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Special Pops Exam 1 > Contraception -> > Flashcards

Contraception -> Flashcards

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1
Q

Definition of contraception?

A

Deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse

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2
Q

What does PATH stand for (PATH questions)?

A

Pregnancy
Attitudes
Timing
How important is prevention
*shared decision making

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3
Q

When counseling on contraception options, what should be considered?

A

Hx and C/I’s, efficacy, ease of use, side effects, risks, benefits, STI protection, plans for future pregnancy, cost

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4
Q

Most effective birth control methods?

A

Sterilization, IUD, implant

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5
Q

Moderately effective birth control options?

A

Injections, pill, patch, ring, diaphragm

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6
Q

Less effective birth control options?

A

Condoms, withdrawal, sponge, fertility awareness-based, spermicides

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7
Q

Behavioral methods of contraception?

A

Abstinence, outercourse, coitus interruptus, post-coital douche, lactational amenorrhea, cervical mucus methods

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8
Q

What is outercourse?

A

Sexual activity with no vaginal penetration or no penetration at all

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9
Q

Examples of outercourse?

A

Kissing, masturbation, mutual touching

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10
Q

Can outercourse pass infections?

A

Yes

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11
Q

What is coitus interruptus?

A

Withdrawal of the penis before ejaculation

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12
Q

What is a post-coital douche?

A

Water or vinegar that is used to flush semen out of the vagina

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13
Q

Is post-coital douche effective/reliable?

A

No, sperm found in cervical mucus w/in 90 sec after ejaculation

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14
Q

What is lactational amenorrhea?

A

Breastfeeding that can postpone ovulation and menstruation

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15
Q

Recommendations for using lactational amenorrhea as contraception method?

A

-must be only source of infant nutrition
-feed at least q4 hrs/day and q6 hrs/night
-at most 6 mos after birth & stop when period returns

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16
Q

Pregnancy rates in the first 6 months of using lactational amenorrhea?

A

0.9-1.2%

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17
Q

What is the cervical mucus method?

A

Cervix produces mucus of different quality/quantity before & during ovulation: when mucus is tacky, cloudy, sticky, slippery –> unsafe days

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18
Q

Pregnancy rates with cervical mucus method?

A

Of 100 couples in 1 year –> 3 pregnancies

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19
Q

What are the fertility based awareness methods of contraception?

A

Tracking ovulation/cycle, standard days method/cycle beads, birth control app, symptothermal method

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20
Q

When are women most fertile?

A

In the days near ovulation

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21
Q

Guidelines for using standard days method?

A

Must have regular cycle, never shorter than 26 days/longer than 32 days, AVOID unprotected sex day 8-19

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22
Q

What do the colors of cycle beads indicate (standard days method)?

A

Brown beads = safe days
White = unsafe days
Red = first day of period
*move rubber ring every day

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23
Q

Pregnancy rates in couples using the standard days method?

A

Of 100 couples in 1 year –> 5 pregnancies

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24
Q

How does the birth control (natural cycles) app work?

