Comprehensive Reproductive Health Final Exam Study Guide

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Questions and Answers

A patient presents for a medication abortion at 10 weeks gestation. She has a history of anemia. What lab is indicated in this scenario?

Quantitative B-hCG

Hemoglobin and Hematocrit (correct)

Rh status

All of the above

Which of the following is a contraindication for medication abortion?

Anemia

Previous history of ectopic pregnancy

Long-term systemic corticosteroid use (correct)

IUD in place (correct)

Heavy menstrual bleeding

A patient presents for a medication abortion at 8 weeks gestation. She has a regular menstrual cycle and no history of ectopic pregnancy. What is the most appropriate next step in her care?

Refer to a specialist for surgical abortion

Administer mifepristone immediately (correct)

Administer misoprostol immediately

Perform an ultrasound

Order a quantitative B-hCG

A patient presents for a medication abortion at 11 weeks gestation. She has irregular menses and her last menstrual period (LMP) is unclear. What is the most appropriate next step?

Perform an ultrasound Signup and view all the answers

A patient presents for medication abortion with heavy vaginal bleeding and a positive urine pregnancy test. Her estimated gestational age is 8 weeks. What should be the first step in her management?

Perform an ultrasound Signup and view all the answers

When is it appropriate to initiate an IUD after a medication abortion?

After confirming abortion completion at a follow-up visit Signup and view all the answers

A patient presents for a medication abortion and wants to begin contraception immediately. Which contraceptive method can be started at the time of mifepristone administration?

Hormonal implant Signup and view all the answers

A patient has completed a medication abortion. During her follow-up visit, she reports no further symptoms of pregnancy. What is the most likely reason for this?

The medication abortion was successful Signup and view all the answers

What is the percentage of abortions performed under 13 weeks gestation?

92.7% Signup and view all the answers

Which of the following is NOT an advantage of medication abortion?

Requires hospitalization Signup and view all the answers

What action should be taken if a patient decides to continue their pregnancy?

Start prenatal vitamins and refer for prenatal care Signup and view all the answers

Pregnancy-associated mortality rates are particularly higher among which demographic?

BIPOC women Signup and view all the answers

Which of the following statements regarding first trimester abortions is true?

They have no impact on future fertility. Signup and view all the answers

What percentage of abortions are performed after 13 weeks gestation?

7.2% Signup and view all the answers

What is a recommended pre-procedure step for medication abortion?

Conduct a baseline ultrasound or quantitative hCG test. Signup and view all the answers

What is one of the critical components of providing options counseling for pregnancy decisions?

Using active listening and exploring feelings with empathy. Signup and view all the answers

What is the effectiveness rate of aspiration abortion?

99% Signup and view all the answers

Which of the following is a disadvantage of aspiration abortion?

Requires pelvic instrumentation Signup and view all the answers

How long does the aspiration abortion procedure typically last?

5-10 minutes Signup and view all the answers

What effect does the absence of a gestation sac have on follow-up after a medical abortion?

Confirms complete abortion and no further action needed Signup and view all the answers

Which of the following is NOT a comfort measure during aspiration abortion?

Anesthetic incompetence Signup and view all the answers

What is the recommended action regarding contraception immediately following an aspiration abortion?

IUD can be inserted immediately after aspiration Signup and view all the answers

Study Notes

Module 1: Contraceptives, Pregnancy Options, Cervical Cancer Screening

Pregnancy-associated mortality rate is 32.9 per 100,000 live births, with higher rates among BIPOC populations.
Pregnancy mortality is elevated in states with strict abortion laws.
Approximately 7 million women are hospitalized annually due to unsafe abortions.
Use all options counseling to foster a supportive environment while exploring pregnancy-related decisions with empathy and curiosity.
Pregnancy options include: terminating pregnancy, carrying it to term, medication abortion, procedural abortion, parenting, and adoption.
For patients who choose to continue their pregnancy, initiate prenatal vitamins, refer for prenatal care, educate on warning signs, and assess needs related to nutrition, housing, finances, and childbirth education.
About 92.7% of abortions occur within the first trimester, with only 7.2% after 13 weeks.
Two key types of abortion are medication abortion and aspiration, both performed in the first trimester.
First trimester abortions do not increase risks of infertility, ectopic pregnancy, miscarriage, birth defects, preterm delivery, breast cancer, or mental health disorders.
Medication abortion can be performed up to 77 days from the last menstrual period (LMP) and has a 95% effectiveness rate.
Advantages of medication abortion include less invasiveness, increased autonomy, and available telehealth options.
Disadvantages of medication abortion comprise prolonged bleeding, cramping, and the potential need for surgical intervention if medication fails.
The medication abortion regimen includes mifepristone (200 mg) followed by misoprostol (800 mcg) taken 24-48 hours later, with specific dosing for pregnancies between 9-11 weeks.
Mifepristone blocks progesterone, leading to cervical ripening, while misoprostol promotes uterine contractions and expulsion.
Patients should expect cramping and bleeding within 4-24 hours post misoprostol; NSAIDs or opiates can be provided for pain relief.
Medication abortion requires verification of a positive urine pregnancy test, and estimated gestational age must be less than 77 days.
Contraindications for medication abortion include the presence of an IUD, allergies to medications, chronic adrenal insufficiency, and certain co-morbidities.
Labs may include hematocrit and hemoglobin for patients over 10 weeks or with anemia history, Rh status check, and quantitative beta-hCG measurement if necessary.
Criteria for ultrasound include suspected ectopic pregnancy, uncertain LMP, irregular menstrual history, and vaginal bleeding.
For post-abortion contraception, an implant can be placed immediately, while pills, patches, or rings can be started the day after mifepristone; IUDs are placed after confirming abortion completion.
Assessing abortion completion can involve follow-up visits or evaluating bleeding patterns and measuring hCG levels, ensuring an 80% decrease within a week.
A negative urine pregnancy test four weeks after mifepristone indicates successful abortion; a positive result necessitates further evaluation.
Aspiration abortion is 99% effective, performed rapidly, and requires no follow-up; suitable for later-stage abortions (up to 14 weeks).
Disadvantages of aspiration abortion include the need for pelvic instrumentation and less control for the patient.
Analgesia options for aspiration abortion include NSAIDs and varying levels of sedation, while comfort measures can enhance patient experience.
The aspiration procedure typically lasts 5-10 minutes and allows for immediate contraception placement afterward.

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Description

This study guide covers various topics related to reproductive health, including contraceptives, pregnancy options, cervical cancer screening, and more. It is designed to help students achieve 100% recall on their final exam.