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Isleans Mrcog Part 2 > Contraception > Flashcards

Contraception Flashcards

(64 cards)

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1
Q

Give advice:

On COCP 2 pills missed in week one day 1-7

A

Take last pill
EC needed
7day break as usual
Additional protection for 7 days

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2
Q

Give advice:

On COCP 2 pills missed in week two, day 8-14

A

Take last pill
EC not needed
7day break as usual
Additional protection for 7 days

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3
Q

Give advice:

On COCP 2 pills missed in week three, day 15-21

A

Take last pill
EC not needed
No 7 day break
Additional protection for 7 days

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4
Q

Give advice:

On COCP 2 pills missed in week four, day 22-28

A

Pull free week/placebo

EC if more than 7 days pill free plus EC

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5
Q

Give advice:

On Traditional POP missed pill by >3h

A

Take pill ASAP
EC needed
Additional protection for 2 days

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6
Q

Give advice:

On Desogestrel POP missed pill by >12h

A

Take pill ASAP
EC needed
Additional protection for 2 days

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7
Q

Give advice

14 weeks and 1 day since DMPA or 10+1 since NET-EN

UPSI within last 3 days

A

Give injection

Offer EC copper IUD or LNG

Additional protection for 7 days

UPT 21 days later

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8
Q

Give advice

14 weeks and 1 day since DMPA or 10+1 since NET-EN

UPSI within last 4-5 days

A

Give injection

Offer EC copper IUD

No additional protection if IUD

UPT 21 days later

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9
Q

Give advice

14 weeks and 1 day since DMPA or 10+1 since NET-EN

UPSI more than 5 days ago

A

Do not give injection

Do not give EC

Additional protection for at least 21 day

UPT 21 days later

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10
Q

How log should the copper IUD be used for if for EC only

A

Time next menstrual period

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11
Q

How effective is the copper IUD as an EC

A

99%

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12
Q

What is the mechanism of LNG EC

How effective is it

A

Inhibit ovulation by inhibiting LH surge

98%

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13
Q

What is the mechanism of UPA EC

How effective is it

A

Inhibition of ovulation, mechanism unknown

99%

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14
Q

What are the contraindications to the LNG EC

A

None

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15
Q

What are the contraindications to the UPA EC

A

Severe asthma
Taking enzyme inducers
Taking ant-acids

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16
Q

When using LNG EC for how long is additional contraception required

A

COCP 7 days
POP 2 days
Qlaira 9 days

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17
Q

When using UPA for how long is additional contraception required

A

COCP 14 days
POP 9 days
Qlaira 16 days

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18
Q

With UPA EC when should a repeat dose be considered

A

Vomiting within 3 hours

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19
Q

With LNG EC when should a repeat dose be considered

A

Vomiting within 2 hours

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20
Q

To what age can COCP be used till if no other contraindications

A

50yr

<30ug of ethynyloestradiol should be used

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21
Q

To what age can DMPA be used

A

50 yr

Re evaluate every 2 yr due to osteoporosis risk

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22
Q

To what age can POP be used till

A

Until menopause

If >50yr continue for 1yr amenorrhoea

If <50yr continue for 2yr amenorrhoea

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23
Q

How long can the Cu IUD be used for

A

5-10yr

If fitted >40yr it can be kept until menopause

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24
Q

When should the mirena be changed or removed

A

After 5 years

If fitted >45yr it can be kept for 7 years or until the menopause

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25
How protective is breast feeding as a contraceptive
If exclusive the risk of pregnancy at 6 months is only 2%
26
When postpartum should contraception be started if pregnancy is not desired, at the latest
Day 21
27
When can the COCP be started postpartum
On D21 of not breastfeeding If more than 21 days, additional contraception for 7 days required If breast feeding > 6months Partial = UKMEC 3 Fully = UKMEC 4
28
When can the POP be started postpartum
Any time If > 21 days use additional contraception for 2 days
29
When can the implant be started postpartum
Anytime Will need 7 days additional contraception if after D21
30
When can the Injection be started postpartum
If breast feeding >D21 If not breast feeding, anytime Will need 7 days additional contraception if after D21
31
Can EC be used postpartum
Not required within 21 days If using UPA, don't breastfeed for 36 hours
32
How long after UPSI can the Cu IUD be used for EC
5 days or 5 days from ovulation if known
33
Which EC should be offered 1st line
CU IUD due to its low failure rate
34
How long after UPSI can the UPA be used for EC
120 hours
35
How long after UPSI can the LNG be used for EC
72 hours is working licence, can consider up to 96 hours
36
Regarding ongoing contraception following EC, what is not recommended until pregnancy excluded
Progestogen injectables Can be used if other methods not appropriate or acceptable
37
In women taking enzyme inducing drugs, what EC can be offered
Cu IUD LNG 3mg
38
For how long after taking enzyme inducers are EC effected
28 days
39
What EC can be used more than once in a cycle
LNG
40
What is the mechanism of each form of EC
CU IUD toxic to ovum and sperm LNG inhibit ovulation UPA inhibit ovulation
41
With oral EC what is the rate of vomiting after treatment
1% Nausea 20%
42
Within what time period after LNG EC would UPSI not require further EC
12 hours
43
Regarding IUD/IUS postpartum What condition would result in a UKMEC 4 grading
Postpartum sepsis
44
Regarding IUD/IUS postpartum When would insertion be classified as UKMEC grade 1
<48 hours or > 4 weeks >48hr <4 weeks is considered UKMEC 3
45
What contraceptions are UKMEC 1 immediately postpartum regardless of breastfeeding
Implant & POP
46
Regarding IUD/IUS At what age does insertion become UKMEC 2 and why
Under 20yrs due to the increased risk of expulsion
47
What is the failure rate for vasectomy
1:2000
48
What is the lifetime failure rate for filshie clips
1:200 2-3:1000 10yr failure rate
49
What is the 5 year failure rate for hysteroscopic sterilisation
1:500
50
How much copper is used in the most effective IUD
>380mm2
51
At what BMI is the failure rate of progesterone implants increased
>40
52
How effective is LNG EC at 72 hours after UPSI
85% effective
53
How effective is UPA EC at 120 hours after UPSI
85% effective
54
How effective is CuIUD EC at 120 hours after UPSI
99%
55
When is a vasectomy considered a failure
If motile sperm are identified 7 months post procedure
56
Regarding vasectomy When can special clearance be given to cease additional contraception
When <100,000 non-motile sperm are observed in a fresh seamen sample post-vasectomy
57
What progestogens have the lowest risk of VTE
First generation Norethisterone Levonorgestrel Norgestimate 5-7:10,000
58
What is the risk of VTE with First generation progestogens
5-7 : 10,000
59
What is the risk of VTE with Norethisterone
5-7:10,000
60
Which generation progestogen is levonorgestrel
First generation
61
Which generation of progestogens are the following Desogestrel Gestodene Drospirenone What is the risk of VTE
Third generation 3 Desperate Guests Drop None Risk of VTE 9-12:10,000
62
Which generation of progestogens are the following Norethisterone Levonorgestrel Norgestimate What is the risk of VTE
First generation First Norene can't Levitate Nor Gestimate 5-7:10,000
63
What is the risk of VTE IN the general population
0.1-0.2:1000
64
What is the risk of VTE IN the pregnant population
1-2:1000

Isleans Mrcog Part 2 (26 decks)

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