8. Contraceptives

A 28-year-old patient who weighs 210 lbs is interested in using the transdermal contraceptive patch. What is the MOST appropriate counseling point regarding its effectiveness?

A patient is prescribed a vaginal ring for contraception. Which instruction should the patient receive regarding the ring's usage?

A patient using a diaphragm for contraception should be counseled to:

Which of the following is a CONTRAINDICATION for the placement of a cervical cap to prevent pregnancy?

A patient using a contraceptive sponge should be MOST concerned about which potential complication if the sponge is left in place for longer than the recommended duration?

A 36-year-old patient with a history of migraines with aura is seeking contraception. Which of the following options is most appropriate?

A patient reports experiencing breakthrough bleeding while taking a low-dose combined oral contraceptive. What is the most appropriate initial course of action?

Which of the following is a major benefit of combined oral contraceptive pills, besides pregnancy prevention?

A 28-year-old lactating woman is seeking contraception. Which of the following is the most appropriate contraceptive method for her?

Which of the following characteristics makes adolescents ideal candidates for IUDs, according to the American Academy of Pediatrics (AAP)?

A patient presents with unilateral numbness, weakness, and severe leg pain after starting combined oral contraceptives. What is the most appropriate next step?

A 28-year-old patient is interested in the copper IUD (ParaGard). Which mechanism of action should you explain to her?

A patient using progestin-only pills calls the clinic and states she took her pill 5 hours late. What instructions should the provider give?

A patient on continuous combined oral contraceptives reports experiencing a severe headache. Which of the following is the most important next step?

What is the recommended administration schedule for depot medroxyprogesterone acetate (Depo-Provera) injections?

A 30-year-old patient with a history of well-controlled hypertension and who smokes less than half a pack of cigarettes daily is seeking contraception. Which of the following is the MOST appropriate contraceptive method?

Which of the following scenarios presents an absolute contraindication to the use of combined hormonal contraceptives?

Which of the following is a contraindication to the use of etonogestrel implants (Nexplanon)?

A 25-year-old patient presents requesting emergency contraception 80 hours after unprotected intercourse. Which of the following is the MOST appropriate recommendation?

A 34-year-old patient with a history of irregular menstrual cycles and suspected endometriosis is seeking contraception. She expresses concern about potential bone density loss due to hormonal methods. Which of the following contraceptive options would be MOST appropriate, considering her concerns and history?

A 26-year-old patient with a BMI of 35 requests contraception. She is concerned about weight gain, has a history of migraines with aura, and has undiagnosed vaginal bleeding. Her blood pressure is consistently around 145/95 mmHg. Which of the following contraceptive methods is MOST appropriate and safe for this patient?

What is the MOST common surgical approach employed for female sterilization?

Which of the following is a potential long-term complication following a male vasectomy?

Which of the following is a component of pre-sterilization counseling that is essential for informed consent?

After how long of regular, unprotected intercourse should a couple, where the woman is over 35 years old, be evaluated for infertility?

Which anatomical or physiological factor is NOT typically required for successful conception?

Which of the following is the MOST common cause of female infertility?

Azoospermia is not obtained until how many weeks post vasectomy?

Which of the following is a common method of assisted reproductive technology (ART)?

A couple is undergoing intrauterine insemination (IUI), and the woman is prescribed clomiphene citrate. What is the PRIMARY purpose of this medication in this context?

What ethical consideration should be discussed with couples undergoing infertility treatment, particularly IVF?

Which of the following is the MOST likely mechanism of action of combination oral contraceptive pills?

A 25-year-old woman who is breastfeeding her 2-month-old infant is seeking contraception. Considering the information provided, which of the following would be the MOST appropriate recommendation?

A 42-year-old patient with a history of well-controlled hypertension and no other significant medical issues is seeking contraception. Which of the following methods would be least appropriate for her?

Which of the following is a potential advantage of continuous combined oral contraceptive regimens compared to the classic 21-day active hormone/7-day placebo regimen?

A patient taking combination oral contraceptives reports experiencing new-onset headaches. Which of the following headache characteristics would warrant immediate evaluation and discontinuation of the OCP?

A patient presents with a chief complaint of new onset amenorrhea while taking OCPs. What is the MOST appropriate course of action?

A patient presents to the clinic complaining of right upper quadrant (RUQ) pain. She is sexually active and currently takes OCPs. What is the MOST appropriate course of action?

A patient is interested in starting birth control. She is currently 36 years old and smokes occasionally. What is the MOST appropriate birth control for this patient?

