Contraception

Question 1

OCP: Mechanism of action

Answer 1

Influence of estrogen (ethinyl estradiol):
Inhibits the midcycle surge of gonadotropin FSH which prevents ovulation
Influences progestin to suppress LH suppressing ovulation and thickening the cervical mucous to inhibit sperm migration

Question 2

Absolute Contraindications for estrogen contraception

Answer 2

Hx of thromboembolic event or stroke or known thrombogenic mutation (Factor V Leiden)
Known CVD, cardiomyopathy, BP 160/100 or greater, complicated valvular heart disease
SLE with positive antiphospholipid antibodies
Women 35 or older who smoke or have migraines

Question 3

the only proven antimicrobial shown to decrease the efficacy of OCs

Answer 3

Rifampicin

Question 4

Progestin Only Methods: Mechanism of Action

Answer 4

Inhibition of gonadotropin secretion
With resultant inhibition of follicular maturation and ovulation
Thickens cervical mucus
Creates thin, atrophic endometrium
Ovum transport may be slowed by reduced ciliary action in tubes

Question 5

Progestin Only Methods BBW

Answer 5

limit use to 2 years if possible, although no proven increased fracture risk.
NO INDICATION for DEXA

Question 6

Clinical Advantages of DMPA

Answer 6

Sickle cell anemia: decrease in painful crises

Has intrinsic anticonvulsant effect. May be a good choice for woman with seizures

Question 7

IUC Contraindications

Answer 7

Severe uterine distortion
Acute pelvic infection
Known or suspected pregnancy
Wilson's disease or copper allergy
Unexplained abnormal uterine bleeding
Current breast cancer  (Mirena or Skyla)

Question 8

CI of Diaphragm

Answer 8

Toxic Shock Syndrome