Question 7: PID

Question 1

What are the key clinical features of PID?

Answer 1

Lower abdominal pain
Fever
Offensive vaginal discharge
Cervical motion tenderness
Bilateral adnexal tenderness

Question 2

What are the gynecological causes of lower abdominal pain?

Answer 2

Endometriosis
Pelvic Inflammatory Disease (PID)
Ectopic pregnancy
Ruptured ovarian cyst
Ovarian torsion

Question 3

What are the non-gynecological causes of lower abdominal pain?

Answer 3

Appendicitis
UTI/Pyelonephritis

Question 4

What imaging modalities are used in suspected PID?

Answer 4

Pelvic ultrasound: To assess for tubo-ovarian abscess or free fluid.
CT abdomen/pelvis: To evaluate for appendicitis.

Question 5

How is mild to moderate PID managed in an outpatient setting?

Answer 5

Ceftriaxone 250mg IM (single dose): Covers gonorrhea.
Azithromycin 1g PO (single dose): Covers chlamydia.
Metronidazole 400mg PO TDS for 5 days or 2g PO (single dose): Covers anaerobes.

Question 6

How should sexual partners of a patient with PID be managed?

Answer 6

Empirical treatment of the sexual partner.
Abstinence from sexual activity until treatment is completed.

Question 7

How is PID diagnosed?

Answer 7

Clinical diagnosis based on symptoms, pelvic exam findings, and exclusion of other causes

Question 8

What are the stages of PID?

Answer 8

Stage 1: Early salpingitis – mild to moderate tenderness and vaginal discharge.
Stage 2: Late salpingitis – pelvic peritonitis.
Stage 3: Tubo-ovarian complex.
Stage 4: Ruptured tubo-ovarian complex – generalized tenderness and septicemia.