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Y3 Reproductive > Contraception > Flashcards

Contraception Flashcards

1
Q

Give examples of combined hormonal contraception

A

Combined pill COC
Patch CTP
Vaginal ring CVR

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2
Q

Give examples of progesterone only contraception

A

Progesterone only pill POP
Implant
Depot
Intra-uterine system IUS

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3
Q

Give examples of non-hormonal contraception

A

Copper coil
Sterilisation
Barrier contraception
Cyproterone acetate

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4
Q

What method of contraception is being described “blocks sperm getting to genital tract”?

A

Barrier contraception

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5
Q

What method of contraception is being described “blocks the fallopian tubes”

A

Female sterilisation

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6
Q

What method of contraception is being described “the only type of contraception that protects against STIs”?

A

Condoms

barrier contraception

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7
Q

What method of contraception is being described “has the lowest failure rate of all contraception methods”?

A

Implant

progesterone only

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8
Q

What method of contraception is being described “this method of combined hormonal contraception is least likely to cause acne, intermenstrual bleeding and mood changes”?

A

Vaginal ring CVR

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9
Q

What method of contraception is being described “this method only requires 1 dose every 13 weeks”?

A

Depot

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10
Q

What method of contraception is being described “this method of contraception is contraindicated in migraine with aura”

A

Combined pill COC

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11
Q

Why is COC contraindicated in migraine with aura?

A

Increases stroke risk

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12
Q

What method of contraception is being described “this method is less effective in patients who weigh over 90kg”?

A

Combined transdermal patch

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13
Q

Which methods of contraception is being described “this method inhibits ovulation and has an effect on cervical mucus, the endometrium and fallopian tube transport”?

A

Progesterone only: POP, implant, depot

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14
Q

What method of contraception is being described “this method can be start anytime in the menstrual cycle if the patient has had no unprotected sex in the past 3 weeks”?

A

Intra-uterine system IUS

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15
Q

When prescribing the IUS, why must you wait until 3 weeks after unprotected sex before initiating?

A

Risk miscarrying potential ongoing pregnancy

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16
Q

What does LARC stand for?

A

Long acting reversible contraception

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17
Q

What method of contraception is being described “contraception is not its primary indication but it has an indirect contraceptive effect”?

A

Cyptoterone acetate

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18
Q

Name methods of LARC

A

Intra-uterine system
Implant
Depot IJ

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19
Q

What hormones are in combined hormonal contraception?

A

Estrogen + progesterone

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20
Q

What is the method of CHC?

A

-Ve feedback on GnRH
Decreases LH/FSH
Inhibits ovulation

(No folliculogenesis, exogenous estrogen still causes endometrial proliferation hence withdrawal bleeding)

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21
Q

Weight gain is a side effect of combined hormonal contraception. T or F

A

False, no evidence, though estrogen does increase appetite

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22
Q

What are the side effects of combined hormonal contraception?

A 
Venous/arterial thrombosis
Increased BP
Mood
>Stroke/MI risk
Mood
Acne
Intermenstrual bleeding
Tender breasts
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23
Q

What is the dosing regimen for the combined pill?

A

21 days on, 7 days off (withdrawal bleed)

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24
Q

When should you initiate the combined pill?

A

On the 1st 5 days of your period
OR
Any time if definitely not pregnant + 7 days condoms

