NBME Step 2 CK Form 7 Oral contraceptive therapy (NBME Answers)

Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 2/Question#15 (reveal difficulty score)
An asymptomatic 22-year-old nulligravid woman ...
Oral contraceptive therapy 🔍 / 📺 / 🌳 / 📖
tags: repro inc

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submitted by ∗russnels(20)

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My understanding was that both IUDs and OCP can reduce risk of ovarian epithelial cancer. Anybody know why OCPs are better than IUDs?

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lindasmith462 I think it's just that OCPs have been better studied so far than IUDs (but so far studies do indicate that IUDs are protective as well so its pretty weak on NBME - we shouldn't know which one is "better studied"). Also its not even the right answer - with a first degree relative this pt meets qualifications to get genetic testing - you would only offer OCP IF her genetic testing is negative (at the very least she should have a more thorough intentional family history other thank IDK of anyone else with cancer in my fam lol!) +1

merpaperple I had the same thought. OCPs work by suppressing ovulation -> less risk of ovarian cancer IUDs work by either thickening cervical mucus (progestin) or local inflammation (copper) This is how I'm trying to make sense of it anyways +

groovygrinch I generally of IUD's as being primarily locally acting in the uterus/endometrium vs OCP's being more systemic. 50/50 though +

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submitted by ∗carolebaskin(109)

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OCPs offer significant protection against

Ovarian cancer: decreased ovulation --> less damage
endometrial cancer: decreased endometrial proliferation
iron-deficiency anemia: decreased bleeding
reduced risk of benign breast disease

IUDs only act locally

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jlbae thank you carole baskin +1

beans123 IUD's only act locally yes... but the risk for ovarian cancer comes from repeated damage to the ovary every time you ovulate... IUD's cause people not to ovulate as well so it not being "systemic" doesn't really matter here.. still crappy they had both listed +

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submitted by ∗step_prep5(246)

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Benefits of OCPs: Contraceptive, decreased endometrial and ovarian cancer, treatment of hyperandrogenism (PCOS, acne)
Risks of OCPs: DVTs, hypertension, hepatic adenoma, stroke, increased risk of cervical cancer
Key idea: No effective screening (imaging, lab test) is routinely available for ovarian cancer

https://step-prep.org/tutoring/

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submitted by misscorona(5)

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UpToDate listed protective factors: + Bilateral salpingo-oophorectomy + Use of oral contraceptives + Tubal ligation + Hysterectomy + Breastfeeding + Parity @russnels not sure about IUDs

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submitted by ∗krewfoo99(115)

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Im assuming OC pills over IUD since its less invasive. However, the risk of adverse effects would be higher.

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