Inflammatory and Infective Disorders Flashcards Preview

Reproductive - Reproductive Gynaecology > Inflammatory and Infective Disorders > Flashcards

Flashcards in Inflammatory and Infective Disorders Deck (18)
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1
Q

Chronic pelvic pain is defined as pelvic pain which lasts how long?

What are the most common causes for this?

A

More than 6 months

Endometriosis and PID

2
Q

What is endometriosis?

How common is it?

A

The presence of endometrial glands and stroma, outwith the uterine cavity

5-10% of women of reproductive age, 40% of women with subfertility and 80% of women with chronic pelvic pain

3
Q

What are the main 3 clinical features of endometriosis?

A

Cyclical ppelvic pain

Dyspareunia

Subfertility

4
Q

What is the first imaging investigation you may do for endometriosis and what might it show?

What is the gold standard investigation?

A

TVUS - will see endometriod ‘chocolate’ cysts in the ovaries (seen in 20-40% of women with endometriosis)

Laparoscopy

5
Q

The management of endometriosis depends on what? Why?

A

The woman’s fertility plans - there is no medical management for women who want to conceive in the near future

6
Q

What is the aim of medical management for endometriosis?

What are some options?

If this treatment is still not sufficient what can you add?

A

To suppress ovulation and induce amenorrhoea

Essentially any kind of contraception (COCP, POP, implant, IUS, depot)

An NSAID for pain relief

7
Q

Removal of endometriomas which are > 6cm helps with what?

A

To improve fertility rates

8
Q

What is the prognosis of endometriosis?

A

It goes away spontaneously in 1/3rd of women, for the others it is a chronic condition.

Typically, symptoms get better after the menopause

9
Q

What is PID?

What are the most common causes?

A

An ascending infection of the upper female genital tract

Chlamydia and gonorrhoea

10
Q

What are some risk factors for PID?

A

Aged < 25

Multiple sexual partners

Unprotected sex

Recent IUD insertion

11
Q

How can the risk of PID be reduced?

A

Use of barrier contraceptives

Giving women at high risk of STIs prophylactic antibiotics before insertion of the IUD

12
Q

Ascending genital tract infection causes what?

In rare cases, what can develop?

A

Cervicitis, endometritis, salpingitis

Tubo-ovarian abscesses

13
Q

What are some symptoms of PID?

A

Severe lower abdominal pain

Abnormal vaginal bleeding

Offensive vaginal discharge

14
Q

What are some examination findings of PID?

A

Pyrexia

Cervical excitation

Adnexal tenderness and swelling

15
Q

What blood tests are useful in the diagnosis of PID?

What microbiological investigation would you do?

What imaging investigations would you do?

What investigation is used as a last resort?

A

WCC and CRP

NAATs for chlamydia and gonorrhoea

Transvaginal US or MRI

Laparoscopy

16
Q

If you are investigating for PID and perihepatic lesions are found - what does this suggest?

This is most often a complication of what?

A

Fitz-Hugh-Curtis syndrome

Chlamydia infection

17
Q

How is PID treated?

A

Broad spectrum antibiotics

18
Q

PID has a good prognosis if caught and treated early. If not, what are some potential complications?

A

Chronic pelvic pain

Pelvic adhesions

Ectopic pregnancy

Sub/infertility