Contraception Trigger

Question 1

what are the possioble estrogen types found in COC’s

Answer 1

1. ethanyl estradiol (MC)
2. mestranol
3. 17b-estradiol
4. estradiol valerate

Question 2

what are the possible progestins found in COC’s

Answer 2

1. norethindrone
2. levonorgestrel
3. desogestrel
4. norgestimate
5. drosperinone

Question 3

this progestin ingredient has less androgenic effects but a higher VTE risk.

what is it? what class is it?

Answer 3

drospirenone
spironolactone analogue

Question 4

if a patient calls your office and says she has missed 3 doses of her COC’s, how long should you tell her to use barrier contraceptive techniques for? what other advice should you give?

Answer 4

7 days.

if you have had sex in the past 5 days you need to use an emergency contraception

Question 5

a patient misses one dose of her low-dose monophasic COC’s. what do you tell her to do?

Answer 5

double the dose the next day and use barrier contraception for 7 days.

if you have had sex in the past 5 days you need to use an emergency contraception

Question 6

a patient misses a single dose of her high dose monophasic COC’s. what do you tell her to do

Answer 6

continue taking the pills as prescribed, no need to double the next dose. conception is unlikely

Question 7

What are the benefits of using COCs? (8)

Answer 7

1. Reduced ovarian cx
2. Reduced endometrial cx
3. Improved bone mass
4. Decreased progression of RA
5. Improves acne
6. Lower risk of ectopic + PID
7. Decreased risk of benign fibrocystic breast dz
8. Improvement in dysmenorrhea and premenstrual s/s

i know ima forget these and jensens gonna be like “all of the following except!!!!”

Question 8

what contraception has high rates of irregular bleeding and increases overall bleeding rate

Answer 8

POCs

Question 9

which contraception is CI in hepatic neoplasms, active liver dz, breast cx and unexplained vaginal bleeding

Answer 9

POC’s

i would assume COC’s as well, but POC’s specify hepatic neoplasms lol

Question 10

COCs containing levonorgestrel are known as what for emergency contraceptions

Answer 10

the Yuzpe method

Question 11

100mcg ethinyl estradiol + 500-600mcg levono

what is it and how is it taken

Answer 11

Yuzpe method (COCs containing levonorgestrel)

2 doses 12 hrs apart.

Question 12

Main SE of this is nausea and vomiting. its recommended to premedicate for this SE.

what med and dose

Answer 12

Yuzpe method

100mcg ethinyl estradiol + 500-600mcg levono

2 doses 12 hrs apart

Question 13

What is the Plan B one step AKA? what is the dose?

Answer 13

Aftera
levonorgestrel

2 options:
1500 x 1
750 x 2

Question 14

which emergency contraceptives prevent the LH surge

Answer 14

levonorgestrel and ulipristal

these DO NOT stop fertilization or implantation

Question 15

single dose of 1500ug or double of 750ug

Answer 15

levonorgestrel

Question 16

single dose of 30mg

Answer 16

ulipristal

Question 17

SE include liver dz, cervical cx, breast cx, and clots

Answer 17

COC’s

Question 18

which emergency contraceptions inhibit implantation or possibly interfere with sperm function

Answer 18

copper IUD
Levonorgestrel IUD 52mg

Question 19

if a patient reports she had unprotected. sex 4 days ago but missed her doses of birth control over the past 2 days, what are her options for emergency contraception

Answer 19

copper IUD (5-7 days)
Levonorgestrel IUD (5 days)

Question 20

which contraceptive method decreases risk of ectopic, PID, and benign fibrocystic breast disease?

Answer 20

COCs

Question 21

what are the types of transdermal contraceptives? which has a BMI limitation

Answer 21

1. orthoevra
2. xulane
3. zafemy
4. twirla (BMI limitation of 30)

Question 22

a patient presents to you and says she realized her transdermal contraceptive fell off while she was sleeping, but she reapplied it when she woke up. what should you tell her

Answer 22

that she does not need to use a backup method of contraception. she only needs a backup method for a week if it was off for greater than 24hrs.

Question 23

this contraception method has more dysmenorrhea and breast symptoms than others. it also has the possibility of increased VTE and higher failure rate in obese patients.

Answer 23

transdermal patches

Question 24

this contraception is given Q 3 months

Answer 24

depot medroxyprogesterone shot

Question 25

which contraception method can lower endometrial cx by up to 80% and can also lower risks of sickle cell crisis? this also has no increased risk of vascular disease

Answer 25

depot medroxyprogesterone shot

Question 26

what contraception method has a major side effect of decreased bone density and also takes up to 10 months after cessation to return to baseline fertility

Answer 26

depot medroxyprogesterone shot

Question 27

MC SE includes irregular menses, Wt gain and HA

Answer 27

nexplanon

Question 28

CI includes migraine w aura, smoking over 35 and acute liver dz

Answer 28

COC’s

Question 29

CI for this includes displaced uterus, infections, and wilsons dz

Answer 29

copper IUD

Question 30

which lenovo IUD only lasts 3 years?
5?
8?

Answer 30

3 - skyla
5 - kyleena
8 - mirena and liletta

Question 31

which IUDs may help treat heavy menses or dysmenorrhea

Answer 31

Liletta and Mirena

Question 32

CI in patients who have had a prior ectopic prenancy

Answer 32

progesterone IUDs

Question 33

which contraceptive method may reduce HIV risk by 90%?

Answer 33

internal female condom

Question 34

what is the MC and most effective form of pharmaceutical abortion

Answer 34

Mi and Mi
(mifepristone + misoprostol)

<49 days from FDLMP
1st trimester

Question 35

if a patient comes to you and reports they recently found that they are 17 weeks pregnant, what are their options for abortion

Answer 35

• intra-amniotic instillation
• dilation and evac (MC for 2nd trimester)
• hysterectomy/hysterotomy

Question 36

MOA is synthetic prostaglandin E1

causes uterine contractions and cervical ripening

Answer 36

cytotec (misoprostol)