MP CHO - 2022
Pharmacology
Easy
All of the following are progestogen-only injectables except?
Appeared in: MP CHO - 2022
Explanation
- Ethinyl estradiol is a synthetic form of estrogen, a primary female sex hormone.
- It is not a progestogen and is not administered as a progestogen-only injectable contraceptive.
- Its primary use in contraception is as the estrogen component in combined hormonal methods (e.g., combined oral contraceptive pills, patches, and rings) to inhibit ovulation and stabilize the endometrium.
Why Other Options Were Wrong
- Option A: DMPA (Depot Medroxyprogesterone Acetate) is a classic example of a progestogen-only injectable contraceptive.
- Option B: NET-EN (Norethisterone Enanthate) is another common progestogen-only injectable contraceptive.
- Option C: DMPA-SC is a subcutaneous formulation of Depot Medroxyprogesterone Acetate, making it a progestogen-only injectable.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of hormonal contraceptives as background academic context rather than a clinical decision trigger.
- Understanding the difference between progestogen-only and combined hormonal contraceptives is crucial for patient counseling regarding side effects, benefits, and contraindications. Estrogen-containing methods have different risk profiles (e.g., increased risk of thrombosis) compared to progestogen-only methods.
- Progestogen-only methods are often preferred for women who are breastfeeding or have contraindications to estrogen, such as a history of DVT, pulmonary embolism, stroke, or migraine with aura.
- What if? If a patient is 4 weeks postpartum and breastfeeding, a progestogen-only method like DMPA or NET-EN is a suitable option. A combined method containing ethinyl estradiol would generally be avoided until at least 6 weeks postpartum due to potential effects on milk supply and increased thrombotic risk.
How to Approach the Question
- This is a negative-framing question using the word 'except'. The goal is to find the option that does not fit the category mentioned in the stem.
- First, identify the core concept: 'progestogen-only injectables'. This means the contraceptive is delivered by injection and contains only a progestin hormone, with no estrogen.
- Evaluate each option against this definition.
- Recall or identify that DMPA, NET-EN, and DMPA-SC are all well-known progestogen-only injectable contraceptives.
- Recognize that Ethinyl estradiol is a type of estrogen, not a progestogen. Therefore, it is the exception.
- Select the option that is the exception to the rule stated in the question stem.
Concept Tested & Keywords
- Concept Tested: Classification of hormonal contraceptives
- Stem keywords: progestogen-only injectables
- Lead-in keywords: except
- Negative lead-in flag: The question uses 'except', asking for the option that does not belong to the specified category.
Question ID
Q8AylEDO-3htUvqOQT5pOM
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 197-199
Practise the full MP CHO - 2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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