Pelvic Inflammatory Disease (PID) Overview
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Questions and Answers

Which diagnostic test is most relevant for confirming a cervical infection with C.trachomatis?

  • Pelvic ultrasound
  • HCG test
  • Saline microscopy of vaginal fluid (correct)
  • Endometrial biopsy

    • Which of the following symptoms would support a diagnosis of pelvic inflammatory disease (PID)?

  • Cervical rigidity
  • Normal cervical appearance
  • Oral temperature <38.3°C
  • Presence of abundant WBCs on saline microscopy (correct)

    • Which of the following conditions is NOT commonly included in the differential diagnosis for pelvic issues?

  • Ovarian torsion
  • Gastritis (correct)
  • Ectopic pregnancy
  • Acute appendicitis

    • What is the primary management strategy for suspected pelvic inflammatory disease?

    <p>Empirical therapy with broad-spectrum antibiotics</p> Signup and view all the answers

    Which laboratory finding is crucial for a confirmed diagnosis of cervical infection in PID?

    <p>Laboratory documentation of infection with N.gonorrhoeae or C.trachomatis</p> Signup and view all the answers

    What is a primary factor that increases the likelihood of developing PID?

    <p>Having a history of PID</p> Signup and view all the answers

    Which of the following is not a common medication prescribed for PID?

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

    What is the role of education in managing PID risks?

    <p>It helps patients understand the importance of identifying symptoms early.</p> Signup and view all the answers

    What is one method recommended to help reduce the risk of PID?

    <p>Being in a mutually monogamous relationship</p> Signup and view all the answers

    In the context of PID treatment, which medication is to be administered IM in a single dose?

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

    What is a potential consequence of untreated STDs in women?

    <p>Development of PID</p> Signup and view all the answers

    What is the recommended dose of doxycycline for treating PID?

    <p>100 mg orally 2 times a day for 14 days</p> Signup and view all the answers

    Which reproductive health factor can slightly increase the risk of PID when used?

    <p>Intrauterine device (IUD)</p> Signup and view all the answers

    What is a common symptom associated with Pelvic Inflammatory Disease (PID)?

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

    Which factor is NOT considered a risk factor for developing Pelvic Inflammatory Disease?

    <p>Consistent use of barrier contraception</p> Signup and view all the answers

    What percentage of women with Pelvic Inflammatory Disease may remain asymptomatic?

    <p>70-80%</p> Signup and view all the answers

    Which of the following conditions is NOT included in the spectrum of disorders associated with PID?

    <p>Cervical cancer</p> Signup and view all the answers

    Which laboratory finding is indicative of Pelvic Inflammatory Disease during a physical examination?

    <p>Presence of white blood cells on saline microscopy</p> Signup and view all the answers

    What is a leading cause of infertility associated with Pelvic Inflammatory Disease?

    <p>Scar tissue from PID</p> Signup and view all the answers

    Which specific pathogen is commonly associated with cervical infections that can lead to Pelvic Inflammatory Disease?

    <p>Chlamydia trachomatis</p> Signup and view all the answers

    What physical sign may indicate the presence of Pelvic Inflammatory Disease?

    <p>Lower abdominal pain</p> Signup and view all the answers

    What additional criteria can enhance the specificity of a PID diagnosis?

    <p>Oral temperature &gt;38.3°C (&gt;101°F)</p> Signup and view all the answers

    Which test is NOT typically included in the diagnostic evaluation for pelvic issues?

    <p>Blood glucose test</p> Signup and view all the answers

    Which of the following is a condition that could be included in the differential diagnosis for pelvic pain?

    <p>Ectopic pregnancy</p> Signup and view all the answers

    What is a recommended treatment approach for pelvic inflammatory disease?

    <p>Broad-spectrum antimicrobial coverage</p> Signup and view all the answers

    Which of the following does NOT indicate a lab finding supporting pelvic inflammatory disease?

    <p>Normal white cell count</p> Signup and view all the answers

    Which group of women is at a higher risk for developing Pelvic Inflammatory Disease?

    <p>Women under the age of 25 with multiple partners</p> Signup and view all the answers

    What is a common clinical presentation of Pelvic Inflammatory Disease?

