Obgyn Chapter 25 Contraception

Front 1

In assessing the effectiveness of various contraceptive methods, the "method failure rate" reflects the rate of failure when the method is

Back 1

used correctly 100% of the time

Front 2

What is the primary mechanism of action of the interuterine device?

Back 2

Alter the ability of the fertilized egg to implant and grow

Front 3

What is the primary mechanism of action of contraceptive foam?

Back 3

Impose a barrier between the sperm and the egg

Front 4

What is the primary mechanism of action of oral contraceptives?

Back 4

Inhibit the development and release of the egg

Front 5

What is the primary mechanism of action of the long-lasting progesterone injection?

Back 5

Inhibit the development and release of the egg

Front 6

What is the primary mechanism of action of the diaphragm?

Back 6

Impose a barrier between the sperm and the egg

Front 7

Which of the following contraceptive methods does NOT provide some measure of protection from sexually transmitted diseases?

Back 7

Intrauterine contraceptive device

Front 8

The most common method of contraception among younger women in the US is

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oral contraceptive

Front 9

The synthetic estrogen most frequently found in oral contraceptives is

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ethinyl estradiol

Front 10

The hormone used in implantable contraceptive rods (Norplant) is

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levonorgestrel

Front 11

Ethinyl estradiol is approximately how many times as potent as the same weight of mestranol?

Back 11

1.7 times as potent

Front 12

Which of the following progestins used in oral contraceptives has teh LEAST biologic potency?

Back 12

Norethindrone

Front 13

Progesterone-only oral contraceptive agents are less widely used by younger women because they

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have a higher failure rate

Front 14

Combination oral contraceptive pills mainly act to prevent pregnancy through

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suppressing follicle-stimulating hormone and luteinizing hormone release

Front 15

The progestins used in most oral contraceptives tend to

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increase the occurrence of acne

Front 16

Which of the following occurs in users of multiphasic (low-dose) oral contraceptives at a higher rate than it occurs in the general population?

Back 16

Intermenstrual bleeding

Front 17

A 20-year-old G0P0 moderately obese patient consults you about the use of oral contraceptives. Her menarche was at age 15 and her period comes every 30 to 45 days and lasts 2 to 4 days. If this patient were to use an oral contraceptive agent, she would be at greater risk for

Back 17

"postpill amenorrhea"

Front 18

When taken concurrently, which of the following will reduce the efficacy of oral contraceptives?

Back 18

Oral penicillin

Front 19

The most common side effect of injectable or implantable contraceptive steroids is

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random vaginal bleeding

Front 20

Which of the following is NOT an attribute of long-acting injectable and implantable progestins?

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Patient-controlled reversibility

Front 21

A couple wishes to use "natural family planning" for contraception. Her periods are regular, coming every 28 +/- 3 days. This patient's "fertile" period would be days

Back 21

7 to 20

Front 22

At the time of ovulation, basal body temperature typically

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rises

Front 23

Following unprotected coitus, it is recommended that high-dose estrogen preparations be given within a maxium of

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4 days

Front 24

The pregnancy rate for a couple using no method of contraception typically is

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85%

Front 25

In the first year of use, the pregnancy rate for a woman using the combination pill typically is

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3%

Front 26

In the first year of use, the pregnancy rate for a woman using the progestin pill typically is

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3%

Front 27

In the first year of use, the pregnancy rate for a woman using Norplant typically is

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0.2%

Front 28

In the first year of use, the pregnancy rate for a woman using Depo-Provera typically is

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0.3%

Front 29

In the first year of use, the pregnancy rate for a woman using spermicides typically is

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20%

Front 30

In the first year of use, the pregnancy rate for couples using the condom typically is

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12%

Front 31

In the first year of use, the pregnancy rate for a parous woman using a sponge typically is

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28%

Front 32

In the first year of use, the pregnancy rate for a nulliparous woman using a sponge is

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18%

Front 33

In the first year of use, the pregnancy rate for a woman using a cervical cap typically is

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18%

Front 34

In the first year of use, the pregnancy rate for a woman using a diaphragm and spermicide typically is

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18%

Front 35

In the first year of use, the pregnancy rate for a woman using an intrauterine device typically is

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3%

Front 36

In the first year of use, the pregnancy rate for a couple using withdrawal typically is

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18%

Front 37

In the first year of use, the pregnancy rate for a woman using a postcoital douche typically is

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40%

Front 38

In the first year of use, the pregnancy rate for a couple using periodic abstinence typically is

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20%

Front 39

In the first year of use, the pregnancy rate for a couple using the Yuzpe method typically is

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25%

Front 40

What action should be taken when a woman using an oral contracpetive experiences diplopia?

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Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method

Front 41

What action should be taken when a woman using an oral contraceptive has hemoptysis?

