Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 - Reproduction > Contraception > Flashcards

Contraception Flashcards

1
Q

List of contraception options other than condoms?

A

> Combined hormonal contraception:
- Pills, patch, vaginal ring

> Progesterone only methods:
- Pill, injectable, implant

> Intrauterine contraception

> Emergency contraception

> Sterilisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Between 16-49 what is the most commonly used contraception?

A

1) Sterilised (male or female) = 28%
2) Combined hormonal contraception (CHC) = 25%
3) Intrauterine methods (coil) = 6%
4) Progestogen-only pill (POP) = 5%
5) Progestogen-only implants or injectable = 3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which percentage of women aged 16-49 years old who are sexually active and not planning pregnancy are not using contraception?

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the ideal contraception have?

A

> 100% reversible
100% effective
100% unrelated to intercourse
100% free of adverse side-effects
100% protective against sexually transmitted infections
Non-contraceptive benefits
Low maintenance, no ongoing medical input

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which contraceptive options are 100% reversible?

A

> All except sterilisation

> Only delayed reversal is injectables

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which contraceptive options are 100% effective?

A

None - however, best is the vasectomy followed by implant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which contraceptive options are 100% unrelated to intercourse?

A

All except condoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which contraceptive options are 100% free of adverse effects?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which contraceptive options are 100% protective against STIs?

A

Not even condoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which contraceptive options have non-contraceptive benefits?

A

Combined hormonal contraception (CHC) and IUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which contraceptive options have low maintenance, no ongoing medical input?

A

Implant or IUT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the pearl index?

A

ThePearl Indexis defined as the number of contraceptive failures per 100 women-years of exposure. It looks at the total months or cycles of exposure from the initiation of the product to the end of the study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the life table analysis?

A

Life Table Analysis provides the contraceptive failure rate over a specified time-frame and can provide a cumulative failure rate for any specific length of exposure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is method failure?

A

Pregnancy despite correct use of method by user

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is user failure?

A

Pregnancy because method not used correctly by user

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the advantage of using long-acting reversible contraception (LARC)?

A

Minimises user input and so minimises user failure rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which type contraception with perfect use has the worst efficiency - percentage of women experiencing an unintended pregnancy within the year of use?

A

1) Cervical cap (Parous woman) = 26%
2) Spermicides = 18%
3) Cervical cap (Nulliparous woman) = 9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which type contraception with typical use has the worst efficiency - percentage of women experiencing an unintended pregnancy within the year of use?

A

1) Cervical cap (Parous woman) = 32%
2) Spermicides = 29%
3) Withdrawal = 27%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which type contraception with perfect use has the best efficiency - percentage of women experiencing an unintended pregnancy within the year of use?

A

1) Progesterone implant = 0.05%
2) Levenorgestrel intrauterine system = 0.1%
3) Combined pill and minipill/ Combined hormone patch/ injectable progesterone = 0.3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which type contraception with perfect use has the worst efficiency - percentage of women experiencing an unintended pregnancy within the year of use?

A

1) Progesterone implant = 0.05%
2) Levenorgestrel intrauterine system = 0.1%
3) Male sterilisation = 0.15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which days does someone usually ovulate?

A

12-18 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long does the egg survive following ovulation?

A

24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long do most sperm survive?

A

Most sperm survive less than 4 days (5% may survive 7 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When is the highest chance of getting pregnant and why?

A

Days 8-19, because:

1) Ovulation usually occurs 12-18days (2 weeks before period)
2) Sperm survives less than 4 days usually
3) Eggs survive 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which two hormones are within the combined hormonal contraception (pill, patch vaginal ring)?

A

1) Ethinyl estradiol

2) Synthetic progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What can patch EVRA cause?

A

<5% have a skin reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How often is the patch EVRA changed?

A

Once weekly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How often is ring nuvaring changed?

A

Every 3 weeks, it can be taken out for 3 hours in 24 hours so some may take it out for sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How does the combined contraceptive hormones work?

A

Negative feedback on the female HPG axis (Hypothalamus and anterior pituitary) stops the release of LH and FSH.

Therefore, ovulation is inhibited and also affect cervical mucus and endometrium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the non-contraceptive benefits of the combined hormonal contraceptives?

A

> Regulate/reduce bleeding- help heavy or painful natural periods

> Stop ovulation- may help premenstrual syndrome

> Reduction in functional ovarian cysts

> 50% reduction in ovarian and endometrial cancer

> Improve acne / hirsutism

> Reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the “troublesome” (not serious risks) side effects of the combined hormonal contraceptive?

A 
> Breast tenderness
> Nausea
> Headache
> Irregular bleeding first 3 months
> Mood  ? Causal or other life events
> Weight gain- not causal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the serious risks side effects of the combined hormonal contraceptive?

