Sexual And Reproductive Health ( Platinum ) - EMQ

Option List :

A. DMPA
B. Barrier Methods
C. Male condom with combined oral contraceptive pills.
D. Implanon
E. Male condoms
F. Spermicidal foam
G. Tubal clip application
H. Progesterone only Pill.
I. IUCD
J. Female condom
K. Combined contraceptive patch
L. Vasectomy
M. Natural methods
N. EC with the pill
O. Combined oral contraception
P. Hysteroscopic sterilisation

For each description below,choose the single most appropriate and safe contraceptive from the above list of options.Each option may be used once, more than once or not at all

1. A 20 years old girl requests contraception.She has been sexually active for 1 year now & is in a new relationship for past 2 mths. She gives history of menorrhagia as well. What is the most appropriate option?

2. A 35 years old lady requests contraception.Her BMI is 40.She suffers from painful heavy periods.She is not interested in further childbearing. She smokes more than 10 cigarettes in a day. What is the most appropriate option?

3. 35 years old P2L2 previous both babies with LSCS, requests for permanent method of contraception. She was on the pills, got pregnant twice due to missing of pills. She had dysmenorrhoea with coil. But the partners are ready for the procedure. What is the most appropriate advice?

4. A 40 years old lady who is P5 requests contraception. She was using the oral combined pill but is now worried about the effects of hormones & requests a non-hormonal reliable long-term method.

5. A 20 years old gave birth to a baby girl 3 weeks ago. She is breast feeding the baby & requires contraception immediately. She doesn’t want any injections or other devices placed in her body.

Option List :

A. Chlamydia trachomatis
B. Neisseria Gonorrhoea
C. Mycobacterium genitalium
D. Trichomonas Vaginalis
E. Candidiasis

6. A 32 year lady diagnosed with PID received treatment with Moxifloxacin and has been called for TOC at 4 weeks. Which is the most likely organism?

7. Organism for which TOC is only required in some cases like a pregnancy and not earlier than 3 weeks

8. TOC 7 days following treatment using RNA NAAT

9. TOC 14 days following treatment using DNA NAAT

10. Most commonly reported curable bacterial STI in the UK with a high frequency of transmission, with concordance rates of up to 75% of partners being reported

Option List :

A. Double dose of LNG
B. Single dose of LNG
C. Copper T
D. Condoms
E. LNG-IUS
F. DMPA
G. High dose combined contraceptive pill
H. Low dose combined contraceptive pill
I. Ulipristal Acetate
J. Sterilisation
K. Vasectomy
L. Implant
M. Do a pregnancy test

Choose the most appropriate method of emergency contraception for these following scenarios. Choose option once or more than once or not at all.

11. Ms X, an 18-year-old presents to you requesting emergency contraception. She has taken ulipristal acetate for emergency contraception 5 days before. Again, she had multiple unprotected sexual intercourses last 4 days. Her last menstrual period was 12days back. She gets periods every 28 days. she is currently on antibiotics for a recent episode of PID.

12. Mrs A. 20 year old she has taken LNG for emergency contraception 5 days before, yesterday night condom broke during sex. She has a regular cycle of 28days her last menstrual period was 13days back. Otherwise, she is generally healthy

13. Ms Sweetie 21-year-old got raped by a stranger 4day back, and she has undergone forensic examination which confirms the same. After counselling She has been given Postexposure prophylaxis for HIV (tenofovir, emtricitabine and raltegravir ) and Hepatitis B vaccination. She is asking for emergency contraception. But she doesn’t want copper T as she still recovering from trauma. otherwise she is generally fit and fine.

14. Ms Angelina 17-year-old in her 2nd week of her cycle. She has taken ulipristal acetate for emergency contraception 4 days back for UPSI. her cycles are regular -30 days cycle and last period was 15days back.