    <p>Fever or chills</p> Signup and view all the answers

    Which inflammatory disorder is NOT commonly included in the spectrum of conditions associated with Pelvic Inflammatory Disease?

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

    What type of discharge might be observed during a physical examination for a woman suspected of having Pelvic Inflammatory Disease?

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

    What correlation is noted between sexually transmitted infections and Pelvic Inflammatory Disease?

    <p>Higher incidence of STIs leads to higher incidence of PID</p> Signup and view all the answers

    Which of the following is a potential symptom that may indicate the presence of Pelvic Inflammatory Disease?

    <p>Abnormal vaginal bleeding</p> Signup and view all the answers

    Which lifestyle factor is associated with an increased risk for Pelvic Inflammatory Disease?

    <p>Living in high STI prevalence areas</p> Signup and view all the answers

    What might contribute to a woman's risk of developing Pelvic Inflammatory Disease during medical procedures?

    <p>Intrauterine contraceptive device insertion</p> Signup and view all the answers

    Which medication regimen includes both doxycycline and metronidazole for treating PID?

    <p>Cefoxitin and Probenecid</p> Signup and view all the answers

    What is a primary risk factor for developing pelvic inflammatory disease?

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

    What is the recommended dose of ceftriaxone for patients weighing over 150 kg with gonococcal infection?

    <p>1 g IM</p> Signup and view all the answers

    Which of the following is NOT recommended as a preventive measure against PID?

    <p>Having multiple sexual partners</p> Signup and view all the answers

    How long should doxycycline be administered for treating PID?

    <p>14 days</p> Signup and view all the answers

    Which demographic is more likely to develop PID?

    <p>Women under 21 years old</p> Signup and view all the answers

    What is the main complication associated with untreated PID in women?

    <p>Difficulty getting pregnant</p> Signup and view all the answers

    Which of the following is part of the empirical treatment for a patient suspected of having PID?

    <p>Ceftriaxone 500 mg IM</p> Signup and view all the answers

    Which laboratory finding is associated with the diagnosis of pelvic inflammatory disease (PID)?

    <p>Elevated erythrocyte sedimentation rate</p> Signup and view all the answers

    What is a characteristic feature of cervical discharge that may indicate pelvic inflammatory disease?

    <p>Mucopurulent discharge</p> Signup and view all the answers

    Which of the following conditions is included in the differential diagnosis for pelvic pain?

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

    Which additional criterion might enhance the specificity for the diagnosis of pelvic inflammatory disease?

    <p>Presence of cervical friability</p> Signup and view all the answers

    What is a key approach in the management of pelvic inflammatory disease?

    <p>Empirical therapy with broad-spectrum antibiotics</p> Signup and view all the answers

    What is a common reason for gynecologic emergency visits related to women's health?

    <p>Pelvic Inflammatory Disease</p> Signup and view all the answers

    Which risk factor is associated with an increased likelihood of developing Pelvic Inflammatory Disease?

    <p>Multiple sexual partners</p> Signup and view all the answers

    Which factor can decrease a woman's risk of developing Pelvic Inflammatory Disease?

    <p>Using barrier contraceptives</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with Pelvic Inflammatory Disease?

    <p>Severe itching</p> Signup and view all the answers

    What type of physical examination finding is indicative of Pelvic Inflammatory Disease?

    <p>Elevated WBC count on saline microscopy</p> Signup and view all the answers

    What is a potential longer-term consequence of Pelvic Inflammatory Disease?

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

    Which lifestyle choice is linked to an increased risk of Pelvic Inflammatory Disease?

    <p>Cigarette smoking</p> Signup and view all the answers

    What is a common clinical feature observed during the physical examination of a woman suspected to have Pelvic Inflammatory Disease?

    <p>Lower abdominal pain</p> Signup and view all the answers

    What is the role of doxycycline in the treatment of PID?

    <p>It is given orally for 14 days in addition to other medications.</p> Signup and view all the answers

    Which factor is least likely to increase the risk of developing PID?

    <p>Being in a mutually monogamous relationship.</p> Signup and view all the answers

    How is ceftriaxone administered for PID treatment?

