Pelvic inflammatory disease and sexually transmitted infection diagnosis and management scenarios tested on USMLE Step 2 CK.
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- What is the minimum clinical criteria set used to empirically diagnose and treat pelvic inflammatory disease (PID)?
- Cervical motion tenderness, uterine tenderness, or adnexal tenderness in a sexually active woman with pelvic pain
- What are the two most common causative organisms of pelvic inflammatory disease?
- Chlamydia trachomatis and Neisseria gonorrhoeae
- What is the standard outpatient antibiotic regimen for PID?
- A single dose of IM ceftriaxone plus 14 days of oral doxycycline, with or without metronidazole
- What is the standard inpatient IV antibiotic regimen for PID?
- IV cefoxitin or cefotetan plus doxycycline
- Name three indications for hospitalizing a patient with PID.
- Tubo-ovarian abscess, pregnancy, or failure to respond to or tolerate oral outpatient therapy
- What is Fitz-Hugh-Curtis syndrome?
- Perihepatitis causing right upper quadrant pain as a complication of PID spreading along the peritoneum
- How is a tubo-ovarian abscess managed if it fails to improve on IV antibiotics?
- Image-guided or surgical drainage
- What are the major long-term complications of pelvic inflammatory disease?
- Infertility, ectopic pregnancy, and chronic pelvic pain
- What is the most common bacterial sexually transmitted infection in the United States?
- Chlamydia trachomatis infection
- What is the typical clinical presentation of chlamydial infection in women?
- Most infections are asymptomatic
- What is the first-line treatment for chlamydia infection?
- Doxycycline for 7 days
- What do Neisseria gonorrhoeae organisms look like on Gram stain?
- Gram-negative diplococci
- What is the current first-line treatment for uncomplicated gonorrhea?
- A single IM dose of ceftriaxone
- How soon after birth does gonococcal conjunctivitis (ophthalmia neonatorum) typically present?
- Within 2 to 5 days after birth
- How soon after birth does chlamydial conjunctivitis typically present?
- About 5 to 14 days after birth