APEA Pharm–Women’s Health Study
Guide aligned with an updated
2026/2027 syllabus
1. Contraception Pharmacology
1. A 22-year-old wants combined oral contraceptives (COCs). She has migraines with aura.
What should you do?
Avoid estrogen-containing contraceptives due to stroke risk.
ANSWER ✓
2. Which progestin-only pill (POP) is most commonly used in the U.S.?
Norethindrone 0.35 mg.
ANSWER ✓
3. A patient on COCs misses 2 active pills in week 3. What is the correct action?
Take the most recent missed pill, discard others, finish pack, skip placebo week.
ANSWER ✓
4. Which antibiotic is known to reduce COC efficacy (though evidence is weak)?
Rifampin (rifampicin).
ANSWER ✓
5. A breastfeeding patient at 8 weeks postpartum wants contraception. Which method is
preferred?
Progestin-only pill, implant, or IUD.
ANSWER ✓
6. What is the main mechanism of the etonogestrel implant (Nexplanon)?
Ovulation suppression and cervical mucus thickening.
ANSWER ✓
7. A patient on the etonogestrel implant has heavy bleeding. First-line management?
NSAIDs or short-term COCs to control bleeding.
ANSWER ✓
8. Which copper IUD is available in the U.S.?
ParaGard T 380A.
ANSWER ✓
, 9. A copper IUD user has heavy, painful periods. What can be offered?
NSAIDs or switching to levonorgestrel IUD.
ANSWER ✓
10. Levonorgestrel IUD (Mirena) is FDA-approved for how many years for contraception?
8 years.
ANSWER ✓
11. A patient with BMI > 35 wants emergency contraception (EC). Which is most effective?
Copper IUD or ulipristal acetate (Ella).
ANSWER ✓
12. When should ulipristal acetate be taken for EC?
Within 120 hours (5 days) of unprotected intercourse.
ANSWER ✓
13. Levonorgestrel EC is less effective if taken after what time?
After 72 hours, and if weight > 165 lb (75 kg).
ANSWER ✓
14. A patient on enzyme-inducing antiepileptics wants COCs. What should you do?
*Increase estrogen dose (≥ 50 mcg) or use non-hormonal/IUD.*
ANSWER ✓
15. Depo-medroxyprogesterone acetate (DMPA) is given how often?
Every 11–13 weeks (90 days).
ANSWER ✓
16. Long-term DMPA use is associated with what bone density concern?
Decreased BMD, usually reversible after discontinuation.
ANSWER ✓
17. A patient wants the vaginal ring (NuvaRing). How long is it left in?
3 weeks in, 1 week out.
ANSWER ✓
18. The contraceptive patch (Xulane) should not be used if BMI > ?
BMI > 30 (higher VTE risk, lower efficacy).
ANSWER ✓
19. Which drug reduces efficacy of all hormonal contraceptives?
St. John’s wort.
ANSWER ✓
20. A patient has a history of DVT. Which contraceptives are safe?
Progestin-only, copper IUD, or levonorgestrel IUD.
ANSWER ✓
Guide aligned with an updated
2026/2027 syllabus
1. Contraception Pharmacology
1. A 22-year-old wants combined oral contraceptives (COCs). She has migraines with aura.
What should you do?
Avoid estrogen-containing contraceptives due to stroke risk.
ANSWER ✓
2. Which progestin-only pill (POP) is most commonly used in the U.S.?
Norethindrone 0.35 mg.
ANSWER ✓
3. A patient on COCs misses 2 active pills in week 3. What is the correct action?
Take the most recent missed pill, discard others, finish pack, skip placebo week.
ANSWER ✓
4. Which antibiotic is known to reduce COC efficacy (though evidence is weak)?
Rifampin (rifampicin).
ANSWER ✓
5. A breastfeeding patient at 8 weeks postpartum wants contraception. Which method is
preferred?
Progestin-only pill, implant, or IUD.
ANSWER ✓
6. What is the main mechanism of the etonogestrel implant (Nexplanon)?
Ovulation suppression and cervical mucus thickening.
ANSWER ✓
7. A patient on the etonogestrel implant has heavy bleeding. First-line management?
NSAIDs or short-term COCs to control bleeding.
ANSWER ✓
8. Which copper IUD is available in the U.S.?
ParaGard T 380A.
ANSWER ✓
, 9. A copper IUD user has heavy, painful periods. What can be offered?
NSAIDs or switching to levonorgestrel IUD.
ANSWER ✓
10. Levonorgestrel IUD (Mirena) is FDA-approved for how many years for contraception?
8 years.
ANSWER ✓
11. A patient with BMI > 35 wants emergency contraception (EC). Which is most effective?
Copper IUD or ulipristal acetate (Ella).
ANSWER ✓
12. When should ulipristal acetate be taken for EC?
Within 120 hours (5 days) of unprotected intercourse.
ANSWER ✓
13. Levonorgestrel EC is less effective if taken after what time?
After 72 hours, and if weight > 165 lb (75 kg).
ANSWER ✓
14. A patient on enzyme-inducing antiepileptics wants COCs. What should you do?
*Increase estrogen dose (≥ 50 mcg) or use non-hormonal/IUD.*
ANSWER ✓
15. Depo-medroxyprogesterone acetate (DMPA) is given how often?
Every 11–13 weeks (90 days).
ANSWER ✓
16. Long-term DMPA use is associated with what bone density concern?
Decreased BMD, usually reversible after discontinuation.
ANSWER ✓
17. A patient wants the vaginal ring (NuvaRing). How long is it left in?
3 weeks in, 1 week out.
ANSWER ✓
18. The contraceptive patch (Xulane) should not be used if BMI > ?
BMI > 30 (higher VTE risk, lower efficacy).
ANSWER ✓
19. Which drug reduces efficacy of all hormonal contraceptives?
St. John’s wort.
ANSWER ✓
20. A patient has a history of DVT. Which contraceptives are safe?
Progestin-only, copper IUD, or levonorgestrel IUD.
ANSWER ✓
