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obstetric - gynecol step 2 > contraception > Flashcards

contraception Flashcards

1
Q

hormone replacement therapy - contraindications

A
  1. estrogen-depended carcinoma (breast or endometrial)

2. history of pulmonary embolism or DVT

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2
Q

contraception - types

A
  1. female condoms
  2. vaginal diaphragm
  3. OCPs
  4. vaginal ring
  5. trandermal Patch
  6. Intramuscular injetion
  7. intrauterine device
  8. sterilization
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3
Q

female condom - structure

A

2 rings and a thin material in between. 1 ring is placed deep into the vagina while the other is left at the introitus (opening that leads to the vaginal canal)
larger and bulkier than male condoms

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4
Q

female condom - properties

A

offer some protection against HIV and STDs and are under female control

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5
Q

Vaginal diaphragm - structure / placement

A
  • circular ring with contraceptive jelly that covers the cervical canal (without the jelly is ineffective). The jelly is also used as a lubricant while placing the diaphragm
  • should be placed 6 h before intercourse and left fot at least 6 h after
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6
Q

Vaginal diaphragm - disadvantages

A
  1. need to be fiitted properly
  2. proper use requires advance preparation
  3. improper placement or dislodging reduced efficay
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7
Q

OCP - structure / way of using

A

combination pill of both estrogen + prgesterone. The pill is taken for 21 days and a placebo is taken for 7 days. During the 7 days of the placebo pills, the patient will experience menstruation. Women should start again on the Sunday after menst.

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8
Q

OCP - properties

A

reduce risk of ovarian ca, endometrial ca, ectopic pregnancy
but increase the risk of thromboembolsim

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9
Q

vaginal ring - structure and properties

A

vaginal ring that releases both estr and prog is inserted into the vagina for 3 wks. Hormone are released on a constant basis. When the ring is removed, withdrawal bleeding will occur. similar side effect and efficacy to OCPs

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10
Q

Transdermal Patch - everything

A

a patch with a combination of estrogen and progest is placed on the skin for 7 days. Each wk the previous patch is removed and a new patch is placed. 3 wks of patches are follow by a free week (withdrawal bleeding).
NOT PLACED ONTHE BREAST
Similar side effect and efficacy to OCPs

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11
Q

intramuscular injection - everything

A

depot medroxyprogesterone acetate is an intramuscular injection that is effective contraception for 3 months

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12
Q

intrauterine device - location / properties

A

placed into the uterus and provides contraception for 10 years

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13
Q

intrauterine device - types

A
  1. copper device

2. levonogestrel device

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14
Q

intrauterine device - side effects

A

PID (genital culture before placement)

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15
Q

Sterilization?

A

surgical sterilization can done on both men + women/ Sterilization via tubal ligation and vasectomy is permanent of these devices

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16
Q

sterilization - types

A
  1. tubal ligation

2. vasectomy

17
Q

sterilization - tubal ligation

A
  • surgical procedure that women may choose to undergoo for permanent contraception
  • very low risk of pregnancy (but it occurs)
  • increase incidence of ectopic pregnancy
18
Q

sterilization - vasectomy

A

surgical procedure in which ligation of the vas deferens is preformed

19
Q

medroxyprogesterone - SE

A

similar to pregnancy: weight gain, fatigue, breast tenderness

20
Q

emergency contraception options - methods and mechanism

A
  1. copper IUD –> inf reaction
  2. Ulipristal pill –> antiprogestin –> delays ovaluation
  3. Levonorgestrel –> progenstin –> delays ovaluation
  4. OCPs –> progenstin –> delays ovaluation
21
Q

emergency contraception options - methods and time after intercourse (hours)

A
  1. copper IUD –> 0-120
  2. Ulipristal pill –> 0-120
  3. Levonorgestrel –> 0-72
  4. OCPs –> 0-72
22
Q

emergency contraception options - methods and efficacy

A
  1. copper IUD –> 99%
  2. Ulipristal pill –> 85 or more
  3. Levonorgestrel –> 85%
  4. OCPs –> 75%
23
Q

absolute ontraindications to combined hormonal contraceptives

A
  1. migraines with aura
  2. 15 or more cigarettes daily plus 35 or older years old
  3. hypertension more than 160/100
  4. heart disease
  5. DM with end organ
  6. history of thromboembolic
  7. antiphospholipid syndrome
  8. history of stroke
    9 breast cancer
  9. cirrhosis + liver cancer
  10. major surgery with prolonged immobilization
    12 use less than 3 wks postpartum
24
Q

Estrogen-progestin contracepties - benefits

A
  1. pregnancy prevention
  2. endometrial + ovarian cancer risk reduction
  3. menstrual regulation
  4. hyperandrogenism treatment
25
Q

Estrogen-progestin contracepties - risks

A 
DVT
hypertension
hepatic adenoma
stroke or MI (both rare)
cervical cancer

obstetric - gynecol step 2 (22 decks)

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