1) Select the contraceptives that require compliance for efficacy.

a) Copper IUD
b) Condoms
c) Implant
d) Hormone coil (IUS)
e) The combined pill
.

2) Give three advantages of the use of intra-uterine devices (IUD).

Any three:
-99% effective
-Prevents sperm fertilising the ovum , copper IUD acts as spermicide.
-No issues with drug to drug interactions

3) How effective is barrier contraception when used correctly?

a) 98%
b) 95%
c) 80%
d) 60%
.

4) What may the combination of oestrogen and progestogen be referred to as?

The Pill

5) Put the following steps regarding the mode of action of the pill in order 1 to 4.
a) The mucus in the womb thickens so sperm cannot penetrate the womb and reach the egg.
b) Ovulation no longer occurs.
c) The pill acts on the hypothalamopituitary axis to reduce production of LH and FSH.
d) The lining of the womb thins so there is a reduced chance of a fertilised egg implanting
inside of the womb.
A: 3
B: 2
C:1
D: 4

6) Which of the following statements is true for second generation combined oral contraceptives?
a) Has undesirable adverse effects such as acne and growth of body hair.
b) A common first choice oral contraceptive in modern day.
c) Reduces body mass index.
d) Associated with risks of thromboembolism and breast cancer.
.

7) The adverse effects of oestrogens include:

Increased risk of venous [thromboembolism.
Increased risk of cardio[vascular disease and strokes.
Increased risk of [Breast and [cervical cancer.
 8) 80% of [breast cancer tumours are oestrogen [receptor positive.
oestrogen drives [tumour growth.
oestrogen can come from [gonads, [adipose tissue and oral contraceptives.

9) What is venous thrombo-embolism?

The inappropriate coagulation that occludes a blood vessel and a detached mass is
carried to another part of vasculature.

10) Are progestogen only contraceptives less effective or more effective than the combined
contraceptives?
Less effective

11) What happens to oestrogen levels during menopause?

a) Levels increase
b) Levels remain stagnant
c) Levels fluctuate
d) Levels decline
.

12) What is an unpleasant symptom associated with menopause?

Hot flashes

13) What is the purpose of hormone replacement therapy (HRT) in menopause?

i) What are the risks of HRT?
Reduce symptoms associated with a decline in oestrogen.

i) Increases risk of breast and endometrial cancer.

14) Which of the following are factors that affect lifetime exposure to oestrogen?
a) Breast Density
b) Menopause Age
c) Plasma level of circulating oestrogen
d) BMI
e) All the above
.

15) Using Virchow's Triad the three main contributors to thrombosis are:
1. Endothelial [injury
2. Hyper[coagulability
3. Abnormal [blood flow

16) Which of the following increases the risk of thrombosis in an individual? (you may select more
than one answer)
a) Changes in levels of fibrinolytic inhibitors.
b) The size of the sex chromosome.
c) Overabundant or abnormal coagulation factors.
d) All the above
.
17) Fill in the blanks for the highest risk experiences of acquired thrombophilias.
Prolonged [bed rest or immobilisation.
[Myocardial Infarction.
[Tissue damage.
Prosthetic [cardiac valves

18) Which of the following drugs are enzyme inducers? (you may select more than one answer)
a) Carbamazepine
b) St John's Wort
c) Modafinil
d) Griseofulvin
.

19) Which of the following contraceptives cannot be taken with enzyme inducers?
a) Progestogen-only pill
b) Progestogen-only implant
c) Copper IUD
d) Combined contraception
.

20) Is the following statement true or false?

The WHI study found that there were 36 extra cases per 100,00 patients found with CHD,
stroke, pulmonary embolism, VTE and breast cancer while using progestogen and oestrogen
therapy during menopause.
a) True
b) False
.