Barrier Methods of contraceptions

Barrier Methods of contraceptions

Q. 1

Spermicidal jelly acts through :

 A

Acrosomal enzyme

 B

Cervical enzyme alteration

 C

Glucose uptake inhibition by sperms

 D

Disruption of cell membrane

Q. 1

Spermicidal jelly acts through :

 A

Acrosomal enzyme

 B

Cervical enzyme alteration

 C

Glucose uptake inhibition by sperms

 D

Disruption of cell membrane

Ans. D

Explanation:

Ans. is d i.e Disruption of cell membrane

Spermicides :

“Spermicides are contraceptive chemical agents. They comprise,of a chemical capable of destroying sperm, incororated into an inert base. The commonly used spermicidal agents contgain nonionic surfactants which alter sperm surface membrane permeability, causing osmotic changes resulting in killing of sperm. Most of the spermicides contain nonoxynol-9 which is the best for this purpose.”


Q. 2

Spermicidal agents are :

 A

Nonoxynol

 B

Menfegol

 C

Progestasert

 D

a and b

Q. 2

Spermicidal agents are :

 A

Nonoxynol

 B

Menfegol

 C

Progestasert

 D

a and b

Ans. D

Explanation:

Ans. is a and b i.e. Nonoxynol; and Menfegol

  • Spermicidal agents kill the sperms before it enters to the cervical canal. They are available as foam tablets, soluble pessaries, creams, jellies or as films.
  • Contents are :             Nonoxynol – 9 (N – 9)

Octoxynol

Menfegol

Enzyme inhibiting agents

Benzalknonium chloride.

  • Failure rate is 20-25 per 100 woman years when used alone. When used in conjunction with a mechanical barrier, they give a reliable contraceptive effect.

Note :4, Recent evidences indicate spermicides are not effective in preventing cervical Gonorrhoea, Chlamydia or HIV infection. In addition, frequent use of spermicides containing N-9 has been associated with an increased risk of HIV transmission.

  • Advantage 24 is a new contraceptive gel which contains nonoxynol.

Most common problem associated with the use of condom is Contact Dermatitis.



Q. 3

Best mode of contraception for a newly married lady with rheumatic heart disease :

 A

Oral pills

 B

Norplant

 C

IUCD

 D

Condom

Q. 3

Best mode of contraception for a newly married lady with rheumatic heart disease :

 A

Oral pills

 B

Norplant

 C

IUCD

 D

Condom

Ans. D

Explanation:

Ans. is d i.e Condom


Q. 4

Pelvic Inflammatory Disease occurs least com­mon with :

 A

OCPs

 B

Condom

 C

IUCD

 D

Diaphragm

Q. 4

Pelvic Inflammatory Disease occurs least com­mon with :

 A

OCPs

 B

Condom

 C

IUCD

 D

Diaphragm

Ans. B

Explanation:

Ans. is b i.e. Condom

Barrier methods (especially condom) and OCP’s both protect against PID, but the protection offered by OCP’s is less than that by Barrier method.

“The incidence of pelvic inflammatory disease (P1D) is reduced. though it does not reach the same low level as seen with the barrier methods.”

As far as diaphragm is concerned, it does not protect against HIV, whereas condom does.



Q. 5

Which one of the following is not a correct statement regarding the use of condom :

 A

Air should be squeezed out of tip

 B

It should be tested by inflating

 C

It should be unrolled on erect penis

 D

K-Y jelily may be used for lubrication

Q. 5

Which one of the following is not a correct statement regarding the use of condom :

 A

Air should be squeezed out of tip

 B

It should be tested by inflating

 C

It should be unrolled on erect penis

 D

K-Y jelily may be used for lubrication

Ans. B

Explanation:

Ans. is b i.e. It should be tested by inflating

Directions for use of condom :

  1. The condom should be put on by unrolling it over the erect penis after pulling back the foreskin, before there is any contact between the male and female organs. An airfree space should be left by squeezing the tip and holding it up till it is unrolled fully for better collection of semen.
  2. It should be used only once.
  3. It should not be inflated for testing.
  4. Vaseline oils, skin lotions, cold creams, should not be used as they increase the chance of rupture. If lubrication is needed, glycerine, K-Y jelly or spermicidal jelly can be used.
  5. Soon after discharge, the male should withdraw the penis holding the condom firmly against his body
  6. To increase the effectiveness, a dose of spermicidal jelly or foam tablet may be used at the same time. In case of breakage, slippage, or defective use, women should report or use emergency contraceptive within 72 hours and a spermicidal agent should be quickly inserted into the vagina.



