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Reproductive System > Contraception, Infertility, genital infections and STI > Flashcards

Contraception, Infertility, genital infections and STI Flashcards

1
Q

what types of combined hormonal contraception exist?

A

pill
patch
ring

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2
Q

what types of progesterone only contraception exist?

A

mini-pill
implant
injection

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3
Q

what intrauterine contraception devices are there?

A

copper coil

hormonal coil

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4
Q

name some side effects of combined hormonal contraception

A
  • headaches
  • nausea
  • breast tenderness
  • mood swings
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5
Q

what does combined hormonal contraception put women at more risk of?

A
  • venous and arterial thrombosis
  • liver/gallbladder damage if underlying disease
  • slightly higher risk of certain cancers (cervical, breast)
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6
Q

what is the mechanism of action of combined hormonal contraception?

A

maintain low levels of hormone causing a negative feedback to pituitary/hypothalamus
no ovulation as result

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7
Q

name a few benefits of the combined pill

A
  • reduces heavy bleeding
  • hormonal control (acne, hirsutism)
  • reduces certain cancers (ovarian, endometrial, colon)
  • reduces RA, osteoporosis
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8
Q

name some side effects of progestogen only contraception methods

A
  • increased appetite
  • weight gain
  • headache
  • acne
  • mood changes
  • bloatedness
  • hair changes
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9
Q

what is the mechanism of action of progestogen contraception?

A

reduces ovulation

thickens cervical mucus

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10
Q

what are the two types of intrauterine contraception devices?

A
  • copper (non hormonal) coil

- hormonal coil

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11
Q

how long after UPSI can the Levonorgestrel pill (Levonelle) be taken?

A

72 hours

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12
Q

how long after UPSI can the ulipristal pill (Ellaone)

A

120 hours

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13
Q

what is the incidence of pregnancy after taking emergency contraception measures?

A

0-2%

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14
Q

what is the most effective option for emergency contraception, and when can it be taken?

A

copper coil

  • 120 hrs after UPSI
  • by day 19 of 28 day cycle
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15
Q

how does the copper coil promote contraception?

A

copper is toxic to sperm
can stop fertilisation of egg
can stop implantation of egg

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16
Q

which type of progestogen only contraception has a direct causal side effects, and what are the side effects?

A

progestogen injection

  • weight gain
  • delayed return of fertility
  • reduced bone density
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17
Q

what is an important downside to choosing progestogen injections for contraception?

A

it can delay return of fertility for about 9 months

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18
Q

what is the window of gestation during which medical termination of pregnancy can be carried out?

A

week 5 to 24

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19
Q

what is the window of gestation during which surgical termination of pregnancy can be carried out?

A

week 5 to 12

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20
Q

how is medical termination of pregnancy carried out?

A
  • mifepristone (antiprogesterone) is given to stop its effect on endometrium
  • 36-48 hours later misoprostol (prostaglandin) is given to induce uterine contractions
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21
Q

how is surgical termination of pregnancy carried out?

A

misoprostol (prostaglandin) given to initiate uterine contractions, under local or general anaesthetic

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22
Q

what is the contraception option for males?

A

vasectomy

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23
Q

what are the sterilisation options for women?

A

sterilisation:

  • tube clipping
  • salpingectomy
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24
Q

how long after delivery, miscarriage or abortion can a woman get pregnant again?

A

21 days after delivery

5 days after miscarriage/abortion

25
Q

which type of contraception is progestogen only but doesn’t stop ovulation?

A

levonorgestrel (hormonal) coil

26
Q

levonorgestrel is used in which types of contraception?

A

hormonal coil and emergency contraception pill

27
Q

if a woman starts contraception at any given point of her cycle, when will she be covered?

A

after 7 days

28
Q

if a woman starts contracaeption within first few days of her cycle, when will she be covered?

A

immediately

29
Q

what is the legal document that describes the guidelines for termination of pregnancy?

A

1967 Abortion Act

30
Q

who is eligible for home abortion?

