Week 6.1 - Pelvic inflammatory disease Flashcards Preview

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

What is endometritis?

A

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

2
Q

What is salpingitis?

A

-Inflammation and infection of the uterine tubes

3
Q

Name a complication of salpingitis

A

-Tubo-ovarian abscess

4
Q

How does a tubo-ovarian abscess form?

A
  • 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
Q

Describe the pathophysiology of PID

A

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

6
Q

Describe the aetiology of PID

A

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

7
Q

What are the risk factors for PID?

A
  • Young
  • Lack of barrier contraception
  • Multiple sexual partners
  • On insertion/removal of IUD
8
Q

Outline the management of PID

A
  • Empirical treatment for 14 days to cover all microbes involved eg ceftriaxone + doxycycline + metronidazole
  • IV antibiotics or sugery for severe PID
9
Q

What classifies severe PID?

A

-Signs of peritonitis, tubo-ovaran abscess or sepsis

10
Q

When is surgical management indicated?

A

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

11
Q

List some possible complications of PID

A
  • Infertility
  • Ectopic pregnancy
  • Chronic pelvic pain
  • Fitz-hugh-curtis syndrome
  • Reiter syndrome
12
Q

What is fitz-hugh-curtis syndrome?

A
  • Rare complication of PID characterised by perihepatitis and adhesions
  • Can manifest as shoulder tip pain, RUQ pain and tenderness
13
Q

What is reiter syndrome?

A

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

14
Q

Describe the typical history of PID

A

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

15
Q

Describe what will be found on examination of PID

A
  • Lower abdo tenderness
  • fever
  • adnexal tenderness
  • cervical motion tenderness
  • Cervicitis and discharge on speculum examination
16
Q

Name 3 differential diagnoses of PID

A
  • IBS/appendicitis
  • UTI
  • Ectopic pregnancy
17
Q

What investigations are done in suspected PID?

A
  • Pregnancy test
  • STI swab
  • Bloods -> WBC and CRP
18
Q

Define PID

A

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