infectious disease in women health

Question 1

what is the tx for sexually transmitted PID?

Answer 1

mild - moderate:
ceftriaxone 500mg in 2 mL in 1% lignocaine IM
PLUS metronidazole 400mg oral, 12 hourly for 14 days
PLUS azithromycin 1g oral, stat dose

severe;
ceftriaxone 2g IV, daily
PLUS azithromycin 500mg IV daily
PLUS metronidazole 500mg IV daily

Question 2

what is the tx for non sexually transmitted PID?

Answer 2

mild - moderate:
amoxicllin/ampicillin 2g IV 6 hourly
PLUS doxycycline 100mg oral

severe:
amox/ampicillin 2g IV 6 hourly
PLUS gentamicin IV
PLUS metronidazole 500mg IV, 12 hourly

Question 3

complications of PID

Answer 3

(early tx can prevent tubal damage and consequently infertility and ectopic pregnancy, but it cannot prevent scarring and adhesion formation that accompanying healing of infection damaged tissues)

recurrent PID 
hydrosalpinx 
tubo-ovarian abscess 
chronic pelvic pain 
infertility 
ectopic pregnancy 
ovarian cancer

Question 4

what are some investigations that should done when PID is suspected?

Answer 4

endocervical OR high vaginal swab for PCR
(if all not possible, first pass urine sample for PCR)
+
endocervical swab for gram stain and culture for n. gonorrhea for susceptibility testing

Question 5

what are organisms involved in PID (sexually transmitted/non sexually transmitted)

Answer 5

sexually transmitted: chlamydia trachomatis, neisseria gonorrhea, mycoplasma genitalium
vaginal flora; anaerobic bacteria, facultative gram-negative bacteria, mycoplasma hominis

Question 6

what are some risk factors for STD (Sexually transmitted disease)?

Answer 6

age less than 25 years old
young age at first sex
non barrier method of contraception
new/multiple sex partners
oral contraception
cervical atopy

Question 7

what are the clinical features of PID?

Answer 7

lower abdominal pain of recent onset, lasting