A

> Increased risk of venous thrombosis (DVT and PE)
Increased risk of arterial thrombosis (MI and ischaemic stroke)
Increased risk of cervical cancer
Increased risk of breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

In terms of increased venous thrombosis risk who shouldn’t take the combined hormonal contraceptive?

A

> If BMI >34
Previous venous thrombosis (VTE)
1st degree relative with VTE under 45
Thrombophillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In terms of increased arterial thrombosis risk who shouldn’t take the combined hormonal contraceptive?

A 
> Smoker >35 years old
> Previous arterial thrombosis
> Focal migraine 
> Age >50 years old 
> Hypertension 140/90 mm Hg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

In terms of past GI pathologies who shouldn’t take the combined hormonal contraceptive?

A

> Gall bladder disease

> Previous liver tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How long does it take of not taking the combined hormonal contraceptive to return the risk of breast cancer back to normal?

A

10 years off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

In absolute terms the risk of VTE increases from - general population?

A

5 per 100,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In absolute terms the risk of VTE increases from - Combined oral contraceptive population?

A

15 per 100,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

In absolute terms the risk of VTE increases from - pregnancy?

A

60 per 100,000

40
Q

What is another term for the progesterone only pill?

A

Mini-pill

41
Q

When should the progesterone only pill be taken?

A

Same time every day

42
Q

What is the main advantage of the progesterone only pill versus the combined oral contraceptive?

A

Due to being oestrogen free there is less contradictions e.g. breast cancer or liver tumour

43
Q

What are the side effects of progesterone only pill?

A 
Very variable between women – troublesome not ‘dangerous’:
> Appetite increase
> Hair loss/gain
> Mood change
> Bloating or fluid retention
> Headache
> Acne
44
Q

How often is the injectable progesterone pill administered?

A

1) 150mg/1ml deep intramuscular injection into the upper quadrant of the buttock every 13 weeks
2) There is a new 0.6ml subcutaneous version for self administration Sayana press

45
Q

How does the injectable progesterone contraception work?

A

1) Prevents ovulation
2) It alters cervical mucus making it hostile to sperm
3) Makes endometrium unsuitable for implantation

46
Q

What often happens after 3 doses of the injectable progesterone?

A

70% women amenorrhoeic after 3 doses

47
Q

How long does it usually take for fertility to return to normal following withdrawal of the injectable progesterone contraceptive?

A

Average 9 months

48
Q

What are some of the negative side effects of the injectable progesterone pill?

A

> Delay in return to fertility - average 9 months
Increased risk of osteoporosis - Reduced bone density
Problematic bleeding especially after 2 doses
Weight gain - 2/3rds of women gain 2-3kg

49
Q

What is another word for the subdermal progesterone?

A

“The rod”

50
Q

What is the subdermal progesterone?

A

Nexplanon is a small plastic rod measuring 4cm in length and 2mm in cross sectional diameter.

The rod contains 68mg of the progestogen etonogestrel dispersed in a matrix of ethinylvinylacetate (EVA). The rod is then covered in a rate controlling membrane made from ethanol vinyl acetate (EVA).

51
Q

How long does the progesterone implant last?

A

Can last 3 years

52
Q

What effect can the progesterone implant have on bleeding?

A

> 60% are almost bleed free

> 30% have prolonged frequent bleeding

53
Q

How does the progesterone implant work?

A

Inhibition of ovulation + effect on cervical mucus

54
Q

What negative effects can the progesterone implant have?

A

> Can cause mood changes

> 30% experience excessive bleeding

55
Q

What is another name for the intrauterine contraception?

A

“The Coil”

56
Q

How long does the intrauterine contraception work?

A

Long acting reversible contraception (LARC), intrauterine contraception lasts 5-10 years use

57
Q

What are the negative side effects of intrauterine contraception?

A

> Small risk of infection in the first 3 weeks <1:1000
1:1000 risk of perforation
5:100 risk expulsion
If conceives may be ectopic

58
Q

How does the copper IUD work?

A

Usual mode of action- Toxic to sperm -stop sperm reaching egg- may sometimes prevent implantation of fertilised egg

59
Q

Negative effects of the the copper IUD?

A

Can make periods heavier and increased cramps

60
Q

How does the Levonorgestrel IUS work?

A

> Slow release progestogen on stem
Affect cervical mucus and endometrium most women still ovulate
Stop fertilisation of egg- may prevent implantation fertilised egg

61
Q

What is the most effective emergency contraception?

A

Copper IUD

If 100 women use there would be <1 pregnancy

62
Q

What is the least effective emergency contraception?

A

> The Levonorgestrel pill-’Levonelle’ - take within 72 hrs

> If 100 women use will be 2-3 pregnancies

63
Q

How soon should the Levonorgestrel pill-’Levonelle’ be taken after sex?

A

Take within 72 hours

64
Q

How soon should the Ulipristal pill ‘ellaone’ after sex?

