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IM 6 Test 3 > Reproduction and Conception > Flashcards

Reproduction and Conception Flashcards

1
Q

when is differentiation of the external genitaliacomplete

A

12 weeks

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2
Q

where does spermatogenesis occur

A

epididymis

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3
Q

what do all glands in the male repro tract secrete and why

A

alkaline frutose colution

alkaline - urine is acidid

fructose - energy to swim

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4
Q

what does the hypothalamus secrete

A

GnRH

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5
Q

what does the anterior pituitary secrete

A

FSH and LH

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6
Q

when are males capable of reproduction

A

13.5 y/o

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7
Q

Tanner stages

A

measure of sexual maturation

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8
Q

what tanner stage signals male puberty

A

Stage III

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9
Q

when are women capable of reproduction

A

8-13 y/o

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10
Q

what tanner stage signals female puberty

A

III or IV

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11
Q

when does menarche occur

A

2-2.5 years after puberty

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12
Q

what is menarche

A

1st menstrual period

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13
Q

spinnkarkeit

A

elasticity of cervical mucus

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14
Q

mittelschmerz

A

ovulation pains

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15
Q

pregnancy after 50

A

uncommon

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16
Q

when does fertility begin to decline

A

35-40

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17
Q

most pregnancies over 35 y/o are

A

unintentional

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18
Q

how long should contraception continue after LMP

A

12 months

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19
Q

5 P’s of sexual health history

A 
Partners in last 12 months
Pregnancy status
Protection from STI's
Practices
Past Hx of STI's
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20
Q

consistency with contraception outweighs

A

absolute reliability

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21
Q

abstinence

A

refraining from sexual intercourse

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22
Q

abstinence pt Ed X3

A
  • saying no
  • yes to other sexual activities
  • requires self control
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23
Q

abstinence advantages

A

failure rate is 0%

effective if practiced perfectly

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24
Q

abstinence disadvantages

A

not common amongst peers

unrealistic

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25
Q

abstinence risks

A

none if abstinence is maintained

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26
Q

lactational amenorrhea

A

exclusive breastfeeding for 6 months - avoid ovulation and menses

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27
Q

lactational amenorrhea pt ed

A
  • effectiveness is enhanced by frequent feedings or use of barrier methods
  • disruption of breastfeeding or supplementing increases r/o pregnancy
  • alternate method once menses returns
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28
Q

