SAEM M4 CURRICULUM 2 2026 COMPLETE
STUDY GUIDE FULL SOLUTIONS 362
QUESTIONS VERIFIED A+
◉ 3 sx PID. Answer: -lower abd pain
-purulent vag d/c
-vag bleed
◉ when getPID sx. Answer: Symptoms begin shortly after the start of
the menstrual cycle, when there are fewer defenses by the cervical
mucosal barrier to ascending infections.
◉ PID with gonnoccal. Answer: more likely to appear toxic (fever, N/V)
◉ dont forget one risk factor pid. Answer: -recent instrumentation of
uterus
◉ common exam findings pid. Answer: -b/l adenexal tenderness
-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
,◉ if pain is u/l think more. Answer: TOA
◉ if RUQ tender think. Answer: Fitz-Hugh Curtis (perihepatitis,
inflamation of liver capsule)
◉ best test for gonorrohea and chlaymida. Answer: NAAT with PCR or
DNA probes (either urine or cervical secretions)
◉ if suspect TOA get. Answer: US
◉ ruptured ovarian cyst shows. Answer: free fluid in pouch of douglas
◉ ovarian torsion shows. Answer: absence of blood flow to one ovary
on pelvic ultrasound with doppler
◉ why US>CT. Answer: CT cannot eval for torsion bc there is no
doppler
◉ who gets abx for PID. Answer: -lower abdominal or pelvic pain
coupled with adnexal, uterine or cervical motion tenderness on exam, in
a patient at risk for STDs with no other discernible cause for the illness
identified
◉ complications of pid. Answer: -chronic pelvic pain
,-infertility
-ectopic
-toa
-fitz-hiugh curtis
◉ toa process. Answer: walled-off abscess that originates in the infected
fallopian tube and extends to involve the ovary
◉ how confirm dx of Fitz hugh curtis. Answer: elevated liver fxn tests
◉ inpatient abx pid. Answer: -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
◉ outpatient abx pid? add _____ if 2. Answer: -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
◉ who getsa dmitted. Answer: -toa
-fitz hugh curtis
, -septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
◉ d/c with PID need what testing. Answer: test for other STD
◉ describe whats going on in ovarian torsion. Answer: ovary, and often
the fallopian tube as well (adnexal torsion) become twisted around their
vascular pedicle.
◉ progression of torsion. Answer: twisting initially obstructs venous
flow, which causes engorgement and edema. The engorgement can
progress until arterial flow is compromised, leading to ischemia and
infarction
◉ risk factors for torsion. Answer: ovary with a mass or cyst is more
prone to twisting by virtue of its asymmetry
◉ classic present torsion. Answer: sudden onset of unilateral lower
abdominal pain which is initially visceral in character (ie, vague and
poorly localized) and may be accompanied by nausea and vomiting. It
may radiate to the groin or flank.
STUDY GUIDE FULL SOLUTIONS 362
QUESTIONS VERIFIED A+
◉ 3 sx PID. Answer: -lower abd pain
-purulent vag d/c
-vag bleed
◉ when getPID sx. Answer: Symptoms begin shortly after the start of
the menstrual cycle, when there are fewer defenses by the cervical
mucosal barrier to ascending infections.
◉ PID with gonnoccal. Answer: more likely to appear toxic (fever, N/V)
◉ dont forget one risk factor pid. Answer: -recent instrumentation of
uterus
◉ common exam findings pid. Answer: -b/l adenexal tenderness
-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
,◉ if pain is u/l think more. Answer: TOA
◉ if RUQ tender think. Answer: Fitz-Hugh Curtis (perihepatitis,
inflamation of liver capsule)
◉ best test for gonorrohea and chlaymida. Answer: NAAT with PCR or
DNA probes (either urine or cervical secretions)
◉ if suspect TOA get. Answer: US
◉ ruptured ovarian cyst shows. Answer: free fluid in pouch of douglas
◉ ovarian torsion shows. Answer: absence of blood flow to one ovary
on pelvic ultrasound with doppler
◉ why US>CT. Answer: CT cannot eval for torsion bc there is no
doppler
◉ who gets abx for PID. Answer: -lower abdominal or pelvic pain
coupled with adnexal, uterine or cervical motion tenderness on exam, in
a patient at risk for STDs with no other discernible cause for the illness
identified
◉ complications of pid. Answer: -chronic pelvic pain
,-infertility
-ectopic
-toa
-fitz-hiugh curtis
◉ toa process. Answer: walled-off abscess that originates in the infected
fallopian tube and extends to involve the ovary
◉ how confirm dx of Fitz hugh curtis. Answer: elevated liver fxn tests
◉ inpatient abx pid. Answer: -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
◉ outpatient abx pid? add _____ if 2. Answer: -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
◉ who getsa dmitted. Answer: -toa
-fitz hugh curtis
, -septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
◉ d/c with PID need what testing. Answer: test for other STD
◉ describe whats going on in ovarian torsion. Answer: ovary, and often
the fallopian tube as well (adnexal torsion) become twisted around their
vascular pedicle.
◉ progression of torsion. Answer: twisting initially obstructs venous
flow, which causes engorgement and edema. The engorgement can
progress until arterial flow is compromised, leading to ischemia and
infarction
◉ risk factors for torsion. Answer: ovary with a mass or cyst is more
prone to twisting by virtue of its asymmetry
◉ classic present torsion. Answer: sudden onset of unilateral lower
abdominal pain which is initially visceral in character (ie, vague and
poorly localized) and may be accompanied by nausea and vomiting. It
may radiate to the groin or flank.
