PID

Question 1

Complications PID (5)

Answer 1

• Abscess
• Fitz-hugh-curtis Syndrome
• Tubal factor infertility
• Ectopic pregnancy
• chronic pain + dyspareunia

Question 2

Clinical presentation PID

Answer 2

• Lower abdominal pain 4 - 21 days
• B s/s
• Dysmenorrhea
• Menorrhagia
• Breakthrough bleeding on OCP
• Discharge
• GI/GU s/s

Question 3

Minimum Clinical Criteria PID

Answer 3

• Lower abdominal Tenderness
• Bilateral adnexal tenderness
• Cervical motion tenderness

Question 4

Use of Pelvic Sonogram

Answer 4

Detect masses; will NOT detect mild tubal changes

Question 5

What is the Golf standard for PID diagnosis in patients w/ uncertain diagnosis?

Answer 5

Diagnostic Laparaoscopy

Question 6

What two condition should be ruled out before aPID?

Answer 6

Appendicitis; ectopic pregnancy

Question 7

What are indications foir hospitalization in pts w/ PID?

Answer 7

Uncertain diagnosis
Clinical failure of O/P therapy
Pregnancy
Appendicitis
Suspected anaerobic infection
History of instrumentation
 IUCD
Suspected pelvic abscess or TOA
- Compliance issues
- Severe Disease

Question 8

CDC recommendations for PID Tx

Answer 8

• The CDC recommends that empiric treatment of PID be instituted on the presence of three minimum clinical criteriain the absence of an established cause other than PID
• The CDC recommends that treatment of PID be instituted on the presence lower abdominal pain or pelvic pain if no other causes for pain can be identified w/ Cervical motion tenderness, Uterine tenderness, adnexal tenderness

Question 9

PID Pharm Tx

Answer 9

• Regiment A: Cefotetan/Cefoxitin + Doxy
• Reg B: Clindamycin + Gentamicin
• Alt: Amp/Sublactam + Doxy;

Question 10

PID adjunctive Tx

Answer 10

• Rest in Semi-fowler’s position
• Pelvic rest
• fluids
• analgesics