pelvic inflammatory disease

Question 1

causative organisms

Answer 1

chlamydia trachomatis
neisseria gonorrhoea
mycoplasma genitalia

Question 2

risk factors: 2 main types of risk factors

Answer 2

factors relating to sexual behaviour

recent intrumentation of uterus/interuption of cervical barrier

Question 3

risk factors: factors relating to sexual behaviour

Answer 3

young age 
early age 1st coitus
multiple sexual partners
recent new partner
Hx STI

Question 4

risk factors: recent instrumentation uterus/interuption cervical barrier

Answer 4

termination pregnancy
new IUD
IVF
intra uterine insemination

Question 5

complications

Answer 5

tubal infertility
ectopic pregnancy
chronic pelvic pain

Question 6

symptoms

Answer 6

pelvic pain 
deep dyspareunia 
abnormal vaginal bleeding
abnormal discharge
dysmenorrhoea

Question 7

signs

Answer 7

lower abdominal tenderness
bimanual: adnexal tenderness, cervical motion tenderness, uterine tenderness
speculum: abnormal discharge
fever >38

Question 8

when to admit to hospital

Answer 8

pregnant
can't rule out ectopic pregnancy 
can't rule out surgical emergency 
severe symtoms/signs 
unwell

Question 9

investigations

Answer 9

high vaginal swab: BV, thrush
chlamydia, gonorrhea, mycoplasma
vaginal/endovercial pus cells on microscopy
ESR, CRP, WCC

Question 10

management

Answer 10

analgesia: paracetamol, ibuprofen

empirical antibiotics

Question 11

antibiotics

Answer 11

IM ceftriaxone
oral doxycycline
oral metronidazole