Lecture 43

Question 1

cervical cancer screening rec

Answer 1

under 21 yo - no screening (ACS recommends under 25, ACOG recommends 21)
21 to 29 yo - pap smears every 3 years
30 to 65 yo - either pap smear every 3 years, HPV testing every 3 years, or co-testing (Pap + HPV) testing every 5 years
65+ yo - no screening

Question 2

screening if a person has had a hysterectomy

Answer 2

none regardless of age

Question 3

SE of HPV Vaccination

Answer 3

injection site reaction (most common)
dizziness, fatigue, and headache (2nd)
syncope, vomiting, and myalgia (uncommon)

Question 4

HPV vaccination 9-15 yo

Answer 4

2 dose series
dose one, then another 6 to 12 months later

Question 5

HPV vaccine in 16-45 yo

Answer 5

3 dose series
does one now, then dose two 2 months later, and then final dose 6 months after first dose

Question 6

risk vs benefits for ages 27 to 45 for HPV vaccine

Answer 6

must do a discussion
benefits - 88 to 95% effective for genital warts, vulvar cancer, vaginal cancer, and cervical cancer in females with efficacy inferred for men

Question 7

behavioral methods for non hormonal contraception

Answer 7

coitus interruptus
lactation amenorrhea method (LAM)
fertility awareness methods (FAM)
natural family planning (NFP)

Question 8

Natural Family Planning (NFP)

Answer 8

combined with FAM
methods – basal body temperature, billing ovulation methods, calendar/rhythm method, standard days methods, and two day
failure rate between 1 and 34%

Question 9

advantages of NFP

Answer 9

no effect on hormones or menstrual cycle
no side effects
inexpensive or free
acceptable in many religions and cultures

Question 10

disadvantages of NFP

Answer 10

no protection against STI
difficulty predicting ovulation in those with irregular cycles
requires consistent and accurate record keeping
requires extended periods of abstinence or backup contraception

Question 11

types of barrier method

Answer 11

male/female condom
vaginal sponge
diaphragm
cervical cap
contraceptive gel
spermicide

Question 12

barrier method

Answer 12

physically prevents sperm from entering the uterus
must be used correctly each time a person has intercourse
fewer side effects but less efficacy compared to hormonal contraceptives

Question 13

common advantages of barrier methods

Answer 13

no systemic side effects (diaphragm, cervical cap)
low cost (male condom, spermicide)
HIV/STI protect (male/female condom)

Question 14

common disadvantages of barrier methods

Answer 14

user dependent (condoms, vaginal sponge)
no HIV/STI protection (vaginal sponge, diaphragm, cervical cap, contraceptive gel, spermicide)
need proper fitting (diaphragm, cervical cap)

Question 15

long term method of nonhormonal contraceptives

Answer 15

copper intrauterine device

Question 16

Copper IUD advantages

Answer 16

prevents pregnancy for up to 10 years
could be used as emergency contraception
extremely effective (under 0.8% failure)
non-hormonal

Question 17

copper IUD disadvantages

Answer 17

expensive
no STI prevention
side effects of heavy/painful bleeding and spotting

Question 18

permanent methods

Answer 18

surgery sterilization (male vasectomy or female tubal ligation)

Question 19

what should a pt use if they want it to be highly effective but still allow her to have children later?

Answer 19

Number One Choice – Copper IUD (up to 10 years)
Secondary due to effectiveness – Diaphragm, Female Condom, Cervical Cap, Vaginal Sponge, FAM, Spermicide

Question 20

What should a pt use if they want no painful side effects?

Answer 20

diaphgram
THEN male condom, female condom, cervical cap, or sponge
THEN FAM or spermicide

Question 21

what should a pt use if they do not want to think about contraceptives?

Answer 21

copper IUD or implant

Question 22

what should a pt use if they are need HIV/STI prevention?

Answer 22

male/female condom

Question 23

what should a pt use if they are only worried about STI prevention?

Answer 23

copper IUD
(male and female condom prevent against both HIV/STI)