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Combined contraception contraindication — USMLE Step 3 MCQ

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ModerateOB/GYN (prenatal care, contraception, screening)Combined contraception contraindicationUSMLE Step 3

A 38-year-old woman requests contraception. She smokes 15 cigarettes daily and has migraine with aura. Blood pressure is 132/78 mm Hg. She has no history of venous thromboembolism and wants to avoid pregnancy for several years. Which of the following is the most appropriate at this time?

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Correct answer: A — Recommend a progestin-based or nonhormonal method

Estrogen-containing contraception is contraindicated with migraine with aura and in smokers older than 35 years due to thrombotic and stroke risk.

Reference: CDC U.S. Medical Eligibility Criteria for Contraceptive Use