Contraception

Question 1

Sperm on average (mean) have been shown to survive for

Answer 1

1-2 days

Up to 7 days

Question 2

Oocyte average lifespan

Answer 2

17 hours up to 24 hours

Question 3

Ovulation occurs how many days after menses

Answer 3

12-16 days before a woman’s next menses

Question 4

How old can we rely on breastfeeding as a contraception

Answer 4

6 month

Question 5

How do breastfeeding offers contraception

Answer 5

Suckling increases the production of prolactin, decreases the release of GRH and suppresses ovulation

Question 6

Fraser guideline is applied in

Answer 6

Contraception
Ttt of STDs
Termination of Pregnancy

Otherwise, we use Gillick competency

Question 8

The contraceptive method with lowest failure rate

Answer 8

Implanon

Question 9

Implanon failure rate

Answer 9

0.05%
5/10000

Question 10

Contraceptive methods failure rate

Answer 10

Implanon 0.05%
Vasectomy 1/1000
Mirena & DMPA 2/1000
COC & POP 3/1000
Female sterilization 5/1000
IUCD 6/1000

Question 11

Why DMPA is not used at extreme of age

Answer 11

Osteoprosis

Question 12

When to insert IUD after delivery

Answer 12

Less than 48hr PP
AFTER 4 weeks

Question 13

How much progesterone in DMPA

Answer 13

150 mg

Question 14

When to put and remove vaginal diaphragm

Answer 14

Put 3 hrs before intercourse
Remove 6 hours after

Question 15

The type of estrogen in quadriphasic CHC (qlaira)

Answer 15

Estradiol valerate

Question 16

Cancers risk increased and reduced by CHC

Answer 16

Inc:
- cervical
- breast

Dec:
- endometrial
- ovarian

Question 17

When to start CHC

Answer 17

Start at anytime
- better 1st 5 days of the cycle
If after-> use condom for 1 week

Qlaira:
Start at day 1
If After-> condom for 9 days

Question 18

How long she takes CHC

Answer 18

3 weeks on
4-7 days off

Question 19

What antibiotics contraindicated with CHC

Answer 19

Rifampicin
Rifabutin

Question 20

How CHC causes contraception

Answer 20

By ovulation suppression

Question 21

When to say its a missed pill of CHC

Answer 21

After 48 ours of the last taken pill

Question 22

What to do if she missed a CHC pill

Answer 22

If in the 1st week, its critical as she just came out of Hormone free interval, give:
- the old pill
- the new pill
- 7d using barrier
- emergency pill
If 2nd w: no emergency pill
If 3rd w: no EP, no HFI

Question 23

With CHC, if vomiting or diarrhea

Answer 23

If vomiting within 3 hrs
If severe diarrhea for 24 hr

Take new pill

Question 24

Type of estrogen usend in Nuvaring and Implanon

Answer 24

Etonogestrel

Question 25

When quick starting POP after levonorgestrel oral emergency contraception, condoms should be advised for:

Answer 25

DRSP: for 7 days
Any other POP: for 2 days

Question 26

1ry mofe of action of desogestrel

Answer 26

Suppression of ovulation

Question 27

When to start POPs

Answer 27

Any: 1-5 days DRSP: day 1

Question 28

CHC with lamotrigine

Answer 28

Each affects the efficacy of the other

Question 29

What contraception use inhibition of ovulation

Answer 29

CHC DMPA IMPLANT DSG POP DSP POP

Question 30

How POPs cause contraception

Answer 30

Old: Thickened cervical mucus New: Suppression of ovulation

Question 31

How IUCD INHIBIT PREGNANCY

Answer 31

Inhibition of fertilization

Question 32

if she had sex last night how long it takes to become pregnant

Answer 32

3 weeks

Question 33

absolute incidence rate of VTE in pregnancy and puerperium

Answer 33

1-2/1000

Question 34

woman took UPA as EC, and wants to start CHC, what to do?

Answer 34

wait 5 days, after UPA bef starting CHC, use condom or abstain. as it decreases the efficacy of CHC

Question 35

what are different types of progesterones present in UK

Answer 35

1. Desogestrel 75 ug 2. Drospirenone 4 mg 3. LNG 30 ug 4. norethisterone 350 ug

Question 36

when POP is missed

Answer 36

traditional: after 3 hours of it time (27 hr of last taken pill) DSG: after 12 hr (36 of it last taken pill) DRS: after 24 hr (48hr)

Question 37

what to do if she missed POP

Answer 37

traditional & DSG: -old pill - new pill - EC -condom for 2 days DRSP: -old pill - new pill - EC -condom for 7 days - no HFI (if the missed pill was last week) | in all: consed UPT in 3 weeks

Question 38

DRSP is the same like CHC

Answer 38

1. HPO suppression 2. HFI 3. window 24 hours 4. condom 1 week 5. EC in 1 w+HFI 6. STOP HFI if problem in last week 7. DRSP=Qliara (start frm day 1)

Question 39

what to do if vomitting after POP

Answer 39

Old: 2 hrs new: 3-4 hrs take another pill

Question 40

for how long mirena be put?

Answer 40

if put <45y -> 6 years if put >45y -> till age of 55 as HRT -> 5 years

Question 41

Cautions when insertion of IUD in case of adrenal insuffieency

Answer 41

* schedule it in early morning * inc dose of steroids before and for 24 hours after insertion

Question 42

management of IUC unschedueled bleeding

Answer 42

- Tranexamic acid or NSAIDs - 3 months trial of CHC

Question 43

what to do with pregnancy on top of iuc

Answer 43

if <12w: remove it if seen threads this can improve future pregnancy outcome

Question 44

when to remove malpositioned IUC

Answer 44

1. >2 cm from the fundus 2. fully or partially within cx canal 3. symptoms of malposition (pain or bleeding) | in this case: consider UPT and EC

Question 45

Failure rate of lactational amenorrhea method of postpartum contraception

Answer 45

2/100

Question 46

Once menopausal woman start HRT, how often should she be reviewed

Answer 46

Annually