PID

Question 1

Causative Pathogens in PID

Answer 1

• Claymida Trichomatis
• N. Gonorrhea

Less:

• Anaerobes

Question 2

__ lowers risk of PID

Answer 2

Pregnancy

Question 3

Clinical features of PID

Answer 3

• LAP (usually bilateral)
• Fever
• Dyspareunia
• Urinary Sx
• Abnormal VAGINAL DISCHARGE

Question 4

Patient demographic in PID

Answer 4

Sexually active YOUNG woman

Question 5

Diagnosis of PID based on key clinical features. These are..

Answer 5

• Patient history
• LAP

• Vaginal exam

• Cervical motion tenderness
• Purulent, bloody cervical/ vaginal discharge

Question 6

Lab tests in diagnosis is of PID

Answer 6

• Blood

• leucocytosis
• Elevated ESR
• Pregnancy test
• Cervical/urethral SWAB
• PCR & Culture
• Gomes’s stain (Chlamydia only)

Question 7

Imaging modalities for PID

Answer 7

• Ultrasound
• Exploratory Lap. (no response to tx or ambiguous cases)
• Endometrial biopsy (confirm endometriosis)
• Culdocentesis

Question 8

Lower abdominal pain in women of reproductive age.

Differential diagnoses?

Answer 8

• Ectopic pregnancy
• PID
• Appendicitis
• Ovarian Cyst rupture
• Kidney stones
• Ovarian torsion
• Cervicitis

Question 9

Non infectious causes of cervicitis

Answer 9

• Localized trauma (cervical caps, tampons)
• Chemical irritation (contraceptive creams)
• Malignancy

Question 10

In Cervicitis, key findings of Physical exam are..

Answer 10

• Cervical motion tenderness
• Erythematous, FRIABLE cervix
• usually NO fever

Question 11

Treatment of PID

Outpatient:

Answer 11

• Single dose IM Ceftriaxone
• Oral Doxycycline

• Metronidazole (If vaginitis)

Question 12

Tx of PID

Inpatient:

Answer 12

Cefoxitin or Cefotetan + Doxycycline

Question 13

PID, Short term complications

Answer 13

• Pelvic peritonitis
• Fitz Hugh Curtis Syndrome
• Tubo-Ovarian abscess

Question 14

PID, long term complications

Answer 14

• Infertility
• Ectopic pregnancy
• Chronic pelvic pain
• Hydrosalpinx
• Chronic Salpingitis