Contraception Other Questions

Question 1

Actinomyces in the vagina or cervix by any lab technique is ____ (yes/no) diagnostic of disease.

Answer 1

Not diagnostic of disease

Question 2

T/F; Standard abx tx without IUD removal may be offered to asymptomatic women with lab evidence of gonorrhoea or chlamydia.

Answer 2

True. Should be assessed for appropriateness for continued IUD use

Question 3

Women who conceive with an IUD that remains in site, the risk of miscarriage is _____ %

Answer 3

40 - 50%. Twice as high as general obstetric population. Whenever possible, removing IUD is the right answer

Question 4

If Leep or an ablative procedure is to be performed with IUD in situ do you leave the IUD in or take it out

Answer 4

Leave it in and push strings into cervical canal to perform procedure

Question 5

How do you treat someone who misses OCP pills

Answer 5

back up method for seven days after two missed pills regardless of dose

Question 6

How much ethinyl estradiol is in standard OCPs

Answer 6

30 - 35mcg.

Question 7

OCPs with lower dose ethinyl estradial are just as effective as those with 30 - 35mcg

Answer 7

Similar contraceptive efficacy, as long as adherence is good

Question 8

metabolism of OCs is accelerated by any drug that increases liver microsomal enzyme activity such as many of the anticonvulsant drugs, including ____ and _____

Answer 8

phenytoinandphenobarbital.

As a result, the contraceptive efficacy of an OC is likely to be decreased in women taking these drugs

Question 9

the metabolism of OCs isnotaffected by antibiotics, with the exception of______.

Answer 9

rifampin

Question 10

What is the Ddx? woman with a longstanding IUD develops new severe cramping or abdominal tenderness-

Answer 10

Ddx- pelvic inflammatory disease, ectopic pregnancy, miscarriage, and IUD expulsion or perforation.

Question 11

What is the Ddx? new onset abnormal bleeding in women after prolonged use of IUDs – watch out for Age

Answer 11

Ddx- displacement of the device, pregnancy (intrauterine or ectopic), infection, as well as gynecologic disorders of the cervix or uterus (eg, leiomyomas, polyps, endometrial cancer)

Question 12

42 year old divorced, new sexual partner , met at online dating site preparing for first date

. List 3 counselling items to discuss?

Answer 12

Pregnancy/contraception/STI/safety

Question 13

List barrier methods of contraception .

The first two must be reuseable

Answer 13

diaphragm
cervical cap
sponge
female condoms
male condoms

Question 14

What are three important unacceptable health risk/absolute contraindications for use of combined OCP

Answer 14

1. Age ≥35 years and smoking ≥15 cigarettes per day
2. positive or unknown antiphospholipid antibodies)
3. Migraine with aura at any age

Question 15

what are all unacceptable health risk/absolute contraindications for use of combined OCP

Answer 15

Age ≥35 years and smoking ≥15 cigarettes per day
●Multiple risk factors for arterial cardiovasculardisease (such as older age, smoking, diabetes, and hypertension)
●Hypertension (systolic ≥160 mmHg or diastolic ≥100 mmHg)
●Venous thromboembolism
●Known thrombogenic mutations
●Known ischemic heart disease
●History of stroke
●Complicated valvular heart disease (pulmonary hypertension, risk for atrial fibrillation, history of subacute bacterial endocarditis)
●Systemic lupus erythematosus (positive or unknown antiphospholipid antibodies)
●Migraine with aura at any age
●Breast cancer
●Cirrhosis
●Hepatocellular adenoma or malignant hepatoma

Question 16

What are conditions in which a progestin only contraceptives may be desirable

Answer 16

Migraine HA 
Age > 35 yo 
Hx of thromboembolic disease 
Cardiac Dx, esp CAD or Heart failure 
Cerebrovascular disease
early post partum period 
HTN with vascular disease or older than 35 years of age 
SLE with vasc. disease, nephritis, or ANA +
Hypertriglyceridemia