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)
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2
Q

HEADSSS

A
Home
Education/Eating
Activities
Drugs
Sexuality
Suicide Risk/Depression
Safety
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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
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4
Q

PID epidemiology

A

sexually active females age 15-19

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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
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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
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7
Q

Additional history questions in young female with abdominal pain (5)

A

-menstrual history, dysmenorrhea, dyspareunia, contraception and sexual hx, vaginal discharge

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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

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