Upper Female Reproductive Tract and Systemic Infections Flashcards Preview

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Flashcards in Upper Female Reproductive Tract and Systemic Infections Deck (19):
1

when does endometritis occur?

after instrumentation, c/s, IUD placement

2

what finding will be present in endometrial bx of a non-puerperial pt w/endometritis?

plasma cells

3

tx of endometritis

clindamycin IV if severe, cephalosporin IV if mild. Continue until pt is asx'c and/or afebrile for 48h.

if chronic, doxycycline for 3w

4

how to make dx of endometritis?

uterine tenderness, fever, elevated WBC

5

what age group is PID most common?

15-19 year-olds b/c of increased high-risk sexual behavior, lack of routine gyn care

6

how to dx PID?

fever, elevated WBC, pelvic pain, cervical motion tenderness, adnexal tenderness
laparoscopy is definitive dx, only used when appendicitis cannot be r/o

7

Fitzhugh-Curtis syndrome

perihepatitis froma scending infection from PID infecting liver

8

tx of PID:

hospitalize for IV cefoxitin or cefotetan until pt is asx'c for 48h. Then 10-14d doxycycline PO.
if compliant, can do outpt IM ceftriaxone until sx's resolve followed by PO doxycycline

9

what are the major sequelae of PID?

increased rates of ectopic pg'ies
infertility

10

how is a tubo-ovarian abscess not really an abscess?

it is not walled-off :. more responsive to abx

11

when should you consider TOA?

when PID is not responsive to tx

12

dx of TOA?

elevated WBC, ESR, adnexal or posterior cul-de-sac fullness. Puss on culdocentesis.
U/s to distinguish b/w TOA and TOC

13

tx of TOAs?

IV broad-spec abx - cefoxitin + doxycycline
if that doesn't work, expand using amp + gent + clinda or metronidazole
until afebrile for 48h
surgery if abx don't work

14

causative organism of TSS?

s. aureus that produces TSST-1 (toxin)

15

cp of TSS:

high fever
rash w/desquamation of skin
hypotension
myalgias
GI upset
low plts
azotemia
blood cx w/b neg

16

tx of TSS:

hospitalization, maybe even ICU
IV fluids, pressors
IV abx

17

what is the rate of neonatal HIV infection (born to HIV+ moms)?

25-30%

18

mgt of pregnant HIV+ pt?

get her on HAART. Want viral load t/b low.
AZT after first trimester, antepartum, and to neonate
c/s prior to ROM decreases rate of transmission

19

pap smear screening in HIV+ pts?

high incidence of invasive cervical ca. in HIV+ pts. Pap smear at initial visit, then 6 mos later. If both -, annual. If not, q6mos.