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Gross but true (OBGYNE) > Contraception > Flashcards

Contraception Flashcards

1
Q

Effects of this component of OCPs includes: inhibition of the midcycle surge/ovulation. Usual dose is 30-35mcg

A

ethinyl estradiol

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2
Q

Can treat other problems including acnes, dysfunctional uterine bleeding, ovarian cysts, endometriosis

A

high dose estrogen pills

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3
Q

Name the older, more androgenic progesterones that lower HDL. Dose is 0.15-1.0mg

A

Norethindrone, norethindrone acetate, levonorgestrel

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4
Q

Name the newer, less androgenic progesterones. Have less effect on carbs/lipid metabolism, more effective at reducing hirsutism.

A

Norgestimate & desogestrel

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5
Q

What is there an increased risk of with newer progestins?

A

thromboembolism

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6
Q

Makes endometrium less suitable for implantation. Alters cervical mucus making it less permeable to penetration of sperm. Impairs normal tubal motility and peristalsis

A

progestins

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7
Q

What forms of OCP have a cycle that is 24 days on, 4 days off?

A

drospirenone containing forms

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8
Q

What is the timeframe for the extended cycle OCPs?

A

84 days on, 7 days off

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9
Q

What pill formulation are lactating women usually given?

A

mini-pill

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10
Q

How long must a patient continue a backup method until pill has taken effect?

A

7-14 days

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11
Q

What is the Sunday start method?

A

start 1st Sunday after period

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12
Q

What does education for 1-2 missed pills include?

A

If miss 1 pill still covered for birth control. If miss 2 pills in a row must use back up method for the rest of that cycle

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13
Q

How does OCP therapy affect dysmenorrhea, Fe deficiency anemia, ectopic pregnancy, ovarian cancer, benign breast dz, endometriosis?

A

lowers the risk of developing these conditions

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14
Q

Most common side effect of OCP that is independent of progestin

A

breakthrough bleeding

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15
Q

What can you do to address breakthrough bleeding as a side effect?

A

add extra estrogen or switch to more estrogenic progestin

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16
Q

Why is the risk of cervical cancer increased with OCP?

A

In HPV positive OCP users a metabolite of estradiol can act as a cofactor w/ oncogenic HPV

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17
Q

What are women who get frequent migraines at risk of with concurrent OCP use?

A

cerebral thromboembolis

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18
Q

What is the effect of drugs that increase liver microsomal enzyme activity on OCPs? Examples include Phenobarbitol, phenytoin, carbamazepine, barbituates, griesofulvin. st. john’s wort

A

accelerates OCP metabolism

19
Q

What effect do antibiotics such as rifampin, tetracycline, PCNs, cephalosporins have on OCP?

A

decrease OCP efficacy.

20
Q

Delivers 20 mcg estradiol and 150 mcg of norelgestromin daily. Delivers constant level of hormone. Ortho-Evra worn for 3 wks, 1 wk off for menses.

A

contraceptive patch

21
Q

Delivers 15 mcg estradiol and 120 mcg estonogestrel daily for 3 weeks intravaginally. Removed for 1 week then a new one is inserted

A

vaginal ring

22
Q

Inhibition of ovulation by inhibiting gonadotropin secretion. Inhibits follicular maturation. Thickens and decreases amount of cervical mucus. Creates thin, atrophic endometrium. Ovum transport may be slowed

A

Progestin only mechanism of action

23
Q

Indications for progestin only methods

A

htn, age >35 and smoker or obese, migraines, SLE

24
Q

Black box warning for Depo-provera

A

bone density decrease

25
Q

How long might fertility be delayed after stopping DMPA?

A

18 months after last injection

26
Q

Single rod with slow release of 68mg etonogestrel. Lasts for 3 years. Inserted in the upper arm subdermally in the office. Irregular bleeding was the primary reason of discontinuation

A

Implanon/Nexplanon

27
Q

How long is Mirena and Styla approved for?

A

Mirena 5 yrs and Styla 3 yrs

28
Q

Local progestin effect where endometrial concentration of levonorgestrel are 1000 x higher then seen w/ implant and blood levels are very low.

A

Intrauterine Contraception (IUC)- Mirena and Styla

29
Q

releases copper continuously into the uterine cavity; this interferes with sperm transport and prevents fertilization of ova

A

Paragard

30
Q

How long can Paragard remain in place?

A

10 yrs

31
Q

Type of birth control that the following patients are ideal candidates for: low risk of STIs, not planning pregnancy for 1 yr, want a reversible form of contraception and need to avoid estrogen

A

IUC

32
Q

A dome-shaped cup made of latex or silicone. Partially filled w/ spermicidal cream/jelly and then inserted into the vagina over the cervix
must be left in the vagina for 6 to 8 hrs after intercourse, then needs to be removed

A

diaphragm

33
Q

CI for diaphragm

A

toxic shock syndrome

34
Q

Reusable, deep rubber cup that fits over the cervix, must be used with a spermicide has to remain in for 6-8 hrs can be left in place for up to 48 hours

A

cervical cap (FemCap)

35
Q

circular disk that contains 1000 mg of nonoxynol-9 and has attached loop for removal. moistened w/ tap water before insertion
“one size” fits all; does not require a prescription, or fitting

A

sponge

36
Q

Lines the vagina and shields introitus providing physical barrier during intercourse. More problems with breakage, slippage and incorrect penetration

A

female condom

37
Q

Disadvantages include: irritation, yeast vaginitis, enhanced spread of HIV

A

spermacides

38
Q

Associated w/ subfertility, but can only be relied upon to prevent pregnancy when: The woman is < 6 months postpartum. She is breastfeeding exclusively. She is amenorrheic

A

lactation

39
Q

What dose of emergency contraceptive is available OTC without age restrictions?

A

The single 1.5 mg dose regimen

40
Q

Inhibiting or delaying ovulation. Interfering w/ fertilization or tubal transport. Preventing implantation by altering endometrial receptivity. Causing regression of the corpus luteum

A

emergency contraceptive

41
Q

How long are emergency conraceptives effective for?

A

up to 120hrs after the event

42
Q

Recommended for couples who desire permanent contraception or sterilization

A

vasectomy

43
Q

comparable to sterilization in terms of efficacy, but are non-surgical and reversible for women who request sterilization

A

LARC methods

Gross but true (OBGYNE) (17 decks)

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