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Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method

Front 42

What action should be taken when a woman using an oral contraceptive is discovered to have a hepatic mass?

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Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method

Front 43

What action should be taken when a woman using an oral contraceptive experiences a slurring of speech?

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Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method

Front 44

What action should be taken when a woman using an oral contraceptive has a severe headache?

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Continue oral contraceptive but evaluate immediately

Front 45

What action should be taken when a woman using an oral contraceptive experiences severe chest/neck pain?

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Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method

Front 46

What action should be taken when a woman using an oral contraceptive experiences severe leg pain and tenderness?

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Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method

Front 47

The failure of oral contraceptives usually is related to

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missed doses of the oral contraceptive

Front 48

The estrogenic components of oral contraceptives preferentially inhibit

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follicle-stimulating hormone (FSH) and are dose-dependent

Front 49

Hormonal agents in oral contraceptives make cervical mucus

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thicker

Front 50

The use of oral contraceptives offers some protection against all of the following EXCEPT

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asthma (oral contraceptives offer protection against endometrial carcinoma, benign breast disease, ovarian carcinoma, and ectopic pregnancy)

Front 51

Compared with low-dose oral contraceptives, high-dose oral contraceptives have a

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lower incidence of breakthrough bleeding

Front 52

Approximately what percent of pateints will experience postpill amenorrhea when discontinuing oral contraceptives after long-term use?

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3%

Front 53

Postpill amenorrhea is more likely to be experienced by

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younger women

Front 54

What is the dosage of Depo-Provera that is given every 3 months for the purpose of contraceptives?

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150 mg

Front 55

Most women who discontinue Depo-Provera injections will not become fertile for how many months?

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4 to 5 months

Front 56

Norplant is effective for how many years after insertion?

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5 years

Front 57

Injectable and implantable progestin contraceptive methods cause all of the following EXCEPT

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thinned cervical mucus

(injectable & implantable progestins cause suppressed ovulation, thickened cervical mucus, and impeded sperm transport)

Front 58

Which of the following is NOT a positive attribute of barrier contraceptives?

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Requirement for good patient compliance

Front 59

In addition to the failure rate, which of the following is the most common problem associated with the use of condoms?

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Contact dermatitis

Front 60

When used for contraception, a diaphragm must be left in place following intercourse for at least

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6 to 8 hours

Front 61

If a diaphragm is in place following intercourse (during the "waiting time" before diaphragm removal), what should be done before additional intercourse?

Back 61

Insert additional jelly without disturbing the diaphragm and restart the waiting time

Front 62

When correctly fitted and worn, a contraceptive diaphragm should

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have its apex in the posterior fornix

Front 63

Susceptibility to urinary tract infections by women who use diaphragms is

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slightly higher

Front 64

Following intercourse using contraceptive foam, douching should be avoided for at least

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8 to 10 hours

Front 65

Spermicidal foam provides protection for

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a single act of intercourse

Front 66

How does the presence of a reservoir tip in a condom affect the likelihood of breakage during use?

Back 66

Decreases the likelihood

Front 67

The vaginal sponge acts as a contraceptive primarily by

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Delivering spermicide

Front 68

Following unprotected intercourse, an intrauterine contraceptive device may prevent pregnancy if it is inserted within

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5 days

Front 69

The main contraceptive action of intrauterine contraceptive devices as a class is to

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prevent implantation

Front 70

The most important factor in selection of patients for IUD use is

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risk for sexually transmitted diseases

Front 71

The relative ratio of extrauterine pregnancy in an IUD user compared with an oral contraceptive user is

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greater

Front 72

The overall risk of ectopic pregnancy in users of IUDs is

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unchanged

Front 73

The spontaneous expulsion rate of IUDs in the first year following insertion is

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10%

Front 74

What is the best time for insertion of an IUD?

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At the time of the menstrual period

Front 75

Increased vaginal bleeding and menstrual pain is experienced in what percent of women using an IUD?

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5 to 10%

Front 76

The increased vaginal bleeding and menstrual pain sometimes associated with IUD use may be lessened in some women by the use of what adjucntive regimen in the first few months of IUD use?

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Nonsteroidal anti-inflammatory drugs

Front 77

The ParaGard IUD is

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medicated

Front 78

The Progestasert IUD is

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medicated

Front 79

The Lippes Loop IUD is

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unmedicated

Front 80

For a woman with mild dysmenorrhea, which intrauterine device may offer advantages in addition to contraception?

Back 80

Progestasert

Front 81

The copper from copper-containing IUDs may exert all of the following additional contraceptive effects EXCEPT

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endometrial decidualization

(copper does however, cause enhanced endometrial inflammatory response and enhanced spermicidal effect in cervical mucus)

Front 82

Which of the following patients should not use IUDs for contraception?

