Pelvic Inflammatory Disease

Question 1

What is pelvic inflammatory disease (PID)?

Answer 1

It is defined as a condition in which there infection and inflammation of the female pelvic organs – including uterus, fallopian tubes, ovaries and peritoneum

Question 2

What is the pathophysiological cause of pelvic inflammatory disease?

Answer 2

It is secondary to ascending infection from the endocervix

Question 3

What are the seven risk factors associated with pelvic inflammatory disease?

Answer 3

Young Age < 25 Years Old

Sexually Active

Multiple Sexual Partners

Unprotected Sexual Intercourse

Sexually Transmitted Infection

Intrauterine Devices

Vaginal Douching

Question 4

What are the two sexually transmitted infections associated with pelvic inflammatory disease?

Answer 4

Chlamydia

Gonorrhoea

Question 5

What are the seven clinical features of pelvic inflammatory disease?

Answer 5

Fever > 38C

Lower Abdominal Pain

Vaginal Discharge

Vaginal Bleeding

Cervical Excitation

Dyspareunia

Dysuria

Question 6

What are the three investigations used to diagnose pelvic inflammatory disease?

Answer 6

Pregnancy Test

High Vaginal Swab

Nucleic Acid Amplification Tests (NAATs)

Question 7

How are pregnancy tests used to investigate pelvic inflammatory disease?

Answer 7

In order to exclude the differential diagnosis of an ectopic pregnancy

Question 8

What is the gold standard investigation used to diagnose pelvic inflammatory disease?

Answer 8

High Vaginal Swab

Question 9

How are high vaginal swabs used to diagnose pelvic inflammatory disease?

Answer 9

It is used to identify the causative organism, in order to guide management options

Question 10

What are the four causative organsisms associated with pelvic inflammatory disease?

Answer 10

Chlamydia Trachomatis

Neisseria Gonorrhoea

Mycoplasma Genitalium

Mycoplasma Hominis

Question 11

What is the most common causative organism of pelvic inflammatory disease?

Answer 11

Chlamydia Trachomatis

Question 12

What is important to note about high vaginal swabs in diagnosing pelvic inflammatory disease?

Answer 12

They tend to be negative, therefore a low threshold for treatment is required

Question 13

How are NAATs used to diagnose pelvic inflammatory disease?

Answer 13

They are used to screen for chlamydia and gonorrhoea, which are infections associated with pelvic inflammatory disease

Question 14

What are NAATS?

Answer 14

It involves checking directly for the DNA/RNA of the organsim

Question 15

What is the conservative management option of pelvic inflammatory disease?

Answer 15

It involves intrauterine device (IUD) removal

Question 16

What is the pharmacological management option of pelvic inflammatory disease?

Answer 16

Antibiotics

Question 17

What are the two antibiotic regimens used to manage pelvic inflammatory disease?

Answer 17

Oral ofloxacin and oral metronidazole

OR

Intramuscular ceftriaxone and oral doxycycline and oral metronidazole

Question 18

What are the four complications associated with pelvic inflammatory disease?

Answer 18

Chronic Pelvic Pain

Infertility

Ectopic Pregnancy

Fitz-Hugh Curtis Syndrome

Question 19

What is another term for Fitz-Hugh Curtis Syndrome?

Answer 19

Perihepatitis

Question 20

What is the clinical feature of Fitz-Hugh Curtis syndrome?

Answer 20

Lower Abominal Pain

Question 21

What is the feature of Fitz-Hugh Curtis syndrome on laparoscopy?

Answer 21

Multiple fine adhesions between the liver and abdominal wall