Term
| % of pregnancy in 1y unprotected sex |
|
Definition
|
|
Term
| % of unwanted pregnancies aborted |
|
Definition
|
|
Term
| #1 most common form of birth control |
|
Definition
|
|
Term
| #2 most common form of birth control |
|
Definition
|
|
Term
| #3 most common form of birth control |
|
Definition
|
|
Term
| what is more common IUD or depo |
|
Definition
|
|
Term
| from 15-19yo what percent who got pregnant were using non LARCS |
|
Definition
|
|
Term
| from 15-19yo what percent who got pregnant were using LARCs |
|
Definition
|
|
Term
| efficacy of birth control |
|
Definition
|
|
Term
| effectiveness of birth control |
|
Definition
|
|
Term
| what is the best way to determine how good a birth control is |
|
Definition
| life table analysis (risk over time, 1y/10y failure rates) |
|
|
Term
|
Definition
| measure of effectiveness (# of unintended pregnancies in 100 women in 1y) |
|
|
Term
| 6 ways to be reasonably sure someone isn't pregnant |
|
Definition
| <7d from start of menses, no intercourse since last menses, correctly using reliable contraception, <7d from SAB, within 4wk PP, exclusively breastfeeding |
|
|
Term
| define exclusively breastfeeding - 3 |
|
Definition
| >85% of feeds, amenorrhic, <6mo PP |
|
|
Term
| % of women who have sex before 6wk PP |
|
Definition
|
|
Term
| mean time to ovulation postpartum |
|
Definition
|
|
Term
| % of female sterilization occurring postpartum |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - vasectomy |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - female sterilization |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - paragurd |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - mirena |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - nexplanon |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - depo |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - OCP/patch/ring |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - condoms |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - diap[hragm |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - spermicide |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - sponge |
|
Definition
|
|
Term
| failure rate (effectiveness/efficacy) - NFP |
|
Definition
|
|
Term
| estrogen MOA birth control |
|
Definition
| decreases FSH/LH which decreases ovulation, causes cellular endometrial changes |
|
|
Term
| estrogen MOA hypercoaguabulity - 7 |
|
Definition
| decrease factor VII, IX, X, fibrinogen, AT3, protein S. increases PLT activity |
|
|
Term
| MOA progesterone birth control - 5 |
|
Definition
| decreases sperm fertilization/capication, decreases LH, increases cervical mucous, endometrial atrophy, decreases tubal motility |
|
|
Term
| progesterone MOA hypercoaguability - |
|
Definition
| increases SHBG which decreases protein C, increases PT, and increases VII |
|
|
Term
| contraindications estrogen - 11 |
|
Definition
| smoker >35yo, history VTE, DM with vascular disease, migraine with aura, HTN, CAD, undiagnosed VB, breast cancer, liver disease, SLE/APAS |
|
|
Term
| contraindications progesterone - 5 |
|
Definition
| breast cancer, liver disease, undiagnosed VB, active VTE |
|
|
Term
| contraindications specific to progesterone in depo/Nexplanon - 2 |
|
Definition
| diabetes with neuropathy, ischemia/stroke |
|
|
Term
| what is an extended cycle OCP, 1 benefit, 1 risk |
|
Definition
| no placebo for >28d, less pain, more spotting |
|
|
Term
| management of spotting with extended cycle OCPs |
|
