Shared Flashcard Set

Details

contraception
contraception
29
Medical
Undergraduate 4
05/30/2017

Additional Medical Flashcards

 


 

Cards

Term
after giving birth women require contraception after day?...
Definition
21
Term
advice for POP postpartum
Definition
women can start POP at anytime postpartum
after 21 days additional contraception needs to be used for 2 days

a small amount of progesterone enters breast milk but it is not harmful to baby
Term
a mother is breastfeeding and is < 6 weeks postpartum. which contraception is absolutely CI?
Definition
COCP

it may reduce breast milk production in lactating mothers
Term
postpartum what advise would you give to someone start COC?
Definition
can be started from day 21 so long as they are not breastfeeding
after day 21 you need barrier methods for 7 days
Term
what is the lactational amenorrhoea method? LAM?

this is valid for 6 months!
Definition
if a women is fully breastfeeding including night feeds, is less than 6 months postpartum and is having no periods then this is 98% effective as contraception
Term
35 year old diagnosed with breast cancer. she is using COC. what needs to happen.
she still wants contraception. what wold you recommend?
Definition
recommend the copper IUD because breast cancer is an absolute CI to all hormonal forms of contraception
Term
what guides the decision to start someone on COC?
Definition
UK medical eligibility criteria

UKMEC
Term
describe different stages of UKMEC
Definition
UKMEC 1- no restriction for contraception
UKMEC 2 - advantages outweigh disadvantages
UKMEC 3 - disadvantages generally outweigh advantages
UKMEC 4 - unacceptable health risk
Term
give some examples of UKMEC4 conditions
Definition
> 35 and smoking >15
migraine with aura
hx of thromboembolic disease/mutation
hx of stroke/IHD
breastfeeding <6 weeks postpartum
uncontrolled HTN
current breast cancer
major surgery with prolonged immobilisation
Term
if a person is > 35 and smoking < 15 cigarettes which category UKMEC are they?
Definition
they are MEC3

UKMEC4 is > 35 and >15 cigarettes
Term
BMI >35 falls into which UKMEC category?
Definition
UKMEC3 - disadvantages generally outweigh benefits
Term
which injection contraceptive is associated with delayed return to fertility?
Definition
Depo-Provera

it can take several months for fertility to return back to normal
Term
features of Depo Provera?
Definition
contains 150mg of progesterone
given IM injection every 12 weeks
can be given up to 14 weeks after last injection without needing extra contraception

MOA: inhibits ovulation

counselling: cannot be reversed once given and fertility can take up to 12 months to return back to baseline

SE:irregular bleeding, weight gain, risk of osteoporosis, cannot be reversed once given, delay in return to fertility
Term
there is another injection called Noristerat that is licensed in the UK. how often is this given?
Definition
8 weeks
Term
which method of contraception has a proven association with weight gain?
Definition
Depo provera
Term
what advice would you give to someone on POP who has missed her pill more than 3 hours ago

what different advise is there for cerazette?
Definition
if it has been < 3 hours and you have missed 1 pill no action is needed. just take the pill

if it has been > 3 hours and you have missed one pill then take the missed pill. take the next pill at the usually time. this may mean taking 2 pills in one day. used barrier methods for 48 hours

cerazette has a long missed pill gap of 12 hours. so if it is > 12 hours then you should follow the advice stated above
Term
COC work by inhibiting ovulation whereas POP work mainly by thickening cervical mucus. however there is one POP that works primarily by inhibiting ovulation. which one is this?
Definition
desogestrel

MOA: inhibits ovulation
also thickens cervical mucus
Term
POP mainly work by thickening cervical mucus

however the injectable progesterone, implantable progesterone and desogestrel POP work in another way what is it?
Definition
they inhibit ovulation

and also thicken cervical mucus
Term
how do desogestrel, IM depo and implant differ from the rest of the POP?
Definition
POP mainly work to thicken cervical mucus

however desogestrel, IM injection and implant primarily inhibit ovulation whilst also thickening cervical mucus
Term
IUD copper coil MOA?
Definition
toxic to sperm and ova

also inhibits implantation
Term
MOA of both types of contraceptive pill?
Definition
inhibit ovulation
Term
MODE of action for IUS eg mirena?
Definition
prevents endometrial proliferation (thus reduces bleeding) and also thickens cervical mucus
Term
I am an IUS called mirena what is my mode of action?
Definition
I prevent endometrial proliferation. this is why I can reduce bleeding

I also thicken cervical mucus
Term
UKMEC3
Definition
> 35 age and < 15 cigarettes
BMI > 35
controlled HTN
migraine without aura
1st degree relative with Hx of DVT/PE < 45 years
Brca 1/2 gene
immobility eg in wheelchair
Term
prescribing the COCP to someone who has a family hx of breast cancer but with no brca1 mutation falls into which UKMEC ?
Definition
MEC1

you can prescribe it for them
Term
what advice should be given to all women who are on enzyme inducing drugs?
Definition
to use a reliable method that isn't affected by the drug these include:

Copper coi
IM depo
mirena

copper first choice as it has no hormones.
if lady is obese ward away from depot as it causes weight gain
Term
what could you do in a person on enzyme inducing drugs who wishes to take COCP?
Definition
advise that effectiveness is decreased and there is an increased chance of pregnancy.

you can increase oestrogen to 50mcg with no pill free interval or reduce gap from 7 days to 4 days. this reduces the chance of ovulation
Term
nexplanon implant features
Definition
valid for 3 years
effective immediately if implanted upto day 5 of period
if inserted after day 5 use condoms for first 7 days

no association with weight gain
se: irregular bleeding for 3months or more
Term
what is the window period for missing desogestrel?
Definition
12 hours
Supporting users have an ad free experience!