MRCOG Part 2 – Sexual and Reproductive Health SBA

1. A 23 year old woman has been assessed at the family planning clinic and is eligible for the combined oral contraceptive pill. Her LMP was 7 days ago with a regular 28 day cycle. She is has not had unprotected intercourse. When can she start taking the pill?

2. Pt treated with rectal administration of drugs for treatment of IBD. Such treatment reduces efficacy of which contraceptive methods.

3. Which of the following statements regarding use of DMPA by women with obesity is true?

4. A 27-year-old woman who has been using the progestogen-only injectable presents complaining of frequent bleeding since her second injection 6 weeks ago. She experiences migraine with aura. After consideration and exclusion of other factors, what is the single most appropriate treatment to offer her?

5. A 45-year-old woman who has been using the POP for the past 10 years with regular bleeds presents complaining that these are becoming erratic and more frequent. She has had no change in partner and has not missed any pills. What is the single most appropriate management of this woman?

6. A 26-year-old para 1 comes to your clinic requesting contraception. She mentions that her maternal aunt had deep vein thrombosis (DVT) and is on warfarin. She is worried that if she takes hormonal contraception she will also develop DVT. Which of the following advice regardling DVT is incorrect.

7. Which of the following is true? UPA-EC may be less effective if a woman:

8. A woman presents for a Cu-IUD for EC after using her combined hormonal contraception incorrectly only during Week 1. A Cu-IUD can be inserted for EC up to how many days after the start of the hormone-free interval?

9. The Standard Days Method® of contraception involves abstaining or using additional precautions:

10. A woman presents enquiring about the use of breastfeeding as a contraceptive. Which of the following best describes the criteria that she would need to fulfil?

11. Which of the following UK Medical Eligibility for Contraceptive Use (UKMEC) recommendations for a woman with a diagnosis of IBD is correct?

12. Which of the following statements regarding Emergency Contraception is false?

13. The woman is currently using the LNG-IUS for contraception which is due to be replaced and they are considering sterilisation as an alternative option. She has a body mass index of 40 kg/m2 and a history of heavy menstrual bleeding, which was improved after LNG-IUS use. Both partners are willing to be sterilised. What is the single most appropriate advice to offer this couple?

14. A 42-year-old woman presents to the labour ward at 34 weeks’ gestation in pre- term labour. She progress very quickly and proceeds to have an emergency Caesarean section for fetal distress. She was discharged home after 1 week as her baby was admitted to the special care baby unit. Two weeks later, she attends the GP centre seeking contraception. She wants to continue to breastfeed her baby.

15. A 20-year-old, BMI 30 presents to the emergency gynaecology services at a hospital at midnight for advice. She gives a history of condom rupture while having sexual intercourse 3 hours ago. She is worried that she will get pregnant and her parents will abandon her. She has erratic cycles and prefers to continue pregnancy is by chance it occurs.