Contraception
Pharm for contraception
STI
HAP
LUCKY DIP

100

When Mei sought a contraceptive method, what is the major comparison she would be asked about to determine her type of contraceptive use?

Non-hormonal and Hormonal

100

What is the difference between COCP and POCP

COCP = combined EE and progestogen

Progestogen only tablet 

100

Are all STI's bacterial?

Discuss

No! 

Bacterial, parasitic, fungal and viral

100

What is FGM? examples.

Female Genital mutilation

- excision

- clitoridectomy 

- infibulation


100

What is the pearl index?

system used to determine the likelihood of falling pregnant. 

Pearl index of 3 means 3 in 100 women fall pregnant

200

Mei is confused, what are the different tiers and types of contraception?

Tier 1:

- LARCS

- irreversible methods


Tier 2:

- COCP

- POCP


Tier 1:

- condoms

- fertility awareness

- peri-coital i.e. diaphragms, spermacidal gels, rings

200

Mei is curious and wants to know the role of ethinylestrodial and progestogens on the menstrual cycle

EE = inhibits FSH so prevents the follicular stage from progressing 

Progestogens = Inhibits LH thus prolonging/delaying ovulation AND thickens cervical mucus preventing implantation

200

A recent test showed clue cells present in the microscopy, what is this indicative of, and what is the treatment methods?

bacterial vaginosis 

- Clindamycin topical cream 

200

How does sexual abuse change pubertal development?

sexual abuse at a young age makes the individual more inclined to go through puberty at an earlier age.

200

Can you use spermamicidal gels by themselves or do you use them with other methods?

You technically can but shocking pearl index of 36 in 100, so normally used in addition to diaphragm or condom

300

If Mei and her boyfriend decided to adopt the fertility awareness method, what days/times would abstinence be advised?

days 9-18 just incase

300

Mei wants to know the risks associated with use of the OCP and repercussions of long term use

When on it:

- increased DVT risks

- increase in LDL (depending on OCP given)

- potential increased risk of CV event 

No long term effects of use! 

300

A man presents to ED and is diagnosed with proctitis, what infection is he most likely to have?

chlamydia

300

Mei's parents are considering arranged marriage as they are not fans of her current boyfriend. Is this legal in Australia?

Yes, so long as both partners willingly consent, with no duress

300

What is the trade name of the implantable contraceptive?

Implanon

400

Mei took an emergency contraceptive the following day, but what are her options and if she presented to the doctor 2 days later and hadn't taken anything yet?

72 hours

- Yupze method = EE and levonorgestrel combo 3 tablets 

- Positnor = levonorgestrel 

- EllaOne = ulipristal acetate

- Copper IUD = 5 days later

400

Mei has began experiencing an increase in appetite and her breasts are really tender, what is responsible for this?

Progestogen excess:

Oligomenorrhoea

Amenorrhoea

Appetite

Breast size & tenderness

Dry vagina

Depression

Libido

400

Mei's boyfriend presents with a genital ulcer which was painless but now he has a very painful lymph node above his genitals. What does he have and how do you treat it?

What if the lymph node was also painless?

LGV, azithromycin and abstinence for a week

if painless lymph node consider syphillis

400

Why are men more likely to perform pedophillic acts?


Once men enter their 30's they begin to become attracted to females slightly younger than them (evolutionary bc reproductive age). Pedophilia is associated with an extreme attraction to younger females.

400

Discuss the stages of syphillis in the body.

What stage of syphillis is the most infective?


Primary: 

  • Punched out ulcer, hard base, painless (hard chancre)
  • Penis or cervix 
  • Rectum, lips, hands
  • Disappear in 2-6 weeks thus go unnoticed
  • Localised enlarged rubbery painless lymph nodes

 

Secondary:

  • 2-10 weeks after chancre
  • Spread in lymphatics and bloodstream
  • Maculopapular rash: palms, soles
  • Generalized lymphadenopathy, fever and malaise 
  • HIGHLY INFECTIOUS stage 
  • Heals spontaneously

 

Tertiary:

  • 3 - 30 years after primary lesion
  • Granulomatous nodules in skin, mucous membranes or bones
  • Punched out ulcers 

 

Late:

  • Cardiovascular: aortic aneurysm
  • Neurosyphilis: paresis (muscular paralysis due to nerve damage)

500

In 15 years, Mei and her partner are now wanting to fall pregnant in the next few months. Is this possible with all contraceptive methods?

No, the DMPA injection is unpredictable and even though it only provides cover for 3 months, it can take anywhere from 9-18 months for fertility to come back 

500

We need to work out the main differences between the 2nd and 3rd generation progestogens, to ensure we can target what Mei wants out o the pill, what are they?

2nd gen = more androgenic

  • Fluid retention
  • Weight gain
  • Decreased HDL cholesterol levels
  • Headaches & mood disturbances

 

3rd gen = less adrenergic

  • Less acne
  • Less weight gain
  • Higher risk of VTE

500

Mei is treated with Azithromycin, what could she possibly be being treated for?

Gonnorhea, Chlamydia, LGV and Chancroid

500

What is the Westermarck Effect?

When a young woman is adopted into a family with a son, and is raised with him, eventually to be married there is a lack of sexual attraction, thus decreased fertility and fewer kids

500

A certain contraception cant be used for breastfeeding mothers - what is it and explain the physiology

COCP

after giving birth - the first 6 weeks of breastfeeding the mother already has high levels of oestrogen and so giving more would decrease production of prolactin and thus breastmilk production would decline