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25
By what mechanism does combined hormonal contraception have an effect on metabolism?
Induce P450 liver enzymes
26
What is the dosing regimen for the combined transdermal patch?
Lasts 1 wk | 3 wk on, 1 wk off
27
How long does the combined vaginal ring last?
3 wk on, 1 wk off
28
By what mechanism does combined hormonal contraception increase risk of venous and arterial thrombosis?
Estrogen decreases antithrombin III and has effects on protein S
29
For which methods of combined hormonal contraception should you monitor blood pressure?
All 3 of them
30
How often should you check blood pressure with combined hormonal contraception?
Once after 1st 3 months, annually from then on
31
What are the contraindications to all types of combined hormonal contraception?
BP >140/90 <6wk postpartum PMH/ genetic FH breast cancer
32
Why is combined hormonal contraception contraindicated in patients <6wk postpartum?
Increased VTE risk
33
What is the name of the progesterone only pill?
Desogestrel
34
Does the progesterone only pill effect liver metabolism PY450?
No
35
When should you initiate progesterone only contraception?
On 1st 5 days of period day OR Anytime if certain not pregnant + 2 days condoms
36
Intermenstrual bleeding as a side effect of combined hormonal contraception usually settles within what time frame?
First 3 months
37
What is the name of the drug in the depot IJ?
DMPA
38
Where should the depot injection be injected?
Subcutaneously
39
What are the contraindications to progesterone only contraception?
Osteopenia, breast cancer
40
How long does the intrauterine system last?
Mirena and Kyleena 5yr | Jaydess 3yr
41
When should the intra-uterine system IUS be initiated?
Anytime in cycle if no unprotected sex UPSI past 3wk
42
Does the intra-uterine system effect liver metabolism PY450?
Yes
43
Which method of contraception prevents fertilisation?
Copper coil IUD | also cause an inflammatory response in the uterus
44
How long does the copper coil IUD last?
5 years
45
What is the name of the copper coil IUD?
No brand name
46
What are the direct indications for cyproterone acetate?
Acne/hirsutism
47
What must you be careful of when deciding when to perform female sterilisation?
Must have 0 pregnancy risk at time; causes ectopic Make sure not to cut the ureter (Ureter vermiculates, water under the bridge)
48
When should the copper coil IUD be inserted?
Anytime if no UPSI 3wk OR Emergency contraception
49
When in the menstrual cycle is the copper coil IUD effective as emergency contraception
5 days after likely ovulation (Would potentially be effective 5 days prior but that would technically be causing a miscarriage so isn't licensed) (Can also be inserted if unprotected sex less than 5 days go and ovulation more than 5 days ago since 0 pregnancy risk so no miscarriage risk)
50
What is the most effective method of emergency contraception?
Copper coil IUD | should be offered to everyone requesting emergency contraception
51
Having the combined patch or ring out/off for longer than ____ is an indication for emergency contraception
48hours
52
In someone who isn't breastfeeding, how long postpartum can you say it is reasonably certain they're not pregnant?
Less than 4 weeks
53
How many days since someone's last period can it be for you to say it is reasonably certain they're not pregnant?
Less than 7 days
54
What are the names of the oral methods of emergency contraceptions
LNG (levonorgestrel) | UPA (ulipristal acetate)
55
How long post UPSI is the oral emergency contraception effective?
LNG 3 day | UPA 5 day
56
What is the method of emergency contraception LNG?
Progestogen: delays LH surge; delays ovulation
57
When is LNG emergency contraception not effective?
2 day post ovulation
58
When should you double dose LNG emergency contraception?
BMI >26
59
What is the method of emergency contraception UPA?
Anti-progestogen delay ovulation
60
When is emergency contraception UPA contraindicated?
Severe asthma | Breastfeeding
61
When is UPA emergency contraception not effective?
2day post ovulation | Taken POP/CHC in past 7 days
62
What days of the menstrual cycle are you most fertile?
8-18
63
What are the criteria for lactational amenorrhea
Exclusively breastfeeding <6/12 postnatal Amenorrhea
64
How can cervical mucus be monitored for fertility?
Thick sticky for 3day after ovulation | No mucus 0-5 days, from 5 to 14 days gets progressively less sticky, from 14-28 days sticky
65
When monitoring basal body temperature (before rising in the morning) what change indicates you are more fertile?
Temp >0.2 for 3 days after 6 days of
66
What position is the cervix in when fertile?
High in vagina, soft, open
67
Nexplanon is the brand name for which type of contraception?
Subdermal implant
68
Name 3 brand names of the COC
Rigevidon, microgynon, yasmin
69
The IUS is good for dysmenorrhea. T or F
True
70
What method of contraception is spermicidal?
Copper coil Also causes local inflammatory response and kills blastocysts pre-implantation
71
How long is it until the IUD copper coil is effective?
Immediately
72
How long is it until the IUS is effective?
After 7 days | Except 1st 7 days of menstrual cycle when infertile anyway
73
What are absolute contraindications to the IUS and IUD?
Uterine abnormality eg. huge fibroids | Pregnant

Y3 Reproductive (28 decks)

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