Definition
| decreases on own in 6mo, give 3-4d drug holidays every 5mo |
|
|
Term
| why isn't the placebo week >7d |
|
Definition
|
|
Term
| circulating levels of progesterone compared IUD vs pill vs emergency |
|
Definition
| IUD 100-200 ug/mL, 150mcg pill 2500 pg/mL, 1.5mg pill 14600 pg/mL |
|
|
Term
| why is progesterone sometimes less effective in obesity |
|
Definition
| lower circulating levels due to sequesteration in fat cells |
|
|
Term
| what changes in the phases of pills |
|
Definition
| mono - same prog/E2 every day, bi - two doses of pg in cycle, twi - 3 doses of pg in cycle |
|
|
Term
|
Definition
| quick - start now, use back up 7d, day 1 start, sunday start, switch start immediate |
|
|
Term
|
Definition
| no periods on weeknd, no back up needed |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what do you do if you miss a pill |
|
Definition
| use condoms for 7d, 1 pill take now, 2 pill 2 now 2 tomorrow, 3 pills start a new pack |
|
|
Term
| compare potency, VTE, and androgen SE for each progesterone generation |
|
Definition
1- lower potency, SE, VTE
2- higher potency, SE, lower VTE
3- higher potency, lower SE, higher VTE
4- higher potency, lower SE, higher VTE |
|
|
Term
| 1st generation progesterone's - 2 |
|
Definition
| norethindrone, ethinodiol |
|
|
Term
| 2nd generation progesterone's - 4 |
|
Definition
| norgestrol, levanogestrol, medroxyprogesterone, desogestrel |
|
|
Term
| 3rd generation progesterone's - 4 |
|
Definition
| desogestrol, norgestimate, norgestroin, etnogestrol |
|
|
Term
| 4th generation progesterone's 2 |
|
Definition
|
|
Term
| progesterone in mini pill |
|
Definition
|
|
Term
|
Definition
|
|
Term
| progesterone in yuptze method |
|
Definition
|
|
Term
|
Definition
|
|
Term
| progesterone in depo prover |
|
Definition
|
|
Term
| progesterone in nexplanon |
|
Definition
|
|
Term
|
Definition
|
|
Term
| at how many hours is the mini pill have undetectable levels |
|
Definition
|
|
Term
| #1 SE minipill (other than effectiveness..) |
|
Definition
|
|
Term
| mg progesterone in mini pill |
|
Definition
|
|
Term
|
Definition
|
|
Term
| how long is the depo provera interval |
|
Definition
|
|
Term
| depo provera, IUD, vs, Nexplanon amenorrhea rate |
|
Definition
| depo 50% 1y 80% 5y, nex 1/3, mirena 24% 1y 60% 5y |
|
|
Term
| 4 medical conditions depo provera can help |
|
Definition
| fibroid pain, endometriosis pain, sickle cell crisis frequency, epileptic seizure frequency |
|
|
Term
| effect on ovarian cancer IUD vs Nexplanon vs depo provera |
|
Definition
| all no effect, none decrease ovulation |
|
|
Term
| return to fertility IUD vs depo provera vs nexplanon |
|
Definition
| depo 7-9mo > IUD > Nexplanon (fastest) |
|
|
Term
| weight gain IUD vs depo provera vs nexplanon |
|
Definition
| depo 5#/1y 16#/6y, Nexplanon 3#/3y, IUD n/a |
|
|
Term
| who has highest risk of weight gain with depo provera - 2 |
|
Definition
|
|
Term
| effect of depo provera on lipids |
|
Definition
| decreases HDL, increases LDL |
|
|
Term
| 2 highest risk scinerios for BMD on depo provera |
|
Definition
| <30yo >10 injections …>… >10inj past use |
|
|
Term
| how long does it take for BMD to improve after depo provera |
|
Definition
|
|
Term
| when is the best time in the cycle to place an IUD |
|
Definition
|
|
Term
| comparison of dose and years for the IUDs |
|
Definition
| Skyla 13.5mg 3y, kyleena 19.5mg 5y, lyletta 52mg 5y, mirena 20mg 5y |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 0.5:1000 (baseline 4:1000) |
