SAEM M4 Curriculum 2: Questions With
Complete Solutions
Question : PID cause
CORRECT ANSWER : originates as a cervical infection
with Neisseria gonorrheaand/or Chlamydia trachomatis, and becomes polymicrobial as it ascends into the uterus, fallopian tubes and ovaries.
Question : 3 sx PID
CORRECT ANSWER : -lower abd pain
-purulent vag d/c -vag bleed
Question : when getPID sx
CORRECT ANSWER : Symptoms begin shortly after the
start of the menstrual cycle, when there are fewer defenses by the cervical mucosal barrier to ascending infections.
Question : PID with gonnoccal
CORRECT ANSWER: more likely to appear toxic (fever,
N/V)
Question : dont forget one risk factor pid
CORRECT ANSWER : -recent instrumentation of uterus
Question : common exam findings pid
CORRECT ANSWER : -b/l adenexal tenderness
-cervical d/c cervical motion tenderness -uterine tender -lower abd tenderness
Question : if pain is u/l think more
CORRECT ANSWER : TOA
Question : if RUQ tender think
CORRECT ANSWER : Fitz-Hugh Curtis (perihepatitis,
inflamation of liver capsule)
Question : best test for gonorrohea and chlaymida
CORRECT ANSWER : NAAT with PCR or DNA probes
(either urine or cervical secretions)
Question : if suspect TOA get
CORRECT ANSWER : US
Question : ruptured ovarian cyst shows
CORRECT ANSWER : free fluid in pouch of douglas
Question : ovarian torsion shows
CORRECT ANSWER : absence of blood flow to one ovary
on pelvic ultrasound with doppler
Question : why US>CT
CORRECT ANSWER : CT cannot eval for torsion bc there
is no doppler
Question : 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
Question : complications of pid
CORRECT ANSWER : -chronic pelvic pain
-infertility -ectopic -toa -fitz-hiugh curtis
Question : toa process
CORRECT ANSWER : walled-off abscess that originates in
the infected fallopian tube and extends to involve the ovary