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Contraception*The ideal method of contraception for a cardiac patient with mitral valve disease who desires no more children is by Tubal ligation 40 days after delivery by laparotomy *The most effective contraceptive known is Combined contraceptive pills (estrogen + progesterone) *Combined oral contraceptive pills is Less effective in patient with epilepsy on treatment *Contraindications for the use of combined oral contraceptive pills: .Chronic liver disease .Secondary amenorrhea .Thrombo-embolic disease .Sickle cell disease .Carcinoma of the breast .Migraine headache +Lactating mother & Hirsutism & Endometriosis (are not contra.) *Side effects of oral contraceptives: .Weight gain .Hypertension .Deep vein thrombosis .Strike *The effectiveness of oral contraceptives is reduced following interaction with the following drugs: .Ampicillin .Phenobarbitone .Phenytoin .Carbamazepine *OCP (Inhibit release of gonadotropic hormones) *The use of combined oral contraceptive pills may increase the risk of hepatic adenoma *Most common side effect of low-dose oral contraceptive pills is Breakthrough bleeding *Failure rate for IUCD is 2-3 % women every year *Absolute contraindications to Intrauterine Contraceptive Device IUCD is: .Bicornuate uterus .Pregnancy .Pelvic infection .Multigravida .Dysfunctional uterine bleeding .Patient with heart disease *Intrauterine contraceptive device may be associated with following complications: .Pelvic infection .Uterine perforation .Ectopic pregnancy .Cervical erosion .Menorrhagia *The most common method of contraception in Jordan is Intrauterine device (IUCD
*Percentage of couples in the reproductive age is unable to conceive after one year of coitus without contraception is 15% *All of the following are possible indications of ovulation: .Increased plasma levels of progesterone in the second half of the cycle .Increased basal temperature in the second half of the cycle .Change in the cervical mucus .Mid cycle abdominal pain *Ovulation can be diagnosed by the following: .Measuring day 14 serum progesterone .Observing a rise in basal body temperature in the second half of the menstrual cycle .Study of cervical mucus .Endometrial biopsy .Vaginal wall cytology .Progesterone level *Induction of ovulation may be achieved by giving Clomiphene citrate *Clomiphene citrate is contraindicated in Ovarian tumors *Normal semen should have the following characteristics: .Volume 2.5-5 cc .Liquefaction in 30 minutes .Motility 60-70% after 3 hours .After 6 hours only 30% *Causes azoospermia: .Blockage of the ducts .Klinefelter syndrome .Orchitis due to mumps .Surgical trauma to the spermatic artery *Male sterilization (vasectomy) cause Azoospermia
*Causes of abnormal spermatogenesis: .Cryptorchidism .Genetic abnormality .Varicoceles .Drugs *Environmental factors might adversely affect spermatogenesis: .Prolonged sitting .Febrile illness .Hot bath .Frequent saunas
PCOS *Polycystic ovary syndrome: .Wedge resection is the treatment of choice .Absence of LH surge .Low or normal FSH .High testosterone level * PCOS characterized by: .Hirsutism .Infertility .Obesity .Anovulation *Problems may occur with an ovarian cyst: .May undergo torsion .May undergo rupture .May undergo hemorrhage .May undergo malignant changes .Are associated with hirsutism .Are associated with infertility .Are associated with obesity *The proper treatment for woman was found to have ovarian cyst is Laparotomy and cystectomy as soon as discovered
VULVA *The etiologic agent for vulvar cancer is unKnown *The most common symptom of vulvar cancer in elderly woman is Pruritus *A blue swelling on the vulva is most likely due to Varicosity *The most common histopathological finding in primary carcinoma of the vagina is Squamous cell carcinoma
CERVIX *The lining of cervical erosion is Columnar epithelium *In case of cervical carcinoma in situ in 50 years old woman, the treatment of choice is Hysterectomy *(pap) smear is recommended for cervical cancer screening *Invasive carcinoma of the cervix commonly present with all the following: .Post coital bleeding .Intermenstrual bleeding .Vaginal discharge .Acyclic vaginal bleeding *The most common benign neoplasm of the cervix and endocervix is polyps *The first symptom of cervical cancer is Pain during intercourse *Cervical smear is a method to detect early cancer of cervical
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