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Contraception

Clinical Discipline(s)/Organ System(s)
General Practice, Obstetrics & Gynaecology, Reproduction & Development
Progress Test Topic(s)
Women's health
Description
A 36 year old NZ European woman, with three children, comes to her GP because she wants to know what contraceptive options are available to her. She smokes 15 cigarettes a day.
Progress Test-Type Questions:   Question 1 | Question 2 | Question 3
Applied Science for Medicine 
   - Physiology of the normal menstrual cycle
   - Physiology of conception and implantation
   - Mechanism of action of the methods of contraception
   - The role of exogenous oestrogens on cardiovascular and gynaecological oncology risk factors
   - Pharmacology of ethinyl estradiol, progestogens (norethisterone, levonorgestrol,medroxyprogesterone), emergency contraceptive pill
   - Adherence to medication; drug interactions
Clinical and Communication Skills 
   - Elicit a full gynaecological history including past medical and family history
   - Appropriate examination for contraceptive prescribing
   - Counsel a patient about contraceptive options and give them the information to decide what would be safe, effective options for them
   - Contraceptive options for men and women (barrier, pills, intrauterine devices (IUDs), implants, injections, vaginal ring, Essure and tubal ligation/vasectomy)
   - Categorise contraceptive options according to their reversibility and effectiveness, as well as timeline for return to fertility
   - Awareness of evidence-based side effects of and medical complications of contraception
   - Explore the reasons for seeking contraception and ensure there is no coercion to women's choices
   - Appropriate and safe prescribing of contraception with reference to WHO/UK Medical Eligibility Criteria risk stratification for contraceptive choices
   - Prescribing to under 16 year olds and vulnerable women groups with reference to the principles of Gillick Competency
   - Awareness of prevention of sexually transmitted infections with condoms
   - Indications for and effectiveness of emergency contraceptive pill and postcoital IUD
   - Management of common side effects of each contraceptive
   - Prescribing the emergency contraceptive pill
Personal and Professional Skills 
   - Communicating the risks and benefits of contraceptive methods; discussing prescribing options with patients
   - Communicating about safe sexual practice and screening for sexually transmitted diseases
   - Appreciate the reproductive and sexual health needs of women in same sex relationships
   - Appreciate the different religious and cultural approaches to contraception
   - Smoking cessation counselling