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GU I > Contraception > Flashcards

Contraception Flashcards

1
Q

what contraceptives protect against endometrial cancer?

A

CHC, depot, non medicated IUCs

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2
Q

what contraceptives protect against ovarian cancer?

A

CHC

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3
Q

how soon after a hysteroscopic tubal sterilization or vasectomy do you need to check for completion?

A

3 mo

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4
Q

what are the potential side effects of a diaphragm?

A

UTIs, vaginal irritation, recurrent yeast infections

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5
Q

when should you not prescribe COCs in women >35?

A

if they smoke

this increases their risk for cardiovascular risk

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6
Q

what tests do you need before prescribing COCs?

A

blood pressure

pregnancy

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7
Q

what test do you need before prescribing a diaphragm or cervical cap?

A

bimanual exam

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8
Q

when should you not prescribe COCs to a woman > 35?

A

if they smoke,
will increase cardiovascular risk
if they have a migraine w/ aura
will inc. risk of stroke

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9
Q

what is the main mechanism of COCs?

A

inhibit ovulation

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10
Q

what does the estrogen component of a COC do?

A

suppresses FSH release, stabilizes endometrium

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11
Q

what does the progesterone component of a COC do?

A

increases mucus thickness and keeps implantation from happening

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12
Q

is levonorgestrel prescribed for emergency contraception

A

yes

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13
Q

what is the initial recommended estrogen treatment?

A

low dose,

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14
Q

what can higher doses of estrogen cause?

A

inc. risk of DVT/PE and stroke

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15
Q

what can a lower dose estrogen cause?

A

spotting or breakthrough bleeding

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16
Q

which generation of progesterone has a higher rate of DVT? what is the name?

A

3rd gen

Norgestimate

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17
Q

what are extended cycle COCs good for? what commonly happens with them

A

endometriosis, PMDD, lifestyle reasons

breakthrough bleeding

18
Q

side effects of COCs

A

breakthrough bleeding, N, wt gain, mood swings, breast tenderness, headaches, acne, facial hair growth

19
Q

what COC health risks are increased with smoking?

A

VTE, stroke, MI

20
Q

what are the health risks with COCs?

A

VTE, stroke, MI, inc. triglycerides, cervical neoplasias

21
Q

what doubles the risk of cervical neoplasia?

A

> 5 years on COCs

22
Q

who is at increased risk of stroke on COCs?

A

women with migraines + aura

23
Q

what should obese women be prescribed?

A

progestin only, IUDs, barriers, sterilization

24
Q

what class of drugs can lower the contraceptive blood levels if taken at the same time?

A

antiepileptics

use DMPA or IUD

25
Q

what antibiotic causes dec. COC hormone levels?

A

rifampin

26
Q

what can you safely prescribe for systemic lupus erythematous patients?

A

progestin only options

especially if they have vascular/renal dz, anitphospholipid ABs

27
Q

what is the MOA of progestin only contraceptives?

A

suppress ovulation
thicken cervical mucus
alter tubal motility
altering endometrium

28
Q

what contraception can breast feeding mother use?

A

progestin only or IUDs

29
Q

contraindications for progesterone only?

A

pregnancy, carcinoma of the breast/genitals, undiagnosed vaginal bleeding
sever hepatic dysfunction

30
Q

when should you use progesterone only

A

migraines, >35 w/ smoking and obesity, hx of DVT, cardiac dz, cerebrovascular dz, HTN, systemic lupus, hypertriglyceridemia

31
Q

why must you adhere to the strict criteria of progesterone only?

A

does not effectively suppress ovulation, so if not adhered to properly can dec the efficacy

32
Q

what are the side effects of progesterone only

A

spotting, ovarian cysts, breast tenderness, irregular bleeding

33
Q

what are the side effects of depo?

A

menometrorrhagia, wt gain, bone loss

34
Q

what does the black box warning for depo say?

A

inc. risk of bone loss

do not use depo for more than 2 years

35
Q

what are the side effects of the ring?

A

vaginitis, leukorrhea, spotting, HA, nausea

36
Q

when is the patch less effective?

A

in obese women

37
Q

what is the biggest risk with the patch?

A

2 fold inc. in DVTs

38
Q

what are the 4 options for emergency contraception?

A

progestin only (plan B)
ulipristal
copper IUD
estrogen and progestin (higher doses)

39
Q

what is the moa of ulipristal? and who is it good for?

A

bind to progesterone receptors so inhibits ovulation and alters endometrium
good for obese patients

40
Q

what are the adverse effects of IUDs

A

perforation, expulsion, infections

41
Q

what is the contraindication of a copper IUC?

A

wilsons dz, copper allergy

42
Q

what do you have an inc. risk of with IUDs?

A

ectopic pregnancy

GU I (8 decks)

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