Obgyn - Contraception and family planning (46) Flashcards

1
Q

OBG - 5.1
Which does not pruves the ovulation
A) BBT
B) pregnancy
C) progesteron level above 3 ng/l
D) secretory transformation of the endometrium
E) menstruation

A

ANSWER
E) menstruation
EXPLANATION
The rise in body basal temperature, pregnancy, present of corpus luteum, secretoric transformation of the endometrium are proof of ovulation. The presence of menstruation does not prove it, it could be anovulatoric bleeding also.

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2
Q

OBG - 5.2
Side effect of chemical and barrier contraception methods, except:
A) toxic shock syndrome
B) urogenital infection
C) pregnancy rate between 5–15%
D) fetal congenital malformations
E) salpingitis

A

ANSWER
E) salpingitis
EXPLANATION
The use of chemical spermicides or mechanical barriers can increase the risk of urogenital infection or nonmenstrual toxic shock syndrome. (Toxic shock syndrome is caused from intoxication by one of several related Staphylococcus aureus exotoxins, which colonized the vagina.) Due to the use of teratogenic chemicals may cause congenital malformation by the fetus. The efficacy of chemical or barrier contracpetion methods is not 100 %. Salpingitis do not occur with the use of barriers or spermicides.

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3
Q

OBG - 5.3
Contraception methods of spermicides are based on, except:
A) killing sperm
B) immobilizing the sperm
C) attacking the acrosomal membranes of the sperm
D) dissolving the external lipoprotein film
E) neutralizing the acid vaginal pH

A

ANSWER
E) neutralizing the acid vaginal pH

EXPLANATION
Spermicides can decrease sperm motility, inactivate acrosome enzymes or solve the external lipoprotein layer. Neutralisation of the acidic vaginal pH does not have contraception effect

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4
Q

OBG - 5.4
Effects of combined hormonal contraception, except:
A) prevent ovulation
B) reduce sperm motility
C) inhibit secretion of FSH
D) supression of the LH surge
E) inhibit folliculogenesis

A

ANSWER
B) reduce sperm motility
EXPLANATION
Combined oral contraceptives prevent ovulation and the evolution of follicules due to inhibit the excretion of gonadotropin ((LH, FSH) hormones. It has no effect on sperm motility.

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5
Q

OBG - 5.7
Characteristic for combined oral contraceptives, except:
A) estrogen component is usually ethinyl estradiol
B) are either monophasic or multiphasic
C) each active pills contains the same dose of estrogen
D) one of the main mechanisms of contraceptive action is supression of the LH surge

A

ANSWER
C) each active pills contains the same dose of estrogen
EXPLANATION
Oral contraceptives (OC) contains also estrogen and progestin hormones. Different formulation are available containing estrogen, usually ethinyl estradiol. Preparation of OC-s are either monophasic (each active pills contains the same dose of hormones) or multiphasic (the dose of hormones varies among the pills in the package regarding to the physiological cycle based estrogen and progestin levels) One of the main mechanisms of contraceptive action is supression of the LH surge to prevent ovulation.

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6
Q

OBG - 5.8
Possible complications of Copper-IUD:
A) PID (pelvic inflammatory disease)
B) Ectopic pregnancy
C) Uterine perforation during insertion
D) Dysmenorrhea
E) All of the above

A

ANSWER
E) All of the above
EXPLANATION
Insertion of IUD’s can be associated infrequently with complications such as perforation or ectopic pregnancy and there is also a trasient increased risk of pelvic inflammatory disease due to endometrial contamination during device insertion. Copper IUDs may be associated with dysmenorrhea, therefore women with heavy menses or dysmenorrhea are better served by the hormonal IUS-s.

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7
Q

OBG - 5.9
Contraception methods that can be used during lactation:
A) multiphasic oral contrapectives
B) IUD
C) progestin only pills
D) B and C are both true

A

ANSWER
D) B and C are both true
EXPLANATION
During breastfeeding, the chance of getting pregnant is lower but not zero. There is a theoretical concern that hormonal contraceptives containing estrogen may impair lactation through their effect on the action of prolactin on the breast. Estrogen and progesterone combination inhibit prolactin activity. On the other side hormones ingested by the infant in breast milk may result in circulating levels that are higher than expected because of an immature liver that cannot metabolize the hormones, immature kidneys that may not be able to excrete the hormones, and a plasma-binding capacity that may be low, resulting in higher levels of free and biologically active hormones. Progestin-only oral contraceptives contain only a progestin and recommended during lactation.