A

Tracks basal body temp/menstrual cycle to detect fertile days

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25
How effective is period tracking using a website?
92%
26
Use efficacy of natural cycles app?
93%
27
How does the symptothermal method work?
Uses combo of calendar, temp, cervical mucus method to predict ovulation *increased accuracy
28
Available modalities to use the symptothermal method?
Commercially available fertility monitors (clearblue)
29
Barrier methods of contraceptive?
Condoms, vaginal sponge, cervical cap, diaphragm, spermicide,
30
How effective are condoms in preventing pregnancy?
85%
31
How effective are internal condoms at preventing pregnancy?
79%
32
What is a vaginal sponge?
Round, plastic foam with spermicide 2 in in diameter, covers cervix/kills sperm
33
Who are sponges/caps more effective in?
Women who have never give birth
34
Do sponges prevent STIs?
No
35
How effective are sponges at preventing pregnancy?
76-88%
36
How long after insertion should sponges be removed?
Within 30hrs d/t TSS
37
What is a cervical cap?
Silicone cup that covers cervix (used w/ spermicide
38
Do cervical caps protect against STIs?
No
39
How effective are cervical caps at preventing pregnancy?
71-86%
40
How long must cervical caps remain in place after sex?
6 hrs
41
Max time a cervical cap should be left in?
No longer than 48 hrs (TSS)
42
How long do cervical caps last?
2yrs (needs care)
43
Those using cervical caps need to be examined to determine what?
Size
44
Are cervical caps available OTC?
No, need rx
45
What is a diaphragm?
Shallow flexible dome shaped silicone cup that covers the cervix (must be used w/ spermicide)
46
Some diaphragm users may develop what?
Frequent UTIs
47
How long should a diaphragm be left in after sex?
6 hours
48
Max time a diaphragm should be left in?
No longer than 24 hrs
49
How long does a diaphragm last?
2 yrs (needs care)
50
Requirements for diaphragm?
Exam and fitting
51
Are diaphragms available OTC?
No, need Rx
52
ROA for spermicides?
Cream, jelly foam, suppositories
53
How effective is spermicide at preventing pregnancy?
71%
54
How long after application of spermicide can you have sex?
Must wait for 10 minutes after application
55
MOA of birth control pills?
Made of hormones that prevent egg from releasing from ovary, also cause thickening of cervical mucus to block sperm
56
Effectiveness of OCPs in preventing pregnancy?
91%
57
Hormonal levels for combo pills?
monophasic (preferred): same amount bi-progestin: increases once halfway through tri-level: changes every 7 days
58
How many days is the regimen for combo pills?
21 or 28 day regimen: 21 active pills, 1 wk of reminder pills *can be taken continuously to bypass period
59
How many days is the regimen for mini pill?
Active pills for all 28 days
60
When is the mini pill used?
Postpartum or unable to have estrogen
61
S/E of birth control pills?
Nausea, breast tenderness, dec. libido RARE in combo pill: heart attack, stroke, blood clots
62
Who should not take birth control pills?
Smokers (15+ cigs/day) 35+
63
Should birth control pills be taken at the same time every day?
Yes
64
If the mini pill is not taken within 3 hours of the regular time, what should be done?
Use backup contraception for 48 hrs
65
Meds that make birth control pills less effective?
Rifampin, griseofulvin, St. Johns wort, certain anti-seizure and HIV meds
66
Regimen for birth control patch?
New patch placed on skin same time every week x3wks w/ 1 patch-free week
67
Do birth control pills and the patch have the same amount of hormonal delivery?
Yes
68
S/E of birth control patch?
Same as BCP but may have skin interactions
69
What meds interfere w/ bc patch?
Same as BCP
70
Who are birth control patches contraindicated in?
Obese women d/t blood clot risk
71
Where should birth control patches be applied?
Upper outer arm, upper torso, abdomen, buttocks *AVOID: breasts or open/red skin *DO NOT apply patch to same area 2 wks in a row
72
Does the birth control patch need an Rx?
Yes
73
How often is a bc vaginal ring inserted?
Once a month
74
Regimen for vaginal ring?
Leave in for 3 weeks, remove for 1 week, replace with new ring
75
MOA, S/E, and med interactions of the vaginal ring are the same as what methods of BC?
Pill, patch -may also have vaginal discharge, irritation, infection
