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123 Cards in this Set

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In assessing the effectiveness of various contraceptive methods, the "method failure rate" reflects the rate of failure when the method is
used correctly 100% of the time
What is the primary mechanism of action of the interuterine device?
Alter the ability of the fertilized egg to implant and grow
What is the primary mechanism of action of contraceptive foam?
Impose a barrier between the sperm and the egg
What is the primary mechanism of action of oral contraceptives?
Inhibit the development and release of the egg
What is the primary mechanism of action of the long-lasting progesterone injection?
Inhibit the development and release of the egg
What is the primary mechanism of action of the diaphragm?
Impose a barrier between the sperm and the egg
Which of the following contraceptive methods does NOT provide some measure of protection from sexually transmitted diseases?
Intrauterine contraceptive device
The most common method of contraception among younger women in the US is
oral contraceptive
The synthetic estrogen most frequently found in oral contraceptives is
ethinyl estradiol
The hormone used in implantable contraceptive rods (Norplant) is
levonorgestrel
Ethinyl estradiol is approximately how many times as potent as the same weight of mestranol?
1.7 times as potent
Which of the following progestins used in oral contraceptives has teh LEAST biologic potency?
Norethindrone
Progesterone-only oral contraceptive agents are less widely used by younger women because they
have a higher failure rate
Combination oral contraceptive pills mainly act to prevent pregnancy through
suppressing follicle-stimulating hormone and luteinizing hormone release
The progestins used in most oral contraceptives tend to
increase the occurrence of acne
Which of the following occurs in users of multiphasic (low-dose) oral contraceptives at a higher rate than it occurs in the general population?
Intermenstrual bleeding
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
"postpill amenorrhea"
When taken concurrently, which of the following will reduce the efficacy of oral contraceptives?
Oral penicillin
The most common side effect of injectable or implantable contraceptive steroids is
random vaginal bleeding
Which of the following is NOT an attribute of long-acting injectable and implantable progestins?
Patient-controlled reversibility
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
7 to 20
At the time of ovulation, basal body temperature typically
rises
Following unprotected coitus, it is recommended that high-dose estrogen preparations be given within a maxium of
4 days
The pregnancy rate for a couple using no method of contraception typically is
85%
In the first year of use, the pregnancy rate for a woman using the combination pill typically is
3%
In the first year of use, the pregnancy rate for a woman using the progestin pill typically is
3%
In the first year of use, the pregnancy rate for a woman using Norplant typically is
0.2%
In the first year of use, the pregnancy rate for a woman using Depo-Provera typically is
0.3%
In the first year of use, the pregnancy rate for a woman using spermicides typically is
20%
In the first year of use, the pregnancy rate for couples using the condom typically is
12%
In the first year of use, the pregnancy rate for a parous woman using a sponge typically is
28%
In the first year of use, the pregnancy rate for a nulliparous woman using a sponge is
18%
In the first year of use, the pregnancy rate for a woman using a cervical cap typically is
18%
In the first year of use, the pregnancy rate for a woman using a diaphragm and spermicide typically is
18%
In the first year of use, the pregnancy rate for a woman using an intrauterine device typically is
3%
In the first year of use, the pregnancy rate for a couple using withdrawal typically is
18%
In the first year of use, the pregnancy rate for a woman using a postcoital douche typically is
40%
In the first year of use, the pregnancy rate for a couple using periodic abstinence typically is
20%
In the first year of use, the pregnancy rate for a couple using the Yuzpe method typically is
25%
What action should be taken when a woman using an oral contracpetive experiences diplopia?
Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method
What action should be taken when a woman using an oral contraceptive has hemoptysis?
Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method
What action should be taken when a woman using an oral contraceptive is discovered to have a hepatic mass?
Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method
What action should be taken when a woman using an oral contraceptive experiences a slurring of speech?
Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method
What action should be taken when a woman using an oral contraceptive has a severe headache?
Continue oral contraceptive but evaluate immediately
What action should be taken when a woman using an oral contraceptive experiences severe chest/neck pain?
Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method
What action should be taken when a woman using an oral contraceptive experiences severe leg pain and tenderness?
Discontinue oral contraceptive and evaluate immediately; start nonhormonal contraceptive method
The failure of oral contraceptives usually is related to
missed doses of the oral contraceptive
The estrogenic components of oral contraceptives preferentially inhibit
follicle-stimulating hormone (FSH) and are dose-dependent
Hormonal agents in oral contraceptives make cervical mucus
thicker
The use of oral contraceptives offers some protection against all of the following EXCEPT
asthma (oral contraceptives offer protection against endometrial carcinoma, benign breast disease, ovarian carcinoma, and ectopic pregnancy)
Compared with low-dose oral contraceptives, high-dose oral contraceptives have a
lower incidence of breakthrough bleeding
Approximately what percent of pateints will experience postpill amenorrhea when discontinuing oral contraceptives after long-term use?
3%
Postpill amenorrhea is more likely to be experienced by
younger women
What is the dosage of Depo-Provera that is given every 3 months for the purpose of contraceptives?
150 mg
Most women who discontinue Depo-Provera injections will not become fertile for how many months?
4 to 5 months
Norplant is effective for how many years after insertion?
5 years
Injectable and implantable progestin contraceptive methods cause all of the following EXCEPT
thinned cervical mucus

