Repro CIS Flashcards
1
Q
Pelvic Infl Dz
A
- acute infection of upper genital tract structures in women (uterus, oviducts, ovaries)
- results in endometritis, salpingitis, oophoritis, peritonitis, perihepatitis, and tubo-ovarian abscess
- polymicrobial infection- broad coverage
- Chlamydia and Neisseria
2
Q
PID
A
- pregnancy test
- barrier contraception after tubal ligation
- sexual abuse screening
- Chlamydia, Neisseria, HIV, hepatitis, syphilis testing
- male sex partners of women w PID should be evaluated and treated
- neg endocervical screening for chlamydia and gonorrhea do not rule out upper tract infection
3
Q
PID- clinical features
A
- lower abd pain
- pain during or shortly after menses
- new vaginal discharge
- dyspareunia
- abnormal bleeding
- pain w jarring movement
4
Q
indications for hospitalization in PID
A
- pregnancy
- lack of response to tx
- non,adherence
- inability to take oral meds due to N/V
- severe clinical illness (fever, severe pain, V)
- complication w abscess
- possible need for surgical intervention or exploration
5
Q
PID complications
A
- 10% have perihepatitis (Fitz-Hugh Curtis Syndrome)- infection of liver capsule and peritoneal surfaces of RUQ
- patchy purulent fibrinous exudate- “violin string” adhesions
- Bartholin gland abscess
- long term- infertility, ectopic pregnancy, chronic pain
- pelvic abscess- TVUS if suspected
6
Q
PID risk factors
A
- 10% of untreated gonorrhea and 20% of untreated chlamydia
- STD risk factors- young age at 1st sex, non-barrier contraception, mult sexual partners
- facilitate PID- previous PID, sex during menses, vaginal douching, BV, IUD
7
Q
Tx options for PID
A
-2nd or 3rd gen cephalosporin and azithromycin or doxycycline!!!
8
Q
if recent uterine instrumentation or IUD- coverage for?
A
-IUD- anaerobe actinomyces israelii!!!
9
Q
OMT when?
A
-after pt has been abx for 48 hrs and no fever
10
Q
viscerosomatic reflexes of ovaries, uterus, fallopian tubes, colon- symp
A
- ovaries- T10-11
- uterus- T9-L2
- fallopian tubes- T10-L2
- colon- T9-L2
11
Q
parasymp
A
- female urogenital tract and distal colon- S2-4
- proximal to mid-transverse colon- AA/OA
