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Repro > Contraception & TOP > Flashcards

Contraception & TOP Flashcards

1
Q

primary mode of action of

a) COCP
b) implant
c) copper IUD

A

a) inhibits ovulation
b) inhibits ovulation
c) decreases sperm motility and survival

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2
Q

levonorgestrel - what type of contraceptive?

A

progesterone only

used for EC

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3
Q

how long following UPSI is levonorgestrel licensed for use

A

up to 72 hrs

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4
Q

how long following UPSI can EllaOne (Ulipristal) be used

A

up to 120 hrs

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5
Q

can the pill be started again straight away after ulipristal EC?

A

hormonal contraception can interfere with its action&raquo_space; restart 5 days after

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6
Q

breastfeeding should be delayed for 1 week following ulipristal/levonorgestrel?

A

ulipristal

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7
Q

IUD must be fitted within ? days of UPSI

A

5 days

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8
Q

The pearl index describes the no. of pregnancies that would be seen if ? women used the contraceptive in question for ? year(s)

A

one hundred women
1 year

if pearl index = 0.2 then this means 0.2 pregnancies for every 100 women, or 2 for every 1000 women

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9
Q

how long after amenorrhoea is contraception not needed if

a) < 50
b) > 50

A

a) 2 yrs

b) 1 yr

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10
Q

which methods of contraception can be used over 50 yrs

A

implant, POP, IUS

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11
Q

most common adverse effect of POP

A

irregular bleeding

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12
Q

POP - if started up to and including day ? of the cycle it provides immediate protection. otherwise other methods should be used for the first ? days

A

day 5

2 days

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13
Q

POP missed pill > 3 hrs

A

take pill soon as possible and use extra precautions until normal pill taking has been established for 48 hrs

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14
Q

COCP - can it be used whilst breast feeding?

A

no
absolutely contraindicated if breast feeding < 6 weeks post partum
(may reduce milk production)

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15
Q

when is lactational amenorrhoea suitable contraception

A

fully breast feeding
amenorrhoeic
< 6 months post partum

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16
Q

medical TOP

A

2 stages

  1. oral mifepristone 200 mg
  2. 48 hours later, vaginal or oral prostaglandin e.g misoprostol, gemeprost (up to 9 weeks, can complete 2nd stage at home, later than this need repeat doses of PGE 3 hourly)
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17
Q

surgical TOP

A

vacuum aspiration

18
Q

TOP aftercare

A

urine pregnancy test at 2-3 weeks

anti D

19
Q

which days in a standard cycle are most fertile

A

8 > 18

20
Q

basal body temp - how to tell when you’re most fertile

A

take before rising in the morn

most fertile during the 2/3 days before your temp increases (by > 0.2 degrees C)

21
Q

consistency of fertile cervical mucous

A

wet and slippery

22
Q

what is the pearl index

A

no. of accidental pregnancies x 1200
/
total no. of months of exposure

23
Q

how long is the implant licensed

A

3 yrs

24
Q

py action of injection and implant

A

inhibition of ovulation

25
Q

how often is the injection given

A

every 13 weeks

26
Q

how long is additional contraception needed if injectable or implant is begun after first 5 days of cycle?

A

7 days

27
Q

side effects of injectable

A

weight gain
delay in return of fertility
irreg bleeding
possible risk of osteoporosis

28
Q

side effects of implant

A

weight gain
irreg bleeding
acne
nerve damage/vascular injury

29
Q

primary action of copper IUD

A

prevents fertilisation

30
Q

s/e’s of copper IUD

A

heavy prolonged period
pain, infection, PID risk increased in first 20 days
perforation
increased risk miscarriage

31
Q

primary action of IUS

A

effect on implantation (endometrium unfavourable, effect on mucous)

32
Q

contraindications for IUD or IUS

A 
current pelvic infection 
abnormal uterine anatomy 
gestational trophoblastic disease if bHCG levels are abnormally elevated 
pregnancy 
endometrial ca 
cervical ca
33
Q

main action of combined hormonal contraception

A

inhibits ovulation via action on hypothalamic pituitary ovarian axis

34
Q

is it ok to miss 1 pill?

A

fine if youve taken 7 before and take 7 after. take the missed pill

35
Q

what to do if you miss 2 or more pills?

A

additional contraception for next 7 days. may need EC if youve had UPSI in the past 7 days
take the last pill that you missed and leave the others
dont take your period break if theres less than 7 left in the pack

36
Q

safest time to miss a pill

A

middle 7 days

37
Q

which COC has highest risk of VTE

A

cyproterone acetate (co-cyprindol)

38
Q

what types of cancer does CHC protect against

A

endometrial and ovarian

39
Q

what types of cancer does CHC increase the risk of

A

cervical and breast

40
Q

how many missed POP pills before EC needed

A

ONE + upsi

41
Q

what type of drug does POP interact with

A

liver enzyme inducers - cytochrome p450

42
Q

types of POP

A

traditional - levonorgestrel, norethisterone

newer - etonorgestrel - longer acting

Repro (12 decks)

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