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Question 1
Which of the following is true? UPA-EC may be less effective if a woman:
A
Has severe asthma managed with oral glucocorticoids.
B
Is taking truvada and raltegravir given for post-exposure HIV prophylaxis after sexual exposure (PEPSE).
C
Commences a hormonal contraceptive on the same day.
D
Takes UPA-EC between 0 and 72 hours after UPSI.
Question 2
Contraindications to the insertion of a Cu-IUD for EC are the same as those for routine IUD insertion. Which of the following is a relative contraindication?
A
Between 48 hours and 28 days after childbirth
B
Risk of sexually transmitted infection
C
Previous ectopic pregnancy
D
Young age and nulliparity
Question 3
Following vasectomy, the optimal time to undertake a post-vasectomy semen analysis is:
A
8 weeks post-procedure
B
12 weeks post-procedure
C
16 weeks post-procedure
D
24 weeks post-procedure
Question 4
Which of these women cannot be offered the IUCD as a form of EC?
A
Women who have been sexually assaulted
B
Adolescents
C
Perimenopausal women
D
None of the above
Question 5
The Cu-IUD is the most effective method of EC. A 2012 systemic review reported an overall pregnancy rate of:
A
<0.01%
B
<0.1%
C
<1%
D
<10%
Question 6
During a woman’s fertile period, the pregnancy risk following a single episode of unprotected sexual intercourse (UPSI) has been estimated to be up to
A
10%
B
20%
C
30%
D
40%
Question 7
How does emergency contraception (EC) work? Which of the following statements is false?
A
A. The primary mechanism of contraceptive action of the copper intrauterine device (Cu-IUD) is inhibition of fertilisation by its toxic effect on sperm and ova.
B
If fertilisation does occur, the local endometrial inflammatory reaction resulting from the presence of the Cu-IUD prevents implantation.
C
Given that the earliest implantation is believed to occur 6 days after ovulation, a Cu-IUD can be inserted up to 6 days after the first UPSI in a cycle.
D
The mechanism of contraceptive action of oral EC is to delay or inhibit ovulation for at least 5 days.
Question 8
A woman requesting EC is taking hepatic enzyme-inducing drugs. Which of the following statements is false:
A
single dose of 60 mg UPA-EC (double the licensed dose) can be used off-licence.
B
The effectiveness of UPA-EC and levonorgestrel EC (LNG-EC) could be reduced.
C
A Cu-IUD should be recommended if the criteria for use are met.
D
A single dose of 3 mg LNG (double the licensed dose) can be used off-licence.
Question 9
Regarding oral EC, which of the following is false?
A
Regular contraception should be started as soon as possible after EC because of the risk of pregnancy due to delayed ovulation in the same cycle.
B
Oral EC can be offered if there has been UPSI or oral EC has already been given earlier in the same cycle.
C
Use of LNG-EC rather than UPA-EC may be considered if the woman has taken any progestogen in the week prior to EC.
D
If LNG-EC is used, progestogen-containing drugs should not be restarted for 5 days afterwards.
Question 10
A couple attend the clinic for contraceptive advice. The woman is currently using the LNG-IUS for contraception but it is due to be replaced and they are considering sterilisation as an alternative option. She has a body mass index of 42 kg/m2 and a history of heavy menstrual bleeding. Both partners are willing to be sterilised. What is the single most appropriate advice to offer this couple?
A
Due to her body mass index, she is not a candidate for sterilisation; therefore vasectomy is the best option.
B
Either partner could be sterilised but female sterilisation increases bleeding, therefore vasectomy is the best option.
C
Either partner could be sterilised but female sterilisation would be best as most women become amenorrhoeic.
D
Either partner could be sterilised but the LNG-IUS is also highly effective and would help with heavy menstrual bleeding.
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