    <p>Intramuscularly as a single dose.</p> Signup and view all the answers

    What is a significant complication of untreated PID?

    <p>Infertility in women.</p> Signup and view all the answers

    What is the correct treatment regimen if a patient weighs more than 150 kg with a documented gonococcal infection?

    <p>1 g of ceftriaxone IM plus 100 mg doxycycline orally for 14 days.</p> Signup and view all the answers

    Which of the following is an effective prevention method against PID?

    <p>Regularly getting tested for STDs.</p> Signup and view all the answers

    Which medication is typically combined with metronidazole for the treatment of PID?

    <p>Ceftriaxone.</p> Signup and view all the answers

    What is the duration for which metronidazole should be administered for treating PID?

    <p>14 days.</p> Signup and view all the answers

    Study Notes

    Pelvic Inflammatory Disease (PID)

    • PID is an infection of a woman's reproductive organs.
    • It often results from untreated sexually transmitted diseases (STDs) like chlamydia and gonorrhea.
    • Other non-STD infections can also cause PID.
    • PID significantly increases the risk of infertility (1 in 8 women with a history of PID have fertility issues).
    • Often asymptomatic in early stages, which can lead to delayed diagnosis. Signs and symptoms will vary based on the causative pathogen.
    • Symptoms can include lower abdominal pain, fever, chills, cramping, dysuria, low back pain, nausea, vomiting, abnormal vaginal bleeding (postcoital or intermenstrual).
    • Physical exam may reveal lower abdominal pain, elevated temperature (>38.3°C or 101°F), abnormal vaginal discharge (mucopurulent), presence of white blood cells (WBCs) in vaginal secretions, elevated erythrocyte sedimentation rate (ESR), elevated C-reactive protein (CRP), and evidence of cervical infection (e.g., with N. gonorrhoeae or C. trachomatis).

    Risk Factors

    • Young age (under 25 years).
    • Multiple sexual partners.
    • Lack of consistent contraception.
    • Living in areas with high STI prevalence.
    • Past history of PID.
    • Sexual activity with partners who have other partners.
    • Douching.
    • Use of an intrauterine device (IUD) (risk is mostly limited to the first three weeks).

    Diagnosis

    • Diagnostic tests might include HCG, pelvic ultrasound, rapid plasma reagin (RPR), HIV testing, endometrial biopsy, MRI, Doppler studies, and laparoscopy.
    • Lab tests also include elevated oral temperature (> 38.3°C or 101°F), presence of abundant WBCs in vaginal fluid, elevated ESR, elevated CRP, and lab confirmation of causative pathogens like N. gonorrhoeae or C. trachomatis.

    Differential Diagnoses

    • Ectopic pregnancy
    • Acute appendicitis
    • Ovarian torsion
    • Ovarian cyst
    • Endometriosis
    • Corpus luteum bleeding
    • Pelvic adhesions
    • Benign ovarian tumor
    • Inflammatory bowel disease
    • Irritable bowel syndrome
    • Diverticulitis
    • Pyelonephritis
    • Nephrolithiasis
    • Cystitis

    Treatment

    • Empirical broad-spectrum antibiotic therapy to treat likely infections.
    • Combination therapies are necessary. Including anaerobic coverage to account for possible anaerobic bacteria.
    • Sexual partners should be treated also if active within 60 days of symptom onset.
    • Monitoring of treatment response is crucial.

    Common Medications

    • Ceftriaxone 500 mg IM in a single dose.
    • Doxycycline 100 mg orally twice daily for 14 days.
    • Metronidazole 500 mg orally twice daily for 14 days.
    • Alternative options include cefoxitin 2 g IM with probenecid 1g orally, or other parenteral third-generation cephalosporins (e.g., ceftizoxime or cefotaxime) along with doxycycline and metronidazole.

    Prevention

    • Abstaining from vaginal, anal, and oral sex.
    • Mutual monogamy with negative STD testing.
    • Correct and consistent use of latex condoms.

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    Description

    This quiz covers the essential aspects of Pelvic Inflammatory Disease (PID), including its causes, symptoms, and implications for women's health. Learn about the role of sexually transmitted infections and the importance of early diagnosis to prevent complications such as infertility.

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