Family Planning

Question 1

what is the MOA of Combined Oral Contraceptive (COC)

Answer 1

suppression of ovulation by inhibiting GnRH, LH, FSH, at the mid cycle surge.

Question 2

what are the progestin side effects with COC use?

Answer 2

effects the endometrium rendering less suitable for implantation.

thickening of cervical mucus to prevent penetration by sperm

impaired fallopian tube peristalsis and motility inhibiting ovum transport.

Question 3

if you start COC on any day other than the first day of the cycle, what is recommended by Doctors who support contraceptives?

Answer 3

a backup method to be used on the first month

Question 4

what should happen if a COC pill is missed at any time with no sex in the last 5 days?

Answer 4

two pills should be taken, and a backup for 7 days.

Question 5

what should happen if you are using COC, you missed a pill, and intercourse occurred in the previous 5 days?

Answer 5

emergency contraception, restart pills the following day.

Question 6

what are some advantages of COC?

Answer 6

lighter menses
improved dysmenorrhea sx
decreased risk of ovarian and endometrial cancer
improvement of acne
ovarian cysts less likely
myomas less likely
benefits to bone mass

Question 7

Contraindications of COC?

Answer 7

pregnancy, breast feeding
thromboembolic disorders
stroke or coronary artery disease
cancer
abnormal vagina bleeding
over 35 and smoking more than 15 cigs a day
migraine with aura

Question 8

what is the progestin Minipill MOA?

Answer 8

endometrium less suitable for implantation of an ovum
thickening cervix mucus
impairment of fallopian tube peristalsis

Question 9

which birth control must be taken with precise accuracy, withing a 3 hour window everyday?

Answer 9

progestin minipill

Question 10

does the progestin minipill have a “placebo week”

Answer 10

no

Question 11

what are some advantages of the minipill?

Answer 11

safe for lactation (may increase milk production)
safe for patients over 35
benefits outweigh risk for those who smoke or have DVT, thromboembolic disorders, diabetes

Question 12

contraindications of mini pill?

Answer 12

irregular bleeding
more frequent ectopic pregnancies
weight gain
mild headaches

Question 13

what contraceptive is similar to the minipill except can be injected or implanted?

Answer 13

Contraceptive Injections and implants (long acting progestins)

Question 14

how long is Nexplanon implant effective?

Answer 14

3 years

Question 15

what is the most common reason for discontinuation of Nexplanon?

Answer 15

irregular bleeding. however, no delay in return to fertility after discontinuation

Question 16

what is a hormonal birth control that is applied to lower abdomen, upper torso, or butt once a week for 3 consecutive weeks, followed by a patch less week?

Answer 16

transdermal patch (Ortho Evra)

Question 17

what may Contraceptive Vaginal ring users experience an increase in?

Answer 17

incidences of vaginal discharge

Question 18

what method of contraceptive is highly effective with failure rates similar to surgical sterilization?

Answer 18

intrauterine device

Question 19

what are the types of intrauterine devices?

Answer 19

Levonorgestrel (LNG) releasing
Copper bearing (paragard)

Question 20

what are contraindications of IUD’s?

Answer 20

pregnancy
pelvic infections
menorrhagia or server dysmenorrhea
missing IUD strings

Question 21

between male and female condoms, which offers significant protection from both pregnancy and STDs?

Answer 21

female controlled.

Question 22

if you are practicing sympothermal natural family planning, what are three things that can help you monitor ovulation?

Answer 22

increase in clear elastic cervical mucus
“mitterlschmerz” (brief midcycle abdomen discomfort)
rise of basal body temp

Question 23

how long must you monitor your menstrual cycle when using the calendar method to make calculations to determine fertile periods?

Answer 23

8 months

Question 24

a slight drop in temperature in basal body temperature (taken in AM before any activity) is normal how many hours before ovulation?

Answer 24

12-24 hrs

Question 25

a rise of how many degrees Celsius occurs 1-2 days after ovulation?

Answer 25

a rise of about .4 degrees C

Question 26

risk of pregnancy increases starting how many days prior to the day of ovulation?

Answer 26

5 days

Question 27

emergency contraception should be started as soon as possible within how many days/hours after unprotected coitus?

Answer 27

120 hours/5 days

Question 28

What is plan B?

Answer 28

levonorgestrel 1.5, available OTC for women 17 and older.

Question 29

what are the combined oral contraceptives you combine as emergency contraception?

Answer 29

Ethinyl estradiol
levonorgestrel

give twice in 12 hrs. used w/in 72 hrs. (give with anti-nausea medication)

Question 30

what is a 30 mg single dose oral contraceptive, more effective than levonorgestrel? particularly among overweight women

Answer 30

Ulipristal

Question 31

IUD can be used as an emergency contraceptive if inserted w/in how many days after one episode of unprotected midcycle coitus?

Answer 31

5 days.

Question 32

what are the two navy policy references that deal with abortion?

Answer 32

BUMEDINST 6300.16
OPNAVINST 6000.1 series

Question 33

what is the most popular method of birth control for couples who want no more children?

Answer 33

sterilization

Question 34

after a vasectomy there is a follow up semen analysis at how many months post procedure?

Answer 34

3 months