Flashcards in Acute Salpingitis Deck (17)
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Salpingitis – a.k.a.? Suggestive physical exam sign?
Pelvic inflammatory disease; Cervical motion tenderness
1
Tubo-ovarian abscess? Treatment?
Collection of purulent material around distal tube and ovary;
unlike typical abscess, can be treated with antibiotic therapy
2
Common presentation of salpingitis?
Young, nulliparous female complaining of lower abdominal/pelvic pain and vaginal discharge with fever, and nausea/vomiting
3
Signs and symptoms of acute salpingitis?
1. Abdominal, Cervical motion, adnexal tenderness
2. Vaginal discharge
3. Fever
4. Pelvic mass on physical exam/ultrasound
4
Fitz-Hugh and Curtis syndrome?
Right upper quadrant pain seen in salpingitis when PERIHEPATIC ADHESIONS are present
5
When salpingitis diagnosis is in doubt – best confirmatory method? Look for?
Laparoscopy; purulent discharge from fimbria
6
Manage salpingitis as outpatient if? Tx?
1. Low-grade fever
2. Absence of paratonia signs
3. Tolerance of oral medication
Single IM ceftriaxone and oral doxycycline for 10-14 days
7
Criteria for inpatient therapy?
1. Fails outpatient therapy (after reassessing for you hours after initiating)
2. Pregnant
3. Extremes of age (no teenagers)
4. Cannot tolerate oral medication ( nausea)
IV cefotetan or oral/IV doxycycline
8
Patient on inpatient therapy for salpingitis does not improve within 48 to 72 hours – next step?
Laparoscopy to assess disease
9
Tubo-ovarian abscess – organism? Abx? Complication?
Alternative treatment?
Anaerobics; clindamycin or metronidazole
Rupture
Radiological percutaneous drainage
10
Long-term complications of salpingitis?
1. Chronic pelvic pain
2. Involuntary infertility
3. Ectopic pregnancy
11
Infertility from PID directly related to?
Number of episodes of salpingitis
12
Contraception that increases risk for PID? (Why?) another risk factor?
Decreases risk?
IUD (endocervical barrier is broken upon placement of IUD); OCP
Nulliparity
13
Acute salpingitis – organism?
Multiple organisms
14
Gold standard for diagnosing salpingitis?
Laparoscopy
15
Sulfur granules in tubes – organism? Woman likely has a? Treatment?
Actinomyces; IUD; penicillin
16