lactational amenorrhea advantages

A

inexpensive

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29
Q

lactational amenorrhea disadvantages

A

failure rate high since 1st ovulation is unpredictable

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30
Q

lactational amenorrhea risks

A

unplanned pregnancy

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31
Q

coitus interruptus aka

A

withdrawal

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32
Q

withdrawal method

A

removal of the penis prior to ejaculation

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33
Q

withdrawl pted

A

preejaculate fluid may contain sperm and can leak prior to ejaculation

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34
Q

withdrawal advantages

A

choice for monogamous couple with religious conviction

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35
Q

withdrawal disadvantages

A

failure rate is 22%

no protection against STD’s

require self control on males part

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36
Q

withdrawal risks

A

unplanned pregnancy

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37
Q

fertility awareness

A

awareness of fertile cycle

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38
Q

fertile days

A

sperm is 4-5 days and ovum is 24-48 hours

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39
Q

fertility awarness advantages

A

works best with regular menstrual cycles

acceptable to religions who prohibit birth control

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40
Q

fertility awareness disadvantages

A

interfere with sexual spontaneity

poor choice for irregular cycle, breast feeding, perimenopause

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41
Q

family planning calendar

A

based on ovulation - occurs approx. 14 days prior to menses

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42
Q

when should you avoid intercourse with family planning

A

days 8-19

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43
Q

calendar method advantages

A

inexpensive

no drug or hormones

combined with barrier method to improve effectiveness

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44
Q

calendar method disadvantages

A

failure rate 24%

no protection against STI’s

unpredictable menstrual cycles/ovulation

compliance with abstinence during fertile period

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45
Q

calendar method risks

A

unplanned pregnancy

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46
Q

symptothermal method

A

assessment of BBT, cervical mucus and other symptoms near ovulation

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47
Q

symptothermal method pt ed

A

measure BBT same time each morning prior to getting out of bed

BBT decreases before ovulation and increases after ovulation

avoid intercourse until 3rd night after increased BBT

BBT will then decrease 2-4 days before menses or remain increased if pregnant

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48
Q

BBT advantages

A

inexpensive

accepted by most religions

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49
Q

BBT disadvantages

A

failure rate 24%

stress, fatigue, illness, or environmental temp can affect

no protection against STI’s

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50
Q

BBT risks

A

unplanned pregnancy

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51
Q

cervical mucus method

A

cervical mucus becomes thin, flexible and stretches between fingers at ovulatoin

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52
Q

cervical mucus pt ed

A

good hand hygiene

obtain mucus from vaginal introitus

examine for consistency start on last day of cycle

observing for thinning characteristic

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53
Q

cervical mucus advantages

A

women become knowledgable regarding mucus

self-evaluation diagnostically helpful in recognizing ovulation

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54
Q

cervical mucus disadvantages

A

failure rate - 24%

uncomfortable touching her own genitals and mcus

no protection against STI’s

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55
Q

cervical mucus risks

A

inaccurate if mixed with blood, semen, contraceptive foam or discharge

unplanned pregnancy

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56
Q

spermicides

A

chemical gel, foam, cream or suppository inserted deep into vagina 15 minutes prior to intercourse to destroy sperm

57
Q

spermicide pt ed

A

inserted into vagina prior to intercourse

must be reapplied for multiple acts

58
Q

spermicide advantages

A

inexpensive, readily available and easy to use

59
Q

spermicide disadvantages

A

failure rate 28%

irritation, allergic reaction

must be reapplied for multiple acts

no protection for STI’s

60
Q

spermicide risks

A

unplanned pregnancy

61
Q

male condom

A

thin rubber sheath worn over the penis during intercourse

62
Q

male condom pt ed

A

roll condom onto erect penis, leaving empty space in tip

used with spermicide increases effectiveness

following ejaculation - remove erect penis

heat accelerates deterioration - avoid storage in hot place

use water-soluble jelly, petroleum canc ause deterioration

63
Q

male condom advantages

A

protects against STI’s

involves male birth control

inexpensive and readily available

64
Q

male condom disadvantages

A

failure rate 18%

reduces spontaneity and non-compliance

one time use do not reuse

65
Q

male condom risks

A

allergic reaction, Ci if latex allergy

rupture or leak resulting in unwanted pregnancy

66
Q

female condom

A

synthetic rubber sheath inserted into the vagina prior to intercourse which prevents sperms from entering the uterus

67
Q

female condom pt ed

A

insert closed end of condom into vagina

push towards the back of the vagina

make sure the inner ring fits over cervix

open outer ring covers labia

following intercourse - twist outer ring, remove and discard

68
Q

female condom advantages

A

non-latex, protects against STI’s

79% effective

no rx is needed

69
Q

female condom disadvantages

A

failure rate 21%

reduces spontaneity & non-compliance

more expensive than male condom

noisy during sex

on time use

70
Q

female condom risks

A

allergic reaction

71
Q

sponge

A

pillow soft, cup shaped, absorbent sponge which fits over the cervix containing spemicide