|
|
Term
|
Definition
| overall low, highest I 1st 20d |
|
|
Term
| what do you do if actinomeces is found on pap and an IUD is in place |
|
Definition
|
|
Term
| what do you do if you cant see IUD strings |
|
Definition
| hCG > cytobrush > U/S > KUB > LSC if seen, if not it was expelled |
|
|
Term
| what do you do with IUD in pregnant patient what is the risk of each option |
|
Definition
remove if you can see - 25% SAB
leave in if cant see - SAB, septic AB, PPROM #1, PTD |
|
|
Term
| what do you do if US says non-fundal IUD |
|
Definition
| if stem is above the internal os remove/replace if causing symptoms only, if stem is below the internal os remove/replace |
|
|
Term
| IUD risk of expulsion % by timing of placement - 7 |
|
Definition
overall 2-10%
post SVD 5-10%
post CD 20%
1st 20d 3%
other risks - 9wk post 1T SAB, post 2T SAB, nulliparity |
|
|
Term
| progesterone level anovera |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| estrogen level xulane patch |
|
Definition
|
|
Term
| contraindication to BC patch |
|
Definition
|
|
Term
| how long is BC patch theraputic |
|
Definition
|
|
Term
| how long is nuvaring theraputic |
|
Definition
|
|
Term
| how long can nuvaring coome out for |
|
Definition
|
|
Term
| progesterone level in nuvaring |
|
Definition
|
|
Term
| how long is an anovera used for |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| hyperkalemia, hyperglycemia, AUB (0.4% DC due to AUB) |
|
|
Term
| contraindications drospirone - 4 |
|
Definition
| renal/liver disease, progesterone sensitive cancer, liver tumor |
|
|
Term
| is dreospirone - safe in PP/BF, smoker, history of VTE |
|
Definition
|
|
Term
| management of AUB on depo provera |
|
Definition
| Premarin 1.25mg/d for 14d, cycle of combined OCPs, doxycycline |
|
|
Term
| why does doxycycline help with AUB on progesterone only methods |
|
Definition
| alters expression of metaloproteases in endometrial cells reducing pro-inflammatory mediators |
|
|
Term
| changes in hormones of OCPs - AUB |
|
Definition
| increase E2, decrease PR, decrease androgens |
|
|
Term
| what medication can be used for AUB while on BC - 2 |
|
Definition
| if only progesterone used can use mifepristone or estrogen, but estrogen only helps current episode not future |
|
|
Term
| changes in hormones of OCPs - nausea |
|
Definition
| take at night, decrease E2 |
|
|
Term
| changes in hormones of OCPs - breast tenderness |
|
Definition
|
|
Term
| changes in hormones of OCPs - weight gain |
|
Definition
|
|
Term
| changes in hormones of OCPs - no period |
|
Definition
|
|
Term
| changes in hormones of OCPs - depression |
|
Definition
|
|
Term
| changes in hormones of OCPs - moodiness |
|
Definition
|
|
Term
| changes in hormones of OCPs - endometriosis |
|
Definition
| decrease E2, increase PR, increase androgens |
|
|
Term
| changes in hormones of OCPs - acne |
|
Definition
|
|
Term
| why does OCPs cause weight gain |
|
Definition
| progesterone increases androgens which increase muscle mass and appetite, estrogen increases fat deposition and mineralcorticoid activity which can lead to fluid retention |
|
|
Term
| bacteria causing acne and the location |
|
Definition
| prepinibacterium acnes in pyelosebaceous unit |
|
|
Term
| why do androgens cause acne |
|
Definition
|
|
Term
| why does puberty cause acne |
|
Definition
| increased ILG-1 increases androgen receptor activity which causes increased sebum |
|
|
Term
| labs associated with acne - 3 |
|
Definition