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Immunosuppressed individuals

(Adolescents, nulliparas, and women with fibroids can use IUDs)

Front 83

The management of an asymptomatic woman with a positie cervical culture for gonorrhea and an IUD is

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treatment of teh infection without IUD removal and careful observation

Front 84

Insertional infection (occurs within 6 to 8 weeks of insertion of an IUD) should be treated by

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Doxycycline 200 mg orally before insertion

Front 85

Delayed infection (occurs 3 or more months after insertion of an IUD) should be treated by

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Ceftriaxone 25 mg intramuscularly and doxycycline 100 mg orally twice daily for 7 days

Front 86

Women who are breast feeding and are given an IUD generally have a

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decreased incidence of postinsertional discomfort/bleeding

Front 87

What percent of patients will spontaneously abort if they become pregnant while using an IUD?

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40 to 50%

Front 88

Removal of an IUD in the first trimester of a pregnancy is associated with a spontaneous abortion rate of

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30%

Front 89

If an IUD is left in situ during pregnancy, there is an increased incidence of

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preterm labor and delivery

Front 90

Which of the following is an effective postcoital antifertility method?

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Yuzpe method

Front 91

The two types of estrogen compounds present in oral contraceptives are

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ethinyl estradiol and mestranol

Front 92

Which of the following has been implicated as the causative agent of thromboembolism in women using oral contraceptives?

Back 92

Estrogen

Front 93

Which of the following statements about the portesin-only minipill is INCORRECT?

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It is more effective in younger women

(True about progestin pill - does not alter quality or quantity of breast milk, may be started immediately postpartum, and must be taken at the same time every day)

Front 94

Which of the following is NOT a mechanism of action of the progestin-only minipill?

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It suppresses ovulation

Front 95

The failure rate of the Yuzpe method of postcoital contraception is approximately

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25%

Front 96

What is the dosage of Lo-Ovral in the Yuzpe method of postcoital contraception?

Back 96

four tablets follwed by four tablets in 12 hours, administered within 72 hours of the unprotected coital event

Front 97

What is the dosage of Ovral in the Yuzpe method of postcoital contraception?

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two tablets followed by two tablets in 12 hours, administered within 72 hours of the unprotected coital event

Front 98

What is the dosage of Nordette in the Yuzpe method of postcoital contraception?

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four tablets follwed by four tablets in 12 hours, administered within 72 hours of the unprotected coital event

Front 99

What is the dosage of Triphasil (yellow pills) in the Yuzpe method of postcoital contraception?

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four tablets follwed by four tablets in 12 hours, administered within 72 hours of the unprotected coital event

Front 100

About what percent of women who successfully use the Yuzpe method of emergency contraception will have a menstrual period within 3 weeks?

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100%

Front 101

Is migraine headache a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?

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Relative contraindication

Front 102

Is thrombophlebitis or thromboembolic disease a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?

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Absolute contraindication

Front 103

Is cerebral vascular disease a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?

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Absolute contraindication

Front 104

Is coronary occlusion a relative or absolute contraindication to teh use of biphasic oral contraceptive therapy?

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Absolute contraindication

Front 105

Is impaired liver fuction a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?

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Absolute contraindication

Front 106

Is known or suspected breast cancer a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?

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Absolute contraindication

Front 107

Is abnormal vaginal bleeding of unknown origin a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?

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Absolute contraindication

Front 108

Is known or suspected pregnancy a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Absolute contraindication

Front 109

Is hypertension in a patient who is under the age of 35 a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Relative contraindication

Front 110

Is gallbladder disease a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Relative contraindication

Front 111

Is obstructive jaundice in a previous pregnancy a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

Back 111

Relative contraindication

Front 112

Is diabetes mellitus a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Relative contraindication

Front 113

Is epilepsy a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Relative contraindication

Front 114

Is severe obesity a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Relative contraindication

Front 115

Is being a smoker over the age of 35 a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Absolute contraindication

Front 116

Is congenital hyperlipidemia a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Absolute contraindication

Front 117

Is hepatic neoplasm a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?

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Absolute contraindication

Front 118

Which of the following is NOT common in individuals using the Depo-Provera and Norplant systems?

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Inhibition of ovuation

Front 119

What percent of women using Depo-Provera will resume normal menses wihtin 6 months?

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50%

Front 120

In which of the following cases should biphasic oral contraceptives be discontinued?

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Hepatic mass with tenderness

Front 121

For purposes of contraception, injectable medroxyprogesterone and estradiol cyprionate are given every

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month (Lunelle)

Front 122

As compared with the Yuzpe method, Plan B emergency contraception has

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a decreased incidence of nausea

Front 123

The Yuzpe or Plan B contraceptive regimens are best used for all of the following indications EXCEPT

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interval contraception

(Use Yuzpe or Plan B for IUD expulsion, unintended unprotected intercourse, and sexual assault when no contraceptive method is in use)