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General Gynecology > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the two most common forms of contraceptions?

A

OCPs, Sterilization

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2
Q

What is the fastest growing form of contraception?

A

IUD

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3
Q

What form of contraception has the highest efficacy rate?

A

Nexplanon

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4
Q

What is the failure rate for nexplanon?

A

0.05%

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5
Q

What is the failure rate for Mirena IUD?

A

0.2%

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6
Q

What is the failure rate for paragard IUD?

A

0.6%

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7
Q

amount of estrogen in low dose OCP

A

30 - 50 ug

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8
Q

amount of estrogen in ultra low dose OCP

A

< 30 ug

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9
Q

What are the 2 main effects of estrogen in OCP pills?

A
  1. Potentiates negative feedback on HPA axis

2. Stabilizes endometrium to reduce frequency of breakthrough bleeding

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10
Q

What is the failure rate of OCPs with typical use?

A

3-9%

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11
Q

What is the failure rate of OCPs with perfect use

A

0.3%

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12
Q

Estrogen ___ the levels of SHBG, thus ____the levels of testosterone

A

increases, decreases

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13
Q

Breakthrough bleeding on OCPs occurs in ___ percent of patients in the first ____ months.

A

25%, 3 months

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14
Q

True or false: OCPs cause a decrease in sexual desire in up to 20% of users

A

True

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15
Q

What is the mean time to resumption of menses after discontinuation of OCPs?

A

32 days

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16
Q

what percentage of patients will continue to ovulate on POPs?

A

40%

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17
Q

By what mechanism do POPs work to prevent pregnancy?

A

Cervical mucus thickening

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18
Q

What are the two main advantages of using a Patch or Ring for contraception?

A

Ease of use and increased compliance

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19
Q

How many weeks do you keep a patch on for contraception?

A

3 weeks

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20
Q

What is the daily release of hormones in a birth control Patch?

A

150 ug norelgestrain, 35 ug ethinyl estradiol

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21
Q

A Patch has ____ total amount of estrogen but _____ Peak levels.

A

higher, lower

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22
Q

What are the two main side effects of the birth control patch

A

site reaction, breast tenderness

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23
Q

What is the daily release of hormones in a Nuva ring?

A

120 ug etonorgesterol, 15 ug ethinyl estradiol

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24
Q

How long do you leave a Nuva ring in for?

A

3 weeks

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25
Q

True or false: the nuva ring contains adequate hormones for 5 weeks of use?

A

True

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26
Q

The Nuva ring delivers ____ levels of estrogen compared to OCPs

A

lower

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27
Q

What is the dose of medroxyprogesterone in depo Provera?

A

150mg

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28
Q

How often do you give Depo Provera?

A

every 3 months

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29
Q

What is the failure rate of Depo Provera?

A

0.3 %

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30
Q

What are the three mechanism of action of Depo Provera?

A
  1. Inhibits ovulation, blocks LH surge
  2. Thickens cervical mucus
  3. Alters endometrium
31
Q

What populations is it useful to use Depo Provera?

A

lactating women, seizure disorders, sickle cell

32
Q

What weight gain is associated with Depo Provera?

A

4-8lbs per year

33
Q

True or false: Depo Provera can cause decreased bone density?

A

True

34
Q

True or false: There is a delay in return of fertility with Depo Provera Use?

A

True

35
Q

How much etonogesterol is released by a Nexplanon daily?

A

60 - 70 mcg

36
Q

Does Nexplanon consistently block ovulation?

A

Yes

37
Q

What is the expulsion rate of a copper IUD in the first year?

A

5%

38
Q

What percent of women report increased pain and bleeding with a copper IUD in the first year?

A

12%

39
Q

How much levonorgesterol does a mirena IUD release in the Uterus per day?

A

20ug

40
Q

What is the main mechanism of the Mirena IUD?

A

thickens cervical mucus, suppresses endometrium

41
Q

For how long should you anticipate having irregular bleeding or spotting with a Mirena IUD following insertion?

A

3-6 months

42
Q

What percent of patients experience ammenorhea at 6 months following Mirena insertion?

A

40%

43
Q

How much levonorgesterel is released by a Skyla per day?

A

14 ug/day

44
Q

How much levonorgesterel is released by a Liletta IUD?

A

18.6 mcg/day

45
Q

How high is the expulsion rate of an IUD placed post placental?

A

up to 24%

46
Q

True or false: postplacental IUD placement is contraindicated in the setting of chorioamnionitis/ endometritis

A

True

47
Q

True or false: The absolute risk of an ectopic is higher when using an IUD

A

False

48
Q

True or false: when a pregnancy occurs with an IUD in place it is more likely to be an ectopic?

A

True

49
Q

What is the failure rate of a tubal ligation in the first year?

A

0.5%

50
Q

What is the 10 year failure rate of postpartum tubal ligation?

A

0.75%

51
Q

What is the failure rate of essure coils after 5 years?

A

0.25%

52
Q

Is an alternative form of contraception required following essure placement?

A

Yes

53
Q

What is required prior to discontinuation of alternative contraceptive method?

A

Hysterosalpingogram confirming blocked tubes

54
Q

What is the failure rate of vasectomies?

A

0.1%

55
Q

True or false: condoms made out of lamb intestine do not block STDs?

A

True

56
Q

What is the failure rate of condoms with typical use?

A

18%

57
Q

What is the main advantage of condoms?

A

Only method that prevents STD transmission

58
Q

What is the failure rate of a female diaphragm with typical use?

A

16 - 24%

59
Q

True or false: A female diaphragm can reduce the transmission of chlamydia and gonorrhea, but not HIV

A

True

60
Q

There is a slight ____(increase/decrease) risk of UTIs with diaphragm use

A

Increase

61
Q

What is the mechanism of action of the female sponge?

A

spermacidal action of nonoxynol-9

62
Q

How long can a cervical cap be left in place?

A

48hrs

63
Q

cervical caps have _____(increased/decreased) efficacy in parous women?

A

decreased

64
Q

What is the Yuzpe regimen for emergency contraception?

A

two doses of 0.5mg levonorgesterel + 100 ug ethinyl estradiol 12 hours apart

65
Q

What were the main side effects of the Yuzpe method for emergency contraception?

A

nausea and vomiting

66
Q

What is the progesterone only method for emergency contraception?

A

2 doses 0.75mg progesterone given 12 hours apart

67
Q

What is the mechanism of action of high dose progesterone method for emergency contraception?

A

Inhibition or delay in ovulation and prevention of fertilization

68
Q

If Plan B is taken within ____ hours of coitus, it prevents___percent of pregnancies

A

72 hours, 85%

69
Q

What is the mechanism of action of Ulipristal (Ella)

A

selective progesterone receptor modulator

70
Q

what is the dose of Ulipristal (Ella)?

A

30 mg

71
Q

Ulipristal (Ella) can be used within ___ days of coitus

A

5 days

72
Q

What is the most effective method of emergency contraception?

A

Copper IUD

73
Q

Copper IUD can be inserted within ____ days of coitus for emergency contraception?

A

5 days

General Gynecology (11 decks)

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