General

Question 1

Situations where only copper IUD is best

Answer 1

Liver cancer
Severe decompensated cirrhosis
Breast cancer past/present
Ischaemic heart disease
Stroke

Question 2

Contraindications for progesterone only pill

Answer 2

UKMEC4 - current breast cancer

UKMEC 3:
Liver - severe decompensated cirrhosis, hepatocellular adenoma/carcinoma
Vascular - ischaemic heart disease, stroke (only to continue)
Breast - past breast cancer

Question 3

Contraindications for depot

Answer 3

UKMEC4 - current breast cancer

UKMEC3
Liver - severe decompensated cirrhosis, hepatocellular adenoma/carcinoma
Vascular - multiple risk factors for CVD, HTN with vascular disease, ischaemic heart disease, stroke
Breast - past breast cancer
Uterine - unexplained PV bleed

Question 4

Contraindications for implant

Answer 4

UKMEC4 - current breast cancer

UKMEC3
Liver - severe decompensated cirrhosis, hepatocellular adenoma/carcinoma
Vascular - ischaemic heart disease, stroke (only to continue)
Breast - past breast cancer
Uterine - unexplained PV bleed

Question 5

Contraindications for Mirena

Answer 5

UKMEC4
Pregnancy - post partum sepsis, post abortion sepsis, GTD elevated hCG or malignant disease
Gynae - unexplained PV bleed, awaiting cervical cancer treatment, endometrial cancer (to start), current PID (to start), symptomatic chlamydia, purulent cervicitis/gonorrhoea, pelvic TB
Breast - current breast cancer

UKMEC3
Pregnancy - post partum 48hrs-4 weeks, GTD decreasing hCG
Gynae - radical trachelectomy, distortion of uterine cavity, asymptomatic chlamydia
Vascular - ischaemic heart disease, stroke (to continue), long QT syndrome (to start)
Complicated transplant (e.g. graft failure) - to start only
Breast - past breast cancer
CD4

Question 6

Contraindications for copper IUD

Answer 6

UKMEC4
Pregnancy - post partum sepsis, post abortion sepsis, GTD elevated hCG or malignant disease
Gynae - unexplained PV bleed, awaiting cervical cancer treatment, endometrial cancer (to start), current PID (to start), symptomatic chlamydia, purulent cervicitis/gonorrhoea, pelvic TB

UKMEC3
Pregnancy - post partum 48hrs-4 weeks, GTD decreasing hCG
Gynae - radical trachelectomy, distortion of uterine cavity, asymptomatic chlamydia
Vascular - long QT syndrome (to start)
Complicated transplant (e.g. graft failure) - to start only
CD4