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8
Q

OBG - 5.10Contraceptive typical failure rates within 1 year of use of combined oral contraceptives:
A) 3-10 %
B) 1-2%
C) 5%
D) 9.5%
E) 0.001%

A

ANSWER
A) 3-10 %
EXPLANATION
Contraceptive failure rates within 1 year of use of combined oral contraceptives: The failure rate (can be perfect or typical failure rate) represents the percentage of women who conceive in the first year of use the contraceptive method as instructed. Combined oral contraceptive methods are in the very effective group of methods with typical failure rate between 3% to 10 %.

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9
Q

OBG - 5.12
Characteristic of Levonorgestrel-releasing intrauterine system (LNG-IUS), except:
A) releases the oestrogen directly into the uterus
B) prevents pregnancy primarily by maintaining impenetrable cervical mucus and has a local effect on endometrium
C) results 70% to 90% reduction of menstrual blood loss
D) appropiate nulliparous women
E) approved for up to 5 years

A

ANSWER
A) releases the oestrogen directly into the uterus
EXPLANATION
The LNG-IUS (levonorgestrel-releasing intrauterine system) released daily certain amount of levonorgestrel and not estrogen. Due to a local endometrial atrophic effect and maintain thick impenetrable cervical mucus prevents pregnancy. IUS can be approved for nulliparous and for up to 5 years.

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10
Q

OBG - 5.13
Contraindications of hormonal contraception, except for:
A) pregnancy
B) deep venous thrombosis
C) smoking after the age 35
D) age under 18 years
E) liver disorders

A

ANSWER
D) age under 18 years
EXPLANATION
OCs, due to their estrogen containt also affects the cardiovascular system, central nervous system, lipid metabolism. Potential medical contraindications were defined as history of hypertension, myocardial infarction, cerebral vascular accidents, migraines with aura, any migraine and age 35 years or older, smoking in women older than 35 years, venous thromboembolism, or liver disease. The age under 18 without any other risk factor is not a contraindication for use.

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11
Q

OBG - 5.14
Hormonal Contraception Methods, except ?
A) Implant
B) Vaginal ring
C) Female condom
D) Intramuscular Injection
E) Transdermal Patch

A

ANSWER
C) Female condom
EXPLANATION
Different formulations are available containing estrogen and/or progestin such as: Oral contraceptive pills, implants, vaginal ring, transdermal patch, or depot injection. Female condom is a barrier contraceptive method without any hormones.

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12
Q

OBG - 5.16
The life span of the mature human oocyte is:
A) 6–12 hours
B) 12–24 hours
C) 24–48 hours
D) 24–72 hours

A

ANSWER
B) 12–24 hours
EXPLANATION
The lifespan of the egg after ovulation is just 12-24 hours

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13
Q

OBG - 5.17
Which is not the indication for intrauterine Insemination (IUI)?
A) unexplained infertility
B) cervical factor
C) ovulation dysfunction
D) mild oligozoospermy
E) tubal occlusion both side

A

ANSWER
E) tubal occlusion both side
EXPLANATION
Unexplained infertility, sperm abnormalities, ovulatory or cervical factors are the indication of intrauterine insemination. Tubal occlusion on the both side requires in –vitro fertilization. (IVF)

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14
Q

OBG - 5.20
Which content is responsible for the risk of deep vein thromboembolism in combined oral contraceptives?
A) gestogen
B) oestrogen
C) both of them
D) none of them

A

ANSWER
B) oestrogen
EXPLANATION
Estrogen containing oral contraceptives increase the risk for VTE because estrogen among others increase the plasma concentration of clotting factors (II, VII, X, XII, factor VIII, and fibrinogen). Since the introduction of the first birth controll pill the doses of estrogen have decreased from 50 ug to 20 ug per tablet.

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15
Q

OBG - 5.21
Absolute contraindications to the use of estrogen –containing contraceptives, except:
A) endometrial cancer
B) lupus erythematosus
C) ulcerative colitis
D) fibroid

A

ANSWER
C) ulcerative colitis
EXPLANATION
Fibroids have more estrogen receptors than has the nearby normal myometrium and estrogen can cause uterine fibroids to grow larger. Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia are absolute contraindication of OC use. Estrogen-containing hormonal contraceptives are contraindicated in patients with positive antiphospholipid antibodies (aPL) in systemic lupus erythematosus. Theres is no known association between OC use and ulcerative colitis progression

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16
Q

OBG - 5.22
Efficacy of contraception methods from high to low effective:
A) oral contraceptives, IUD, condom
B) condom, IUD, oral contraceptives
C) IUD, oral contraceptives, condom
D) all of them represents the same efficacy

