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Repodction > Contraception > Flashcards

Contraception Flashcards

1
Q

In a standard 28 day cycle, when is a woman most fertile?

A

Days 8 to 18

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2
Q

3 criteria for using breast feeding as contraception?

A
  • Exclusively breastfeeding
  • less than 6/12 post natal
  • amenorrhoeic
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3
Q

UK MEC1

A

no restriction for the use of contraception method

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4
Q

UK MEC2

A

Where the advantages of using the method generally outweigh the theoretical or proven risks

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5
Q

UK MEC3

A

A condition where the theoretical or proven risks generally outweigh the advantages

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6
Q

UK MEC4

A

A condition which represents unacceptable risk if the contraceptive method is used

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7
Q

If you prescribe contraception, how often do you need to check it?

A

Annually

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8
Q

Give an example of LARC

A

Depo injection

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9
Q

Give 3 examples of VLARC

A
  • implant
  • IUD
  • IUS
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10
Q

How does depo work?

A

Inhibits ovulation

(also effects:

  • cervical mucous
  • endometrium)
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11
Q

What checks must you do before giving depo?

A
  • check BMI and BP
  • check smear status if relevant
  • consider risk factors for osteoporosis
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12
Q

When can depo be started?

A

Up to and including day 5 of the cycle without the need for additional contraception

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13
Q

What happens if a woman wants to start depo after day 5?

A

Can start depo after day 5, as long as she is ‘reasonably certain’ she is not pregnant and uses condoms/abstinence for 7 days

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14
Q

A woman wants to start depo after having a baby, when can she start it?

A

Up to 21 days after having baby with immediate cover

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15
Q

A woman wants to start depo after a TOP, when can she start it?

A

Up to day 5 since TOP

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16
Q

Side effects of depo?

A
  • weight gain
  • delay in return of fertility
  • irregular bleeding
  • possible risk of osteoporosis!
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17
Q

What is depo and how long does it work for?

A
  • injection similar to progesterone

- works for 12 weeks

18
Q

Gold standard IUD

A

380mm^2 copper

19
Q

IUD primary mode of action

A

Prevents fertilisation

Inflammatory response in endometrium

20
Q

How long is an IUD licenced for?

A

5-10 years

21
Q

IUS primary mode of action?

A

Effect on implantation

also effect on cervical mucous and pre-fertilisation effects

22
Q

Contraindications to IUD/IUS

A
  • Current pelvic infection
  • Abnormal uterine anatomy
  • Pregnancy!
  • Sensitivity to any of the constituents
  • Gestational trophoblastic disease when BHCG levels are abnormal
  • Endometrial ca
  • Cervical ca awaiting treatment
23
Q

What checks must you do before giving IUD/IUS?

A

PV to check uterine size/position

BP and pulse if condition indicates

24
Q

Can an IUD be used as emergency contraception?

A

Yes

25
Q

Can an IUS be used as emergency contraception?

A

No

26
Q

How long is the 52mg LNG-IUS licenced for?

A

5 years

27
Q

How long is the 13.5mg LNG-IUS licenced for?

A

3 years

28
Q

How long is the rod licenced for?

A

3 years

29
Q

How does the rod work?

A

Inhibits ovulation

-also effect on cervical mucous and endometrium

30
Q

When can an implant be fitted?

A

Within first 5 days of cycle

31
Q

You want to switch from depo to implant, is this okay?

A

Yes, if last depo within 14 weeks

32
Q

You want to switch from the pill to the implant, is this okay?

A

Yes, fit after last active pill in packet taken

33
Q

You want to switch from COC/patch/vaginal ring to the implant, is this okay?

A

Yes if you fit during weeks 2-3 of COC/patch/vaginal ring

34
Q

You want to switch from POP to implant is this okay?

A

Need to use protection for the first 7 days

35
Q

You want to switch from the LNG-IUS to the implant, is this okay?

A

Need to use protection for the first seven days

36
Q

This contraception improves the quality if breast milk postpartum

A

Depo

37
Q

Why does depo improve quality of breast milk?

A

Depo has high levels of pregestogens which improve milk production

38
Q

Recognised treatment of mennorhagia in smokers over the age of 35

A

Mirena coil (IUS)

  • releases minimal doses of levonorgestrel every day
  • slims down the endometrium thereby reducing menstrual loss over a time span of 4-9 months
39
Q

This contraception is contra-indicated in smokers over 35 years of age

A

COC

contains synthetic oestrogens and these increase risk of cardiovascular effects

40
Q

Progesterone effect on the GI tract

A

Delays gastric emptying

Case example from pastest, not really contraception related:

“a 25 year old woman who has been on methadone for the past 3 weeks has a convulsion, why?” Answer: drug and alcohol withdrawal
-since gastric emptying is delayed due to the progesterone effect on the GI tract, insufficient drug levels in the plasma may be the cause for convulsion

Repodction (52 decks)

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