Pelvic Inflammatory Disease

Question 1

What is PID?

Answer 1

inflammation and infection of the organs of the pelvis

Question 2

what causes PID?

Answer 2

infection spreading up through the cervix

Question 3

2 significant outcomes of PID

Answer 3

tubular infertility

chronic pelvic pain

Question 4

salpingitis

Answer 4

inflammation of fallopian tubes

Question 5

oophritis

Answer 5

inflammation of ovaries

Question 6

parametritis

Answer 6

inflammation of parametrium

Question 7

parametrium

Answer 7

connective tissue around the uterus

Question 8

main cause of PID

Answer 8

STIs

Question 9

3 main STIs which can cause PID

Answer 9

Neisseria gonorrhoea
chalmydia trachomatis
mycoplasma genitalia

Question 10

less common causes of PID

Answer 10

gardnerella vaginalis - BV
H influenzae - rep infections
E coli - UTI

Question 11

Risk factors for PID

Answer 11

no barrier contraception 
multiple sexual partners
younger age 
existing STi
previous PID
IUD eg copper coil

Question 12

presentation

Answer 12

pelvic or lower abdo pain 
abnormal discharge or bleeding
dyspareunia
fever 
dysuria

Question 13

examination findings

Answer 13

pelvic tenderness
cervical motion tenderness/excitation
inflamed cervix
purulent discharge

Question 14

testing for causative STI

Answer 14

NAAT for gonorrhoea, chalmydia and mycoplasma genitalium
HIV test
syphilis test

Question 15

investigations

Answer 15

STI tests - NAAT and bloods
high vaginal swab - BV, candidiasis
pregnancy test
inflammatory markers

Question 16

what can a microscope detect?

Answer 16

pus cells

Question 17

why should a pregnancy test be done?

Answer 17

exclude ectopic pregnancy

Question 18

management

Answer 18

Refer to GUM
contact tracing
im ceftriaxone 1g
doxycycline 14 days 100mg
metronidazole 400mg 14 days

Question 19

complications of PID

Answer 19

sepsis 
abscess
infertility 
chronic pelvic pain 
ectopic pregnancy 
Fitz-Hugh-Curtis syndrome

Question 20

what is Fitz-Hugh-Curtis syndrome

Answer 20

inflammation and infection of liver capsule

adhesions between liver and peritoneum

Question 21

presentation of Fitz-Hugh-Curtis syndrome

Answer 21

RUQ pain –> right shoulder tip

Question 22

managing Fitz-Hugh-Curtis syndrome

Answer 22

laparoscopy

adhesiolysis