Archers Q bank - anudoc7

[ArchivalUser]

118) A 30-year-old woman has been using oral contraceptive pills, combination type for past 8 yrs. However, she also has a history of migraines. Lately, she has been experiencing an average of 14 episodes of severe migraine without aura yearly. Careful evaluation of her headache calender reveals that most of them occur exclusively during the pill-free week of her OC regimen. She has no history of smoking. She has never had DVT or family hx of thrombophilia. Her physical exam is normal without any neurological deficits. Next step in management ?
A. Switch to low dose estrogen pills
B. Switch to minipill
C. Discontinue OC pills
D. Start extended duration OC pills like seasonale

Answer

[ArchivalUser]

D.some migrains improve with OCP due to the progestrone effect

[ArchivalUser]

Most females complain that their migraine gets worst during mensturation...due to decrease in estrogen levels(just before or during menses when estrogen levels decline).
extended dose prevents the fall in estogen levels during menses ..but has to be taken for 3 or more months so that the patient doesnt suffer from the month end levels in estrogen...the same applies to this patient.

[ArchivalUser]

answer D