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RDA > Lecture 18 - 2018/2017 > Flashcards

Lecture 18 - 2018/2017 Flashcards

1
Q

How much sperm roughly is in a typical ejaculate?

A

350,000,000 (3-5mls per ejaculate).

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2
Q

When does ovulation roughly occur?

A

14 days before next period starts (roughly day 12-16).

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3
Q

How long can sperm survive in the uterus for?

A

Up to 7 days (maximum).

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4
Q

How long can egg survive (after being released) without being fertilised?

A

12-24 hours,

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5
Q

What is the temperature method?

A

When a woman measures her temperature every day (before she gets out of bed, drinking, eating etc). Temperature rises due to progesterone (the day after ovulation). It is a “natural” contraception.

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6
Q

What is the legal age of consent?

A

16.

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7
Q

Describe contraception and the law in NZ?

A

Studies suggest that by the age of 15 up to 30% of NZ teenagers have had sex.

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8
Q

What is the law regarding contraception?

A

No restriction on prescribing contraception to under 16s without parental consent. Informed consent relies on an assessment of competence - a competent child has sufficient understanding and maturity to fully comprehend the proposed treatment.

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9
Q

Define conception?

A

Union of egg and sperm followed by implantation of the zygote.

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10
Q

Define contraception?

A

A method of preventing pregnancy via interference with ovulation, fertilsation or implantation.

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11
Q

What is a long acting reversible contraception (LARC)?

A

Method of contraception which needs to be administered less than once a month.

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12
Q

What are the contraceptive methods available in NZ?

A
  1. Combined oral contraceptive pill.
  2. Progesterone only pill.
  3. condoms.
  4. Depo provera.
  5. Jadelle.
  6. Copper IUD.
  7. Mirena IUS.
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13
Q

What is the UK MEC?

A

Evidence based guidance for providers of contraception.

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14
Q

What is MEC 1?

A

No restriction on use.

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15
Q

What is MEC 2?

A

Advantages of use of method generally outweigh the disadvantages.

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16
Q

What is MEC 3?

A

Disadvantages of use generally outweigh the advantages.

17
Q

What is MEC 4?

A

Do not use.

18
Q

What is perfect use?

A

This is the result under laboratory conditions.

19
Q

What is typical use?

A

This is your typical every day use e.g. where people can miss a pill.

20
Q

What is the contraceptive tier?

A
  1. Sterilisation/implant/IUD - 2 pregnancies per 100 women per year.
  2. Pill/injection - 3-9 pregnancies per 100 women per year.
  3. Condoms/fertility awareness - 10-20 pregnancies per 100 women per year.
  4. Spermicide - 21-30 pregnancies per 100 women per year.
21
Q

How does the combined oral contraceptive pill work - physiology wise?

A

There is an increase in estrogen (you take in more estrogen) which will cause a decrease on GnRH and FSH and LH (due to negative feedback) which can stop ovulation from happening.

22
Q

What is the function of the COC pill?

A
  1. Suppress ovulation.
  2. Reduces sperm transport in upper genital tract.
  3. Alters the endometrium and inhibiting implantation.
  4. Thickens cervical mucus.
23
Q

If a woman is taking the COCP she may not be protected from pregnancy if the following occurs?

A
  1. Miss 2 hormone pills or take them more than 12 hours after the normal time.
  2. Vomit within 3 hours of taking 2 hormone pills or continuous vomiting.
  3. Loose bowels several times.
24
Q

What happens if a female misses two hormone pills?

A

She must follow the 7 day rule - she has to take 7 hormone pills in a row and is not allowed to have sex that is non barrier in those 7 days. Give her emergency contraception if required.

25
Q

What is the emergency contraceptive pill?

A

Postinor 1 (1 tablet) that is made up of 1.5mg of levonorgestrel (high dose of progesterone).

26
Q

When does a female need to take the emergency contraceptive pill?

A

Within 72 hours of unprotected intercourse - the sooner the better. It is not effective if given after ovulation.

27
Q

Can a female take the ECP if her BMI is >30?

A

No - she will need to use an emergency post-coital IUD instead.

28
Q

What is the common way of taking the COCP?

A

Taking 21 days of hormone pills and then 7 days of placebo pills (pill free interval) - the pill free interval is to allow for a withdrawal bleed.

29
Q

How does the progesterone only pill work?

A

It works by thickening the cervical mucus - this effect is maximal 48 hours after starting the POP. Need to take it within 3-4 hours of the same time every day.

30
Q

What is depo provera?

A

12 weekly injection of progesterone.

31
Q

How does depo provera work?

A

It prevents ovulation and thickens cervical mucus to block sperm.

32
Q

What is the jadelle?

A

LARC implant that is inserted into the upper arm. It can last for five years.

33
Q

How does the jadelle work?

A
  1. Alters endometrium - prevents the womb lining from preparing to receive an egg, so even if an egg has already been released it can’t embed itself into the lining.
  2. Influences cervical fluid - thickens cervical mucus to prevent sperm from reaching the uterus.
  3. Stops ovulation - prevents the release of an egg from the ovaries by making the body think it’s already occurred.
34
Q

What is the copper IUD?

A

Non-hormonal form of contraception that is implanted in the uterus.

35
Q

How does the copper IUD work?

A

The bands on the IUD (cooper) act as spermasides which kill the sperm as it reaches the uterus.

36
Q

What is the mirena IUS?

A

Hormonal form of contraception that is implanted in the uterus.

37
Q

How does the mirena work?

A
  1. Makes the endometrium thinner.
  2. Creates an unfavourable environment for sperm in the uterus and the fallopian tubes so fertilisation is prevented.
  3. Makes the cervical mucus thicker so that sperm passage is obstructed.

RDA (19 decks)

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