Pelvic Inflammatory Disease Flashcards Preview

B - Gynaecology > Pelvic Inflammatory Disease > Flashcards

Flashcards in Pelvic Inflammatory Disease Deck (34)
1

What is pelvic inflammatory disease (PID)?

An infection of the upper genital tract in females which affects the uterus, fallopian tubes and ovaries

2

How common is PID?

Relatively common

3

How many people are diagnosed with PID in primary care each year?

280/100,000 people

4

What age group has the highest prevalence of PID?

15-24

5

What causes PID?

Spread of bacterial infection from the vagina or cervix to the upper genital tract

6

What are the most common causative organisms of PID?

- Chlamydia trachomatis
- Neiserria gonorrhoea

7

What % of PID cases are caused by chlamydia and gonorrhoea?

25%

8

What are the risk factors for PID?

- Sexually active
- Age 15-24
- Recent partner change
- Intercourse without barrier contraceptive protection
- History of STIs
- Personal history of PID

9

How can PID occur through non-sexual transmission?

- Gynaecological surgery
- Termination of pregnancy
- Insertion of intrauterine copper device

10

What are the symptoms of PID?

- Lower abdominal pain
- Deep dyspareunia
- Menstrual abnormalities
- Post-coital bleeding
- Dysuria
- Abnormal vaginal discharge

11

What menstrual abnormalities can occur in PID?

- Menorrhagia
- Dysmenorrhoea
- Intermenstrual bleeding

12

What features of vaginal discharge are suggestive of PID?

- Purulent
- Unpleasant odour

13

What are the features of advanced PID?

- Severe lower abdominal pain
- Fever
- Nausea
- Vomiting

14

What features may be present on examination in PID?

- Uterine/adnexal tenderness
- Cervical excitation
- Palpable mass in lower abdomen
- Abnormal vaginal discharge

15

What are the differentials for PID?

- Ectopic pregnancy
- Ruptured ovarian cyst
- Endometriosis
- UTI

16

What is the aim of investigations of PID?

Identify the infective organism

17

What swabs should be taken in suspected PID?

- Endocervical swabs
- High vaginal swabs

18

What organisms are tested for by endocervical swabs for PID?

- Gonorrhoea
- Chlamydia

19

What organisms are tested for by high vaginal swabs in PID?

- Trichomona vaginalis
- Bacterial vaginosis

20

What test is performed on swabs for PID?

Nucleic acid amplification test (NAAT)

21

Do negative swabs exclude PID?

No

22

What additional investigations may be useful in PID?

- Full STI screen
- Urine dipstick
- Pregnancy test
- Transvaginal USS
- Laparoscopy

23

What can urinalysis in suspected PID help exclude?

UTI

24

Why may a laparoscopy be required in suspected PID?

To observe for gross inflammatory changes and to obtain peritoneal biopsy

25

When is a laparoscopy indicated for PID?

In severe cases where there is uncertainty

26

How is PID managed?

Broad spectrum antibiotics for 14 days

27

What are the antibiotic options for treating PID?

- Doxycycline, ceftriaxone and metronidazole
- Ofloxacin and metronidazole

28

What advice should be given to patients with PID?

- Rest
- Avoid sexual intercourse
- All sexual partners for last 6 months should be tested and treated

29

When should women with PID be admitted to hospital?

- If pregnant
- Severe symptoms
- Signs of pelvic peritonitis
- Unresponsive to oral abx
- Need fore emergency surgery

30

What can cause an increased risk of complications of PID?

- Recurrent infections
- Delaying treatment

31

What are the potential long-term complications of PID?

- Ectopic pregnancy
- Infertility
- Tubo-ovarian abscess
- Chronic pelvic pain
- Fits-Hugh Curtis syndrome

32

What causes the increased risk of ectopic pregnancy following PID?

Narrowing and scarring of the fallopian tubes

33

What proportion of people with PID have infertility?

1 in 10

34

What is Fitz-Hugh Curtis syndrome?

Peri-hepatitis that typically causes RUQ pain