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PID cause - 🧠 ANSWER ✔✔originates as a cervical infection with Neisseria
gonorrheaand/or Chlamydia trachomatis, and becomes polymicrobial as it
ascends into the uterus, fallopian tubes and ovaries.
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
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, -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