Pelvic Inflammatory Disease Overview
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Questions and Answers

What is the most common cause of pelvic inflammatory disease?

  • Chlamydia trachomatis (correct)
  • E.coli
  • Ureaplasma
  • Mycoplasma

    • Which of the following is NOT a common clinical finding associated with pelvic inflammatory disease?

  • Abnormal vaginal discharge
  • Fever
  • Severe headache (correct)
  • Lower abdominal pain

    • Which laboratory finding is most typically associated with pelvic inflammatory disease?

  • Increased CRP (correct)
  • Normal pregnancy test
  • Decreased white blood cell count
  • Increased liver enzymes

    • What are risk factors for developing pelvic inflammatory disease?

    <p>IUD use</p> Signup and view all the answers

    Which symptom is specifically related to pelvic inflammatory disease?

    <p>Menorrhagia/metrorrhagia</p> Signup and view all the answers

    What is a significant imaging technique used to investigate thickened endometrium and rule out false positives?

    <p>Hydroultrasonography</p> Signup and view all the answers

    Which laboratory test is essential for assessing heavy uterine bleeding alongside CBC?

    <p>Coagulation studies</p> Signup and view all the answers

    In the context of a pelvic ultrasound for ovarian cancer, which characteristic is NOT typically observed?

    <p>Well-defined margins</p> Signup and view all the answers

    Which tumor marker is commonly elevated in postmenopausal women and raises suspicion of malignancy in ovarian cancer?

    <p>CA-125</p> Signup and view all the answers

    What defines primary dysmenorrhea in terms of timing and pathology?

    <p>Recurrent lower abdominal pain shortly before or during menstruation without pathological findings</p> Signup and view all the answers

    Which of the following is an absolute contraindication for oestrogen containing oral contraceptive pills?

    <p>Coronary heart disease</p> Signup and view all the answers

    Which condition falls under the relative contraindications for oestrogen containing OCP?

    <p>Diabetes Mellitus</p> Signup and view all the answers

    What is a contraindication regarding age and smoking for oestrogen containing oral contraceptive use?

    <p>Smoking after 35 years</p> Signup and view all the answers

    Which of the following is not an absolute contraindication for oestrogen containing OCP?

    <p>Genital bleeding of unknown cause</p> Signup and view all the answers

    Among the following, which condition is classified as an absolute contraindication related to metabolic issues?

    <p>Insulin-dependent Diabetes Mellitus</p> Signup and view all the answers

    Which of the following describes a relative contraindication for starting oestrogen containing OCP?

    <p>Lupus erythematosus</p> Signup and view all the answers

    What is considered an absolute contraindication regarding malignancy for oestrogen containing OCP?

    <p>Oestrogen-dependent tumors</p> Signup and view all the answers

    Which of the following is not listed among the contraindications for oestrogen containing OCP related to inflammation?

    <p>Autoimmune disease</p> Signup and view all the answers

    What is a physiological change in the skin that can occur during pregnancy?

    <p>Hyperpigmentation</p> Signup and view all the answers

    Which symptom is primarily associated with increased insulin levels during pregnancy?

    <p>Hypoglycemia</p> Signup and view all the answers

    What is one of the anatomical changes in the uterus during pregnancy?

    <p>Increase in weight</p> Signup and view all the answers

    What is a common musculoskeletal change seen in pregnant women?

    <p>Increased flexibility of joints</p> Signup and view all the answers

    During an initial office visit, what is an important aspect of taking a medical history in pregnant women?

    <p>Family history of congenital disorders</p> Signup and view all the answers

    What key finding would be expected during the physical examination of a pregnant woman?

    <p>Presence of a closed external cervical os</p> Signup and view all the answers

    Which physiological change affects vaginal health during pregnancy?

    <p>Increased risk of chorioamnionitis</p> Signup and view all the answers

    What is a common weight gain expectation during pregnancy?

    <p>Approximately 12.5 kg</p> Signup and view all the answers

    Which of the following is NOT a cause of infertility related to ovarian function?

    <p>Endometrial polyps</p> Signup and view all the answers

    What is a common structural cause of infertility in females that affects the fallopian tubes?

    <p>Endometriosis</p> Signup and view all the answers

    Which laboratory test is specifically used to assess thyroid function related to infertility?

    <p>TSH levels</p> Signup and view all the answers

    Which of the following is an inherited disorder that can lead to infertility in males?

    <p>Klinefelter syndrome</p> Signup and view all the answers

    Which condition is associated with the formation of antisperm antibodies in males?

