Exam 2: Contraception Flashcards
(121 cards)
1
Q
Safety category 1?
A
No restrictions
2
Q
Safety category 2?
A
Benefits outweigh risk
3
Q
Safety category 3?
A
Risk usually outweightr benefits- try to avoid
4
Q
Safety category 4?
A
Don’t prescribe! Not safe!
5
Q
How many days long is the menstural cycle?
A
28 days
6
Q
Menstruation is which days of the menstural cycle?
A
1-7
7
Q
Follicular/Proliferative Phase is which days of the menstural cycle?
A
7-13
8
Q
Which does is ovulation?
A
14
9
Q
Luteal/Secretory Phase is which days of the menstural cycle?
A
15-28
10
Q
Menses is which day of menstural cycle?
A
Day 1 of mensturation
11
Q
3 strategies to prevent contraception?
A
- Prevent ovulation
- Prevent fertilization
- Prevent implantation
12
Q
Combined oral contraceptives, nexplanon, nuva ring, and depo-provera are which type of contraception?
A
Prevent Ovulation
13
Q
Abstinance, pull out, condoms is which type of contraception?
A
Prevent fertilization
14
Q
IUD and emergency contraception are which type of contraception?
A
Prevent implantation
15
Q
Urine HCG positive when?
A
After 2 weeks
17
Q
What ages to ask if she wants to get preggers in next year?
A
18-50
19
Q
Most effective form of STI prevention?
A
Male condom
20
Q
What is the least effective contraceptive option?
A
Periodic abstinance
21
Q
Coitus interruptus, LAM, fertility-awareness based methods are all which type of contraceptive option?
A
Periodic Abstinance. Least effective in preventing contraception.
22
Q
What is the most effective contraceptive method?
A
Emergency contraception
23
Q
Does a female diaphragm protect against STIs?
A
Nope
24
Q
Which 2 agents are in Combined Oral Contraceptives?
A
- Progestational agent
2. Estrogenic agent
25
Q
What do Combined Oral Contraceptives prevent?
A
Prevent ovulation
26
Q
Combined Oral Contraceptives prevent ovulation by inhibiting what?
A
Inhibiting gonadotropin secretion
27
Which 2 brain centers are effected by Combined Oral Contraceptives?
Pituitary and hypothalamic centers
28
Which hormone is suppressed by the progestational agent in Combined Oral Contraceptives?
LH secretion
29
Which hormone is suppressed by the estrogenic agent in Combined Oral Contraceptives?
FSH
30
What does FSH cause the development of?
Dominant follicle
31
Estrogenic agents do what to follicles?
Suppress development of dominant follicle by suppressing FSH
32
COCs increased VTE risk by which agent?
Estrogen
33
COCs CI’d to which age and smoker?
35+ if smoker
34
COC CIed at which BP?
>160/100
35
Which generation COC has highest angrogenic effect? (acne, hirsutism)
2nd gen
36
Which generation COC has lowest angrogenic effect? (acne, hirsutism)
3rd
37
Monthly COCs divided into what types of pills?
21 days of hormones, 7 days placebo (menses)
38
What 2 things to check before prescribing COCs?
BP and BMI!
39
Which method is preferred for starting COCs?
Quick Start
40
When it Quick Start for COCs started?
Same day as prescribed
41
What must be reasonable excluded before doing COC Quick Start?
Preggers
42
If more than 5 days from menses and want to do COC Quick Start what must give? For how long?
Backup methods for 7 days (condoms, abstinance, etc)
43
When is Sunday Start for COCs?
Start Sunday after period begins
44
Backup for Sunday Start COCs?
Yes, for 7 days.
45
When is First Day Start for COCs?
Start first day of menses
46
Backup for First Day Start of COCs?
No backup needed! Only one which doesn’t need backup.
47
What to do if miss one COC pill and within 48h? Backup or emergency needed?
Take ASAP, take regular pill, no additional pill or emergency needed.
48
What to do if miss two COC pills and ≥48h? Backup or emergency needed?
Take ASAP, use backup for 7 days (condoms or abstinance)
49
If miss 2+ COC pills during days 15-21?
Omit hormone free days and start new pack
50
When to use emergency contraception on COCs? (hint: which week? sex?
Pills missed during first week and had unprotected sex in previous 5 days
51
Progestin-only pill suppressed what?
Ovulation
52
Progestin-only pill does what to cervical mucuous and endometrium?
Thickens mucous, thins endometrium
53
Northindrone has which agent
Progestin-only pill
54
Speed of Progestin-only pill act?
Rapid acting
55
How long need to use backup for when on Progestin-only pill?
2 days only
56
Downside of when to take Progestin-only pill?
Take same time each day
57
Bleeding and Progestin-only pill?
Irregular bleeding
58
Progestin-only pill and follicular cysts?
No estrogen=not effective at suppressing follicular cysts
59
Micronor and Nor-QD are which oral contraceptive?
Progestin-only pills
60
Which contraceptive is a vaginal insert
Nuvaring
61
Which contraceptive has Estradiol and Etonogestrel
Nuvaring
62
Nuvaring in for how long? Out for how long?
In 3 weeks, out 1 week (menses)
63
Nuvaring delay <48 hours? Backup or emergency?
Insert ASAP. No backup or emergency needed.
