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Obs and gynae > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the three main groups of contraception?

A

Barrier methods, Daily methods and Long acting methods of reversible contraception (LARCs)

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2
Q

What are the two main oral contraceptives?

A

Combined oral contraceptive pill and progesterone only pill

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3
Q

What are the four main long acting reversible contraceptives?

A

implantable contraceptives, injectable contraceptives, IUS IUD.

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4
Q

What is the main mode of action for the combined oral contraceptive?

A

Inhibits ovulation

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5
Q

What is the main mode of action for the progesterone only pill?

A

Thickening of cervical mucus

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6
Q

What is the main and secondary mode of action of the injectable contraceptive?

A

Primary: Inhibition of ovulation, Secondary thickens cervical mucus

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7
Q

What is the main and secondary of action of the implantable contraceptive?

A

Primary: Inhibition of ovulation, Secondary thickens cervical mucus

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8
Q

What is the mode of action of the inrauterine device?

A

Decreases sperm motility and survival

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9
Q

What is the main and secondary mode of action of the intrauterine system?

A

Primary prevents endometrial proliferation, Secondary thickens cervical mucus

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10
Q

What are the three main methods of emergency contraception?

A

Levonorgestrel, Ulipristal and IUD

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11
Q

What are the primary modes of action of the IUD in emergency contraception?

A

Toxic to sperm and ovum and inhibits implantation

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12
Q

What is the main mode of action of levonorgestrel in emergency contraception?

A

Inhibition of ovulation

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13
Q

What is the main mode of action of Ulipristal in emergency contraception?

A

Inhibition of ovulation

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14
Q

Aside from it’s use as a reversible contraceptive what other advantages come with the use of the combined oral contraceptive pill?

A

Usually makes periods regular, lighter and less painful, it may also protect against PID, reduce risk of ovarian, endometrial and colorectal cancer and reduced ovarian cysts, benign breast disease and acne vulgaris

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15
Q

What are the health risks that come with the combined

oral contraceptive?

A

Increased risk of venous thromboembolic disease, breast and cervical cancer, stroke and ischaemic heart disease.

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16
Q

What are the common side effects with the combined oral contraceptive pill?

A

nausea, headache and breast tenderness.

17
Q

How long is the window in which levonorgestrel is useful as emergency contraception?

A

72 hours after unprotected sexual intercourse

18
Q

How is vomiting relevant to the use of levonorgestrel as emergency contraception?

A

If it occurs with 2 hours a repeat dose is required

19
Q

What is the window in which Ulipristal is useful as emergency contraception?

A

120 hours

20
Q

What counselling regarding contraception should be given when prescribing Ulipristal as emergency contraception?

A

Ulipristal reduces the efficacy of hormonal contraception. Barrier methods should be used for five days after this other methods should be restarted.

21
Q

What form of contraception is contraindicated in those with a migraine with aura and why?

A

Combined oral contraceptive as the risk of stroke is increased.

22
Q

When is it safe to assume contraception is no longer needed?

A

12 months after the last period in someone over 50. 24 months after the last period in someone under 50

23
Q

What are the five criteria of the Fraser Guidelines? In order for a child under the age of 16 to receive contraceptive guidance.

A

1) They must understand the doctor’s advice.
2) That they cannot convince the patient to inform their parents of their decision to seek contraception.
3) That they are likely to continue having sexual intercourse with or without contraception.
4) That unless they receive contraceptive advice their health is likely to suffer
5) That it is in the patient’s best interests to give contraceptive advice with or without parental consent

24
Q

Under what age should sexual activity be typically reported regardless.

A

13

25
Q

What is the typical pattern of taking the COCP?

A

21 days taking the pill, seven days off during which there should be a bleed (note some brands give placebo pills during these seven days which can help compliance

26
Q

Aside from the efficacy as contraceptive and the side effects of the contraceptive in mind what is the other main factor that influences contraceptive choice?

A

Management of menstrual cycle. Contraceptives can ease unpleasant parts of the menstrual cycle and help them become more predictable/manageable

27
Q

How long does the COCP take to have effect?

A

If taken during the first five days of the patient’s cycle then as soon as they’ve been taken if not one week.

28
Q

What should you advice someone who is taking the combined oral contraceptive to do if they have missed a tablet.

A

take the last pill even if it means taking two pills in one day then continue as normal

29
Q

What is the conservative advice for someone who has missed two doses of their COCP

A

Take the last pill even if it means taking two in one day. Conservative advice is to use protection until there have been seven consecutive days having taken the pill.

30
Q

What is the best advice if someone has missed 2 or more pills in week one of their cycle?

A

Emergency contraception should be considered if unprotected sex occured during the pill free interval

31
Q

What is the best advice if someone has missed 2 or more pills in week two of their cycle?

A

No emergency contraception necessary if the pills in the preceding 7 days have been taken consistently and correctly

32
Q

What is the best advice if someone has missed 2 or more pills in week three of their cycle?

A

Omit the pill free interval i.e finish pills in the current pack or discard placebo tablets

33
Q

How long is the window in which one taking a progesterone only pill to remember to take it?

A

three hours

34
Q

What should one do if they miss one mini pill?

A

take one as soon as they remember the next at the usual time and use additional contraception for two days

35
Q

What should one do if they miss two mini pills?

A

take the most recent one immediately (ignore others that have been missed), take subsequent pills at the usual time use addition contraception for two days

Obs and gynae (3 decks)

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