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Finals > Sexual Health > Flashcards

Sexual Health Flashcards

1
Q

What is the causative organism in gonorrhoea?

A
  1. Neisseria gonorrhoea
    (Gram -ve intracellular diplococcus)
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2
Q

What is the incubation period for gonorrhoea?

A
  1. 2-7 days
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3
Q

Give 8 symptoms of gonorrhoea

A
  1. Penile/vaginal discharge
  2. Dysuria
  3. Pelvic pain
  4. IM bleeding
  5. Conjunctivitis
  6. Deep dysparaeunia
  7. Proctitis
  8. Bartholin’s cyst (tender mass in labial fold)
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4
Q

Give 7 complications of gonorrhoea

A
  1. PID
  2. Epididymo-orchitis
  3. Tubo-ovarian cyst
  4. Ectopic pregnancy
  5. Infertility
  6. Disseminated gonococcal infection (presenting as rash)
  7. Septic arthritis
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5
Q

Give 1 diagnostic test for gonorrhoea

A
  1. NAAT - first catch urine sample in men, vaginal swab in women
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6
Q

Give the management of gonorrhoea

A
  1. Ceftriaxone (IM stat)
  2. Azithromycin (PO stat) - accounts for increasing resistance
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7
Q

What impact does gonorrhoea have on pregnancy?

A
  1. Causes opthalmia neonatorum (occurring earlier than chlamydial conjunctivitis) and so requires management in the pregnant mother
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8
Q

Is partner notification required for gonorrhoea?

A
  1. Yes
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9
Q

Give the causative organism for chlamydia

A
  1. Chlamydia trachomatis (Gram -ve bacterium)
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10
Q

Give 8 symptoms of chlamydia

A
  1. Penile/vaginal discharge
  2. Dysuria
  3. Conjunctivitis
  4. Pelvic pain
  5. Dysparaeunia
  6. IM bleeding
  7. Proctitis
  8. Post-coital bleeding
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11
Q

Give 7 complications of chlamydia

A
  1. PID
  2. Epididymo-orchitis
  3. Tubo-ovarian cyst
  4. Infertility
    5.Ectopic pregnancy
  5. Sexually-acquired reactive arthritis (arthritis, rash, urethritis, uveitis)
  6. Peri-hepatitis
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12
Q

Give 1 investigation for chlamydia

A
  1. NAAT - first pass urine sample in men, vaginal swab in women
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13
Q

Give the management of chlamydia

A
  1. Doxycycline PO
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14
Q

Give the impact of chlamydia infection in pregnancy

A
  1. Causes neonatal conjunctivits (2-4 weeks after birth - presents later than opthalmia neonatorum)
  2. Causes neonatal pneumonitis (managed with erythromycin PO)
  3. Treat the mother with azithromycin (doxycycline is contra-indicated in pregnancy)
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15
Q

Is partner notification required for chlamydia?

A
  1. Yes
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16
Q

Give the causative organism for lymphogranuloma venereum

A
  1. Chlamydia trachomatis serovar L1-3 (more infective subtype)
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17
Q

Give the presentation of lymphogranuloma venereum

A
  1. Proctitis
  2. Tenesmus
  3. Fever
  4. Inguinal lymphadenopathy
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18
Q

Give 1 complication of lymphogranuloma venereum

A
  1. Fistulae formation
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19
Q

Give the management for lymphogranuloma venereum

A
  1. Doxycycline PO (prolonged course)
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20
Q

Give the causative organism of syphilis

A
  1. Treponema pallidum (spirochete bacterium)
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21
Q

Give the 5 stages of syphilis

A
  1. Primary syphilis
  2. Secondary syphilis
  3. Early-latent syphilis
  4. Late-latent syphilis
  5. Tertiary syphilis
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22
Q

Give the presentation of primary syphilis

A
  1. Chancre formation (single painless ulcer on genitals)
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23
Q

