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MFSRH Part 2 (2023) > Incorrect Use of Combined Hormonal Contraception > Flashcards

Incorrect Use of Combined Hormonal Contraception Flashcards

1
Q

What constitutes as being late to restart a new pill packet after the HFI?

A

≥9 completed days since last active pill was taken

(I.e. if a woman took her last pill before the HFI at 9am on monday, as long as she restarts before 9am on wednesday the following week she’s okay)

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2
Q

A patient is 3 days late restarting her new pill packet after the HFI, what do you advise?

A
  • Consider EC if UPSI has taken place during or after the HFI
  • Take the most recent missed pill ASAP
  • Continue the remaining at the usual time
  • Condoms for 7 days
  • Follow-up PT if applicable
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3
Q

A patient has missed 1 pill (48 to <72 hours since last pill) in week 1 after the HFI, what do you advise?

A
  • Check the first pill after HFI was taken correctly
  • If yes, EC not required if consistent, correct use earlier in week 1 and the 7 days prior to HFI
  • Take missed pill ASAP
  • Continue remaining pills as usual
  • No additional precautions required if meets all the above critera
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4
Q

A patient has missed 1 pill in week 3 after HFI, what do you advise?

A
  • EC not required if consistent, correct use in previous 7 days
  • Take missed pill ASAP
  • Continue remaining pills as usual
  • No additional precautions required if meets the above criteria
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5
Q

A patient misses 2 pills (≥72 hours since last pill was taken) in week 1 after the HFI, what do you advise?

A
  • Check the first pill after the HFI was taken correctly
  • Consider EC if UPSI has taken place during the HFI or week 1
  • Take most recent pill ASAP
  • Continue remaining pills as usual
  • Condoms for 7 days
  • Consider follow-up PT
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6
Q

A patient has missed 2 pills in week 3 after HFI, what do you advise?

A
  • EC not required if consistent, correct use in previous 7 days
  • Take most recent missed pill ASAP
  • Continue remaining pills as usual
  • If in the week prior to scheduled HFI, omit the HFI
  • Use condoms for 7 days (overcautious)
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7
Q

A patient realises she has missed 8 consecutive pills of COC, what do you advise?

A
  • Treat as new start contraception
  • Consider EC etc
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8
Q

What constitutes as being late restarting the combined vaginal ring after HFI?

A
  • ≥ 8 completed days since ring was removed for HFI

(I.e. if a woman removed her ring at 9am on Monday, she needs to insert a new ring by 9am the following Tuesday)

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9
Q

A patient is late to insert her new ring post HFI by 3 days. What do you advise?

A
  • Consider EC if UPSI has taken place during or after the HFI
  • Insert new ring ASAP
  • Keep ring in until scheduled removal day
  • Condoms for 7 days
  • Consider follow-up PT
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10
Q

A patient realises her ring fell out 36 hours ago in week 1 after HFI, what do you advise?

A
  • EC not required in unscheduled ring removal for <48 hours, IF consistent use earlier in week 1 and in the 7 days prior to HFI
  • Insert new ring ASAP
  • Keep ring in until scheduled ring removal day
  • No additional precautions required if the above criteria met
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11
Q

A patient realises her ring fell out 36 hours ago in week 3 after HFI, what do you advise?

A
  • EC not required in unscheduled ring removal for <48 hours, IF consistent use in the previous 7 days
  • Insert ring ASAP
  • Keep ring in until scheduled removal day
  • No additional precautions required if meets the above criteria
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12
Q

A patient realises her ring fell out 50 hours ago in week 1 after HFI, what do you advise?

A
  • Consider EC if UPSI has taken place during the HFI or week 1
  • Insert new ring ASAP
  • Keep ring in until scheduled ring removal day
  • Condoms for 7 days
  • Consider follow-up PT
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13
Q

A patient realises her ring fell out 50 hours ago in week 3 after HFI, what do you advise?

A
  • EC not required if correct use in previous 7 days
  • Insert ring ASAP
  • Keep in until scheduled removal day
  • If in the week before HFI, omit the HFI
  • Condoms for 7 days (over cautious)
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14
Q

A patient accidentally kept her ring in for 26 days, what do you advise?

A
  • As long as ≤28 days, EC not required if ring was correctly used from day 21 to day 28
  • Start HFI (if scheduled) and insert new ring at end of HFI, OR just insert a new ring (if not wanting HFI)
  • No additional precautions necessary if correct use otherwise
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15
Q

A patient accidentally kept her ring in for 4 weeks and 2 days, what do you advise?

A
  • EC not required with continued use of same ring for >4 weeks and ≤5 weeks (if correct use of the ring otherwise)
  • Omit HFI
  • Insert new ring ASAP
  • Condoms for 7 days (over cautious)
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16
Q

A patient accidentally kept her ring in for 6 weeks, what do you advise?

A
  • Consider EC if UPSI has taken place after 5 weeks or later
  • PT
  • Omit HFI
  • Insert new ring ASAP
  • Condoms for 7 days
  • Follow-up PT
17
Q

What constitutes as being late to restart a patch after the HFI?

A
  • If ≥ 8 completed days since last patch was removed for scheduled HFI

(i.e. if woman removed her patch at 9am on Monday, she has until 9am the following Tuesday to apply a new one)

18
Q

A patient is 72 hours late restarting her patch after the HFI, what do you advise?

A
  • Consider EC if UPSI has taken place during or after the HFI
  • Attach new patch ASAP
  • Keep new patch on until scheduled removal day
  • Condoms for 7 days
  • Follow-up PT
19
Q

A patient’s patch fell off but she’s certain it was for <48 hours, and she is in week 1 after HFI, what would you advise?

A
  • EC not required if correct use earlier in week 1 and the 7 days prior to HFI
  • Attach new patch ASAP
  • Keep new patch on until scheduled removal day
  • No additional precautions required if the above criteria met

These same rules apply if continued use of the same patch for up to 48 additional hours

20
Q

A patient’s patch fell off but she’s certain it was for <48 hours, and she is in week 3 after HFI, what would you advise?

A
  • EC not required if correct use in previous 7 days
  • Attach new patch as soon as possible
  • Keep new patch on until scheduled removal day
  • No additional precautions required if the above criteria were met

These same rules apply if continued use of the same patch for up to 48 hours

21
Q

A patient’s patch fell off but she thinks it may have fallen off 72 hours ago, and she is in week 1 after HFI, what would you advise?

A
  • Consider EC if UPSI during the HFI or week 1
  • Attach new patch as soon as possible
  • Keep new patch on until scheduled removal day
  • Condoms for 7 days
  • Follow up PT

These same rules apply if continued use of the same patch for ≥48 additional hours

22
Q

A patient’s patch fell off but she thinks it may have fallen off 72 hours ago, and she is in week 3 after HFI, what would you advise?

A
  • EC not required if correct use in the previous 7 days
  • Attach new patch ASAP
  • Keep new patch on until scheduled removal day
  • If the patch fell off in the week prior to HFI, omit the HFI
  • Condoms for 7 days

MFSRH Part 2 (2023) (22 decks)

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