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Flashcards in Exam 2 Deck (56):
1

when does pregnancy begin (when can bhcg be measured)?

implantation

2

when is the peak fertility window?

day 9-15 of cycle

3

7 main categories of contraception

1. surgical sterilization
2. IUD
3. barrier methods
4. E/P method
5. progestin only
6. emergency contraception
7. natural family planning

4

what needs to be considered when prescribing birth control?

1. reversibility
2. effectiveness
3. contraindications
4. secondary benefits
5. AEs
6. cost

5

which methods are immediately irreversible?

1. copper IUD
2. condom
3. natural family planning
4. birth control pills

6

which 5 birth control methods are the most effective?

1. progesterone implant
2. vasectomy
3. LNG-IUD
4. tubal ligation
5. copper IUD

7

which 5 birth control methods are the least effective?

1. spermicide
2. natural family planning
3. withdrawal
4. female condom
5. sponge

8

which time frames are considered long acting (in terms of needing to think about it)?

1. once
2. Q3-10 yrs

9

which contraceptive method is reversible but takes 6 months?

DMPA

10

what are the CIs to EP pills?

1. current breast disease
2. severe cirrhosis
3. hx of DVT/PE
4. DM nephropathy/retinopathy/neuropathy
5. headache w/aura
6. HTN
7. CVD
8. seizure d/o
9. strokes

11

which contraceptive methods are most expensive?

diaphragm, condoms, DMPA

12

which contraceptive method can be delivered as short acting or long acting?

progestin only

13

how often is DMPA delivered?

Q3mon

14

how often are progestin IUDs good for?

3-5 years

15

which contraceptive method can be delivered as an injection, implant, IUD, or pill?

progestin only

16

how do EP methods work?

1. suppress follicle development
2. thickens cervical mucus
3. inhibits ovulation

17

how does progesterone specifically act as a contraceptive?

1. LH suppression
2. thickens cervical mucous
3. atrophic endometrium

18

how does estrogen specifically act as a contraceptive?

1. FSH suppression
2. altered tubular transport

19

what can estrogen alone cause?

endometrial cancer

20

what can progestin alone cause?

acne, mood swings

21

what are the 3 methods of EP delivery?

1. pill
2. ring
3. patch

22

what is the point of the triphasic EP pill and what causes this multiphasic nature?

to mimic nature (caused by progestin)

23

what are the common SE of EP?

1. N/V
2. HA
3. breast enlargement/tenderness
4. libido alteration
5. breakthrough bleeding
6. acne, oily skin, hirsutism
7. hair loss

24

what are the secondary benefits of EP?

1. acne
2. menstrual cycle control
3. lighter/shorter periods
4. improved cramps
5. bone protection
6. decr risk for ovarian and endometrial cancer

25

what are the types of IUD?

1. copper IUD
2. LNG-IUD

26

how do IUDs work?

inhibit fertilization & secondarily inhibit implantation

27

how does the copper T act?

reduces sperm motility and viability

28

how does the LNG-IUD work?

inhibits ovulation, thickens cervical mucus, reduces sperm motility and viability

29

CI for IUDs

1. current STI
2. unexplained uterine bleeding
3. large deforming fibroids
4. Wilson's
5. copper allergy

30

what are the SE of an IUD?

1. uterine perforation
2. expulsion
3. cramping
4. PID
5. heavy menses (copper)
6. irregular spotting (LNG)

31

what are two benefits of barrier contraception over hormonal?

most dont require prescription and they offer STI protection

32

what 2 types of barriers are there?

chemical and physical

33

what are the types of chemical barriers?

1. today sponge
2. spermicides
3. diaphragm and cervical cap

34

when is natural family planning esp not the best method?

if you have irregular cycles (<21 days or >28 days)

35

what is natural family planning?

selective abstinence

36

what are the forms of emergency contraception?

1. levonorgestrel (OTC)
2. Ulipristal
3. copper IUD
4. combo EP pills (need to take multiple)

37

which emergency contraceptives are good for 120 hours?

ulipristal and copper IUD

38

how do hormonal emergency contraceptives work?

delay ovulation and may interfere with sperm migration and function at all levels of genital tract

39

for which patients may EC not work?

overweight (copper IUD will work)

40

what are the side effects of EC?

1. uterine bleeding
2. N/V
3. HA
4. abd pain

41

which EC may cause early abortion?

ulipristal

42

what is medication abortion?

mifepristone

43

what needs to be done after admin mifepristone?

US to confirm

44

which contraceptive cannot be used while breastfeeding?

EP pill

45

what are common problems with DMPA?

weight gain and decr bone density

46

for which women are estrogen alone pills ok?

those w/o a uterus

47

What is a w/d bleed?

when a woman takes the placebo pills in the EP pack

48

how is the nuvaring managed?

slow release and needs to be taken out Q3wks

49

how does copper IUD affect risk of PID?

not more risk than average person except for first month after insertion

50

what is NEVER a contraceptive method?

ovulation sticks

51

between the calendar method and monitoring cervical mucus, which is more effective?

monitoring cervical mucus

52

what is the failure rate with the calendar method?

25%

53

how does EC work?

delays ovulation by giving lots of progesterone to stop LH surge and tricks your body into thinking it already ovulated

54

what will EC not do?

prevent pregnancy if implantation has already occurred

55

what is the second effect of the ECs?

makes the endometrium an inhospitable environment for implantation

56

with a positive pregnancy test which EC method can be used?

mifepristone/misoprostol (b/c implantation has already occurred