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Primary Care Block Year 3 > Contraception > Flashcards

Contraception Flashcards

(73 cards)

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1
Q

What are the types of contraception available? (13)

A

COCP
POP
IUD
IUS
Depot injection
Patch
Implant
Condom
Diaphragm
Nuvaring
Tubal ligation
Vasectomy
Fertility Awareness Method

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2
Q

What approach should be taken when a woman is on COCP and is due to have a surgery?

A

Stop the pill 4 weeks before surgery and restart 2 weeks after

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3
Q

Why must COCP be stopped before surgery?

A

Both COCP and surgery are risk factors for venous thromboembolism. The pill needs to be stopped to prevent clotting

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4
Q

When can COCP be restarted post-partum?

A

After six weeks due to increased risk of venous thromboembolism

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5
Q

How soon after taking Levonorgestrel emergency contraception can a woman restart COCP?

A

Immediately - patient should be advised to use a condom for 7 days after restarting

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6
Q

How soon after taking Ulipristal Acetate emergency contraception can a woman restart COCP?

A

5 days

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7
Q

How long after UPSI can Ulipristal Acetate be used?

A

120 hours ( 5 DAYS )

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8
Q

How long after UPSI can Levonorgestrel be used?

A

3 days

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9
Q

What can patients with suspected STI or PID not have as emergency contraception?

A

Copper IUD

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10
Q

What type of contraception can be offered immediately to post-partum women?

A

POP

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11
Q

What effect does the Mirena ( IUS ) have on periods?

A

Initially irregular bleeding later followed by light menses or amenorrhoea
80%

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12
Q

What is the primary effect of the implant?

A

Inhibition of ovulation. Progesterone inhibits the secretion of FSH and LH from the pituitary.

Secondary effect of thickening cervical mucous

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13
Q

Can Levonorgestrel and Ulipristal Acetate be used in the same cycle?

A

Yes

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14
Q

What is the most common side effect occurring within the first 6 months of insertion of the IUS?

A

Irregular bleeding

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15
Q

How long until the IUD is effective? ( Not inserted on first day of period )

A

Immediately

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16
Q

How long until the POP is effective? ( Not taken from first day of period )

A

2 days

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17
Q

How long until the COCP is effective? ( Not taken from first day of period )

A

7 days

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18
Q

How long until the injection is effective? ( Not injected on first day of period )

A

7 days

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19
Q

How long until the implant is effective? ( Not put in on first day of period )

A

7 days

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20
Q

How long until the IUS is effective? ( Not put in on first day of period )

A

7 days

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21
Q

What is the correct way to use the patch effectively?

A

Change patch weekly with a 1 week break after 3 patches

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22
Q

Where is the implant inserted?

A

Sub-dermal , non-dominant arm

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23
Q

How long is the window for the POP?

A

3 hours

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24
Q

How long is Nexplanon ( implant ) effective?