A

ANSWER
A) oral contraceptives, IUD, condom
EXPLANATION
The highly effective methods are the combined hormonal methods of contraceptions and the last group includes all the barriers. From high to low: OCs-IUD-condom

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17
Q

OBG - 5.23
Recommended contraceptive method for women suffering dysmenorrhea:
A) IUD
B) combined oral contraceptive pills
C) barrier methods
D) emergency contraception

A

ANSWER
B) combined oral contraceptive pills
EXPLANATION
Women lose less blood with menses and suffer less dysmenorrhea with cyclic OC use.

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18
Q

OBG - 5.24
The lifespan of the Copper-IUD device:
A) 1 years
B) 3 years
C) 5 years
D) 20 years

A

ANSWER
C) 5 years
EXPLANATION
The Copper IUD is approved for up to 5 years use.

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19
Q

OBG - 5.25
Routine follow-up visit after IUD insertion is recommended:
A) not necessary
B) only by complains
C) after the first post insertion menses (usually 1 month)
D) every month

A

ANSWER
C) after the first post insertion menses (usually 1 month)
EXPLANATION
Normally, clients should return after the first post insertion menses, but not later than three months, for their first check up. Thereafter, there is no need for a fixed follow-up schedule.

20
Q

OBG - 5.26
Behavioral contraception methods (natural family planning) can be recommended to avoid pregnancy:
A) for women with well known, regular cycle
B) in case of vaginal discharge
C) with irregular menstruational cycle
D) during lactational amenorrhea

A

ANSWER
A) for women with well known, regular cycle
EXPLANATION
Behavioral contraception methods (natural family planning) can be recommended for women with well known, regular cycle to calculate fertile days accurately. The efficacy of this method is very poor by irregular cycle, by sever vaginal discharge or by lactational amenorrhea.

21
Q

OBG - 5.27Contraindications of hormonal contraceptive, except:
A) cardiovascular disease
B) severe varicose veins
C) severe myopia
D) leiomyomas

A

ANSWER
C) severe myopia
EXPLANATION
Cardiovascular diseases, estrogen dependent neoplasms, severe varicose veins are contraindications. Hormonal contraceptive methods has no effect on myopia.

22
Q

OBG - 5.28
Recommended ages for hormonal contraception use:
A) from the first sexual intercourse until menopause or above 50 years
B) between 18–40 ages
C) before the first birth
D) no recommendation, use is irrespective for ages

A

ANSWER
B) between 18–40 ages
EXPLANATION
Healthy, reproductive-aged women without any contraindication can use hormonal contraceptive methods under 35 years. The newest contraception pills (the doses of porgestin and estrogen decreased) provide the opportunity to use that methods for less than 18 or above 40 years.

23
Q

OBG - 5.31
Clomiphen, an orally active antiestrogen is used for:
1) anovulation form of PCO
2) hypoprolactinaemia
3) luteal phase defect
4) abnormal cervical factor
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
B) 1st and 3rd answers are correct
EXPLANATION
1., 3. Are true Clomiphen is an orally active antiestrogen. By inhibiting the negative feedback effect of endogenous estrogen, causes a rise of FSH and LH, stimulation of follicule maturation. Correction of the luteal phase defect is possible by use clomiphen (LH effect)

24
Q

OBG - 5.32
IVF treatment are recommended:
1) abnormal male coital factor
2) severe oligozoosperm
3) endometriosis
4) tubal occlusion on both sides
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
C) 2nd and 4th answers are correct
EXPLANATION
2.,4. Are true. IVF procedure is preferable in cases of severe male factor infertility or in tubal occlusion. IVF is ineffective in the treatment of endometriosis or by coital abnormalities.

25
Q

OBG - 5.33
Side effects of combined hormonal contraceptives, regarding the estrogen contain:
1) increase plasma HDL level
2) decrease plasme HDL level
3) decrease plasma LDL level
4) increase plasma LDL level
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
B) 1st and 3rd answers are correct
EXPLANATION
Synthetic and natural estrogens increase high density lipoprotein (HDL) cholesterol levels, while lower the LDL levels. Progestins lower such levels and increase slightly the LDL levels. The combined effects of oral contraceptives on plasma lipoproteins are: increase plasma HDL level and decrease plasma LDL level (ar

26
Q

OBG - 5.34
Complications of oral hormonal contraceptions:
1) post pill amenorrhea
2) pulmonary embolism
3) myocardiac infarction
4) bening hepatic tumors
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
E) all of the answers are correct
EXPLANATION
Complication of oral hormonal contraceptives could be deep vein thrombosis, pulmonary embolism, coronary vascular disease, cerebrovascular accident, post-pill amenorrhea and beging hepatic laesions. Fortunately serious complications are infrequent with the use of reduced hormonal doses.

