Contraception and sterilization (Wootton)

Question 1

What provide the most effective reversible contraception?

Answer 1

Hormonal contraceptives

Question 2

Majority of oral contraceptives are a combination of ____ and ____.

Answer 2

Estrogen and progesterone

Question 3

Oral contraceptives cause suppression of what hormones?

Answer 3

1) GnRH

2) LH and FSH

Question 4

The __1__component of the oral contraceptive is the major player by suppressing LH and therefore ovulation as well as thickening cervical mucus, inhibiting sperm migration and creating an unfavorable atrophic endometrium for implantation.

The __2__ component mainly improves cycle control by stabilizing the endometrium and allows less breakthrough bleeding.

Answer 4

1) Progesterone

2) Estrogen

Question 5

1) The progestin-only oral contraceptives have a MOA of?

2) Who is it mainly used in?

Answer 5

1) Making cervical mucus thick and impermeable

2) Breastfeeding and anyone with contraindication to estrogen

Question 6

Some benefits of oral contraceptives include a __1__ menstrual cycle.

They can improve __2__ which is a common side effect of menstruation.

They decrease the risk of __3__ due to shorter and less heavy cycles.

They can lower incidence of __4__ and __4__ cancers.

Answer 6

1) Regular
2) Dysmenorrhea
3) Iron deficiency anemia
4) Endometrial and ovarian

Question 7

What are side effects seen with oral contraceptives either in the first three months or in the first year?

Answer 7

1) Breakthrough bleeding

2) Amenorrhea

Question 8

Some serious side effects of oral contraceptives include?

Answer 8

1) Venous thrombosis
2) PE
3) MI
4) Hepatic tumors

VMPH (VaMPHire)

Question 9

1) The transdermal patch contraceptive has what hormones in it?
2) There is caution with use in women greater than how many pounds?
3) Side effects and precautions same as oral contraceptives except for greater risk of?

Answer 9

1) Estrogen and progesterone
2) 198 pounds
3) Thrombosis

Question 10

The vaginal ring contraceptive has what hormones in it?

Why is it associated with greater compliance?

Answer 10

1) Estrogen and progesterone

2) Because of its once a month use

Question 11

What is the prescription for the newer vaginal ring, the annovera vaginal ring?

How long do you place the annovera vaginal ring in then remove?

Answer 11

Prescription for 13 months in one reusable ring

2) Keep in for 21 days
Remove for 7 days

Question 12

a

Answer 12

Null

Question 13

What populations can not use oral contraceptives?

Answer 13

1) Over 35 and smoke
2) History of thromboembolic event
3) Liver disease

Question 14

Depot medroxyprogesterone acetate (Depo provera) is given by __1__ every 11-13 weeks.

It maintains contraceptive level of __2__ for about 14 weeks.

Preferred to be given within first 5 days of __3__ and if not use a backup method for 2 weeks.

Answer 14

1) Intramuscular injection
2) Progestin
3) Menses

Question 15

The MOA of Depot medroxyprogesterone acetate is a thickening of __1__.

__2__ of the Endometrium.

It blocks the __3__ and ovulation.

Answer 15

1) Cervical mucus
2) Decidualization
3) LH surge

Question 16

With Depo-Provera, alterations of ____ is associated with decreased estrogen levels.

Answer 16

Bone metabolism

Question 17

What side effects are associated with Depo-Provera?

Answer 17

1) Weight Gain
2) Irregular bleeding
3) Exacerbation of depression

WIE

Question 18

What are the types of LARCS

Long acting reversible contraceptives)

Answer 18

Implant and IUD

Question 19

1) What implantable hormonal contraceptive is a single, radiopaque, rod-shaped implant containing 68mg ETONOGESTREL, 4cm long and 2mm in diameter?
2) It can be used for how many years?
3) MOA?

**LARCA

Answer 19

1) Nexplanon (Etonogestrel implant)
2) Three years
3) Thickens cervical mucus and Inhibits ovulation

Question 20

What are side effects of implants?

