Contraception: emergency contraception in obesity: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Contraception: emergency contraception in obesity

Sample item

A woman with a BMI of 36 kg/m2 presents 48 hours after unprotected intercourse requesting emergency contraception. Which is the best option?

ACopper IUCD insertion, or ulipristal acetate 30 mgBNo treatment is possibleCLevonorgestrel 1.5 mg alone as the most reliableDCombined pill taken once

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Copper IUCD insertion, or ulipristal acetate 30 mg

The efficacy of levonorgestrel emergency contraception falls in women with a BMI of 30 or more. A copper IUCD is the most effective method and can be inserted up to 5 days after intercourse, and ulipristal acetate 30 mg also remains effective up to 120 hours. Hormonal methods delay ovulation but do not act after implantation.

Option by option

A. Copper IUCD insertion, or ulipristal acetate 30 mg (correct)
Correct. A copper IUCD or ulipristal is preferred when BMI is high.
B. No treatment is possible
Effective options exist up to 5 days.
C. Levonorgestrel 1.5 mg alone as the most reliable
Levonorgestrel is less effective at higher BMI.
D. Combined pill taken once
A single combined pill is not an established regimen.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Copper IUCD insertion, or ulipristal acetate 30 mg. The efficacy of levonorgestrel emergency contraception falls in women with a BMI of 30 or more.

Why is "No treatment is possible" not the answer?

Effective options exist up to 5 days.

Why is "Levonorgestrel 1.5 mg alone as the most reliable" not the answer?

Levonorgestrel is less effective at higher BMI.

Why is "Combined pill taken once" not the answer?

A single combined pill is not an established regimen.

What concept does this question test?

It tests Contraception: emergency contraception in obesity in OBG. A copper IUCD is the most effective method and can be inserted up to 5 days after intercourse, and ulipristal acetate 30 mg also remains effective up to 120 hours. Hormonal methods delay ovulation but do not act after implantation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Contraception: emergency contraception in obesity?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.