(injectable & implantable progestins cause suppressed ovulation, thickened cervical mucus, and impeded sperm transport)
Which of the following is NOT a positive attribute of barrier contraceptives?
Requirement for good patient compliance
In addition to the failure rate, which of the following is the most common problem associated with the use of condoms?
Contact dermatitis
When used for contraception, a diaphragm must be left in place following intercourse for at least
6 to 8 hours
If a diaphragm is in place following intercourse (during the "waiting time" before diaphragm removal), what should be done before additional intercourse?
Insert additional jelly without disturbing the diaphragm and restart the waiting time
When correctly fitted and worn, a contraceptive diaphragm should
have its apex in the posterior fornix
Susceptibility to urinary tract infections by women who use diaphragms is
slightly higher
Following intercourse using contraceptive foam, douching should be avoided for at least
8 to 10 hours
Spermicidal foam provides protection for
a single act of intercourse
How does the presence of a reservoir tip in a condom affect the likelihood of breakage during use?
Decreases the likelihood
The vaginal sponge acts as a contraceptive primarily by
Delivering spermicide
Following unprotected intercourse, an intrauterine contraceptive device may prevent pregnancy if it is inserted within
5 days
The main contraceptive action of intrauterine contraceptive devices as a class is to
prevent implantation
The most important factor in selection of patients for IUD use is
risk for sexually transmitted diseases
The relative ratio of extrauterine pregnancy in an IUD user compared with an oral contraceptive user is
greater
The overall risk of ectopic pregnancy in users of IUDs is
unchanged
The spontaneous expulsion rate of IUDs in the first year following insertion is
10%
What is the best time for insertion of an IUD?
At the time of the menstrual period
Increased vaginal bleeding and menstrual pain is experienced in what percent of women using an IUD?
5 to 10%
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?
Nonsteroidal anti-inflammatory drugs
The ParaGard IUD is
medicated
The Progestasert IUD is
medicated
The Lippes Loop IUD is
unmedicated
For a woman with mild dysmenorrhea, which intrauterine device may offer advantages in addition to contraception?
Progestasert
The copper from copper-containing IUDs may exert all of the following additional contraceptive effects EXCEPT
endometrial decidualization

(copper does however, cause enhanced endometrial inflammatory response and enhanced spermicidal effect in cervical mucus)
Which of the following patients should not use IUDs for contraception?
Immunosuppressed individuals

(Adolescents, nulliparas, and women with fibroids can use IUDs)
The management of an asymptomatic woman with a positie cervical culture for gonorrhea and an IUD is
treatment of teh infection without IUD removal and careful observation
Insertional infection (occurs within 6 to 8 weeks of insertion of an IUD) should be treated by
Doxycycline 200 mg orally before insertion
Delayed infection (occurs 3 or more months after insertion of an IUD) should be treated by
Ceftriaxone 25 mg intramuscularly and doxycycline 100 mg orally twice daily for 7 days
Women who are breast feeding and are given an IUD generally have a
decreased incidence of postinsertional discomfort/bleeding
What percent of patients will spontaneously abort if they become pregnant while using an IUD?
40 to 50%
Removal of an IUD in the first trimester of a pregnancy is associated with a spontaneous abortion rate of
30%
If an IUD is left in situ during pregnancy, there is an increased incidence of
preterm labor and delivery
Which of the following is an effective postcoital antifertility method?
Yuzpe method
The two types of estrogen compounds present in oral contraceptives are
ethinyl estradiol and mestranol
Which of the following has been implicated as the causative agent of thromboembolism in women using oral contraceptives?
Estrogen
Which of the following statements about the portesin-only minipill is INCORRECT?
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)
Which of the following is NOT a mechanism of action of the progestin-only minipill?
It suppresses ovulation
The failure rate of the Yuzpe method of postcoital contraception is approximately
25%
What is the dosage of Lo-Ovral in the Yuzpe method of postcoital contraception?
four tablets follwed by four tablets in 12 hours, administered within 72 hours of the unprotected coital event
What is the dosage of Ovral in the Yuzpe method of postcoital contraception?
two tablets followed by two tablets in 12 hours, administered within 72 hours of the unprotected coital event
What is the dosage of Nordette in the Yuzpe method of postcoital contraception?
four tablets follwed by four tablets in 12 hours, administered within 72 hours of the unprotected coital event
What is the dosage of Triphasil (yellow pills) in the Yuzpe method of postcoital contraception?
four tablets follwed by four tablets in 12 hours, administered within 72 hours of the unprotected coital event
About what percent of women who successfully use the Yuzpe method of emergency contraception will have a menstrual period within 3 weeks?
100%
Is migraine headache a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?
Relative contraindication
Is thrombophlebitis or thromboembolic disease a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?
Absolute contraindication
Is cerebral vascular disease a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?
Absolute contraindication
Is coronary occlusion a relative or absolute contraindication to teh use of biphasic oral contraceptive therapy?
Absolute contraindication
Is impaired liver fuction a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?
Absolute contraindication
Is known or suspected breast cancer a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?
Absolute contraindication
Is abnormal vaginal bleeding of unknown origin a relative or absolute contraindication to the use of biphasic oral contraceptive therapy?
Absolute contraindication
Is known or suspected pregnancy a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Absolute contraindication
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?
Relative contraindication
Is gallbladder disease a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Relative contraindication
Is obstructive jaundice in a previous pregnancy a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Relative contraindication
Is diabetes mellitus a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Relative contraindication
Is epilepsy a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Relative contraindication
Is severe obesity a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Relative contraindication
Is being a smoker over the age of 35 a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Absolute contraindication
Is congenital hyperlipidemia a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Absolute contraindication
Is hepatic neoplasm a relative or absolute contraindication to the use of biphasic oral contraciptive therapy?
Absolute contraindication
Which of the following is NOT common in individuals using the Depo-Provera and Norplant systems?
Inhibition of ovuation
What percent of women using Depo-Provera will resume normal menses wihtin 6 months?
50%
In which of the following cases should biphasic oral contraceptives be discontinued?
Hepatic mass with tenderness
For purposes of contraception, injectable medroxyprogesterone and estradiol cyprionate are given every
month (Lunelle)
As compared with the Yuzpe method, Plan B emergency contraception has
a decreased incidence of nausea
The Yuzpe or Plan B contraceptive regimens are best used for all of the following indications EXCEPT
interval contraception

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