Which of the following is the MOST likely side effect of Progestin only pills?

Nextstellis is a new oral contraceptive pill that combines estetrol with drospirenone. Which of the following is the MOST accurate description of estetrol?

A new oral contraceptive (OC) containing estetrol is being marketed as having less impact on coagulation markers compared to traditional OCs. What is the primary distinguishing characteristic of estetrol in this new formulation?

When counseling a patient on the use of the transdermal contraceptive patch, which of the following application sites is MOST appropriate to recommend?

Compared to daily oral contraceptive pills, how is the hormone release pattern of a vaginal contraceptive ring designed to function?

Barrier contraceptives, such as condoms and diaphragms, offer benefits beyond pregnancy prevention. Which of the following sexually transmitted infections (STIs) are barrier methods known to provide some protection against?

A patient was initially fitted for a diaphragm three years ago and has been using it successfully. Which of the following scenarios would MOST necessitate refitting for her diaphragm?

Compared to the diaphragm, the cervical cap has a potentially higher incidence of which of the following complications?

The contraceptive sponge demonstrates varying levels of effectiveness depending on a woman's parity. In which population is the contraceptive sponge generally considered more effective?

Which of the following uterine conditions is considered an acquired contraindication to the placement of an intrauterine device (IUD)?

The FDA has issued a warning regarding the use of depot medroxyprogesterone acetate (DMPA) injections and bone mineral density (BMD). How does the American College of Obstetricians and Gynecologists (ACOG) currently recommend managing this concern in clinical practice?

A patient weighing 180 lbs (82 kg) requests emergency contraception approximately 48 hours after unprotected intercourse. Considering weight-related efficacy, which of the following options is likely to be MOST effective for this patient?

A patient started using the transdermal contraceptive patch. When should she replace the patch?

When is the vaginal ring placed for contraception?

Which of the following statements about barrier contraceptives is correct?

A patient asks how long a diaphragm should be left in place after intercourse. What is the correct duration?

Compared to diaphragms, cervical caps have a higher association with which of the following adverse effects?

A nulliparous (never given birth) woman asks about the effectiveness of the contraceptive sponge. What is the MOST accurate counseling point?

What is a significant advantage of long-acting reversible contraceptives (LARCs) like IUDs and implants?

Why are adolescents considered ideal candidates for IUDs?

The FDA issued a warning regarding the use of depot medroxyprogesterone acetate (DMPA) injections. What was the primary concern?

A 27 year old female presents for emergency contraception after unprotected intercourse 4 days (96 hours) prior. Which is her best option?

Which of the following BEST describes the primary mechanism by which progestin-only pills prevent pregnancy?

A 45-year-old patient is seeking contraception but has a history of migraines without aura. Which of the following hormonal contraceptive options would be the SAFEST to initiate?

What is the MOST significant advantage of continuous combined oral contraceptive regimens compared to traditional cyclic regimens?

A patient using combined oral contraceptives reports experiencing new, persistent headaches. Which characteristic of the headache would necessitate IMMEDIATE discontinuation of the OCPs and further evaluation?

A patient on combined oral contraceptives presents with new-onset right upper quadrant (RUQ) pain. What is the MOST appropriate initial step in management?

A 19-year-old patient who is sexually active asks about the effectiveness of different contraceptive methods. What is the BEST response?

A patient taking a combination birth control pill reports experiencing a new breast mass. What is the most appropriate next step.

A woman > 35 years of age presents and is a smoker. Which of the following hormonal contraception has a contraindication to initiation in this patient population?

A patient reports to the clinic that they have been experiencing loss of vision and diplopia while taking oral contraceptive pills. What is MOST likely occurring?

How does the hormone release pattern of a transdermal contraceptive patch compare to daily oral contraceptive pills?

Following a male vasectomy, how long is typically required before complete azoospermia is achieved, necessitating a follow-up semen analysis to confirm sterility?

Which of the following is the MOST reversible female sterilization method?

A 29-year-old female is undergoing a hysteroscopic sterilization procedure. Which of the following materials are utilized in the Essure system?

During pre-sterilization counseling, which of the following is the MOST important to emphasize to a patient?

A 37-year-old woman and her partner have been trying to conceive for 7 months with regular, unprotected intercourse. What is the MOST appropriate next step in their care?

Which factor is LEAST critical for successful natural conception?

A 32-year-old woman is diagnosed with infertility. What percentage of infertility cases are attributed to female factors?

A couple is undergoing infertility treatment. The male partner's semen analysis reveals oligozoospermia. What does this finding indicate?

