Gynae

Question 1

POP time to effect

Answer 1

2 days

Question 2

Nexplanon time to effect

Answer 2

Immediately if day 1-5 of period otherwise after day 7

Question 3

Chlamydia treatment (not pregnant)

Answer 3

Doxycycline for 7 days

Question 4

Chlamydia treatment (pregnant)

Answer 4

Azithromycin (1g stat), amoxicillin or erythromycin

Question 5

Absolute contraindications to the COCP (UKMEC 4)

Answer 5

more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
major surgery with prolonged immobilisation
positive antiphospholipid antibodies (e.g. in SLE)

Question 6

Mechanism of action of nexplanon

Answer 6

Inhibits ovulation

Question 7

Within how long following UPSI can levonorgestrel be offered?

Answer 7

Up to 72 hours

Question 8

Within how long following UPSI can ullipristal be offered?

Answer 8

Up to 120 hours

Question 9

Mechanism of action of levonorgestrel (emergency contraception)

Answer 9

Not fully understood, inhibits implantation and ovulation

Question 10

Mechanism of action of ullipristal

Answer 10

Inhibits ovulation

Question 11

CI for ullipristal

Answer 11

Severe asthma

Question 12

First line medication management for infertility with PCOS

Answer 12

Clomifene (anti-oestrogen)

Question 13

Management of small (<5cm) simple ovarian cysts in young women

Answer 13

Repeat USS in 8-12 weeks and consider referral if persistent/ problematic

Question 14

Management of ovarian cysts in post- menopausal women

Answer 14

Urgent referral to gynae (given not ovulating more likely to be malignant)