Contraception/Women's Health

Question 1

Normal range of menses is ___-___ days w/avg of ___.
Normal duration is ___-___ days w/avg of ___.
Normal blood loss is ___-___ ml w/avg of ___-___.

Answer 1

21-35, 28
2-6, 4
20-80, 30-35

Question 2

___ is the absence of a period for 3 or more months in women w/past menstruation.

Answer 2

amenorrhea

Question 3

___ is diminished menstrual flow (spotting)

Answer 3

hypomenorrhea

Question 4

___ is bleeding > 35 day intervals.

Answer 4

oligomenorrhea

Question 5

___ is painful periods

Answer 5

dysmenorrhea

Question 6

___/___ is bleeding at regular intervals but marked w/prolonged bleeding > 7 days or excess of 80cc.

Answer 6

menorrhagia/hypermenorrhea

Question 7

___ is irregular but frequent uterine bleeding in variable amts.

Answer 7

metrorrhagia

Question 8

___ is uterine bleeding occurring irregularly in frequency and excessive in amt.

Answer 8

menometrorrhagia

Question 9

___ is uterine bleeding occurring at intervals < 21 days.

Answer 9

polymenorrhea

Question 10

___ is bleeding of variable amts occurring btwn regular menses.

Answer 10

intermenstrual

Question 11

___ is any bleeding occurring more than 1 yr following menopause.

Answer 11

postmenopausal

Question 12

___ is bleeding occurring after sexual intercourse

Answer 12

post-coital

Question 13

___ is bleeding any time during a cycle outside of menses while on hormones.

Answer 13

breakthrough bleeding

Question 14

___ is bleeding occurring when estrogen is withdrawn.

Answer 14

withdraw bleeding

Question 15

About 90% of dysfunctional bleeding (DUB) is ___, which is menses < ___ days or > ___ days.

Answer 15

anovulatory, 21, 35

Question 16

___ abnormal uterine bleeding is d/t ectopic and threatened abortion, infection, polyps, fibroids.

Answer 16

Organic

Question 17

___ abnormal uterine bleeding is r/t ___ axis and typically d/t medications, IUD, and sexual trauma.

Answer 17

Systemic, hypothalamic-pituitary-ovarian

Question 18

___ ___ are considered to be the gold standard in contraception. It decreases risk for ___ CA and supplies ___ to our bones.

Answer 18

oral contraceptives, ovarian, Ca+

Question 19

Progesterone has a ___-___ metabolism where it is metabolized by the ___ after absorption from the ___ before it reaches the ___.

Answer 19

first-pass, liver, intestine, bloodstream

Question 20

First-generation progestins include: ___. They have a decreased ___ effect, so they work well for ___ pt’s.

Answer 20

norethynodrel, norethindrone, norethindrone acetate, ethynodiol diacetate, progesterone, diabetic

Question 21

Second-generation progestins include:___. They have a longer ___-___ and are associated w/___ s/e like increased lipids, oily skin, acne, and facial hair growth.

Answer 21

norgestrel and levonorgestrel, half-life, androgenic

Question 22

Third-generation progestins include: ___. Major s/e is ___ ___, but helps to control ___.

Answer 22

desogestrel, noregestimate, sprintec, ortho-tricyclin, venous thromboembolisms, acne.

Question 23

Fourth-generation progestins include: ___. Major s/e is ___ ___, but helps to control acne.

Answer 23

drospirenon-spironolactone, venous thromboembolisms, acne

Question 24

Next-generation progestins include: ___. Help to control bleeding.

Answer 24

dienogestrel

Question 25

___ provide for better cycle control.

Answer 25

estrogens

Question 26

MOA for progestin: suppresses the release of ___ from the hypothalamus, suppresses the ___/___ surge that induces ovulation, and thickens cervical mucus to hamper ___. Also decreases risk of ___.

Answer 26

GnRH, LH/FSH, sperm, PID

Question 27

MOA of estrogen: suppresses the release of ___ from the pituitary.

Answer 27

FSH

Question 28

MOA of comb.: ___ tubal motility, endometrial ___ and localized ___ of the endometrium.

Answer 28

slow, atrophy, edema

Question 29

As hormone levels ___, pregnancy rates ___.

Answer 29

decrease, increase

Question 30

___ has a major impact on the effectiveness of BC.

Answer 30

obesity

Question 31

Advantages of BC include: ___ reversible control of fertility, short-acting and out of system w/in ___-___ days, decreases risk of ___ and ___ CA, ___ risk of benign breast conditions, improvement of ___ and ___, decreases ___ ___ anemia, reduces ___ s/s.

