PID/PCOS/ENDOMETRIOSUS Flashcards
(63 cards)
ascending spread of microorganism and contiguous structures from vagina or cervix to endometrium, tubes, ovarious
PID
60% of PID is ___
subclinical or silent
examples of PID RF
adolescence GC or CHL or HX of GC/CT Multiple partners Inserting IUD Demographic SES Hx of PID Male Partners w/ GC or Chl BV OCP in some cases
top 2 most common pathogens with PID
N. gonorrhoeae
C. trachomatis
what are some sx women with subclinical PID may experience?
- dyspareunia
- irregular bleeding
- dysuria
- GI sx
what bacteria is implicated with subclinical PID presentation?
C. trachomatis
most common sign on pelvic exam in pt with moderate PID
uterine, cervical motion, and adnexal TTP
Chandelier sign
what s/s indicate severe PID
high WBC and ESR/CRP
very ill: fever, chills, purulent d/c, N/V
risk of ectopic pregnancy is __ higher after PID
6-10 times higher after PID
tubal infertility rates after __ episodes of PID
1: 8% of women
2: 20% of women
3: 50% of women
what is fitz hugh Curtis syndrome
RUQ pain associated with acute salpingitis
indicating perihepatitis
what is fitz hugh Curtis syndrome mistaken for?
acute cholecystitis may be suspected but signs of PID show up quickly
PID dx criteria
uterine TTP or cervical motion TTP (w/ no other explanation)
Other add on signs:
- temp 38.3
- abnormal discharge
- WBC on saline wet prep
- Gonorrhea or chlamydia test
Mucopurulent Cervical discharge + test
5 reasons to admit PID pt
- cant r/o appendicitis ectopic
- Pregnancy
- No response to output antimicrobial tx 48-72 hrs
- severe illness (N/V, fever, TOA)
- HIV infxn with low CD4 count
1st line PID tx
ceftriaxone 250mg IM + doxy 100 mg BID for 14 days
OR
Ceftriaxone 250mg IM + Metronidazole 500mg BID X 14 days
if choosing cefoxitin instead of ceftriaxone what po med would you pair it with for PID tx
cefoxitin 2g IM + Probenecid 1 g PO administered
PLUS
doxy or metronidazole
parenteral PID tx
cefotetan 2gIV q 12 hr plus doxy
women with PID sex?
no wait until tx is done, sx resolved and partners are treated
all women with PID need to be tested for..
HIV, GC, HIV and Chl (NAAT)
PID pts should show improvement with tx in ___
72 hrs
all women dx with GC/Chl should be retested ____after tx regardless of whether their partner has been treated
3mo
all pregnant women in 1st trimester are screened for___
PID
when is screening for chlamydia recommended
all women that are active and under 25, and all those active over 25 that are high risk
t/f male partners of women with PID should be examined and tx if they had contact within 60 days prior to sx onset
true!
