Question 1

A female patient reports cramping, dysuria, low back pain, and nausea. A dipstick urinalysis is normal and a pregnancy test is negative. What will the provider do next?&#10;A) Obtain vaginal secretions for testing&#10;B) Refer for radiological studies&#10;C) Schedule for an endometrial biopsy&#10;D) Treat with empirical antibiotics

Accepted Answer

The symptoms reported by the patient suggest a possible genitourinary infection, despite a normal dipstick urinalysis. Obtaining vaginal secretions for testing can help identify the infection and guide appropriate treatment. Radiological studies and endometrial biopsy are not indicated based on the presenting symptoms alone. Empirical antibiotics may be considered in certain cases, but obtaining vaginal secretions for testing is a more specific approach.

Question 2

Which are greatest risk factors for pelvic inflammatory disease? (Select all that apply.)&#10;A) Age under 25 years&#10;B) Cigarette smoking&#10;C) Tubal sterilization&#10;D) Using barrier methods of contraception&#10;E) Vaginal douching

Accepted Answer

Age under 25 years, cigarette smoking, and vaginal douching are all risk factors for pelvic inflammatory disease. Tubal sterilization and using barrier methods of contraception are not considered risk factors.

Question 3

A sexually active female has symptoms of pelvic inflammatory disease (PID) with fever. Cultures are pending. For outpatient treatment, what will the provider order?&#10;A) Ampicillin and doxycycline&#10;B) Cefotetan and doxycycline&#10;C) Clindamycin and gentamicin&#10;D) Rocephin, doxycycline, and metronidazole

Accepted Answer

Rocephin (ceftriaxone) is a broad-spectrum antibiotic effective against the most common organisms causing PID, including Chlamydia trachomatis and Neisseria gonorrhoeae. Doxycycline is often combined with ceftriaxone to treat the same organisms as well as anaerobes. Metronidazole is added to cover anaerobes and to treat bacterial vaginosis, which is commonly associated with PID. This combination therapy covers a broad range of pathogens and provides effective outpatient treatment for mild to moderate PID.

Deck 150: Pelvic Inflammatory Disease