Chapter 23

Question 1

Pelvic inflammatory disease (PID)

Answer 1

An infection of the upper female reproductive organs—specifically, the uterus, ovaries, and fallopian tubes—that occurs almost exclusively in sexually active women
Disease-causing organisms enter the vagina during sexual activity and migrate through the opening of the cervix and into the uterine cavity.
The infection may then expand to the fallopian tubes (producing scarring that can increase the risk of life-threatening ectopic pregnancy or sterility), eventually involving the ovaries (leading to the development of a life-threatening abscess).
Ectopic pregnancy is a pregnancy that develops outside the uterus, most often in the fallopian tube.
Although PID itself is seldom a threat to life, it can lead to an ectopic pregnancy or an abscess, which can be life threatening.
The most common presenting sign of PID is generalized lower abdominal pain.
Other signs and symptoms include:
Abnormal and often foul-smelling vaginal discharge
Increased pain during sexual intercourse
Fever
General malaise
Nausea and vomiting

Question 2

Chlamydial

Answer 2

Currently the most commonly reported sexually transmitted disease in the United States
Although the symptoms of chlamydia are usually mild or absent, some women may report lower abdominal pain, low back pain, nausea, fever, pain during sexual intercourse, and/or bleeding between menstrual periods.
Chlamydial infection of the cervix can spread to the rectum, leading to rectal pain, discharge, or bleeding.
If left untreated, the disease can progress to PID.
In rare cases, chlamydia causes arthritis that may be accompanied by skin lesions and inflammation of the eye and urethra.

Question 3

Bacterial vaginosis

Answer 3

Bacterial vaginosis is the most common vaginal infection in women age 15 to 44.
Normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.
Symptoms may include itching, burning, or pain and may be accompanied by a “fishy,” foul-smelling discharge.
Pregnant women with bacterial vaginosis may have premature babies or babies born with low birth weight.
If left untreated, bacterial vaginosis can lead to more serious infections, or result in PID.

Question 4

Gonorrhea

Answer 4

Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply rapidly in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women and in the urethra in women and men.
The bacterium can also grow in the mouth, throat, eyes, and anus.
Symptoms, which are generally more severe in men than in women, appear approximately 2 to 10 days after exposure.
Women may not have any symptoms, or only mild ones, until the infection has spread to other parts of the reproductive system.
Symptoms in women present as:
Painful urination, with associated burning or itching
A yellowish or bloody vaginal discharge, usually with a foul odor
Blood associated with vaginal sexual intercourse
More severe infections may present with cramping and abdominal pain, nausea and vomiting, and bleeding between menstrual periods.
These symptoms indicate that the infection has progressed to PID.