PID Flashcards
(47 cards)
What is the primary mechanism that lowers the frequency and intensity of pelvic infection?
Defence mechanism
The defence mechanism helps to prevent the spread of infections between pelvic organs.
What are the two types of vulval defence?
- Anatomic: Apposition of the cleft by labia, Compound racemose type of Bartholin’s glands
- Physiologic: Fungicidal action of the secretion (undecylenic acid), Natural high resistance to infection of the vulval and perineal skin
How does the vaginal defence change at birth?
Vaginal epithelium becomes multilayered under maternal estrogen influence
The desquamated epithelium containing glycogen is converted into lactic acid.
What role do Doderlein’s bacilli play in vaginal defence?
They convert glycogen into lactic acid, maintaining acidic pH
Doderlein’s bacilli appear from the gut and are crucial for vaginal health.
At what stages of life is vaginal defence lost?
- Following 10 days of birth till puberty
- During menstruation
- Following abortion and childbirth
- During menopause
What is the effect of estrogen on vaginal defence during the reproductive period?
Restores vaginal defence
High estrogen levels lead to a multilayered epithelium and increased glycogen.
What anatomical features contribute to cervical defence?
- Racemose type of glands
- Mucus plug
What physiological aspect contributes to cervical defence?
Bactericidal effect of the mucus
What are the two main anatomical features of uterine defence?
- Cyclic shedding of the endometrium
- Closure of the uterine ostium of the fallopian tube
What is the primary source of bacterial pathogens in upper genital tract infections?
Normal flora of the vagina and endocervix
Exogenous sources include sexually transmitted infections or unhygienic conditions.
What are the main types of organisms involved in upper genital tract infections?
- Pyogenic
- Sexually transmitted disease (STD)
- Parasitic
- Fungal
- Viral
- Tubercular
Which gram-positive organism is commonly responsible for pyogenic infections?
Staphylococcus
What is a common anaerobic organism associated with pyogenic infections?
Bacteroides fragilis
Name two sexually transmitted diseases and their causative organisms.
- N. gonorrhoeae
- Chlamydia trachomatis
What is the most common mode of infection spread in pelvic infections?
Ascending route
What are the classic modes of infection for specific organisms?
- Through continuity and contiguity (e.g., gonococcal infection)
- Through lymphatics and pelvic veins (e.g., post-abortal infections)
- Through blood stream (e.g., tubercular infections)
- From adjacent infected extra-genital organs
What are some causes of acute pelvic infection?
- Pelvic inflammatory disease (PID)
- Following delivery and abortion
- Following gynecological procedures
- Following IUD insertion
- Secondary to other infections (e.g., appendicitis)
What does PID stand for?
Pelvic Inflammatory Disease
PID is a disease of the upper genital tract involving the uterus, fallopian tubes, ovaries, and pelvic peritoneum.
What are the primary organs involved in PID?
- Uterus (endometrium) * Fallopian tubes * Ovaries * Pelvic peritoneum
PID typically involves the ascending spread of microorganisms from the cervicovaginal canal.
What is the preferred term for PID based on the organ involved?
Endometritis, salpingitis, pelvic peritonitis, tubo-ovarian abscess
The term ‘cervicitis’ is not included in the list of preferred terminologies.
What is the epidemiological trend for PID?
Incidence is on the rise due to increased sexually transmitted diseases
The incidence varies from 1–2 percent per year among sexually active women.
What percentage of PID cases are spontaneous infections?
85 percent
The remaining 15 percent follow procedures that favor the organisms to ascend.
What are the risk factors for PID?
- Menstruating teenagers * Multiple sexual partners * Absence of contraceptive pill use * Previous history of acute PID * IUD users * Areas with high prevalence of STDs
Teenagers have lower hormonal defense against genital tract infections.
What are some protective factors against PID?
- Contraceptive practice * Barrier methods (condoms, diaphragm with spermicides) * Oral steroidal contraceptives * Monogamy * Pregnancy * Menopause * Vaccines (hepatitis B, HPV)
Oral contraceptives create a thick mucus plug and decrease the duration of menstruation.
