Pelvic Inflammatory Disease Flashcards
1
Q
pelvic inflammatory disease
A
- pelvic refers to a region -> the entire female reprod system is located w/in this region, so PID affects the entire reprod tract
- extensive inflmtn beyond the cervix -> uterus -> fallopian tubes -> ovaries (ascending infection)
- endomitritis (inflamed uterus)
- salpingitis (inflamed fallopian tubes)
- oophoritis (inflamed ovaries)
2
Q
etiology
A
- ascending polymicrobial infection that is pyogenic
- sexually transmitted
chlamydia (20% of PID)
gonorrhea (10% of PID)
3
Q
patho
A
- microbes enter cervix (often during menstruation d/t dilation of the cervix and the endometrium providing nutritive material)
- microbes move up into the uterus -> multiply very rapidly as endometrium sloughs off providing nutrition for microbe proliferation
- ascend to tubes -> ovaries -> body cavity -> peritonitis (complx)
- microbes could also enter circulatory system and cause bacteremia
- infection -> inflmtn -> adhesion
4
Q
manifestations
A
- fever d/t infection
- heavy, purulent vaginal discharge
- bleeding ? (occasional)
- adnexal tenderness
- abdominal and lower back pain
5
Q
when is bleeding a problem?
A
pre-menopausal women = between menses
postmenopausal women = at any time
6
Q
adnexal tenderness
A
towards uterus (pain on palpation in region of uterus)
7
Q
complications
A
- peritonitis; pelvic abscess
- bacteremia
- infertility
8
Q
diagnosis
A
- based on manifestations
- labs (CBC, WBCs, increased CRP, increased ESR)
- laparascopy
9
Q
treatment
A
- multiple broad spectrum Abx (90% success)
- Sx if required for complx
10
Q
what is ESR and why is it increased?
A
- erythrocyte sedimentation rate; measures amount of time it takes for RBCs to settle down
- when inflmtn is present, a variety of proteins are prod. such as CRP, Abs, fibrinogen, and the increased [protein] = RBCs separated into groups that settle faster = increased ESR
