PID

Question 1

Name some microbes that cause PID

Answer 1

Neisseria gonnhoeae 
C trachomatis 
Mycoplasma hominis 
Gardnerella vaginalis 
(Anaerobes) 
(Actinomycosis)

Question 2

What is the order of infection in PID?

Answer 2

Endocervitis 
Endometritis 
Salpingitis 
Parametritis 
Oophoritis 
Tubo-ovarian abscess 
Pelvis peritonitis `

Question 3

What are the key features of a PID history?

Answer 3

Pyrexia
Pain (lower abdominal/ deep dyspareunia)
Abnormal vaginal/ cervical discharge
Abnormal vaginal bleeding
Sexual history
Previous STI
Contraceptive history - IUCS/ lack of barrier contraceptives

Question 4

What are some gynaecological differentials to PID?

Answer 4

Ovarian cyst complications
Ectopic pregnancy
Endometriosis

Question 5

What investigations should be carried out in suspected PID?

Answer 5

Urinalysis and serum pregnancy test
Endocervical and high vaginal swabs

Blood tests (WCC and CRP)

Screening for other STIs and HIVs

Diagnostic laparoscopy

Question 6

What is an advantage of performing a laparoscopy in suspected PID?

Answer 6

Adhesiolysis - drain abscesses

Question 7

What are some complications of PID?

Answer 7

Ectopic pregnancy 
Infertility 
Chronic pelvic pain 
FHC syndrome 
Reiter syndrome

Question 8

Why would you give IV ABx in PID?

Answer 8

Signs of tuboovarian abscess
>38 pyrexia
No oral Tx response
Pelvic peritonitis