Term
| What are some benefits of diaphragm? |
|
Definition
| Non-hormonal, little advanced planning, no direct involvement of male partner, low cost |
|
|
Term
| What are common risks/complaints of the diaphragm |
|
Definition
| TSS, UTI, possible increase in aquisition to HIV if exposed, allergic reaction, vaginal irritation, less effective |
|
|
Term
| How long must a diaphragm be left in place after intercourse? |
|
Definition
|
|
Term
| What landmarks are used for fitting a diaphragm |
|
Definition
| Posterior fornix to pubic arch |
|
|
Term
| What are the risks of a male comdom? |
|
Definition
| latex allergy, breakage or slippage |
|
|
Term
| What is the active ingrediant of Spermacides/today sponge |
|
Definition
|
|
Term
| Does spermicide prevent STI's? |
|
Definition
|
|
Term
| Is the thromboemoblism risk higher, lower, or the same as COC's? |
|
Definition
| The same as 35mcg EE COC, despite claims |
|
|
Term
| Mechanism of action of ortho evra? |
|
Definition
Prevents ovulation by supressing LH and FSH
Also thickens cervical mucous and changes endometrium to prevent implantation |
|
|
Term
| Does Ortho Evera release 15, 20, 25 or 50 mcg of Ethinyl estradiol a day? |
|
Definition
| Supposed to be 20mcg, may be as high as 50 on the first day |
|
|
Term
| Those weighing more than ___ Lbs have lower serum levels on ortho evera and are at an increased risk for pregnancy? |
|
Definition
|
|
Term
|
Definition
| Weekly dosing -> increased compliance,may be more forgiving than COC's if changing of patch is delayed |
|
|
Term
| Patient education for patch |
|
Definition
| rotate sites (buttocks, upper torso, upper arm, lower abdomen), don't place on breasts, apply to clean, dry, intact skin |
|
|
Term
| What medical history would you want to screen for specific to patch that you wouldn't need to with other conditions |
|
Definition
| Psoriasis, eczema, frequent sunburn |
|
|
Term
| How long are hormones at therapeutic levels after patch is removed |
|
Definition
|
|
Term
| What type of progestin is used in ortho evra |
|
Definition
|
|
Term
| How many mcg of ehhinyl estradiol does nuva ring release a day |
|
Definition
|
|
Term
| What type of progestin is used in the nuvaring |
|
Definition
|
|
Term
| if the nuva ring is out of the vagina for greater than ___ hours in a 24 hour period, what should the patient do? |
|
Definition
| reinsert the ring and use backup contraception for 7 days |
|
|
Term
| What is the most common side effect of the nuva ring |
|
Definition
|
|
Term
| does the nuva ring increase risk of BV or yeast? |
|
Definition
| No, but leukorrhea is a side effect |
|
|
Term
| What are other complaints specific to nuva ring but not other contraceptives |
|
Definition
| the "ick" factor of insertion, foreign body sensation, expulsion, coital problems |
|
|
Term
| What are benefits of nuvaring |
|
Definition
| easy, forgiving, low steady hormone release -> fewer SE |
|
|
Term
| is there a wrong place to put nuva ring in the vagina? |
|
Definition
|
|
Term
| how long do hormone levels remain therapeutic if the nuva ring remains in place? |
|
Definition
| 35 days, meaning that if the patient leaves it in 2 weeks extra they are still receiving therapeutic benefits |
|
|
Term
| What are contraindications specific to nuva ring |
|
Definition
| significant pelvic relaxation, vaginal stenosis or obstruction |
|
|
Term
| What should the patient do if breakthrough bleed on nuva ring |
|
Definition
| take out for 3 days then start again |
|
|
Term
| To what other type of contraception do IUD's have comprable effectiveness? |
|
Definition
|
|
Term
| How soon to follow up after insertion of IUD |
|
Definition
|
|
Term
| What is the number one complaint of paragard |
|
Definition
| heavy bleeding, up to 55% increase |
|
|
Term
| How quickly does patient retern to fertility after removal of IUD |
|
Definition
|
|
Term
| What is the rate of uterine perforation in IUD placement |
|
Definition
|
|
Term
| What do you do with IUD if patient does become pregnant |
|
Definition
|
|
Term
| What cancer does mirena protect against and possibly treat? |
|
Definition
| endometrial CA/hyperplasia |
|
|
Term
| what can be used to decrease discomfort with IUD insertion |
|
Definition
| lidocaine, bupivicaine and or premedication with NSAIDS |
|
|
Term
| Does paraguard increase or decrease risk of PID |
|
Definition
| decreases d/t thickened mucous |
|
|
Term
| What disorder would be a contraindication to paragard |
|
Definition
| Wilson's disease (genetic d/o where copper accumulates in tissue), and copper allergy |
|
|
Term
| If a perimenopausal patient came to you c/o irregular bleeding and wanting an IUD, what would you need to do first? |
|
Definition
|
|
Term
| When should a patient come in for an IUD insertion |
|
Definition
|
|
Term
| how soon can a patient have intercourse or use tampons after IUD insertion |
|
Definition
|
|
Term
| What must the sound measure to place the IUD |
|
Definition
|
|
Term
| is there an increased or decreased risk of eptopic pregnancy in a woman with an IUD compared to general population |
|
Definition
| decreased d/t high effectiveness of IUD |
|
|
Term
| Do you need to remove an IUD for a colposcopy? |
|
Definition
|
|
Term
| Will the IUD stings cause a "wick" effect and cause bacteria to migrate into uterus? |
|
Definition
|
|
Term
| what is the MofA of paragard |
