MP CHO - 2022
Obstetrics & Gynaecology
Easy
The most commonly used third-generation intrauterine device is?
Appeared in: MP CHO - 2022
Explanation
- Mirena is classified as a third-generation IUD because it is a medicated device that releases a hormone (levonorgestrel).
- Third-generation IUDs use a progestin to provide high contraceptive efficacy, thicken cervical mucus, and alter the endometrium.
- Among the third-generation devices, Mirena is the most widely used globally, as Progestasert, an earlier hormonal IUD, is no longer manufactured or in common use due to its short one-year duration.
Why Other Options Were Wrong
- Option B: Although it is a third-generation (hormone-releasing) IUD, it has a short effective life of only one year. It has been largely replaced by newer, longer-acting devices like Mirena and is no longer commonly used.
- Option C: This is a second-generation IUD. Second-generation devices work by releasing copper ions, which create an inflammatory reaction toxic to sperm, not by releasing hormones.
- Option D: This is a first-generation, non-medicated (inert) IUD. It is now considered obsolete and is no longer used in clinical practice due to lower efficacy and higher rates of side effects.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Intrauterine Devices (IUDs) by generation and common examples as background academic context rather than a clinical decision trigger.
- Understanding IUD generations helps nurses counsel patients on the most appropriate choice based on their health history, desire for hormonal vs. non-hormonal methods, and desired duration of contraception.
- Nurses must educate patients on the different side effect profiles: second-generation copper IUDs often increase menstrual bleeding, while third-generation hormonal IUDs like Mirena typically reduce it or cause amenorrhea.
- A key nursing role is teaching patients how to check for IUD strings monthly to ensure the device has not been expelled, which is crucial for preventing unintended pregnancy.
How to Approach the Question
- Identify the key terms in the question: 'most commonly used' and 'third-generation intrauterine device'.
- Recall the classification of IUDs into three generations based on their composition and mechanism.
- First generation: Inert/non-medicated (e.g., Lippes Loop).
- Second generation: Copper-releasing (e.g., Copper T-380).
- Third generation: Hormone-releasing (e.g., Progestasert, Mirena).
- Evaluate the options based on this classification. This eliminates Lippes Loop (1st gen) and Copper T-380 (2nd gen).
Concept Tested & Keywords
- Concept Tested: Classification of Intrauterine Devices (IUDs) by generation and common examples.
- Stem keywords: intrauterine device, third-generation, most commonly used
- Lead-in keywords: most commonly used
- Negative lead-in flag: false
Question ID
QrXA1FAntVifIySA_QrW9D
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 190-192
E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart B (pp 276-535 of 550) p. 45-47
E6 Gynecology Williams p. 116-144
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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