S9) Pelvic Inflammatory Disease Flashcards
What is pelvic inflammatory disease?
- Pelvic inflammatory disease is the infection of the female upper genital tract which ascends from the endocervix
- It presents with endometritis, salpingitis, parametritis, oophoritis, tubo-ovarian abscess and/or pelvic peritonitis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/042/a_image_thumb.png?1511335308)
In four steps, describe the pathophysiology of Pelvic Inflammatory Disease
⇒ Ascending infection from the endocervix & vagina
⇒ Infection causes inflammation
⇒ Inflammation causes damage to tubal epithelium
⇒ Adhesions form
What is endometritis?
Endometritis is the inflammation and infection of the endometrium lining of the uterus
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/082/a_image_thumb.jpg?1511335383)
What is salpingitis?
Salpingitis is the inflammation and infection of the uterine tubes
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/090/a_image_thumb.jpeg?1511335424)
What is parametritis?
Parametritis is the inflammation of the uterine ligaments and parametrium (connective tissue adjacent to the uterus)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/103/a_image_thumb.png?1511335938)
What is oophoritis?
Oophoritis is the inflammation of the ovaries, often arising due to infection and often accompanied with salpingitis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/105/a_image_thumb.png?1511335948)
What is a tubo-ovarian abscess?
- A tubo-ovarian abscess is an encapsulated pocket of pus which forms due to infection of the fallopian tubes and ovaries
- It is a late complication of PID and can be life-threatening if the abscess ruptures and results in sepsis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/116/a_image_thumb.jpg?1511336006)
What is pelvic peritonitis?
Pelvic peritonitis is the inflammation and infection of the peritoneum, which is the membrane that lines the abdomen in the pelvic area, often occurring as a complication of salpingitis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/225/745/129/a_image_thumb.jpg?1511336023)
Identify the two commonest organisms which cause PID
Sexually transmitted infections:
- Chlamydia trachomatis
- Neiserria gonorrhoea
Identify 4 other organisms which commonly cause PID
- Gardnerella vaginalis
- Mycoplasma hominis
- Anaerobes
- Actinomycosis
Which group of people have a high incidence of PID?
Sexually active women (20-30 years old)
Identify 5 risk factors for pelvic inflammatory disease
- Young age
- Lack of use of barrier contraception
- Multiple sexual partners
- Low socioeconomic class
- Intrauterine contraceptive device (IUCD)
Identify 6 symptoms of PID
- Pyrexia
- Lower abdominal pain
- Deep dyspareunia
- Abnormal vaginal/cervical discharge
- Abnormal vaginal bleeding
Describe 5 features observed during the examination of a typical patient with PID
- Fever
- Lower abdominal tenderness (bilateral)
- Lower genital tract infection
- Purulent cervical discharge
- Cervicitis
Provide a differential diagnosis of PID in terms of bladder, bowel and gynaecological conditions respectively
- Bladder conditions – UTI
- Bowel conditions – IBS, appendicitis
- Gynaecological conditions – ectopic pregnancy, endometriosis, ovarian cyst complications