Contraception and Family Planning Practice Questions

Q: Which method of contraception is shown below?

Pomeroy's technique. ***Pomeroy's technique*** - The image illustrates the **Pomeroy method** of tubal ligation, where a loop of the fallopian tube is lifted, ligated (tied), and then excised (cut). - This method is one of the most common and effective techniques for **permanent female sterilization**. *Parkland method* - The Parkland method involves ligating the fallopian tube in two places and then excising the segment between the two ligatures, leaving **raw ends** that might adhere. - The image distinctly shows a **single loop ligated and excised**, which is characteristic of the Pomeroy technique. *Hulka method* - The Hulka method utilizes a **plastic clip (Hulka clip)** to occlude the fallopian tube, which is a different mechanism than shown in the illustration. - This method is not depicted as the image shows the tube being **tied and cut**, not clipped. *Clipping method* - The clipping method, while a form of tubal ligation, involves applying a **clip (e.g., Filshie or Hulka clip)** to the fallopian tube to block it. - The illustration clearly shows the tube being **ligated and a segment removed**, which is distinct from simply applying a clip.

Q: Which of the following is true about the pill shown in the image?

High content of Progestin. ***High content of Progestin*** - Emergency contraceptive pills like i-pill contain **Levonorgestrel 1.5 mg**, which is a **high-dose progestin-only** pill - This is significantly higher than the daily dose in regular oral contraceptive pills (0.15 mg levonorgestrel) - The high progestin dose works by **inhibiting or delaying ovulation**, preventing fertilization, or potentially altering the endometrial lining - Modern emergency contraceptive pills are **progestin-only** formulations, not estrogen-containing pills - Most effective when taken within **72 hours** of unprotected intercourse, though can be used up to 120 hours *Start 24 hours before intercourse* - Emergency contraceptive pills are designed to be taken **after unprotected intercourse**, not before - They are for emergency use only, not for routine pre-planned contraception - Effectiveness decreases with time after intercourse, emphasizing the need for **prompt use** *More effective than emergency IUD insertion* - **Emergency copper IUD insertion** is the **most effective** form of emergency contraception, with effectiveness rates over **99%** - Oral emergency contraceptive pills have effectiveness rates of **85-89%** when taken within 72 hours - ECPs are **less effective** than emergency IUD, especially when taken more than 24 hours after intercourse *Intraception method* - **Intraception** refers to methods that primarily prevent implantation of a fertilized egg (e.g., copper IUD) - Emergency contraceptive pills' **primary mechanism** is **delaying or inhibiting ovulation** and interfering with fertilization - While they may have some effect on the endometrium, this is not their primary mechanism - They are classified as **contraceptive** rather than purely intraceptive methods

Q: What is the most distinctive functional characteristic of the barrier method shown?

Can be retained in vagina for extended periods. ***Can be retained in vagina for extended periods*** - The image displays a **contraceptive sponge**, which can be inserted up to 24 hours before intercourse and provides continuous protection for that duration, allowing for multiple acts of coitus. - It must be left in place for at least **6 hours after the last intercourse** but not for more than **30 hours in total**. - This extended retention capability is a **distinctive feature** of the contraceptive sponge compared to other barrier methods. *More effective than male condom* - The **contraceptive sponge** has a **higher failure rate** (typical use: 12-24% for parous women, 9-12% for nulliparous women) compared to male condoms (typical use failure rate of 13%). - Male condoms are generally **more effective** in preventing pregnancy and provide additional protection against sexually transmitted infections (STIs). *Must be inserted immediately after coitus* - The contraceptive sponge is designed for **pre-coital insertion**, not post-coital use. - It should be inserted **before intercourse** to be effective, as its mechanism relies on trapping sperm and releasing spermicide continuously. - It remains effective for multiple acts of intercourse within the 24-hour insertion window. *Consists of nonoxynol-9 impregnated polyurethane* - While this statement is **technically accurate** (the contraceptive sponge is made of polyurethane foam impregnated with 1000mg of nonoxynol-9), it describes the **composition** rather than a functional characteristic. - The most **clinically distinctive** feature of the sponge is its extended retention time, making Option A the **best answer** among the choices provided. - This distinguishes the sponge from other barrier methods like diaphragms or cervical caps, which also use spermicide but have different insertion timing requirements.

Q: What is the contraceptive method shown in the image called?