27
Q

OBG - 5.37
Relative contraindication of oestrogen–containing contraceptives:
1) mild hypertension
2) leiomyomas
3) hypertriglyceridemia
4) breast cancer within last 5 years
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Mild hypertension, leiomyomas, hypertriglicerdiaemia are only relative contraindication. Active breast cancer or breast cancer within 5 years are absolute contraindication of use.

28
Q

OBG - 5.38
Positive effects of vaginal ring (for example Nuvaring)
1) consistent hormone levels
2) provide uterine prolapse
3) lower hormonal dose compare to OCs
4) protection against STD-s
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
B) 1st and 3rd answers are correct
EXPLANATION
Nuvaring (vaginal ring) is a flexible plastic ring made with ethinyl estradiol ad etonogestrel. NuvaRing has the advantage of avoiding gastrointestinal absorption and hepatic first-pass metabolism, and serum hormone levels are consistent during administration of the ring. This ring is not kind of barrier method and has got no effect to protect against STDs. Uterine prolapse can not be prevent by using Nuvaring.

29
Q

OBG - 5.39
Positive effect of oral contraceptive pills:
1) reduce dysmenorrhea
2) has an boost effect on body power
3) reduce blood loss during menstruation
4) increase ’work mood ’
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
B) 1st and 3rd answers are correct
EXPLANATION
Women lose less blood with menses and suffer less dysmenorrhea with cyclic OC use.

30
Q

OBG - 5.40
The common cause of the spotting during OC use:
1) pill administration failure
2) drug interaction
3) absorption abnormalities
4) psychogenic stress
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
E) all of the answers are correct
EXPLANATION
Spotting or slight bleeding often attributed to lower-dose OC use, and can occure in any cases

31
Q

OBG - 5.43
Which stage is best suited to the insertion of an IUD?
1) anytime
2) during menstruation
3) by ovulation
4) in the 6th week after birth

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
C) 2nd and 4th answers are correct
EXPLANATION
The inserrtion procedure is best suited when the cervical canal is slightly open. It can be during menstruation and two days after the menstruational bleeding, or after the birth when the cervical canal has not been closed. (during 6th week after the birth)

32
Q

OBG - 5.44
Complication of using IUD can be:
1) abnormal bleeding
2) ectopic pregnancy
3) PID (pelvic inflammation)
4) varicose veins on the upper limbs
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
A) 1st, 2nd and 3rd answers are correct
EXPLANATION
There is a trasient increased risk of upper genital tract infection. The effect against the implantation of the fertilized egg induced by the IUDs and the inflammatory changes within the endometrium can increase the risk of ectopic pregnancy. There is no effect on varicose veins.

33
Q

OBG - 5.45
Which contraception methods can be recommended during lactation?
1) combined contraception pills
2) IUD
3) vaginal ring
4) barrier methods
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
C) 2nd and 4th answers are correct
EXPLANATION
Combined (estrogen+progestin) contraceptives such as pills or vaginal ring are contraindicated because estrogen decrease milk production. Usually products which don’t contain estrogen are preferred during breastfeeding or another contraceptive methods such as IUD or barrier.

34
Q

OBG - 5.46
Ovulation can be proved by:
1) tracking the cervical mucus pattern
2) detection of midcycle pain („Mittelschmerz”)
3) folliculometry
4) measure of BBT (body basal temperature)
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
E) all of the answers are correct
EXPLANATION
All of them are characteristic for ovulation but the most accurate is the folliculometry.

35
Q

OBG - 5.47
Contraindication of IUD insertion:
1) PID (pelvic inflammation disease)
2) abnormal bleeding (metrorrhagia, spotting)
3) leiomyomas
4) multiparity

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

ANSWER
A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Abnormal uterine bleeding, pelvic inflammation are contraindication of the IUD insertion. In case of the uterine cavity is distorted by leiomyomas IUD is not recommended.

