Future Contraceptive Technologies — MCQs
What is the most commonly recommended reversible contraceptive method for a newly married, healthy couple?
What is the best index of contraceptive efficacy?
The contraceptive which is contraindicated in DVT is?
Which of the following statements about undescended testis is true?
Which of the following is considered a temporary method of contraception?
Which contraceptive method has the lowest pregnancy failure rate (typical use)?
Which of the following reduces the risk of pelvic inflammatory disease (PID)?
Contraceptive of choice in a woman with Rheumatic heart disease.
Hormonal contraceptive of choice in a lactating woman is
A 26-year-old woman presents with vaginal discharge and dyspareunia. Wet mount microscopy shows clue cells. Which of the following additional findings would confirm the diagnosis?
Future Contraceptive Technologies Indian Medical PG Practice Questions and MCQs
Question 1: What is the most commonly recommended reversible contraceptive method for a newly married, healthy couple?
- A. Barrier methods
- B. Intrauterine contraceptive device (IUCD)
- C. Natural family planning methods
- D. Oral contraceptive pills (Correct Answer)
Explanation: ***Oral contraceptive pills*** - **Oral contraceptive pills (OCPs)** are among the most commonly prescribed reversible contraceptive methods for healthy, newly married couples in India, offering high efficacy with perfect use and easy reversibility. - They provide additional non-contraceptive benefits including **menstrual cycle regulation**, reduced dysmenorrhea, and decreased risk of ovarian and endometrial cancers. - Their ease of initiation without requiring a procedure makes them a frequent first-line choice in clinical practice. *Barrier methods* - **Barrier methods** like condoms have higher typical-use failure rates (13-18% annually) compared to hormonal methods or IUCDs, making them less reliable as the sole contraceptive method. - Their effectiveness is highly dependent on **correct and consistent use** with each act of intercourse, requiring high user motivation and compliance. *Intrauterine contraceptive device (IUCD)* - **IUCDs** (both copper and hormonal) are highly effective long-acting reversible contraceptives (LARCs) with typical-use efficacy >99%, and are safe and appropriate for nulliparous women. - While increasingly recommended by guidelines, they require a minor procedure for insertion and may be reserved for women seeking longer-term contraception or those who prefer non-daily methods. - In practice, many providers still initially offer OCPs due to their ease of initiation and patient familiarity, though IUCDs are gaining acceptance as first-line options. *Natural family planning methods* - **Natural family planning (NFP)** methods rely on fertility awareness and periodic abstinence, requiring significant commitment, training, and meticulous tracking. - They have substantially **higher typical-use failure rates** (12-24% annually) compared to OCPs or IUCDs, making them less suitable for couples seeking highly reliable contraception.
Question 2: What is the best index of contraceptive efficacy?
- A. Pearl index (Correct Answer)
- B. Quetelet index
- C. Broca index
- D. Chandelier's index
Explanation: ***Pearl index*** - The **Pearl Index** (also known as the Pearl Rate) is the most common measure of contraceptive efficacy, representing the number of unintended pregnancies per 100 woman-years of exposure. - It considers both the duration of use and the number of women-months a contraceptive method is used, providing a standardized way to compare different methods. *Chandelier's index* - **Chandelier's index** is not a recognized or standard measure for contraceptive efficacy in scientific literature or clinical practice. - This term does not correspond to any known medical or statistical index for evaluating contraceptive methods. *Quetlet index* - This is likely a misspelling or incorrect reference to the **Quetelet index**, which is another name for the **Body Mass Index (BMI)** used to assess body fat based on height and weight. - The **Quetelet index/BMI** has no relevance to measuring contraceptive efficacy. *Broca index* - The **Broca index** is a historical method for assessing ideal body weight based on height, often used in older anthropometric studies. - It is not used to measure contraceptive efficacy or any other aspect of reproductive health.
Question 3: The contraceptive which is contraindicated in DVT is?
- A. Barrier method
- B. Non hormonal IUCD
- C. Billing's method
- D. OCP (Correct Answer)
Explanation: ***OCP*** - **Oral contraceptive pills (OCPs)**, especially those containing estrogen, increase the risk of **venous thromboembolism (VTE)**, including deep vein thrombosis (DVT). - Estrogen promotes a **hypercoagulable state** by increasing clotting factors and decreasing natural anticoagulants. *Barrier method* - **Barrier methods** like condoms or diaphragms are non-hormonal and act physically to prevent sperm from reaching the egg. - They have **no systemic effects** on coagulation and are safe for individuals with DVT. *Non hormonal IUCD* - **Non-hormonal intrauterine contraceptive devices (IUCDs)**, such as copper IUCDs, prevent conception primarily by causing a local inflammatory reaction in the uterus. - They do not release hormones and therefore **do not affect coagulation** or increase DVT risk. *Billing's method* - The **Billing's ovulation method** (cervical mucus method) is a natural family planning technique based on observing changes in cervical mucus. - It involves no medications or devices and thus has **no impact on DVT risk**.
Question 4: Which of the following statements about undescended testis is true?