Q. 6

A case of vasectomy is said to have failed as the vasectomised person’s wife gives birth to a child ten months after the operation. Which one of the following is the most probable cause :

 A

Failure of the husband to use a condom after vasectomy

 B

Surgical failure

 C

Recanalisation

 D

Wife had extra — marital contact

Q. 6

A case of vasectomy is said to have failed as the vasectomised person’s wife gives birth to a child ten months after the operation. Which one of the following is the most probable cause :

 A

Failure of the husband to use a condom after vasectomy

 B

Surgical failure

 C

Recanalisation

 D

Wife had extra — marital contact

Ans. A

Explanation:

Failure of the husband to use a condom after vasectomy


Q. 7

Which one of the following is the most common problem associated with the use of condom :

 A

Increased monilial infection of vagina

 B

Premature ejaculation

 C

Contact dermatitis

 D

Retention of urine

Q. 7

Which one of the following is the most common problem associated with the use of condom :

 A

Increased monilial infection of vagina

 B

Premature ejaculation

 C

Contact dermatitis

 D

Retention of urine

Ans. C

Explanation:

Contact dermatitis


Q. 8

A primipara with a cardiac lesion (MI) has come on the 40th day of delivery asking for contracep­tion. The contraceptive of choice is :

 A

Condom with spermicidal jelly

 B

Oral contraceptive pill

 C

Intrauterine contraceptive device

 D

Laproscopic sterilization

Q. 8

A primipara with a cardiac lesion (MI) has come on the 40th day of delivery asking for contracep­tion. The contraceptive of choice is :

 A

Condom with spermicidal jelly

 B

Oral contraceptive pill

 C

Intrauterine contraceptive device

 D

Laproscopic sterilization

Ans. A

Explanation:

Condom with spermicidal jelly


Q. 9

Which of the following has the least risk of ectopic pregnancy?

 A Tubectomy
 B

OC pills

 C Copper T
 D

Condoms

Q. 9

Which of the following has the least risk of ectopic pregnancy?

 A Tubectomy
 B

OC pills

 C Copper T
 D

Condoms

Ans. D

Explanation:

Condoms REF: Dutta obs 6th e p. 179-180

Condoms and diaphragms are protective for Ectopic pregnancy

Risk factors for ectopic pregnancy

  • Pelvic infections/present salphingitis
  • Contraceptives: progestasert > copper t
  • IVF/ ovulation inducers
  • Previous ectopic
  • Endometriosis
  • Fibroids
  • Developmental defects of the tube
  • Transperitoneal ovum migration
  • Salphingits icthmica nodosum
  • Cigarette smoking > 20 / day
  • Multiple partners
  • Intercourse before 18 yrs
  • In utero DES exposure
  • Age> 40 yrs
  • Tubal surgeries
  • Tubal sterilization (greatest risk within 2 yrs.)
    (Condoms and diaphragms are protective)

Q. 10

Contraceptive failures with condoms are MOST often due to which of the following?

 A

Slip off during coitus

 B

Tear during coitus

 C

Incorrect use

 D

Manufacturing defect like leak

Q. 10

Contraceptive failures with condoms are MOST often due to which of the following?

 A

Slip off during coitus

 B

Tear during coitus

 C

Incorrect use

 D

Manufacturing defect like leak

Ans. C

Explanation:

Condoms can be a highly effective method of contraception, if used correctly at every coitus.

In survey reports pregnancy rate vary from 2-3 per 100 women year to more than 14 in a typical user.

