Missed pills? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
USMLE Articles
Go Back   USMLE Forums > USMLE Step 3 Forum

USMLE Step 3 Forum USMLE Step 3 Discussion Forum: Let's talk about anything related to USMLE Step 3 exam

Thread Tools Search this Thread Display Modes
Old 05-21-2012
DrSeddik's Avatar
USMLE Forums Veteran
Steps History: 1+CK+CS
Posts: 236
Threads: 57
Thanked 455 Times in 107 Posts
Reputation: 468
Drug Missed pills?

A 25 year old female patient calls you to ask you about her oral contraceptive pills. She is your patient, she is in a monogomous relationship with her boyfriend. During her last visit to your office her last menstrual period period was 25 days ago, her pap smear was normal, her physical examination was normal otherwise. She asked you to prescribe her oral contraceptives as she and her boyfriend are not comfortable with using condoms. Now she is in the 18th day of her OCP course and she tells you that she missed taking the pills for 2 days. She had unprotected sexual intercourse with her bodyfriend yesterday. What is the most appropriate management plan:

a- Tell her to come to your office to prescribe emergency contraception
b- Take the 2 pills and continue her course as if she did not miss them
c- abstinence from sex for 7 days, take the two pills, and after she finishes the 3rd week, she should discard the 7 "inactive pills" and start her new OCP course without waiting 7 days
d- Tell her to get a pregnancy test
Reply With Quote Quick reply to this message

Old 05-24-2012
DrSeddik's Avatar
USMLE Forums Veteran
Steps History: 1+CK+CS
Posts: 236
Threads: 57
Thanked 455 Times in 107 Posts
Reputation: 468

It is much more fun when somebody participates

Anyway the answer kind of stands out from the other choices, it is C.
If she would've missed one pill, she can take it and complete her course as usual. But two or more missed pills, requires that the patient at least, take the two missed pills, restrain from sex (or use another method of contraception such as condoms for 7 days). Add to that:
-If she is in the first week of taking the pills, and she had unprotected sex, she should get emergency contraception
- If she is in her third week, she should start the next course right away, without waiting for 7 days for her period, or in lay man terms, without taking her 7 inactive pills.
Reply With Quote Quick reply to this message
Old 06-01-2012
kemoo's Avatar
USMLE Forums Guru
Steps History: 1+CK+CS
Posts: 378
Threads: 161
Thanked 103 Times in 52 Posts
Reputation: 117

I choose B, but not sure.
Reply With Quote Quick reply to this message
Old 07-18-2013
USMLE Forums Scout
Steps History: Not yet
Posts: 37
Threads: 9
Thanked 12 Times in 9 Posts
Reputation: 22
Default missed pills

answer is surely C as said!

its the 18th day means the 3rd week.
Had it been the 1st week, she would need emergency contraception.
Here its the 3rd week; back up cntraception for 7 days + finish active pack + start new pack the next day only without the 7 days gap
Reply With Quote Quick reply to this message


ObGyn-, Reproductive-, Step-3-Questions

Quick Reply

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Please enter a password for your user account. Note that passwords are case-sensitive.
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Where you live. Leave blank if you don't want to tell.


Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Similar Threads
Thread Thread Starter Forum Replies Last Post
Missed two closures amberafzal USMLE Step 2 CS Forum 8 08-15-2013 06:39 PM
Missed five questions from block 1 rehanajmalsarmad USMLE Step 2 CK Forum 3 11-08-2011 11:00 PM
missed step Cocochanel IMG Residency Match Forum 1 11-02-2011 06:30 PM
Screening before starting oral contraceptive pills docoftheworld USMLE Step 2 CK Forum 9 06-06-2011 06:48 AM
16 yr old girl asking for birth control pills khushboo USMLE Step 1 Forum 7 05-30-2010 11:11 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)