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)?
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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?
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Chlamydia trachomatis and Neisseria gonorrhoeae- What is the standard outpatient antibiotic regimen for PID?
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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?
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IV cefoxitin or cefotetan plus doxycycline- Name three indications for hospitalizing a patient with PID.
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Tubo-ovarian abscess, pregnancy, or failure to respond to or tolerate oral outpatient therapy- What is Fitz-Hugh-Curtis syndrome?
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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?
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Image-guided or surgical drainage- What are the major long-term complications of pelvic inflammatory disease?
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Infertility, ectopic pregnancy, and chronic pelvic pain- What is the most common bacterial sexually transmitted infection in the United States?
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Chlamydia trachomatis infection- What is the typical clinical presentation of chlamydial infection in women?
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Most infections are asymptomatic- What is the first-line treatment for chlamydia infection?
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Doxycycline for 7 days- What do Neisseria gonorrhoeae organisms look like on Gram stain?
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Gram-negative diplococci- What is the current first-line treatment for uncomplicated gonorrhea?
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A single IM dose of ceftriaxone- How soon after birth does gonococcal conjunctivitis (ophthalmia neonatorum) typically present?
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Within 2 to 5 days after birth- How soon after birth does chlamydial conjunctivitis typically present?
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About 5 to 14 days after birth
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