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Zorluk: OrtaMenstrual Cycle Abnormalities and Contraception

Match each patient's clinical profile with the most appropriate contraceptive method based on the World Health Organization Medical Eligibility Criteria (WHO MEC).

  • 37-year-old woman who smokes 1.5 packs of cigarettes daily and specifically requests an oral contraceptive method.Progestin-only oral pill
  • 28-year-old woman with Wilson disease who desires a highly effective, intrauterine contraceptive method.Levonorgestrel-releasing intrauterine device (LNG-IUD)
  • 22-year-old woman being treated for acute pelvic inflammatory disease who desires a highly effective, non-daily, reversible contraceptive.Etonogestrel subdermal implant
  • 34-year-old woman with a history of estrogen-receptor positive breast cancer treated 3 years ago who desires a long-acting reversible contraceptive.Copper intrauterine device (Cu-IUD)

Cevap

1 matches with Progestin-only oral pill; 2 matches with Levonorgestrel-releasing intrauterine device; 3 matches with Etonogestrel subdermal implant; 4 matches with Copper intrauterine device.
Each patient's clinical profile presents a specific absolute contraindication (WHO MEC Category 4) that eliminates certain contraceptive options, leaving a unique, safe, and highly effective choice that meets their stated preferences.

Adım Adım Çözüm

1
Identify the absolute contraindication (WHO MEC Category 4) for the 37-year-old heavy smoker seeking an oral method.
Estrogen-containing combined oral contraceptives are contraindicated.
There is an unacceptably high risk of thromboembolism and myocardial infarction. A progestin-only pill is the safest oral option.
2
Identify the absolute contraindication for the patient with Wilson disease seeking an intrauterine method.
The copper IUD is contraindicated.
Wilson disease prevents normal copper excretion. The LNG-IUD is a safe intrauterine alternative.
3
Identify the absolute contraindication for the patient with active PID seeking a non-daily method.
All IUD insertions are contraindicated.
Inserting an IUD during active PID can worsen the infection. The etonogestrel implant is a safe, non-daily alternative.
4
Identify the absolute contraindication for the patient with a history of breast cancer seeking a long-acting method.
All hormonal contraceptives are contraindicated.
Breast cancer is hormonally sensitive. The hormone-free copper IUD is the safest highly effective long-acting choice.

Anahtar Kavram

Selecting appropriate contraceptive methods requires recognizing WHO Medical Eligibility Criteria (MEC) Category 4 (absolute) contraindications, such as avoiding estrogen in older smokers, avoiding copper IUDs in Wilson disease, avoiding IUD insertions during active PID, and avoiding all systemic hormones in breast cancer patients.
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Menstrual Cycle Abnormalities and Contraception

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