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3152 > pre-IC16 & IC16 > Flashcards

pre-IC16 & IC16 Flashcards

1
Q

How does progestin and estrogen prevent ovulation?

A

Progestin block LH surge + estrogen suppress FSH release

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2
Q

Which substance provide most contraceptive effect?

A

Progestin

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3
Q

Which substance stabilize the endometrial lining and provide cycle control?

A

Estrogen

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4
Q

Will there be period for progestin only contraceptive?

A

No

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5
Q

Most commonly used estrogen

A

Ethinyl estradiol

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6
Q

Androgenic SE examples

A

Acne, oily skin, hirsutism

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7
Q

Usually, lower or higher estrogen dose is used?

A

Lower

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8
Q

Factors favoring higher doses of EE (30-35 mcg)

A
  • Obesity or weight > 70.5 kg
  • Early to mid cycle breakthrough bleeding/spotting
  • Tendency to be non-adherent
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9
Q

Which is the ONLY progestin agent that does not have androgenic effects?

A

Drospirenone

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10
Q

Adverse effects of Drospirenone

A

hyperkalemia, thromboembolism and bone loss

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11
Q

Monophasic vs multiphasic COC

A

Mono: Same amounts of estrogen & progestin in every pill
Multi: Variable amounts of estrogen and progestin

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12
Q

Benefit of monophasic COC

A

Less confusing, less complicated miss-dosed instructions

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13
Q

Benefit of multiphasic COC

A

Tend to have lower progestin overall -> lesser side effects

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14
Q

Regimen for Conventional cycle COC

A

21 days active pill + 7 day placebo = 28 days

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15
Q

Which COC leads to lesser periods?

A

Extended-cycle / continuous COC

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16
Q

Regimen for Extended-cycle / continuous COC

A

84 days followed by 7 days placebo (no placebo at all for continuous)

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17
Q

Which method does not need backup contraceptive?

A

First Day Method

18
Q

When to avoid/stop COC to prevent breast cancer?

A

Avoid: Age > 40; Family history/ risk factors of breast CA
Stop: Current/ recent PMH of breast CA (within 5 years)

19
Q

Which substances could contribute to venous thromboembolism?

A

Estrogens & New generation progestins (esp Drosperinone, Cyproterone & Desogestrel)

20
Q

Alternative contraceptive methods to avoid VTE

A
  • Low dose estrogen with older progestins
  • Progestin-only contraceptive
  • Barrier methods
21
Q

What to do if one COC pill is missed < 48h?

A
  • Take the missed dose immediately and continue the rest as usual
  • This may mean 2 pills on the same day
22
Q

What to do if two or more consecutive COC dose missed (more than 48 hours)?

A
  • Take the missed dose immediate and discard the rest of the missed doses
  • Continue the rest as usual (may have 2 pills on the same day)
  • Backup contraceptive required for at least 1 week
23
Q

What to do If the COC pills were missed during last week of hormonal tablets (e.g. day 15-21)

A
  • Finish remaining active pills
  • SKIP hormone-free interval and start a new pack the next day
  • Backup contraceptive for at least 1 wk
23
Q

Contraindication with progestin only pill

A

current/ recent history of breast cancer

24
Q

What to do If late POP dose by > 3 hours?

A

back up for 2 days

25
Q

How to use transdermal contraceptives?

A

Applied once weekly for 3 weeks followed by 1 patch-free week

26
Q

How long is vaginal ring used?

A

Used for 3 weeks then discarded

27
Q

Transdermal patch/ vaginal ring has the highest risk of ____ compared to other methods

A

VTE

28
Q

Regimen for progestin injections

A

IM injection every 12 weeks

29
Q

SE for progestin injection

A
  • Variable breakthrough bleeding esp the first 9 months
  • Weight gain
  • Short term bone loss
30
Q

Limit use of progestin injection to no more than ____

A

2 years

31
Q

Which IUD results in Heavier menses/bleeding ?

A

Copper IUD (compared to levonorgestrel)

32
Q

MOA of IUDs

A

inhibition of sperm migration, damage ovum, disrupt transport of fertilized ovum.

If with progestin -> endometrial suppression, thicken mucus

33
Q

3 categories of Long acting reversible contraception (LARC)

A
  • Hormone releasing implant (Subdermal Progestin Implants)
  • Levonorgestrel IUD (hormone releasing)
  • Copper IUD
34
Q

Proteinuria: 24h-urinary protein (UTP)

A

≥ 300 mg

35
Q

Proteinuria: Dipstick protein

A

≥ 2+

36
Q

Proteinuria: Urine protein: creatinine ratio (uPCR)

A

> 0.3 mg/dL

37
Q

Signs of end- organ damage

A
  • Platelet count < 100
  • Neurological complications
  • LFTs > 2X ULN
  • Doubling of SCr in absence of other renal disease
  • Pulmonary edema
38
Q

Treatment for HTN in pregnancy

A

Nifedipine ER/ labetalol

39
Q

Prevention of preeclampsia

A

Low dose aspirin (100mg or more daily)

40
Q

Who should take aspirin for prevention of preeclampsia? and When??

A

HTN on previous pregnancy, multifetal gestation, autoimmune diseases, DM, CKD, etc

To be started after 12 weeks, ideally before 16 weeks, and continued till delivery

41
Q

When does headache (For COC) usually occur?

A

During pill-free interval

3152 (18 decks)

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