72
Q

sponge pt ed

A

one size fit all

remain in place for 6 hours

73
Q

insertion for sponge

A

empty bladder

hand hygiene

moistened with water prior to inserting vaginally

74
Q

sponge advantages

A

available of the counter

one time use but may be used for multiple acts within 24 hours

75
Q

sponge disadvantages

A

difficult to insert and remove

does not protect against STI’s

76
Q

sponge risks

A

failure rate 12% no prior birth and 24% prior birth

irritation and allergic reaction

absorbs vaginal secretions - vaginal dryness

TSS

77
Q

diaphragm

A

dome shaped latex or silicone cup which fits over the cervix

78
Q

cervical cap

A

soft cup which fits over cervix to prevent sperm from entering

79
Q

diaphragm and cap pt ed

A

requires fitting and refitting every 2 years, after childbirth or a +/- 20% weight

requires proper insertion

remains in place for 6 hours after intercourse

clean with soap and water after removal

TSS

80
Q

how do you insert diaphragms and caps

A

empty bladder

erform hand hygiene

apply spermicide and insert into vagina

81
Q

diaphragm and cap advantages

A

can remain in place for multiple acts

82
Q

diapragm and cap disadvantages

A

requires fitting and rx

inconvenient and inhibits spontaneity

spermicidal cream must be applied and reapplied

difficult to insert and remove

does not protect against STI’s

83
Q

diaphragm and cap risks

A

failure rate of 12%

irritation, latex allergic reactions

cap can be associated with cervical changes

TSS

84
Q

BC pill

A

estrogen, progestin combo - suppresses ovulation and thickens cervical mucus

progestin only - less effective - causes thickened cervical mucus

85
Q

other uses for the pill

A

regulate menstrual cycles

reducing dysmenorrhea, blood loss for excessive menstrual cycles and anemia

86
Q

when does fertility return after BC pill cessation

A

3 months but use an alternate method still

87
Q

BC pill advantages

A

improves:

  • acne
  • benign breast disease
  • endometriosis
  • fibroid bleeding
  • premenstrual symptoms
  • hirsutism
88
Q

BC Pill disadvantages

A

SE:

  • breakthrough bleeding
  • breast tenderness
  • excessive cervical mucus
  • N/V
  • HA
  • HTN
89
Q

BC pill risks

A

3% failure
no STI protection
alter blood sugar levels

90
Q

what doe BC pills increase the incidence of X3

A

thromboembolic disease
HTN and strokes
migraines

91
Q

what do BC pills interact with

A

decrease effectiveness of abx
avoid hepatotoxic meds
interfere with bromocriptine mesylate and anticoagulants
increase toxicity of tricyclic antidepressants

92
Q

BC pill pt ed

A

consistent and proper use to be effective

93
Q

what to do if you miss 1 BC pill

A

take asap

94
Q

what to do if you miss 2-3 BC pills

A

back up method must be used

95
Q

postpartum and lactation risks with BC pills

A

increased risk for DVT and decreased milk production

96
Q

how does the mini pill stop pregnancy

A

thickens cervical mucus preventing sperm penetration

alters uterine lining preventing implantation

97
Q

mini pill admin

A

same time daily

if taken 3 hours late must use back up method

98
Q

mini pill and post partum/lactation

A

better choice for breast feeding women

99
Q

transdermal contraceptive patch

A

releases continuous small amounts of estrogen and progestin to suppress ovulation and thicken cervical mucus

100
Q

transdermal patch pt ed

A

requires Rx

apply patch to buttocks, abdomen, upper arm same day of week for 3 weeks

use alternate birth control fo 1st week

remove patch for 4th week

101
Q

transdermal patch advantages

A

apply weekly as effective as oral contraceptives

102
Q

transdermal patch disadvantages

A

skin irritation

103
Q

transdermal patch risks

A

failure 9%

less effective for larger women

104
Q

nuvaring

A

soft flexible vinyl ring which releases small amounts of estrogen and progestin continuously to prevent ovulation

105
Q

nuvaring pted

A

rq rx

must be refrigerated

1st insertion use back-up method unless placed 1st 5 day of menses

48 hrs w/o ring in 1st 2 weeks rq back up method for 7 days

106
Q

nuvaring advantages

A

fitting not required

can remove for 3 hours wihtout loss of effectiveness

107
Q

nuvaring disadvantages

A

failure 9%

can remove for 3 hours without loss of effectiveness

108
Q

nuvaring risk

A

expulsion resulting in unplanned pregnancy

109
Q

IUD’s

A

chemical/hormonal active device which is inserted into uterus, damages sperm and prevents fertilization