 
Ref: Park’s textbook of Preventive and Social Medicine, 21st edition, page-457

Q. 11

A 28 year old female, has come to the OP asking for contraception. She has a one year old daughter. She is diagnosed of having diabetes few months ago and it is under control with diet and exercise. Which among the following is the best contraceptive method of choice in this patient?

 A

Condoms by the husband

 B

IUCD

 C

OCP

 D

Today sponge

Q. 11

A 28 year old female, has come to the OP asking for contraception. She has a one year old daughter. She is diagnosed of having diabetes few months ago and it is under control with diet and exercise. Which among the following is the best contraceptive method of choice in this patient?

 A

Condoms by the husband

 B

IUCD

 C

OCP

 D

Today sponge

Ans. A

Explanation:

IUCD predispose to infections especially in a diabetic patient.

OCP may result in thromboembolic phenomenon.

Using condoms by the husband is the best way for contraception in this patient.


Q. 12

A 6 weeks pregnant primigravida is brought to the emergency department with severe, acute abdominal pain. USG shows ectopic pregnancy. Which of the following has the LEAST risk of ectopic pregnancy?

 A

Tubectomy

 B

Infertility >1 year

 C

Copper T

 D

Condoms

Q. 12

A 6 weeks pregnant primigravida is brought to the emergency department with severe, acute abdominal pain. USG shows ectopic pregnancy. Which of the following has the LEAST risk of ectopic pregnancy?

 A

Tubectomy

 B

Infertility >1 year

 C

Copper T

 D

Condoms

Ans. D

Explanation:

Condoms reduces the incidence of tubal infertility and ectopic pregnancy.

Risk factors of ectopic pregnancy:
  • Prior ectopic pregnancy
  • Prior tubal surgery
  • Smoking >20 cigarettes per day
  • Prior STD with confirmed PID by laparoscopy and/or positive test for Chlamydia trachomatis
  • Three or more prior spontaneous miscarriages
  • Age 40 years
  • Prior medical or surgical abortion
  • Infertility >1 year
  • Lifelong sexual partners >5
  • Previous IUD use
 
Ref: Textbook of Obstetrics by D C Dutta, 6th edition, Page 533.

Q. 13

Which is the safest contraceptive method for a woman with sickle-cell anaemia ?

 A

Intrauterine device

 B

Low dose progesterone pill

 C

Condom or diaphragm

 D

Low dose oestrogen-progesterone

Q. 13

Which is the safest contraceptive method for a woman with sickle-cell anaemia ?

 A

Intrauterine device

 B

Low dose progesterone pill

 C

Condom or diaphragm

 D

Low dose oestrogen-progesterone

Ans. C

Explanation:

Condom or diaphragm


Q. 14

On an average failure rate in the couples using condom is about

 A

0-5 percent

 B

10-20 percent

 C

30-40 percent

 D

50 percent or more

Q. 14

On an average failure rate in the couples using condom is about

 A

0-5 percent

 B

10-20 percent

 C

30-40 percent

 D

50 percent or more

Ans. B

Explanation:

Ans. is `b’ i.e., 10-20% 

Condom

o Condom is the most widely known and used barrier device by the males around the world.

o Condom prevents the semen from being deposited in vagina.

o The effectiveness of a condom may be increased by using it in conjunction with a spermicidal, jelly inserted into the vagina before intercourse. The spermicide serves as additional protection in the unlikely event that the condom should slip off or tear.

o Failure rates vary from 2-3 per 100 women years to more than 14 in typical users.


Q. 15

Dutch cap is

 A

Diaphragm

 B

Condom

 C

Vaginal sponge

 D

None

Q. 15

Dutch cap is

 A

Diaphragm

 B

Condom

 C

Vaginal sponge

 D

None

Ans. A

Explanation:

Ans. is ‘a’ i.e., Diaphragm 

Diaphragm

o Also known as Dutch cap.

o It is a vaginal barrier.

o It has a flexible rim made of spring or metal.

o It is held in position partly by the spring tension and partly by the vaginal muscle tone, so the vaginal tone must be reasonable for its use –> In cystocele (prolapse), the rim may slip down.