Give the presentation of secondary syphilis

A
  1. Widespread non-pruritic maculopapular rash involving the palms of the hands and the soles of the feet
  2. Alopecia
  3. Oral snail-track lesions
  4. Pyrexia, fatigue, malaise
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24
Q

Give the presentation of early-latent syphilis

A
  1. Asymptomatic infection with positive serology within 2 years of diagnosis
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25
Q

Give the presentation of late-latent syphilis

A
  1. Asymptomatic infection with positive serology greater than 2 years after diagnosis
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26
Q

Give the presentation of tertiary syphilis

A
  1. Untreated syphilis may develop to: neurosyphilis (paresis, strokes) or cardiovascular syphilis (aortitis, aneurysm)
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27
Q

Give 3 investigations for syphilis

A
  1. Dark ground microscopy of chancre fluid
  2. PCR from chancre
  3. Serology (including VDRL - becomes raised in secondary syphilis)
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28
Q

Give the management of syphilis

A
  1. IM pencillin STAT (benzathene penicillin) - azithromycin as 2nd line
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29
Q

Give 1 side effect of syphilis management

A
  1. Jarisch-Herxheimer Reaction - acute inflammatory response to toxins released during spirochete cell lysis causing fever, myalgia and headache. Presents with sepsis-like picture
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30
Q

Give the impact of syphilis in pregnancy

A
  1. May cause stillbirth and miscarriage
  2. May cause congenital syphilis - presenting with deformed bone, rash, meningitis and anaemia
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31
Q

Give 1 complication of syphilis management

A
  1. Jarisch-Herxheimer reaction - antibiotic management of syphilis causes endotoxin release, presenting with a sepsis-like picture. Can be prevented with steroids
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32
Q

Give the causative organism of trichomoniasis

A

Trichomonas vaginalis (flagellated protozoan)

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33
Q

Give the presentation of trichomoniasis

A
  1. Vaginal discharge
  2. Vulval itch
  3. Dysparaeunia
  4. Dysuria
  5. Balanitis and urethral discharge (men)
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34
Q

Give the management of trichomoniasis

A
  1. Metronidazole (PO single dose)
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35
Q

Give the diagnostic investigation of choice for trichomoniasis

A
  1. NAAT of urine sample of swab of vaginal discharge
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36
Q

Is partner notification required for trichomoniasis?

A

Yes

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37
Q

Give 3 complications of trichomoniasis

A
  1. PID (increases risk of infertility)
  2. Prostatitis
  3. Increased risk of premature rupture of membranes and premature birth
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38
Q

Give the causative organism of genital herpes

A
  1. Herpes zoster virus 1 and 2 (DS DNA virus)
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39
Q

Give the presentation of genital herpes

A
  1. Either primary infection or recurrence
  2. Blisters which progress to painful ulcers
  3. Dysuria
  4. Pyrexia
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40
Q

Give the investigations for genital herpes

A
  1. HSV PCR - swab from lesions (burst an ulcer nd swab the base)
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41
Q

Give 1 complication of genital herpes

A
  1. Encephalitis
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42
Q

Give the management of genital herpes

A
  1. Aciclovir (for primary, recurrence and as prophylaxis)
  2. Pain relief, topical vaseline, salt water baths
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43
Q

Give the presentation of neonatal herpes

A
  1. Vesicular rash
  2. Encephalitis (seizures, bulging fontanelle, irritability)
  3. Respiratory failure
  4. Hepatic failure
  5. Disseminated intravascular coagulation
  6. Death
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44
Q

Give the management of neonatal herpes

A
  1. Aciclovir
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45
Q

Give the causative organism of genital warts

A

Human papillomavirus 6 and 11 (DS DNA virus)

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46
Q

Give the symptoms of genital warts

A
  1. Vulval, vaginal, anal or penile warts
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47
Q

Give the management of genital warts

A
  1. May resolve spontaneously
  2. Topical podophyllin paint (avoid in pregnancy)
  3. Cryotherapy
  4. Surgical removal (likely to scar)
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48
Q

