SAEM M4 CURRICULUM ACTUAL
QUESTIONS AND VERIFIED ANSWERS
COMPLETE STUDY PACK
●● 3 sx PID
Answer: -lower abd pain
-purulent vag d/c
-vag bleed
●● when getPID sx
Answer: Symptoms 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
Answer: more likely to appear toxic (fever, N/V)
●● dont forget one risk factor pid
Answer: -recent instrumentation of uterus
●● common exam findings pid
Answer: -b/l adenexal tenderness
,-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
●● if pain is u/l think more
Answer: TOA
●● if RUQ tender think
Answer: Fitz-Hugh Curtis (perihepatitis, inflamation of liver capsule)
●● best test for gonorrohea and chlaymida
Answer: NAAT with PCR or DNA probes (either urine or cervical
secretions)
●● if suspect TOA get
Answer: US
●● ruptured ovarian cyst shows
Answer: free fluid in pouch of douglas
●● ovarian torsion shows
,Answer: absence of blood flow to one ovary on pelvic ultrasound with
doppler
●● why US>CT
Answer: CT cannot eval for torsion bc there is no doppler
●● who gets abx for PID
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
Answer: -chronic pelvic pain
-infertility
-ectopic
-toa
-fitz-hiugh curtis
●● toa process
Answer: walled-off abscess that originates in the infected fallopian tube
and extends to involve the ovary
●● how confirm dx of Fitz hugh curtis
, Answer: elevated liver fxn tests
●● inpatient abx pid
Answer: -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
●● outpatient abx pid? add _____ if 2
Answer: -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
●● who getsa dmitted
Answer: -toa
-fitz hugh curtis
-septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
QUESTIONS AND VERIFIED ANSWERS
COMPLETE STUDY PACK
●● 3 sx PID
Answer: -lower abd pain
-purulent vag d/c
-vag bleed
●● when getPID sx
Answer: Symptoms 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
Answer: more likely to appear toxic (fever, N/V)
●● dont forget one risk factor pid
Answer: -recent instrumentation of uterus
●● common exam findings pid
Answer: -b/l adenexal tenderness
,-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
●● if pain is u/l think more
Answer: TOA
●● if RUQ tender think
Answer: Fitz-Hugh Curtis (perihepatitis, inflamation of liver capsule)
●● best test for gonorrohea and chlaymida
Answer: NAAT with PCR or DNA probes (either urine or cervical
secretions)
●● if suspect TOA get
Answer: US
●● ruptured ovarian cyst shows
Answer: free fluid in pouch of douglas
●● ovarian torsion shows
,Answer: absence of blood flow to one ovary on pelvic ultrasound with
doppler
●● why US>CT
Answer: CT cannot eval for torsion bc there is no doppler
●● who gets abx for PID
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
Answer: -chronic pelvic pain
-infertility
-ectopic
-toa
-fitz-hiugh curtis
●● toa process
Answer: walled-off abscess that originates in the infected fallopian tube
and extends to involve the ovary
●● how confirm dx of Fitz hugh curtis
, Answer: elevated liver fxn tests
●● inpatient abx pid
Answer: -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
●● outpatient abx pid? add _____ if 2
Answer: -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
●● who getsa dmitted
Answer: -toa
-fitz hugh curtis
-septic
-peritontiis
-pre-pubertal kid
-iud (which needs to be removed)
-pregnant