  • The diaphragm is inserted before sexual intercourse and must remain in place for not less than 6 hours after sexual intercourse.

o The spermicidal jelly is always used along with the diaphragm.

o Failure rate –> 6 to 12 per 100 women years.


Q. 16

Best protection from STD and Syphilis is by:

March 2005

 A

IUCD

 B

Condom

 C

OCP

 D

Tubectomy

Q. 16

Best protection from STD and Syphilis is by:

March 2005

 A

IUCD

 B

Condom

 C

OCP

 D

Tubectomy

Ans. B

Explanation:

Ans. B: Condom

Advantages of Condoms

  • Available on shelves without any medical prescription.
  • Most harmless method of contraception.
  • Best protection against sexually transmitted diseases and AIDS (HIV infection).
  • Most suitable for couples having infrequent coitus, during lactation (breast-feeding), during holidays, for teenagers particularly to prevent unwanted pregnancies.
  • Doesn’t require any special training.

Q. 17

Conventional contraception is:      

September 2006

 A

OCP

 B

Surgical sterilization

 C

Condoms

 D

IUCD

Q. 17

Conventional contraception is:      

September 2006

 A

OCP

 B

Surgical sterilization

 C

Condoms

 D

IUCD

Ans. C

Explanation:

Ans. C: Condoms

Barrier methods of contraception involve the use of device that prevents the passage of sperm through canal. Due to many reasons, use of condom is the most popular conventional contraceptive device worldwide. These are cheaper and relatively simple to use, but when used alone, the pregnancy rate is relatively high.


Q. 18

Barrier method is:          

JIPMER 13

 A

Oral contraceptive pill

 B

Intrauterine devices

 C

Spermicidal

 D

Tubectomy

Q. 18

Barrier method is:          

JIPMER 13

 A

Oral contraceptive pill

 B

Intrauterine devices

 C

Spermicidal

 D

Tubectomy

Ans. C

Explanation:

Ans. Spermicidal


Q. 19

Failure rate of female condom ‑

 A

< 1 per 100 women-years

 B

1-5 per 100 women years

 C

5-20 per 100 women years

 D

20-40 per 100 women years

Q. 19

Failure rate of female condom ‑

 A

< 1 per 100 women-years

 B

1-5 per 100 women years

 C

5-20 per 100 women years

 D

20-40 per 100 women years

Ans. C

Explanation:

Ans. is ‘c’ i.e., 5-20 per 100 women years

Female condom

  • The female condom is a pouch made of polyurethane, which lines the vagina.
  • An internal ring in the close end of the pouch covers the cervix and an external ring remains outside the vagina.
  • It is prelubricated with silicon, and a spermicide need not be used.
  • It is an effective barrier to STD infection.
  • However, high cost and acceptability are major problems.
  • The failure rates during the first year use vary from 5 per 100 women-years pregnancy rate to about 21 in typical users.

Q. 20

A 6 weeks pregnant primigravida is brought to the emergency department with severe, acute abdominal pain. USG shows the condition as represented in the picture below. Which of the following has the LEAST risk of the condition as represented in the picture below ? 

 A

Tubectomy.

 B

Infertility >1 year.

 C

Copper T.

 D

Condoms.

Q. 20

A 6 weeks pregnant primigravida is brought to the emergency department with severe, acute abdominal pain. USG shows the condition as represented in the picture below. Which of the following has the LEAST risk of the condition as represented in the picture below ? 

 A

Tubectomy.

 B

Infertility >1 year.

 C

Copper T.

 D

Condoms.

Ans. D

Explanation:

The condition shown in the USG picture above represents ectopic pregnancy.

Condoms reduces the incidence of tubal infertility and ectopic pregnancy.

Risk factors of ectopic pregnancy:
  • Prior ectopic pregnancy
  • Prior tubal surgery
  • Smoking >20 cigarettes per day
  • Prior STD with confirmed PID by laparoscopy and/or positive test for Chlamydia trachomatis
  • Three or more prior spontaneous miscarriages
  • Age 40 years
  • Prior medical or surgical abortion
  • Infertility >1 year
  • Lifelong sexual partners >5
  • Previous IUD use.


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