contraceptives

Question 1

What contraceptive increases osteoporosis?

Answer 1

Depo
get them on Ca and vita D supplement and do not use longer than 2-5 yeas

Question 2

Which contraceptive for breastfeeding moms?

Answer 2

Mini pill, IUD

Question 3

What contraceptives cannot be used in women with migraine with auras?

Answer 3

combined as estrogen puts pt at increased risk for clot

Question 4

Which combine contraceptive (estrogen and progesterone) has the highest risk for clot?

Answer 4

xulane patch (transdermal on for 1 week fr 3 weeks and off one week. The higher risk for blood clot ( not as effective in women with BMI over 30.

Question 5

Contraindication to combined BCC?

Answer 5

clot, hx clot, liver disease, over 35 and smoking, migraine with aura, current cx, uncontrolled htn, breastfeeding women

Question 6

pt missed 2 active pills? what do they do?

Answer 6

take the most recent missed pill and get rid of all missed pills, and utilize a backup method.

Question 7

Do minors need parental for STI, BCC, or preg treatment?

Answer 7

none

Question 8

At what age do you start pap smears?

Answer 8

21
At 25 you can cotest
(okay every 5 years instead of 3 with contesting

Question 9

what results are worrisome

Answer 9

LISL and AHIL results
Refer to colposcopy:
worry/ more serious if
CIN II and CIN III

Question 10

ASCUS (atypical squamous cells undetermined significance) is a result what do we do?

Answer 10

it is low grade. we need to do HPV co-testing.

Question 11

If HPV is positive?

Answer 11

they need a colposcopy

Question 12

Gardisel vaccine

Answer 12

11-13 all genders and at age 9 in the right situation. HPV 16, 18 which causes cervical cancer and genital warts.

Question 13

Genital warts treatment?

Answer 13

cryotherapy
TCA acid

Question 14

is it normal to see vaginal bleeding in post-menopause women (1 year no period) normal?

Answer 14

no, need to refer for endometrial biopsy

Question 15

how does the pt start taking the pill? ( 3 options)

Answer 15

1) start the day off visit with 7 day back up method
2) Starts on the day menstral period starts do not need back up method
3) start on Sunday (7 days back up method), no bleeding on weekend

Question 16

Educate if they miss one pill?

Answer 16

take the pill as soon as you remember and continue usually schedule encourage back up method

Question 17

combined OCP

Answer 17

improve acne, decrease endometrial and ovarian cx, less ovarian cysts.

Question 18

nuva ring

Answer 18

keep in place 3 weeks (remove for 1 week to have menses), reinsert if it falls out, reincert within 3 hrs it will not loose effectiveness, less up and down.

Question 19

progestin-only pills are great for which pt? Not to be used in?

Answer 19

do not prescribe for lung issues and active cx.

Good for breastfeeding moms, + other’s that cannot take combined. (if you miss 1 increase risk of bleeding), 3hr window that you might ovulate

Question 20

depo (medroxyprogesterone acetate

Answer 20

progestin-only
can be given to breastfeeding mom’s

depo needs to be every 12 week
-stops depo delay up to a year or longer for fertility
-increase wt and acne
-long term: bone density risk
vit D and Ca supplement. (max 2-5years)

Question 21

IUDs

Answer 21

pelvic exam and STI screening.
should be able to feel strings
US to check status

Question 22

plan B

Answer 22

progestin and administered withn 72hrs decreases risk by 75%. not impact an established preg
-spotting
-n/v