Give 2 preventative measures for genital warts

A
  1. Behavioural
  2. Quadrivelant HPV vaccine
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49
Q

Give the pathophysiology of HIV

A
  1. SS RNA virus
  2. Incorporates into host cell DNA using reverse transcriptase and integrase enzymes
  3. Viral proteins are assembled by proteases, which are released from the cell via budding - killing the cell
  4. New virions affect further cells - any with a CD4 receptor (incl. CD4+ T-cells, macrophages, monocytes)
  5. CD4+ T-cells are gradually destroyed, resulting in reduced immunity
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50
Q

Give the presentation of HIV seroconversion illness

A
  1. 2-6 weeks following exposure
  2. Fever, malaise, myalgia
  3. Maculopapular rash
  4. Widespread lymphadenopathy
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51
Q

Give the presentation of AIDS

A
  1. Marked immunodeficiency with reduced CD4+ T-cell count
  2. Clinical syndrome of disease in the presence of HIV:
    a) Respiratory/oesophageal candida
    b) Chronic HSV
    c) Disseminated TB
    d) Toxoplasmosis of the brain
    e) Recurrent salmonella
    f) Lymphoma of the brain
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52
Q

Give the investigations for HIV

A
  1. Antigen-antibody test - positive 2-6 weeks following exposure
  2. Western blot test
  3. CD4+ T-cell count - measures immune function
  4. HIV RNA - ‘viral load’ to monitor treatment progress
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53
Q

Give the management of HIV

A
  1. Anti-retroviral therapy - aims to reduce virl load to below detectable levels
  2. 2x nucleotide analogue reverse transcriptase inhibitors (NRTIs), PLUS 1x protease inhibitor OR 1x non-NRTI
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54
Q

Give 2 examples of NRTIs

A
  1. Tenefovir
  2. Zidovudine
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55
Q

Give 3 side effects of NRTIs

A
  1. GI distrubance
  2. Anaemia
  3. Neuropathy
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56
Q

Give 1 example of a protease inhibitor

A
  1. Indinavir
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57
Q

Give 1 example of a non-NRTI

A
  1. Nevirapine
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58
Q

Describe post-exposure prophylaxis

A
  1. Effective if taken within 72 hours of exposure
  2. Truvada (tenefovir plus emtracitabine) PLUS raltegravir
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59
Q

Describe pre-exposure prophylaxis

A
  1. Truvada (tenefovir plus emtracitabine)
  2. Can be taken daily or event-driven (2 tablets 2-24 hours prior to sex PLUS 1 tablet every 24 hours for at least 2 doses after sex)
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60
Q

Give the management of HIV in pregnancy

A
  1. Mother should take nevirapine (non-NRTI)
  2. Elective caesarean at 38 weeks
  3. Abstain from breast feeding
  4. May vertically transmit HIV to foetus
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61
Q

Give the transmission route for Hepatitis A

A
  1. Faeco-oral
  2. Rarely transmitted via sex
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62
Q

Give the presentation of Hepatitis A

A
  1. Often asymptomatic
  2. Jaundice, malaise, abdominal pain, fever
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63
Q

Give the investigations for Hepatitis A

A
  1. Abnormal LFTs
  2. Anti-HAV antibodies
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64
Q

Give the management of Hepatitis A

A
  1. Usually self-limiting, lasting around 6 weeks
  2. No unprotected sex for 7 days following onset of jaundice
  3. Not associated with chronic hepatic disease
  4. Hepatitis A vaccine as prophylaxis
65
Q

Give the infection route for Hepatitis B

A
  1. Sexually
  2. Blood-borne
66
Q

Give the pathophysiology of Hepatitis B

A
  1. Hepatocytes become infected with Hep. B and present HBsAg
  2. T-cells induce apoptosis in these cells
67
Q

