Define PID?
List the organisms that usually cause PID starting with the most common.
T/F: Screening women for chlamydia and gonorrhea reduces their risk of PID.
T/F: Treating BV reduces risk of PID
T/F: Screening for mycopladma genitalia reduces risk of PID
T/F: Women with PID often have subtle/ nonspecific symptoms or are asymptomatic.
True.
This is what makes acute PID sometimes hard to diagnose
Explain how laprascopy be used to diagnose PID?
When co.pared clinical fi dings to laparascopy, what is the positive predictive value?
65%-95%
T/F: No single historical, physical, or laboratory finding is both sensitive and specific for the diagnosis of acute PID.
True
T/F: Mild or asymptomatic PID does not pose a risk to fertility.
False
Providers need a low threshold for suspicion - asymptomatic findings: vaginal bleeding, dyspareunia and vaginal discharge should not be overlooked
When should presumptive treatment of PID be initiated?
What are tje nore specific criteria for diagnosing PID?
Hint: think of investigations
T/F: i) All minimum criteria must be present before starting antibiotic therapy. ii) Why?
How can the specificity of the minimum criteria for PID be improved?
How can the specificity of the minimum criteria for PID be improved?
Hint: 6 points
T/F: Absence of an abnormal vaginal discharge and absence of leucocytes on wet prep does not exclude the diagnosis of PID.
What is the aim with PID treatment?
Why are treatment regimes that cover anaerobic activity preferred?
What is the criteria for hospitalization?
What are the 3 parenteral regimes?
Memory Gem:
Cefotetan - 2 t’s : 2nd gen; 2g given
twice/bd
Cefoxitin - 2nd gen, 2g given qid
- fox has 4 legs
**both have anaerobic activity
Why is oral docy preferred when possible?
Because the doxycycline infusion is painful.
Bioavailability is the same for oral and parenteral/IV
- same as for metronidazole
i) When is parenteral therapy for PID stopped/switched to oral? ii) What is the oral regime?
