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contraception Flashcards

(48 cards)

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1
Q

Perfect Use vs Typical Use

A

COC 0.3/8.7
POP 0.5/3
Mirena 0.1/0.1 - best
Cu IUD 0.6/1
Implanon 0.05/1
DMPA 0.3/0.3
Withdrawal 4/18.4
Condom Male 2/17.4

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2
Q

Lap sterilization

A

unipolar/bipolar coag
fislhie clip (yung parang ipit lang na walang teeth –> best, titanium)
silastic/yoon (yung ring na rubber)
hulka (yung may teeth na plastic)

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2
Q

types of BTL

A

Pomeroy
Irving
Uchida

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3
Q

best vasectomy reversal

A

if within 3 yrs from procedure

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4
Q

predictors of success reversal BTL

A

age at reversal
4cm remaining tube

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5
Q

OCP VTE risk

A

low dose OCP regardless of progestin has inc vte risk in the first to second yr

risk inc with age and weight

estrogen inc clotting factors while progestin no effect

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6
Q

OCP MI/Stroke

A

no inc risk regardless of age if nonsmoker and EE<50mcg

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7
Q

OCP and cancers

A

(-) endom Ca
(-) ovarian Ca
(-) colorectal
+ cervical – inc CIS
+ liver Ca – hepatocellular ca
+ breast CA – uncertain

(-) = protective
+ = inc risk

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8
Q

DMPA special indication

A

sickle cell disease
seizure disorder

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9
Q

DMPA disadvantages

A

must ensure PT negative or else IUGR associated neonatal death

9 month delay to ovulation

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10
Q

PID highest in IUD

A

20 days after insertion

can be inserted post partum
but if not inserted due to infection, 4-5weeks post partum

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11
Q

DMPA backup

A

if not started during menses, backup x 7 days

can be late for up to 2 weeks

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12
Q

Diaphragm/cap/sponge/female condom

when to insert

A

6/6/24/8

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13
Q

Diaphragm/cap/sponge/female condom

duration post coitus

A

6/8/6/6

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14
Q

Diaphragm/cap/sponge/female condom
max

A

24/48/30/8

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15
Q

1st generation estrane

A

norethisterone, lynestrenol, norethyndronel, ethynodiol diacetate

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16
Q

1st generation pregnane

A

MPA, megace

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17
Q

2nd generation

A

levonorgestrel, norgestrel

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18
Q

3rd generation

A

gestodene, norgestimate, desogestrel, etonogestrel, norelgestromin

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19
Q

4th generation estrane

Study These Flashcards
A

dienogest
drosperinone

20
Q

4th generation pregnane

Study These Flashcards
A

nomegestrol acetate
nesterone
trimgestrone

21
Q

19-nortestosterone hormones

androgenic, progestational, estrogenic

inc insulin resistance, dec glucose tolerance

Study These Flashcards
A

norethindrone
norethyndronel
ethyndronel diacetate
lynestrenol

22
Q

extended regimen

Study These Flashcards
A

24 day products to:
decrease ovarian activity
dec breakthrough bleeding

23
Q

greatest incidence of breakthrough bleeding

Study These Flashcards
A

first 3 months 10-30%

24
patch backup algorithm
week 1 - backup x 7 days week 2/3 - <48 hrs - no backup week 2/3 - >48 hrs - backup x 7 days week 4 - kebs
25
MOA OCP
Progestin - inhibit LH surge - no ovulation Estrogen - stabilize endometrium to prevent BB + inhibit FSH so no dominant follicle + help inc LH receptors
26
MOA OCP progestin
atrophy EM thickens cervical mucus alters tubal secretion/peristalsis prevents ovulation
27
max length of protection of breastfeeding
10 weeks
28
LAM (bellagio consensus)
no menses baby <6 months exclusive breastfeeding (>5 feedings >65mins/day) 98% efficacy
29
when to start breastfeeding
miscarriage <12 weeks - start immediately >12 weeks - after 3 weeks FT/PT/SVD/CS no BF - after 3 weeks (POP), 7 weeks (COC) BF - 3 months
30
postpill amenorrhea
0.7-0.8%
31
MOA breakthrough bleeding
decidualized/atrophic EM = EM fragility fluctuations of estrogen levels associated with estrogen growth and demise
32
Treatment for BB in OCPs
1) estrogen x 7 days regardless of day in cycle 2) stop pill x 1 week then restart 3) switch to extended regumen 24 days
33
heavy smokers
>15 sticks
34
POP MOA
thickens cervical mucus and EM hostile to implantation gonadotropins not suppressed consistently must be given same time daily 22hrs wear off effects, 24 hrs = sperm penetration
35
major cause of d/c pills
breakthrough bleeding
36
backup algorithm POP
>3 hrs late = backup x 48 hrs if missed pill, drink pill = backup x 48 hrs if 2 or more missed, (-) menses = do PT
37
backup algorithm OCPs
1 pill missed - take as soon as possible, no backup 2 pills missed: week 1/2 - take 2 pills, backup x 7 days week 3 - start new pack, backup x 7 days week 3 missed pills = start new pack + backup x 7 days
38
Yuzpe
4 pills 12 hours apart x 2 doses best if within 72 hours
39
EC
Yuzpe Ovral - EE 30mcg + 0.15mg LNG Alesse EE 20mcg + 0.10mg LNG = 5tabs q12 x 2 doses Nordette - EE 30mcg + 0.15mg LNG = 4 tabs q12 hrs x 2 doses Plan B 0.75mg LNG q12 x 2 doses Plan B 1step 1.5mg x 1 dose Mifepristone 600mg Ullipristal Acetate 30mg Copper IUD
40
MOA IUD copper
spermicidal intrauterine environment
41
MOA EC
delays ovulation and prevents fertilization does not prevent implantation/not abortifacent
42
MOA IUD Mirena
spermicidal inhibit implantation, sperm capacitation, penetration, survival
43
in bariatric patients
transvaginal route pregnancy not allowed within 18months from surgery
44
ileostomy patients
pills absorbed in small intestine so pwede maabsorb pa din
45
DMPA and sickle cell disease
inhibition of sickling and improvement in anemia in patients with sickle cell disease
46
absolute CI OCPs
1. 2. Thrombophlebitis, thromboembolic disorders (including a close family history, parent or sibling, suggestive of an inherited susceptibility for venous thrombosis), cerebral vascular disease, coronary occlusion, or a past history of these conditions, or conditions predisposing to these problems. Markedly impaired liver function or liver cancer. Steroid hormones are contraindicated in patients with hepatitis until liver function tests return to normal. 3. History of coronary heart disease or cerebrovascular disease. 4. Migraine headaches with aura. 5. Diabetes mellitus with vascular disease. 6. Known or suspected breast cancer. 7. Undiagnosed abnormal vaginal bleeding. 8. Known or suspected pregnancy. 9. Smokers over the age of 35. 10. Severe hypercholesterolemia or hypertriglyceridemia. 11. Uncontrolled hypertension. 12. Breast-feeding and less than 21 days postpartum. 13. Surgery with prolonged nonmobility. 14. History of peripartum cardiomyopathy.
47
relative CI OCPs
1. Migraine headaches without aura 2. Controlled hypertension 3. Gestational diabetes 4. Diabetes mellitus 5. Seizure disorders 6. Obstructive jaundice in pregnancy 7. Sickle cell disease or sickle C disease 8. Gallbladder disease 9. Mitral valve prolapse 10. Systemic lupus erythematosus 11. Hyperlipidemia 12. Smoking younger than 35 13. Hepatic disease

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