PID cause - ACCURATE ANSWERS originates as a cervical infection with Neisseria gonorrhea and/or Chlamydia trachomatis, and becomes polymicrobial as it ascends into the uterus, fallopian tubes and ovaries.
3 sx PID - ACCURATE ANSWERS -lower abd pain
-purulent vag d/c
-vag bleed
when getPID s...
PID cause - ACCURATE ANSWERS✔✔ originates as a cervical
infection with Neisseria gonorrhea and/or Chlamydia trachomatis, and
becomes polymicrobial as it ascends into the uterus, fallopian tubes and
ovaries.
3 sx PID - ACCURATE ANSWERS✔✔ -lower abd pain
-purulent vag d/c
-vag bleed
when getPID sx - ACCURATE ANSWERS✔✔ Symptoms begin shortly
after the start of the menstrual cycle, when there are fewer defenses by
the cervical mucosal barrier to ascending infections.
PID with gonnoccal - ACCURATE ANSWERS✔✔ more likely to
appear toxic (fever, N/V)
dont forget one risk factor pid - ACCURATE ANSWERS✔✔ -recent
instrumentation of uterus
common exam findings pid - ACCURATE ANSWERS✔✔ -b/l adenexal
tenderness
-cervical d/c
,cervical motion tenderness
-uterine tender
-lower abd tenderness
if pain is u/l think more - ACCURATE ANSWERS✔✔ TOA
if RUQ tender think - ACCURATE ANSWERS✔✔ Fitz-Hugh Curtis
(perihepatitis, inflamation of liver capsule)
best test for gonorrohea and chlaymida - ACCURATE ANSWERS✔✔
NAAT with PCR or DNA probes (either urine or cervical secretions)
if suspect TOA get - ACCURATE ANSWERS✔✔ US
ruptured ovarian cyst shows - ACCURATE ANSWERS✔✔ free fluid in
pouch of douglas
ovarian torsion shows - ACCURATE ANSWERS✔✔ absence of blood
flow to one ovary on pelvic ultrasound with doppler
why US>CT - ACCURATE ANSWERS✔✔ CT cannot eval for torsion
bc there is no doppler
who gets abx for PID - ACCURATE ANSWERS✔✔ -lower abdominal
or pelvic pain coupled with adnexal, uterine or cervical motion
,tenderness on exam, in a patient at risk for STDs with no other
discernible cause for the illness identified
complications of pid - ACCURATE ANSWERS✔✔ -chronic pelvic pain
-infertility
-ectopic
-toa
-fitz-hiugh curtis
toa process - ACCURATE ANSWERS✔✔ walled-off abscess that
originates in the infected fallopian tube and extends to involve the ovary
how confirm dx of Fitz hugh curtis - ACCURATE ANSWERS✔✔
elevated liver fxn tests
inpatient abx pid - ACCURATE ANSWERS✔✔ -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
outpatient abx pid? add _____ if 2 - ACCURATE ANSWERS✔✔ -
ceftriaxone
-doxy
, -add metro if severe infection or hx of uterine instrumentation
who getsa dmitted - ACCURATE ANSWERS✔✔ -toa
-fitz hugh curtis
-septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
d/c with PID need what testing - ACCURATE ANSWERS✔✔ test for
other STD
describe whats going on in ovarian torsion - ACCURATE
ANSWERS✔✔ ovary, and often the fallopian tube as well (adnexal
torsion) become twisted around their vascular pedicle.
progression of torsion - ACCURATE ANSWERS✔✔ twisting initially
obstructs venous flow, which causes engorgement and edema. The
engorgement can progress until arterial flow is compromised, leading to
ischemia and infarction
risk factors for torsion - ACCURATE ANSWERS✔✔ ovary with a mass
or cyst is more prone to twisting by virtue of its asymmetry
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