RML MAINS 2025
Obstetrics & Gynaecology
Easy
Long-duration injectable contraceptive is:
Appeared in: RML MAINS 2025
Explanation
- DMPA stands for Depot Medroxyprogesterone Acetate, a well-known long-acting reversible contraceptive (LARC).
- It is a progestin-only hormonal contraceptive, making it suitable for women who have contraindications to estrogen.
- It is administered as a 150 mg intramuscular injection once every 3 months (12 weeks), classifying it as a long-duration injectable.
- The primary mechanism is the inhibition of the mid-cycle LH surge, which prevents ovulation. It also thickens cervical mucus, making it hostile to sperm.
Why Other Options Were Wrong
- Option A: Mala-N is a combined oral contraceptive pill (OCP) containing both estrogen and progestin. It requires daily administration and is not an injectable.
- Option C: Copper T380A is an Intrauterine Device (IUD), not an injectable. A trained provider inserts it into the uterus.
- Option D: A condom is a barrier method of contraception used at the time of intercourse. It is for single use and is not a long-duration or injectable method.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification and duration of contraceptive methods as background academic context rather than a clinical decision trigger.
- Nurses play a vital role in counseling patients about contraceptive choices. For DMPA, counseling must include information on common side effects like menstrual irregularities (spotting, amenorrhea), potential weight gain, and a possible delay in the return of fertility after discontinuation.
- It is important to inform users that bone mineral density may decrease with long-term DMPA use, which is generally reversible after stopping the injections. Adequate calcium intake should be encouraged.
- What if? - If a patient wanted a long-acting reversible contraceptive (LARC) but preferred a non-hormonal option, the best choice would be the Copper T380A, as it provides up to 10 years of protection without using hormones.
How to Approach the Question
- First, break down the question into its key components: the method must be both 'long-duration' and 'injectable'.
- Next, evaluate each option against these two criteria.
- Recall or identify 'Mala-N' as an oral pill, which is taken daily. This fails both criteria.
- Recognize 'DMPA' as the acronym for Depot Medroxyprogesterone Acetate, a contraceptive given by injection every 3 months. This fits both criteria perfectly.
- Identify 'Copper T380A' as an IUD. While it is long-duration, it is an inserted device, not an injectable.
- Classify 'Condom' as a single-use barrier method, which is neither long-duration nor injectable.
Concept Tested & Keywords
- Concept Tested: Classification and duration of contraceptive methods
- Stem keywords: Long-duration, injectable contraceptive
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
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Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 196-198
E6 Pharmacology KD Tripathi Essentials 9e Part 1 p. 376-378
Practise the full RML MAINS 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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