110
Q

IUD pt ed

A

inserted by provider in office

check for string monthly to confirm placement

111
Q

potential SE of IUD

A

menorrhagia

PID

ectopic pregnancy or spontaneous abortions

perforation of uterus

112
Q

CI of IUD

A

diabetes

anemia

abnormal pap

hx of pelvic infections

113
Q

IUD advantages

A

stays in place all the time

effective for 5-10 years

safe for breastfeeding mothers

decreases dysmenorrhea and menstrual blood loss

copper IUD - emergency contraceptoin if placed w/n 5 days of intercourse

114
Q

IUD disadvantages

A

1% failure

no protection against STI’s

increased cramping and bleeding in 1st few cycles which resolves

115
Q

implant

A

a sustained release progestin only filled rod which is placed in upper inner arm and under a local anesthetic

116
Q

implant pt ed

A

requires a minor surgical office procedure

must use alternate birth control for 7 days

increased risk of ectopic pregnancy

117
Q

implant advantages

A

long acting (3 yr) contraception

fertility returns immediately

lactating - once breastfeeding is established for 4 weeks

118
Q

implant disadvantages

A

1% failure

no STI protection

same SE as BC pill

removal required

119
Q

depo shot

A

intramuscular hormone injeciton of progestin which prevents pregnancy for 15 weeks, repeat injection should be given every 13 weeks

120
Q

dep pt ed

A

1st dose given during 1st 5 days of menstrual cycle

keep follow up appointments

decreased bone density

calcium and vit D for bone health

may take up to 1 yr after stopping to become pregnanct

121
Q

CI in depo

A

hx of breast Ca, stroke, blood clots, liver disease

122
Q

depo advantages

A

long term BC

does not impair lactation once breast feeding is established

decrease bleeding or absence of period

123
Q

depo disadvantages

A

4% failure

no STI protection

amneorrhea, spotting, irregular bleeding

nervousness, dizziness, GI disturbances, HA, fatigue, weight gain

124
Q

morning after pill

A

prevent pregnancy after unprotected intercourse

125
Q

plan b and next choice

A

progestin levonorgestrel or progestin only

inhibits ovulation, thickens mucus and interferes with corpus luteum function

126
Q

ella

A

ulipristal acetate

delays surge of LH, ovulation and implantation

requires pregnancy test as it can disrupt an early pregnancy

127
Q

emergency pill pt ed

A

taken within 72 hours of unprotected sex

not to be used as regular birth control

128
Q

emergency pill advantages

A

reduces risk of pregnancy for one time unprotected sex

OTC

129
Q

emergency pill disadvantages

A

failure depends on time taken after unprotected sex

no protection against STI’s

does not provide long term contraception

N/V/HA/fatigue

abdominal pain or cramping

possible pregnancy if cycle does not occur within 21 days

130
Q

tubal ligation

A

fallopian tubes are surgically cute, tied, burned and or blocked

131
Q

tubal ligation advantages

A

permanent contraception

sexual function is unaffected

132
Q

tubal ligation disadvantages

A

failure - 1%

no protection against STI’s

surgical procedure which requires anesthesia

should be considered irreversible if future pregnancies are desired

133
Q

tubal ligation risks

A

surgical complications

risk for ectopic pregnancies

134
Q

vasectomy

A

vas deferens is surgically severed and ligated

135
Q

vasectomy pt ed

A

surgical office procedure

alt. contraception until 2 negative sperm counts

scrotal support

limit activity for a couple of days

136
Q

vasectomy advantages

A

permanent contraception - difficult to reverse

short, safe, simple office procedure requiring local anesthesia only

sexual function is not impaired

137
Q

vasectomy disadvantages

A

failure - 1%

discomfort for 2-3 days

considered irreversible

alternate contraception until 2 negative sperm counts

138
Q

vasectomy risks

A

bleeding, infection and anesthesia reactions

IM 6 Test 3 (4 decks)

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