SAEM m4 curriculum 2/ 362 Quizzes & Correct Ans. Terms like:
who gets abx for PID - Answer: -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
SAEM m4 curriculum 2/ 362 Quizzes & Correct
Ans.
who gets abx for PID - Answer: -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
,toa process - Answer: walled-off abscess that originates in the infected fallopian
tube and extends to involve the ovary
how confirm dx of Fitz hugh curtis - Answer: elevated liver fxn tests
inpatient abx pid - Answer: -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
outpatient abx pid? add _____ if 2 - Answer: -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
who getsa dmitted - Answer: -toa
-fitz hugh curtis
-septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
Page 2 of 51
,PID cause - Answer: 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.
when getPID sx - Answer: 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 - Answer: more likely to appear toxic (fever, N/V)
dont forget one risk factor pid - Answer: -recent instrumentation of uterus
common exam findings pid - Answer: -b/l adenexal tenderness
-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
if pain is u/l think more - Answer: TOA
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, if RUQ tender think - Answer: Fitz-Hugh Curtis (perihepatitis, inflamation of liver
capsule)
best test for gonorrohea and chlaymida - Answer: NAAT with PCR or DNA probes
(either urine or cervical secretions)
if suspect TOA get - Answer: US
ruptured ovarian cyst shows - Answer: free fluid in pouch of douglas
ovarian torsion shows - Answer: absence of blood flow to one ovary on pelvic
ultrasound with doppler
why US>CT - Answer: CT cannot eval for torsion bc there is no doppler
d/c with PID need what testing - Answer: test for other STD
describe whats going on in ovarian torsion - Answer: ovary, and often the fallopian
tube as well (adnexal torsion) become twisted around their vascular pedicle.
progression of torsion - Answer: twisting initially obstructs venous flow, which
causes engorgement and edema. The engorgement can progress until arterial flow
is compromised, leading to ischemia and infarction
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