Sexual & Reproductive Health – SBA

1. What is the average contraception rate for midcycle intercourse?

2. Which is the only frameless IUD currently licensed for use in UK?

3. Which of the following condition is a contraindication to use of POPs as a contraceptive method ?

4. A 21 year old girl with regular cycles comes to you for Emergency contraception.She had UPSI on D16 of a regular 28 day cycle.Upto what day of the cycle can IUD be inserted to provide post coital contraception?

5. Long acting reversible contraceptives are those which are administered

6. Mrs Jane 25 yrsold,has come to discuss about LARC. She wants to know how long would return to fertility be delayed after discontinuation of DMPA?

7. Postpartum intrauterine contraception is the term used to describe initiation of intrauterine method either at birth or shortly afterwards. If an IUCD is to be placed in the immediate postpartum period, it will be placed

8. All of the following are criteria to be met for Lactational amenorrhea method of contraception except

9. Mrs XYZ presents to A&E with h/o UPSI with her husband yesterday night at 10 pm. She is a known epileptic on Carbamazepine 400 mg daily. On enquiry her periods are regular,28 day cycle & yesterday was the 16th day of the cycle. What would be the most appropriate contraceptive you would offer?

10. Sara,35 yrs old, has delivered a baby girl by LSCS a week ago,she lost her husband during the pregnancy, has entered into a new relationship.She is not breastfeeding the baby. She has Protein C deficiency, but no history of Venous thromboembolism .
She is keen to start contraception as soon as possible.

11. Following evacuation of a molar pregnancy which method of contraception is contraindicated until Beta Hcg levels come down to normal?

12. Mrs Z has a 15 year old daughter with Downs syndrome. She is unable to cope with her periods.Her mother requests combined transdermal patches.How will you prescribe this to achieve the same effect as continuous oral contraceptive pill?

13. Primi delivered 7 months ago. Not in a stable relationship at present,comes for EC following UPSI 4 days ago. She is on D20 of her cycle & has taken UPA 10 days ago. What method of EC is best suited for her now?

14. A 30 year P3 comes to you for contraceptive advise. She was on combined oral pill but developed migraine with aura. She is looking for a contraceptive method which would last for 3 yrs.

15. Mrs Smith has undergone surgical evacuation of uterus 2 days ago for missed miscarriage. Regarding contraception which of the following is true?

16. Effectiveness of which drug is reduced in women with BMI>26?

17. Clara,20 yrs old comes to A&E.She has had UPSI previous night. She is on D13 of a regular 28 day cycle.She has previously taken EC in this cycle,4 days ago,which was LNG-EC.What is the oral EC you can offer her now?

18. Which is the only method of  EC,effective after ovulation has occurred?

19. Which is true regarding Ulipristal ( UPA – EC)o?

20. With regards to CHC all are true except

21. Mrs A is 30 yrs old & a known case of primary pulmonary hypertension.She is on various drugs one of which is Bosentan. She has come to you for reliable contraception. What would be the best option for her?

22. Which is the most effective of the LARCs?

23. By how many months post procedure should the vasectomy be considered a failure if motile sperms are still observed in a fresh semen sample? 

24. What is the background rate of VTE in women of reproductive age who do not use oral contraceptives ?

25. Primary mode of action of the progestogen -only injectable method of contraception is

26. A 47-year-old woman seeks advice about continuing the combined oral contraceptive pill (COCP). She is normotensive and a non-smoker with a BMI of 25. She has no other medical history and no significant family history. She is concerned that the COCP may give her additional health risks. Which of the following malignancies would you advise she may have a small additional risk of developing due to taking the COCP?

27. Causes of sterile pyuria include all except

28. You are seeing a patient in your gynae clinic who was been referred by the GP for vulvalabcess.She also complained that she has been having on and off diarrhoea with bloody and mucousy discharge. On examination the vulva is swollen and oedematous with visible granulomas and abscess formation with a sinus tract. What could be the possible diagnosis?

29. A 35-year-old woman comes for a suitable family planning method. She is obese (BMI 35 kg/m2), with a family history of endometrial cancer.What are her options?

30. A 18 year old girl comes to you to seek advise for contraception. But she is also worried that it may affect her fertility in future . Which form of contraception is most strongly associated with delay in return of fertility?

31. A woman presents reporting that she is using phenytoin for epilepsy. She wishes to continue to use IM DMPA. What is the single most appropriate advice to offer her from the list below?

32. Ms. Dolly , para3Living 3 is here for follow up of Intrauterine device.As threads were not visible, XRay and ultrasound was performed, which showed device in abdominal cavity. Elective laparoscopy was arranged to remove copper T. She is requesting for reinsertion of copper T. What is the minimum time she has to wait before reinsertion ?

33. A 25-year-old woman with a bicornuate uterus attends the emergency gynaecology unit requesting emergency contraception (EC). Shehas been on holiday and had a condom breakage 4days back.Today is 11th day of her periods.Her cycles are regular and 28 days cycle. She is in good health. Which of the following is the recommended EC?

34. Post-vasectomy semen analysis ( PVSA).What does special clearance mean?

35. The efficacy of which antiepileptic drug is reduced by use of combined oral pills?

36. All sexually active women presenting with problematic bleeding when using hormonal contraceptives should be:

37. A 36-year-old women who has been using copper IUCD for her contraception for 2 months has now reported very heavy periods.

38. A 47-year-old women who has had IUCD in-situ for 4 years is come to clinic with complaints of some bleeding after few years of amenorrhoea.

39. A 43-year-old woman presents complaining about her bleeding patterns since having the LNG-IUS inserted 3 months ago. She says she was misled and that she had been told she would have no bleeding. What is the single most appropriate advice to give her regarding bleeding patterns associated with the LNG-IUS?

40. There is law on young people, confidentiality and consent, which one of the following statements is correct?

41. Lord Fraser, in his ruling of the Gillick case in the House of Lords, produced guidelines regarding contraceptive advice given by doctors. Doctors can proceed to advise and give contraception provided they are satisfied with the following five criteria. Which one does not apply?

42. Which of the following best reflects the physiological mechanism by which breastfeeding offers contraceptive protection?

43. Which of the following best reflects the cervix and cervical os during the fertile window?

44. Average life of sperm or sperm have been shown to survive for:

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

46. Which of the following best describes the physiological changes that affect cervical mucus following ovulation?

47. 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 39 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?

48. A 23-year-old para 1 is due to get a LNG-IUS inserted 4 weeks post caesarean section. She defaults the appointment due to child care, but attends 3 weeks later (6 weeks postnatally). She is formula feeding her infant. She remains amenorrhoeic and had sexual intercourse with her husband 2 weeks previously, but has not since because it was too uncomfortable. A pregnancy test is negative. She is very keen for contraception, ideally with LNG-IUS, but does not want a progesterone implant.What would be the best management?

49. A 25-year-old patient is referred from the A&E department with lower abdominal pain and vaginal discharge. On examination she has a temperature of 37.3°C, a pulse of 86 bpm and a BP of 120/83 mm Hg. Her abdomen is slightly tender in the LIF region. On vaginal examination the IUCD threads are seen and a swab of mucopurulent discharge is taken. There is tenderness left fornix. She mentions that she has a new sexual partner and has not used barrier contraception.
What is the most appropriate next step in her management?

50. A 28-year-old lady is using IUD for 2yrs and is asymptomatic. In her routine cervical screening reviled that she is having actinomycosis infection. What will the management for her in present case with no symptoms related to actinomycosis?