Health Maintenance and Contraception

Question 1

When is MRI of breast recommended?

Answer 1

Women who have >20% lifetime risk of developing breast cancer

Question 2

What are the most effective contraceptives?

Answer 2

Depot
Sterilization
Long-acting reversible contraception (LARC) - etonogestrel implant or IUD

Question 3

What glucose tolerance test amount is used for diagnosis of diabetes?

Answer 3

75-g 2h GTT

Question 4

What contraception can lead to heavier menstrual flow?

Answer 4

Copper IUD

Question 5

What contraception can cause severe nausea?

Answer 5

Combined OCPs

Question 6

What contraception is contraindicated in depression?

Answer 6

Medroxyprogesterone acetate

Question 7

What contraceptives will decrease risk of ovarian and endometrial cancer? What else do they decrease risk of?

Answer 7

OCPs - lower dose pills also do not raise breast cancer risk

Decrease risk of:
PID
Endometriosis
Ectopic pregnancy
Benign breast changes

Question 8

Dermal contraceptive patch is disadvantageous in what regards?

Answer 8

Failure rate higher in those who weigh >198 lbs
Higher risk for thromboembolism compared to oral contraceptives

Question 9

What IUD can be used for emergency contraception up to 5d?

Answer 9

Copper IUD

Question 10

What contraception is usually preferred for transmen?

Answer 10

Levonorgestrel IUD

Copper IUD, depot, and combined OCPs can cause excessive or cyclic bleeding

Question 11

Emergency contraception timeframe: 0-120 hr vs 0-72 hr and efficacy

Answer 11

0-120 hr: Copper IUD (>99%), Progestin IUD (>99%), Ulipristal (98-99%)

0-72 hr: Oral levonorgestrel (92-98%), oral contraceptives (combined estrogen/progestin OCP containing levonorgestrel or norgestrel; 75-89%)

Question 12

Copper IUD contraindications vs Progestin IUD

Answer 12

Wilson disease vs breast cancer

Both carry risk of:
Active pelvic infection
Severe uterine cavity distortion

Question 13

How do levonorgestrel and ulipristal primarily prevent pregnancy as emergency contraception?

Answer 13

Delaying ovulation

Question 14

How does medroxyprogesterone act as a contraceptive (not used as emergency contraception)?

Answer 14

Inhibit hypothalamic secretion of GnRH –> decreased FSH/LH –> inhibit ovarian follicle development

Question 15

When can estrogen/progestin OCPs be used for postpartum contraception?

Answer 15

> =6 weeks after delivery - decreased risk of clot at that time

Question 16

Long-term IUD raises risk of what infection?

Answer 16

Actinomyces - can ascend to upper genital tract