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Clinical scenario: Pregnancy of unknown location & abortion care
A 21 year-old individual (they/them) presents requesting a medication abortion. Their LMP was five weeks ago. They had a positive home pregnancy test three days ago, confirmed in clinic. Transvaginal ultrasound shows no visible intrauterine pregnancy (no gestational sac or yolk sac) and no signs of ectopic pregnancy. They deny pelvic pain, bleeding, or spotting since their LMP.
Clinical scenario: Contraception and autoimmune conditions
A 24 year-old patient (she/her) comes into clinic. During the visit, she expresses interest in starting on a hormonal implant. She was diagnosed with systemic lupus erythematosus (SLE) six months ago and is currently taking hydroxychloroquine. The patient reports no history of low platelets, but she doesn’t know her antibody status at the time of the visit. She reports no other medical conditions or current medications.
Clinical scenario: Which IUD is it?
A 22 year-old patient (she/her) is currently using an IUD and had it placed at another clinic out of state three years ago. When asked which IUD she has, she is not sure, though she thinks it has hormones. She reports having light, irregular periods. Overall, she is satisfied with the IUD and wants to continue using an IUD for birth control.
Clinical scenario: Effects of birth control on lactation
A 25 year-old patient (she/her) is interested in starting birth control four weeks after having her first child. She is breastfeeding but needs to supplement formula one to two bottles a day because of “not having enough milk.” Prior to pregnancy she was happy with a hormonal implant but is unsure if this method is safe while producing milk.
Clinical scenario: Managing abnormal cervical cancer screening tests
A 29 year-old patient (they/them) is transferring care into your practice. They show you that their medical record from a previous provider, pulled up on their phone, includes an ASCUS cytology with reflex positive Human Papillomavirus (HPV) three months ago without follow-up. They pull up other records on their cell phone of a prior normal cytology test at age 26. “What do I do now? I’m worried that I have cancer.”
Clinical scenario: How long are IUDs and implants effective?
A 20 year-old patient (they/them) had a birth control implant placed three years ago this month. They are happy with their method and want to keep using an implant for birth control.
Clinical scenario: Placing an IUD after unprotected sex
A patient in your clinic is requesting to have an LNG-IUD placed today. You note that their last menstrual period (LMP) started 10 days ago, and when asked about recent unprotected vaginal intercourse, they report they last had sex three days ago.
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