CLIPP 22 - PID Flashcards
1
Q
DDX Abdominal Pain (11)
A
- acute appendicitis (periumbilical/RLQ, McBurney’s point)
- testicular torsion
- Pelvic inflammatory disease (purulent cervical discharge)
- Cholecystits (RUQ/shoulder, Murphy’s sign, worse after eating)
- Pregnancy
- Hepatitis(jaundice, urine color change, hepatomegaly)
- Pancreatitis (constant, band-like pain radiating to back)
- UTI (dysuria, frequency, urgency, CVA tenderness)
- gastroenteritis (vomiting then diarrhea, hx of sick contacts)
- Mesenteric adenitis (RLQ pain with fever, vomiting, and diarrhea)
- Ovarian torsion (Stabbing lower abdominal pain)
2
Q
HEADSSS
A
Home Education/Eating Activities Drugs Sexuality Suicide Risk/Depression Safety
3
Q
PID clinical features
A
- Minimum criteria (at least 1): cervical motion tenderness, uterine tenderness, adnexal tenderness
- Supportive criteria: oral temperature >101, mucopurulent cervical discharge, cervical friability, abundance of WBC on vaginal fluid saline microscopy, elevated ESR, elevated CRP, infection with N. gonorrhoeae or C trachomatis
4
Q
PID epidemiology
A
sexually active females age 15-19
5
Q
PID complications
A
- short term: sepsis, perihepatitis, periappendicitis, Tubo-ovarian abscess, other intra-abdominal abscesses
- long-term: ectopic pregnancy, infertility, chronic abdominal pain, increased risk of recurrent PID
6
Q
PID treatment
A
- IM ceftriaxone 250mg + Doxycline 100mg BID x14d
- IM ceftriaxone + azithromycin 1g qw x 2w
- either of above +/- Metronidazole 500mg po BID x 14d
7
Q
Additional history questions in young female with abdominal pain (5)
A
-menstrual history, dysmenorrhea, dyspareunia, contraception and sexual hx, vaginal discharge
8
Q
Reasons to hospitalize a patient with PID (7)
A
-pregnancy, previous noncompliance, high fever, intractable vomiting, potential surgical emergency, inadequate response to oral therapy within 72 hours, tubo-ovarian abscess
