PID Flashcards
What is pelvic inflammatory disease (PID)
Inflammation of the upper female genital tract (uterus, fallopian tubes, and adjacent pelvic structures)
What are the causative organisms for PID
CHLAMYDIA
GONORRHEA
GENITAL TUBERCULOSIS
most common in virgins
MYCOPLASMA INFECTION
Risk factors for PID
Multiple sexual partners
Unprotected sex
Sex during menstruation
History of PID
History of STD
IUD
Nulliparity
Douching
Cigarette smoking
Iatrogenic procedures
Example of iatrogenic procedures
Endometrial biopsy
Uterine curettage
IUD insertion
Hysterosalpingography
What are protective factors against PID
ORAL CONTRACEPTIVE PILLS
PREGNANCY
MENOPAUSE
MULTIPARITY
Why are oral contraceptive pills, pregnancy, multiparity and menopause protective factors against PID?
Because during these conditions the cervical mucus is thickened
Clinical manifestations of PID
Mild to moderate lower Abdominal pain
Dyspareunia (intercourse pain)
Back pain
Pain during pelvic exam
Urinary discomfort
Fever
Vaginal discharge
Vaginal odor
Irregular periods
Diagnosis of PID
1) LAPAROSCOPY
2) ENDOMETRIAL BIOPSY
3) TRANSVAGINAL SONOGRAPHY/ MRI
4) SALINE WET MOUNT
Leukorrhea
5) ELEVATED ESR & C REACTIVE PROTEIN
6) PELVIC EXAM/ PHYSICAL EXAM
Cervical motion, uterine & adnexal tenderness
7) VERIFY UNDERLYING INFECTION
Complications of PID
PERIHEPATITIS
PERITONITIS
FITZ-HUGH-CURTIS SYNDROME
Violin-string adhesions
TUBO-OVARIAN ABSCESS
INFERTILITY
ECTOPIC PREGNANCY
CHRONIC PELVIC PAIN
Differential diagnosis of PID
CERVICITIS
UTI
ENDOMETRIOSIS
OVARIAN TORSION
ADNEXAL TUMORS
Classifications of PID
MILD
Edema & Erythema of tubes
No purulent exudate
Tubes are mobile
MODERATE
purulent exudate from fimbrial ends
Immobile tubes
SEVERE
Violin-string adhesions in pelvis & around liver
Abscess
Polysalpinx
Inflammatory complex seen
Treatment of PID
1) MILD TO MODERATE PID
CEFTRIAXONE + DOXYCYCLINE + METRONIDAZOLE
CEFOXITIN + PROBENECID + DOXYCYCLINE + METRONIDAZOLE
AZITHROMYCIN + METRONIDAZOLE
AZITHROMYCIN + CEFTRIAXONE
2) SEVERE PID
CEFOXITIN + DOXYCYCLINE
CEFOTETAN + DOXYCYCLINE
CLINDAMYCIN + GENTAMICIN IV
AMPICILLIN/ SULBACTAM + DOXYCYCLINE
What is the common site of genital tuberculosis
- FALLOPIAN TUBES
But In uterus (Cornua)
Features of Genital TB
Asherman syndrome (Intrauterine adhesions/ synechiae)
Honey comb appearance on hysterosalpingography
Bilateral Cornua block
Hydrosalpinx
Beaded appearance of fallopian tube
Most common complication or symptoms of genital tuberculosis
Infertility
Amenorrhea/ hypomenorrhea
Ectopic pregnancy
