GUM Flashcards
(64 cards)
what is pid?
infection or inflammation of upper reproductive tract
pathophysiology of PID?
inflammation of cervix following infection affects mucus plug and allow infection to ascend
what symptoms are seen with PID?
lower abdominal or pelvic pain (usually bilateral), deep dyspareunia, abnormal vaginal bleeding, secondary dysmennorhoea, abnormal PV discharge (often purulent)
if severe can have fever, rigors, chills, night sweats
what are some intra-abdominal complications of PID?
what are other complications of PID?
infertility, ectopicpregnancy, tubo-ovarian abscess, chronci pelvic pain, fitz-hugh curtis syndrome
whatis Fitz-hugh curtis syndrome?
peri-hepatitis, RUQ pain, morecommonly associated with PID secondary to chlamydia.
what is a sign of fitz-hugh curtis syndrome?
adhesions, violin string like around liver capsule??? double check
what can cause PID?
usually polymicrobial
STIs: gonorrhoea, chlamydia, mycoplasma genitalium
non STI: introduction of vaginal flora with intrauterine coil, anaerobes (prevotella, atopobium), gardnerella vaginalis
Who is at higher risk of developing PID?
low economic status, multiple sexual partners young age <25, TOP/miscarriage, coil insertion, appendicitis
what signs are seen with PID?
lower abdominal tenderness, uterine/adnexal tenderness, cervical motion tenderness, adnexal mass, mucopurulent vaginaldischarge, contact bleeding, fever, RUQ tenderness
what conditions can cause pelvic pain?
UTI, ectopic pregnancy, ovarian torsion, endometriosis, appendicitis, bowel inflammation, degenerative fibroids
what investigations can be done for PID?
endocervical/vaginal swabs
urine dipstick
pregnancy test (rule out ectopic pregnancy)
bedside microscopy of vaginal/cervical discharge
how is PID diagnosed?
clinical diagnosis but investigations can help support diagnosis
what can be seen on imaging or laproscopy in PID (usually more severe)?
free fluid in endometrium swollen fallopian tubes or ovaries, abscesses, peri-hepatic adhesions,
management of PID?
mutliple antibiotic course for 2 weeks, analgesia, rest, abstain from sex until patient and partner completed antibiotic treatment
which PID patients will be treated as inpatient?
severe symptoms (nausea, vomiting, pyrexia), signs of peritionitis, not responding to oral antibiotics, pregnancy (higher risk of complication)
what is most common causative organism of PID?
chlamydia
is PID more common in pregnancy?
no it is uncommon in pregnancy
is PID a cause of tubal factor infertility?
yes
what are features of advanced HIV?
CD4<200, opportunistic infections like PCP or crytococcal meningtitis, HIV associated malignancies like Kaposi sarcoma
patients on PrEP and PEPSE may
have delayed or unusual seroconversion
due to very early ART- seek expert advice.
what are some infectious causes of gential sores?
what are non-infectious causes of genital sores?
what associated symptoms are good to ask about with genital sores?
fever, flu like symptoms rashes, any problems with eyes/mouth/joints, urinary symptoms, discharge