36
Q

OBG - 5.48
The reduction of the dose of estrogen is not feasible under particular limit because a proper estrogen activity is required to the production of endometrial progestin receptors and this is the principal condition to the secretional transformation and to the sloughing of the endometrium .
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
B) both the statement and the explanation are true but there is no causal relationship between them;
EXPLANATION
The estrogen component of the OC’s is responsible for the cyclic regulation. The physiologic funtcion requires adequate estrogen amount. This effect on the endometrium inhibits the irregular, spotting. Both statement are true without any connection

37
Q

OBG - 5.49
The effect of the same dose of ethynil-oestradiol is much higher than the same dose of natural oestradiol because it come into existence with a 17-ethinyl substitution.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
B) both the statement and the explanation are true but there is no causal relationship between them;
EXPLANATION
Ethinyl-oestradiol is much more effective than natural estrogens. ESTRADIOL with a 17-alpha-ethinyl substitution and its 3-methyl ether mestranol have good absorption form the gastrointestinal tract. The active estrogen substance of combined hormonal contraception is ethinyl-oestradiol. Statement and the initiation are true without any context.

38
Q

OBG - 5.50
The risk of deep vein thrombose increase four times with OC administration because the progestin is responsible for the development of thrombosis.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
C) the statement is true, but the explanation is false;
EXPLANATION
The risk of deep vein thrombosis has been estimated to be increased by 4fold, and of superficial thrombosis increased by two fold in women who use oral contraceptives. These risks are estrogen –dose related and the risk decreased with the use of formulation containing less ethynil-estradiol and containing different progestin substances without any androgen effect. Probably the balance between estrogen and progestin amount can be responsible for advers effects. Statement is true, but initiation is wrong.

39
Q

OBG - 5.51
The complications of oral contraception raise with the higher amount of estrogen content because the OCs with lower estrogen amount coexistence more often with spotting or with pregnancy.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
B) both the statement and the explanation are true but there is no causal relationship between them;
EXPLANATION
The possible adverse effect of OC’s (deep vein or superficial thrombosis) risks are estrogen –dose related and the risk increased with the use of formulation containing higher estrogen. With the decrease of estrogen containt spotting, breakthrough bleeding are more often. Statement is true, but initiation is wrong.

40
Q

OBG - 5.52
The long lasting activity contraception methods contain only estrogen because it can be used in such case when progestin are contraindicated
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
E) both the statement and the explanation are false
EXPLANATION
The long lasting contraceptive methods such as implant, injection, vaginal ring, LNG –IUS contains only progestin, and in cases when progestin is contraindicated can not be used. Both of the statements are wrong.

41
Q

OBG - 5.53
The LNG-IUS effectiveness is lower than the commercial IUD because the average amount of estrogen released from LNG -IUS is daily 20 ug .
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
E) both the statement and the explanation are false
EXPLANATION
The LNG-IUS effectiveness are almost as high as the effectiveness of tubal ligation. The LNG-IUS release usually daily 20 ug progestin. Both of the statements are wrong.

42
Q

OBG - 5.54
The amenorrhoea induced by the LNG-IUS are common because the POPs containt estrogen and progestin .
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
C) the statement is true, but the explanation is false;
EXPLANATION
The atrophic endometrial changes induced be the LNG primarily affects menstrual bleeding patterns and amenorrhea. The pills contain only progestin named by POP (progesteron-only pill)

43
Q

OBG - 5.55
During OC use two month discontinuance is required in order to residual synthetic derivate eliminate from the body.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
E) both the statement and the explanation are false
EXPLANATION
Discontinuance of oral contraception pills is not required. The active substances or derivates of contraceptives are not hazard to human body and their elimination is faster than two months.

44
Q

OBG - 5.56
Combined OC inhibit ovulation because estrogen reduce FSH production and progestin supresses the LH surge
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
A) both the statement and the explanation are true and a causal relationship exists between them;
EXPLANATION
Ovulation takes not every time place and other mechanisms can assure the contraceptive methods. In that case thickening the cervical mucus, chaning Fallopian tube motility are kind of other possible mechanisms. Both of the two statment are true without any connection.

45
Q

OBG - 5.58
Behavioral methods , natural family planning has a higher failure rate because ovulation may in progress during intercourse and the menstruational cycle could be irregular for external factors.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
A) both the statement and the explanation are true and a causal relationship exists between them;
EXPLANATION
Not many women became familiar with their menstruational cycle, cycle are often irregular and ovulation can occur also in unwanted period such as during intercourse or after psychotic events.

46
Q

OBG - 5.59
Only Progestin- only pills are required during breastfeeding because the progestin excreted into milk do not provoke virilisation.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

ANSWER
C) the statement is true, but the explanation is false;
EXPLANATION
Statement is true because combined contraception have strong negative effect on milk production