    <p>Disruption of the blood-testis barrier</p> Signup and view all the answers

    What is the purpose of conducting a hysterosalpingography in the evaluation of infertility?

    <p>To detect the patency of fallopian tubes</p> Signup and view all the answers

    Which of the following is a male factor that can lead to infertility?

    <p>Reduced sperm count</p> Signup and view all the answers

    Which psychiatric condition can contribute to female infertility?

    <p>Vaginismus</p> Signup and view all the answers

    What is the primary function of performing a semen analysis in male infertility evaluations?

    <p>To assess sperm motility and count</p> Signup and view all the answers

    Which condition is characterized by a decline in functioning oocytes and is often seen with aging?

    <p>Diminished ovarian reserve</p> Signup and view all the answers

    Study Notes

    Contraindications for Oestrogen-containing OCP

    • Absolute Contraindications:

      • Thromboembolism and coagulopathy
      • Coronary heart disease and history of stroke
      • Hypertension over 160/95 mmHg
      • Heart defects

    • Relative Contraindications:

      • Hypercholesterolemia and insulin-dependent diabetes mellitus
      • Previous severe hypertriglyceridemia and liver metabolic disorders
      • Smoking in women over 35 years and morbid obesity
      • Genital bleeding of unknown cause and history of migraine
      • Uterine leiomyomas and gastric/duodenal ulcers

    Causes of Infertility

    Female Factors

    • Ovary-related:

      • Premature ovarian failure and menstrual cycle abnormalities
      • Hyperprolactinemia, thyroid disorders, and systematic conditions like diabetes and obesity
      • Diminished ovarian reserve (age or disorders like endometriosis)

    • Tubal/Pelvic Causes:

      • Pelvic inflammatory disease (PID), endometriosis, fallopian tube adhesions
      • Complications from pelvic surgery or infections

    • Uterine Causes:

      • Anatomical anomalies (e.g., septate or bicornuate uterus) and uterine fibroids
      • Asherman syndrome from past curettage leading to endometrial scarring

    • Cervical Causes:

      • Insufficient cervical mucus production and trauma
      • Immune factors such as antisperm antibodies

    • Psychiatric Causes:

      • Conditions like vaginismus and sexual arousal disorders

    Male Factors

    • Sperm Disorders: Reduced count, motility or ejaculate volume
    • Testicular Damage: From injuries, torsion, infection
    • Chronic Diseases: Liver cirrhosis and renal insufficiency
    • Inherited Disorders: Klinefelter syndrome and Kallmann syndrome causing delayed puberty

    Examination for Infertility

    Female Examination

    • Detailed physical exam and menstrual history
    • Basal body temperature tracking and ovulation prediction tests
    • Hormonal assays including TSH and prolactin levels
    • Endometrial biopsy and imaging (hysteroscopy/laparoscopy) to assess uterine structure

    Male Examination

    • Comprehensive medical history of both partners
    • Semen analysis
    • Mixed antiglobulin reaction test for antisperm antibodies indicating barrier disruption

    Pelvic Inflammatory Disease (PID)

    • Aetiology: Most commonly caused by Chlamydia trachomatis and Neisseria gonorrhoea
    • Risk Factors: Multiple partners, unprotected sex, history of STDs, use of IUD

    Diagnostics

    • Clinical symptoms: Lower abdominal pain, dysuria, nausea, menorrhagia, dyspareunia, and fever
    • Vaginal examination for cervical and uterine tenderness along with discharge
    • Lab tests increasing CRP and leukocyte counts, pregnancy tests, and imaging studies

    Ovarian Cancer

    • Indicators include hypercalcemia and imaging findings from pelvic ultrasounds
    • Ultrasound characteristics: Irregular thickening, indistinct borders, and central vascularization
    • Tumor marker CA-125 levels elevate suspicion, especially postmenopausal

    Dysmenorrhea

    • Defined as recurrent lower abdominal pain before or during menstruation; categorized as primary when there are no pathological findings.
    • Associated cytokine activity leads to hyperpigmentation and musculoskeletal changes during pregnancy.
    • Changes in reproductive organs include an increase in uterus size and cervical mucus formation.

    Antenatal Care

    • Initial office visit includes a detailed history covering obstetrics, medical and surgical backgrounds, and social history
    • Physical examination involves confirmation of gestational age, checking cervical length, and monitoring fetal heart rate when possible.

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    Description

    This quiz covers the key aspects of Pelvic Inflammatory Disease (PID), including its aetiology, common bacteria involved, diagnostic approaches, treatment principles, and potential consequences. Test your understanding of how bacterial infections can impact the female reproductive system.

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