Contraception

Question 1

what is the pearl index?

Answer 1

failure rate per 100 women in year of exposure

Question 2

average cycle days?

Answer 2

26-32 day cycle

Question 3

when are you most likely to ovulate during cycle?

Answer 3

day 12 -18

Question 4

survival of egg? sperm?

Answer 4

egg - 24 hours

sperm - less than 4 days

Question 5

when is the highest chance of pregnancy?

Answer 5

sex on day 8-19

Question 6

what is in the combined pill?

Answer 6

ethinyl estradiol

synthetic progesterone

Question 7

what is CHC regime?

Answer 7

21 days with a hormone free week

can run packs back-to-back

Question 8

CHC forms?

Answer 8

pill
patch
vaginal ring

Question 9

CHC non-contraceptive benefits? (4)

Answer 9

regulate/reduce bleeding
improve acne/hirsutism
may aid premenstrual syndrome
50% reduction in ovarian/endometrial cancer

Question 10

CHC side-effects? (5)

Answer 10

breast tenderness
nausea
headache
mood
weight gain

Question 11

Serious risks associated with CHC?

Answer 11

increased risk of venous/arterial thrombosis

increased risk of cervical/breast cancer

Question 12

Progestogen only pill (POP) regime?

Answer 12

take at the same time everyday without a pill-free interval

Question 13

POP side-effects? (6)

Answer 13

increased appetite
hair loss/gain
mood
bloating/fluid retention
headache
acne

Question 14

Injectable progestogen regime?

Answer 14

every 13 weeks

Question 15

what does Depo-Provera do?

Answer 15

prevents ovulation

affects cervical mucus making it hostile to sperm and makes endometrium unsuitable for implantation

Question 16

disadvantages of Depo-Provera?

Answer 16

delay in return to fertility (9m)
reduction in bone density
problematic bleeding
weight gain 2/3rd women

Question 17

Progestogen implant method of action?

Answer 17

inhibition of ovulation and effect on cervical mucus

Question 18

disadvantage of implant?

Answer 18

may cause long/prolonged bleeding

may cause mood change more often than other progestogen methods

Question 19

Copper IUD?

Answer 19

toxic to sperm
hormone free
may make periods heavier
can last 5-10y

Question 20

Levonorgestrol IUS?

Answer 20

affect cervical mucus and endometrium most women still ovulate
slow release progestogen on stem

Miren and Kyleena

Question 21

emergency contraception? (3)

Answer 21

copper IUD most effective option (fit within 120h)
Levonorgestrel (72h)
Ulipristal pill (120)

Question 22

Abortion consultation?

Answer 22

scan for gestation/viability
medical history
circumstance - reason
what to expect
contraception
STI bloods offered

Question 23

5-12w surgical termination?

Answer 23

cervical priming with prostaglandin
GA or LA block
transcervical 6-10mm suction catheter

Question 24

5-24w medical termination?

Answer 24

Mifepristone oral antiprogestogen tablet

36-48hr later misoprostol initiates uterine contractions which opens cervix and expels pregnancy

4-6 hour to pass pregnancy under 12 weeks

Question 25

home abortion?

Answer 25

legal to supply misoprostol for woman to take away for home admin

option for any women under 10w gestation

phone advice and pregnancy test at 2 weeks