Health Maintenance and Contraception Flashcards
When is MRI of breast recommended?
Women who have >20% lifetime risk of developing breast cancer
What are the most effective contraceptives?
Depot
Sterilization
Long-acting reversible contraception (LARC) - etonogestrel implant or IUD
What glucose tolerance test amount is used for diagnosis of diabetes?
75-g 2h GTT
What contraception can lead to heavier menstrual flow?
Copper IUD
What contraception can cause severe nausea?
Combined OCPs
What contraception is contraindicated in depression?
Medroxyprogesterone acetate
What contraceptives will decrease risk of ovarian and endometrial cancer? What else do they decrease risk of?
OCPs - lower dose pills also do not raise breast cancer risk
Decrease risk of:
PID
Endometriosis
Ectopic pregnancy
Benign breast changes
Dermal contraceptive patch is disadvantageous in what regards?
Failure rate higher in those who weigh >198 lbs
Higher risk for thromboembolism compared to oral contraceptives
What IUD can be used for emergency contraception up to 5d?
Copper IUD
What contraception is usually preferred for transmen?
Levonorgestrel IUD
Copper IUD, depot, and combined OCPs can cause excessive or cyclic bleeding
Emergency contraception timeframe: 0-120 hr vs 0-72 hr and efficacy
0-120 hr: Copper IUD (>99%), Progestin IUD (>99%), Ulipristal (98-99%)
0-72 hr: Oral levonorgestrel (92-98%), oral contraceptives (combined estrogen/progestin OCP containing levonorgestrel or norgestrel; 75-89%)
Copper IUD contraindications vs Progestin IUD
Wilson disease vs breast cancer
Both carry risk of:
Active pelvic infection
Severe uterine cavity distortion
How do levonorgestrel and ulipristal primarily prevent pregnancy as emergency contraception?
Delaying ovulation
How does medroxyprogesterone act as a contraceptive (not used as emergency contraception)?
Inhibit hypothalamic secretion of GnRH –> decreased FSH/LH –> inhibit ovarian follicle development
