Term
| What method of birth control is 100% reliable? |
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Definition
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Term
| What is the rating scale for safety with contraceptives? |
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Definition
| 1 is approval, 4 is absolute contraindication |
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Term
| What is a general rule safety-wise for contraceptives? |
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Definition
| The method should be safer than pregnancy |
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Term
| What are the two types of IUDs? |
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Definition
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Term
| How long can a copper T be effective? |
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Definition
| Approved for 10 years but effective for at least 20 |
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Term
| What are contraindications for Copper T IUDs? |
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Definition
Active infection
Uterine or cervical cancer
Large or small uterine cavity |
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Term
| How do Copper T IUDs prevent pregnancy? |
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Definition
| Immobilizes and kills sperm |
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Term
| How long is LNG-IUS effective? |
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Definition
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Term
| How does LNG-IUS work/prevent pregnancy? |
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Definition
| Affects cervical mucus and endometrium |
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Term
| What are complications of using an IUD? |
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Definition
Uterine performation
"LOST IUD"
Spontaneous expulsion
Menstrual alterations
Ectopic pregnancy |
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Term
| When do you use progestin only pills and how do they compare to hormonal contraceptives? |
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Definition
| They are often used if contraindication to estrogen (breastfeeding) but are less reliable prevention of ovulation |
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Term
| What are some benefits in taking combined hormonal methods? |
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Definition
| Decreased blood loss, decreased risk of ovarian or endometrial CA |
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Term
| Taking combined hormonal methods would increase risk of? |
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Definition
VTE
Rare benign hepatic tumors |
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Term
| What are absolute contraindications for taking combined hormonal methods? |
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Definition
Heart attack
Stroke
Breast CA
Labile HTN
Advanced DM
Liver failure
migraine with aura |
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Term
| What are the side effect of OCP's? |
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Definition
Breakthrough bleeding
Amenorrhea
Bloating, feeling of weight gain, breast tenderness, nausea, fatigue, headache, depression.
Thromboembolic disease, gallbladder disease, stroke, MI, hepatic tumor |
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Term
| Can you give OCs to smokers over 35? |
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Definition
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Term
| What i a contraindication for giving a progetin only pill? |
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Definition
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Term
| What are some female barrier contraceptives? |
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Definition
Diaphragm
Vaginal Sheild
Cervical Cap
Spermicides |
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Term
| What are some behavioral methods to contraception? |
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Definition
Ovulation awareness
Lactational amenorrhea
Withdrawal |
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Term
| What are some emergency contraceptives? |
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Definition
Combination OCPs or Plan B
IUD insertion
RU486
Taken within 72 hours of unprotected intercourse |
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Term
| What are the success rates for sterilization reversal? |
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Definition
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Term
| How does sterilization work in male? Female? |
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Definition
Block vas deferens
Block tube |
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Term
| What age group is fallopian tube procedures the least effective in? |
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Definition
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Term
| A couple comes to you and wants to undergo a sterilization procedure to either the wife or husband that is least risky. Which do you recommend? Why? |
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Definition
Male sterilization
Output procedure, under local anesthesia, very low failure rate, complications rare.
No effect hormonally, metabolically, or autoimmune |
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Term
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Definition
Put coil into the fallopian tube and the cell will grow around it, blocking the tube.
Important to have a 3 month follow up to make sure it is still blocked |
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Term
| What is the cut off for abortion via medical and surgical procedures? Surgical? |
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Definition
Medical and surgical: before 49 days
After 63 days, must be surgical |
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Term
| What must be discussed during counseling for abortion? |
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Definition
All options must be discussed
Risks and benefits of abortion
Opportunity to discuss feelings about the decision
Confidentiality assured
Information about birth control! |
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Term
| Are counseling and informed consent the same thing? |
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Definition
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Term
| What are three uses of ultrasound? |
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Definition
1. To verify gestational age by sono after 14 weeks
2. Confirm intrauterine pregnancy and gestational age in first trimester
3. Inraoperative use |
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Term
| What are 3 options for abortion in early pregnancy? |
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Definition
Medical abortion
Manual vacuum aspiration
Suction dilatation and curettage |
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Term
| What agents can be used for a medical abortion? |
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Definition
Mifepristone (RU-486)
Methotrexate
Misoprostol |
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Term
| What is the MOA of Mifepristone in causing an abortion? |
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Definition
| Causes separation of trophoblast, increases prostaglandin release, softens cervix |
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Term
| What is the MOA of methotrexate in causing an abortion? |
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Definition
| Inhibits syncitialization of cytotropholast |
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Term
| What is the MOA for how misoprostol causes and abortion? |
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Definition
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Term
| What are contraindications and risks for abortions? |
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Definition
Medical contraindications for agents.
Patient must be willing to participate and take responsibility for care, return for follow up, tolerate time involved.
PAtient must be willing to have surgical abortion if not successful. |
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Term
| How effective is manual vacuum aspiration? |
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Definition
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Term
| When can you use manual vacuum aspiration? |
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Definition
In early pregnancy, can be done in the office with local anesthesia.
DOes not require cervical dilation in advance |
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Term
| What are important medications that should accompany a surgical abortion? |
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Definition
All should be given antibiotics
Rhogam if Rh negative
Pain control |
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Term
| Do you have to dilate the cervix prior to a surgical abortion? |
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Definition
| Yes, you can use an osmotic dilator or misoprostol |
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Term
| What must you do with the tissue after a surgical abortion? Why? |
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Definition
| Tissue floatation or path exam, to make sure you removed conception tissue |
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Term
| How do you perform a second trimester abortion? |
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Definition
D&E
Induction of labor via misoprostol, Prostaglandin, or high dose oxytocin)
May give fetal injection (intracardiac KCl before procedure) |
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