|
Definition
| increase in coppor ions stimulates an inflammatory reaction and is toxic to sperm/ovum and prevents implantation |
|
|
Term
| What is the MofA of mirena |
|
Definition
| thickens cervical mucus, supresses endometrium, causes local foreign body reaction, potentially supresses ovulation |
|
|
Term
| what is the most common complaint of progestin only pills |
|
Definition
|
|
Term
| how many hormone free days are there on the mini-pill |
|
Definition
|
|
Term
| what type of hormonal contraception can a breastfeeding woman use |
|
Definition
| progestin only (implanon, IUD, mini-pill) |
|
|
Term
| what are contrindications to POP? |
|
Definition
| Current DVT, breastfeeding women <6wk post partum, active hepatits or chirrosis, breast cancer |
|
|
Term
| when should POP's be taken |
|
Definition
| close to the same hour every day (within 3 hours) |
|
|
Term
| how long do you need to use backup after starting POP |
|
Definition
|
|
Term
| with POP- what do you do if you miss a pill during the 3-hour window? |
|
Definition
| take it as soon as you remember, even if that means you will take 2 pills in one day. Use backup method for 2 days |
|
|
Term
| With POP- what do you do if you vomit or have diarrhea 4 hours after taking pill |
|
Definition
| backup method for 48 hours |
|
|
Term
| does the POP pill have more or less progestin than the combined? |
|
Definition
|
|
Term
| how quickly does fertility return with POP? |
|
Definition
| immediately after stopping |
|
|
Term
| What is the classic presentation of geneital herpes |
|
Definition
painful multiple vseicular or ulcerative lesions
not always classical presentation |
|
|
Term
| If a woman has herpes, will the husband definitely get it too? |
|
Definition
| no, there is a 40% chance the husband will get it in his lifetime |
|
|
Term
| What can you do if herpes outbreaks happen monthly with menses? |
|
Definition
|
|
Term
| What percent of the population has herpes? |
|
Definition
|
|
Term
| does the virus shed before the lesion? |
|
Definition
| yes, up to 2 weeks before |
|
|
Term
| do condoms prevent herpes spread |
|
Definition
|
|
Term
| when do you start supressive therapy in a pregnant woman |
|
Definition
|
|
Term
| What happens can happen to a newborn if delivery during a herpes outbreak |
|
Definition
| blindness and possibly death |
|
|
Term
| is the herpes culture sensitive? |
|
Definition
| no, often come back negative at the beginning and end of herpetic cycle |
|
|
Term
| Is a pap senitive for herpes? |
|
Definition
| no, but it may show up on pap if cells from the lesion are present |
|
|
Term
| What test does typing of herpes? |
|
Definition
|
|
Term
| does it matter if the patient has HSV 1 or HSV 2? |
|
Definition
| not really... but HSV 1 may be less severe |
|
|
Term
| does the patient usually think they have a herpes infection? |
|
Definition
| no, often think it is something else (UTI, yeast infection, bug bite, latex allergy, BV, etc.) May not be in genitals |
|
|
Term
| Valtrex is ___ (cheaper/more expensive) than Acylovir? |
|
Definition
|
|
Term
| You have to take Acyclovir ____ (more/less) often than valtrex (valacyclovir) |
|
Definition
|
|
Term
| acyclovir 400 mg orally BID is first outbreak, supressive therapy or episodic tx? |
|
Definition
|
|
Term
| acyclovir 400mg TID for 5 days is first outbreak, supressive therapy or episodic tx? |
|
Definition
|
|
Term
| acyclovir 400mg TID for 10 days is first outbreak, supressive therapy or episodic tx? |
|
Definition
|
|
Term
| Valtrex 1g orally BID for 10 days is first outbreak, supressive therapy or episodic tx? |
|
Definition
|
|
Term
| Valtrex 1g orally BID for 5 days is first outbreak, supressive therapy or episodic tx? |
|
Definition
|
|
Term
| Valtrex 500mg daily is first outbreak, supressive therapy or episodic tx? |
|
Definition
|
|
Term
| are topical medications recommended in herpes outbreaks |
|
Definition
| no, but lidocaine topical treatment may be considered for severe outbreaks |
|
|
Term
| What do patients need education/counseling/follow up appointments for herpes |
|
Definition
| Tingling "prodrome" before episodic outbreak, how to tell partners, condom use, supressive therapy |
|
|
Term
| does valtrex decrease transmission of herpes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What should a patient do if they feel prodrome during supressive therapy for herpes |
|
Definition
|
|
Term
| should you order a colpo on a patient with Low grade squamous intraepithelial lesion on a pap? (LSIL) |
|
Definition
|
|
Term
| if a patient has LSIL do you ned to test for HPV? |
|
Definition
|
|
Term
| Would it be uncommon for high grade squamous intraepithelial lesion (HSIL)cells on a pap to come back as CIN II |
|
Definition
| no, will usually come back as CINII |
|
|
Term
| What test will tell us if CIN 1, 2, 3: Pap, biopsy, colposcopy |
|
Definition
| biopsy, obtained during colpo |
|
|
Term
| What do you do if the pap comes back cannot exclude high-grade SIL |
|
Definition
|
|
Term
| What do you do if a pregnant woman's pap comes back as LSIL? |
|
Definition
| may defer the pap until 6 wks post partum |
|
|
Term
| may you want to consider an immediate loop electrosurgical excision for a patient with HSIL (high grade squamous intraepithelial lesion) |
|
Definition
|
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