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CP2 OBGYN > Sexual Health > Flashcards

Sexual Health Flashcards

1
Q

What percentage of 13-15 y/o become pregnant every year?

A

1%

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2
Q

Special considerations: contraception and people with IBD

A 
Decreased absorption of oral contraceptives
Hence use: patches
P only injection 
IUD
impalnts
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3
Q

What C/I contraceptive is there for people with IBS

A

Depo (due to incr risk osteoporosis)

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4
Q

How effective is breast feeding against ovulation?

A

98%

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5
Q

Why should you avoid the COCP until 6 weeks after giving birth?

A

Affects milk volume

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6
Q

What contraception are epileptics advised to use?

A

LARC
IUD
IUS

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7
Q

For how many years should a perimenopausal woman <50 use contraception after her LMP

A

2 years

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8
Q

For how many years should a perimenopausal woman >50 use contraception after her LMP

A

1 year

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9
Q

Mechanism of action COCP

A 
Inhibits ovulation (inhibits FSH)
Thickens endometrial mucus
Thins endometrium
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10
Q

Effectiveness COCP ‘perfect use’

A

99.7%

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11
Q

Effectiveness COCP typically in 1st year

A

92%

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12
Q

Positives COCP (4)

A

Regular bleed
Acne improvement
Risk ovarian + endometrial Ca halved
Improves dysmenorrhoea + menorrhagia + PCOS

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13
Q

What does COCP increase the risk of? (3)

A

VTE
Ischaemic stroke
Cervical cancer

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14
Q

Absolute contraindications COCP (6)

A 
Pregnancy 
Aa/vv thrombosis 
Liver disease 
Undiagnosed vaginal bleeding 
Hx O-dependent tumour 
Recent hydatidiform mole
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15
Q

Name of contraceptive patch

A

Evra patch

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16
Q

Name of contraceptive ring

A

NuvaRing

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17
Q

Who cannot use the patch?

A

If they weigh over 90kg

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18
Q

What is good about the NuvaRing?

A

Because it has low oestrogen levels, it can be considered by women

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19
Q

Mechanism of action POP

A 
Inhibits ovulation (inhibits FSH)
Thickens cervical mucus 
Thins endometrium
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20
Q

How do you take the POP?

A

Every day
No breaks
Must take within 3-hour window

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21
Q

Side effects POP

A

Variable bleeding pattern

Acne

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22
Q

Which POP have a similar efficacy to COCP?

A

Cerazette
Cerelle
Desorex

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23
Q

How often do you have the Depo?

A

Every 12 weeks (up to 13)

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24
Q

Depo failure rate?

A

0.2%

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25
Q

When can the Depo be initiated in relation to giving birth?

A

Anytime after delivery

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26
Q

What hormone does the Depo contain?

A

Progesterone

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27
Q

Where is the Depo injected? How is this different if the patient is very obese?

A

BUm

Deltoid if v obese

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28
Q

How long is the delayed return of fertility with the Depo?

A

12-18 months

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29
Q

Can women taking liver enzyme inducing drugs use the Depo?

30
Q

Side effects depo (6)

A 
Irregular bleeding 
Hormonal; spots, headache, mood changes, breast tenderness 
W gain 
Delay in return to fertility 
Reversible effect on bone density 
Can't be removed
31
Q

Medical name for the Implant

32
Q

How effective is the implant?

A

0.05% failure rate!!

= most effective

33
Q

When can the Implant be initiated in relation to giving birth?

A

Any time after delivery

34
Q

How long does the implant last for?

35
Q

What must a patient initiating the implant be counselled on?

A

Side effects

36
Q

Side effects implant?

A

Irregular bleeding
Hormonal side effects
MOOD SWINGS

37
Q

Procedural risks from the implant (3)

A

Scar
Bruising
Infection

38
Q

Can women taking liver enzyme inducing drugs use the Implant?

A

No - its effectiveness will be reduced

39
Q

How long does the IUS/Mirena last if <45?

40
Q

How long does the IUS/Mirena last if >45?

41
Q

Who is the Mirena first choice for?

A

Women with heavy/painful periods

42
Q

How are the progesterogenic side effects of the Mirena compared to other P-only methods of contraception?

43
Q

How long does the Jaydess coil last?

44
Q

Failure rate mirena coil

45
Q

When can the IUS be fitted in relation to giving birth?

A

Up to 48hrs

Or >4 weeks post delivery

46
Q

SE/RIsks of Minera

A

Irregular bleeding 3-6m
Dramatic effect on reducing menstrual cycle
Procedural risks - perf
Ectopic pregnancy

47
Q

What is the efficacy of IUD?

A

As good as sterilisation

48
Q

What is the risk with the IUD of the coil coming straight out again after insertion?

49
Q

How long can the IUD stay in for?

50
Q

What risks must you counsel the patient on before having an IUD?

A 
Perforation 
Infection 
Expulsion 
Ectopic 
Bleeding
51
Q

When can the IUD be fitted in relation to giving birth?

A

Up to 48hrs

Or >4weeks post delivery

52
Q

Side Effects IUD?

A

Regular bleeding patterns
Possible irregular bleeding up to 6 months
Periods heavier, longer + more painful

53
Q

What are the 2 methods of female sterilisation?

A

Falope rings

Filshie clips

54
Q

Lifetime failure female sterilisation

55
Q

What happens in male sterilisation?

A

Vas deferens is ligated via bilateral incisions to scrotum under LA

56
Q

E.g.s of barrier methods of contraception?

A

Condom
Femidom
Diaphragm/cap

57
Q

Efficacy barrier methods?

58
Q

Which barrier method does not protect against STIs

59
Q

What 2 things does a diaphragm require?

A

To be fitted by a trained professional

Need spermicide

60
Q

2 conditions which diaphragms are not great for

A

Prolapse

Recurrent UTI

61
Q

Which is the most effective emergency contraception?

62
Q

Up to how many days can you get the coil for emergency contraception?

63
Q

Up to how many days can you use ulipristal acetate for ER contraception?

64
Q

Up to how many days can you use levonorgestrel for ER contraception?

65
Q

Ways of predicting fertile + infertile times of the menstrual cycle (4)

A

Menstrual calendar
Charting basal body T
Recognizing changes cervical mucus
Ovulation predictor kit

66
Q

+ves of rhythm methods of contraception (2)

A

No hormones/SE

Good for religious groups

67
Q

-es of rhythm methods of contraception

A

Relies on menstrual cycle regularity

68
Q

Progesterone related side effects in contraception (6)

A 
Vaginal dryness 
Sustained W gain 
Depression/mood changes 
Reduced libido 
Breast tenderness 
Acne/seborrhoea/hirsutism
69
Q

Oestrogen related side effects in contraception (6)

A 
Nausea 
Dizziness 
Cyclical W gain/bloating 
Vaginal discharge 
Some cases breast enlargement/pain 
Some cases lost libido
70
Q

What can be used to treat the bleeding SE associate with the implant?

CP2 OBGYN (21 decks)

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