Contraception

Question 1

Hypothalamus releases which hormone:

Answer 1

Gonadotropin releasing hormone

Question 2

GTRH sends a signal to the anterior pituitary to release:

Answer 2

Follicular stimulating hormone and luteinizing hormone

Question 3

FSH stimulates

Answer 3

immature ovarian follicles, one becoming an ovum along with secondary follicles (granulosa cells)

Question 4

Granulosa cells begin producing

Answer 4

estrogen

Question 5

Estrogen from the granulosa cells prohibit the pituitary gland from producing

Answer 5

FSH

Question 6

The follicle that produces the most estrogen becomes the

Answer 6

Ovum (sometimes two ovum are produced)

Question 7

Estrogen will stimulate the development of the ____ and ____ cervical mucous

Answer 7

Endometrium; thin

Question 8

Luteinizing hormone spikes day 14 and causes

Answer 8

The ovum to be released (ovulation)

Question 9

Luteinizing hormone changes the granulosa cells into luteal cells which is now called the:

Answer 9

Corpus luteum

Question 10

Corpus luteum produces

Answer 10

Some estrogen, relaxin, and large amounts of progresterone

Question 11

Progesterone works by

Answer 11

maintaining endometrium

Question 12

If fertilization does not occur, the corpus luteum becomes the corpus

Answer 12

albicans. Progesterone production drops and the endometrium sloughs

Question 13

How do combination oral contraception prevent pregnancy?

Answer 13

Steady levels of estrogen and/or progesterone cause a negative feedback loop to the pituitary gland and prevent release of LH and FSH (causing ovulation)
*Levels of progesterone trick the body into thinking its already pregnant, thicken the cervical mucous which prevents sperm from entering uterus.

Question 14

Systemic effects of estrogen

Answer 14

Positive effects on bone mass, triglycerides, HDL-to-LDL ratio, stimulation of coagulation and fibrinolytic pathways

Question 15

Systemic effects of progesterone

Answer 15

Increase body temperature and insulin levels. Depress CNS

Question 16

What are the two estrogen formulations available in contraception preparations?

Answer 16

Ethinyl estradiol and mestranol

Question 17

Estrogen contraindications

Answer 17

Migraine with aura, uncontrolled HTN, postpartum <3 weeks and breastfeeding, history of DVT, smoking in women over age 35

Question 18

Describe monophasic, biphasic, and triphasic dosing

Answer 18

Monophasic: same dose of estrogen and progestin for full cycle.
Biphasic: vary dose of progestin, no variation in estrogen dose
Triphasic: vary dose of estrogen, progestin, or both (not used as much)

Question 19

Which medication can decrease efficacy of oral contraceptives?

Answer 19

Rifampin and Rifabutin

Question 20

Plan B contains only:

Answer 20

Progestin

Question 21

Plan B must be taken within ___ hours for it to be effective

Answer 21

72

Question 22

Plan B is less effective is BMI is >___

Answer 22

26. Serum doses are lower than normal weight

Question 23

The emergency contraception Ella can be taken up to __ days after unprotected intercourse and be used in individuals whose BMI is

Answer 23

5;35

Question 24

Copper IUD can be used as EC up to __ days after unprotected intercourse

Answer 24

7

Question 25

Contraindications for CHC

Answer 25

Migraines with aura, uncontrolled HTN, history of bleeding/clotting disorder, smoker > age 35, SLE, MS, liver disease, current cancer, ischemic heart disease, diabetes with nephropathy, retinopathy, vascular disease, <21 days postpartum

Question 26

Hormonal methods are considered safe in women with uncomplicated diabetes of less than how many years duration?

Answer 26

20 years