Week 6.1 - Pelvic inflammatory disease Flashcards Preview

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Flashcards in Week 6.1 - Pelvic inflammatory disease Deck (18):
1

What is endometritis?

-Inflammation and infection of the endometrium resulting in plasma cell infiltration and granuloma formation

2

What is salpingitis?

-Inflammation and infection of the uterine tubes

3

Name a complication of salpingitis

-Tubo-ovarian abscess

4

How does a tubo-ovarian abscess form?

-Inflammatory exudate fills the lumen on the salpinx causing inflamamtion of the serosa and pus leaks from the tube
-Causes adhesions of the tube to the pelvic sidewall leading to blockage and further swelling of the tube with the infection confined by the omenta

5

Describe the pathophysiology of PID

-The infection ascends from the vagina and endocervix and causes inflammation of the tubes -> pain and damage to tubal eipthelium resulting in adhesions

6

Describe the aetiology of PID

-Often polymicrobial from STIs such as chlamydia, gonorrhoea, gardnerella vagialis

7

What are the risk factors for PID?

-Young
-Lack of barrier contraception
-Multiple sexual partners
-On insertion/removal of IUD

8

Outline the management of PID

-Empirical treatment for 14 days to cover all microbes involved eg ceftriaxone + doxycycline + metronidazole
-IV antibiotics or sugery for severe PID

9

What classifies severe PID?

-Signs of peritonitis, tubo-ovaran abscess or sepsis

10

When is surgical management indicated?

-When there is no response to therapy, it is clinically severe or an abscess is present

11

List some possible complications of PID

-Infertility
-Ectopic pregnancy
-Chronic pelvic pain
-Fitz-hugh-curtis syndrome
-Reiter syndrome

12

What is fitz-hugh-curtis syndrome?

-Rare complication of PID characterised by perihepatitis and adhesions
-Can manifest as shoulder tip pain, RUQ pain and tenderness

13

What is reiter syndrome?

-Disemminated chlamydial infection characterised by conjunctivitis, urethritis and arthritis
(can't see, can't pee, can't bend at the knee)

14

Describe the typical history of PID

-Pyrexia
-lower abdo pain
-Deep dysparenia
-Abnormal discharge
bleeding

15

Describe what will be found on examination of PID

-Lower abdo tenderness
-fever
-adnexal tenderness
-cervical motion tenderness
-Cervicitis and discharge on speculum examination

16

Name 3 differential diagnoses of PID

-IBS/appendicitis
-UTI
-Ectopic pregnancy

17

What investigations are done in suspected PID?

-Pregnancy test
-STI swab
-Bloods -> WBC and CRP

18

Define PID

-The result of infection ascending from endocervix causing endometritis, salpingitis, parametritis, oophritis, tubo-ovarian abscess and/or pelvic peritonitis