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gyn-infx uterine dis
Question | Answer |
---|---|
endometritis is most commonly seen when? | after C-section |
endometritis is a _______ infection | polymicrobial |
basics of dxing acute endometritis | uterine tenderness, fever >100.4 on 2nd/3rd day postpartum, elevated WBC, recent hx of procedure, foul smell of vaginal discharge |
tx of endometritis of postpartum pts and pts who have not recently been pregnant | postpartum: IV antibiotics (clinda and gent until 24hrs afebrile) others: PID protocol |
chronic endometritis dx and tx? | dx: endometrial biopsy, tx: doxycycline x10-14d |
general term for bacterial infx of the female pelvic organs | PID |
main organisms of PID | N. gonorrhoeae and C. trachomatis |
PID can lead to what? | infertility and increased risk of ectopic pregnancy; pelvic adhesions, chronic pelvic pain and dyspareunia |
PID RUQ pain may indicate what? | spread of infx to the liver |
CDC diagnostic criteria for PID | hx of pelvic or low abd pain in sexually active women, +CMT, no competing dx |
a pt that does not have the hx of pain but has discharge and CMT would likely be dx with what? | cervicitis |
admit PID pt if... | HIV +, tubo-ovarian abscess present, prego, didn't respond to outpt therapy, cannot follow outpt therapy, severe illness, N/V, or high fever, other surgical emergency not ruled out (appendicitis) |
outpt tx of PID | ceftriaxone IM + doxy x14d (add Metronidazole if they have Trich). TREAT PARTNER! |
a complication arising from persistent PID | tubo-ovarian abscess |
how does a pt w/ tubo-ovarian abscess present? | w/ PID plus an adnexal or rectouterine pouch mass or fullness and usually has a fever and leukocytosis |
test of choice for dx of tubo-ovarian abscess? | US |
tx of tubo-ovarian abscess? | pt admitted to hospital for IV abx and possible surgical excision |