OCP of choice is alesse<\/p>\n
seasonale is a new 3 month cycle pill, but the same is safe with standar pills, just keep taking the actual drug for 12 weeks, discarding the placebos, then skip a week before starting over.<\/p>\n
Antibiotics do not effect OCP efficacy except for Anti-TB agents (J Amer Acad Derm 46(6):917, 2002)<\/p>\n
more ocp info<\/a><\/p>\n Mirena<\/p>\n 5 years<\/p>\n progesterone eluting<\/p>\n brown strings<\/p>\n decreased periods<\/p>\n Paragard<\/p>\n copper eluting<\/p>\n increased periods<\/p>\n clear\/white strings<\/p>\n 10 years<\/p>\n strings should be 2.5 cm<\/p>\n Morning after regimen is 1 plan b (levonorgestrel .75 mg) or ovral at presentation and then 12 hours later. It will not hurt an existing pregnancy.<\/p>\n Can take both plan b tabs at once with no increased pregnancies or side effects (multicenter randomized trial. Lancet<\/i> 2002;360:1803-10<\/a>)<\/p>\n best article (Annals of Intern Med Emergency Contraception 6 August 2002 | Volume 137 Issue 3 | Pages 180-189)<\/p>\n Orally administered mifepristone, an antiprogestin, is also effective as emergency contraception. Randomized, controlled trials have shown that a single oral 600-mg dose of mifepristone was more effective and less noxious than the Yuzpe regimen (13) or danazol (14). Another trial (15) found that lower doses (50 mg and 10 mg) were as effective as the 600-mg dose.<\/p>\n http:\/\/www.not-2-late.com<\/a><\/p>\n The preferred management of vomiting shortly after taking emergency contraception is unknown (58). Some investigators suggest that vomiting indicates that sufficient quantities of steroid have been absorbed. Others recommend repeating the dose, particularly if the vomiting occurs shortly after the dose is taken (within 1 hour). In cases of severe vomiting, the pills can be administered vaginally. Small studies of regular oral contraceptive pills administered by this route indicate that the hormones are absorbed through the vaginal epithelium (74, 75); this has been found to be true for other pills as well (76-78).<\/p>\n <\/p>\n Much better is<\/p>\n Ulipristal (Ella) for Emergency Contraception<\/strong><\/p>\n no deaths by this agent, though prostoglandins can not say the same<\/p>\n <\/p>\n A tampon or pad holds 25 cc of blood<\/p>\n Cervical Polyps\/CA.<\/p>\n Fibroids (Submucosal Myomas).<\/p>\n Uterine CA<\/p>\n Ovarian Cysts<\/p>\n very common at menarche, also c birth control pills. Anovulatory cycles. R\/o coagulation defects and especially consider VWD.<\/p>\n give estrogen (Premarin 25 mg IVPB Q4-6) and send home on OCPs (estrogen only is needed initially.) Use the high dose OCPs, such as or if giving the low dose, use BID dosing without the placebo for 6-8 weeks. Wait one week and then start progesterone. After a few weeks, withdraw the progesterone to allow bleeding.<\/p>\n very common at menarche, also c birth control pills. Anovulatory cycles. R\/o coagulation defects and especially consider VWD.<\/p>\n give estrogen (Premarin 25 mg IVPB Q4-6) and send home on OCPs (estrogen only is needed initially.) Use the high dose OCPs, such as or if giving the low dose, use BID dosing without the placebo for 6-8 weeks. Wait one week and then start progesterone. After a few weeks, withdraw the progesterone to allow bleeding.<\/p>\n Ortho-Novum 1\/50 or Norinyl 1+50 2-4 pills OD for 3-5 days<\/p>\n then 1 pill OD for rest of month.<\/p>\n Ortho-Novum 1\/50 or Norinyl 1+50 2-4 pills OD for 3-5 days then 1 pill OD for rest of month.<\/p>\n If bleeding is severe:<\/p>\n Give 4 tabs ortho tricyclin (need pill with 35 mg estradiol) for 2 days, 3 tabs for 2 days, 2 tabs for 2 days, and 1 tab for 2 days. Pt’s need to be given an anti-emetic as well.<\/p>\n Acute Pelvic Pain<\/p>\n Do pelvic unless you expect placenta previa, in which case get UTS then do pelvic<\/p>\n Adler\u0092s Sign-<\/b>to differentiate between appendicitis and tuboovarian pathology in RLQ pain. Find point of maximal tenderness while the patient is supine. Have them roll onto left side. If pain shifts towards center then may be tubo-ovarian.<\/p>\n ovary can twist on its vasculature (cyst or tumor predispose)<\/p>\n Suspect with enlarged ovary or pelvic surgery (eg. Tubal ligation)<\/p>\n Classic: colicky pain in lower quadrant radiating to flank or groin accompanied by n\/v.<\/p>\n 50% may have abd mass<\/p>\n False negative ultrasound including doppler in 61% of pregnant woemn and 45% of non-pregnant women (AJOG 2010;202:536;e1-6)<\/p>\n follicular or corpus luteum<\/p>\n usually after procedure or during pregnancy<\/p>\n Fibroids-ischemic necrosis, torsion, infection<\/p>\n Dysmenorrhea<\/p>\n Ultrasound is actually not very sensitive (The Journal of Emergency Medicine, Vol. 40, No. 2, pp. 170\u0096175, 2011)<\/p>\n Endometriosis-false implantation of endometrial tissue<\/p>\n | | |<\/p>\n","protected":false},"excerpt":{"rendered":" Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[12],"tags":[],"yoast_head":"\n<\/span>IUDs<\/span><\/h2>\n
<\/span>Morning After Pill<\/span><\/h2>\n
![](\"\/wp-content\/images\/part1\/emergcontra_small.gif\")
<\/a><\/p>\n<\/span>RU-486<\/span><\/h2>\n
<\/h4>\n
<\/span>STDs<\/span><\/h2>\n
<\/span>STDs<\/a><\/span><\/h3>\n
<\/span>Vaginal Bleeding<\/span><\/h2>\n
<\/span>Dysfunctional Uterine Bleeding (DUB)<\/span><\/h2>\n
<\/span>Dysfunction Uterine Bleeding (DUB)<\/span><\/h3>\n
<\/span>Vaginal Bleeding in Pregnancy<\/a><\/span><\/h2>\n
<\/span>Ovarian Torsion<\/span><\/h2>\n
<\/span>Ovarian Cysts<\/span><\/h2>\n
<\/span>Uterine Perforation<\/span><\/h2>\n
<\/h4>\n
<\/span>Tuboovarian Abscess<\/span><\/h2>\n
<\/span>Endometriosis<\/span><\/h2>\n