| increased DHEAs/testosterone, decreased SHBG |
|
|
Term
| how does OCPs decrease acne - 2 |
|
Definition
| increases SHBG and ovarian androgen production |
|
|
Term
| monitoring needed on retin-a - 3 |
|
Definition
|
|
Term
|
Definition
| psych disorders, pseudomotor cerebri, increased TG, pancreatitis, liver toxicity, IBD, changes in vision, heading loss, teratogen |
|
|
Term
| PO treatments for acne - 6 |
|
Definition
| OCPs, retin-a, tetracycline, minocycline, spironolactone, androgens |
|
|
Term
| what combined with OCPs can make acne better then either alone |
|
Definition
|
|
Term
|
Definition
|
|
Term
| androgen medications for ance - 3 |
|
Definition
| bbicalutamide, flutamide, hydroxyflutamide |
|
|
Term
| SE androgen medications for acne - 2 |
|
Definition
| teratogen, hepatotoxicity |
|
|
Term
| how does benzoyl peroxide work for acne - 3 |
|
Definition
| decreases inflrmmation, decreases bacteria, decreases keratin |
|
|
Term
| how do retinoids topical work for acne - 2 |
|
Definition
| decreases keratinization, decreases inflammation |
|
|
Term
| how does azelaic acid work for ance - 1 |
|
Definition
|
|
Term
|
Definition
| benzoyl peroxide, antibiotics, retinoids, azelaic acid |
|
|
Term
| define primary and secondary dysmenorrhea |
|
Definition
| primary has etiology, secondary does not have etiology |
|
|
Term
| % of women with dysmenorrhea |
|
Definition
|
|
Term
|
Definition
| prostaglandins, peak 48h into mensturation |
|
|
Term
| 1st line treatment dysmenorrhea and effectiveness |
|
Definition
| NSAID, 70-90% - OCPs can be first line if desiring contraception anyways |
|
|
Term
| 2nd line treatment dysmenorrhea |
|
Definition
|
|
Term
| third line treatment dysmenorrhea |
|
Definition
| increase progesterone in the OCPs |
|
|
Term
| 4th line treatment for dysmenorrhea |
|
Definition
|
|
Term
| how successful is nerve (uterine, presacral) ablation for dysmenorrhea |
|
Definition
|
|
Term
| effect of OCPs on breast cancer |
|
Definition
|
|
Term
| effect of OCPs on ovarian cancer |
|
Definition
| 40% reduction in 9y, 90% reduction in >15y, some effect in 3-6mo |
|
|
Term
| effect of OCPs on endometrial cancer |
|
Definition
| 56% reduction in 4y, 67% reduction in 8y, 72% reduction in 12y |
|
|
Term
| effect of OCPs on cervical cancer |
|
Definition
| slight increase, should not change management |
|
|
Term
| risk of VTE on OCPs, nothing, pregnancy, postpartum comparison |
|
Definition
| per 100,000 - baseline 5, OCPs 10, pregnancy 20, immediate PP 40 |
|
|
Term
| emergency contraction has help decreases undesired pregnancy by % |
|
Definition
|
|
Term
| side effects of emergency contraception - 5 |
|
Definition
| nausea 35%, vomiting 10%, AUB, breast tenderness, abdominal pain |
|
|
Term
| #1 most effective emergency contraception |
|
Definition
|
|
Term
| #2 most effective emergency contraception |
|
Definition
|
|
Term
| what emergency contreception can someone obese take |
|
Definition
| anything but plan B if >165 lbs |
|
|
Term
| MOA copper IUD emergency contraception |
|
Definition
| decreases tubal and sperm motility |
|
|
Term
| MOA urlipristol emergency contraception |
|
Definition
| selective progesterone receptor modulator, decreases ovulation |
|
|
Term
| plan B MOA emergency contraception |
|
Definition
| prevents LH surge and ovulation |
|
|
Term
| comparison of pregnancy rates for emergency contraception 4 |
|
Definition
| IUD 0.1%, ella 0.9-2.1%, plan B 0.6-3.1%, yutzpe 2-3.5% |
|
|
Term
