Infections

Question 1

3+2 infections included in PID

Answer 1

Endometritis
Salpingitis
Oophoritis

Peritonitis
Perihepatitis (FHC syndrome - VIOLIN STRING ADHESIONS)

Question 2

PID protective factors

Answer 2

Barrier contraceptive
MIRENA

Question 3

Mc organism in various PID

Answer 3

Repro age - Chlamydia
Virgin - Genital TB
Menopausal - E.coli
Cu IUCD - Actinomyces

Question 4

PID Symptoms

Answer 4

Lower abdo pain - mc
Pain in coitus
Fever
AUB
Infertility
Vaginal discharge

Question 5

CDC diagnosis criteria of PID

Answer 5

MINIMAL CRITERIA

Lower abdo pain with any one
Cx motion tend
Adnexal tend
Uterine tend

ADDITIONAL

Fever
Abnormal discharge
Abdundant WBC on
ESR
CRP

Question 6

PID Investigations

Answer 6

USG

tuboovarian mass
Swollen tube
WAIST sign
B-O-S sign
Cogwheel sign

Endomet bx

Laparoscopy

Question 7

Scores in PID

Answer 7

BOER MISEL for conception in PID

GAINSVILLE STAGING in PID

Question 8

Long term consequences PID

Answer 8

Infertility
FHC synd
Ectopic preg
Chronic pelvic pain
Hydrosalpinx
Recurrent PID

Question 9

Mx PID

Answer 9

Broad spec abx

Inj Ceftriaxone 250mg
Tab Doxy 100mg x14d
Tab Metro 400mg x14d

Advice

Abstinence
No alcohol
Barrier
Partner mx

Question 10

Syndromic Approach PID

Answer 10

Patient is KIT 6 YELLOW

TAB CEFIXIME
TAB METRO
TAB DOXY

Partner is KIT 1 GREY

TAB CEFIXIME
TAB AZITHRO

Question 11

Bacterial Vaginosis m/o and definition

Answer 11

Gardenerella vaginalis
Mycoplasma
Mobiluncus

Alteration in vaginal flora
(Not inflammation)

Question 12

M/o causing VAGINITIS

Answer 12

3 org of bact vaginosis
C.albicans
Trichomonas

Question 13

Discharge types in vaginitis

Answer 13

Vaginosis - dirty white w foul smell

Candida - Curdy white (cottage cheese like)

Trichomonas - Frothy yellowish green w foul smell

Question 14

Pruritus seen in which vaginitis

Answer 14

No pruritus in vaginosis

INTENSE pruritus in Trichomonas and candida

Question 15

Dysuria in vaginitis

Answer 15

No dysuria in vaginosis

SPLASH DYSURIA in candida

Also present in tricho

Question 16

Which vaginitis is STD

Answer 16

Trichomonas ONLY

Question 17

Vaginitis and IOC

Answer 17

IOC of all 3 is SALINE MPY

Vaginosis - clue cell
Candida - pseudohyphae and spores
Tricho - Tennis racket app

Question 18

Gold std in vaginitis

Answer 18

Vaginosis - GRAM STAIN (Nugent score)

Tricho and candida - Culture

Question 19

AMSELS Criteria

Answer 19

For bact Vaginosis

3/4 should be present:

Whiff positive
Ph more or equal to 4.5
Clue cells more than 20% of epithelial cells
Dirty white discharge

Question 20

DOC for vaginitis

Answer 20

Vaginosis - Metro 500 BD x7d
Candida - Fluconazole 150mg (Clotrimazole in pregnancy)
Tricho - Metro (same)

Question 21

Org causing Cervicitis

Answer 21

Chlamydia
Gonorrhea

Question 22

Cervicitis Cl/f

Answer 22

Asymptomatic mc
Discharge
Dysuria
Dyspareunia
Post coital bleed

PS - unhealthy cervix
Friable
Bleeds on touch
Erosion
Ulcer

PV - No tenderness in uterus/adnexa

Question 23

IOC and Gold std in Cervicitis

Answer 23

IOC - NAAT for both

gold std

Chlamydia - Mccoy cell line culture
Gonorrhoea- Thayer Martin media culture

Question 24

DOC Cervicitis

Answer 24

Chlamydia - Doxy in non pregnant
Azithro in pregnancy

Gonorrhoea- Ceftriaxone

Question 25

Colored Kits

Answer 25

Vaginitis - GREEN KIT 2 Secnidazole 2gm Fluconazole 150mg Cervicitis - GREY KIT 1 Azithro 1gm Cefixime 400mg PID - YELLOW KIT 6 Cefixime 400mg Metro 400mg BD x14d Doxy 100mg BD x14d

Question 26

Steps leading to tubal block in GENITAL TB

Answer 26

Colonisation of MTB Endosalpingitis Caseous Necrosis Fibrosis & Adhesions

Question 27

IOC & findings in fallopian tube GENITAL TB

Answer 27

HSG is IOC (Only after ATT) Beaded app Golfstick app Tobacco pouch app Lead pipe app B/l cornual block Cotton wool app Hydrosalpinx

Question 28

Presentation of Uterine TB

Answer 28

Initially normal endometrium Acute endometritis causing menorrhagia Chronic leads to adhesions causing Amenorrhea

Question 29

Genital TB presentations

Answer 29

Fever malaise night sweat wt loss Menstrual irregularities Chronic pelvic pain Serosang discharge Ectopic preg Ascites Ulcers on cx, vagina PV has B/l adnexal mass mc finding

Question 30

Diagnosis in GENITAL TB

Answer 30

ENDOMETRIAL BX From cornua In premenstrual phase Sent for culture NAAT PCR Histology D1 blood in virgins USG LAPAROSCOPY (only on high suspicion + no findings on bx)