Upper Female Reproductive Tract and Systemic Infections Flashcards
Most common causes of endomyometritis? Diagnostic findings (3)? Treatment?
Instrumentation of the intrauterine cavity - C-sections, vaginal deliveries, D&C, IUD placement, etc.
Bimanual exam reveals uterine tenderness, fever, and elevated WBC.
IV clindamycin and gentamicin.
Most common serious complication of STI?
PID - can lead to infertility and ectopic pregnancy
Diagnostic criteria for PID (4)?
Additional criteria (6)
Definitive diagnostic test?
Pelvic/Lower abdominal pain + either/and/or
CMT, uterine tenderness, adnexal tenderness.
Fever, discharge, increased ESR, WBC, and C-RP, and infection with chlamydia or gonorrhoeae.
Laprascopic
Hepatic complication and presentation from PID?
Fitzhugh-Curtis Syndrome. Right upper quadrant pain/tenderness and elevated LFT.
Most PID is mono or poly microbial?
Polymicrobial - including bacteroides, gardnerella, E coli etc.
Treatment for PID?
Hospitalization - Cephalosporin IV plus Doxycycline IV/PO for 24 hours. 2 weeks of PO doxycycline out of the hospital.
Difference between tubo ovarian abscess and complex?
Complexes are not walled off, and are more responsive to therapy.
Most common presentation of TOA in patient with PID (3)?
Primary diagnostic test? If that fails? Definitive test?
Pain, fever and leukocytosis in addition to PID findings.
Ultrasound. CT. Laparoscopy.
Treatment of TOA?
Treatment of severe/unresponsive cases?
First Medical Management - IV ampicillin, gentamicin, and clindamicin/metronidazole.
Ranging from ultrasound guided drainage to salpingo-oophorectomy.
Toxic shock syndrome is caused by infection of what organism?
Symptoms?
Historically what risk factors were highly correlated with TSS?
Treatment?
Staph Aureus (exotoxins - TSST-1)
Fever, rash, hypotension, desquamation of palms and soles.
High absorbency tampons and menstruation.
Hospitilization - IV fluids, pressors, clindamycin and vancomycin (decrease recurrence rate) for 2 weeks.
Nucleoside analogs for HIV treatment (3) and function?
Zidovudine (AZT), lamivudine (3TC), abacavir -inhibit reverse transcriptase
Main action mechanisms of HAART medication (2)?
Nucleoside analogs and protease inhibitors
Which cancer has a higher incidence of developing in HIV + women?
How should they be monitored?
Cervical cancer.
Pap smears at 6 month intervals.
Vertical transmission percentage of HIV+ mother to child?
Treatment to bring percentage to 1%?
25%
Zidovudine (nucleoside analog), during pregnancy and labor and HAART.
How is HIV screened for and how is a diagnosis confirmed?
ELISA and Western blot
