Ethics and family planning methods Flashcards
A young married couple consulted for prescriptions of combined oral contraceptive pills for the first time. On further history and PE, you found out that the patient has deep vein thrombosis which is a contraindication for this type of contraception. What will you do?
A. promote a low dose estrogen combined oral contraceptive pills
B. advise other forms of contraception
C. refer her to an internist for thrombolytic and prescribe the COCs
D. refer to another OB-GYN
B
A 44 year old G5P5-5005, married, arrived alone in the ER in active labor. On examination, the fetal elbow and arm is palpable through a 4 cm dilated cervix and advised the patient that she will undergo an emergency cesarean section for transverse lie. The patient told you that she is desirable of bilateral tubal ligation. What will you do?
A. secure consent for cesarean section and bilateral tubal ligation as the patient requested and do the procedure
B. wait for the husband and secure his consent for bilateral tubal ligation
C. schedule for bilateral tubal ligation 6 weeks postpartum
D. advise the patient other options of artificial family planning methods
A
A 21 year old G1P1-1001 married, college graduate consulted the clinic with her husband for advice on whether she can have an IUD placed because she has no desire to get pregnant for the next couple of years. After doing a complete medical history and physical/gynecologic examination, what is the next best thing that you should do?
A. prescribe an IUD and schedule her for insertion
B. explain to her the disadvantages of having an IUD
C. layout all applicable contraceptive options and their benefits and risks
D. refer her to another physician because you do not practice artificial family planning
C
The last normal menstrual period of Ana is February 14 to 17, 2010. She is using the Basal Body Temperature (BBT) method of family planning. When will you tell her to abstain from sexual intercourse?
A. February 14 through the 3rd day after the increase in temperature
B. February 17 through the 5th day after the increase in temperature
C. On the 3rd day after the increase in temperature
D. On the 5th day after the increase in temperature
A
True statements about the calendar or rhythm method
A. Requires recording of the duration of the 10 previous menstrual cycles
B. Shortest cycle minus 11 equals the first day of fertile period
C. Longest cycle minus 11 equals the last day of the fertile period
D. Shortest cycle minus 18 equals the last day of the fertile period
C
True statements about diaphragms EXCEPT
A. Should be used with spermicide cream
B. May be inserted before intercourse
C. Remove immediately after intercourse to avoid toxic shock syndrome
D. Variable in size and may not remain in place if too small
C
True statements about male condoms EXCEPT
A. Safe and has no systemic side effects
B. No medical contraindications (except latex allergy)
C. Absolute protection against sexually transmitted diseases
D. Lower pregnancy rate than female condoms
C
Pregnancy after a vasectomy can be due to the following EXCEPT
A. Unprotected intercourse soon after ligation
B. Incomplete occlusion of the seminal vesicles
C. Recanalization
D. Sexual contact after 10 ejaculations
B
Mrs. Reyes consulted at the clinic for amenorrhea (LMP: December 17,2009) with a positive pregnancy test. She had an IUD inserted a year ago. What will you recommend?
A. Remove the IUD immediately if the string is visible
B. Remove the IUD postpartum if the patient is asymptomatic
C. Remove the IUD when the fetus is viable
D. Administer intravenous antibiotics
A
Bilateral tubal ligation is best recommended for which cause?
A. 39 y/o G4P1 (0121) with history of hypertension during the last pregnancy
B. 38 y/o G3P3 (3003) with first pregnancy with her 2nd husband
C. 40 y/o G5P5 (5005) with completed family size
D. 20 y/o G2P1 (1001) with heart disease
C
Mirena (levonorgestrel releasing) IUD was inserted today (March 1, 2010). When will you recommend this to be replaced? A. 2015 B. 2018 C. 2020 D. 2023
A
True statements about female sterilization EXCEPT
A. Increased risk of ectopic pregnancy
B. Highly effective (0.5 pregnancies per 100 women during first year of use)
C. Effective immediately
D. Decreased complication rate compared to vasectomy
D
Disadvantage of IUD EXCEPT:
A. Uterine cramping or pain
B. Perforation most likely to occur at the time of insertion
C. Ectopic pregnancy with a device in place
D. Increased rate of fetal malformations
D
Main mechanism of action of copper intrauterine device (IUD)
A. Inflammatory actions in the uterus which is spermicidal
B. Inhibits ovulation
C. Inhibits sperm migration by thickening of cervical mucus
D. Interference with successful implantation of the fertilized ovum
A
Mrs Cruz is using Yasmin, a 21 tablet combined oral contraceptive. When will the patient expect her menses while using this form of contraception?
A. After intake of 7 pills
B. After intake of 14 pills
C. Same day as last pill has been taken
D. A few days after last pill has been taken
D
Low-dose contraceptive pills can be taken by all, EXCEPT:
A. Non-smoking, older than 35 y/o
B. Diabetic, no vascular disease
C. Maintained/controlled hypertension, smoker, younger than 35 y/o
D. Headache, normotensive, younger than 35 y/o
C
Prohibited acts EXCEPT:
a. Perform tubal ligation with woman’s consent even without husband’s consent
b. Refuse to give reproductive care due to religion
c. Refuse to give reproductive care due to grades
d. Provide incorrect information regarding health care
A
Respect for the patient’s autonomy or own wishes require that which of the following be assessed?
a. Duty to not inflict harm
b. The impact that the treatment will have on patient’s quality of life
c. Consideration of the best treatment
d. Patient’s personal values
D
True statements about female sterilization EXCEPT:
a. Safer than vasectomy
b. 0.5/100 pregnancy during 1st year of use
c. Effective immediately
d. Increased risk of ectopic pregnancy
A