| how many days can each emergency contraception be used for - 4 |
|
Definition
| IUD 5 (but some efficacy up to 10d), urlipristol 5d, plan b 3d, yutzpe 3d |
|
|
Term
| effectiveness of plan B at 24 and 48h |
|
Definition
|
|
Term
| after emergency contraception when can you start birth control - 4 |
|
Definition
| IUD you did it, urlipristol now, plan B 7d, yutzpe just continue on after it |
|
|
Term
| emergency contraception most likely to causes SE |
|
Definition
|
|
Term
| continuation rate of IUD in teens |
|
Definition
|
|
Term
| continuation rate of Nexplanon in teens |
|
Definition
|
|
Term
| how often does HMB lead to discontinuation of copper IUD |
|
Definition
|
|
Term
| how long does it take for HMB to resolve with copper IUD |
|
Definition
|
|
Term
| contraindication to copper IUD |
|
Definition
|
|
Term
| #1 form contraception used in adolescents |
|
Definition
|
|
Term
| cervical cap efficacy and effectiveness |
|
Definition
|
|
Term
| in what population is a cervical cap, sponge, or diaphragm less effective |
|
Definition
|
|
Term
| how long is a cervical cap used for |
|
Definition
|
|
Term
| when do you need to replace a cervical cap - 3 |
|
Definition
| q2y, postpartum or weight change |
|
|
Term
| complication cervical cap |
|
Definition
|
|
Term
| complications of diaphragm |
|
Definition
|
|
Term
| complications cervical sponge |
|
Definition
|
|
Term
| how long is a diaphragm in place |
|
Definition
|
|
Term
| pregnancies per 1000 women in a year per the crest study - ucheta, bands, bipolar, clips, parkland, irving, pomeroy, monopolar, minilap, essure |
|
Definition
| clips 36, bipolar 25, bands 17, minilap 7.5, monopolar 7, parkland 5, pomeroy 5, essure 2.6, irving 2, ucheta ? |
|
|
Term
|
Definition
| take a mid section of tube out with blade and tie plain gut |
|
|
Term
|
Definition
| make a loop in tube with plain gut |
|
|
Term
|
Definition
| put the uterine part of the tube into the myometrium, tie of the part by the fallopian |
|
|
Term
|
Definition
| put the uterine part of the tube into the misosalpinx, put the fimbriae part outside the misosalpinx |
|
|
Term
| risks of permanent sterilization and the incidence 6 |
|
Definition
| bleeding 1%, injury 1%, infection 1%, death 1:1000000, ectopic 7:000000, regret |
|
|
Term
| risk of regret by age and race - 4 |
|
Definition
| <30yo 20%, >30yo 6%, increased in AA, increased in PP |
|
|
Term
| what increases risk of ectopic with permanent sterilization 3 |
|
Definition
| <30yo, bipolar 17:100,000, PP tubal 1:100 |
|
|
Term
| what is essure made out of |
|
Definition
|
|
Term
| how long does it take for essure to close off tubes |
|
Definition
|
|
Term
| how often at 3mo is tube not closed with essrue |
|
Definition
|
|
Term
| how often at 6mo is tube not closed with essure |
|
Definition
|
|
Term
| what can decrease tubal spasm while placing essure |
|
Definition
|
|
Term
| how many coils is it ok to see with essrue |
|
Definition
|
|
Term
| how many coils do most expulsions have exposed |
|
Definition
|
|
Term
| #1 complication of essure |
|
Definition
|
|
Term
| rate of tubal perforation essure |
|
Definition
|
|
Term
| rate of nickel reaction essure |
|
Definition
| none, a few people reported an itchy rash but likely not related |
|
|
Term
| how long does it take a vasectomy to work |
|
Definition
|
|
Term
| why after a vasectomy reversal is fertility decreased |
|
Definition
|
|
Term
| long term complication and rate post vasectomy |
|
Definition
| post vasectomy pain syndrome 3% |