Cu T 380 A. ***Cu T 380 A*** - The image displays a **T-shaped intrauterine device (IUD)** with copper coiled around its arms and stem. This design is characteristic of a copper IUD. - The "A" in Cu T 380A indicates that it has copper sleeves on the horizontal arms and copper wire around the vertical stem, with a total surface area of **380 mm² of copper**, making it a highly effective non-hormonal contraceptive. *Mirena* - **Mirena** is a **hormonal IUD** that releases **levonorgestrel**. While also T-shaped, it does not have visible copper elements as seen in the image. - The primary mechanism of Mirena involves **thickening cervical mucus** and **thinning the uterine lining**, rather than relying on copper's spermicidal effects. *Cu T 250* - **Cu T 250** refers to a copper IUD with a **smaller copper surface area** (250 mm²) compared to the Cu T 380A. - Although similar in appearance by being a copper IUD, the specific type and longevity often correlate with the amount of copper, and Cu T 380A is a more commonly recognized and widely used device with the depicted design. *Ortho evra* - **Ortho Evra** is a **transdermal contraceptive patch**, not an IUD. It is applied to the skin and releases hormones such as estrogen and progestin. - Its mechanism involves **inhibiting ovulation** and altering cervical mucus, which is distinctly different from the intrauterine action of the device shown.

Q: Which method of contraception usage is shown here?

Female condom. ***Female condom*** - The image shows a device with an **internal ring** that is placed deep inside the vagina, near the cervix, and an **outer ring** that remains outside the vagina. This characteristic two-ring structure identifies it as a female condom. - The female condom creates a **physical barrier** to prevent sperm from reaching the uterus and also offers protection against sexually transmitted infections (STIs). *Vaginal contraceptive film* - A vaginal contraceptive film is a **spermicide-coated, thin film** that dissolves in the vagina, releasing chemicals that kill sperm. - It would appear as a thin, often transparent, film and not a structured device with rings as depicted in the image. *Implanon* - Implanon (now branded as Nexplanon) is a **subdermal hormonal implant**, typically placed under the skin of the upper arm. - It uses hormones to prevent pregnancy and is not visually inserted into the vagina, making the image inconsistent with this method. *Diaphragm* - A diaphragm is a **dome-shaped barrier device** inserted into the vagina to cover the cervix, usually used with spermicide. - Unlike the female condom, it has only **one flexible ring** that fits snugly around the cervix and does not typically feature an external ring or a liner extending out of the vaginal opening.

Q: What is the following contraceptive method called?

Copper T 380A. ***Copper T 380A*** - The image clearly displays a **T-shaped intrauterine device (IUD)** with a **copper wire** wrapped around the stem, which is characteristic of the Copper T 380A. - This IUD provides **non-hormonal contraception** by releasing copper ions, which act as a spermicide and induce an inflammatory reaction in the uterus, preventing fertilization and implantation. - **Copper T 380A** is the **generic medical term** used in clinical practice and medical education, making it the most appropriate answer. *Mirena* - **Mirena** is a **hormonal IUD** that releases levonorgestrel, a progestin. - While it also has a T-shape, it does not have visible copper wiring wrapped around its stem, as its contraceptive action comes from hormone release, not copper ions. *Paragard* - **Paragard** is a **brand name** for the Copper T 380A marketed primarily in the United States. - While the device shown is technically a copper IUD that could be called Paragard, in medical education and clinical practice, **generic names are preferred over brand names** for standardization and universal understanding. - In the Indian context (NEET-PG), the term **"Copper T 380A"** is more commonly used and recognized. *Oestrogen containing Copper T* - There is currently **no commercially available or widely recognized contraceptive IUD** that combines both **oestrogen and copper**. - Copper IUDs are non-hormonal, while hormonal IUDs typically release progestin (like levonorgestrel), not oestrogen.

Q: Identify the contraceptive method shown below:

NuvaRing. ***NuvaRing*** - The image clearly displays a **flexible, clear ring-shaped device** designed for vaginal insertion, which is characteristic of the NuvaRing. - The **NuvaRing** is a **combined hormonal contraceptive** that releases estrogen (ethinyl estradiol) and progestin (etonogestrel) to prevent ovulation. *Plan B ring* - There is no contraceptive device known as a **"Plan B ring."** Plan B is an **oral emergency contraceptive pill**, not a ring. - Emergency contraception is a single-dose or two-dose medication taken after unprotected intercourse, distinct from ongoing methods. *Implanon* - **Implanon** (now usually Nexplanon) is a **subdermal implant**, a small, flexible rod inserted under the skin of the upper arm. - It is not a ring and is not typically visible externally once inserted, unlike the device shown. *Vaginal condom* - A **vaginal condom** (also known as a female condom) is a **pouch-like device** with flexible rings at both ends, which is inserted into the vagina before intercourse. - The item in the picture is a single, continuous ring, not a barrier device with a pouch.

Q: Identify the instrument shown in the image:

Karman syringe. ***Karman syringe*** - This image displays a **Karman syringe**, characterized by its large capacity and specialized tip designed for manual vacuum aspiration (MVA) procedures. - It is specifically used in **gynecology** for procedures such as uterine evacuation, often in cases of miscarriage or abortion. *Gastric lavage aspirator* - A gastric lavage aspirator would be connected to a **nasogastric tube** for stomach irrigation, which is not depicted here. - Its purpose is to remove stomach contents, typically in cases of poisoning or overdose, and it generally does not resemble a simple syringe. *Disposable syringe* - While it shares some features with a disposable syringe, the **volume capacity** and the **specific design of the plunger handle** are distinct. - A standard disposable syringe, usually smaller (e.g., 1-60 mL), is used for injections, aspirations, or drawing blood, and typically has a simpler plunger. *Hegar dilator* - A Hegar dilator is a **solid, rod-shaped instrument** used to gradually widen the **cervix**. - It does not have a plunger or barrel for aspiration, making it visually distinct from the instrument shown.

