Pelvic Inflamatory Disease PID

Question 1

What is pelvic inflammatory disease (PID)?

Answer 1

PID is an infection and inflammation of the upper female genital tract, including the uterus, fallopian tubes, and ovaries.

Question 2

What are the most common causes of PID?

Answer 2

PID is commonly caused by sexually transmitted infections, particularly Chlamydia trachomatis and Neisseria gonorrhoeae.

Question 3

Can PID be caused by non-sexually transmitted organisms?

Answer 3

Yes, it can also be caused by organisms like Mycoplasma genitalium, anaerobes, or post-surgical infections.

Question 4

What are the typical symptoms of PID?

Answer 4

Symptoms include lower abdominal pain, abnormal vaginal discharge, dyspareunia (pain during intercourse), fever, and irregular menstrual bleeding.

Question 5

Can PID be asymptomatic?

Answer 5

Yes, PID may be asymptomatic or present with mild symptoms in some cases.

Question 6

What are the risk factors for PID?

Answer 6

Risk factors include multiple sexual partners, unprotected sex, a history of STIs, and recent gynaecological procedures.

Question 7

How does PID affect fertility?

Answer 7

PID can lead to infertility due to scarring and damage to the fallopian tubes.

Question 8

What is the pathophysiology of PID?

Answer 8

PID occurs when pathogens ascend from the lower genital tract to the upper genital tract, causing inflammation and tissue damage.

Question 9

What are the clinical examination findings in PID?

Answer 9

Findings include lower abdominal tenderness, cervical motion tenderness, and adnexal tenderness.

Question 10

What are the diagnostic criteria for PID?

Answer 10

Diagnosis is clinical, supported by symptoms, examination findings, and sometimes additional investigations.

Question 11

What investigations are commonly performed in suspected PID?

Answer 11

Investigations include swabs for STIs, pelvic ultrasound, and blood tests (e.g., CRP, white cell count).

Question 12

What is the role of pelvic ultrasound in PID?

Answer 12

Ultrasound may identify complications such as tubo-ovarian abscesses or rule out other causes of abdominal pain.

Question 13

What are the differential diagnoses for PID?

Answer 13

Differentials include ectopic pregnancy, appendicitis, ovarian torsion, endometriosis, and urinary tract infection.

Question 14

How is PID treated?

Answer 14

Treatment involves broad-spectrum antibiotics, covering likely pathogens, such as ceftriaxone, doxycycline, and metronidazole.

Question 15

What is the typical antibiotic regimen for PID?

Answer 15

Regimens often include intramuscular ceftriaxone followed by oral doxycycline and metronidazole for 14 days.

Question 16

Why is partner notification important in PID management?

Answer 16

Partner notification helps identify and treat sexual contacts to prevent reinfection and further transmission.

Question 17

What are the complications of untreated PID?

Answer 17

Complications include chronic pelvic pain, infertility, ectopic pregnancy, and tubo-ovarian abscesses.

Question 18

What is a tubo-ovarian abscess?

Answer 18

A tubo-ovarian abscess is a collection of pus involving the fallopian tube and ovary, often a complication of severe PID.

Question 19

How is a tubo-ovarian abscess managed?

Answer 19

Management includes antibiotics and, in some cases, surgical drainage.

Question 20

What is chronic pelvic inflammatory disease?

Answer 20

Chronic PID refers to long-term sequelae of untreated or recurrent PID, often causing chronic pelvic pain and infertility.

Question 21

How can PID be prevented?

Answer 21

Prevention includes practising safe sex, using condoms, regular STI screening, and prompt treatment of infections.

Question 22

Can intrauterine devices (IUDs) increase the risk of PID?

Answer 22

IUD insertion may slightly increase the risk of PID in the first few weeks post-insertion, but the overall risk is low.

Question 23

What is the role of laparoscopy in PID?

Answer 23

Laparoscopy can provide a definitive diagnosis in uncertain cases and assess the extent of damage in chronic cases.

Question 24

What advice should be given to patients with PID?

Answer 24

Patients should abstain from sexual activity until treatment is complete, ensure partner treatment, and attend follow-up appointments.

Question 25

What are the long-term implications of PID?

Answer 25

Long-term implications include an increased risk of ectopic pregnancy, infertility, and chronic pelvic pain.