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EndoRepro Block 3 > SIM- PID > Flashcards

SIM- PID Flashcards

1
Q

What is the pathway of ascending infxns that cause/contribute to PID?

A

cervicitis –> endometritis –> salpingitis/oophoritis/tubo-ovarian abscess–> peritonitis

“CE SOAP”

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2
Q

What are some risk factors for PID?

A
  • age <25
  • young age @ 1st sexual encounter [<15yo]
  • use of contraception OTHER THAN barrier/condoms
  • Hx of PID
  • personal or partner’s Hx of gonorrhea/chlamydia
  • multiple partners
  • current douching
  • IUD insertion
  • demographics…SES, access to care [this is getting better]
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3
Q

What is a good Diff Dx for PID

A
  • appendicitis
  • ectopic
  • cystitis/UTI/nephrolithiasis
  • Ovarian cyst, torsion
  • endometriosis
  • gastroenteritis/IBS/IBD
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4
Q

What has to be present on pelvic exam to diagnose PID?

A

one or more…

  • cervical motion tenderness aka “chandelier sign”
  • uterine tenderness
  • adnexal tenderness
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5
Q

What test is used for PID?

A

NO SPECIFIC TEST

  • swab for STDs
  • CRP, ESR, WBC elevations
  • US can ID enlarged fallopian tubes or abcess
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6
Q

How is the Diagnosis made for PID?

WHat is the PID spectrum?

A

CLINICALLY!

  • labs & imaging for uncertain cases, failure to respond to Tx or severe illness

PID ranges from Asx’c to life threatening!!!

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7
Q

When should we consider inpatient Tx for PID?

A
  1. unable to follow Tx plan or take oral therapy
  2. severely ill [Dr. P’s major deciding factor]
  3. surgical abdomen
  4. TOA
  5. no improvement after 72 hrs
  6. prego
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8
Q

What medications can be given as Tx for PID?

A
  • Ceftriaxone [IM single dose] + Doxycyline [orally 2xday/14days]
    • +/- metronidazole
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9
Q

What is the drug to Tx gonorrhea?

What about chlamydia?

A

gonorrhea: ceftriaxone

chlamydia: doxycycline

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10
Q

What are possible consequences of PID?

A
  • scarring–>infertility [20%]
  • scarring–> ectopic pregnancy [9%]
  • chronic pelvic pain [18%]
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11
Q

How do we Tx a TOA?

A

surgical drainage + antibiotics

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12
Q

How should we reduce incidence of PID as clinicians?

A

annual chlamydia screen for:

  • sexually active women <25
  • sexually active women >25 at high risk
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13
Q

When should we screen pregnant women?

A

1st trimester!

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14
Q

What is an important [often forgotten] part of Tx’ing a woman with PID?

A

Tx her partner too!!!

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15
Q

Do we have to report PID?

A

Yes, cuz its an STD [Gonorrhea & chlamydia are both reportable]

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16
Q

How do we teach our patients about PID?

A

Counsel them!

  • about transmission
  • risk redxn
  • prevention etc

EndoRepro Block 3 (4 decks)

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