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NM 701 Gynecologic Health > Module 3 Practice Questions > Flashcards

Module 3 Practice Questions Flashcards

1
Q

She loves being a mom and wants another child….but not yet. She’s interested in a method that will be highly effective, but that can be reversed quickly when she and her husband are ready for number 3. She’s also busy, as you can see…and thinks she might forget a method that requires daily attention. What are the options we can offer Rachel?

A

an IUD
Nexplanon (the contraceptive implant)

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2
Q

T/F: Birth control pills cause weight gain.

A

False

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3
Q

T/F: At least 80% of fertilized eggs implant in the uterus.

A

False

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4
Q

What percentage of pregnancies in the United States are unplanned?

A

49

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5
Q

Which of these methods contain hormones?
Paragard IUD
Mirena IUD
Essure
the Patch (“Evra”)

A

Mirena IUD
the Patch (“Evra”)

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6
Q

T/F: Basal body temperature can tell a woman when she is going to ovulate.

A

False

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7
Q

Rank these methods by effectiveness with TYPICAL use: Fertility Awareness

A

Low Effectiveness

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8
Q

Rank these methods by effectiveness with TYPICAL use: Male Condoms

A

Low Effectiveness

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9
Q

Rank these methods by effectiveness with TYPICAL use: IUD

A

Highest Effectiveness

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10
Q

Rank these methods by effectiveness with TYPICAL use: Implant

A

Highest Effectiveness

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11
Q

Rank these methods by effectiveness with TYPICAL use: Birth control pills

A

Medium effectiveness

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12
Q

Rank these methods by effectiveness with TYPICAL use: birth control ring

A

Medium Effectiveness

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13
Q

How effective and safe are progestin-only methods?

A

moderately to highly effective, high safety

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14
Q

How effective and safe are Estrogen plus progestin methods?

A

moderately effective, moderately safe

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15
Q

How effective and safe is fertility awareness?

A

Low effectiveness, high safety

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16
Q

How effective and safe are copper IUDs?

A

high effectiveness, high safety

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17
Q

How is depo provera administered?

A

IM injection

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18
Q

How is evra administered?

A

Transdermal patch

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19
Q

How is Skyla administered?

A

IUD

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20
Q

How is nexplanon administered?

A

subdermal implantation

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21
Q

What is/are the active ingredient(s) in DMPA?

A

Progestin

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22
Q

What is/are the active ingredient(s) in Evra?

A

Estrogen and progestin

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23
Q

What is/are the active ingredient(s) in Nuva Ring?

A

estrogen and progestin

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24
Q

What is/are the active ingredient(s) in Nexplanon?

A

Progestin

25
Q

What is/are the active ingredient(s) in combined pills?

A

Estrogen and progestin

26
Q

What is/are the active ingredient(s) in Paraguard?

A

Copper

27
Q

What is/are the active ingredient(s) in mini-pills?

A

Progestin

28
Q

What is/are the active ingredient(s) in Mirena?

A

Progestin

29
Q

Which of the following contraceptive methods contain estrogen:
-Combined oral contraceptives
-Progestin only oral contraceptive pills (POPs)
-Evra contraceptive patch
-Depo Provera (depomedroxyprogesterone acetate)
-Implanon/Nexplanon
-NuvaRing contraceptive ring
-Mirena (levonorgestrel intrauterine system)
-Paragard (Cu 380A intrauterine device)

A

-Combined oral contraceptives
-Evra contraceptive patch
-NuvaRing contraceptive ring

30
Q

Which of the following contraceptive methods are usually associated with irregular bleeding after the first three months of use:
-Paragard (C8 380A intrauterine device)
-Combined oral contraceptives
-Progestin only oral contraceptive pills (POPs)
-Evra contraceptive patch
-NuvaRing
-Mirena (levonorgestrel intrauterine system)
-Male condom
-Female condom
-Diaphragm
-Implanon/Nexplanon
-DepoProvera (depot medroxyprogesterone acetate)

A

**Progestin only are associated with irregular bleeding
-Progestin only oral contraceptive pills (POPs)
-Mirena (levonorgestrel intrauterine system)
-Implanon/Nexplanon
-DepoProvera (depot medroxyprogesterone acetate)

31
Q

T/F: Users of progestin only pills should be given the same instructions as users of combined oral contraceptives.

A

False

32
Q

T/F: Users of progestin only pills can expect to bleed during the hormone free week a the end of the pill package.

A

False

Note: Progestin only pills do not have a placebo week. All pills contain hormones

33
Q

If the clinician asks a patient, “Do you use protection?,” the patient will understand that s/he is asking about:

A

Who knows? Better to ask specifically about condom/birth control use

34
Q

What pregnancy termination option(s) exist(s) for a woman with an anencephalic fetus at 19 weeks gestation?