|
|
Term
| treatment of AUB in special needs patients - 4 |
|
Definition
| NSAIDs, OCPs, patch, ring |
|
|
Term
| why cant you start OCPs before menarche in special needs patients |
|
Definition
| need to know everything works ok |
|
|
Term
| how long to wait postpartum before starting OCPs |
|
Definition
| 3-4wk, if risk factors 6wk |
|
|
Term
| how long to wait postpartum before starting cervical caps |
|
Definition
|
|
Term
| criteria for lactational amenorrhea - 3 |
|
Definition
| only reliable for 6mo, <10% feeds foemula, no >4h pumping (6h at night) |
|
|
Term
| benefits of lactational amenorrhea |
|
Definition
| decreases breast and ovarian cancer |
|
|
Term
| effectiveness of lactational amenorrhea |
|
Definition
|
|
Term
| OCPs ok in HTN categories - BP >160/100 |
|
Definition
| copper 1, IUD 2, Nexplanon 2, POC 2, depo 3, OCP 4 |
|
|
Term
| OCPs ok in HTN categories - with vascular disease |
|
Definition
| copper 1, IUD 2, Nexplanon 2, POC 2, depo 3, OCP 4 |
|
|
Term
| OCPs ok in HTN categories - >140/90 |
|
Definition
| copper 1, IUD 1, Nexplanon 1, POC 1, depo 2, OCP 3 |
|
|
Term
| OCPs ok in HTN categories - controlled |
|
Definition
| copper 1, IUD 1, Nexplanon 1, POC 1, depo 2, OCP 3 |
|
|
Term
| what do you do if someone develops migraines on OCPs |
|
Definition
|
|
Term
| what do you do if someones headache frequency increases on OCPs |
|
Definition
|
|
Term
| when do you stop OCPs in older women |
|
Definition
|
|
Term
| OCPs not ok in obese patients - 4 |
|
Definition
| patch >90kg, Nexplanon >70kg, plan B >165 lbs, low dose estrogen <20 mcg |
|
|
Term
| when starting OCPs in obese patient how long should they use back up contraception for |
|
Definition
|
|
Term
| category of birth control diabetes - with vascular disease or >20y duration |
|
Definition
| copper 1, IUD 2, Nexplanon 2, POC 2, depo 3, OCP 4 |
|
|
Term
| category of birth control diabetes - neuropathy, retinopathy, nephropathy |
|
Definition
| copper 1, IUD 2, Nexplanon 2, POC 2, depo 3, OCP 4 |
|
|
Term
| category of birth control diabetes - insulin dependent |
|
Definition
| copper 1, IUD, nexlanon, depo, POC, OCPs all 2 |
|
|
Term
| antiviral that lower birth control - 2 |
|
Definition
|
|
Term
| amount of estrogen needed for someone on antiepileptic |
|
Definition
| 35mcg - their metabolized fast |
|
|
Term
| effect of lamictal and OCPs |
|
Definition
| lamotrigine is reduced 50% with 28d combination OCPs, monitor every 7-21d |
|
|
Term
| best OCP option if on lamictal |
|
Definition
| extended cycle, although all OCPs are category 3 |
|
|
Term
| what does progesterone do to antiepileptic levels |
|
Definition
|
|
Term
| birth control categories for antiepileptics |
|
Definition
| 1 (copper, mirena, depo), 2 (Nexplanon), 3 (POC, OCPs) |
|
|
Term
| can you put in an IUD if someone has vaginitis |
|
Definition
|
|
Term
| can you put in an IUD if someone has PIT |
|
Definition
|
|
Term
| ok birth control for lupus with APAS Ab |
|
Definition
|
|
Term
| ok birth control for lupus with nephritis, vascular disease |
|
Definition
|
|
Term
| management of break through bleeding for coppuer IUD |
|
Definition
|
|
Term
| management of breakthrough bleeding Nexplanon |
|
Definition
| NSAIDS 5-7d, OCP/estrogen 10-20d |
|
|
Term
| management breakthrgough bleeding depo provera |
|
Definition
| NSAIDS 5-7d, OCP/estrogen 10-20d |
|
|
Term
| management breakthrough bleeding continuous OCPs |
|
Definition
| hormone free interval for 3-4d every 5mo never >7d |
|
|
