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True about combined oral contraceptive pills (Multiple correct answers)
a. Reduces risk of venous thromboembolism
b. Reduces risk of benign disease
c. Protects against endometrial cancer
d. Decreases bone density

Ans: (b, c)
Oral contraceptives have noncontraceptive benefits. The decrease in both estrogen and
progestin content in the last decade has led to a reduction in both side effects and
cardiovascular complications. As a result, these preparations are a safe contraceptive option
for many women.
Estrogen-progestin contraceptives reduce the risk of cancer of endometrium, ovary and colon.
The risk of cervical cancer appears to be increased, while data on breast cancer are
conflicting. There is a reduction in various benign breast diseases.
Estrogen-progestin contraceptives are used as treatment for acne, hirsutism, menorrhagia,
dysmenorrhea, pelvic pain, and premenstrual syndrome.
Women who use combined estrogen-progestin oral contraceptives have a two to four-fold
increased risk of venous thromboembolism when compared to non-users. Although the
reduction in steroid content of OCs has improved the safety and side effect profile of the pill,
the increased risk of venous thrombosis has not been eliminated. In general, the lowest VTE
risk is seen with estrogen-progestin contraceptives containing levonorgestrel, a
second-generation progestin.
Estrogen increases bone density.

1) True about findings in normal infants (Multiple correct answers)
a. Papilledema is rare in raised intracranial pressure
b. Floppy infant
c. Tapping patellar tendon of one side leads to contraction on opposite side
d. Elbow cross midline if passively done by examiner
e. Moro refle

Papilledema rarely occurs in infancy because the skull sutures can separate to accommodate
the expanding brain. Among infants with chronic, progressive elevation in ICP (eg,
slow-growing brain tumor), macrocephaly for age with a bulging anterior fontanel is the most
common presenting feature because unfused cranial sutures can accommodate rising ICP
without acutely compromising neurologic status. In addition, infants and young children may
be unable to articulate certain symptoms (eg, headaches) and therefore are more likely to
present with irritability. Alternatively, infants may display lethargy, lack of interest in their
surroundings, and poor feeding.
Nausea and vomiting are common presenting symptoms at any age. In older children and
adolescents, other common findings include headache, visual disturbance, abnormal gait,r coordination, and papilledema