64
Nuvaring delay >48 hours? Backup or emergency?
Insert ASAP. Backup for 7 days. Emergency is sex within 5 days.
65
Which contraceptive is a transdermal patch?
Orthoevra
66
Orthoevra on and off?
3 weeks on, 1 week off
67
Blackbox warning for Orthoevra?
Increased risk of VTE if smoker d/t estrogen
68
Orthoevra effective in obese?
Less effective
69
Need back <48 hour delayed Orthoevra?
No backup needed if <48h
70
Need back >48 hour delayed Orthoevra?
Need backup
71
Which contraceptive is injected Medroxyprogesterone?
Depo-Provera
72
What does Medroxyprogesterone suppress and inhibit?
Suppresses gonadotropins to inhibit ovulation
73
Depo-Provera doses when?
q90d
74
Depo-Provera does what to weight?
Gains
75
Depo-Provera and bone loss?
Causes bone loss. Take VitD and Ca.
76
Depo-Provera and regaining fertility?
Very delayed return to fertility after stopping
77
When can start Depo-Provera?
Any time
78
Need backup if start Depo-Provera >7d after menses?
Yes, need backup (condoms, abstinance, etc)
79
Nexplanon and IUDs are examples of what class of contraception?
Long Acting Reversible Contraception
80
How long to avoid estrogen when post-partum? Why?
4 weeks. Increased risk of VTE.
81
What does estrogen do to breast milk supply?
Decreases
82
Which is Progestin rod implanted in upper arm?
Nexplanon
83
Nexplanon releases progestin over how many years?
3 years. 68mg Progestin.
84
Nexplanon suppressed what and inhibits what?
Suppresses ovulation. Inhibits fertilization.
85
Most common LARC?
IUDs
86
IUDs have an efficacy similar to what?
Sterilization
87
Hormonal IUDs prevent what and inhibit what?
Prevent implantation. Inhibit sperm and egg binding.
88
Copper IUDs prevent what and enhance what?
Prevent implantaiton. Enhance cytotoxic inflammatory response within endometrium.
89
When is IUD implantation CI’d?
Preggers, active infx, disruption of uterine cavity (didelphys), undiagnosed uterine bleeding
90
What does hormonal IUD do to menses? (hint: time and flow)
Lighter flow, shorter menses
91
What does Copper IUD do to menses? (hint: time and flow)
Heavy menses, dysmenorrhea
92
Which IUD can be used as emergency contraception?
Copper IUD (non-hormonal)
93
What 2 things to check/do before implanting hormonal IUD?
Bimanual exam, cervical inspection
94
Mirena lasts for how long?
5 years
95
Styla lasts for how long?
3 years
96
Tubal Ligation is what sort of contraception?
Sterilization
97
Tubal Ligation can help protect against which cancer?
Ovarian cancer
98
Tubal Ligation can cause what kind of preggers?
Ectopic preggers
99
Is Tubal Ligation permanent?
Yes
100
Cut vas deferens to keep sperm out of semen called?
Vasectomy
101
Can offer emergency contraception up to how many days after unprotected sex?
5 days
102
Most effective emergency contraception?
Copper IUD- Paragard
103
Most common emergency contraception?
Progestin-only pills
104
Are progestin-only pills for emergency contraception OTC?
yup
105
Progestin-only emergency contraception up to how many days?
3
106
Ulipristal up to how many days for emergency contraception?
5 days
107
Copper IUD for emergency contraception up to how many days?
5 days
108
Who is the genius behind these flashcards?
Brad!
109
Which post-partum contraception if breastfeeding?
Progesterone-online (POP, Depo, Nexplanon, IUD)
110
When can start COC for post-partum contraception?
5 week after birth d/t VTE risk
111
what is something to counsel patients on when they use combined OCPs?
breakthrough bleeding
-this bleeding usually goes away after 90 days, but MUST LET THE 90 DAYS PASS TO SEE AND IF DOESN'T STOP THEN CAN CHANGE MED
112
what meds decrease efficacy of combined OCPs?
phenytoin and rifampin
113
if pt is complaining of acne, how can you manage their OCP?
increase estrogen or decrease androgen/progestin
114
if pt is complaining of amenorrhea, how can you manage their OCP?
increase estrogen
115
if pt is complaining of breast tenderness/swelling, how can you manage their OCP?
decrease estrogen
116
if pt is complaining of BTB, spotting (days 1-9), how can you manage their OCP?
increase estrogen
117
if pt is complaining of nausea, how can you manage their OCP?
take with food at night
decrease estrogen or increase progestin
118
if pt is complaining of androgenic effect (hirsutism, etc), how can you manage their OCP?
select 3rd gen progestin, low dose norethindrone or ethynodiol diacetate
119
if pt is complaining of irregular, heavy, painful menses, how can you manage their OCP?
increase progestin or decrease estrogen
120
if pt is complaining of BTB, spotting (days 10-28), how can you manage their OCP?
increase progestin
121
if pt has high risk of thrombosis, how can you manage their OCP?
decrease estrogen (b/c adr of estrogen is clots)
122
at what dose of estrogen in OCPs is there an increase in BTB?
dose < 20 mcg (low dose)
123
vasectomy disadvantages? back up method?
requires semen analysis at 3 months post procedure
USE BACK UP METHOD FOR 3 MONTHS!!!