Give the incubation period for Hepatitis B

A

1-4 months

68
Q

Give the presentation of Hepatitis B

A
  1. Fever, malaise, fatigue, joint pain
  2. Jaundice, pale stool, dark urine
  3. Chronic hepatitis B may cause liver cirrhosis or cancer
69
Q

Give the investigations for Hepatitis B

A
  1. Deranged LFTs
  2. Positive hepatitis B serology
70
Q

Give the pathophysiology of Hepatitis B

A
  1. Hepatocytes become infected with Hep. B and present HBsAg
  2. T-cells induce apoptosis in these cells
71
Q

Describe serology positive for acute/chronic Hepatitis B infection

A
    • HBsAg
    • Anti-HBc
    • Anti-HBs

Acute = < 6 months
Chronic = > 6 months

72
Q

Describe the serology positive for immunity following Hepatitis B vaccination

A
    • HBsAg
    • Anti-HBc
    • Anti-HBs
73
Q

Give the serology positive for immunity following previous Hepatitis B infection

A
    • HBsAg
    • Anti-HBc
    • Anti-HBs
74
Q

Give the complications of Hepatitis B infection

A
  1. Acute liver failure
  2. Chronic hepatitis B
  3. Cirrhosis
  4. Hepatocellular carcinoma
75
Q

Give the management of Hepatitis B

A
  1. Symptomatic management during acute infection
  2. Anti-viral therapy in chronic infection (e.g. interferon)
  3. Alcohol abstinence
  4. Vaccination of sexual partners
  5. HBIg if exposed
76
Q

Give the management of Hepatitis B in pregnancy

A
  1. HBIg to baby within 24 hours of birth
  2. Full course of vaccination for baby
77
Q

Give the transmission route for Hepatitis C

A
  1. Blood-borne
  2. Sex (rare)

Most commonly transmitted in IVDU

78
Q

Describe the epidemiology of Hepatitis C

A
  1. Rare in the UK
  2. 19% of population affected in Egypt
79
Q

Give the presentation of Hepatitis C

A
  1. Often asymptomatic
  2. Jaundice, malaise, abdo pain, nausea, fever
  3. Most cases are discovered on routine LFT
80
Q

Give the investigations for Hepatitis C

A
  1. Raised ALT, bilirubin
  2. Decreased INR
  3. Anti-HCV and HCV PCR
  4. Liver USS - assess for cirrhosis and hepatocellular carcinoma
81
Q

Give the management of Hepatitis C

A
  1. Antiviral therapy e.g. sofosbuvir + ledipasvir
  2. Transmission counselling
82
Q

Give the impact of Hepatitis C in pregnancy

A
  1. C-section doesn’t reduce risk of transmission
  2. Test babies at age 18 months
  3. Breastfeeding is safe - unless nipples cracked or bleeding
83
Q

Give the most common causative organism of candida

A
  1. Candida albicans - CAN NOT BE SEXUALLY TRANSMITTED
84
Q

Give the presentation of candida

A
  1. Vaginal discharge - characteristically white (cottage cheese)
  2. Vulvitis
  3. Balanitis
85
Q

Give the investigations for diagnosis of candida

A
  1. Clinical
  2. Swab - false positives often seen
86
Q

Give the management of candida

A
  1. Clotrimazole - pessary/cream
  2. Fluconazole
87
Q

Give the presentation of bacterial vaginosis

A
  1. Smelly (fishy) white discharge - comprising waste products of colonising bacteria
  2. Vaginal itch
88
Q

Give the investigations for bacterial vaginosis

A
  1. Whiff test - add KOH, if a strong fish smell present then positive for BV
  2. pH > 4.5
  3. Culture - determines causative organism
89
Q

Give the management of bacterial vaginosis

A
  1. Metronidazole
  2. Clindamycin
90
Q

Give the risks of bacterial vaginosis during pregnancy

A
  1. Pre-term labour
  2. Intra-amniotic infection
91
Q

Give the presentation of mycoplasma genitalum

A
  1. Males - urethral discharge, dysuria, epididymitis
  2. Females - dysuria, PC bleeding, PID

Tiny self-replicating bacteria which are usually asymptomatic. Mainly indicated in the absence of chlamydia/gonorrhoea.