76
Use of oil-based yeast infection meds may increase what when using a vaginal ring?
Inc. blood levels of hormones
77
What to do if ring slips out of vagina during sex?
Wash w/ warm water and reinsert
78
Use backup method of bc if vaginal ring has been left out for how long?
3 hrs
79
How long may the annovera vaginal ring be used for?
1 year, but should be taken out every 3 weeks for 1 week to allow a period
80
What is depo provera injection?
IM injection of progestin q3mos -also available: SQ version at home w/ lower dose of progestin but off label/more expensive
81
MOA of depo shot?
Same as mini pill
82
How effective is the depo shot at preventing pregnancy?
94%
83
Can the depo shot be used during breastfeeding?
Yes
84
Side effects of the depo shot?
Menstrual irregularity, weight gain, headaches, slow return of fertility, diabetes risk (hypo-estrogen state), reduced bone density (recovery when stopped but not 100%)
85
What to advise for pts who have reduced bone density from depo shot?
CA & Vit D, exercise, no smoking
86
What options are LARC (long acting reversible contraception)?
Nexplanon, IUD
87
What hormone does nexplanon release?
Progestin hormone: Etonogestrel w/ same MOA as pill
88
How log does nexplanon prevent pregnancy?
Up to 5 yrs
89
How effective is the nexplanon at preventing pregnancy?
99%
90
Can nexplanon be used while breastfeeding?
Yes, at 4 wks postpartum
91
Proper implantation of nexplanon should result in what?
Ability to palpate under skin
92
S/E of nexplanon?
Menstrual irreg, mood swings, wt gain, headache, acne
93
Med interactions w/ nexplanon?
Anti-seizure and antiretrovirals for HIV
94
Risks with nexplanon?
Blood clots, problems at insertion site, ovarian cysts
95
How effective are IUDs at preventing pregnancy?
99%
96
Can IUDs be used while breast feeding?
Yes
97
How does the copper IUD prevent pregnancy?
Copper wire wrapped around stem of IUD (toxic to sperm)
98
How long does the copper IUD stay in place?
10-12 years
99
Those with which disease should not use copper IUD?
Wilson's Disease
100
What hormone does the hormonal IUD release?
Progestin
101
How long do hormonal IUDs last?
3-6yrs
102
Risks of IUD?
Can slip from uterus (has to be removed), infection, uterine perf
103
S/E of IUD?
Pain w/ insertion, menstrual irreg, acne, headaches, breast tenderness w/ hormonal IUD
104
What must be ruled out before IUD insertion?
STIs and pregnancy
105
Follow up how long after insertion of IUD?
1-3 mos
106
Permanent methods of contraception?
Tubal sterilization, vasectomy,
107
What is tubal sterilization?
Closing/blocking fallopian tubes --> stops pathway for eggs to travel to uterus
108
How can tubal sterilization be done?
Ligation (tying/cutting tubes), electrocautery, clips, clamps, rings
109
How is TL performed?
Sedation and laparoscopy
110
Risks of tubal ligation?
those associated w/ ansthesia/surg, tubes can reconnect --> risk for ectopic preg, regret
111
Is tubal reversal/reconnection a guarantee of pregnancy?
No
112
What is a vasectomy?
Vas deferens blocked so sperm cannot mix with seminal fluid
113
Is vasectomy immediately effective?
No, effective in ~3mos *sperm sample will be analyzed
114
Risks of vasectomy?
Risks associated w/ surgery, ends of tube may rejoin, regret (can be reversed or sperm bank used)
115
How many days can emergency contraceptive prevent pregnancy after unprotected sex?
Up to 5 days after unprotected sex
116
Methods of emergency contraceptive?
IUD or morning after pill
117
How does the morning after pill work?
Attempts to prevent ovary from releasing egg longer than usual
118
How effective are the morning after pills Plan B and Next choice if taking w/in 3 days?
89%, effectiveness decreases as time passes
119
How effective is the morning after pill Ella if taking w/in 5 days?
85% for all 5 days
120
How may weight effect emergency contraception?
Plan B: must be under 165lb Ella: under 195lb If obese, IUD is best emergency contraceptive
121
Serious complications of emergency contraceptives?
None reported
122
S/E of emergency contraceptives?
N/V, headache, menstrual irreg
123
Which emergency contraceptive pill requires rx?
Ella, can get online w/ next day delivery

Special Pops Exam 1 (8 decks)

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