Answer 31

rapid, 2-3, ovarian, endometrial, decreases, acne, and hirsutism, iron deficiency, endometriosis

Question 32

Disadvantages of BC include: ___ administration, readily ___, does not protect against ___.

Answer 32

daily, accessible, STD’s

Question 33

A condition for which there is no restriction for the contraception method is category ___.
Advantages outweigh the risk of taking is category ___.
Proven risks usually outweigh the advantages of use is category ___.
Unacceptable health risk if contraceptive method is used is category ___.

Answer 33

1
2
3
4

Question 34

Health risks for BC include:

Answer 34

pregnancy, DVT/VTE, MI, stroke, HTN, gallbladder disease, benign liver tumors, risk of STD’s, cervical dysplasia and carcinoma

Question 35

Breastfeeding women should take a ___-only BC.

Answer 35

progesterone

Question 36

Drugs that BC may interact w/or cause a decreased hormone level:

Answer 36

antibx (Rifampin), anticonvulsants, antivirals, antidepressants, K-sparing antihypertensives, NSAIDS

Question 37

Mainstay BC tx is: ___, which is a ___ generation.

Answer 37

Brevicon, first

Question 38

___/___ is best BC for DUB/bleeders and is a ___ generation.

Answer 38

Lo/Ovral, third

Question 39

___ is best BC for ovarian cyst and is a ___ generation and is also ___.

Answer 39

Ovcon, first, chewable

Question 40

___ is best BC for headache pts b/c it ___ estrogen levels.

Answer 40

Mircette, increases

Question 41

___ is the best BC for breastfeeding b/c it has increased amts of ___ which increases milk supply.

Answer 41

Micronor, progesterone

Question 42

___ ___ is used for emergency contraception.

Answer 42

Plan B

Question 43

Pt’s who smoke should not take a ___ BC.

Answer 43

combination

Question 44

An annual pelvic exam is suggested but not ___.

Answer 44

required

Question 45

True or False: if you miss a dose, take it when you remember.

Answer 45

True

Question 46

Be consistent w/BC pills and take at ___ time every day in order to be effective.

Answer 46

same

Question 47

Instruct pt to call the clinic immediately if they experience the acronym ___, which includes severe ___ pain, severe ___ pain, severe ___, severe ___ pain, and changes in ___.

Answer 47

ACHES, abdominal, chest, headaches, extremity (leg/arm), sight

Question 48

Estrogen can cause ___.

Answer 48

hyperlipidemia

Question 49

___ contraception substantially reduces the chances of pregnancy after an episode of ___ intercourse.

Answer 49

Emergency, unprotected

Question 50

Advantages of Plan B: prevents ___ after unprotected intercourse, missed too many ___, breastfeeding woman had her ___, failed ___ method, cannot feel ___ strings or removed

Answer 50

pregnancy, OCP’s, period, withdrawal, IUD, 8, teratogens

Question 51

Major s/e of Plan B is:

Answer 51

nausea/vomiting, menstrual changes

Question 52

Plan B has no effect on ___ and does not disrupt an already ___ fetus.

Answer 52

fertility, implanted

Question 53

The use of ___ is not recommended in lactation.

Answer 53

Ella

Question 54

Major risks of IUD is ___

Answer 54

PID

Question 55

Plan B should be used w/in ___hrs of ___ days of unprotected intercourse. Important to abstain from intercourse until next ___. Follow up if no menses in ___ wks.

Answer 55

120, 5, cycle, 3

Question 56

___ are the most commonly used reversible method of contraception.

Answer 56

IUD’s

Question 57

2 most common IUD’s include ___ and ___. The first is ___-free and has a duration of ___ yrs. The second is also ___-free and has a duration of ___ yrs.

Answer 57

Paragard, Mirena, latex, 10, latex, 5

Question 58

MOA of an IUD is to prevent ___ from fertilizing ___. It does not interrupt an implanted ___. It creates ___ to eat/kill sperm.

Answer 58

sperm, ova, pregnancy, macrophages

Question 59

___ are the superior long-term protection against unintended pregnancy.

Answer 59

IUD’s

Question 60

Advantages of IUD’s include: highly ___ and ___, non-___, ___-term protection, reduced risk of ___ CA.