92
Q

Give the investigations for mycoplasma genitalum

A
  1. NAAT
93
Q

Give the management of mycoplasma genitalum

A
  1. In urethritis - doxycycline + azithromycin
  2. In PID/epididymo-orchitis - moxifloxacin
94
Q

Give 1 example of a combined oral contraceptive pill and the drugs which it contains

A
  1. Microgynon (ethinylestradiol and leveonorgestrel)
95
Q

Give 3 benefits of the COCP

A
  1. Reversible
  2. Can reduce risk of dysmenorrhoea and menorrhagia, endometrial and ovarian cancers, PID and fibroids/ovarian cysts
  3. Effective treatment for acne and endometriosis
96
Q

Describe the course of COCP

A

21 day course with a 7 day pill-free (or placebo) break

Still protected during this time

97
Q

Give the mechanism of action of the COCP

A

Prevents ovulation, thins the uterine wall and thickens cervical mucus to prevent passage of sperm into the uterus.

98
Q

Give the side effects of the COCP

A
  1. Breast tenderness
  2. Breakthrough bleeding
  3. Headache
  4. Mood changes
  5. Nausea
  6. Thromboembolic events
99
Q

Give the contraindications for COCP use

A
  1. Migraine with aura or of great severity
  2. Previous DVT/PE/stroke
  3. Age >50
  4. Smoker and age >35
  5. Heart disease or BP > 160/95
  6. BMI >35
100
Q

Describe the management of missed COCP doses

A
  1. Pill can be taken within 24 hours of normal time, so take missed tablet ASAP even if taking 2 pills at once
  2. If 2 pills are missed then significant risk of pregnancy - give emergency contraception if has had sex. Take rest of pack as normal but use additional contraception for 7 days.
  3. If this 7 days includes part of the pill-free break then commence new pack immediately - do not have pill-free break!
  4. If vomiting within 2 hours of taking pill, take another dose
  5. Do not take missed pills if >2 missed
101
Q

Give 3 drug interactions for the COCP

A
  1. Rifampicin
  2. St. John’s wort
  3. Carbamazepine

Stop taking COCP and use alternative protection of on antibiotics or if within 4 weeks of surgery (due to clotting risk)

102
Q

Describe how the COCP should be commenced

A
  1. Start on day 1 of cycle
  2. If started on any other day of cycle then use additional contraception for 7 days

Can be started 3 weeks after birth IF not breast feeding (additional contraception should also be used for 7 days)

103
Q

Describe how the POP should be switched to the COCP

A

Start POP on day 1 of cycle, or if the patient is amenorrhoeic then start on any day of cycle

104
Q

Give 1 indication for progestogen only contraceptive use

A

COCP contra-indicated (e.g. breastfeeding, older women, CV risk, DM, >35 years and smoke)

105
Q

Give 2 examples of the POP

A
  1. Mini-pill
  2. Cerazette
106
Q

Describe the mechanism of action for the POP

A
  1. Thickens cervical mucus to prevent passage of sperm
  2. Thins uterine lining
  3. In high doses may prevent ovulation
107
Q

When is fertility restored after ceasing POP use?

A

Immediately

108
Q

Give 3 risks of the POP

A
  1. Ovarian cysts
  2. Ectopic pregnancy
  3. Breast tenderness
109
Q

When should the POP be commenced?

A
  1. Day 1 of cycle
  2. If taken within 5 days of the start of the cycle then protection is immediate
  3. Otherwise use additional contraception for 2 days (also if patient has a short menstrual cycle)

Can be commenced immediately after pregnancy

110
Q

What advice should be given if a dose of POP is missed?

