Contraception/Infertility Flashcards

1
Q

menses occurs during which phase

A

follicular

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2
Q

at the start of menses, estrogen is (low/high) and progesterone is (low/high)

A

low, low

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3
Q

prenancy tests test for

A

hCG

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4
Q

women planning to conceive should take which supplement

A

folate (B9)

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5
Q

which contraceptive may cause delay in the return to fertility

A

medroxyprogesterone

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6
Q

T/F: female internal condoms provide more protection than male external condoms

A

T

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7
Q

Caya

A

diaphragm

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8
Q

what type of lubricant should be used with condoms

A

water or silicone-based

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9
Q

phexxi

A

Rx, vaginal gel that maintains acidic pH, do not use if vaginal ring or history of UTI

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10
Q

hormonal contraceptives work by inhibiting

A

production of FSH, LH

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11
Q

common estrogen in oral contraceptive

A

ethinyl estradiol

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12
Q

common progestins in oral contraceptive

A

norethindrone, levonorgesterol, drospirenone

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13
Q

monophasic

A

same dose estrogen and progestin throughout

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14
Q

multi-phasic

A

mimic estrogen and progestin levels in menstrual cycle

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15
Q

drospirenone is unique in that it…

A

is a mild potassium-sparing diuretic which dec bloating/weight gain

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16
Q

which drug is used for moderate to severe pain associated with endometriosis

A

Orlissa (Elagolix)

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17
Q

Which hormonal drugs are indicated for heavy menstrual bleeding (menorrhagia)

A

Natazia, Mirena (IUD)

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18
Q

which drug is indicated for heavy bleeding associated with fibroids

A

Oriahnn

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19
Q

what non-hormonal drug is available for menorrhagia

A

Lysteda

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20
Q

which hormonal drug may be used for migraine prophylaxis and is safe in migraines with aura

A

mini-pill (progestin-only)

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21
Q

why can’t estrogen be used in migraines with aura

A

risk of stroke

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22
Q

what’s an important counseling point for mini pills

A

must take pill within 3 hours of scheduled time

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23
Q

“Lo” indicates

A

= 35 mcg estrogen (i.e. less SE)

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24
Q

“Fe” indicates

A

iron supplement is included

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25
Q

“24” indicates

A

shorter placebo time

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26
Q

Monophasic formulations

A

Junel, Microgestin, Sprintec, Loestrin, Yasmin

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27
Q

Triphasic formulation

A

Tri-sprintec

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28
Q

extended cycle formulation

A

Seasonique

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29
Q

Xulane

A

transdermal patch

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30
Q

Nuvaring

A

vaginal ring

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31
Q

brand names of mini pills

A

Errin, Camila, Nora-BE

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32
Q

Injected contraception containing only progestin

A

depot-provera

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33
Q

depo provera is injected how often

A

every 3 months

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34
Q

which patient can receive Xulane? a) 35 yo F, plays golf professionally, smoker b) 30 yo F, uncontrolled HTN, does not drink alcohol c) 26 yo F BMI is 29, DM II d)24 yo F who recently gave birth two weeks ago

A

c; patches have higher estrogen exposure so do not use in pts with high clotting risk

35
Q

which patients are considered high clotting risk

A

> 35 and smokes, CVD/ blood clots, postpartum, BMI>/=30

36
Q

Depot provera generic

A

DMPA (medroxyprogesterone acetate)

37
Q

DMPA is injected how

A

IM or SC

38
Q

T/F: all IUDs are hormone free

A

F; some can contain levonorgestrel

39
Q

after 1 year, DMPA users may become

A

amenorrheic

40
Q

which contraceptive is approved with no placebo pills and allows you to skip menses

A

amethyst

41
Q

spotting usually resolves in

A

3-6 months

42
Q

drospirenone is contraindicated in

A

renal or liver disease

43
Q

nuva ring can be reused for how long

A

1 year

44
Q

major side effects of estrogen

A

nausea, breast tenderness, melasma, bloating

45
Q

what are symptoms you should watch out for that indicate clotting

A

ACHES (abdominal pain, chest pain, H/A, eye problems, swelling or sudden leg pain)

46
Q

what lab may need to be reviewed for a patient taking drospirenone

A

potassium (can inc levels)

47
Q

DMPA may have what side effect

A

loss in bone mineral density

48
Q

which contraceptive product is best for a patient with acne or hirsutism

A

combination OC with progestin that has lower androgenic activity (drospirenone)

49
Q

which contraceptive product is best for a patient who is breastfeeding

A

progestin only product or nonhormonal

50
Q

which contraceptive product is best for a patient with a contraindication to estrogen

A

progestin only product or nonhormonal

51
Q

which contraceptive is best for a patient who experiences migraine

A

if aura then progestin only or nonhormonal; if no aura then any product

52
Q

which contraceptive is best for a patient with HTN

A

progestin only or nonhormonal

53
Q

which contraceptive is best for a patient who has mood changes/disorders

A

monophasic combination OC or continuous drosperinone

54
Q

which contraceptive is best for a patient experiencing nausea

A

dec estrogen dose, progestin only, nonhormonal

55
Q

which contraceptive is best for a patient who is overweight

A

Any (but not the patch in obese patients, and no DMPA if planning to lose weight

56
Q

which contraceptive is best for postpartum patient

A

nonhormonal (wait at least 3 weeks or 6 weeks with VTE risk factors to start hormonal therapy)

57
Q

which contraceptive is best for PDD

A

drospirenone

58
Q

early spotting may be fixed by increasing

A

estrogen

59
Q

late spotting may be fixed by increasing

A

progestin

60
Q

rifampin use may require patient to have backup contraceptive method for how long

A

6 weeks

61
Q

what drugs may interact with hormonal birth control

A

anticonvulsants, St John’s wort, tobacco, ritonavir, colesevelam, byetta

62
Q

liver toxicity may occur in patients taking oral contraceptives with

A

Mavyret

63
Q

How many days does it take hormonal pills to achieve contraceptive efficacy

A

7 days

64
Q

No backup birth control method is needed if hormonal oral contraceptive is started when

A

Within 5 days after the start of the period

65
Q

How many days does it take for progestin only pills to achieve contraceptive efficacy

A

2 days

66
Q

Back contraception is needed for patients taking combined OC if they miss

A

2 pills

67
Q

Progestin only pills require backup method if missed dose is

A

> 3h past scheduled time

68
Q

Para guard can be used for up to

A

10 years

69
Q

Paraguard may have what side effects

A

Heavy bleeding and cramping

70
Q

Nexplanon is used up to

A

3 years

71
Q

Copper iud can be used as an emergency contraceptive if used within

A

5 days

72
Q

Ella (does/ does not) require a prescription

A

Does

73
Q

Ella can be be effective up to how many days after sex

A

5 days

74
Q

Plan B can be effective up to how many days after sex

A

3 days

75
Q

paragard is the brand name for

A

copper iud

76
Q

primary side effect of levonorgetrel

A

nausea

77
Q

diaphragms should be left in for how long

A

6-24 hours after intercourse

78
Q

diaphragms can be reused for up to how long

A

2 years

79
Q

sponge should be left in for how long

A

6-24 hours after intercourse

80
Q

patients on medroxyprogesterone should have a daily recommended intake of

A

calcium, vitamin D

81
Q

what treatment choices are available for infertile women with absent ovulation

A

clomiphene, letrozole

82
Q

gonadotropins may be used in infertility in which situations

A

intrauterine insemination or in vitro fertilization

83
Q

how is a gonadotropin administered

A

IM injection