Contraception and Family Planning Practice Questions

Q: Which of the following is a contraindication for coitus interruptus?

Premature ejaculation. **Explanation:** **Coitus Interruptus (Withdrawal Method)** is a traditional contraceptive method where the male partner completely withdraws the penis from the vagina before ejaculation occurs. Its success depends entirely on the male partner's ability to sense the "point of inevitability" and withdraw in time. **Why Premature Ejaculation is the Correct Answer:** Premature ejaculation is a definitive contraindication because the male partner lacks voluntary control over the timing of ejaculation. In such cases, ejaculation may occur before or during the process of withdrawal, leading to the deposition of semen in the vagina or on the vulva, resulting in a high risk of unintended pregnancy. **Analysis of Incorrect Options:** * **A. Erectile Dysfunction:** While this may make intercourse difficult, it is not a contraindication for the method itself; rather, the inability to maintain an erection often precludes the need for contraception during that specific act. * **B. Perimenopausal Age:** Women in this age group can use coitus interruptus, though more reliable methods are often recommended due to irregular cycles. It is not a medical contraindication. * **D. Illiterate Male Partner:** Literacy is not a prerequisite for using this method. Success depends on self-control and physiological awareness, not formal education. **High-Yield Clinical Pearls for NEET-PG:** * **Failure Rate:** The typical use failure rate is high (approx. **20-22%**), while the perfect use failure rate is about **4%**. * **Pre-ejaculate:** A common reason for failure even with "perfect use" is the presence of live sperm in the pre-ejaculatory fluid (from the Cowper’s glands). * **Mechanism:** It is classified as a **behavioral/natural method** of contraception. * **Advantage:** No cost, no hormonal side effects, and available at all times. * **Disadvantage:** No protection against STIs/HIV.

Q: What is the ideal contraceptive for a couple who lives in different cities and meets only occasionally?

Barrier method. **Explanation:** The choice of contraceptive method depends on the frequency of intercourse, the need for long-term protection, and the patient's lifestyle. **Why Barrier Method is Correct:** For couples who meet **infrequently or occasionally**, the **Barrier method (Condoms)** is the ideal choice. This is because it is a "user-dependent, coitus-related" method. It does not require continuous medication or invasive procedures for a couple who does not need daily protection. Additionally, it provides the added benefit of protection against Sexually Transmitted Infections (STIs), which is a crucial consideration for couples living apart. **Why Other Options are Incorrect:** * **IUCD (Option B):** These are Long-Acting Reversible Contraceptives (LARC) best suited for couples seeking long-term spacing (3–10 years) with frequent intercourse. It is an invasive procedure and unnecessary for occasional use. * **OCPs (Option C):** Oral pills require strict daily compliance to maintain efficacy. For a couple meeting only occasionally, taking a daily hormone pill is an unnecessary systemic burden. * **DMPA (Option D):** This is an injectable contraceptive given every 3 months. Like OCPs, it provides continuous hormonal suppression, which is not indicated for infrequent exposure. **NEET-PG High-Yield Pearls:** * **Ideal for Newly Married:** OCPs (Centchroman/Chhaya is often preferred in the Indian government program). * **Ideal for Lactating Mothers:** Progestogen-only pills (POPs) or IUCD (Cu-T 380A). * **Post-Coital (Emergency) Choice:** Levonorgestrel (1.5mg) within 72 hours or Cu-T within 5 days. * **Pearl Index:** Used to measure contraceptive failure rates (Lower index = Higher efficacy). Condoms have a higher typical-use failure rate compared to LARC.

Q: Contraceptive efficacy is expressed as:

100 women-years. **Explanation:** The efficacy of a contraceptive method is traditionally expressed using the **Pearl Index**. This index calculates the number of unintended pregnancies that occur per **100 women-years** of exposure. **Why Option C is Correct:** The Pearl Index is the standard epidemiological measure for contraceptive failure. It represents the number of failures (pregnancies) per 100 women using a specific method over one year. * **Formula:** (Total number of pregnancies × 1200) / (Total number of months of exposure). * The "1200" in the formula converts the data into the standard unit of 100 women-years (100 women × 12 months). **Why Other Options are Incorrect:** * **Option A (100 women-months):** This is too short a duration to account for seasonal variations or long-term consistency in contraceptive use. * **Options B & D (1000 or 10 women-years):** These are not the standardized units used in global reproductive health statistics or clinical trials. **High-Yield Clinical Pearls for NEET-PG:** * **Pearl Index vs. Life Table Analysis:** While the Pearl Index is common, **Life Table Analysis** is considered more accurate as it calculates failure rates at specific intervals (e.g., at 6 months, 12 months) and accounts for "drop-outs." * **Most Effective:** Implants (Nexplanon) and Vasectomy have the lowest Pearl Indices (highest efficacy). * **Least Effective:** Barrier methods (condoms) and behavioral methods (withdrawal/rhythm) have higher Pearl Indices due to user inconsistency. * **Perfect Use vs. Typical Use:** Always distinguish between these; "Typical use" Pearl Indices are always higher because they account for human error.

Q: What is a contraindication for laparoscopic tubal ligation?

Postpartum state. ### Explanation The correct answer is **A. Postpartum state**. **Why Postpartum state is a contraindication for Laparoscopy:** In the immediate postpartum period (typically the first 48 hours to 7 days), the uterus is significantly enlarged and remains an intra-abdominal organ (reaching the level of the umbilicus). This makes **laparoscopic** tubal ligation technically difficult and dangerous due to: 1. **Risk of Uterine Perforation:** The soft, enlarged uterus is easily injured by the Veress needle or trocar. 2. **Limited Space:** The bulky uterus obscures the pelvic view and limits the working space for laparoscopic instruments. 3. **Alternative Gold Standard:** The preferred method for sterilization in the postpartum period is **Mini-laparotomy (Pomeroy’s technique)**, usually performed via a small sub-umbilical incision. **Analysis of Incorrect Options:** * **B. Post MTP:** Sterilization can be safely performed concurrently with MTP (Concurrent Tubal Ligation) via laparoscopy, as the uterus is not as large as in a full-term pregnancy. * **C. Gynecologic malignancies:** While surgery is complex, malignancy itself is not a contraindication to the *procedure* of tubal ligation, though the clinical focus usually shifts to treating the cancer (e.g., hysterectomy). * **D. Three previous childbirths:** High parity is an indication for sterilization, not a contraindication. **High-Yield Clinical Pearls for NEET-PG:** * **Timing:** Postpartum sterilization is ideally done 24–48 hours after delivery. * **Laparoscopy Timing:** Laparoscopic sterilization is best performed as an **"Interval Sterilization"** (at least 6 weeks after delivery) when the uterus has undergone complete involution. * **Absolute Contraindications for Laparoscopy:** Intestinal obstruction and generalized peritonitis. * **Most common method used in India:** Laparoscopic ligation (Interval) and Pomeroy’s (Postpartum).

Question 1

Which of the following is a contraindication for coitus interruptus?

Accepted Answer

Premature ejaculation

Answer

Erectile dysfunction

Answer

Perimenopausal age

Answer

Illiterate male partner

Question 2

What is the ideal contraceptive for a couple who lives in different cities and meets only occasionally?

Accepted Answer

Barrier method

Answer

Intrauterine contraceptive device (IUCD)

Answer

Oral contraceptive pills (OCP)

Answer

Depot medroxyprogesterone acetate (DMPA)

Question 3

Contraceptive efficacy is expressed as:

Accepted Answer

100 women-years

Answer

100 women-months

Answer

1000 women-years

Answer

10 women-years

Question 4

Which of the following is NOT an ideal candidate for insertion of an Intrauterine Contraceptive Device (IUCD)?

Accepted Answer

Cancer of the Cervix

Answer

Has normal menstrual periods

Answer

No history of Pelvic Inflammatory Disease (PID)

Answer

Has at least one child

Question 5

What is a contraindication for laparoscopic tubal ligation?

Accepted Answer

Postpartum state

Answer

Post MTP (Medical Termination of Pregnancy)

Answer

Gynecologic malignancies

Answer

Three previous childbirths

Contraception and Family Planning — MCQs

Contraception and Family Planning — MCQs

On this page

Practice by Chapter

Want unlimited practice?