A
  1. Dose must be taken within a 3 hour window (window for cerazette is 12 hours)
  2. Take missed pill ASAP
  3. If outside window then use condoms for 2 days
  4. Emergency contraception if sex has occurred during this time
  5. If vomiting after taking the POP, use condoms for 2 days
111
Q

Give the mechanism of action for the Mirena IUD

A

Releases levonorgestrel directly into the uterine cavity, thickening cervical mucus and preventing proliferation of the endometrium

112
Q

Give 2 indications for insertion of the Mirena IUD

A
  1. Contraception
  2. Menorrhagia (may take 6 months to take effect)
113
Q

How long does the Mirena IUD last?

A

5 years

114
Q

Give 4 advantages of the Mirena IUD over the copper IUD

A
  1. Reduced risk of PID
  2. Reduced blood loss
  3. Reduced risk of dysmenorrhoea
  4. Reduced risk of ectopic pregnancy
115
Q

Give 1 advantage of the Mirena IUD over the POP

A
  1. Very few systemic effects
116
Q

Give 3 risks of the Mirena IUD

A
  1. Increased risk of ectopic pregnancy
  2. Avoid for 5 years after breast cancer
  3. Perforation and expulsion
117
Q

Give 4 side effects of the Mirena IUD

A
  1. Altered menstrual bleeding
  2. Breast pain
  3. Mood changes
  4. Ovarian cysts
118
Q

How long does the copper IUD last?

A

Either 5 or 10 years

119
Q

Give the mechanism of action for the copper IUD

A

Encourages a mild inflammatory state to prevent implantation.

Copper is toxic to sperm

120
Q

Give 2 contraindications to IUD insertion

A
  1. Infection - conduct STI test prior to insertion
  2. Pregnancy - conduct pregnancy test prior to insertion
121
Q

Give 1 side effect of copper coil insertion

A
  1. Heavy bleeding - manage with TXA (antifibrinolytic)
122
Q

When can the copper coil be inserted?

A

Any time in cycle, and is immediately effective.

Fertility returns quickly after removal.

Tampons can be used alongside the IUD.

123
Q

Give the mechanism of action for the morning after pill

A
  1. Levonorgestrel - high dose (1.5mg)
  2. Prevents ovulation, fertilisation and implantation

DOES NOT CAUSE ABORTION

124
Q

When is the morning after pill effective?

A

Up to 72 hours following unprotected sex

125
Q

Give the benefits of the copper IUD as emergency contraception

A
  1. Can prevent pregnancy up to 5 days after unprotected sex
  2. Provides continued contraception for 5-10 years
  3. The most effective method of emergency contraception
126
Q

Give 2 examples of hormonal implant contraception

A
  1. Implanon
  2. Nexplanon

Levonorgestrel implants

127
Q

Where is the hormonal implant placed?

A

Subcutaneously in medial aspect of non-dominant upper arm

128
Q

How long does the hormonal implant provide effective contraception for?

A

3 years (2 years in obese women)

129
Q

Give the mechanism of action for the hormonal implant

A

Slowly releases levonorgestrel, which acts to thicken cervical mucus, prevent ovulation and prevent endometrial proliferation.

130
Q

Give the side effects of the hormonal implant

A
  1. Irregular bleeding patterns
  2. Acne
  3. Breast tenderness
  4. Mood swings
131
Q

Give the benefits of the hormonal implant

A
  1. Set it and forget it
  2. Less likely to have periods than on POP
  3. No interaction with Abx
  4. Reduced risk of cysts and ectopic pregnancy
132
Q

Give 2 examples of hormonal contraceptive injection

A
  1. Depo-provera (administered every 12 weeks)
  2. Novisterat (administered every 8 weeks)
133
Q

Give the mechanism of action of hormonal contraceptive injection

A
  1. Slowly releases progesterone into the body
  2. Thins the endometrium, thickens cervical mucus and prevents ovulation
134
Q

