CH. 45 Adnexa Path

Question 1

What does PID stand for?

Answer 1

Pelvic Inflammatory disease

Question 2

PID is most commonly associated with..?

Answer 2

STDs (gonorrhea and Chlamydia)

Question 3

what are some less common causes of PID?

Answer 3

• ruptured appendix
• post surgical infection
• appendicitis

Question 4

is PID unilateral or bilateral?

Answer 4

bilateral usually

Question 5

what are the long-term consequences of PID?

Answer 5

pelvic pain, infertility, increased risk of ectopic pregnancy

Question 6

what are the risk factors for PID?

Answer 6

• early sexual contact
• multiple sexual partners
• History of STDs
• douching

Question 7

what is endometritis?

Answer 7

inflammation of endometrium

Question 8

what is salpingitis?

Answer 8

inflammation of fallopian tubes

Question 9

what is hydrosalpinx?

Answer 9

fallopian tube is blocked by fluid

Question 10

what is pyosalpinx?

Answer 10

fallopian tubes filled with pus

Question 11

what is periovarian inflammation?

Answer 11

infection or inflammation that has spread to the fallopian tube, ovary and broad ligament

Question 12

what is a Tubo-Ovarian Abscess? (TOA)

Answer 12

infection of a pocket of pus that forms in the fallopian tube and ovary, involving the broad ligament

Question 13

what is peritonitis?

Answer 13

inflammation of the peritoneum

Question 14

how does PID spread?

Answer 14

spreads along the mucosa of pelvic organs

Question 15

where does PID infect first?

Answer 15

cervix

Question 16

how does PID progress from the Cervix?

Answer 16

the endometrium, then fallopian tubes, ovaries, and finally the peritoneum

Question 17

what are the clinical signs for PID?

Answer 17

• pelvic pain
• fever
• vaginal discharge
• increased WBC count

Question 18

How does PID appear on ultrasound?

Answer 18

• fluid/ pus in the posterior cul-de-sac
• thickened endo
• fluid in fallopian tubes
• complex abscess

Question 19

what are the stages of PID?

Answer 19

1) endometritis
2) salpingitis
3) severe PID in broad ligament and ovarian involvement
4) chronic long-standing PID

Question 20

what are the clinical signs for salpingitis?

Answer 20

• asymptomatic pelvic discomfort
• low-grade fever

Question 21

how does salpingitis appear on ultrasound?

Answer 21

• dilated tubes
• tortuous tubes

Question 22

define TOA

Answer 22

tubo-ovarian abscess, this is where adhesions cause the ovary to be stuck to the fallopian tube &/or the broad ligament, leaving scars

Question 23

define peritonitis

Answer 23

inflammation of the peritoneum and the serous membrane lining of the abdominal cavity.

Question 24

list several causes for peritonitis

Answer 24

when infectious process spreads OUTSIDE the pelvis; ovaries and tubes to involve bladder, ureter, bowel, and adnexal area.

Question 25

what is the sonographic appearance of peritonitis?

Answer 25

- gas forming bubbles - loculated areas of fluid

Question 26

what is the most common cause of endometritis in a non-OB patient?

Answer 26

STDs

Question 27

what is the most common cause of fever after delivery?

Answer 27

c-section endometritis

Question 28

what is the ultrasound appearance of endometritis?

Answer 28

- endo >20mm - thick endo - fluid, air, clot in the endo

Question 29

what is endometriosis?

Answer 29

fuctional endometrial tissue in abnormal locations

Question 30

what are the symptoms of endometriosis?

Answer 30

- dysmenorrhea - pelvic pain

Question 31

How does endometriosis appear on ultrasound?

Answer 31

- hypoechoic - ill-defined borders - ground glass (endometrioma)

Question 32

what is a chocolate cyst?

Answer 32

endometrioma

Question 33

what are the two main reasons for ultrasound intervention with PID?

Answer 33

- biopsy and access abscess drainage - evaluate post-op pelvic masses