Contraception

Question 1

Mirena

Answer 1

Progesterone-releasing IUD
Thickens cervical mucus to prevent sperm penetration
Slows tubal motility
Atrophic endometrium inhibits implantation
Lasts 5 years

Question 2

Copper IUD

Answer 2

Interference with sperm transport, fertilization, and implantation
Exact mechanism unknown

Question 3

IUD insertion timing

Answer 3

Immediately after abortion
During menses
Any day of cycle if pregnancy can be excluded
>4 weeks postpartum when uterus is involuted

Question 4

Sponge

Answer 4

Donut shaped device fits into vagina and covers cervix
Contains spermicide, effective up to 24 hours
Leave in for >6, <30 hours

Question 5

Calendar Method

Answer 5

Record exact date of menses for >6 mos

Assume sperm survive 5 days, ovum survives 1 day, and luteal phase is 12-16 days long

Question 6

Cervical cap

Answer 6

Rubber cap which fits over cervix
Better than diaphragm for women with
weak vaginal muscles

Question 7

Mifepristone “RU 486”

Answer 7

Blocks progesterone receptors which decreases endometrial blood supply. Disruption of embryo causes decreased hCG production, which leads to CL regression. This causes demise of pregnancy. Once placenta is in place, this method won’t work. (After 9 weeks)

Question 8

Dilation and Curettage

Answer 8

Laminaria slowly expands by absorbing moisture & atraumatically dilates cervix
Curette loosens uterine contents
Vacuum extraction of POC

Question 9

Dilation and Evacuation

Answer 9

Second trimester termination
Dilate cervix with laminaria or tapered dilators
Grasp fetal parts and remove manually

Question 10

Depo Provera

Answer 10

Long-acting progestin injection
Suppresses FSH and LH
Inhibits ovulation
Thickens cervical mucus

Question 11

Nuvaring

Answer 11

Vaginal ring of estrogen and progesterone reservoir
Insert within 5 days of menses
3 weeks in, 1 week out for withdrawal bleed

Question 12

Implanon

Answer 12

Implantable progestin rod (etonogestrel)
Up to 3 years, can be replaced
Inner side of upper arm subdermally

Question 13

Orthevra

Answer 13

Contraceptive patch
99% effective
Weekly application for 3 out of 4 weeks
Apply to upper outer arm, torso, abdomen, or buttocks (not breast)

Question 14

OCP actions

Answer 14

Progesterone prevents ovulation by inhibiting LH
Progesterone thickens cervical mucus
Progesterone causes atrophic endometrium
Estrogen stabilizes endometrium to prevent breakthrough bleeding
Estrogen enhances effect by inhibiting FSH and allowing lower dose of progesterone

Question 15

OCP warning signs

Answer 15

A abd pain, jaundice from liver tumor
C chest pain, cough from MI or PE
H headache from CVA
E eye (visual) disturbances from clot
S severe calf pain from DVT

Question 16

Plan B

Answer 16

Levonorgestrel0.75 mg

may use up to 5 days after intercourse