10 - Gynae - Genital Tract Infection - Infections of Uterus and Pelvis - Acute Pelvic infection and PID Flashcards Preview

CP2 > 10 - Gynae - Genital Tract Infection - Infections of Uterus and Pelvis - Acute Pelvic infection and PID > Flashcards

Flashcards in 10 - Gynae - Genital Tract Infection - Infections of Uterus and Pelvis - Acute Pelvic infection and PID Deck (8):
1

PID or salpingitis - ST pelvic infection/?
incidence ?
?, poorer, sexually active ? women most at risk. Pelvic infection never occurs with a viable ?

endometritis
incr
younger
nulliparous
pregnancy

2

aetiology - ? infection of bacteria in ? and cervix.
sexual factors account for ?%
more common if dont used ??
? is partially protective, as is ? IUS
spread of prev ? STIs to pelvis is usually ? but can be from uterine ? (eg ?, ERPC, laparoscopy and ? test, and ?) and/or complx of ? and ?
descending infection from local organs eg ? can occur.

ascending
vagina
80
barrier contraception
COCP
mirena
aSx
spontaneous
instrumentation
TOP
dye
IUD
childbirth and miscarriage
appendix

3

Pathology/bacteriology - what are the two no1 STI culprits?
? and bilateral ? and parametritis occur, ? rarely affected .

chlamydia and gonococcus
endometritis
salpingitis
ovaries

4

Hx points
-many have no Sx so presx later with ? or ? problems
-what is hallmark Sx? usually with abnormal pv bleed or ?

subfertility
menstrual
bilat lower abdo pain w deep dyspareunia
discharge

5

Ex points
- in severe Ex reveals ? and high ?, signs of lower abdo ? with ? adnexal tenderness and cervical ? (pain on moving the cervix)
Mass (pelvic ?) may be felt ?


more frequently the diagnosis is not clear and can be confused with ? and ovarian ? accidents (usually ? pain) or ?? (preg test ? with unilateral pain)

tachycardia
fever
peritonism
bilateral
excitation
abscess
vaginally

appendicitis
cyst
unilateral
ectopic preg
+ve

6

Ix - ? swabs taken for ? and gonococcus, ?? sent if fever.
WBC and ? may be raised.
Pelvic ??? helps r/o ? or ovarian ?. Laparoscopy with ? biopsy and culture is gold standard

endocervical
clap
blood cultures
CRP
USS
abscess
cysts
fimbrial

7

MGMT
- ? and either a parenteral cephalosporin eg ?? ? , followed by ? and ?
-? pts should be admitted for IV therapy
-review diagnosis after ? if no sing improv - then ? done
- pelvic abscess may not respond to ? therapy and may need ? under ??? or ?
Rupture of large ? ? can be life threatening

analgesia
IM Ceftriaxone
doxy and metronidazole
febrile
24h
laparoscopy
ABx
drainage
USS / lap
pelvic abscess

8

Complx
-main early complx is formation of abscess or ?
later many women dev ? obstruction and ?, chronic pelvic ? or chronic pelvic ?
?? if 6x more common after pelvic infection
chance of ? damage after one acute episode of PID is 12%

pyosalpinx
tubal
subfertility
pain
infection
ectopic preg
tubal

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