inspection

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2
Q

What are 2 contraindications to an IUD?

A
  • Uterine anomaly
  • PID/current infection
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3
Q

When can IUDs be inserted?

A

Any time as long as reasonably certain not pregnant

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4
Q

When is back up NOT needed after insertion of a Cu-IUD vs LNG-IUD?

A
  • Copper- no back up needed
  • LNG- no back up if inserted w/in 1st 7d of menses
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5
Q

Which type of contraception is recommended for adolescents

A

Long acting reversible contraception (IUDs preferred)

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6
Q

What 3 conditions is an IUD not recommended?

A
  1. Cervical cancer
  2. Purulent cervicitis
  3. Current Chlamydia/gonorrhea or high likelihood of STI exposure
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7
Q

If a patient becomes pregnant with an IUD- what are they at increased risk of? (3)

A
  • Ectopic pregnancy
  • spontaneous abortion
  • preterm delivery
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8
Q

What is the MOA of the Levonorgestrel IUD?

A
  • Thickens cervical mucus
  • Alters endometrium to prevent implantation of fertilized ovum
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9
Q

What is the MOA of the copper IUD?

A
  • Inhibits sperm motility
  • Inflammatory rxn of the endometrium phagocytizes the sperm
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10
Q

How long can the LNG-IUD be used for? The copper IUD?

A

LNG- 3-5 years

Copper- 10 years

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11
Q

The copper IUD may cause what 2 things

A

May increase menstrual blood loss and dysmenorrhea

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12
Q

What is the MOA of the Etonogestrel implant (3)

A
  • thickened cervical mucus
  • inhibit tubal motility
  • inhibit follicular maturation and ovulation
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13
Q

What is a side effect of the etonogestrel implant

A

unpredictable, irregular menstrual bleeding

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14
Q

You wouldn’t prescribe the Etonogestral implant if the patient has history of what 2 medical conditions?

A
  1. breast cancer
  2. Liver diseases
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15
Q

What is the MOA of emergency contraception

A

disrupts normal follical development and maturation

(blocks LH surge and inhibits ovulation)

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16
Q

What is the effect of emergency contraception on an implanted pregnancy

A

does NOT disturb

(not an abortifacient)

17
Q

How long after sexual intercourse are emergency contraceptives effective

A

up to 72 hrs

18
Q

Within what time frame can a copper IUD be inserted as a form of emergency contraception?

A

Within 5 days or beyond 5 days if it is not > 5 days after ovulation

19
Q

What are the 3 emergency contraceptiv pill options

A
  • Ulipristal acetate (UPA), 30 mg single dose (Ella)
  • Levonorgestrel (Plan B)- single dose or split dose
  • Combined estrogen and progestin in 2 doses (less effective and more SEs)
20
Q

What are side effects of emergency contraception

A

Nausea and vomiting

(if V w/in 3 hrs of taking EC, take another dose)

21
Q

When can contraceptives be started after taking UPA, LNG and combined estrogen/progestin (emergency contraceptive pills)

A

Immediately

22
Q

When should a preg test be perfromed after taking UPA, LNG and combined estrogen/progestin (emergency contraceptive pills)

A

if no withdrawal bleed w/in 3 weeks

23
Q

Emergency contraceptives:

How long should back-up be used after taking UPA, LNG and combined estrogen/progestin?

A

post UPA: Back up x14 days or until next menses

Post LNG and combined estrogen/progestin: Back up x7days

24
Q

POPCORN

A patient has an increased risk of regret after steriliazation if they meet what 8 criteria?

A
  1. < 30y/o
  2. Low parity
  3. Sterilization at time of C-section
  4. Change in marital status
  5. Poverty
  6. Minority status
  7. Misinformation about permanence or risks
  8. Hurried decision
25
Q

Vasectomy: Alternative contraception is needed until when

A

Until 2 consecutive sperm samples show no motile sperm

26
Q

What 4 forms of contraception are recommended for women >45y/o?

A

Progestin only or non-hormonal options:

  • Progestin only pills
  • implants
  • LNG-IUD
  • Cu-IUD
27
Q

What is the best contraceptive method for preventing unintended, rapid repeat pregnancy and abortion in young women?

A

LARC

28
Q

You should take caution with which 2 contraception methods in obese patients?

A
  • Ortho Evra Patch
  • Depot Provera medroxyprogesterone (causes weight gain)
29
Q

Obesity and Contraception:

  • Hormonal contraception decreases risk of what 2 conditions
A

endometrial hyperplasia and cancer

30
Q

ACOG and North American Menopause society recommend continued contraceptive use until when?

A

menopause or age 50-55

31
Q

When should you follow up with a patient after prescribing contraceptives?

A
  • Any time for side effects
  • If want to change methods
32
Q

If you have an obese patient with h/o PCOS that frequently travels, what contraceptive should you recommend

A

Copper IUD

(Can’t do anything with estrogen b/c of hypercoag state, no Depo b/c of obesity)

GK F3E5 (19 decks)

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