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waitingonprometric
I forgot to say--> she has PID, therefore, most likely cause of PID from our list of answer choices = gonorrhea.
+4
iceberglettuce
In addition, cervical motion tenderness (on exam) is highly suggestive of PID.
+1
hchairston
Bacterial vaginosis is not painful, vaginitis is painful. So there is an easy way to r/o bacterial vaginosis.
FA 2019 page 181
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submitted by โwaitingonprometric(264)
This lady likely has pelvic inflammatory disease. PID occurs when sexually transmitted bacteria travel from the vagina to the uterus, fallopian tubes, or ovaries.
Symptoms of PID include--pain in the lower abdomen and pelvis, abnormal vaginal discharge, abnormal vaginal bleeding, pain during intercourse, fever and/or chills, and painful/frequent urination.
Causes of PID most commonly include gonorrhea and chlamydia. Risk factors include sexual activity, esp. with multiple partners or without a condom. Having a history of PID or STI is also a risk factor for PID.
Complications of PID include: ectopic pregnancy, infertility, tubo-ovarian abscess.
Our patient has abdominal pain + fever + vaginal discharge + high WBC count. She also has a hx of ectopic pregnancy 1 year ago, which could mean she had a bout of PID, putting her at risk for a second.
https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594