Pelvic Inflammatory Disease Flashcards
Briefly explain PID.
Inflammation extends from the cervix -> uterus -> Fallopian tubes -> ovarian (ascendingg infection)
Endometritis?
Inflamed uterus
Salpingitis?
Inflamed Fallopian tubes
Oophoritis?
Inflamed ovaries
Etiology of PID.
- Polymicrobial (can be caused by many different microbe typically pyogenic)
- Untreated bacterial infections (often STIs)
Pyogenic?
formation of pus (pus-producing microbes)
What are the common STI’s that cause PID?
- Chlamydia (~20%)
- Gonorrhea (~10%)
Pathology of PID?
Microbes enter the cervix -> microbes move up into the uterus -> multiply very rapidly as endometrium sloughs off providing nutrition for microbe proliferation -> Ascend to tubes -> ovaries -> move out the infundibulum into the peritoneum -> peritonitis (complication)
When is a peak time for microbes to enter the cerviX?
Often during menstruation d/t dilation of the cervix and the endometrium
What is a complication of PID?
Peritonitis
Manifestations of PID?
- Systemic and local manifestations
- fever d/t infection
- heavy, purulent vaginal discharge d/t infection
- Inflammation -> inflammatory pain in back and lower abdomen
- Adnexal tenderness
- Leukocytosis
Adnexal tenderness?
Pain on palpation in the region of the uterus
Diagnostics of PID?
- Presentation of condition (pain, discharge, etc)
- Labs (CBCs, WBCs, Increased C-reactive protein, increased ESR)
- Laparoscopy
ESR?
Erythrocyte sedimentation rate. It measures the time it takes for RBCs to settle down
Why can you not culture vaginal discharge?
Because there is flora present in the vagina normally, and the cause of PID is polymicrobial