Answer 60

effective, safe, estrogenic, long, endometrial

Question 61

Disadvantages of IUD’s include: ___ disturbances, ___/discomfort, ___, ___, ___ perforation, requires placement ___.

Answer 61

menstrual, cramping, expulsion, infection, uterine, training

Question 62

Women who are contraindicated for using an IUD: young teens who have never been ___, ___, ___, ___, hx of ___ CA, women not in a ___ relationship, hx of ___, hx of ___.

Answer 62

pregnant, breastfeeding, immunocompromised, diabetes, breast, monogamous, VTE, c-section/uterine/cervical sgy

Question 63

Educate pt’s to check for strings at least ___ per month and to abstain from intercourse for ___ days after placing/removing.

Answer 63

once, 7

Question 64

Patches and rings are changed ___ and are applied to the ___, upper ___, lower ___, or ___.

Answer 64

changed, bottom, arm, abdomen, torso

Question 65

MOA of patches/rings: works similar to ___ through suppression of ___ and prevention of ___. Cervical mucus ___ and endometrium changes to hamper ___ and prevent ___.

Answer 65

OCP’s, gonadotropins, ovulation, thickens, sperm, implantation

Question 66

Advantages of patches: ___ of applying once wkly, no significant weight ___, rapidly ___, great for those who can not take a ___ or have ___ absorptive issues.

Answer 66

convenience, gain, reversible, pill, GI

Question 67

Disadvantages of patches: risk of ___, ___, skin ___, ___, ___ compliance.

Answer 67

VTE, migraines, reaction, obesity, adolescent

Question 68

Example of patch is ___.

Answer 68

ortho evra patch

Question 69

Example of ring is ___.

Answer 69

nuvaring

Question 70

Nuvaring is placed in ___ and is left for ___ wks, then removed during last week. Superior to ___.

Answer 70

vagina, 3, OCP’s

Question 71

Advantages of rings: convenience of placing once/___, rapidly ___, can use w/___, can be removed for ___ hrs and still have proper efficacy.

Answer 71

month, reversible, tampons, 3

Question 72

Disadvantages of rings: risk of ___, ___, ___, ___ symptoms, and ___ d/t not wanting to touch themselves.

Answer 72

VTE, Toxic Shock Syndrome (TSS), headache, vaginal, adolescents

Question 73

Rings have a prolonged use and are effective for ___ wks.

Answer 73

4

Question 74

The injectable contraception is ___ and it has a ___ wk interval and is a ___ only method.

Answer 74

Depo-Provera, 12, progestin

Question 75

Depo-Provera is not compromised by ___ ___ like a lot of the others.

Answer 75

body wt

Question 76

MOA of Depo-Provera is that it inhibits ___ w/suppression of ___ and ___. It eliminates the ____ surge and inhibits ___ pulsatility.

Answer 76

ovulation, FSH, LH, LH, GnRH

Question 77

The major down-fall of Depo-Provera (injectable contraception) is that the return of ovulation takes btwn ___-___ months from last injection. You may also have increased vaginal ___.

Answer 77

15-45, discharge

Question 78

Biggest disadvantage to Depo-Provera is ___ ___.

Answer 78

weight gain

Question 79

Depo-Provera not a good method for those thinking about becoming pregnant anytime in future d/t lack of quick return of ___.

Answer 79

fertility

Question 80

Implant devices (aka ___) are placed ___ under the skin in the upper arm in the office and last ___ yrs. This is considered to be the ___ effective type of BC.

Answer 80

Implanon, SQ, 3, most

Question 81

Implanon has a ___ risk of ectopic pregnancy.

Answer 81

decreased

Question 82

Disadvantages of Implanon include: uterine ___, weight ___, ovarian ___, no ___ protection, decrease in bone ___, risk of ___.

Answer 82

bleeding, gain, cyst, STI, density, VTE

Question 83

A ___ remains the most widely available and most commonly used method of BC. It reduces risk of ___ and ___.

Answer 83

condom, pregnancy, STI’s

Question 84

Advantages of barrier methods/condoms is that you can perform ___/___ sex.

Answer 84

anal/oral

Question 85

Disadvantages of barrier methods is reduced ___, difficulty having an ___.

Answer 85

sensation, erection

Question 86

Other available methods of contraception include:

Answer 86

spermicides (not really used all that often), diaphragm, cap, withdraw method, fertility awareness, PP contraception (breastfeeding), sterilization (permanent)