Pelvic Inflammatory Disease 2

Pelvic Inflammatory Disease PID- Etiology - Answer- caused by ascent of bacteria to vagina, endocervix, fallopian tubes, ovaries (cause - chlyd, gonorrhea, bacteroids, aerobic streptococci and anaerobic cocci PID- Signs & Symptoms - Answer- lower abdominal/pelvic pain, distension, decreased bowel sounds, +/- rebound tenderness, usually bilateral, back pain may radiate down to legs, fever/chills, abnormal vaginal discharge, less common symptoms: (nausea/vomiting, vaginal bleeding, dysuria) PID- Dx: what three do you absolutely need? - Answer- abdominal tenderness, adnexal tenderness, cervical motion tenderness (chandelier's sign) PID- Dx: what one of more of the following do you need? - Answer- gram stain that's positive for gram - bacteria, temp101 F, WBC 10,000, elevated ESR, documented cervical infx of gonorrhea or chlamydia, pus on culdocentesis PID- Dx/investigation! - Answer- CBC - leukocytosis w/left shift, culture w/gonorrhea or chlamydia, elevated esr, discharge=pus!, US shows enlarged tender fallopian tubes or cul-de sac fluid, do laparascopy to differentiate b/w conditions, cogwheel sign on us: thick wall