During IUI, washed semen is introduced via catheter into which location?

A couple is exploring IVF as an infertility treatment option. What is a critical ethical consideration that should be discussed with the couple?

A patient presents requesting a non-prescription oral contraceptive. Considering the information provided, what would it contain?

Following unprotected intercourse 60 hours prior, a 200 lb patient requests emergency contraception. Which agent would be MOST appropriate?

A patient reports that their condom broke during intercourse. They seek medical care 96 hours after the incident. What contraceptive intervention is still indicated?

A patient presents requesting a diaphragm for contraception. Beyond pregnancy prevention, what additional protection does this barrier method provide?

A 30-year-old patient with a history of heavy menstrual bleeding desires long-acting reversible contraception but has a known uterine fibroid distorting the cavity. Which LARC is LEAST appropriate?

A 32-year-old nulliparous patient with a history of well-managed essential hypertension, currently controlled with lifestyle modifications alone, seeks initiation of combined oral contraceptives (COCs). Upon further questioning, she reports experiencing episodic migraines without aura, occurring approximately twice monthly and effectively managed with over-the-counter analgesics. Considering her clinical profile and the nuanced contraindications to COC use, which of the following physiological mechanisms poses the MOST significant theoretical risk necessitating judicious evaluation prior to COC initiation?

A 24-year-old woman, postpartum at 6 weeks and exclusively breastfeeding, presents for contraceptive counseling. She is adamant about avoiding any hormonal contraception that could potentially impact lactation. Considering the subtle pharmacodynamics of progestin-only pills (POPs) and their minimal systemic exposure compared to other hormonal methods, which of the following statements MOST accurately reflects the contemporary consensus regarding POPs and breastfeeding, informing optimal clinical decision-making?

In the context of combination oral contraceptive (COC) pharmacology, the inclusion of ethinyl estradiol serves a multifaceted role beyond endometrial stabilization and cycle regulation. Considering the intricate interplay between estrogen and progesterone components, which of the following mechanisms BEST elucidates the synergistic contribution of ethinyl estradiol to the overall contraceptive efficacy of COCs, particularly in scenarios of potential progestin breakthrough ovulation?

A 39-year-old patient with a history of migraines with aura and well-controlled hyperlipidemia, managed with a statin, is seeking contraception. She is a non-smoker and has no personal or family history of thromboembolic events. Given the absolute contraindications to estrogen-containing contraceptives and the nuances of migraine subtypes, which of the following progestin-based contraceptive modalities would be considered the MOST judicious initial approach, mitigating potential cerebrovascular risk while providing effective contraception?

A 21-year-old patient using combination oral contraceptives presents to the emergency department with acute onset of severe, unilateral leg pain, edema, and palpable cord-like tenderness in the posterior calf. She denies any recent trauma or prolonged immobilization. Considering the temporal association with COC initiation and the concerning symptomatology, which of the following represents the MOST critical and immediate next step in diagnostic and therapeutic management?

A patient using progestin-only pills (POPs) for contraception reports consistently taking her pill approximately 4 hours late each day due to her work schedule. To optimize contraceptive efficacy and mitigate the risk of unintended pregnancy, which of the following counseling points is MOST crucial regarding POP administration and the need for adjunctive contraceptive measures?

Nextstellis, a novel oral contraceptive containing estetrol (E4) and drospirenone, is marketed with claims of a potentially improved safety profile compared to traditional ethinyl estradiol (EE)-based COCs, particularly regarding coagulation parameters. Which of the following pharmacological properties of estetrol BEST differentiates it from ethinyl estradiol and underpins the purported coagulation safety advantage?

A 27-year-old patient presents requesting initiation of a transdermal contraceptive patch. She weighs 240 lbs (109 kg) and expresses concern about contraceptive effectiveness in the context of her weight. Considering the pharmacokinetic limitations associated with transdermal hormone delivery in higher BMI individuals, which of the following counseling points MOST accurately reflects the evidence-based recommendations regarding patch efficacy and weight?

A 41-year-old patient is considering discontinuing her long-term use of depot medroxyprogesterone acetate (DMPA) injections due to concerns about potential bone mineral density (BMD) loss, despite its contraceptive convenience. She is otherwise healthy and has no other risk factors for osteoporosis. Which of the following strategies represents the MOST evidence-based and clinically recommended approach to mitigate BMD concerns in the context of continued DMPA use, according to current ACOG guidelines?

