Exam 2: Contraception

Question 1

When does pregnancy begin?

Answer 1

implantation

Question 2

what is the window of ideal fertility?

Answer 2

Days 9-15 of the menstrual cycle

Question 3

what is the average failure rate of barrier methods?

Answer 3

about 10-20 percent

Question 4

What is the average failure rate of pills/rings/patches that are E/P or P only?

Answer 4

<10%

Question 5

what is the average failure rate of IUDs, tubal ligation, vasectomy, progesterone implant?

Answer 5

less than <1%

Question 6

what is contraindicated in a breastfeeding woman?

Answer 6

estrogen-containing contraception

Question 7

what are the three ways progestin acts as contraception?

Answer 7

1. hormonal feedback that prevents LH surge
2. thick cervical mucous that forms a barrier
3. atrophic endometrium

Question 8

what is the reason people frequently stop progesterone depot?

Answer 8

weight gain (10-15 lbs/year)

Question 9

E/P pills are contraindicated in patients

Answer 9

with hypertension

Question 10

what’s the danger of giving unopposed estrogen (estrogen alone)?

Answer 10

endometrial cancer

Question 11

what does estrogen do that acts as contraception?

Answer 11

FSH suppression

altered tubular transport of sperm

Question 12

what are multiphasic OCPs?

Answer 12

dose of E or P mimics natural cycle levels

Question 13

what are common side effects of E/P pills?

Answer 13

lower libido

headache

acne, oily skin

hirsutism

hair loss

Question 14

what is the window where a woman can use emergency contraception after sex to prevent pregnancy?

Answer 14

120 hours (5 days)

Question 15

what are contraindications to getting an IUD?

Answer 15

current STI (gonorrhea or chlamydia)

unexplained uterine bleeds

large deforming fibroids

Wilson’s disease or copper allergy (for copper IUDs)

Question 16

your patient with an IUD comes to the office because she can’t find her strings. You can’t either. What do you do next?

Answer 16

ultrasound

Question 17

how does emergency contraception act?

Answer 17

by delaying ovulation

Question 18

What is the cut off for a short acting vs a long acting birth control method?

Answer 18

Lasts less than 3 months vs more than 3 months

Question 19

When is estrogen used as a single agent?

Answer 19

HRT

after oophrectomy

during menopause (usually for 5 years or less)

hirsutism

amenorrhea

dysfunctional uterine bleeding

Question 20

when is estrogen never used as a single agent?

Answer 20

contraception

Question 21

where are estogens produced before ovulation

Answer 21

in the follicle by theca and granulosa cells

Question 22

Where are estrogens produced after ovulation

Answer 22

In the corpus luteum by the luteinized granulosa and theca cells