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MRCOG PART 2 SBAs and EMQs

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EMQ1462
SBA2091
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essay 341

essay 341 Posted by suad H.

   .   CLINICAL ASSESSMENT I WILL ASK ABOUT HER PREVIOUS EXPIERINCE  OF   CONTRACEPTIVE METHOD WHICH METHOD SHE WAS USE  AND FOR HOW LONG . HER MENSTRUAL HISTORY REGULARITY   , DATE . IF SHE HAS ABNORMAL BLEEDING . IWILL ASK HER ABOUT HER MEDICAL HISTORY AS  HER BMI 42 MAY HAS HYPERTENSION , DIABETIES . ASK ABOUT PREVIOUS HISTORY OF VTE OR STROKE . ANY RECENT ATTACK OF  STD  FAMILY HISTORY OF CANCER BREAST , OVARIAN CANCER .IWIIL CHECK HER BP .  BREAST EXAMINATION . LOCAL EXAMINATION FOR ANY ABNORMAL  DISCHARGE  TENDERNESS ON VAGINAL EXAMINATION . PELVIC MASSES I WILL CHECK HER RBS TO DETECT DM FBC FOR ANEMIA  . LIVER FUNCTION TEST  PREGNANCY TEST IF SHE HAS IRREGULAR CYCLE

OPTIONS FOR HORMONAL CONTRACEPTIVE  . COMBINED METHOD , COC FAILURE RATE 0.1/100 WOMEN YEAR , IT REDUCE CYCLE, CORRECT ANEMIA  ,IMPROVE DYSMENORRHEA DECREAS RISK OF PID OVARIAN AND ENDOMETRIAL MALIGNANCY . RAIPD RERETURN OF FERTEILTY. ITS COMIPLCATION S INCREASE RISK OF VTE . STROK ,BREAST CANCER, CX CANCER , MYOCARDIAL INFARCTION, HYPERTENSION , LIVER DISEASE . HER BMI 42 SO UK MEC 3

OTHER PREPARATION OF COMBINED METHODS ARE INJECTABLE USED ONCE  MONTHLY   . CONTRACEPTIVE PATCHES, PEARL INDEX 0.88  , PATCH CHANGE EVERY 7D FOR 3W THEN 7 DAYS FREE  SIDE EFFECT SKIN REACTION HEADACHE BREAST TENDERNESS ,NAUSEA.

PROGESTOGEN ONLY METHODS  .  POP  EFFECT CAUSE THICKNING OF CERVICAL MUCUS CERRAZETTE INHBIT OVULATION IN 97% PEARL INDEX 0.3/ 100 WOMEN YEAR, ADVANTAGES EFFECTIVE . REVERSIBLE NO DELEAY IN FERTILITY.DISADVANTAGES AMENORRHEA . IRREGULARE BLEEDING WT GAIN VAGINAL DRYNESS  MOOD SWINGES  . INJECTABLE  PEARL INDEX 0.2 100WOMEN YEAR INJECTION IM EVERY 3M FOR DEPO-PROVERA  , 2MOMTH FOR NORISTERAT . DISADVANTAGES MENSTURAL IRREGULARTY . DELAY RETURN FOR FERTLITIY  UP TO 2 YR , WEIGHT GAIN . OSTEOPROSIS

SUBDERMAL IMPLANTS  INHIBIT OVULATION  PEARL INDEX LESS THAN 1 /1000 3YR USE  LARC CAN BE USE WITH BMI MORE THAN  30   DISADVANTAGES . IRREGULAR BLEEDING  NEED EXPIRENCE PERSON FOR INSERTION AND REMOVAL.WRITTEN INFORMATION ABOUT   ALL CONTRACEPTION SIDE EFFECT ADVANTAGES . DISADVANTAGES  WHEN TO SEEK ADVICE SHOLUD GIVEN TO THE WOMEN .

.   USE OF INTRAUTRINE CONTRACEPTION IN THE WOMEN   IT PREVENT FERTILZATION AND IMPLANTATION . IUS HAS LOCAL PROGESTOGENIC EFFECT ON ENDOMETRIUM AND CX MUCUS . DISADVANTAGES DIFFICULT IN INSERTION .PAIN VAGINAL BLLEDING RISK OP PID . EXPULSION . . CONTRAINDICATIONS SEPTIC ABORTION .GESTAIONAL TROPHOBLAST WITH ELEVATED HCG  UNEXPLAINED VAGINAL BLEEDING . ENDOMETIRIAL CANCER ..TYPES  CU T380 A USED FOR 10 YR FAILURE RATE 2 FOR 100WOMEN 5YR  EXPALSION 8PER 100WOMEN 5YR . MULTILOAD USE FOR 5YR , GYNAE FIX FOR 5YR REDUCE DYSMENORRHEA . MENSTRUAL LOSS EASY FOR INSERTION IN NULLIPARA . MERINA IUS CONTAIN LEVONORGESTEREL RELEASE 20MCG PER DAY  USED FOR 5 Y ADVANTAGES   USE IN MANAGMENT OF MENORRHAGIA . DYSMENORRHEA LOWER RATE OF ECTOPIC PREGNANCY PROTECTION AGAINST PID . DISADVANTAGES  PROGESTOGENIC SIDE EFFECT. SO INTRAUTRINE DEVICE CAN BE SUTIBLE  LARC FOR THIS WOMEN .  .