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OB/GYN > EXAM #1: CONTRACEPTION > Flashcards

EXAM #1: CONTRACEPTION Flashcards

1
Q

What is nonoxynol-9?

A

Spermicide

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2
Q

What are the disadvantages of nonoxynol-9?

A

1) No protection against STD
2) High failure rate
3) Messy/ irritating

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3
Q

What STDs do condoms NOT protect well against?

A

HSV and HPV

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4
Q

What should a diaphragm be used with?

A

Spermicide

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5
Q

Can you get a diaphragm OTC?

A

NO- this is fitted by an OB/GYN

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6
Q

What are diaphragms associated with (adverse effects)?

A

Increased risk of UTI

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7
Q

What is periodic abstinence?

A

“Natural Family Planning”

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8
Q

What is the mechanism by which progesterone prevents conception?

A

1) Inhibits ovulation
2) Thickens cervical mucous

Estrogen and Progestins inhibit LH/FSH and thus prevent estrogen surge. No estrogen surge → no LH surge → no ovulation.

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9
Q

What is the mechanism by which estrogen aids in preventing conception?

A

1) Maintains the endometrium
2) Prevents unscheduled bleeding

Estrogen and Progestins inhibit LH/FSH and thus prevent estrogen surge. No estrogen surge → no LH surge → no ovulation.

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10
Q

Generally, what is the difference between the various generations of oral contraceptives?

A

Androgen effect DECREASES with INCREASING generation

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11
Q

What exactly is the estrogen component of the estrogen in oral contraceptives?

A

Ethinyl estradiol or mestranol

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12
Q

What are the adverse effects of the estrogen component in oral contraceptives?

A

1) Nausea
2) Breast tenderness
3) Fluid retention

*Also can induce melasma

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13
Q

What are the adverse effects of the progestin component in oral contraceptives?

A

1) Weight gain
2) Acne
3) Mood changes

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14
Q

In terms of blood clots, what do you need to remember about oral contraceptives?

A

History of inherited clotting disorder puts the patient at an increased risk of DVT/PE

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15
Q

What patient’s are at a risk of CVA with oral contraceptives?

A

Patient that has migraines WITH aura

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16
Q

Is there a higher risk of DVT/PE with oral contraceptives or actually being pregnant?

A

Pregnant

17
Q

Are oral contraceptives a risk factor for cervical dysplasia?

A

No

18
Q

Are oral contraceptives a risk or protective factor in endometrial and ovarian cancer?

A

Protective

19
Q

What are the absolute contraindications to oral contraceptives?

A

1) History of vascular disease
2) Systemic disease that may affect the vascular system
- SLE
- DM
- Retinopathy
3) Cigarette smoking and older than 35
4) Uncontrolled HTN
5) ER+ neoplasm
6) CVA, MI or known CAD
7) Pregnant female
8) Active liver disease
9) Migraines with aura

20
Q

What drugs will decrease the efficacy of OCP?

A

1) Barbiturates
2) Sulfonamides
3) Cyclophosphamide
4) Rifampin

21
Q

What are the non-contraceptive uses for OCP?

A

1) Reduced blood loss during menstruation
2) Decreased dysmenorrhea
3) Decreased risk of ectopic pregnancy

22
Q

What is the general MOA of emergency contraception?

A

Disruption of ovulation

23
Q

What drugs are in emergency contraception?

A

1) High dose estrogen

2) High dose progesterone

24
Q

What is Plan B?

A

High dose progesterone

25
Q

What is the common name for Depo-medroxyprogesterone acetate?

A

DEPO-provera

26
Q

What is a drawback to DEPO-provera?

A

Can take a year to regain fertility

27
Q

What can DEPO-provera exacerbate?

A

Depression

28
Q

How long can a progestin implant be left in?

A

3 years

29
Q

What is the mechanism of the progestin implant?

A

Daily release of progestin that inhibits ovulation/thickens cervical mucous

30
Q

What are the advantages to progestin implants?

A

1) Decreased iron deficiency anemia
2) Decreased PID
3) Decreased endometrial cancer
4) Decreased ovulation pain
5) Reduced sx. of endometriosis
6) Reduced primary dysmenorrhea

31
Q

What are the benefits of IUDs?

A

1) Lack of associated metabolic effects
2) Very high level of efficacy
3) Single time “motivation”

32
Q

What is the mechanism of action of IUDs?

A

Local sterile inflammatory reaction

33
Q

What are the adverse effects of IUDs?

A

1) Uterine bleeding

2) Uterine perforation

34
Q

If a woman gets pregnant with an IUD in, what should she do? What should you do?

A
  • She should take the IUD out

- You need to ensure no ectopic pregnancy

35
Q

What are the contraindications to IUDs?

A

1) Pregnancy
2) Acute PID
3) Post-partum endometritis
4) Known or suspect cervical malignancy
5) Genital bleeding of unknown etiology
6) Untreated acute cervicitis
7) She already has 1x IUD

36
Q

What is the most cost effective method of contraception?

A

IUD

OB/GYN (19 decks)

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