25/05/2026
Yep, let’s do it. *15 BCQs on Contraindications + WHO MEC Categories* — this is one of the most repeated topics in CPSP Part 1.
All questions are single best answer, clinical stem, with distractors based on MEC 1-4.
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*Contraception BCQs – WHO MEC Focus*
*1.* A 42-year-old woman with controlled hypertension, BP 135/85 mmHg, on amlodipine wants contraception. The MEC Category 4 method is:
A. Copper IUD
B. Etonogestrel implant
C. Combined oral contraceptive pill
D. Depot medroxyprogesterone acetate
E. Male condom
*Answer: C. Combined oral contraceptive pill*
*Explanation:* MEC 4 for COC in uncontrolled hypertension ≥160/100 or with vascular disease. Category 3 for 140-159/90-99. Progestin-only and non-hormonal methods are safe.
*2.* A woman with systemic lupus erythematosus, positive antiphospholipid antibodies, asks about contraception. The safest method is:
A. Combined oral contraceptive pill
B. Combined transdermal patch
C. Copper IUD
D. Vaginal ring
E. Injectable DMPA
*Answer: C. Copper IUD*
*Explanation:* APS = MEC 4 for estrogen due to thrombosis risk. Cu-IUD is MEC 1. DMPA is MEC 2 due to bone density concerns.
*3.* A 19-year-old nulliparous woman with BMI 28 wants long-acting contraception. Which is MEC 1?
A. Combined oral contraceptive pill
B. Levonorgestrel IUS
C. Injectable DMPA
D. Etonogestrel implant
E. Combined vaginal ring
*Answer: D. Etonogestrel implant*
*Explanation:* All progestin-only methods and Cu-IUD are MEC 1 for nulliparity. COC and combined hormonal methods are MEC 2.
*4.* A woman 3 weeks postpartum, not breastfeeding, with no complications. Which method is contraindicated?
A. Progestogen-only pill
B. Copper IUD
C. Combined oral contraceptive pill
D. Etonogestrel implant
E. Barrier method
*Answer: C. Combined oral contraceptive pill*
*Explanation:* MEC 3 for COC
