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Flashcards in Contraception Deck (55):
1

What is the primary mode of action of the COCP?

Inhibits ovulation (does this by reducing production of FSH and LH)

2

What is a secondary mode of action of the COCP?

Thickening of cervical mucus

3

What should a patients blood pressure be below to start the COCP?

140/90

4

You have just started a 29 year old women on the COCP for the first time. When do you need to check her blood pressure?

At three months
Anually after that

5

What COCP is useful if a patients has acne and/or hirsutism?

Co cyprindiol (Dianette)

6

Is the risk of cervical cancer increased or decreased with COCP use?

Increased

7

What two measurments are important to record before the first prescription of the COCP?

Blood pressure
BMI

8

What two cancers is use of the COCP protective from?

Ovarian
Endometrial

9

When can the COCP be started that means no other means of contraception needed from day 1?

Up to day 5 of the cycle

10

If the COCP is started on day 10 of the cycle, how many days will it be until the women has contraceptive cover?

7

11

How long after taking levonelle 1500 should you use a barrier contraception/abstain for?

7 days

12

How long after taking ellaOne how long should you wait before starting contraception?

5 days

13

What should you do if you miss one COCP?

Take the missed pill as soon as remembered and take the remaining pills at the normal time. Emergency contraception not required

14

What should you do if you miss 2 COCP pills?

Take the most recent missed pill
Take the remaining pills at the correct time
Use condoms/abstain until 7 pills have been taken consecutively

15

If you miss more that 2 pills in the last week of a pack what should you do to minimise risk of pregnancy?

Omit the next pill free interval

16

Which week is pregnancy most likely if you have missed two pills and you have had sex?

1st week of a pack

17

How long can a contraceptive patch stay off for before its efficacy is reduced?

48 hours

18

How many days can a patch be worn for before its efficacy is reduced?

9 days (7 days + 48hrs)

19

Describe how you use a contraceptive patch

1 patch is applied and worn for 1 week to suppress ovulation. Thereafter the patch is reapplied weekly for a further 2 weeks. The fourth week is patch free to allow a withdrawal bleed.

20

Describe how you use a vaginal ring?

Ring placed in the vagina and left for 21 days. After this there is a ring free interval for 7 days when there will be withdrawal bleed and then a new ring should be inserted

21

How long can a vaginal ring be out of the vagina for before its efficacy is reduced?

48 hours

22

How long can a vaginal ring be worn for before its efficacy is reduced?

4 weeks

23

Which progesterone out of these 3 is the longest acting:
- Levonorgestrel
- Norethisterone
- Etonorgestrel

Etonorgestrel

24

What the primary mechanism of the progesterone only pill?

Thickening cervical mucus

25

What is the primary mechanism of the etonorgestrel progesterone pill?

Thickening of cervical mucus and suppression of ovulatuon in 97% of cycles

26

What are the secondary mechanisms of the progesterone only pills?

Suppression of ovulation
Reduced endometrial receptivity to blastocyst
Reduction in cilia activity in fallopian tube

27

Which progesterone out of these 3 is used in newer progesterone only pills:
- Levonorgestrel
- Norethisterone
- Etonorgestrel

Etonorgestrel. Due to it being longer acting

28

Describe how you take the progesterone only pill?

Daily at the same time with no break

29

With the older progesterone pills (levonorgestrel & norethisterone) how may hours have should there be between doses?

Between 24 - 27 hours

30

With the newer progesterone pills (etonorgestrel) how many hours should there be between doses?

24 - 36. Longer window than older POPs

31

How many progesterone only pills do you have to miss to require emergency contraception?

1

32

List 5 methods of natural family planning

1. Basal body temperature
2. Cervical mucous thickness
3. Cervical position
4. Calculating fertile days
5. Breastfeeding

33

What is the position of the cervix when you are fertile?

High in the vagina, soft and open

34

What is the position of the cervix when you are less fertile?

Low in vagina; firm and closed

35

In a 28 day cycle what days are you most fertile?

Days 8 - 18

36

What are the three criteria that you need to fulfil to make breastfeeding a reliable contraceptive?

1. Only breast feeding
2. Less that 6 months post natal
3. Amenorrhoeic

37

What does it mean if a contraception is in category MEC 1?

No restriction for use of this contraceptive method

38

What does it mean if a contraception is in category MEC 2?

Advantages of using this method generally outweigh the risks

39

What does it mean if a contraception is in category MEC 3?

Risks of using this contraceptive generally outweigh the advantages (expert clinical judgement required)

40

What does it mean if a contraception is in category MEC 4?

A condition which represents unacceptable risk if the contraceptive method is used.

41

What calculation is used to work out the pearl index for contraception reliability?

Number of accidental pregnancies x 1200/ Total months of exposure

42

What is the primary action of the depo provera injection?

Inhibits ovulation

43

What condition do you need to consider the risk off before prescribing depo provera?

Osteoporosis

44

When can the depo provera injection be given so it will be effective straight away?

Up to an including day 5 of the cycle

45

How long do you have to use another method of contraception for if you start the depo provera on day 9?

7 days

46

What are the main side effects of the depoprovera injection?

Weight gain
Delay in return of fertility
Irregular bleeding
Risk of osteoporosis

47

What is the main mode of action of the IUD?

Prevents fertilisation
Inflammatory response in endometrium

48

What is the main mode of action of the IUS?

Effect on implantation - endometrium rendered unfavourable for implantation

49

How many days after UPSI can the IUD be fitted for emergency contraception?

5 days

50

How many days after a TOP can the IUD be fitted?

Immediately (of products of conception seen)

51

How many days after childbirth can the IUD be fitted for emergency contraception?

Either within 48 hrs or after 4 weeks

52

How many days after childbirth can the IUS be fitted for emergency contraception?

Either within 48 hrs or after 4 weeks

53

How many days after a TOP can the IUS be fitted?

Immediately (if products of conception seen)

54

How long is the contraceptive implant licenced for?

3 years

55

What is the primary mode of action of the implant?

Preventing ovulation