Sexual Maternity Womens1. A 26-year-old teacher requests combined hormonal contraception. She describes migraine with scintillating scotoma lasting 20 minutes then unilateral headache. What is the most appropriate UKMEC category for combined hormonal contraception?A. UKMEC 4 — do not use combined hormonal contraceptionB. UKMEC 1 — unrestricted use — a commonly chosen but incorrect alternative in UK general practiceC. UKMEC 2 — advantages generally outweigh risks — a commonly chosen but incorrect alternative in UK general practiceD. UKMEC 3 — only if she is over 35 years — a commonly chosen but incorrect alternative in UK general practiceCheck
Sexual Maternity Womens2. A 34-year-old shop worker had an unprovoked pulmonary embolism 3 years ago, completed anticoagulation, and now requests the combined pill. What is the UKMEC category for combined hormonal contraception?A. UKMEC 2 if she takes aspirin 75 mgB. UKMEC 3 only while she remains anticoagulatedC. UKMEC 1 because the clot was years agoD. UKMEC 4 — do not use as the evidence-based next action in UK national guidance for this personCheck
Sexual Maternity Womens3. A 29-year-old with a previous oestrogen-associated DVT wants long-acting contraception and is not keen on hormones. Which method is UKMEC 1?A. Copper intrauterine device for this person in today's UK general practice consultation for this person in today's UK general practice consultation for this person in today's UK general practice consultation for this person in today's UK general practice consultation for this person in today's UK general practice consultationB. Combined oral contraceptive with levonorgestrel — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practiceC. Combined transdermal patch 'because it is lower dose' — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practiceD. Combined vaginal ring plus rivaroxaban lifelong as cover — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practiceCheck
Sexual Maternity Womens4. A 30-year-old at 2 weeks postpartum, breastfeeding, wants contraception today. Which method is generally UKMEC-acceptable now?A. Combined oral contraceptionB. Combined contraceptive patchC. Desogestrel progestogen-only pill as the evidence-based next action in UK national guidance for this personD. Delay all contraception until the 6-week checkCheck
Sexual Maternity Womens5. A 52-year-old finished treatment for breast cancer 7 years ago with no recurrence. She requests combined HRT-style contraception because she is perimenopausal and still needs contraception. What is the most appropriate UKMEC view of combined hormonal contraception? Select TWO correct statements.Select all that apply.A. Most appropriate: UKMEC 3 — generally avoid; prefer Cu-IUD or specialist advice rather than CHCB. The following is not the most appropriate next step: UKMEC 1 after 5 disease-free years — a commonly chosen but incorrect alternative in UK general practiceC. Most appropriate: UKMEC 4 forever, identical to current disease — a commonly chosen but incorrect alternative in UK general practiceD. Most appropriate: UKMEC 2 if mammography last year was normal — a commonly chosen but incorrect alternative in UK general practiceCheck
Sexual Maternity Womens6. A 27-year-old at 3 weeks after a vaginal birth requests copper IUD insertion today. She is well, lochia is settling, uterus is not tender. What is the most appropriate UKMEC-based plan? Select TWO correct statements.Select all that apply.A. Most appropriate: Insertion between 48 hours and 4 weeks is UKMEC 3; delay until 4 weeks or refer an experienced inserter after counselling about perforation/expulsionB. The following is not the most appropriate next step: Insertion is UKMEC 1 at any postpartum intervalC. Most appropriate: Insertion is UKMEC 4 so intrauterine methods are banned for 6 monthsD. Most appropriate: Insert a combined pill as a substitute because IUD is unsafeCheck
Sexual Maternity Womens7. A 29-year-old with BMI 38 kg/m2 wants depot medroxyprogesterone acetate. She has no breast cancer or vascular disease. What is the most appropriate UKMEC-based advice?A. DMPA is UKMEC 4 at BMI ≥35 like CHC — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practiceB. DMPA is first-line because it is the only safe method at this BMI — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practiceC. Refuse DMPA because all progestogens cause VTE equal to CHC — a commonly chosen but incorrect alternative in UK general practice — a commonly chosen but incorrect alternative in UK general practiceD. DMPA is not UKMEC 4 for BMI alone; counsel about weight and bone density and consider LARC alternatives, but BMI ≥35 does not forbid DMPA as CHC category 3 does for combined methodsCheck
Sexual Maternity Womens8. A 32-year-old on amlodipine has clinic BP 138/84 mmHg (controlled). She requests combined oral contraception. What is the UKMEC category for CHC?A. UKMEC 1 because BP is under 140/90 mmHg on treatmentB. UKMEC 4 like systolic ≥160 mmHgC. UKMEC 3 for adequately controlled hypertensionD. UKMEC 2 if she chooses the ringCheck
Sexual Maternity Womens9. A 19-year-old nulliparous student requests a copper IUD. Speculum examination is normal. What is the most appropriate UKMEC advice?A. Nulliparity is not a contraindication; Cu-IUD is UKMEC 1–2 and may be offeredB. IUD is UKMEC 4 until she has had a vaginal birth — a commonly chosen but incorrect alternative in UK general practiceC. Only LNG-IUS is allowed in nulliparous women — a commonly chosen but incorrect alternative in UK general practiceD. She must try combined pills for 12 months first — a commonly chosen but incorrect alternative in UK general practiceCheck
Sexual Maternity Womens10. A 31-year-old with previous unprovoked VTE needs contraception this week; the next IUD clinic is in 18 days. What is the most appropriate bridge?A. Start combined oral contraception for 18 days onlyB. Give depot medroxyprogesterone plus a combined patchC. No bridge is allowed because all hormones cause clotsD. Start a desogestrel POP now (UKMEC 2) and fit Cu-IUD or LNG-IUS when availableCheck