Antiprogesterone

Antiprogesterone

Q. 1

Decreased vascularity of fibroid is seen with :

 A

GnRH agonist

 B

Danazol

 C

Mifepristone

 D

All

Q. 1

Decreased vascularity of fibroid is seen with :

 A

GnRH agonist

 B

Danazol

 C

Mifepristone

 D

All

Ans. D

Explanation:

Ans. is a, b, and c i.e. GnRH analogues; Danazol; and Mifeprestone

As I have already explained in previous question, the drugs used to decrease blood loss / vascularity of fibroid during surgery are :


Q. 2

Which of the following statements are true about mifepristone :

 A

Also called RU — 486

 B

It is a 19 — norsteroid

 C

Acts on receptors

 D

All

Q. 2

Which of the following statements are true about mifepristone :

 A

Also called RU — 486

 B

It is a 19 — norsteroid

 C

Acts on receptors

 D

All

Ans. D

Explanation:

Ans. is a, b, c Also called RU – 486; It is a 19 Norsteroid; Acts on receptors; Used for menstrual regulation

Route of administration : Oral

RU 486 (Mifepristone) is a 19 Norsteroid synthetic derivative of progesterone. It has affinity for progesterone receptors and therefore blocks its actions.

Uses :

  1. As post coital (600mg given within 72 hrs. of unprotected sex).
  2. To induce abortion upto 7 weeks of amenorrhea along with mesoprostol (medical abortion).
  3. Ripening of cervix prior to prostaglandin induction of mid trimester abortion.
  4. Management of ectopic pregnancy.
  5. Cushing’s syndrome : because of its antiglucocorticoid action.
  6. Medical management of uterine fibroid.
  • Headache
  • GI upset
  • Adrenal failure
  • Teratogenesity (If medical methods of abortion fails with RU – 486, pregnancy should be terminated any how).

Contraindication :  Adrenal failure

  • Cardiac disease
  • Asthma
  • Haemorrhagic disease
  • Glucoma
  • Woman on long term glucocorticoid therapy and anticoagulants.

Q. 3

Anti progesterone drug is :

 A

Cyproterone

 B

Mifepristone

 C

Spironolactone

 D

Tamoxifen

Q. 3

Anti progesterone drug is :

 A

Cyproterone

 B

Mifepristone

 C

Spironolactone

 D

Tamoxifen

Ans. B

Explanation:

Mifepristone


Q. 4

Drugs used in emergency contraception :

 A

Levonorgestrel

 B

Estrogen + progesterone

 C

Danazol and Mifepristone

 D

All

Q. 4

Drugs used in emergency contraception :

 A

Levonorgestrel

 B

Estrogen + progesterone

 C

Danazol and Mifepristone

 D

All

Ans. D

Explanation:

Ans. is a, b  and c i.e. Levonorgestrel; Estrogen +Progesterone; Danazol; and Mifepristone

Emergency contraceptives are :

  • Ethinyl oestradiol                                             • Conjugated oestrogen
  • Ethinyl oestradiol + Levonorgestrel                • Levonorgestrel
  • Mifepristone                                                      • Copper IUCD’s
  • Danazol

Q. 5

Mifepristone is not used in?

 A Abortion
 B

Cushing syndrome

 C PPH
 D

Cervical ripening

Q. 5

Mifepristone is not used in?

 A Abortion
 B

Cushing syndrome

 C PPH
 D

Cervical ripening

Ans. C

Explanation:

PPH REF: Shaw 13th ed p. 307, William’s 22nd edition different pages, http://en.wikipedia.org/wiki/ Mifepristone

Therapeutic uses of Mifepristone

  1. Medical termination of intrauterine pregnancies of up to 49 days gestation (up to 63 days gestation in Britain and Sweden)
  2. Use in combination with gemeprost for termination of pregnancies between 13 and 24 weeks gestation
  3. Missed abortion
  4. Ectopic pregnancy
  5. Softening and dilatation of the cervix prior to mechanical cervical dilatation for pregnancy termination
  6. Labor induction in fetal death in utero
  7. Mifepristone has been used to treat Cushing’s syndrome with treatment durations being as long as 10 years without noticeable adverse effect
  8. Postcoital contraception

Q. 6

Mifepristone is not used in –

 A

Threatened abortion

 B

Fibroid

 C

Ectopic pregnancy

 D

Molar pregnancy

Q. 6

Mifepristone is not used in –

 A

Threatened abortion

 B

Fibroid

 C

Ectopic pregnancy

 D

Molar pregnancy

Ans. A

Explanation:

Ans. is a i.e. Threatened abortion

Threatened Abortion is a clinical entity where the process of abortion has started but has not progressed to a state from which recovery is impossible. The treatment of threatened abortion is aimed at preserving pregnancy and not at terminating pregnancy.