- A. Hormonal therapy is effective
- B. More common on the right side
- C. Increased risk of malignancy (Correct Answer)
- D. Secondary sexual characteristics are universally normal
Explanation: ***Increased risk of malignancy*** - Undescended testis is associated with a **3 to 14 times increased risk** of testicular malignancy, particularly **seminoma**. - The risk remains elevated even after orchiopexy, though the procedure allows for **easier surveillance and examination**. - This is one of the **most important clinical features** of cryptorchidism and a key reason for early surgical correction. - Even a **corrected cryptorchid testis** maintains higher cancer risk compared to normally descended testes. *Secondary sexual characteristics are universally normal* - In **unilateral cryptorchidism** (90% of cases), the normally descended contralateral testis produces **adequate testosterone** for normal secondary sexual development. - However, in **bilateral cryptorchidism** or if the descended testis is functionally impaired, **testosterone deficiency** can occur, leading to delayed or abnormal sexual development. - Therefore, secondary sexual characteristics are **not universally normal** in all cases of undescended testis. *Hormonal therapy is effective* - Hormonal therapy with **hCG (human chorionic gonadotropin)** or **GnRH (gonadotropin-releasing hormone)** has **limited and inconsistent effectiveness**. - Success rates are generally **low** (10-30%), particularly for truly undescended testes (as opposed to retractile testes). - **Orchiopexy** (surgical correction) remains the **definitive treatment**, ideally performed between **6-18 months of age** to optimize fertility potential. *More common on the right side* - Undescended testis is actually **slightly more common on the left side** (~55-60%) than the right (~40-45%). - **Bilateral cryptorchidism** occurs in approximately 10-20% of cases. - There is no significant right-sided predilection.
Question 5: Which of the following is considered a temporary method of contraception?
- A. Vasectomy
- B. OCP (Correct Answer)
- C. Tubectomy
- D. Postpartum sterilisation
Explanation: ***OCP*** - **Oral Contraceptive Pills (OCPs)** are a common type of hormonal contraception that require daily administration and are easily reversible, fitting the definition of a **temporary method**. - They work by preventing ovulation, thickening cervical mucus, and thinning the uterine lining, effects that cease once the pills are stopped. *Vasectomy* - A **vasectomy** is a surgical procedure for male sterilization where the vas deferens are cut or sealed, making it a **permanent method** of contraception. - While sometimes reversible, reversal procedures are complex, expensive, and not always successful, making it generally considered irreversible. *Tubectomy* - A **tubectomy**, or tubal ligation, is a surgical procedure for female sterilization where the fallopian tubes are cut, tied, or sealed, making it a **permanent method** of contraception. - It is intended as an irreversible method to prevent the egg from reaching the uterus or sperm from reaching the egg. *Postpartum sterilisation* - **Postpartum sterilization** refers to a tubectomy performed after childbirth, which is a **permanent method** of contraception. - It falls under permanent surgical contraception and is not considered temporary, as its intent is to prevent future pregnancies indefinitely.
Question 6: Which contraceptive method has the lowest pregnancy failure rate (typical use)?
- A. Diaphragm
- B. Condom
- C. Intrauterine Contraceptive Device (IUCD) (Correct Answer)
- D. Oral Contraceptive Pills (OCP)
Explanation: ***Intrauterine Contraceptive Device (IUCD)*** - **IUCDs** are highly effective, with a **pregnancy failure rate of less than 1%** in typical use due to their long-acting and reversible nature, requiring no daily action from the user. - They are **fit-and-forget methods**, eliminating user error inherent in other forms of contraception, leading to very low typical use failure rates. *Diaphragm* - The **diaphragm** has a significantly higher typical use failure rate (around 12-16%) because its effectiveness depends on **correct placement** and consistent use with spermicide before each intercourse. - It is a **user-dependent method**, making its efficacy susceptible to improper use or non-use during sexual activity. *Condom* - **Condoms** have a typical use failure rate of about 13-18%, largely due to **incorrect use**, breakage, or slippage. - Their effectiveness relies heavily on **consistent and proper application** with every act of intercourse. *Oral Contraceptive Pills (OCP)* - **Oral Contraceptive Pills (OCPs)** have a typical use failure rate of approximately 7-9%, primarily because effectiveness is dependent on **daily adherence** at roughly the same time. - **Missed pills** are a common reason for failure, significantly increasing the risk of pregnancy compared to methods that do not require daily action.
Question 7: Which of the following reduces the risk of pelvic inflammatory disease (PID)?