Answer 20

Irregularly irregular vaginal bleeding!!
Headache
Weight gain

Question 21

What are contraindication of implant?

Answer 21

1) Known or suspected pregnancy
2) Liver tumors or active liver disease
3) Known or suspected breast cancer

Question 22

What are some complication of implant insertion?

Answer 22

1) Deep insertion
2) Infection
3) Persistent pain or paraesthesia at site

DIP

Question 23

What are the types of IUD (Intrauterine Devices)

Answer 23

Copper T (paragard)
Mirena/Liletta
Skyla/Kyleena

Question 24

Intrauterine devices have an increased risk of ____ if pregnancy would occur.

Answer 24

Ectopic pregnancy

Question 25

1) The levonorgestrel containing IUDs such as Mirena/Liletta and Skyla/Kyleena are contraindicated with?
2) Copper T is contraindicated with?

Answer 25

1) Breast cancer

2) Wilson’s disease

Question 26

A benefit of IUDs is protection of the ___ from unopposed estrogen.

Answer 26

Endometrial lining

Question 27

What is the MOA of Copper T (Paragard)?

Answer 27

Copper interferes with sperm transport

Question 28

Diaphragms are small latex covered, dome shaped devices that must be used with a ____.

Answer 28

Spermicide

Question 29

Women who use diaphragms are more likely to get?

Answer 29

Urinary tract infections

Question 30

A cervical cap (FemCap) is a smaller version of diaphragm that is applied to the cervix itself. It has a high risk of displacement and?

What must it be used with?

Answer 30

1) Toxic shock syndrome

2) Spermicide

Question 31

What form of barrier contraceptive is small, pillow shaped and contains spermicide?

Who is it more effective in?

Answer 31

1) Sponge

2) Nulliparous

Question 32

Basal body temperature method is done by checking temperature daily before getting out of bed and noting a .5 to 1 degree change at time of ovulation and avoid sex for ___ days after.

Answer 32

3 days

Question 33

Cervical mucus method is done by the woman assessing her cervical mucus and notes changes around ovulation (spinnbarkeit) and avoid sex for ___ days after peak.

Answer 33

4 days

Question 34

How is the Symptothermal method done?

Answer 34

Combine cervical mucus and basal body temperature methods

Question 35

What emergency contraception method uses a regimen of tablets within 72 hours of unprotected sex?

Answer 35

Combined oral contraceptive method

Question 36

Plan B is __1__ only 2 pills taken twelve hours apart and is over the counter for women older than 17.

It must be used within __2__ after unprotected intercourse.

Answer 36

1) Progestin (levonorgestrel)

2) 120 hours

Question 37

Ella is __1__ postpones follicular rupture/inhibit or delay ovulation.

It is indicated for up to __2__ days after unprotected intercourse.

Answer 37

1) Ulipristal acetate

2) 5 days

Question 38

What is the most frequently used method of contraception in the U.S?

Answer 38

Sterilization

Question 39

1) A vasectomy is performed by occlusion of the ____.

2) Laparoscopy is performed by occlusion of the ____.

Answer 39

1) Vas deferens

2) Fallopian tubes

Question 40

With laparoscopy, electrocautery can increase risk of

• Thermal injury to surrounding tissues
• Poor reversibility
• Greater risk of ____ if failures occur.

Answer 40

Ectopic pregnancy

Question 41

With laparoscopy, what is the most reversible method but greatest failure rate?

What has the highest incidence of postoperative pain?

Answer 41

1) Hulka/Filshie

2) Bands (falope rings)

Question 42

What sterilization technique is increasing in use due to recent literature regarding decrease in ovarian cancer risk?

Answer 42

Salpingectomy

Question 43

Which sterilization technique uses small infra-umbilical incision in postpartum period or suprapubic incision as an interval procedure?

Answer 43

Mini-laparotomy