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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 1/Question#2 (reveal difficulty score)
An asymptomatic 37-year-old woman comes to ...
Discontinue the oral contraceptive ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—step_prep(148)
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Contraindications to combined contraception includes:

  1. Women > 35 yo who smoke (which is case with this patient)
  2. Migraines with aura
  3. Hypercoagulable risk factors (<3 weeks postpartum, prolonged immobilization, history of DVT/PE, blood disorders [factor V leiden, etc.])
  4. Active breast cancer
  5. Liver disease (liver involved in metabolizing estrogen)

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  • Combined oral contraceptive pills contain estrogen and progesterone to promote anovulation and prevent pregnancy, as well as to treat PCOS, menorrhagia, and endometriosis.

  • They should be avoided in patients with a history of deep venous thrombosis, pulmonary embolism, stroke, myocardial infarction, hypertension, migraine with aura, severe cirrhosis, and current breast cancer.

  • They are also contraindicated in patients 35 years or older who concomitantly smoke cigarettes!


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