Women's health

Question 1

What should a patient do if they vomit within two hours of taking their OCP?

Answer 1

Take another one as soon as possible

Question 2

What are the missed pill rules for week 1?

Answer 2

Use emergency contraception if UPSI in pill free interval for one week

Question 3

What are the missed pill rules for week 2?

Answer 3

No need for emergency contraception

Question 4

What are the missed pill rules for week 3?

Answer 4

Take the last pill that was missed, finish the current pack and start the next pack immediately after.

Question 5

How long does the progesterone only pill take to become effective?

Answer 5

48 hours

Question 6

How long does the COCP take to become effective?

Answer 6

Seven days

Question 7

What is the preffered option in women and girls with PCOS for contraception?

Answer 7

COCP

Question 8

Which emergency contraceptive option should be adjusted as per the patients weight?

Answer 8

Levonelle

Question 9

When should a double dose of levonelle be taken?

Answer 9

When the patient weights over 70kg or BMI>26

Question 10

How long after UPSI can levonelle be taken?

Answer 10

Within 3 days

Question 11

What is the least effective method of emergency contraception?

Answer 11

Levonelle

Question 12

How long after taking levonelle should regular contraception be resumed?

Answer 12

12 hours

Question 13

After what time period is a Norethisterone pill considered missed?

Answer 13

3 hours , after this time condoms should be used for SI for next two days

Question 14

After what time period is a Desogesterel pill considered missed?

Answer 14

12 hours

Question 15

Up to what time period can Ella One (Ulipristal acetate) be used as emergency contraception?

Answer 15

5 days

Question 16

In what conditions is Ellaone (ulipristal acetate) contraindicated?

Answer 16

Liver disease
Asthma
Must not breast feed for a week after taking

Question 17

Side effects of EllaOne (ulipristal acetate)?

Answer 17

Painful periods, mood swings, back pain

Question 18

How long after taking EllaOne (ulipristal acetate) is vomitting ‘safe’?

Answer 18

3 hours

Question 19

How long does the contraceptive implant last?

Answer 19

3 years, but can be taken out sooner and fertility will return quickly following removal

Question 20

Side effects of contraceptive implant?

Answer 20

Irregular periods
Absent periods
Longer periods
Acne (or worsening of)
Tenderness, bruising, swelling at site of implantation

Question 21

What is the contraceptive method of choice for girls under 16?

Answer 21

Implant

Question 22

Important adverse affect of depo-provera injection?

Answer 22

Delayed return to fertility (aprox one year)

Question 23

How does the IUD affect periods?

Answer 23

Heavier, longer

Question 24

What is the only acceptable form of contraception for a woman with known breast cancer?

Answer 24

Copper IUD

Question 25

What is the most effective emergency contraception method?

Answer 25

IUD

Question 26

How long can an IUD stay in?

Answer 26

Up to 10 years | Once removed fertility returns to normal

Question 27

Contraindications for IUD?

Answer 27

Current pelvic infection or distorted uterus Repeated history of STI Unexplained bleeding Abnormal cervix

Question 28

How long after post-partum is an IUD reccommended from?

Answer 28

28 days

Question 29

When can an IUD be used as emergency contraception?

Answer 29

Up to 120 hours after the first episode of UPSI or after the earliest expected date of ovulation

Question 30

Why can ellaOne not be used in asthma?

Answer 30

Antiglucocorticoid effect

Question 31

Over what age can women who smoke >15 a day no longer take the COCP?

Answer 31

35 years old

Question 32

What are the absolute contraindications to the combined oral contraceptive pill (UKMEC 4)?

Answer 32

Known or suspected pregnancy Smoker over the age of 35 >15 ciggarettes/day Obesity Breast feeding <6 weeks post partum Active breast cancer or cancer within the last few years BRACA genes

Question 33

When do the disadvantages of the COCP outweigh the advantages (but not an absolute contraindication) (UKMEC 3)?

Answer 33

``` Breast feeding > 6 weeks post partum Previous arterial or venous clots Continued use after HD or stroke Migraines with aura Active disease of liver or gallbladder ```

Question 34

When do the advantages of the COCP outweigh the disadvantages (UMEC 2)?

Answer 34

Initiation after current or past history of MI or stroke | Multiple risk factors for arterial CVD

Question 35

How do you calculate the earliest date of ovulation?

Answer 35

Length of cycle-14 days

Question 36

What is the association of COCP with cancer?

Answer 36

Increased risk of breast cancer and cervical cancer | Reduced risk of endometrial and ovarian cancer

Question 37

Which intra utirine method of contraception makes periods lighter?

Answer 37

IUS (mirena coiil)

Question 38

How long does the IUS work?

Answer 38

5 years | Once removed fertility returns to normal

Question 39

What is the only suitable contraceptive method for a woman post-partum who is breastfeeding?

Answer 39

POP

Question 40

When should the COCP be stopped in relation to surgery?

Answer 40

4 weeks before until 2 weeks after

Question 41

When, postpartum, can an IUD be instered?

Answer 41

48 hours within giving birth of from 4 weeks post-partum

Question 42

What with LH, FSH, and oestorgen levels be in a patient with ovarian failure?

Answer 42

LH raised FSH raised A low serum oestrogen

Question 43

In those <40 years with suggestive features of menopause how should their hormones be investigated?

Answer 43

2 FSH levels taken 4-6 weeks apart

Question 44

Common symptoms are experience in menopause?

Answer 44

Vasomotor (flushing) Urogenital (urinary incontinence, atrophic vaginitis) Psychological

Question 45

Average age of menopause?

Answer 45

47.5 years

Question 46

What is the most common cause of post-coital bleeding in pre-menopausal women?

Answer 46

Cervical ectropian

Question 47

What are uterine fibroids

Answer 47

the most common benign tumour of the uterus. Sometimes called leiomyomata, these growths are primarily composed of smooth muscle and fibrous connective tissue. While many uterine fibroids are asymptomatic, they can also present with menorrhagia, fatigue, infertility, and a sense of abdominal bloating. Patients of a black ethnicity are also at a significantly higher risk of developing uterine fibroids, the reason for this is not yet fully understood.

Question 48

When can oestrogen only HRT be used?

Answer 48

In patients who have had a hysterectomy

Question 49

Symptoms of PCOS?

Answer 49

 irregular periods or no periods at all  difficulty getting pregnant as a result of irregular ovulation or failure to ovulate  excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks  weight gain  thinning hair and hair loss from the head  oily skin or acne  PCOS is also associated with an increased risk of developing health problems in later life, such as type 2 diabetes and high cholesterol levels.

Question 50

When will PCOS usually present by?

Answer 50

Early 20s

Question 51

What is the EVRA patch?

Answer 51

Oestrogen plus progesterone contraceptive

Question 52

Breast cancer screening in the UK?

Answer 52

50-70 | Mammogram every 3 years

Question 53

Common tumour markers and the cancers they are associated with?

Answer 53

``` AFP liver, testicular CEA colorectal PSA prostate Ca125 Ovarian CA 15-3 breast cancer HcG ovarian and testicular Ca 19-9 Pancreatic cancer, cholangiocarcinoma ```