Q: The X-ray pelvis AP shows presence of:

Uterine sounding to check position of dislodged IUD. ***Uterine sounding to check position of dislodged IUD*** - The image shows a **T-shaped radiopaque object**, consistent with an **intrauterine device (IUD)**, located aberrantly outside the expected uterine cavity but within the pelvis. - A **uterine sound**, appearing as a long, thin radiopaque rod, has been inserted, indicating an attempt to locate or assess the position of the dislodged IUD. *Endoscopic removal of ureteric stones* - This image does not show any typical features of **ureteric stones** (e.g., small, dense calcifications along the ureteric course) or instruments commonly used for their endoscopic removal (e.g., ureteroscope or basket catheter). - The depicted objects are clearly a dislodged IUD and a uterine sound, which are unrelated to ureteric stone removal. *Uterine sounding to check for the site of uterine tear* - While a **uterine sound** can be used in cases of uterine perforation, the primary finding here is a clearly **dislodged IUD** outside the uterus. - The presence of the IUD in an extra-uterine location, rather than an obvious tear, suggests the sounding is for IUD localization. *Pelvic trauma* - There are **no signs of bony fractures, dislocations, or soft tissue injury** consistent with **pelvic trauma** on this X-ray. - The radiopaque objects observed are medical devices (IUD and uterine sound), not indicative of traumatic injury.

Q: The following picture shows a contraceptive. All are correct about the device except:

Protects against STD. ***Protects against STD*** - **Diaphragms** provide minimal to no protection against **sexually transmitted diseases (STDs)** as they only cover the cervix and do not prevent **skin-to-skin contact** transmission. - Unlike **condoms**, diaphragms do not cover the entire genital area and are not considered effective for **STD prevention**. *Made of latex* - **Diaphragms** are commonly manufactured from **latex** or **silicone** materials to provide flexibility and durability. - The **latex material** allows for proper fitting over the cervix while maintaining effectiveness as a barrier contraceptive. *Increases UTI risk* - **Diaphragm** use is associated with increased risk of **urinary tract infections (UTIs)** due to pressure on the urethra during insertion. - The device can alter **vaginal flora** and facilitate bacterial growth, leading to higher UTI incidence. *Efficacy enhanced with spermicide* - The contraceptive effectiveness of **diaphragms** is significantly improved when used with **spermicidal agents**. - **Spermicides** provide additional protection by immobilizing and destroying sperm that may bypass the physical barrier.

Question 1

Which method of contraception is shown below?

Accepted Answer

Pomeroy's technique

Answer

Parkland method

Answer

Hulka method

Answer

Clipping method

Question 2

Which of the following is true about the pill shown in the image?

Accepted Answer

High content of Progestin

Answer

Start 24 hours before intercourse

Answer

More effective than emergency IUD insertion

Answer

Intraception method

Question 3

What is the most distinctive functional characteristic of the barrier method shown?

Accepted Answer

Can be retained in vagina for extended periods

Answer

More effective than male condom

Answer

Must be inserted immediately after coitus

Answer

Consists of nonoxynol-9 impregnated polyurethane

Question 4

What is the contraceptive method shown in the image called?

Accepted Answer

Cu T 380 A

Answer

Mirena

Answer

Cu T 250

Answer

Ortho evra

Question 5

Which method of contraception usage is shown here?

Accepted Answer

Female condom

Answer

Vaginal contraceptive film

Answer

Implanon

Answer

Diaphragm

Question 6

What is the following contraceptive method called?

Accepted Answer

Copper T 380A

Answer

Mirena

Answer

Paragard

Answer

Oestrogen containing Copper T

Question 7

Identify the contraceptive method shown below:

Accepted Answer

NuvaRing

Answer

Plan B ring

Answer

Implanon

Answer

Vaginal condom

Question 8

Identify the instrument shown in the image:

Accepted Answer

Karman syringe

Answer

Gastric lavage aspirator

Answer

Disposable syringe

Answer

Hegar dilator

Question 9

The X-ray pelvis AP shows presence of:

Accepted Answer

Uterine sounding to check position of dislodged IUD

Answer

Endoscopic removal of ureteric stones

Answer

Uterine sounding to check for the site of uterine tear

Answer

Pelvic trauma

Question 10

The following picture shows a contraceptive. All are correct about the device except:

Accepted Answer

Protects against STD

Answer

Made of latex

Answer

Efficacy enhanced with spermicide

Answer

Increases UTI risk

Contraception and Family Planning — MCQs

Contraception and Family Planning — MCQs

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