Acute Pelvic Pain Flashcards Preview

Jason's MD3 Women's > Acute Pelvic Pain > Flashcards

Flashcards in Acute Pelvic Pain Deck (26):
1

Pelvic pain def'n? What 3 things to think about?

Pain over the lower abdomen lasting less than 3 months
First presentation
Previously undiagnosed

2

Causes of pelvic pain?

Gastro
Urinary
GYNE
Obs
Other

3

Suprapubic pain DDx?

Acute urinary retention
UTIs
Cystitis
PID
Ectopic Pregnancy
Diverticulitis

4

RIF DDx?

Appendicitis
Diverticulitis
PID
Ureteric colic
Ectopic
Ovarian torsion
Ovarian cyst

5

LIF DDX

Appendicitis (less likely)
Diverticulitis
PID
Ureteric colic
Ectopic
Ovarian torsion
Ovarian cyst

6

Other causes of DDx pelvic pain

Constipation
IBS
UC
Bowel obstruction, perforation viral infections
Gall bladder disease
Hernias
Malignancy (more insidious)

7

Most common O&G causes of pelvic pain DDx?

Obs: ectopic, miscarraige
Non-preg: PID, ovarian torsion, cyst rupture

8

Incomplete miscarriage?

Retained products of conception still

9

BHCG changes how in preg? Ectopic/miscarriage

Beginning: doubles every 48 hours - normal

10

When can you see imaging of baby re: BCG?

When BCG is around 2000

11

If BCG is more than 3000 but no sac then what to worry?

ectopic?

12

What do you see at 5,6,7 weeks

5- gestation sac
6-fetal pole
7-fetal heart

13

When can you see fetal heart for first time?

7 weeks

14

Ectopic investigations ladder

BHCG
Ultrasound
Laparoscopy

15

Non pregnant pelvic pain DDx?

PID
Ovarian torsion
Cyst rupture

16

Most common pathogens for PID?

Chlamydia
Gonorrhoea
Mycobacterium

17

How to Dx PID?

Cervical swab
urine PCR now

18

Gonorrhoea vs. chlamydia symptoms?

Gonorrhoea more symptomatic: urethritis, and discharge

19

Cyst rupture DDx?

Ovulation
Can be near a vessel, a bit of blood

20

U/S findings for ovarian torsion

Reduced flow to ovary
Ring of oedema around ovary
Usually everything else is normal, maybe small raised CRP

21

Examination of pelvis?

Inspection
Palpation: peritonitis

22

What sign indicates peritonitis?

Rigidity

23

Targeted exam for PID GYN cause?

Vaginal examination:
Speculum
Bimanual: cervical tenderness, adenexal mass, uterine size

24

Common investigations

Blood tests:
Urinanalysis
Swabs high vaginal, cervical
Preg test

25

Radiology for acute pelvic pain?

U/S
X-ray (not really, mainly bowel obstruction/perforation)
CT (First line now)

26

Laparoscopy probs?

Invasive
Expensive
Not always available