- A. Copper T IUCD
- B. TODAY vaginal sponge
- C. Spermicidal agents
- D. Oral contraceptive pills (OCPs) (Correct Answer)
Explanation: ***Oral contraceptive pills (OCPs)*** - OCPs **thicken cervical mucus**, which creates a barrier that can prevent the ascent of bacteria from the vagina into the upper reproductive tract. - This cervical mucus barrier reduces the risk of cervical infection spreading to the uterus and fallopian tubes, thereby **lowering the incidence of PID**. *Copper T IUCD* - The Copper T IUCD is associated with a **slightly increased risk of PID** in the first few weeks after insertion, especially in women with pre-existing sexually transmitted infections (STIs). - It does not offer protection against ascending infections and can potentially facilitate their spread if the cervical barrier is compromised. *TODAY vaginal sponge* - The TODAY vaginal sponge contains **spermicide and acts as a barrier contraceptive**, but it does not protect against STIs, which are the primary cause of PID. - Some studies suggest that spermicides can **irritate vaginal mucosa**, potentially increasing susceptibility to certain infections. *Spermicidal agents* - Spermicidal agents primarily work by **immobilizing and killing sperm** to prevent pregnancy. - They **do not protect against STIs** and, in some cases, frequent use can cause vaginal and cervical irritation, potentially making the user more vulnerable to infections that can lead to PID.
Question 8: Contraceptive of choice in a woman with Rheumatic heart disease.
- A. Progesterone only pills
- B. IUCD (Correct Answer)
- C. Condom with spermicidal jelly
- D. OCPs
Explanation: ***IUCD*** - **Intrauterine contraceptive devices (IUCDs)** are highly effective and do not involve systemic hormones, making them safe for women with **rheumatic heart disease**. - Both copper and hormonal IUCDs can be used, as they pose no additional risk of **thromboembolism** or worsen cardiac function. *Progesterone only pills* - While generally safer than combined oral contraceptives for women with cardiac issues, **progesterone-only pills** still carry a slight risk of **thrombosis**, especially in women with certain heart conditions. - Their effectiveness can be slightly lower than IUCDs, and adherence to strict daily timing is crucial for optimal contraception. *Condom with spermicidal jelly* - **Condoms with spermicidal jelly** are a barrier method and do not pose any direct risk to a woman with rheumatic heart disease. - However, they have a significantly **higher failure rate** compared to highly effective methods like IUCDs, making them less ideal as a primary contraceptive for a condition where pregnancy could be high-risk. *OCPs* - **Combined oral contraceptive pills (OCPs)** containing both estrogen and progestin are generally **contraindicated** in women with rheumatic heart disease, particularly those with valvular lesions or a history of **embolism**. - Estrogen increases the risk of **thromboembolic events**, which can be dangerous for individuals with compromised cardiac function.
Question 9: Hormonal contraceptive of choice in a lactating woman is
- A. Multiphasic Pill
- B. Combined Pill
- C. Centchroman
- D. Mini Pill (Correct Answer)
Explanation: ***Mini Pill*** - The **mini-pill** (progestin-only pill) is the contraceptive of choice for **lactating women** because it does not suppress **milk production**. - **Progestin-only contraceptives** are generally considered safe and effective during lactation, with minimal impact on infant growth and development. *Multiphasic Pill* - **Multiphasic pills** are a type of **combined oral contraceptive** containing both estrogen and progestin, with varying hormone doses. - The **estrogen component** in combined oral contraceptives can **reduce breast milk supply** and may have theoretical risks for the infant. *Combined Pill* - **Combined oral contraceptives** contain both **estrogen and progestin**. - **Estrogen** can decrease **milk volume** and alter milk composition, making them unsuitable for lactating women, especially in the early postpartum period. *Centchroman* - **Centchroman** (Ormeloxifene) is a **selective estrogen receptor modulator (SERM)** used as a non-steroidal oral contraceptive. - While effective, it is generally **not recommended during lactation** due to limited data on its safety and potential effects on the infant or milk supply.
Question 10: A 26-year-old woman presents with vaginal discharge and dyspareunia. Wet mount microscopy shows clue cells. Which of the following additional findings would confirm the diagnosis?
- A. Pseudohyphae on microscopy
- B. Positive whiff test and vaginal pH > 4.5 (Correct Answer)
- C. WBCs > 10 per high power field
- D. Motile trichomonads
Explanation: ***Positive whiff test and vaginal pH > 4.5*** - The combination of **clue cells**, a **positive whiff test** (amine odor after adding KOH), and a **vaginal pH > 4.5** are diagnostic criteria for **bacterial vaginosis (BV)**. - This classic triad, along with thin, homogeneous discharge, forms part of the **Amsel criteria** for diagnosing BV. *Pseudohyphae on microscopy* - **Pseudohyphae** are characteristic findings in **vulvovaginal candidiasis (yeast infection)**, not bacterial vaginosis. - Candidiasis typically presents with thick, white, "cottage cheese-like" discharge and intense pruritus, which differs from the described symptoms. *WBCs > 10 per high power field* - An increased number of **white blood cells (WBCs)**, specifically polymorphonuclear leukocytes, suggests **inflammation** or infection but is typically *absent* or minimal in uncomplicated bacterial vaginosis. - High WBC counts are more indicative of **trichomoniasis** or **cervicitis**. *Motile trichomonads* - The presence of **motile trichomonads** on wet mount microscopy is diagnostic for **trichomoniasis**, a sexually transmitted infection. - While trichomoniasis can cause vaginal discharge and dyspareunia, its microscopic features are distinct from clue cells.
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free