Contraception and Family Planning Practice Questions

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.

Q: The contraceptive shown below acts by:

Preventing implantation. ***Preventing implantation*** - The image shows **Saheli (Centchroman/Ormeloxifene)**, a non-steroidal oral contraceptive that works primarily as a **Selective Estrogen Receptor Modulator (SERM)**. - Its **primary mechanism** is to render the **endometrium unsuitable for implantation** by causing endometrial changes that prevent the blastocyst from attaching to the uterine wall. - This is the main contraceptive effect that makes Saheli effective at preventing pregnancy. *Preventing fertilization* - While Centchroman may have some **secondary effects** on cervical mucus and tubal motility that could affect sperm transport, this is not its primary mechanism of action. - Fertilization can still occur with Saheli use; the contraceptive effect primarily occurs at the implantation stage. - Unlike barrier methods or spermicides, Saheli does not primarily work by preventing sperm-egg union. *Preventing ovulation* - Saheli is specifically known for being a **non-hormonal contraceptive that does NOT suppress ovulation**. - This distinguishes it from combined oral contraceptive pills (COCs) that work by preventing ovulation. - Ovulation occurs normally in women taking Saheli, which is one of its advantages as it maintains more natural hormonal cycles. *Preventing zygote cell multiplication* - This would imply a direct toxic effect on the dividing embryo, which is not the mechanism of Centchroman. - The drug works by altering the endometrial receptivity rather than directly affecting the zygote's cellular division process. - Its action is on the **uterine environment** rather than on embryonic cell multiplication.

Q: A patient has received the following birth control method. It is called:

Contraceptive implant. ***Contraceptive implant*** - The image shows a **small, flexible rod inserted under the skin of the upper arm**, which is characteristic of a contraceptive implant. - This device continuously releases a progestin hormone to **prevent pregnancy** for up to three years or more.

Q: The contraception method shown below is made of:

Molybdenum-cobalt steel alloy. ***Molybdenum-cobalt steel alloy*** - The image displays the Essure device, which used a **molybdenum-cobalt steel alloy** for its inner core, providing structural integrity. - The outer fibers of the device were made of **polyethylene terephthalate**, inducing a localized inflammatory response to cause tubal occlusion, but the question specifically asks about the core material. *Quinacrine pellet* - Quinacrine is a drug used in **nonsurgical sterilization** but is delivered as a pellet, not as a coiled device as depicted. - This method involves placing quinacrine pellets directly into the uterus to induce scarring and block the fallopian tubes, which is a different mechanism and appearance. *Quinacrine pellet with LNG* - While quinacrine is mentioned above for non-surgical sterilization, a combination with **levonorgestrel (LNG)** in a single pellet form for this specific purpose is not a standard or widely recognized contraceptive method that matches the device shown. - LNG is a progestin commonly found in hormonal IUDs and implants, but not typically associated with the quinacrine pellet method for tubal occlusion. *Nickel-titanium steel alloy* - While **nickel-titanium alloys** (like nitinol) are used in various medical devices due to their shape memory and superelastic properties, the **Essure device** specifically used a molybdenum-cobalt steel alloy for its core. - Other medical implants might use nickel-titanium, but it is not the primary material for the device shown in the image.

Q: Identify the laparoscopic tubal sterilization shown below.

Filshie clip. ***Filshie clip*** - The image clearly displays a **clip** being applied to the fallopian tube, which is characteristic of the **Filshie clip** method of tubal sterilization. - Filshie clips are widely used due to their **high efficacy** and ability to be applied with minimal tissue damage. *Falope ring* - A Falope ring, also known as a Yoon ring, involves placing a **silastic band** to create a loop of the fallopian tube. The image does not show a looped tube with a ring. - This method typically causes a segment of the tube to become **necrotic** and atrophy, severing continuity. *Hulka clip* - The Hulka clip is a spring-loaded clip that is typically **smaller and more rounded** at the ends compared to the clip shown in the image. - It also involves occlusion of the fallopian tube but has a distinct appearance from the Filshie clip. *Pomeroy's technique* - Pomeroy's technique is a method of tubal ligation where a loop of the fallopian tube is **ligated and then excised**, which is a surgical procedure rather than the application of a device. - This method results in a **severed and separated** fallopian tube, unlike the clip shown in the image.

Q: What is the method of contraception shown below?

Bipolar electrocoagulation. ***Bipolar electrocoagulation*** - The image shows a **bipolar forceps** grasping and coagulating a fallopian tube. The characteristic **blackened, constricted appearance** of the tube segment is indicative of tissue coagulation. - This method uses **high-frequency electrical current** passed between two electrodes (the jaws of the forceps) to cause **thermal damage** and occlude the fallopian tube. *Pomeroy's technique* - This technique involves **ligating a loop** of the fallopian tube with absorbable suture and then **excising the looped segment**. - The image does not show a ligated and excised segment, nor the presence of sutures. *Parkland technique* - The Parkland technique involves **ligating two segments** of the fallopian tube at a distance from each other and then **resecting the intervening segment**. - This method results in a gap between the ligated ends, which is not depicted in the image. *Falope ring* - The Falope ring method involves applying a **small silicone band** or ring to a **knuckled loop** of the fallopian tube, causing necrosis and occlusion. - The image clearly displays grasping forceps and electrocoagulation, **not the application of a ring**.

Question 1

What is the following contraceptive method called?

Accepted Answer

Copper T 380A

Answer

Mirena

Answer

Paragard

Answer

Oestrogen containing Copper T

Question 2

Identify the contraceptive method shown below:

Accepted Answer

NuvaRing

Answer

Plan B ring

Answer

Implanon

Answer

Vaginal condom

Question 3

Identify the instrument shown in the image:

Accepted Answer

Karman syringe

Answer

Gastric lavage aspirator

Answer

Disposable syringe

Answer

Hegar dilator

Question 4

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 5

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

Question 6

The contraceptive shown below acts by:

Accepted Answer

Preventing implantation

Answer

Preventing ovulation

Answer

Preventing fertilization

Answer

Preventing zygote cell multiplication

Question 7

A patient has received the following birth control method. It is called:

Accepted Answer

Contraceptive implant

Answer

Intrauterine device (IUD)

Answer

Contraceptive patch

Answer

Vaginal ring

Question 8

The contraception method shown below is made of:

Accepted Answer

Molybdenum-cobalt steel alloy

Answer

Quinacrine pellet

Answer

Quinacrine pellet with LNG

Answer

Nickel-titanium steel alloy

Question 9

Identify the laparoscopic tubal sterilization shown below.

Accepted Answer

Filshie clip

Answer

Falope ring

Answer

Hulka clip

Answer

Pomeroy's technique

Question 10

What is the method of contraception shown below?

Accepted Answer

Bipolar electrocoagulation

Answer

Pomeroy's technique

Answer

Parkland technique

Answer

Falope ring

Contraception and Family Planning — MCQs

Contraception and Family Planning — MCQs

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