This set of Molecular Endocrinology Multiple Choice Questions & Answers (MCQs) focuses on “Combined Estrogen and Progestin Contraceptives”.
1. Which among the following is an example of older Combined oral contraceptive pills (COCPs)?
a) Norethindrone
b) Androgenic progestins
c) Norgestimate
d) Desogestre
View Answer
Explanation: The strong estrogen ethinyl estradiol is used by all current COCPs formulated with 35 μg of estrogen or less. Each of the five progestin includes older COCP preparations: norethindrone, acetate of norethindrone, diacetate of ethynodiol, norgestrel, or levonorgestrel.
2. Which among the following is an example of newer Combined oral contraceptive pills (COCPs)?
a) Norethindrone
b) Norgestimate
c) Ethynodiol
d) Norgestrel
View Answer
Explanation: The dosage of estrogen and progestin in COCPs has steadily decreased over time, and the progestin type has improved. The less androgenic progestin, Norgestimate, Desogestre, and drospirenone are used in newer formulations.
3. Which among the following is the most common gynecologic cancer in U.S. women?
a) Mammalian lymphoma
b) Ovarian cyst
c) Endometrial adenocarcinoma
d) Melanoma
View Answer
Explanation: The most common gynecologic cancer in U.S. women is endometrial adenocarcinoma. Through the use of COCP, the incidence of endometrial adenocarcinoma is decreased by 50% and protection continues for at least 20 years after the discontinuation of oral contraception.
4. Combined oral contraceptive pills (COCPs) offer safe, reversible, and convenient birth control.
a) True
b) False
View Answer
Explanation: Combined oral contraceptive (COCP) pills provide safe, reversible, and easy birth control that is highly effective for those who take pills correctly on a regular basis. Oral contraception offers essential non-contraceptive advantages in many settings.
5. COCPs were originally formulated to mimic the normal menstrual cycle.
a) True
b) False
View Answer
Explanation: Initially, COCPs were formulated to imitate the natural menstrual cycle. Modern COCPs appear to contain active pills for 21 to 24 days, although there is no proof that any health benefits are given by a hormone-free interval.
6. Which among the following is the common side effect of Combined oral contraceptive pills (COCPs)?
a) Hormonal imbalance
b) Vaginal bleeding
c) Testicular pain
d) Diarrhea
View Answer
Explanation: Unforeseen vaginal bleeding is common, affecting approximately 25% of COCP users during the initial 3 months of use, but with continued COCP use, the incidence declines. Unscheduled bleeding is more likely with ethinyl estradiol preparations at lower doses (20 μg) than at normal doses (30 or 35 μg).
7. Which among the following is the example of condition for safety of COCP in which the theoretical or proven risks usually outweigh the advantages?
a) Gallbladder disease
b) Kidney Stone
c) Diarrhea
d) Leptonema
View Answer
Explanation: Four categories consider the protection of COCP. The situation where potential or confirmed risks generally outweigh the benefits is one of the conditions. Gallbladder disease, less than 21 days after birth, lactation up to 6 months after delivery, and drugs that may interfere with the effectiveness of COCP are examples.
8. Which among the following is the example of a condition for safety of COCP in which there is presence of an unacceptable health risk if the contraceptive method is used?
a) Gallbladder disease
b) Lactation up to 6 months after delivery
c) Drugs interfering with the effectiveness of COCP
d) Cardiovascular accident
View Answer
Explanation: One among the conditions for the safety of COCP is the existence of an unacceptable health risk if the contraceptive method is used. The personal history of deep venous thrombosis or pulmonary embolism, cardiovascular injuries, documented patterns in thrombophilia, and migraine headaches with aura or other neurological symptoms are examples.
9. The established increased risk of venous thromboembolism (VTE) is related to which among the following components?
a) Estrogenic component
b) Progesterone component
c) Androstenedione component
d) FSH component
View Answer
Explanation: The estrogenic component is linked to the identified increased risk of venous thromboembolism (VTE). There is a lower risk for low-dose preparations, but the incidence of VTE is still increasing. A fourfold increased risk of VTE is associated with COCPs containing less than 50 mg of ethinyl estradiol.
10. Anticonvulsants and antibiotics that induce which among the following enzymes may reduce the contraceptive efficacy of COCPs?
a) Aromatases
b) Hepatic enzymes
c) Pancreatic lipases
d) Cardiac enzymes
View Answer
Explanation: The contraceptive effectiveness of COCPs can be decreased by anticonvulsants and antibiotics that trigger hepatic enzymes. In these cases, it may be safer to use high dose progestin-only approaches such as depot medroxyprogesterone acetate (DMPA) or intrauterine contraception.
11. What is the name of the contraceptive patch which is used as a transdermal acceptable alternative to COCPs?
a) Ortho Evra
b) NuvaRing
c) Mewiral
d) Evecare
View Answer
Explanation: Ortho Evra is an example of the contraceptive patch which can be used as transdermal acceptable alternative to COCPs. In order to provide combined estrogen-progestin contraception, the transdermal and transvaginal routes are safe and appropriate alternatives to COCPs.
12. What is the name of the contraceptive vaginal ring which is used as a transdermal acceptable alternative to COCPs?
a) Ortho Evra
b) NuvaRing
c) Mewiral
d) Evecare
View Answer
Explanation: The contraceptive vaginal ring (NuvaRing) offers estrogen-progestin contraceptives for women without taking daily pills. The ring is inserted into the vagina for 3 weeks and then removed for 1 week, after which it is expected to have withdrawal bleeding.
13. Which is the biologically active metabolite of the progestin Norgestimate?
a) Norelgestromin
b) Norelegromin
c) Noradrostenedione
d) Progestenone
View Answer
Explanation: Norelgestromin is the biologically active metabolite of the progestin Norgestimate. Ortho Evra is the only contraceptive patch that is available in United States. Together with Norelgestromin, they release 20 μg of ethinyl estradiol every day.
14. Which is the biologically active metabolite of the progestin desogestrel?
a) Ethinyl estradiol
b) Norelgestromin
c) Etonogestrel
d) Progestenone
View Answer
Explanation: Ethinyl estradiol is the biologically active metabolite of the progestin desogestrel. The vaginal mucosa provides excellent sex steroid absorption. In the United States, the only contraceptive vaginal ring available is the NuvaRing that releases ethinyl estradiol, a 4 mm thick, flexible plastic ring with an outside diameter of 54 mm.
15. What is the main disadvantage of the progestin-only contraceptives?
a) Changes in vaginal bleeding patterns
b) Changes in ovulation
c) Fluctuation in menstrual cycle
d) Polycystic Ovarian Syndrome
View Answer
Explanation: Changes in vaginal bleeding patterns are the primary downside of progestin-only contraceptives. This is predominant in consumers of progestinone oral contraceptives and is the most common cause of discontinuation of contraception.
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