Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which condition is contraindicated when using skin patches for contraception?

Hypertension
Tuberous sclerosis
Diabetes mellitus
Cardiac arrhythmia

The correct answer is: Tuberous sclerosis

Using skin patches for contraception can present risks in specific medical conditions, and one of the main concerns is regarding the use of estrogen. Tuberous sclerosis is a genetic disorder that can cause various benign tumors and is associated with other complications, including potential renal issues and neurological manifestations. While not all patients with tuberous sclerosis will have problems related to the use of hormonal contraceptives, the use of estrogen in patients with this condition raises concerns regarding the potential for exacerbating pre-existing tumors or other complications related to the disease. On the other hand, conditions like hypertension, diabetes, and cardiac arrhythmia can have varying impacts on the choice of contraceptive method, but they are not absolute contraindications. For example, patients with controlled hypertension or well-managed diabetes can often safely use hormonal contraception, provided they are monitored closely. Therefore, tuberous sclerosis stands out as a condition where the potential risks associated with estrogen, which is utilized in skin patches for contraception, may outweigh the benefits.