In the evaluation of a couple presenting with primary infertility, the initial assessment of the male partner's semen analysis reveals normozoospermia, but with 45% of spermatozoa exhibiting hyperactivation upon capacitation assays. Considering the complex cascade of events leading to fertilization, which of the following interpretations MOST accurately reflects the potential implications of this finding for the couple's fertility prognosis?

What coil materials comprise Essure?

Minilaparotomy facilitates occlusion of fallopian tubes via?

Complete azoospermia post-vasectomy typically requires?

First line infertility treatment includes?

Female infertility accounts for what percent of infertility cases?

Estetrol's impact on coagulation is _____ ethinyl estradiol.

Combined pills are contraindicated in smokers over _____ years.

Progestin thickens cervical mucus impeding _____ migration.

A patient on Progestin-Only Pills must take it at the same time EVERY day, and if they are more than ____ hours late, they must use back up contraception.

Combination pills prevent _____, if that occurs the progestin will thicken cervical mucus.

Besides pregnancy prevention, combination pills LOWER endometrial cancer risk by _____%

After starting hormonal birth control, diplopia may indicate retinal _____ thrombosis.

A patient who is lactating would benefit MOST from _____ pills.

The most effective, reversible pregnancy prevention available are _____.

The hormone, _____, increases the efficacy of progesterone & stabilizes the endometrium.

Compared to ethinyl estradiol, what is a primary distinguishing feature of estetrol in newer oral contraceptives?

A transdermal contraceptive patch demonstrates decreased efficacy in patients exceeding _____ lbs.

Regarding vaginal contraceptive rings, at which point in the menstrual cycle should placement occur?

Besides pregnancy prevention, what STI does a condom NOT provide some protection against?

Post-coital, how long must a diaphragm remain inside a patient?

Compared to diaphragms, cervical caps pose an increased incidence of _________.

Contraceptive sponges are MOST effective in which population?

Within what timeframe must Plan B be administered to be most effective?

What is the MOST effective method of emergency contraception?

If a condom breaks, advise patients to seek medical care within how many hours?

Following a vasectomy, complete azoospermia, indicating sterility, is typically achieved after approximately how many weeks?

Among the female sterilization methods listed, which is explicitly identified as the most reversible in the provided text?

The Essure hysteroscopic sterilization system employs a coil inserted into each fallopian tube. This coil is comprised of which combination of materials?

In pre-sterilization counseling, particularly for female patients, which element should be most strongly emphasized to ensure truly informed consent and minimize potential regret?

According to the guidelines provided, a woman over the age of 35 should be evaluated for infertility after how many months of consistent, unprotected intercourse without conception?

Within the context of natural conception, as outlined, which factor is LEAST directly related to the initial stages of fertilization and embryo formation itself?

Female factors are implicated in a significant proportion of infertility cases. According to the provided data, approximately what percentage of infertility cases are attributed to female-related causes?

Oligozoospermia, a term frequently used in male infertility evaluations, specifically refers to a deficiency in which semen parameter?

In the intrauterine insemination (IUI) procedure, washed semen is introduced directly into which anatomical location within the female reproductive system?

When counseling couples undergoing infertility treatment, particularly in vitro fertilization (IVF), which ethical consideration regarding potential pregnancy outcomes is most critical to address?

A patient using combination oral contraceptives reports new onset of unilateral visual disturbances. Which of the following is the MOST concerning potential etiology?

Compared to traditional cyclic combined oral contraceptive regimens, continuous regimens are designed to MOST significantly reduce the frequency of:

A patient consistently takes her progestin-only pill (POP) four hours later than her scheduled time. To maintain optimal efficacy, she should be advised to use backup contraception for the next:

In female sterilization via minilaparotomy, fallopian tube occlusion is MOST commonly achieved through which method?

Which of the following BEST describes the primary mechanism by which estetrol, a novel estrogen in Nextstellis, is suggested to have a potentially improved coagulation profile compared to ethinyl estradiol?

For a couple with unexplained infertility, the INITIAL first-line treatment approach, prior to considering advanced reproductive technologies, typically includes:

A 38-year-old woman, gravida 0, is interested in a diaphragm for contraception. Which of the following instructions regarding diaphragm refitting is MOST accurate and clinically relevant?

Following a successful vasectomy, complete azoospermia, confirming sterility, is typically achieved after approximately how many weeks?

The Essure system for hysteroscopic sterilization utilizes micro-inserts primarily composed of which materials?

In the context of infertility evaluation, a semen analysis result indicating 'oligozoospermia' MOST accurately denotes: