Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Contraception > Flashcards

Contraception Flashcards

1
Q

Rhythm method

A
  • increase in basal temp means ovulation has occured
  • abstenence for 5-10 d around ovulation
  • Track mucus: abundant, thin, wand watery
  • Measure for LH levels in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is a Gyneclogical exam recommended before CHC prescription given?

A

No, but Med history and BP measurement needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is ovulation inhibited?

A

Progestins block LH surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which progestin is available as a contraceptive patch?

A

Norelgestromin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other effects of progestins

A

Thicken cervical mucus, induce endometrial atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common Estrogen in CHCs?

Dose?

A 
Ethinyl Estradiol (EE)
20-25 ug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Estrogens function in CHC

A
  • Suppress FSH, prevent LH surge

- Stabilize endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which hormone provides most of the effect in CHC?

A 
the progestins
Mimics pregnancy (Corpus luteum secretes progesterone to prevent 2nd ovulation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Non-contraceptive benefits of CHC`

A
  • Decreased menstrual problems (cramps, pain, irregularity), Acne
  • Decreased risk of ovarian andometriial cancers, ovarian cysts, Pelvic inflammatory disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CHC ADRs; Estrogen excess

A
  • Nausea, breast tenderness, HA, Fluid Retention**

- Treat by decreasing estrogen dose, using progestin only, or IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CHC ADRs; Estrogen deficiency

A
  • Midcycle breakthrough bleeding
  • Vasomotor symptoms (hot flashes), anxiety, decreased libido
  • Amenorrhea
  • Treated by increasing estrogen dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CHC ADRs; Progestin Excess

A
  • Increased appetite, weight gain, bloating
  • Acne, oily skin, hirsutisim
  • Depression, fatigue, irritability
  • Treat by decreasing progestin dose or use less androgenic progestin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CHC ADRs; Progestin deficiency

A
  • Dysmenorrhea, late cycle breakthrough bleeding/spotting

- Treat by increasing progestin dose, use extended cycle or continuous regimen, or progestin-only, or IUD contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CHC risks and age

A

low dose (

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CHC and smokers

A

Women over 35 and smokers are advised against COCs

-Progestin-only methods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Use of CHC in perimenopausal women

A

Helps increase bone mineral density and helps with vaso motor symptoms (hot flashes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CHCs and HTN

A
  • Even low dose EE increases BP

- Use ok in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CHC and Dyslipidemias

A

-Progestins decrease HDL; increase LDL
-Estrogens decrease LDL; increase HDL
–>CHC usually no effect lipid profile
–>if controlled, can use CHC
Else (LDL>160 mg/dL) no use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is theCVD risk with CHCs in dyslipidemia

A

Thrombosis, not atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Diabetes and CHCs

A

In healthy pt:
Most have no affect on insulin or HbA1c
Noincreased risk of TIIDM
**Women with DM should not use CHCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CHCs and migraines

A

CHCs increase and decrease risk of migraines

  • Prodromal aura –> stroke risk
  • *Women subject to migraines should not use CHCs
  • *If migraines develop, D/c immediately

***Progestin only may be substituted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CHCs and Breast Cancer

A

No association

OK in benign breast disease, and family history of BC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

CHCs and thromboembolism

A

Estrogens increase hepatic production of clotting factors

  • -> risk of DVT & PE
  • -> Less risk than occurs in pregnancy, but still risk

**contraindicated in women with Hx of thromboembolic events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which CHC has least risk of thromboembolic event

A

Levonorgestrel less than desorgestrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CHCs and obesity risks

A
  • Obese pt increased risk for contraceptive failure

- Increased risk of VTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CHCs and obesity

Preferred therapy

A

Depot MPA or Levonorgestrel IUD preffered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CHCs and Lupus

A

should be avoided in pt with SLE + anti-phospholipid antibodies or vascular complications

**Use progestin only contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which progestin has anti-aldosterone effects?

What is that effect

A

Drospirenone

Less bloating/weight gain

29
Q

3rd/4th gen progestins

A

Dropirenone, Deogestrel, norgestimate

30
Q

What warning must be on Drospirenone (Yasmin, Yaz, Beyaz, Safyral) box?

