SAEM M4 Curriculum 2 Questions and Answers Graded A+.
PID cause correct answeroriginates as a cervical infection with Neisseria gonorrheaand/or
... [Show More] Chlamydia
trachomatis, and becomes polymicrobial as it ascends into the uterus, fallopian tubes and ovaries.
3 sx PID correct answer-lower abd pain
-purulent vag d/c
-vag bleed
when getPID sx correct answerSymptoms begin shortly after the start of the menstrual cycle, when
there are fewer defenses by the cervical mucosal barrier to ascending infections.
PID with gonnoccal correct answermore likely to appear toxic (fever, N/V)
dont forget one risk factor pid correct answer-recent instrumentation of uterus
common exam findings pid correct answer-b/l adenexal tenderness
-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
if pain is u/l think more correct answerTOA
if RUQ tender think correct answerFitz-Hugh Curtis (perihepatitis, inflamation of liver capsule)
best test for gonorrohea and chlaymida correct answerNAAT with PCR or DNA probes (either urine or
cervical secretions)
SAEM M4 Curriculum 2 Questions and Answers
if suspect TOA get correct answerUS
ruptured ovarian cyst shows correct answerfree fluid in pouch of douglas
ovarian torsion shows correct answerabsence of blood flow to one ovary on pelvic ultrasound with
doppler
why US>CT correct answerCT cannot eval for torsion bc there is no doppler
who gets abx for PID correct answer-lower abdominal or pelvic pain coupled with adnexal, uterine or
cervical motion tenderness on exam, in a patient at risk for STDs with no other discernible cause for the
illness identified
complications of pid correct answer-chronic pelvic pain
-infertility
-ectopic
-toa
-fitz-hiugh curtis
toa process correct answerwalled-off abscess that originates in the infected fallopian tube and extends
to involve the ovary
how confirm dx of Fitz hugh curtis correct answerelevated liver fxn tests
inpatient abx pid correct answer-cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
outpatient abx pid? add _____ if 2 correct answer-ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
who getsa dmitted correct answer-toa
-fitz hugh curtis
-septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
d/c with PID need what testing correct answertest for other STD
describe whats going on in ovarian torsion correct answerovary, and often the fallopian tube as well
(adnexal torsion) become twisted around their vascular pedicle.
progression of torsion correct answertwisting initially obstructs venous flow, which causes engorgement
and edema. The engorgement can progress until arterial flow is compromised, leading to ischemia and
infarction
risk factors for torsion correct answerovary with a mass or cyst is more prone to twisting by virtue of its
asymmetry
classic present torsion correct answersudden onset of unilateral lower abdominal pain which is initially
visceral in character (ie, vague and poorly localized) and may be accompanied by nausea and vomiting. It
may radiate to the groin or flank.
intermittent torsion correct answerseveral episodes of pain over the course of hours, days, or even
weeks,
why does current pregnancy inc risk of torsion correct answercorpus lutem cyst on ovary
tests for torsion correct answerThere are no laboratory tests which are helpful in establishing the
diagnosis of adnexal torsion
best way to dx torsion correct answerUS
careful with US: correct answerimportant to note that the presence of Doppler blood flow does not
exclude the diagnosis of torsion
signs of torsion on US correct answer-enlargement/edema of ovary
-ovrian mass or cyst
-free pelvic fluid
what does CT torsion show correct answerfinding an enlarged ovary or ovarian mass
-assocaited free fluid
-thick fallopian tube
-deviation of uterus to the affected side
definitively dx torsion correct answerOR
tx torsion correct answer or (try and salvage ovary but testicle just gets removed)
torsion so try often sounds like correct answer kidney story. [Show Less]