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Flashcards in PID Deck (16)
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1

PID?

includes acute salphingitis ( gonococcal or nongonoccal)
-IUD related pelvic cellulitis
-tubo-ovarian abscess
-pelvic abscess

2

what organisms are associated w/ PID?

polymicrobial upper genital infx (mixed aerobic and anaerobic)
-gonorrhea
-chlamydia
-endogenous organisms (H. flue, enteric gram neg rods, streptococci, mycoplasma genitalium)

3

who normally gets PID?

young, sexually active, reproductive age wome

4

RF for PID?

sexually active, multiple partners, douching, smoking

5

what are complications of PID?

inferitlity and ectopic prego

6

infertility risk?

10% after 1st episode, 25% after 2nd episode, 50% after 3rd episode

7

Clinical features of PID

-lower abdominal and pelive pain (bilateral
-N (+/- V)
-HA
-lower back pain
+/- fever

8

PE will show?

lower abdominal and pelvic pain,
-cervical motion tenderness (Chandelier sign)
-purulent discharge and inflammation of Bartholin or Skene gland

9

what is the chandelier sigh?

cervical motion tenderness

10

what would a adnexal mass indicate?

tubo-ovarian abscess

11

lab studes for PID

DNA probe for gonorhea/chlamydia (most common cause)

12

imaging for PID

transvaginal US is helpful in differentiating acute and chronic inflammation or in the prexence of adnexal mass

-culdocentesis or laproscopy may be required

13

culdocentisis

peritoneal fluid obtained from the culde sac

14

tx of mild PID

-outpatients w/ abx, atipyretics, analgesics, bed rest

-ceftriaxone IM X 1 dose + azithromycin (or doxy)

may add metronidazole to cover for anaerobes

15

tx of those w. severe dz

Women with severe disease should be hospitalized for IV antibiotic therapy and possible surgery.
 Cefotetan or Cefoxitin PLUS doxycycline
 Doxycycline should be continued orally for 14 day

16

when to hospitalize a pt w/ PID

-surgical emergencies
-prego
-doesn't respond to oral antimicrobial tx
-unable to follow to tolerate oral regimen
-severe illnes
-TO abscess