A

Surgical abortion

35
Q

How many different types of Emergency Contraception are available?

A

Four

36
Q

Which of the following can be used for Emergency Contraception?
-Mirena (levonorgestrel IUD)
-Paragard (copper IUD)
-monophasic combined oral contraceptive pills
-ella (ulepristol acetate)
-Levonorgestrel pills such as Plan B, Next Step, or generic LNG
-Micronor (progestin only oral contraceptive pills)
-Any of the pills in a triphasic combined oral contraceptive pill pack

A

-Paragard (copper IUD)
-monophasic combined oral contraceptive pills
-ella (ulepristol acetate)
-Levonorgestrel pills such as Plan B, Next Step, or generic LNG

37
Q

What compounds can cause an abortion after implantation?

A

mifepristone and misoprostol

38
Q

What percentage of pregnancies in the U.S. are unplanned?

A

49%

39
Q

Which birth control methods do women THINK are most effective?

A

birth control pills, followed by vasectomy, tubal ligation then IUDs

40
Q

What is the difference between perfect use effectiveness and typical use effectiveness?

A

Perfect is using exactly as it is meant to be used, typical is how people actually use the method

41
Q

What is the problem with sharing only the perfect use or typical use statistic?

A

Perfect use: they may have unrealistic expectations of the method
Typical use: they may think it is less effective than it is

42
Q

What methods are progestogen only?

A

Mini-pill, LNG IUDs, Nexplanon and Depo Provera

43
Q

What are the side effects and contraindications associated with progestin only methods?

A

Side Effects: unpredictable irregular bleeding

Contraindications: breast CA [Depo-active liver dx, CVD risk]

44
Q

What is the primary and secondary MOA of most progestin only methods?

A

Primary: Thickening cervical mucus
Secondary: Thinning endometrium, may inhibit ovulation

Exception: Depo-prevents ovulation (secondary-thickens cervical mucus)

45
Q

What methods are included in combined hormonal methods?

A

COC, nuvaring, patch

Note: there is a week of placebo with these (NOT with progestin only)

46
Q

What is the primary and secondary MOA for CHC?

A

Primary: suppresses ovulation
Secondary: Thins the endometrial lining and thickens mucus

47
Q

Which method may be best for someone with a history of ectopic pregnancies?

A

IUD because it significantly decreases chance of pregnancy

48
Q

If your patient has an IUD in place and becomes pregnant, what should you be most concerned about?

A

An ectopic pregnancy. It is rare to get pregnant with an IUD but of those pregnancies there is a high chance it may be ectopic.

49
Q

A 24 year old graduate student with no family hx, medical hx or allergies presents today for contraception. What is your first question?

A

Do you plan to become pregnant in the next year?
Have you used contraception before, what did you like or not like?
What are your goals with using contraception?

Key: get to know her and how it can help her best.

50
Q

Your patient tells you she does not want to start contraception which is likely to lead to weight gain. What methods are eliminated?

A

DMPA only-only one shown to cause weight gain

51
Q

Your patient wanting to start contraception wants an effective method because she is in college and not in a steady relationship. Her life is busy and somewhat unpredictable. What methods should we eliminate from this information?

A

Tier 3 effectiveness: condoms, diaphrams, withdrawal, etc.

52
Q

Your patient wants to start contraception. She has a history of migraine headaches with aura. What method should not be given to her? Why?

A

Combined hormonal methods: COC, nuvaring, patch

Estrogen: increased risk of stroke

53
Q

Your patient wants to start contraception but would like kids in about 3-4 years. Which methods are ruled out?

A

Sterilization

54
Q

A 29 year old patient comes in with light predictable periods. She currently uses condoms for BC but would like something more reliable. She does not want her bleeding to change. Which methods would be possible choices from what you know so far?

A

COC, ring, patch

55
Q

What is most likely to happen if a woman doesn’t like the BC method prescribed?

A

She’ll stop using it and WONT call you or come back in

56
Q

What are the key elements in prescribing contraception effectively?

A

Shared decision-making, listening to your patient, using safe methods for her

57
Q

What is the difference between monophasic and triphasic COC?

A

Monophasic has the same level of hormones every week. Triphasic has different levels of hormones each week to mimic natural hormone levels in the cycle

Note: managing contraception p 109

58
Q

Your patient presents today complaining of irregular bleeding. She is currently using a POP and would like to try something else. She is 34 years old, smokes 1 ppd and is BF her 1 year old. What is NOT a good option for her?

A

CHC because is close to 35 years old and smokes >15 cig/day

NM 701 Gynecologic Health (12 decks)

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