Contraception

Question 1

5 factors for contraceptive counseling

Answer 1

personalized/shared decisions
rapport build
goalset
counseling
hx, CI ID

Question 2

The below are used to assess…

7 or fewer days after menses start or abortion

no intercourse since last menses

reliable contraception use

4 weeks postpartum

breast feeding, amenorrhea, < 6 mo post patum

Answer 2

pregnancy (99% predictive)

Question 3

condoms should always be used for what reason

Answer 3

STI prevention

Question 4

How effective?

implant
IUD
Vasectomy
tube tie

Answer 4

most effective

Question 5

How effective?

OCPs
injections
patch
ring
diaphragm

Answer 5

2nd most effective

Question 6

How effective?

male/female condoms

withdrawal

sponge

Answer 6

3rd most effective

Question 7

how effective?

fertility awareness
spermicide

Answer 7

least effective

Question 8

The below can have what side effects?

Pill, patch, ring

Answer 8

spotting for first few months

lighter periods

Question 9

Which IUD can cause heavier periods?

Answer 9

copper

Question 10

Which IUD can cause spotting, lighter, or no periods?

Answer 10

LNG

Question 11

How long does an IUD last?

Answer 11

3-12 years

Question 12

How long does an implant last?

Answer 12

3 years

Question 13

Copper IUD lacks ______ and can therefore cause _______

Answer 13

hormones

cause more cramps

Question 14

Does LNG IUD have estrogen? What effect on cramping?

Answer 14

no estrogen

reduced cramps

Question 15

does an implant have estrogen?

Answer 15

no

Question 16

Do injectables have estrogen? what effect on cramping

Answer 16

no estrogen

reduced cramps

Question 17

These forms of contraception may reduce cramps/anemia, improve acne, lower CA risk

Answer 17

pill, patch, ring

Question 18

how long does the patch last?

Answer 18

week

Question 19

how long does the ring last?

Answer 19

month

Question 20

women w. 26-32 day cycles can use what method of natural family planning?

Answer 20

standard days method

Question 21

in the standard days method, sex is abstained from on what days?

Answer 21

8-19

Question 22

women w/out 26-32 day cycles can use what method of natural family planning?

Answer 22

calendar method

Question 23

calendar method requires monitoring cycles for how long?

Answer 23

6 mo

Question 24

In the calendar method, the first day of the fertile period is…

Answer 24

length of shortest menstrual cycle - 18 days, add that number from 1st day of cycle

Question 25

in the calendar method, the last day of the fertile period is

Answer 25

length of longest menstrual cycle - 11 days = add that number to the first day of that cycle

Question 26

When is it ok to have intercourse using the 2 day method of natural family planning?

Answer 26

no cervical secretions for 2 consecutive days

Question 27

Which method of natural family planning? Check cervical mucus daily Peak day = last day of “stretchy” clear mucus Fertile period occurs w/ 1 st signs of mucus and continues until 4 days after peak day

Answer 27

cervical mucous method

Question 28

in the cervical mucus method, abstinence should occur when?

Answer 28

any cervical secretion until 4 days after peak day

Question 29

Which method of natural family planning? Check basal body temperature upon wakening every AM before getting out of bed Rise in temperature of 0.5 1* F = ovulation Abstain from sex from end of menstrual period until 3 days after temperature increase

Answer 29

basal body temperature method

Question 30

Which method of natural family planning? Combination of cervical mucus + basal body temp methods Also monitor for physical signs of ovulation Fertile period: 1 st sign of ovulation until 3 days after temp rise or 4 days after peak mucus

Answer 30

symptothermal

Question 31

Which type of female barrier/spermicidal method? can be left in place 48 hrs must be in for 6 hours after cex

Answer 31

cervical cap

Question 32

Which type of female barrier/spermicidal method? can be left in place 24 hrs must leave in for 6 hours after sex

Answer 32

diaphragm

Question 33

how far in advance can condoms for women be inserted?

Answer 33

8 hours in advance

Question 34

Which type of female barrier/spermicidal method? release continual spermicide must remain in place 6 hrs after sex

Answer 34

sponge

Question 35

2 disadvantages of female barrier/spermicidal methods

Answer 35

``` UTI risk (diaphragm) no HIV protection ```

Question 36

2 advantages of female barrier/spermicidal methods

Answer 36

no effect on menses immediately active

Question 37

Emergency OCPs must be taken as ___ doses within ____

Answer 37

2 doses within 72 hours of unprotected sex

Question 38

an IUD can be used as emergency contraception if placed within ______ of unprotected sex

Answer 38

5 days

Question 39

What type of emergency contraception? selective progesterone receptor modulator effective for 5 days after unprotected intercourse

Answer 39

ella/ulipristal acetate

Question 40

Duration of the below... Oral Contraceptive Pills (“the pill”) Nuva Ring ® (vaginal ring) OrthoEvra Patch ® (“the patch”) Depo Provera ® (“the shot”)

Answer 40

short acting/frequent use

Question 41

What type of contraceptive is good for women with the below: Women who have a short interval prior to wanting a pregnancy Women who are not looking for long term pregnancy prevention Women using these methods for non-contraceptive benefits Uninsured women with financial concerns

Answer 41

OCPs/ring/patch/shot (short acting)

Question 42

why must BP be measured before starting COCs?

Answer 42

ID severe HTN

Question 43

Which type of COC? Single dose of estrogen and progesterone for 21-24 days; + placebo pills for 4-7 days

Answer 43

monophasic pill

Question 44

What is the preferred monophasic formulation due to increased efficacy and decreased hormone withdrawal SEs?

Answer 44

24/4 or 21/7

Question 45

Which type of COC? Differing dose of estrogen and progesterone throughout the course of the pack; +placebo pills usually for 7 days

Answer 45

triphasic

Question 46

Which type of COC? Usually monophasic Packaged with 84 active pills and 7 placebo pills (seasonale) or 365 days of active pills (lybrel).

Answer 46

continuous

Question 47

The below are adverse effects of... HTN VTE MI/CVA Lipid/metabolic changes

Answer 47

COCs

Question 48

Which OCP has the below mechanism? ``` thickens cervical mucus to prevent sperm entry  Thin endometrium (inhibits implantation)  Ovulation suppression in 50% of cycles  Slows sperm motility ```

Answer 48

progestin only pill/mini pill

Question 49

progestin only pills are used for...

Answer 49

nursing mothers or estrogen C/I

Question 50

The below are adverse effects for: Limited window for missed pills (>3 hours late taking dose will decrease effectiveness) Increased spotting/intermenstrual bleeding Intermittent amenorrhea

Answer 50

progestin only pills

Question 51

The below are C/Is for what contraceptive method? Age ≥35 years and smoking Hypertension uncontrolled Migraine with aura Diabetes mellitus VTE Known ischemic heart disease History of stroke breast cancer severe cirrhosis

Answer 51

COCs

Question 52

implants have which hormone?

Answer 52

progestin only

Question 53

implants can be a good choice for women with...

Answer 53

estrogen contraindications

Question 54

Levonorgestrel IUD confers increased risk of...

Answer 54

ovarian cyst

Question 55

how does a copper IUD work?

Answer 55

prevents sperm motility

Question 56

IUD has increased risk of what conditions?

Answer 56

ectopic pregnancy miscarriage preterm delivery

Question 57

three forms of female sterilization

Answer 57

tube ligation salpingectomy hysteroscopic

Question 58

4 types of tube ligation...

Answer 58

removal band clip essure