Give 3 advantages of the hormonal contraceptive injection

A
  1. No oestrogen content - can be used in breastfeeding and epilepsy
  2. Reduced risk of PID
  3. May stop periods
135
Q

Give the cautions to hormonal contraceptive injection use

A
  1. Risk of reduction in bone density - don’t usually prescribe in <18 and >45. Avoid injection if other RF for osteoporosis - e.g. low oestrogen, smoker, long-term steroid use
136
Q

Give the side effects of hormonal contraceptive injection use

A
  1. Heavy menstruation - settles down eventually
  2. Mood swings
  3. Weight gain
137
Q

How is the hormonal contraceptive injection administered?

A

IM injection into arm or gluteals

138
Q

When should the hormonal contraceptive injection be administered?

A

Commence within 5 days of start of cycle. If started outside this period, use 7 days of additional contraception.

139
Q

When can the hormonal contraceptive injection be commenced following pregnancy?

A
  1. Re-start 6 weeks after birth
  2. Can start from 21 days if required - will also need additional methods of contraception
140
Q

When can the COCP be re-started after pregnancy?

A

3 weeks - due to risk of VTE

141
Q

When can hormonal contraception (COCP and POP) be re-started after levonorgestrel emergency contraceptive use?

A

Immediately

142
Q

Which contraceptive methods are not affected by enzyme-inducing drugs (e.g. carbamazepine, rifampicin)?

A
  1. Copper IUD
  2. Depo-provera
  3. Mirena IUS

Copper IUD is usually 1st choice as non-hormonal

143
Q

Which contraceptive methods have immediate effect?

A

Copper IUD

144
Q

Which contraceptive methods become effective after 2 days?

A

POP

145
Q

Which contraceptive methods become effective after 7 days?

A

COCP, injection, implant, Mirena IUS

146
Q

Give the effect of gastric sleeve surgery on contraceptive use

A

Can never have oral contraceptive or oral emergency contraceptive due to decreased efficacy

147
Q

Which emergency contraceptive should be used in PID?

A

Hormonal - levonorgestrel (within 72 hours) or ulipristal acetate (72-120 hours)

148
Q

What is the most likely effect of the Mirena IUS on bleeding?

A

Initially irregular bleeding followed by light menses or amenorrhoea

149
Q

When is the copper IUD indicated as emergency contraceptive?

A

The copper intrauterine device can be used as emergency contraception if it is inserted within 5 days of UPSI, or up to 5 days after the likely ovulation date.

150
Q

Which contraceptive method is contra-indicated in wheelchair users?

A

COCP - oestrogen results in increased risk of VTE

151
Q

How long should you wait before restarting hormonal contraceptive following ulipristal acetate emergency contraception?

A

After taking ulipristal acetate women should wait 5 days before starting regular hormonal contraception

152
Q

Give 1 contraindication to ulipristal acetate use

A

Ulipristal should be used with caution in patients with severe asthma

153
Q

Give 1 contraindication to injectable hormonal contraceptive

A

Current breast cancer is a contraindication for injectable progesterone contraceptives

154
Q

Give 1 contraindication to injectable hormonal contraceptive

A

Current breast cancer is a contraindication for injectable progesterone contraceptives

155
Q

Following pregnancy, when may an IUD/IUS be inserted?

A

The intrauterine device or intrauterine system can be inserted within 48 hours of childbirth or after 4 weeks

156
Q

Which cancers does the COCP increase the risk of?

A

increased risk of breast and cervical cancer

157
Q

Which cancers is the COCP protective against?

A

protective against ovarian and endometrial cancer

158
Q

What impact do antibiotics have on the POP?

A

Progestogen only pill + antibiotics - no need for extra precautions

159
Q

When switching from the POP to COCP, how many days of barrier protection are needed?

A

When switching from a traditional POP to COCP (with correct prior use) 7 days of barrier contraception is needed

Finals (11 decks)

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