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Contraception and Sterilization

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Which of the following poses the highest risk of death in fertile women aged 35 to 44 years?

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a. Pregnancy

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b. Oral contraceptive use

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c. Intrauterine device (IUD) use

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d. Surgical tubal sterilization procedure

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Which of the following is a first-tier contraceptive method with an expected failure rate of 2 pregnancies per 100 women during the first year?

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a. Spermicide

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b. Male condom

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c. Intrauterine device (IUD)

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d. Depot medroxyprogesterone acetate (DMPA)

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Which of the following is a second-tier contraceptive method with an expected failure rate of 3 to 9 pregnancies per 100 users during the first year?

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a. Spermicide

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b. Withdrawal

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c. Intrauterine device

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d. Oral contraceptive pills

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A 35-year-old woman presents to your office as a new family planning patient for initiation of contraception. Her medical history is notable for migraines with aura. She wishes to use combination oral contraceptive pills (COCs). You refer to the United States Medical Eligibility Criteria (US MEC) guidelines and see that this method is rated a “4.” Which of the following corresponds to this score and describes the safety profile for COC use in this particular patient?

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a. Use is not restricted.

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b. Method advantages outweigh risks.

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c. Method risks outweigh advantages.

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d. Method poses an unacceptable high health risk.

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Your patient delivered a healthy infant 2 weeks ago and wishes to initiate use of a contraceptive method during the next few weeks. She is breastfeeding exclusively. For which of the following is there strong evidence that use decreases the quantity and quality of breast milk?

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a. Progestin-only pills

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b. Depot medroxyprogesterone acetate

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c. Combination hormonal contraceptives

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d. None of the above

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