portmoon's version from 2015-07-10 13:15

% of every 100 women who experienced an unintended pregnancy within the first year of typical use

Question Answer
Contraceptive Implant0.05%
Female sterilization0.5%
Injectable contraception6%
Contraceptive Pill9%
Male/Female condom18-21%
Male sterilization0.15%
Fertility awareness24%
Lactation amenorrhoea2% (in first 6 months)

Which of the following are an ABSOLUTE contraindication to the COCP?

Question Answer
FHx of VTE in 1st degree relative < 45 yearsnot absolute
BMI > 39absolute
immobility e.g. wheelchairnot absolute
FHx of arterial disease in 1st degree relative < 45not absolute
Smoking > 40/dayabsolute
Age >50 yearsabsolute
breastfeeding < 6 weeks postpartumabsolute
migraine with aura: absolute

What are the contraindications and cautions for the POP?


Question Answer
arterial diseaseCaution
sex-steroid dependent cancerCaution
past ectopicCaution
active trophoblastic diseaseCaution
functional ovarian cystsCaution
Hx of jaundice in pregnancyCaution
liver diseaseCaution
recurrent jaundiceCaution
undiagnosed vaginal bleedingContra-indication
severe arterial diseaseContra-indication
acute porphyriaContra-indication
Hx breast Ca in last 5 yrsContra-indication
liver tumourContra-indication

How long does each of the following work for?


Question Answer
Depo-Provera12 weeks
Noristerat8 weeks
Nexplanon3 years
Mirena IUS5 years
Copper IUD5-10 years

How long after UPSI can the following be used?


Question Answer
Levonellewithin 24 hrs (96% effective), 24-48 hrs (85%), 49-72 hrs (58%)
ellaOneup to 120 hours (do not breastfeed for one week. PPIs/ranitidine can interfere with effectiveness)
IUCDup to 5 days (almost 100% effective)

Which of the following does the RCOG recommend for PMT?


Question Answer
vitamin B6recommended
Low dose SSRIs day 15-28recommended
Tricyclic antidepressantsnot recommended

Match up the statement regarding mode of action to the correct contraception

Question Answer
Ovulation is inhibited in 97% of cyclesDesogestrel POP
Works predominantly by inducing an inflammatory response in the uterusIUCD
Works mainly by reducing endometrial growth and preventing implantationIUS
Form a physical barrier, preventing entrance of sperm to the cervixDiaphragms and caps

Regarding the COCP, which of the following are true?

Question Answer
Can bring relief from menstrual problemsTrue
Increases risk of pelvic inflammatory diseaseFalse
Increases incidence of benign breast disease, ovarian cysts, ovarian cancer and endometrial cancerFalse
Side-effects include breakthrough bleeding, breast tenderness, mood swingsTrue
Risk of VTE increased but much less than pregnancyTrue
Increased risk of MITrue
Risk of stroke twice that of non-users overallTrue
Slightly decreased risk of breast cancerFalse
Decreased risk of cervical cancerFalse
Increased risk of primary liver cancer with high-dose oestrogenTrue
Increased overall mortality despite careful selection and follow-upTrue

Regarding the POP, which of the following are true?

Question Answer
Avoids the cardiovascular risks of oestrogenTrue
Cannot be used during breast-feedingFalse
Most need to be taken meticulously at the same time each dayTrue
The time taken each day is less important for CerazetteĀ®True
Decreased risk of ovarian cysts (30% decreased risk)False
Decreased risk of breast cancerFalse

Regarding Progestogen injectables, which of the following are true?

Question Answer
Can be used during breast-feedingTrue
Quickly reversibleFalse
Menstrual irregularities found in 80%True
Weight gain of up to 2-3 kg per year may occurTrue
Median delay to conception 5.5 months plus duration of last injectionTrue
Irreversible reduction in bone mineral densityFalse

Regarding menorrhagia if sinister cause ruled out

Question Answer
First line treatmentIUS left in situ for at least 12 months
Second line treatmenttranexamic acid, mefenamic acid or COCP
Reduces menstrual loss by around 25%Mefenamic aid
A plasminogen-activator inhibitor that can reduce flow by up to 50%Tranexamic acid
If colour vision is disturbed, should be discotinuedTranexamic acid
Suppresses production of gonadotrophins and reduces menstrual loss by 50%COCP
Third line treatmentnorethisterone