Option List :

A. Levonorgestrel two tablets stat
B. Reassurance
C. Levonorgestrel one tablet followed by a second tablet 12 hours later
D. Copper intrauterine contraceptive device
E. Contact tracing
F. Levonorgestrel-releasing intrauterine system
G. Resume pills
H. Copper IUCD and a pregnancy test in 2 weeks’ time
I. Levonorgestrel 1.5mg and a pregnancy test if there has been no period in 2 weeks’ time
J. Azithromycin 1 g stat
K. Yuzpe method
L. Levonorgestrel 1.5mg stat, offer a full sexually transmitted infection screen and a pregnancy test if there has been no period in 2 weeks’ time
M. Triple swabs
N. Pregnancy test
O. Intravenous antibiotics

For each description below, choose the single most appropriate answer from the above list of options. Each option may be used once, more than once, or not at all.

15. A 21-year-old girl attends the family planning clinic 6 hours after unprotected sexual intercourse with a stranger. Her periods are regular and the first day of her last menstrual period was 3 weeks ago. Her current contraceptive method is male condoms. She also recalls another episode of condom split 10 days ago. Her pregnancy test is negative. What is the most appropriate advice?

16. A 27-year-old lady attends the family planning clinic 4 days after unprotected sexual intercourse. Her menstrual cycles are very regular (3–4/28). Her last menstrual period was 2 weeks ago. What is the most appropriate option?

17. A 37-year-old woman attends the clinic 6 hours after unprotected sexual intercourse with her husband. She had STI screening and was found negative in that. She suffers from idiopathic thrombocytopenic purpura and is on long- term steroids. Her periods are regular but heavy, and the first day of her last menstrual period was 2 weeks ago. What is the most appropriate option?

18. 21 year old nullipara attends A&E after UPSI with a stranger 8 hrs ago. Her periods are regular. Her last period started 13 days ago.

19. A 16 year old requests EC. She had an episode of UPSI 40 hours ago. She uses male condoms as a contraceptive. Her periods are irregular. What is the first step in her management?

Option List :

A. Stop the COC for a short period
B. Azithromycin 1 gm
C. Remove the IUD,hysteroscopy& curettage
D. Remove implanon& start COCs
E. Doxycycline 100 mg twice a day for 14 days
F. Remove the IUCD & repeat swabs
G. Outpatient endometrial sampling
H. Change the Copper coil
I. Other LARCs
J. Contact tracing
K. Swabs
L. UPT
M. Reassurance
N. Weight reduction
O. Change implanon

For each description below, choose the single most appropriate answer from the above list of options.

20. A 30 year old woman presents with irregular vaginal bleeding of 4 months duration. Her BMI is 31 & she is on COCs for past 6 yrs without any problems. She is in a new relationship for past 2 months

21. A 35 year old attends the clinic with irregular bleeding & spotting since she started using Implanon 3 months ago.She switched to Implanon from COCs because she found it inconvenient to take the pill everyday. Her cervical smears are normal. She is very scared because her sister died of cervical cancer.

22. A 28 year old attends family planning clinic for contraceptive advise. She is on COCs & is very comfortable with it. She has recently started Carbamazepine after she developed seizures

23. A 48 year old attends family planning clinic.Her BMI is 37.She has been on the Cu coil 380 A for past 7 years. Her periods are regular,but she has had a few episodes of intermenstrual bleeding.High vaginal & cervical swabs are negative. she is perfect with her smears.

24. 38 year old lady attends gynecology clinic for irregular pv bleeding of 6 months duration. She has been on Implanon for past 2 years. She has gained about 30 kg recently in 6 months. Smokes about 20 cigarettes per day.

Option List :

A. Copper coil UKMEC 1
B. Copper coil UKMEC 4
C. LNG-IUS UKMEC 4
D. LNG-IUS UKMEC 3
E. CHC UKMEC 3
F. CHC UKMEC 4
G. DMPA UKMEC 3

For each description below, choose the single most appropriate answer from the above list of options.

25. 25 years old P1 delivered 5 weeks ago.No other risk factors. What is UKMEC class of CHC for her?

Sexual And Reproductive Health ( Platinum ) – EMQ

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