A

healthy women who are under 10 weeks gestation

31
Q

name a few possible symptoms that can present in genital infections

A
  • ulcers
  • rashes
  • discharge
  • pain
  • lumps
  • dysuria
  • itch
32
Q

if symptomatic, what is vulvovaginal candidosis called?

A

thrush

33
Q

what are typical symptoms of vulvovaginal candidosis?

A

thick “cottage cheese” discharge

itch

34
Q

what causes vulvovaginal candidosis?

A

candida albicans

35
Q

what investigations are done to diagnose vulvovaginal candidosis?

A

microscopy and culture

36
Q

how is vulvovaginal candidosis treated?

A

antifungals (azoles):

clotrimazole or fluconazole

37
Q

what kind of discharge is seen in bacterial vaginosis?

A

thin, grey/white discharge

38
Q

how is bacterial vaginosis treated?

A

metronidazole

clindamycin

39
Q

how is ovulation assessment carried out in an infertility clinic?

A

serum progesterone measured halfway through luteal phase of cycle

40
Q

if ovulation assessment needs to be carried out for a woman with irregular periods, what test is carried out instead of serum progesterone?

A
  • serum gonadotrophins (FSH and LH)
  • prolactin
  • testosterone
  • TSH
41
Q

what type of imaging is carried out in an infertility clinic to assess for fallopian tube occlusion?

A

HyCoSy - hysterosalpingo contrast sonography

42
Q

what investigations are carried out in women who have been referred to the infertility clinic?

A
  • abdominal/pelvic exam
  • rubella immunity
  • STI (chlamidia) screen
  • ovulation assessment
43
Q

what investigations are carried out in men who have been referred to the infertility clinic?

A
  • abdominal/inguinal/genital exam

- semen testing

44
Q

if a couple presents to the GP because they are struggling to conceive, how long should they keep trying until they are referred to the infertility clinic?

A

one year, unless there are signs that point to infertility

45
Q

what are the three groups of ovulatory disorders?

A

Group 1: hypothalamic-pituitary dysfunction
Group 2: hypothalamic-pituitary-ovarian dysfunction
Group 3: primary ovarian insufficiency

46
Q

how are women with Group 1 ovulatory disorder managed?

A
  • advice on BMI, intense exercise, stress reduction

- gonadotrophins/gonadotrophin releasing hormone agonist

47
Q

what group of ovulatory disorders does PCOS belong to?

A

Group 2

48
Q

what group of ovulatory disorders does primary ovarian insufficiency belong to?

A

Group 3

49
Q

what medications are used to help induce ovulation in women with ovulatory disorders?

A
  • clomifene
  • gonadotrophins
  • gonadotrophin-releasing hormone
50
Q

what is the drug clomifene used for, and what is its mechanism of action?

A

it’s used to induce ovulation, by blocking oestrogen receptors in the pituitary and promoting FSH and LH release

51
Q

when are gonadotrophins given to a woman with an ovulatory disorder?

A

when clomifene has not resulted in ovulation/pregnancy

52
Q

what is the main disadvantage of using gonadotrophins in ovulatory disorders?

A
  • high risk of multifollicular recruitment

- increased risk of ovarian hyperstimulation syndrome

53
Q

what genetic condition can result in azoospermia, infertility and small testicles?

A

Klinefelter’s syndrome

54
Q

what investigations are done to identify the cause of azoospermia in a man?

A
  • FSH/LH/testosterone/prolactin
  • karyotype for Klinefelter’s syndrome
  • CF screen
55
Q

how long should women with unexplained infertility keep trying to conceive before they can receive fertility treatment?

A

2 years

56
Q

can women with unexplained infertility get clomifene to help them ovulate?

A

no

57
Q

what is a tubal cause of infertility in women?

A

hydrosalpinx

58
Q

what is the difference between IVF and ICSI?

A

in IVF egg and sperm fertilise on their own

in ICSI one sperm is injected directly into the egg with a needle

59
Q

what is the difference between Gillick competence and Fraser guideline?

A

Gillick competence is used to assess the capacity of a person under 16 years of age regarding any medical decision
Fraser guideline is specific for girls under 16 who seek contraception

Reproductive System (7 decks)

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