A

3 years

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25
Which method of contraception is most associated with delayed return to fertility?
Depo Injection
26
When can the IUS be inserted post child-birth?
Within 48 hours of delivery or 4 weeks after delivery
27
What does UKMEC 3 mean?
A category for hormonal contraception where risk outweighs benefit
28
What are some examples of UKMEC 3 conditions?
More than 35 years old and Smoking less than 15 cigarettes/day BMI > 35 kg/m^2* Family history of thromboembolic disease in First degree relatives < 45 years Controlled hypertension Immobility e.g. wheel chair use Carrier of known gene mutations associated with breast cancer (e.g. BRCA1/BRCA2) current gallbladder disease
29
What effects does the COCP have on cancer risks?
Increased risk of breast and cervical cancer Protective against ovarian and endometrial cancer
30
What are examples of UKMEC 4 conditions?
More than 35 years old and smoking more than 15 cigarettes/day Migraine with aura History of thromboembolic disease or thrombogenic mutation History of stroke or Ischaemic heart disease Breast feeding < 6 weeks post-partum Uncontrolled hypertension Current breast cancer Major surgery with prolonged immobilisation Positive antiphospholipid antibodies (e.g. in SLE)
31
If a person vomits within 3 hours of taking Levornogestrel what should they do?
Take another dose
32
What contraceptives are unaffected by enzyme-inducing drugs e.g Carbamazepine ?
Copper IUD Progesterone injection Mirena coil ( IUS )
33
What should be done if a child under 13 presents to the GP for contraception?
A child under 13 is always considered unable to consent for sexual intercourse so relevant safeguarding should be contacted
34
If the pearl index score of a contraception is 0.1, what would it mean?
1/1000 women a year will get pregnant if using it correctly
35
What does a migraine with aura present like?
Starts with visual changes then severe left sided headache
36
Why is the COCP contraindicated in women who suffer migraine with aura?
The pill worsens the condition
37
What are some fertility awareness methods?
Cervical secretions Basal body temperatures Length of menstrual cycle
38
What does the lactational amenorrhea method involve?
Breastfeeding delays the return of ovulation after childbirth Suckling stimulus disrupts release of GnRH Affects feedback cycle of HPG axis
39
How long is the lactational amenorrhea method effective for?
Up to 6 months after giving birth
40
What are the advantages and disadvantages of barrier contraception?
Advantages: reliable, protection from STIs, widely available (male condom) Disadvantages: disrupt romantic nature, reduce sexual pleasure, can expire, allergy/sensitivity to latex/ spermicide
41
Identify 2 long-acting reversible contraceptives (LARC)
Progesterone Depot Progesterone Implant
42
What is the role of progesterone in moderate/high doses?
Progesterone enhances the negative feedback of natural oestrogen – reducing LH and FSH secretion No LH surge means no ovulation
43
What is the role of progesterone in lower doses?
Progesterone does not inhibit the LH surge Ovulation is still likely Cervical mucus thickens
44
What is the principal action of the COCP?
Principal action: prevents ovulation
45
Principal action: prevents ovulation
Reduces endometrial receptivity to inhibit implantation Thickens cervical mucus to inhibit penetration of sperm
46
Identify 4 clinical conditions which are at increased risk when on the COCP
Breast and cervical cancer Venous thromboembolism MI Stroke
47
What is the principal action of High Dose Progestogen contraception? ( depot, patch, implant)
Principal action: prevents ovulation
48
What is the principal action of High Dose Progestogen contraception? ( depot, patch, implant)
Thickens cervical mucus to inhibit penetration of sperm Prevents endometrial proliferation
49
What are the advantages and disadvantages of the High Dose Progestogen Implant?
Advantages: reliable, LARC, used by women who can’t use contraception with oestrogen, natural fertility returns quickly Disadvantages: minor procedure to insert, side effects, no STI protection
50
What are the advantages and disadvantages of the Low Dose Progestogen in the POP ?
Advantages: quickly reversible, used where COCP is contraindicated Disadvantages: common menstrual problems, interacts with other medication, risk of ectopic pregnancy, no STI protection
51
What is the intrauterine system (IUS)?
IUS is a progestogen-releasing plastic device Works for 3–5 years
52
What is the intrauterine device (IUD)?
UD is a plastic device with added copper Works for 5-10 years
53
What are the principal and secondary actions of the IUD?
Principal action: copper is toxic to sperm and ovum Secondary action: endometrial inflammatory reaction prevents implantation and changes consistency of cervical mucus
54
Identify 2 forms of sterilisation
Vasectomy Tubual ligation/clipping
55
How is a vasectomy performed?
Vas deferens cut/tied to prevent sperm entering ejaculate Performed under local anaesthetic
56
How is the success of a vasectomy confirmed?
Post-operative semen analysis to confirm no sperm in ejaculate Approx. 12-16 weeks after surgery
57
How is a tubual ligation performed?
Fallopian tubes are cut/blocked to stop the ovum travelling from the ovary to the uterus Performed under local/general anaesthetic
58
Identify 3 forms of emergency contraception
Emergency IUD Emergency pill with ulipristal acetate Emergency pill with levonorgestrel
59
What is subfertility?
Subfertility is the failure of conception in a couple having regular, unprotected coitus for one year
60
What is primary infertility?
Primary infertility is when someone who has never conceived a child in the past has difficulty conceiving
61
Identify the 5 main causes of subfertility
Male factors (30%) Unexplained (25%) Ovulatory disorders (25%) Tubal damage (20%) Uterine or peritoneal disorders (10%)
62
Identify 2 genetic causes for male subfertility
Klinefelter syndrome Y chromosome deletion
63
Identify 4 antispermatogenic agents
Heat Irradiation Drugs Chemotherapy
64
Identify 2 coital problems which can lead to male subfertility
Ejaculatory failure Erectile dysfunction
65
Identify the 3 groups of different ovulatory disorders
Hypothalamic-pituitary failure (10%) Hypothalamic-pituitary-ovarian dysfunction (85%) Ovarian failure (5%)
66
Identify 2 clinical conditions which result from hypothalamic-pituitary failure
Hypothalamic amenorrhea Hypogonadotrophic hypogonadism
67
Identify 2 clinical conditions which result from hypothalamic-pituitary-ovarian dysfunction
Polycystic ovary syndrome Hyperprolactinaemic amenorrhoea
68
Identify 2 clinical conditions which result from ovarian failure
Premature ovarian failure Primary ovarian insufficiency
69
Identify 3 uterine/peritoneal disorders
Uterine Fibroids Endometriosis Pelvic Inflammatory Disease
70
With what condition should Ulipristal Acetate not be given ?
Asthma controlled by oral steroids , due to the anti-glucocorticoid effect of UA
71
Which method is associated with weight gain?
Depo injection
72
For an under 50 woman, how long should they be amenorrhoeic before it is recommended they can stop contraception?
2 years
73
For an over 50 woman, how long should they be amenorrhoeic before it is recommended they can stop contraception?
1 year ( True menopause)

Primary Care Block Year 3 (5 decks)

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