S11C107 - PID Flashcards
1
Q
PID includes:
A
-salpingitis, endometritis, myometritis, parametritis, oophoritis, tubo-ovarian abscess, FHC syndrome
2
Q
PID organisms
A
- STI: CT, NG, HSV, trichomonas
- other: mycoplasma getnitalium, ureaplasma, hominis, anaerobes (bacteroides, peptostreptococcus), aerobes (gardnerella vaginalis, h flu, strep agalactiae, e coli, gm- rods
- most often polymicrobial
3
Q
PID complications
A
- tubo-ovarian abscess
- scarring, adhesions in tubes
- fatal ectopic pregnancy
- infertility
- chronic pelvic pain
- dyspareunia
4
Q
PID Sx:
A
- d/c
- postcoital bleeding
- dysuria
- fever
- malaise
- n/v
5
Q
PID w/u:
A
- preg test
- absence of leukorrhea is a negative predictor
- NG, CT
- may consider syphilis testing, HBV/HCV, HIV
- positive u/a does not exclude PID
- imaging: pelvic u/s, CT, MRI
- endometrial bx
- culdocentesis
- laparoscopy is gold standard for dx of PID
6
Q
PID Dx:
A
- start empiric tx if: lower abdo pain, adnexal tenderness + CMT
- or: fever, d/c, incr CRP, swab positive
- or: laparoscopic confirmation, transvag US positive, bx showing endometeritis
7
Q
STI tx: gonorrhea (BC guidelines)
A
- cefixime 800mg PO once OR Ceftriaxone 250mg IM once PLUS azithro 1g PO or doxy x7d to treat for chlamydia
- OR: azithromycine 1g PO once taken with food to minimize vomiting
-pregnant: cefixime 800mg PO once
or CTX 250mg IM x1 plus amox 500mg TID x7d
or azithromycin 1g PO x1
8
Q
STI tx: chlamydia (BC guidelines 2014)
A
- 1st line: doxy 100mg PO BID x7d OR azithromycin 1g PO once
- 2nd line: erythromycin 500mg PO QID x7d
- pregnant: amoxicillin 500mg PO TID x7d OR azithromycin 1g PO once (if vomiting occurs >1h post dose a rpt dose is not required)
9
Q
PID Tx: (BC 2014)
A
- cefixime 800mg PO oncem (out-pt)
- or CTX 250mg IM once PLUS doxy
- or azithromycin 1g PO x1 then another dose in 1w +/- flagyl
-In treating mild to moderate PID, it is not necessary to remove the IUD during treatment unless there is no clinical improvement after 72 hours of recommended antibiotic treatment.
