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Questions and Answers
What is the most common cause of pelvic inflammatory disease?
Which of the following is NOT a common clinical finding associated with pelvic inflammatory disease?
Which laboratory finding is most typically associated with pelvic inflammatory disease?
What are risk factors for developing pelvic inflammatory disease?
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Which symptom is specifically related to pelvic inflammatory disease?
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What is a significant imaging technique used to investigate thickened endometrium and rule out false positives?
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Which laboratory test is essential for assessing heavy uterine bleeding alongside CBC?
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In the context of a pelvic ultrasound for ovarian cancer, which characteristic is NOT typically observed?
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Which tumor marker is commonly elevated in postmenopausal women and raises suspicion of malignancy in ovarian cancer?
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What defines primary dysmenorrhea in terms of timing and pathology?
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Which of the following is an absolute contraindication for oestrogen containing oral contraceptive pills?
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Which condition falls under the relative contraindications for oestrogen containing OCP?
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What is a contraindication regarding age and smoking for oestrogen containing oral contraceptive use?
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Which of the following is not an absolute contraindication for oestrogen containing OCP?
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Among the following, which condition is classified as an absolute contraindication related to metabolic issues?
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Which of the following describes a relative contraindication for starting oestrogen containing OCP?
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What is considered an absolute contraindication regarding malignancy for oestrogen containing OCP?
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Which of the following is not listed among the contraindications for oestrogen containing OCP related to inflammation?
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What is a physiological change in the skin that can occur during pregnancy?
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Which symptom is primarily associated with increased insulin levels during pregnancy?
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What is one of the anatomical changes in the uterus during pregnancy?
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What is a common musculoskeletal change seen in pregnant women?
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During an initial office visit, what is an important aspect of taking a medical history in pregnant women?
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What key finding would be expected during the physical examination of a pregnant woman?
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Which physiological change affects vaginal health during pregnancy?
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What is a common weight gain expectation during pregnancy?
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Which of the following is NOT a cause of infertility related to ovarian function?
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What is a common structural cause of infertility in females that affects the fallopian tubes?
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Which laboratory test is specifically used to assess thyroid function related to infertility?
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Which of the following is an inherited disorder that can lead to infertility in males?
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Which condition is associated with the formation of antisperm antibodies in males?
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What is the purpose of conducting a hysterosalpingography in the evaluation of infertility?
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Which of the following is a male factor that can lead to infertility?
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Which psychiatric condition can contribute to female infertility?
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What is the primary function of performing a semen analysis in male infertility evaluations?
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Which condition is characterized by a decline in functioning oocytes and is often seen with aging?
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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
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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)
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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.
