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Clin Med II - Exam 5 > Schoenwald - Contraceptive Counseling > Flashcards

Schoenwald - Contraceptive Counseling Flashcards

1
Q

__% of unintended pregnancies occur in women who do not use a method of contraception

and __% of unintended pregnancies occur in women who are on birth control

A

40

60

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2
Q

what test should you perform and document before starting a patient on birth control

A

pregnancy

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3
Q

coitus interruptus, postcoital douche, lactational amenorrhea, periodic abstinence

A

folk methods of contraception

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4
Q

condoms, diaphragm, cervical cap, vagina sponge, spermicides

A

barrier methods of contraception

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5
Q

OCP, patches, ring, injectable

A

hormonal methods of contraception

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6
Q

LARC

A

long acting reversible contraception → IUDs/implantable progestin

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7
Q

tubal ligation or vasectomy

A

sterilization

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8
Q

2 most effective forms of contraception

A

LARCs

sterilization

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9
Q

least effective forms of contraception

A

withdrawal

spermicides

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10
Q

absolute contraindications for OCP/estrogen-containing contraceptives

A

DVT

PE

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11
Q

what form of contraception can increase risk for BV/infxn

A

douching → disrupts normal vaginal flora

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12
Q

is lactational amenorrhea an effective method of contraception for breastfeeding women

A

yes →

BUT

only for first 6 months and breastfeeding must be only form of nutrition

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13
Q

3 methods of periodic abstinence contraception

A

calendar

temperature

cervical mucus (Billings)

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14
Q

major pro of male condoms

A

protect against STI → esp HIV

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15
Q

can you use female condoms w. male condoms

A

no

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16
Q

cons of vaginal diaphragm

A

must be fitted by healthcare provider

need prescription

minimal-no protection against STI

vaginal irritation → increased risk for infxn/STI

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17
Q

major con of spermicides

A

may increase risk of STI

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18
Q

mc used method of oral hormonal contraceptives

A

combined OCP → both estrogen and progestin

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19
Q

what has changed regarding oral hormonal contraceptives over the years

A

reduced estrogen and progestin

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20
Q

recommendation for timing of OCP

A

start first sunday after menses

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21
Q

education for patient using OCP w. abx

A

need back up method of contraception

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22
Q

how do abx reduce efficacy of OCP

A

diminishing gram negative bacteria reduce amt of OCP that gets absorbed

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23
Q

OCP alter the release of

A

LH and FSH from pituitary

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24
Q

common s.e of OCPs

A

nausea

breast tenderness

intermenstrual bleeding

HA

weight gain

HTN

cholelithiasis

benign liver tumors

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25
Q

do OCPs pose a high risk for complications

A

lower dose estrogen pills are safe for most women

26
Q

contraindications for OCPs (6)

A

pregnancy

undiagnosed vaginal bleeding

prior hx VTE, MI. stroke

cigarettes + > 35 yo

current or hx breast ca

active liver dz

27
Q

the patch is applied

A

weekly x 3 weeks

followed by placebo

28
Q

3 brand names for the patch

A

ortho evra

xulane

29
Q

the ring is inserted

A

every 3 weeks

then left out for one week

30
Q

s.e associated w. the ring

A

discomfort

leukorrhea → discharge

vaginitis

foreign body sensation

problems w. intercourse

31
Q

the mini pill contains only

A

progestin → norethindrone 0.35 mg

32
Q

does the mini pill suppress ovulation

A

no

33
Q

pt education for mini pill

A

MUST be taken at the same time every day!!

34
Q

DMPA

A

medroxyprogesterone acetate → DEPO

35
Q

DEPO is administered via

A

injection into gluteus or deltoid

36
Q

con of DEPO

A

10 months to be able to conceive after discontinuing

37
Q

significant s.e of DEPO

A

reduction in bone mineral density during use

not linked to increase in fx risk

38
Q

3 types of emergency contraception

A

Plan B

ellaOne

copper IUD

39
Q

Plan B doesn’t work well for what pt population

A

BMI > 26

40
Q

ellaOne doesn’t work well for what pt population

A

BMI > 35

41
Q

Levonorgestrel - single dose w.in 72 hr

A

Plan B

42
Q

Ulipristal 30 mg x 1 dose

A

Ella

43
Q

w. Plan B you should resume OCPs

A

asap

44
Q

w. ella you should resume OCPs

A

after 5 days

45
Q

which type of IUD can be used for emergency contraception

A

copper

46
Q

3 types of LARC

A

levonorgestrel IUD

copper IUD

etonogestrel (Nexplanon)

47
Q

2 types of IUD

A

copper

levonorgestrel

48
Q

which IUD is non hormonal

A

copper

49
Q

s.e of copper IUD

A

cramping

abnormal bleeding

50
Q

4 types of levonorgestrel IUD

A

mirena

liletta

skyla

kyleena

51
Q

complications of IUD

A

ectopic pregnancy

spontaneous abortion

expulsion

uterine perforation

infxn

irregular bleeding

52
Q

f.u for IUD pt’s

A

4-6 weeks after implantation

yearly after

pt needs to check for strings

53
Q

management of missing strings

A
  1. back up birth control
  2. pregnancy test
  3. transvaginal US
  4. refer to gyn for removal
54
Q

etonogesterel - nexplanon

A

implant similar to action of Depo

55
Q

who can insert/remove nexplanon

A

only certified providers

56
Q

4 types of sterilization

A

tubal ligation

essure

vasectomy

hysterectomy

57
Q

implant into fallopian tubes that encourages scar build up

A

essure

58
Q

what might be a good option for young patients

A

DEPO → less worried about 10 months to return to fertilization

59
Q

pt’s can return to fertility soon after d,c of conception w.

A

OCP

IUD

Nexplanon

60
Q

what method of contraception might be good for a pt. w. contraindications for estrogen (like PE/DVT)

A

mini pill → progestin only

61
Q

what 3 types of birth control contain progesterone only

A

mini pill → norethindrone

Depo

etonogestrel (Nexplanon)

Clin Med II - Exam 5 (23 decks)

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