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12 Cards in this Set
- Front
- Back
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What are some risk factors for PID?
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-<25 y/o
-starting sex activities before 16 -many sex partners -hx of STD -IUD -alcohol abuse -vaginal douching > 3 per month -older sex parter -bacterial vaginosis |
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What is PID?
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ascending infection of the female upper reproductive tract (ureters, tubes and peritoneal cavity)
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What are the most common agents of PID?
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clamydia and N. gonorrhea
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In PID, infection usually starts where?
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cervix
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What 3 things make you suspect the dx of PID?
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-female at risk for STD/PID
-competing Dx/causes adequately excluded -cervical, uterine or adnexal tenderness on bimanual exam |
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What are some additional S/S of PID?
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-dull lower ab pain
-abnormal vaginal discharge or bleeding -dysuria -CMT -rebound tenderness -adnexal mass or fullness -temerature/fever -dysparunia -RUQ tenderness due to Fitz Hugh Curtis syndrome |
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What are some labs done in PID?
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-WBC-leukocytosis only in 50%
-ESR -CRP -B-HCG -Wet mouth for PMN -culture of cervical swab for GC and Chlamydia -screen for other STDs -transvaginal US -CT of pelvis and abdomen -dx laparoscopy |
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What are some general tx options for PID?
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-rest
-sexual abstinence till cure -hydration -antipyretics/analgesics -consider IUD removal -Id and tx partners -pt education on safe sex and use of condoms, etc |
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When do you want to admit a person with PID?
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-surgical emergency-ectopid pregnancy and appendicitis
-tubo-ovarian abscess -pregnant -severerly ill with vomiting, high fever, poor PO intake -failure to respond to oral outpatient tx -unlikley to follow tx plan |
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What are some outpt tx options for PID?
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-ceftriaxone 250 mg IM x 1
plus -doxycycline 100 mg PO BID for 14 days plus/or minus -Metronidazole 500 mg PO BID z 14 days OR -Ofloxin 400 mg po BID x 14 days plus Metronidazole 500 mg PO BID x 14 days |
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What are some inpatient tx options for PID?
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-cefotetan 2 g IV q 12 hrs PLUS doxy 100 mg IV q 12 hrs
OR - Clindamycin 900 mg IV q 8 hours PLUS gentamicin loading dose of 2mg/kg IV followed by maint. dose 1.5 mg/kg q 8 hrs May switch to PO Abx 24 hrs after clinical improvement |
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What are some sequela to PID?
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-infertility
-chronic pelvic pain -tubo-ovarian abscess -Fitz-Hugh-Curtis syndrome -ectopic pregnancy risk increased |