A

Increased risk of VTE

31
Q

Progestin only pills

A

-Less effective
-irregular bleeding
-Must be taken at same time every day
40% of women still ovulate

32
Q

COC first line

A

low dose

33
Q

COC choice for adolescents, underweight, women over 35, perimenopausal

A

Very low dose. 20-25 ug EE

34
Q

COC choice for women >160 lbs

A

35-50 ug EE. Do not exceed 50 ug

35
Q

Progestin-only candidates

A

-Migraines with aura
-Thromboembolic diseases
-SLE
-Women >35 y with:
+smoker
+obseity
+HTN

36
Q 
Transdermal patch (Ortho Evra)
Contents
A

Ethinyl Estradiol + norelgestromin

37
Q

Transderm effectivenes

A

Equally effective as COCs, but higher failure rate in women >189 lbs

38
Q

Transdermal EE exposure

A
  • 60% higher: avoids first pass metabolism

- possible thromboembolic risk

39
Q 
Vaginal rings (Nuvaring)
Contents
A

EE + Etonogestrel

40
Q

Vaginal rings effectiveness

A

Equally effective as COCs

Lower systemic dose of estrogen

41
Q

Vaginal rings use

A

Inserted and worn for 3 weeks

42
Q

Depo-Provera (injectable progestin)

Dose/drug/route(s)

A

150 mg medroxyprogesteron acetate (DMPA)

IM (also SC)

43
Q

Depo-provera

duration *efficacy

A

3 months, 97% actual efficacy

44
Q

Depo cessation

A

prolonged delay to fertility (10-18 months)

45
Q

Depo risk

A

DMPA suppresses estradiol production, risk of decreased bone mineral density

46
Q

Implanton sub dermal progestin implant

Drug, duration, effectiveness

A

etonorgestrel
3 years
97%

47
Q

Implanon complaints

A

irregular menstrual bleeding and spotting

48
Q

Implanon and BMD

A

No decrease in BMD

49
Q

Implanon and removal

A

rapid return to fertility

50
Q

Intra uteron deices
Types
MOA

A 
Copper ions (paragard)
or  levonorgestrel (Mirena, skyla, liletta)
Reduce sperm mobility or interfere with implantation
51
Q

Intra uterine device effectiveness

A

99&

52
Q

Paragaurd
Duration
ADRs

A

10 years
Increase blood flow by 35%
Increased dysmenorrhea

53
Q

Mirena
Duration
dose

A

5 years10

ug pregestin/d with low systemic absorption

54
Q

Mirena ADRs

A

reduces menstrual blood flow but increases spotting in first year.
Amenorrhea 20% first year 60% fifth

55
Q

IUDs general ADR

and removal

A
  • May increase pelvic inflammatory disease

- Fertility returns immediately after

56
Q

What is the most widely used reversible contraception?

A

IUD

57
Q 
Emergency Contraception (Plan B)
Contents
A

1.5 mg levonorgestrel

Taken 1 dose or two split doses q12h

58
Q

Plan B MOA

A

Prevent ovulation, sperm motility

DO NOT EFFECT IMPLANTATION (if ovulation has already occurred: you’re screwed

59
Q

Plan B use

A

should be taken within 72 h of intercourse (max 5d)

60
Q

Plan B adverse effects

A

Nausea

May induce withdrawal bleeding

61
Q

Plan be availability

A

Available behind the counter to patients of lll ages

62
Q

Yuzpe regimen

A

COCs for emergency contraception

100 ug EE + 0.5 mg levonorgestrel; repeate after 12 h

63
Q

Anti-progestins

Eg,

A

Ulipristal (ella)

Mifepristone

64
Q

Anti-progestin

MOA

A
  • Block ovulation, impare endometrial proliferation
  • Effective up until day of LH surge
  • Longer acting than levonorgestrel
65
Q

Anti-progestins use by

A

Must be within 5 days of coitus

66
Q

Which EC is considered embrotoxic?

A

Anti-progestins

67
Q

Anti-progestin availability

A

Rx Only

68
Q

Anti-progestin contraindications and ADRs

A
  • Metabolized by CYP3A4
  • Contraindicated in severe liver disease
  • Minimal ADR: abdominal pain
69
Q

Copper IUD (paragaurd) EC
Use by
Effectiveness

A

up to 5 d post coitus

most effective EC 99%

Endocrine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions