Women's health Flashcards
What should a patient do if they vomit within two hours of taking their OCP?
Take another one as soon as possible
What are the missed pill rules for week 1?
Use emergency contraception if UPSI in pill free interval for one week
What are the missed pill rules for week 2?
No need for emergency contraception
What are the missed pill rules for week 3?
Take the last pill that was missed, finish the current pack and start the next pack immediately after.
How long does the progesterone only pill take to become effective?
48 hours
How long does the COCP take to become effective?
Seven days
What is the preffered option in women and girls with PCOS for contraception?
COCP
Which emergency contraceptive option should be adjusted as per the patients weight?
Levonelle
When should a double dose of levonelle be taken?
When the patient weights over 70kg or BMI>26
How long after UPSI can levonelle be taken?
Within 3 days
What is the least effective method of emergency contraception?
Levonelle
How long after taking levonelle should regular contraception be resumed?
12 hours
After what time period is a Norethisterone pill considered missed?
3 hours , after this time condoms should be used for SI for next two days
After what time period is a Desogesterel pill considered missed?
12 hours
Up to what time period can Ella One (Ulipristal acetate) be used as emergency contraception?
5 days
In what conditions is Ellaone (ulipristal acetate) contraindicated?
Liver disease
Asthma
Must not breast feed for a week after taking
Side effects of EllaOne (ulipristal acetate)?
Painful periods, mood swings, back pain
How long after taking EllaOne (ulipristal acetate) is vomitting ‘safe’?
3 hours
How long does the contraceptive implant last?
3 years, but can be taken out sooner and fertility will return quickly following removal
Side effects of contraceptive implant?
Irregular periods Absent periods Longer periods Acne (or worsening of) Tenderness, bruising, swelling at site of implantation
What is the contraceptive method of choice for girls under 16?
Implant
Important adverse affect of depo-provera injection?
Delayed return to fertility (aprox one year)
How does the IUD affect periods?
Heavier, longer
What is the only acceptable form of contraception for a woman with known breast cancer?
Copper IUD
What is the most effective emergency contraception method?
IUD
How long can an IUD stay in?
Up to 10 years
Once removed fertility returns to normal
Contraindications for IUD?
Current pelvic infection or distorted uterus
Repeated history of STI
Unexplained bleeding
Abnormal cervix
How long after post-partum is an IUD reccommended from?
28 days
When can an IUD be used as emergency contraception?
Up to 120 hours after the first episode of UPSI or after the earliest expected date of ovulation
Why can ellaOne not be used in asthma?
Antiglucocorticoid effect
Over what age can women who smoke >15 a day no longer take the COCP?
35 years old
What are the absolute contraindications to the combined oral contraceptive pill (UKMEC 4)?
Known or suspected pregnancy
Smoker over the age of 35 >15 ciggarettes/day
Obesity
Breast feeding <6 weeks post partum
Active breast cancer or cancer within the last few years
BRACA genes
When do the disadvantages of the COCP outweigh the advantages (but not an absolute contraindication) (UKMEC 3)?
Breast feeding > 6 weeks post partum Previous arterial or venous clots Continued use after HD or stroke Migraines with aura Active disease of liver or gallbladder
When do the advantages of the COCP outweigh the disadvantages (UMEC 2)?
Initiation after current or past history of MI or stroke
Multiple risk factors for arterial CVD
How do you calculate the earliest date of ovulation?
Length of cycle-14 days
What is the association of COCP with cancer?
Increased risk of breast cancer and cervical cancer
Reduced risk of endometrial and ovarian cancer
Which intra utirine method of contraception makes periods lighter?
IUS (mirena coiil)
How long does the IUS work?
5 years
Once removed fertility returns to normal
What is the only suitable contraceptive method for a woman post-partum who is breastfeeding?
POP
When should the COCP be stopped in relation to surgery?
4 weeks before until 2 weeks after
When, postpartum, can an IUD be instered?
48 hours within giving birth of from 4 weeks post-partum
What with LH, FSH, and oestorgen levels be in a patient with ovarian failure?
LH raised
FSH raised
A low serum oestrogen
In those <40 years with suggestive features of menopause how should their hormones be investigated?
2 FSH levels taken 4-6 weeks apart
Common symptoms are experience in menopause?
Vasomotor (flushing)
Urogenital (urinary incontinence, atrophic vaginitis)
Psychological
Average age of menopause?
47.5 years
What is the most common cause of post-coital bleeding in pre-menopausal women?
Cervical ectropian
What are uterine fibroids
the most common benign tumour of the uterus. Sometimes called leiomyomata, these growths are primarily composed of smooth muscle and fibrous connective tissue. While many uterine fibroids are asymptomatic, they can also present with menorrhagia, fatigue, infertility, and a sense of abdominal bloating. Patients of a black ethnicity are also at a significantly higher risk of developing uterine fibroids, the reason for this is not yet fully understood.
When can oestrogen only HRT be used?
In patients who have had a hysterectomy
Symptoms of PCOS?
irregular periods or no periods at all
difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
weight gain
thinning hair and hair loss from the head
oily skin or acne
PCOS is also associated with an increased risk of developing health problems in later
life, such as type 2 diabetes and high cholesterol levels.
When will PCOS usually present by?
Early 20s
What is the EVRA patch?
Oestrogen plus progesterone contraceptive
Breast cancer screening in the UK?
50-70
Mammogram every 3 years
Common tumour markers and the cancers they are associated with?
AFP liver, testicular CEA colorectal PSA prostate Ca125 Ovarian CA 15-3 breast cancer HcG ovarian and testicular Ca 19-9 Pancreatic cancer, cholangiocarcinoma
