SIM- PID Flashcards Preview

EndoRepro Block 3 > SIM- PID > Flashcards

Flashcards in SIM- PID Deck (16):
1

What is the pathway of ascending infxns that cause/contribute to PID?

cervicitis --> endometritis --> salpingitis/oophoritis/tubo-ovarian abscess--> peritonitis

"CE SOAP"

2

What are some risk factors for PID?

  • age <25
  • young age @ 1st sexual encounter [<15yo]
  • use of contraception OTHER THAN barrier/condoms
  • Hx of PID
  • personal or partner's Hx of gonorrhea/chlamydia
  • multiple partners
  • current douching
  • IUD insertion
  • demographics...SES, access to care [this is getting better]

3

What is a good Diff Dx for PID

  • appendicitis
  • ectopic
  • cystitis/UTI/nephrolithiasis
  • Ovarian cyst, torsion
  • endometriosis
  • gastroenteritis/IBS/IBD

4

What has to be present on pelvic exam to diagnose PID?

one or more...

-cervical motion tenderness aka "chandelier sign"

-uterine tenderness

-adnexal tenderness

5

What test is used for PID?

NO SPECIFIC TEST

  • swab for STDs
  • CRP, ESR, WBC elevations
  • US can ID enlarged fallopian tubes or abcess

6

How is the Diagnosis made for PID?

WHat is the PID spectrum?

CLINICALLY!

  • labs & imaging for uncertain cases, failure to respond to Tx or severe illness

 

PID ranges from Asx'c to life threatening!!!

 

7

When should we consider inpatient Tx for PID?

  1. unable to follow Tx plan or take oral therapy
  2. severely ill [Dr. P's major deciding factor]
  3. surgical abdomen
  4. TOA
  5. no improvement after 72 hrs
  6. prego

8

What medications can be given as Tx for PID?

  • Ceftriaxone [IM single dose] + Doxycyline [orally 2xday/14days]
    • +/- metronidazole 

9

What is the drug to Tx gonorrhea?

What about chlamydia?

gonorrhea: ceftriaxone

chlamydia: doxycycline

10

What are possible consequences of PID?

  • scarring-->infertility [20%]
  • scarring--> ectopic pregnancy [9%]
  • chronic pelvic pain [18%]

11

How do we Tx a TOA?

surgical drainage + antibiotics

12

How should we reduce incidence of PID as clinicians?

annual chlamydia screen for:

-sexually active women <25

-sexually active women >25 at high risk

13

When should we screen pregnant women?

1st trimester!

14

What is an important [often forgotten] part of Tx'ing a woman with PID?

Tx her partner too!!!

15

Do we have to report PID?

Yes, cuz its an STD [Gonorrhea & chlamydia are both reportable]

16

How do we teach our patients about PID?

Counsel them!

-about transmission

-risk redxn

-prevention etc