Mifepristone is an abortificient that will cause termination of pregnancy and should not be used in cases of threatened abortion.

Mifepristone may be used for Ectopic pregnancy and for shrinking of Fibroids

-Mifepristone injected into the unruptured ectopic pregnancy causes its resolution”

‘Shrinkage of uterine leiomyoma has been observed following Mifepristone therapy’


Q. 7

Scenario: A 18 year old young lady used emergency contraception to prevent pregnancy after having unprotected sex.
 
Assertion: Emergency contraception should not be taken after 72 hours of intercourse
 
Reason: Use of Mifepristone within 72 hours of intercourse acts by interrupting an early pregnancy
 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 7

Scenario: A 18 year old young lady used emergency contraception to prevent pregnancy after having unprotected sex.
 
Assertion: Emergency contraception should not be taken after 72 hours of intercourse
 
Reason: Use of Mifepristone within 72 hours of intercourse acts by interrupting an early pregnancy
 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. C

Explanation:

Emergency contraception taken after 72 hours is interrupting an early pregnancy and is termed as termination of pregnancy or abortion.

Ref: Shaw’s Textbook of Gynecology, 13th Edition, Page 233


Q. 8

All of the following are uses of mifepristone except‑

 A

Termination of pregnancy

 B

Post coital contraception

 C

Post partum hemorrhage

 D

Cushing’s syndrome

Q. 8

All of the following are uses of mifepristone except‑

 A

Termination of pregnancy

 B

Post coital contraception

 C

Post partum hemorrhage

 D

Cushing’s syndrome

Ans. C

Explanation:

Ans. is ‘c’ i.e., Post partum hemorrhage

o Mifepristone is used in medical termination of pregnancy (most important use), postcoital (emergency) contraception, Cushing syndrome, meningioma, breast cancer, fibroids and endometriosis.


Q. 9

Mifepristone is used in –

 A

Medical terminations of pregnancy

 B

Breast carcinoma

 C

Prostatic carcinoma

 D

Dysfunctional uterine bleeding

Q. 9

Mifepristone is used in –

 A

Medical terminations of pregnancy

 B

Breast carcinoma

 C

Prostatic carcinoma

 D

Dysfunctional uterine bleeding

Ans. A

Explanation:

Ans. is ‘a’ i.e., Medical termination of pregnancy

Mifepristone

  • Mifepristone is a 19-norsteroid with potent competitive antiprogestational, antiglucocorticod and antiandrogenic action.
  • Mifepriston is a partial agonist and competitive antagonist at both A and B isoforms of progesterone receptors.
  • Uses
  1. Termination ofpregnancy              3. Postcoital contraceptive                      5. Induction of labour
  2. Cervical ripening                      4. Once-a-month contraceptive               6. Cushing’s syndrome

o Uses under evaluation are-in endometriosis, uterine fibroid, certain breast cancers and meningioma.


Q. 10

Dose of mifepristone (in mg) for post-coital contraception:     

September 2012

 A

10

 B

20

 C

40

 D

60

Q. 10

Dose of mifepristone (in mg) for post-coital contraception:     

September 2012

 A

10

 B

20

 C

40

 D

60

Ans. A

Explanation:

Ans. A i.e. 10 mg

  • Post-coital contraception. Ten milligrams given within 72 h of unprotected coitus is used as a post-coital contraception

Q. 11

First trimester abortion uses all, except:       

TN 09

 A

Mifepristone

 B

Extra-amniotic ethacrydine lactate

 C

Dilatation and evacuation

 D

Suction evacuation

Q. 11

First trimester abortion uses all, except:       

TN 09

 A

Mifepristone

 B

Extra-amniotic ethacrydine lactate

 C

Dilatation and evacuation

 D

Suction evacuation

Ans. B

Explanation:

Ans. Extra-amniotic ethacrydine lactate



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