Contraception

Question 1

Contraindications of progesterone?

Answer 1

Current breast cancer, severe de compensated cirrhosis, malignant liver tumour, SLE with anti phospholipid antibodies

Question 2

How is the pearl index calculated?

Answer 2

100 x [(# preg) x 12] / [(# of women) x (# months)]

Question 3

Which estrogen containing contraceptive highest risk of vte?

Answer 3

Patch

Question 4

Side effects of copper IUD?

Answer 4

Heavy menses - increase by about 50%
Dysmenorrhea
Actinomyces infection (7-10%) often found on pap, usually after several years only

Question 5

Describe how LNG IUS works.

Answer 5

Inhibits sperm transport, fertilization of ovum, and partially inhibits ovulation

Question 6

How would you counsel a patient who wants IUD?

Answer 6

Topics to include are expulsion, malposition, perforation, strings and how to feel, changes in menstrual cycles including spotting for 3-6 months, pregnancy risk (0.2% with LNGIUS, 0.8% cu-IUD)

Question 7

What are estrogen side effects?

Answer 7

Nausea, breast tenderness, bloating, headache

Question 8

Name some non-contraceptive benefits of COC.

Answer 8

Decreases dysmenorrhea, pelvic pain secondary to endometriosis, ectopic preg, PMS/PMDD, benign breast disease, new ovarian cysts, ov ca, br ca, crc, acne, and hirsutism. Increases regularity of menses.

Question 9

Effectiveness of:
IUD (levonorgestrel and Cu)
Vasectomy
Tubal ligation
Depo-Provera
Pill, patch, ring
Diaphragm
Male condom
Female common
Withdrawal
Fertility awareness
Spermicide
None

Answer 9

LNGIUS: 0.2%, Cu: 0.8%
Vasectomy: 0.15%
Tubal: 0.5%
Depo: 6%
Pill, patch, ring: 9%
Diaphragm: 12%
Male condom: 18%
Female condom: 21%
Withdrawal: 22%
Fertility awareness: 24%
Spermicide: 28%
Non: 85%

Question 10

Absolute contraindications to COC?

Answer 10

VTE, thrombophlebitis, factor v Leiden, CVA, CAD, br ca or other e dependent cancer, undiagnosed abnormal pvb, known or suspected pregnancy, liver tumour, migraines with focal neurological signs