contraceptives Flashcards
What contraceptive increases osteoporosis?
Depo
get them on Ca and vita D supplement and do not use longer than 2-5 yeas
Which contraceptive for breastfeeding moms?
Mini pill, IUD
What contraceptives cannot be used in women with migraine with auras?
combined as estrogen puts pt at increased risk for clot
Which combine contraceptive (estrogen and progesterone) has the highest risk for clot?
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.
Contraindication to combined BCC?
clot, hx clot, liver disease, over 35 and smoking, migraine with aura, current cx, uncontrolled htn, breastfeeding women
pt missed 2 active pills? what do they do?
take the most recent missed pill and get rid of all missed pills, and utilize a backup method.
Do minors need parental for STI, BCC, or preg treatment?
none
At what age do you start pap smears?
21
At 25 you can cotest
(okay every 5 years instead of 3 with contesting
what results are worrisome
LISL and AHIL results
Refer to colposcopy:
worry/ more serious if
CIN II and CIN III
ASCUS (atypical squamous cells undetermined significance) is a result what do we do?
it is low grade. we need to do HPV co-testing.
If HPV is positive?
they need a colposcopy
Gardisel vaccine
11-13 all genders and at age 9 in the right situation. HPV 16, 18 which causes cervical cancer and genital warts.
Genital warts treatment?
cryotherapy
TCA acid
is it normal to see vaginal bleeding in post-menopause women (1 year no period) normal?
no, need to refer for endometrial biopsy
how does the pt start taking the pill? ( 3 options)
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
Educate if they miss one pill?
take the pill as soon as you remember and continue usually schedule encourage back up method
combined OCP
improve acne, decrease endometrial and ovarian cx, less ovarian cysts.
nuva ring
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.
progestin-only pills are great for which pt? Not to be used in?
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
depo (medroxyprogesterone acetate
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)
IUDs
pelvic exam and STI screening.
should be able to feel strings
US to check status
plan B
progestin and administered withn 72hrs decreases risk by 75%. not impact an established preg
-spotting
-n/v
