Contraception and Fertility

Question 1

what hormone surges in the follicular stage

Answer 1

surge in estrogen causes LH and FSH to increase

Question 2

what hormone triggers ovulation

Answer 2

LH surge

Question 3

If someone is trying to conceive at what time in their cycle should they have intercourse

Answer 3

when LH is detected and for 2 days after

Question 4

best time to test fot hcg

Answer 4

in the morning

Question 5

which contraceptive delays return to fertility

Answer 5

medroxyprogesterone injection

Question 6

What lubricant can be used with a latex or non latex condom

Answer 6

water or silicone based (never reccomend oil based)

Question 7

what hormones do contraceptives inhibit?

Answer 7

FSH and LH - prevents ovulation

Question 8

COCs are

Answer 8

combination ORAL contraceptives (estrogen/progestin)

Question 9

CHC

Answer 9

combined hormonal contraceptives

Question 10

what do most COCs contain

Answer 10

ethanyl estradiol and a progestin (norethindrone, levonorgestrel, drospinerone)

Question 11

monophasic birth control

Answer 11

same dose of estrogenand progesten throughout the pill pack

Question 12

biphasic, triphasic, and quadriphasic pill packs

Answer 12

mimick estrogen and progesterone levels

Question 13

indications for cocs besides prengnacy

Answer 13

dysmenorrhea (menstrual cramps), premenstrual syndrome (PMS), acne, anemia (by reducing blood loss), PCOS, endometroisos

Question 14

what is drospinerone

Answer 14

a unique progestin used in some COCs to reduce adverse effects commonly seen with oral contraceptives, a mild potassium sparring diuretic so less bloating

Question 15

what can you track to determine ovulation

Answer 15

temperature and cervical mucus

Question 16

what is required when dispensing oral contraceptives by the FDA

Answer 16

package insert

Question 17

POP uses

Answer 17

progestin only pills are useful in women who are breastfeeding (estrogen decreases milk production) and in women who have migraines with aura (estrogen increases risk of stroke)

Question 18

drawbacks of POP

Answer 18

adherance is essential (within 3 hours of same time every day otherwise need backup for 48 hours)

Question 19

who should not use the patch and what does it contain?

Answer 19

estrogen (higher systemic) therefore no one with clotting risk and also not effective in >198 pounds (xulane) , also not supposed to be used in women >35 years old who smoke

Question 20

what is in depo provera shot and how often is it given

Answer 20

DMPA (depot medroxyprogesterone acetate), a projestin and is given IM or SUBQ every 3 months

Question 21

when does bleeding occur with COC?

Answer 21

normally every 4 weeks but extended cycle every 3 months (seasonique)

Question 22

which contraceptive is approved for those who want no period

Answer 22

amthyst

Question 23

which formulation contains drospinerone

Answer 23

Yasmin and Yaz

Question 24

what are the progestin only brands

Answer 24

Errin, Camilla, Nora BE

Question 25

what is a complaint of continuous contraception and advantage

Answer 25

no period but spotting that resolves in 3-6 months

Question 26

boxed warning depo provera

Answer 26

loss of bone mineral density

Question 27

boxed warning estrogen containing products

Answer 27

do not use in women over 35 years of age who smoke

Question 28

do not use estrogen with these conditions

Answer 28

hx of DVT, stroke, CAD, breast/ovarian/liver cancer, migraines with aura

Question 29

pneumonic for serious estrogen effects

Answer 29

a - abdominal pain severe
C - chest pain
H - headaches
e - eye problems
s - swelling

Thrombosis**

Question 30

side effects of estrogen

Answer 30

nausea, breast tenderness, bloating, weight gain elecated blood pressure

Question 31

benefit of a higher estrogen/progestin dose

Answer 31

les spotting (after three months). for estrogen its early cycle for progestin its late cycle

Question 32

what pill would you give in a women who is prestfeeding, 3-6 weeks postpartum

Answer 32

progestin only pill (less androgenic)

Question 33

when would you give a drospinerone containing product

Answer 33

acne, fluid retention, mmdd (yaz), mood changes

Question 34

natazia or the iud mirenia is indicated for what

Answer 34

heavy menstrual bleeding

Question 35

drugs that decrease hormonal contreceptive efficiency

Answer 35

tHINK INDUCERS: (ps porcs)

rifampin (need backup for 6 weeks, anticonvulsants, st. johns, tobacco, pis

Question 36

QUICK START vs sunday start

Answer 36

quick start: start today but use contrception for 7 days

Sunday start: start the sunday after the onset of menstruation

Question 37

missing coc

Answer 37

if you miss 1 pill take as soon as possible, but if you miss 2 then take the last one as soon as you remember and use contraception for 7 days *unless its during week three then just skip hormone free pills

Question 38

where can you apply xulane patch and how long

Answer 38

once weekly for 3 weeks then 1 off to stomach, buttocks, upper arm, or upper torso

Question 39

mirena

Answer 39

hormonal intrauterine device

Question 40

paragard

Answer 40

copper T iud

Question 41

nexplanon

Answer 41

implant that releases progestin + etonogestrel for three years

Question 42

cutoff for emergency contraceptive

Answer 42

5 days

Question 43

how to use nuvaring

Answer 43

in three weeks, out one week

Question 44

plan b

Answer 44

levonorgestrel one 1.5mg tab

Question 45

ella

Answer 45

ulipristal acetate aka RU 486

Question 46

moa of plan b

Answer 46

prevents ovulation and thickens cervical mucus

Question 47

s/e of plan b

Answer 47

nause/vomiting – if this occurs repeat dose

Question 48

moa of ella

Answer 48

delays ovulaton

Question 49

1st line for infertility

Answer 49

Clomiphene which is a selective estrogen receptor modulator that acts as a agonist and antagonist dependong on the tissue

Question 50

side effect of clomiphene

Answer 50

hot flashes, clotting risks

Question 51

2nd line for infertility

Answer 51

gonadotrophins which stimulate FSH and LH