Contraception Flashcards

1
Q

What is the pearl index and what is the formula for it?

A

Represents the no. of contraceptive failures per 100 women in a year.

No. of accidental pregnancies X1200 / total no. months exposure

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2
Q

List some of the natural family planning methods considered.

A
Basal body temperature.
cervical mucous
cervical position
standard days
Breastfeeding
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3
Q

What is the basis of the BBT concept in natural family planning?

A

Woman records temperature first thing in morning and is waiting for a rise of 0.2 degrees which is maintained for 3 days - indicates ovulation has occurred & fertile period passed.
The couple avoid sex from first day of bleeding until 3 days after rise in temp - to avoid fertile period.
Couple can have unprotected sex on 4th day and until next monthly bleed begins.

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4
Q

Describe cervical position when fertile and infertile.

A

Cervix is high in vagina, soft & open when fertile.

Cervix is low, firm and closed when infertile.

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5
Q

During a 28 day cycle, which days is a female most fertile?

A

standard days = days 8-18

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6
Q

What is lactational amenorrhoea and what are the criteria which need to be met to do this?

A

The natural family planning method which revolves around the fact that females don’t ovulate when breastfeeding.

3 criteria:
exclusively breastfeeding
<6/12 post-natal
amenorrhoeic

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7
Q

When can you start combined hormonal contraception in a patient?

A

start in first 5 days of period
Or
at any time in cycle when reasonably sure not pregnant + use condoms for 7 days

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8
Q

What is the main side effect of the subdural contraceptive implant?

A

prolonged PV bleeding - can be controlled by CHC taken additionally if not contraindicated.

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9
Q

What are the uses of Mirena IUS?

A

heavy periods
can be part of HRT
therapeutic use in endometriosis, hyperplasia etc.

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10
Q

What is the mode of action of the copper coil?

A

Primary action is prevention of fertilisation. It also causes an inflammatory response in the endometrium which has an effect on implantation.

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11
Q

Combined hormonal contraception has a protective effect over breast and cervical cancer.
T/F?

A

FALSE

protection from ovarian and endometrial cancers and increased risk for breast cancer and cervical cancer.

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12
Q

When should you check the BP of a patient you are starting on CHC?

A

check initially, at 3 months and then annually.

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13
Q

CHC is contraindicated in patients with migraines.

T/F?

A

FALSE

contraindicated in patients with migraine WITH AURA (increases risk of ischaemic stroke)

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14
Q

What is the definition of Quick starting contraception?

A

starting contraception when patient presents i.e. not waiting until next period.
(i.e. may not be possible to reliably exclude pregnancy = off-licence)

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15
Q

What is the definition of bridging contraception?

A

when the preferred method can’t be started immediately because pregnancy cannot be excluded, and an interim method is used.

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16
Q

When is there a 30% pregnancy risk during the menstrual cycle?

A

within 6 days before ovulation

17
Q

What are the 3 methods of emergency contraception available in the UK?

A

intrauterine - copper IUD

oral - LNG-EC and UPA-EC

18
Q

What is the timescale of use of LNG-EC?

A

up to 72hrs post-UPSI (up to 96hrs off-licence)

19
Q

What is the timescale of use of UPA-EC?

A

up to 120hrs post-UPSI

20
Q

The copper IUD is more effective than oral EHC.

T/F?

A

TRUE

10x more effective than oral EHC

21
Q

What is the insertion criteria for copper IUD as EC?

A

up to 120hrs post-UPSI
OR
up to 5 days after earliest expected date of ovulation

22
Q

What are the side effects of copper IUD and how can these be managed?

A

often make periods heavier, longer and more painful - esp. during the 3/12 post-insertion.

NSAIDs can help with both pain and bleeding

23
Q

Which form of contraception might be the only suitable reliable method for women after breast cancer?

A

copper IUD

24
Q

Out of the 2 oral EC, which is anti-progestogen and which is high-dose progestogen?

A
UPA-EC = anti-progestogen 
LNG-EC = high-dose progestogen
25
Q

in which patients would you avoid the use of UPA-EC?

A

acute severe asthma uncontrolled by oral steroids