Fallopian tube disorders

Question 1

what are the Fallopian tube disorders?

Answer 1

1. Pelvic inflammatory disease
2. Ectopic pregnancy

Question 2

what is Pelvic inflammatory disease (PID)?

Answer 2

STD that infects ascending

• from the cervix to:
  
  • endometrium, fallopian tubes then pelvic cavity
• Forms an abscess. (tubo-ovarian abscess)

Question 3

what causes PID?

Answer 3

N.gonorrhoeae or C.trachomatis

Question 4

What organisms cause Pelvic Inflammatory Disease?

how are they acquired?

Answer 4

N. gonorrhea and C. trachomatis

• sexual intercourse
• abortion (endometrial curetage)

Question 5

what patients are at risk for Pelvic inflammatory disease?

Answer 5

• Sexually promiscuous women
• Endometrial curettage for abortion

Question 6

what is the distribution of Pelvic Inflammatory Disease?

Answer 6

• Cervix = Cervicitis
• Endometrium = endometritis
• Fallopian tubes = salpingitis, pyosalpinx and tuboovarian abscess
• Pelvic cavity = peritonitis and pelvic abscess

Question 7

Patients with PID present with?

Answer 7

• Fever >38.3 0C
• Lower abdominal pain (salpingits)
• Vaginal discharge (cervicitis)
• Midline abdominal pain (endometritis)
• Abdominal tenderness and peritoneal signs (peritonitis)
• Right upper quadrant pain (perihepatitis).

Question 8

upon examination of patients with PID, what can you find?

Answer 8

• bilateral adnexal tenderness
• Chandelier sign: marked discomfort when the cervix is manipulated

Question 9

what are the complications of PID?

Answer 9

• Tubo-ovarian abscess: Rupture may result in life-threatening peritonitis
• Tubal scarring due to healing = increased rates of ectopic pregnancy; and Infertility

Question 10

how do you treat PID?

Answer 10

Foxy and Doxy (cefoxitin and doxycyclin)

Question 11

what is an ectopic pregnancy?

it most commonly happens in what part?

Answer 11

Means implantation of a fertilized ovum outside the endometrial cavity.

the fallopian tube

Question 12

why does ectopic pregnancy happen?

what causes the above?

Answer 12

Ectopic pregnancy results when passage of the fertilized ovum along the fallopian tube is impeded.

Due to:

• Scarring from previous PID ( damage to cilia)
• Scarring from Endometriosis
• Abnormal tubal motility

Question 13

Clinical features of ectopic pregnancy (4T’s and 1S)

Answer 13

• Temperature > 380C (20%)
• Tenderness abdominal (90%) +/- rebound
• Tenderness on bimanual examination, cervical motion tenderness
• Tissue: palpable adenexal mass
• Signs of pregnancy (Chadwick’s sign, Hegar’s sign)

Question 14

what is Fitz-Hugh Curtis syndrome?

what is another name for this?

Answer 14

violin string adhesions between the fallopian tube and the liver capsule

Perihepatitis