Exam 2

Question 1

when is it recommended Pap Smears start?

Answer 1

not until age 21

Question 2

at what age is first cervical cancer screening?

Answer 2

age 21

Question 3

w/age 30 and older, how often do you screen for cervical cancer?

Answer 3

once every 3 years

Question 4

ages 21-30, what are cervical cancer screening recommendations?

Answer 4

q 2 years

Question 5

4 mechanisms of action for contraception?

Answer 5

1) prevention of ovulation
2) alteration of cervical mucus
3) alteration of endometrial lining
4) alteration of tubal motility

Question 6

first-line choice of contraception per ACOG?

Answer 6

IUD

Question 7

IUD risk for perforation?

Answer 7

1 in 1000

Question 8

the ONE contraindication for IUD?

Answer 8

CURRENT PID

Question 9

does Mirena suppress ovulation?

Answer 9

No! ovulation is not suppressed

causes some thinning of the endometrium & less bleeding over time, esp after 6 mos

Question 10

skyla is good for how long?

Answer 10

3 yrs

Question 11

chief side effect of Nexplanon?

Answer 11

causes a lot of irregular bleeding

also…not good if child scars keloids

Question 12

progestins mechanism of action?

Answer 12

thickens cervical mucus so sperm can’t get to egg

Question 13

ortho evra is made up of?

Answer 13

the patch!
norelgestromin (progestin)
+ ethinyl estradiol (estrogen)

Question 14

ortho evra should not be used in…

Answer 14

pts over 200 lbs

if have a lot of body fat– be wary of patch!

Question 15

side effect of ortho evra?

Answer 15

assoc. w/thromboembolism! higher risk than other methods

Question 16

nuvaring mechanism of action?

Answer 16

1) endometrial changes

2) thickens cervical mucus

Question 17

depo = intramuscular progestin

black box warning is for?

Answer 17

loss of bone density w/prolonged use

Question 18

other ADEs of depo?

Answer 18

breakthrough bleeding
weight gain
depression
acne
headaches

Question 19

benefits of OCPS

Answer 19

• -improves hirsutism
• -prevents ectopic pregnancies, lower rates of ovarian cysts/cancer
• -decrease menstrual cramps, midcycle pain, bleeding PMS
• -can increase libido & increase HDL/decrease LDL

Question 20

low-dose OCPs: dosage?

Answer 20

• -most ppl start at 30-35 & see how they tolerate it
• -20 is lowest effective dose
• -if over 150 lbs: consider 30-35 of Ethinyl estradiol, PLUS ortho-cyclen/sprintec/MonoNessa (norgestimate) or Crystelle/Lo-Ovral/Low-Owgestrel for heavy bleeding (Norgestrel)

Question 21

Yasmin contains:

Answer 21

• -Drospirenone 3mg + 30 mcg Ethinyl estradiol
• **Greater risk thrombolytics
• **Do not use w/renal hepatic or adrenal insufficiency, angiotensin II receptor antagonists, or antiinflammatory drugs –> d/t risk of hyperkalemia

Question 22

Aches pneumonic?

Answer 22

Abdominal pain
Chest pain/SOB/coughing up blood
Headache (severe)
Eye problems
Severe leg pain (calf or thigh)--> thrombosis

Question 23

CIs to OcPs

Answer 23

Active liver disease
Presence of Leiden factor V mutation
Htn
Smokers
Breast cancer