A

Take within 120 hours

65
Q

How effective is the Ulipristal pill ‘ellaone’ after sex?

A

If 100 women use will be 1-2 pregnancies

66
Q

When should contraception be started?

A

Within 5 days of cycle

67
Q

If contraception isn’t started within the first 5 days of the cycle what happens?

A

Condoms should be used for the next 7 days and do pregnancy test after 4 weeks

68
Q

How soon after pregnancy can someone get pregnant?

A

21 days after delivery

69
Q

How soon after miscarriage or abortion can someone get pregnant?

A

5 days

70
Q

How long does breast feeding act as a contraceptive?

A

For first 6 months, if feeding every 4 hours, and amenorrhoeic

71
Q

How does female sterilisation occur?

A

Usually Filshie clips applied across tube to block tube lumen

72
Q

Is female sterilisation reversible?

A

No

73
Q

What is the effect of female sterilisation on ovarian cancer?

A

Reduces the risk

74
Q

What is the effect of female sterilisation on periods/hormones?

A

No effect

75
Q

What is the failure rate of laparoscopic sterilisation?

A

1 in 200 lifetime risk

76
Q

When is a salpingectomy usually performed?

A

At planned Caesarean section if baby seems well and discussed in advance

77
Q

What is ESSURE?

A

Hysteroscopic sterilisation (female)

78
Q

What is vasectomy?

A

Vas deferens divided and ends cauterised small incision midline scrotum

79
Q

Is vasectomy reversible?

A

No due to production of anti-sperm antibodies even is vas reconnected

80
Q

How long does it take for vasectomy to be effective?

A

4-5 months

81
Q

What is the failure rate of vasectomy?

A

> 2 in 100 before 2 sperm samples sent off

> After 2 sperm samples sent off 1 in 2000

82
Q

What is the risk of testicular pain following vasectomy?

A

<1:100

83
Q

What is the effect of vasectomy on testosterone or sexual function?

A

No effects

84
Q

What is the effect of vasectomy on testicular or prostate cancer?

A

No effects

85
Q

How many pregnancies are aborted?

A

1 in 6 in Grampian

86
Q

How many women in their lifetime have an abortion?

A

1 in 3 UK women

87
Q

Termination of Pregnancy

Clinicians’ Rights and Responsibilities ?

A

The right of medical staff to refuse participation in abortion because they have a conscientious objection to the procedure is enshrined within the 1967 Abortion Act

There is an obligation to ensure that the woman is still able to access abortion care

Staff have a right to refuse participation as long as this does not affect any duty to participate in treatment which is necessary to save the life or to prevent grave permanent injury to the physical or mental health of a pregnant woman
Further information available at General Medical Council’s (GMC) guidance on ‘Personal beliefs and medical practice’

88
Q

When was the UK Abortion Act brought in?

A

1967

89
Q

When is termination of pregnancy (Surgical, STOP)?

A

Usually between 5-12 weeks

90
Q

What is used 3 hours prior to termination of pregnancy (Surgical, STOP)?

A

Cervical priming - misoprostol - this helps to dilate and reduce the risk of perforation or haemorrhage

91
Q

How is the termination of pregnancy performed (Surgical, STOP)?

A

> Transcervically, with a 6-10 mm suction catheter

> Can be performed under local or general anaesthetic

92
Q

What is risks of termination of pregnancy (Surgical, STOP)?

A

> 1-4/1000 perforation
<1:100 cervical injury
Infection
Risk from General anaesthetic

93
Q

When is termination of pregnancy (Medical, MTOP)?

A

5-24 weeks

94
Q

How is the termination of pregnancy performed (Medical, MTOP)?

A

1) Mifepristone oral antiprogestogen tablet
2) 36-48 hours later Misoprostol initiates uterine contraction which opens cervix and expels pregnancy
3) Average 4-6 hours to pass pregnancy under 12 weeks

95
Q

What is risks of termination of pregnancy (Medical, MTOP)?

A

1) Failure 1 in 100 <8 weeks, 8 in 100 >12 weeks need surgery for incomplete abortion
2) Infection – test and prophylactic antibiotics
3) < 1 in 1000 need blood transfusion

96
Q

Can abortion be performed at home?

A

Legal to supply misoprostol for woman to take away from clinic for home self administration in Scotland since late 2017

An option for women who are under 10 weeks gestation and prefer a home procedure and and ‘healthy’. Analgesia supplied. Phone advice 24/7. Follow up low sensitivity pregnancy test at 2 weeks.

97
Q

What are the long-term effects of abortion?

A

Physical:
> No effect on future fertility or pregnancy or delivery
> No effect on cancer risks

Mentally:
> Emotional effects depend on reasons for abortion/ pre-existing mental health issues

Year 3 - Reproduction (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions