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86 Cards in this Set
- Front
- Back
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what % of women not using a contraceptive will become pregnant in the next year?
-50 -65 -75 -85 |
85%, probability of 15-33% per cycle
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the ovum is able to be fertilized for how long after ovulation?
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12-24 hours
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sperm usually remain viable for _ days after intercourse.
-1 -3 -5 -7 |
3 days
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when is the most fertile period for women?
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several days prior to ovulation and ends 24 hours after ovulation
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once fertilized, how long does it take the egg to get to the uterus?
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2-3 days; and then implantation takes 6-7 days, following cell division that forms a blastocyst.
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what is the leading method of BC in women 35-44?
-sterilization -ocp -condoms -diaphragm |
sterilization-because men are babies.
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what are the 2 hormones found in ocp's?
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estrogen (typically ethinyl estriol and progestin)
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norgestimate and desogestrel are what generation of progestin?
-1st -2nd -3rd |
3rd are more selective and have fewer androgenic side effects such as acne and adverse lipid effects
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_ is a spironolactone analogue, a unique progestin that has anti-androgenic and anti-mineralocorticoid effects which can improve acne and seborrhea and counteract fluid retention caused by estrogen.
-progestin -norgestimate -desogestrel -drospirenone |
drospirenone-may cause K+ to go up
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oc's work by .....
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suppressing ovulation
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the contraceptive action of ocp's is primarily the result of?
-estrogen -progestin |
progestin
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the creation of thickened cervical mucus that blocks sperm from the uterus, inhibition of capacitation (ability of sperm to fertilize), interference with transport of the egg and sperm, and endometrial changes that interfere with implantation are all in response to?
-estrogen -progestin |
progestin
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t/f
the oc does not disrupt an established pregnancy or harm a developing fetus |
true
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women weighing more than 70 kg should have a minimum of _ mcg of EE.
-20 -35 -50 |
35 mcg
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_ decreases the FSH levels and the LH surge, thus blocking ovulation.
-estrogen -progestin |
estrogen
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t/f
oc's reduce the risk for ovarian and endometrial cancer by 40%, or 80% if used for >10 years |
true
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which 2 of the following are FDA approved for the treatment of acne?
-ortho tri-cyclen -estrostep -alesse -yasmin |
ortho tri-cyclen
estrostep |
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all of the following except 1, are beneficial effects of oc's.
-hypertension prevention -atherosclerosis -osteoporosis -colorectal CA |
all except hypertension prevention
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t/f
both smoking and OC use increase the risk for some CV diseases such as MI, CVA, and VTE. |
true
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t/f
among higher risk women, low dose estrogen contraceptives are the best option |
false; these women should be placed on progestin only pills, such as micronor, or Nor-QD
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which of the following is the MC CV risk associated with oc's?
-MI -VTE -CVA -PE |
VTE; highest during the first 2 years of use, and smoking adds to that risk
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t/f
a recent study found no increased risk of breast CA with use of the OC for either current or former users. |
true; although other studies say the fucking opposite, whatever....
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among women at high risk for breast CA because of the BRCA1 gene mutation, the use of OC should not be used for any longer than _ years.
-1 -5 -7 -10 |
5 years; although the use of OC to prevent ovarian CA, especially after age 30 is still supported
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should you recommend to your OC using pt to use a backup method of birth control when she is on antibiotics?
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yep, during therapy or for 14 days, whichever is shorter
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what is the name of the herbal med that interacts with OC's?
-ginko biloba -st. john's wort -melatonin -fish oil |
st. john's wort
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the mini pill contains....
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only progestin
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what is the name of the other progestin only birth control...other than the mini-pill?
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depo-provera injectable
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how does DMPA work?
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it suppresses ovulation for 3 months at a time
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what is the main advantages to POP or DMPA?
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no exposure to estrogen and the women can breastfeed while on progestin as they do not impair lactation
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what is the most critical factor to educate your patients on when you are prescribing POP?
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to take at the SAME time every day, if it is delayed by more than 3 hours, you must use back up method for 48 hours
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t/f
the efficacy of DMPA-SC 104 is slightly lessened when used in women over 70kg. |
false; works like a dream
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what is the MCC of women who use POP?
-dysmenorrhea -amenorrhea -breakthrough bleeding -vag. discharge |
breakthrough bleeding, it is more common than with traditional OC's and often causes discontinuation
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other than irregular breakthrough bleeding with POP, what is the 2nd MCC a woman will d/c the med?
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wt. gain is huge...like 15 lbs in 4 years.
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what can be a life long side effect of DMPA?
-anemia -irregular menses -BMD loss -hypothyroidism |
BMD loss, it can be significant the longer the med is used. It may not be reversible. Is likely d/t the decrease in ovarian production of estrogen
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what are drugs that commonly interact with DMPA?
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none. trick question.
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All of the following except 1 can cause potential drug interactions with POP's.
-barbiturates -hydantions, -NNRT inhibitors -lamotrigine -rifamycins -valproic acid |
not valproic acid
NNRT inhibitors=HIV meds |
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how long after having a baby, in which is being breast fed can a woman begin progestin only contraception?
-immediately -2 weeks -2 months -6 weeks |
no sooner than 6 weeks d/t the babe's inability to metabolize and excrete drugs
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wt. gain, breakthrough bleeding, and bone loss are all s/e of ?
-OC's -POP's -DMPA -IUD's |
DMPA
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which med can be used after intercourse to prevent pregnancy, is non-prescription for patient's over 18.
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Plan B or OC's of EE plus either levonorgestrel or norgestrel.
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t/f
EC's inhibit implantation of a fertilized egg, but are not abortifacients as they do not disrupt an already established pregnancy |
true
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which is the more effective EC method? Plan B or the Yuzpe method?
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Plan B 89% effective
Yuzpe 75% effective |
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what are the common s/e's of both methods of EC? Yuzpe > Plan B.
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nausea and vomiting, premedication for this is helpful
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which product contains 2 doses of 750 mcg of levonorgestrel, that is taken 12 hours apart?
-Plan B -OC's |
Plan B
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when using the Yuzpe method, it contains EE and either levonorgestrel or norgestrel, what must you keep in mind in regards to these meds?
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that you must give twice the dose of norgestrel then you would of levonorgestrel.
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what are the names of the 2 types IUD's available?
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Copper T-380A and Mirena (LNG-IUS)
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which IUD has a longer duration of effectiveness?
-Copper T 380A -Mirena |
Copper T=10 years
Mirena = 5 years |
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What is the MOA of the Copper T?
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is to prevent fertilization of the egg. It alters tubal and uterine fluids thus impairing sperm function and preventing fertilization
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What is the MOA of Mirena?
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initially releases 20 mcg of levonorgestrel daily which decreases to 10 mcg over time
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t/f
IUD's can act abortifacients |
false
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what is the purpose of putting an IUD in during menses?
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to increase certainty that the woman was not pregnant and to take advantage of the dilation of the cervical os
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Which of the following has the s/e of heavy menses and irregular bleeding which is common in the first 3-6 months of therapy?
-Copper T -Mirena |
Copper T
mirena has light and irregular menses along with oily skin and inc. appetite. But may develop amenorrhea after a 1 year of use. |
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which of the following are contraindications to the use of either IUD?
-migraine without aura -current ovarian, cervical or endometrial -anatomical abnormalities -fibroids -PID -AIDS -STI's -liver disease -breast CA -CVD -DVT/PE |
not migraines without aura; migraines with aura
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t/f
iud's do not increase the risk of PID |
true; but the insertion process does
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all of the following except which are common reasons for IUD expulsion?
-nulliparity -never carried a pregnancy to term -severe dysmenorrhea -multiparity |
multiparity is not a risk factor for expulsion
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when is uterine perforation most likely to occur with IUD's?
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during placement
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how do diaphragm's and cervical cap's prevent pregnancy?
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both are reusable latex physical barriers that are combined with spermicide as a chemical barrier
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which one fits tightly over the cervix?
-diaphragm -cervical cap |
cervical cap
the diaphragm is inserted so the dome covers the cervix |
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which has the greatest failure rate in parity women?
-diaphragm -cervical cap |
cervical cap
there are similar failure rates in both groups with the diaphragm |
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name the 3 types of diaphragms.
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arcing
coil flat spring-most commonly used in the 60-80mm size |
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which device can be inserted up to 6 hours before intercourse and must remain in place for at least 6 hours after intercourse, but should be removed within 24 hours?
-diaphragm -cervical cap |
diaphragm
the cervical cap should be inserted about 30 min. prior to intercourse; stays in at least 6 hours; can remain 48 hours |
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the MC s/e of the diaphragm is colonization of the vagina with _.
-trichomonas -gonorhea -e. coli -chlmydia |
e. coli
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which device could cause TSS?
-diaphragm -cervical cap |
diaphragm; especially if left in over 24 hours
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what must you use along with the sponge?
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spermicide-nonoxynol 9
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the sponge has a greater failure rate with ?
-nulliparous women -parous women |
parous 32%, nulliparity 16%
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name some major benefits of the sponge?
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24 hour protection
can be used for multiple acts of intercourse low cost non-prescription |
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what is the one contraindication to the sponge?
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do not use during menses as it increases the risk of TSS
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what is the MOA of spermicide?
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destroys sperm cell membrane
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what is the minimum amount of spermicide that needs to be used to be effective?
-25 mg -50 mg -100 mg -150 mg |
100 mg of nonoxynol-9
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women should not wash away spermicide or douche for at least _ hours after intercourse.
1 3 6 24 |
6 hours
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t/f
nonoxynol-9 causes lesions of the vaginal mucosa that facilitate transmission of HIV |
true as it becomes irritating and can cause ulcers making it easier for the transmission of sti's
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a form of natural family planning is the temperature method, which is a rise in basal body temperature that occurs just _ ovulation.
-early -mid -late -after |
after
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when using the mucus method, a change in consistency of cervical mucus from thick and dry to clear, thin and sticky occurs at what time?
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ovulation
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when using the calendar method of birth control a women figures out her most fertile period by subtracting _ days from the length of the shortest cycle and 11 days from the longest cycle
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18 days
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due to the fact that a woman's egg survives less than 1 day and sperm survive up to 5 days in the woman's genital tract-the actual fertile period lasts for about _ days each cycle
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6
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adnexal pain with ovulation is aka?
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mittelschmerz pain
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the use of 2 of the following medications are used in medical abortions, which one is not used?
-misoprostol/cytotec -methotrexate -mifepristone/RU 486 |
not methotrexate
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methotrexate has what role in medical abortions?
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cytotoxic drug that blocks dihydofolate reductase, which = DNA synthesis. causes early abortion by blocking the folic acid in fetal cells preventing cell division. it acts on the cytotrophoblast rather than the developing embryo
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medical abortions is typically effective up to _ days of gestation.
-25 -55 -63 -75 |
63 days
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which of the following is the prostaglandin analogue?
-mifepristone/RU-486 -misoprostol/cytotec |
misoprostol/cytotec
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which is more effective in medical abortions?
oral misoprostol/cytotec vaginal misoprostol |
vaginal causes greater uterine contractions
800mcg vaginally or 200mcg orally |
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if you give the regimen of oral cytotec and RU 486, it can only be used in pregnancies under _ days.
25 37 49 63 |
49 days, 92 % efficacy, and the pt. must remain in the clinic for 4 hours
if using oral mifepristone/RU 486 and vaginal misopristone/cytotec is 95-99% effective and can be used up to 63 days gestation |
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misoprostol is contraindicated in a pt with a history of ?
-asthma -seizure disorder -rheumatoid arthritis -osteoarthritis |
seizure disorder
also women with ectopic pregnancy, IUD in place, severe anemia or known coagulopathy. women on long term steroids or allergy to one of the meds also should not have medical abortion |
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what are the MC s/e of medical abortion?
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n/v
thermoregulatory dysfcn (fever, chills, hot flashes) dizziness h/a diarrhea |
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do you need to avoid using nsaids in the tx of discomfort after medical abortion?
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no, they can be used
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uncontrolled hypertension is a relative/absolute contraindication in the use of combined OC's.
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relative
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valvular heart disease is a relative/absolute contraindication in the use of IUD's.
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relative
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