Contraception

Question 1

What form of oestrogen is present in OCP ‘s and what is the amount of oestrogen that the following dose of pills contain

1. High dose pills
2. Low dose pills
3. Very low dose pills
4. Lowest possible

Answer 1

Ethinyl estradiol

1. > /=50mcg
2. <50mcg (on avg 35mcg)
3. = 20mcg
4. 10 mcg
   * lowest possible estrogen comes in lolo estrogen (brand name Lo Loestrin Fe )also contains fe as the name suggest

Question 2

Composition of Mala D and Mala N

Answer 2

Mala D - 30mcg EE +15mg LNG /0.3 mg EE +15mg LNG
Mala N - same (21 days)+ 7 days Fe (fumarate)
Mala N is given free of cost by GOVT

Question 3

Mechanism of action of OCP’s

Answer 3

Mainly inhibition of ovulation

Question 4

Mc S/E of OCP

Answer 4

Breakthrough bleeding -Progesterone breakthrough bleeding

Anovulatory DUB - estrogen break through bleeding

Question 5

If a lady misses 1 OCP pill then what should she do to maintain contraception

Answer 5

She should take 2 pills for following dose

Question 6

If a lady misses her 2 OCP pills then what should she do to maintain contraception

Answer 6

She should then use back up method of contraception

Question 7

What is the normal fertility returning time for a lady on OCP’s

Answer 7

3 months i.e 90 days

Question 8

Which type of contraception has the least ectopic Px risk

Answer 8

OCP’s

Question 9

Effect of OCP’s on the following conditions

1. PID
2. Candida infection
3. Chlamydia infection

Answer 9

1. Decreases risk of PID
2. Increase the risk of candida
3. Increase the risk of chlamydia

Question 10

Effect of OCP’s on the following cancers

1. Cervix Ca
2. Ovarian Ca
3. Endometrial Ca
4. Colon Ca
5. Breast Ca
6. Hepatic adenoma
7. HCC
8. Gall bladder Ca

Answer 10

1. i> risk of cervical Ca
2. d< risk of ovarian cancer by 50%
3. d< risk of endometrial Ca by 60%
4. d< risk of colon Ca
5. no i> risk for breast Ca
6. i> hepatic adenoma
7. HCC no i> risk
8. Gall bladder Ca -no i> risk

Question 11

What does the WHO category 4 tell you about contraception

Answer 11

WHO category 4 are conditions with absolute C/I to contraceptive

1. VTE (venous thromboembolism)
2. Stroke
3. CAD
4. K/c/o breast cancer
5. Uncontrolled HTN>/=160/110mmHg
6. Undiagnosed vaginal bleeding
7. Age > 35 yrs and smoker
8. Migraine with aura (i.e focal neurological deficit)- olden days known as complicated migraine
9. Suspected Px
10. Diabetes with vasculopathy
11. Acute liver disease ( hepatitis )

Question 12

Choice of contraception for newly married couple

Answer 12

OCP

Question 13

Choice of contraception for newly married couple living apart or meeting occasionally

Answer 13

Barrier methods

Question 14

Which contraception is the safest

What are the s/e of the safest contraception

Answer 14

Barrier methods are the safest

Very high failure rate resulting in Px