PID

Question 1

prevalence

Answer 1

about 1 mill women in US / yr

Question 2

ex of risk factors

Answer 2

Hx PID, STD, IUR, multiple partners

bacterial vaginosis, low SES, OCP use

Question 3

most cases of PID are___

Answer 3

polymicrobial

Question 4

Most common pathogens of PID

Answer 4

N. gonorrhoeae

C. trachomatis

Question 5

common gram - pathogens

Answer 5

e coli

Question 6

common anaerobe pathogens

Answer 6

Bacteriodes, Prevotella, peptostreptococcus

Question 7

common gram + organisms

Answer 7

streptococcus spp.

Question 8

pathway of ascendant infection

Answer 8

cervicitis
endometritis
salpingitis/oophoritis
peritonitis

Question 9

subclinical dz

Answer 9

60% of time no sx

Question 10

s/s

Answer 10

lower abdominal pain 
pelvic pain 
cramping 
dysuria 
uterine tenderness

Question 11

severe PID s/s

Answer 11

fever chills 
purulent vaginal discharge 
N/V, high WBC 
ESR up
CRP also up

Question 12

about__% of women with PID will have ___

Answer 12

sequelae: ectopic preg, infertility or chronic pelvic pain

Question 13

risk of ectopic preg. increased ___ after PID

Answer 13

6-10X higher risk

Question 14

tubal infertility after one episode of PID

Answer 14

8%

Question 15

tubal infertility after 3 episodes

Answer 15

50%

Question 16

most sensitive physical exam finding

Answer 16

acute adnexal tenderness

Question 17

dx criteria

Answer 17

uterine / adnexal tenderness with cervical motion tenderness

Question 18

fitz hugh Curtis syndrome def

Answer 18

complication of gonococcal or chlamydial salpingitis

Question 19

fitz hugh Curtis s/s

Answer 19

RUQ pain with association with acute salpingitis indicating perihepatitis

Question 20

if PID and BV are present tx must include

Answer 20

anaerobic coverage

Question 21

when hospitalize

Answer 21

1. cant exclude surgical emergenices
2. pregnancy
3. non-response to oral therapy
4. severe illness, N/V, TOA
5. HIV infxn with low CD4 count

Question 22

all dx with PID should be tested for..

Answer 22

HIV, GC and CHL using NAAT

Question 23

all dx with gono or chlamydia should be retested by___ after tx regardless of whether their partner has been treated

Answer 23

3 mo

Question 24

t/f male partner of women with PID should be examined and treated if they had contact 60 days prior to sx onset

Answer 24

true