290 Obstetrics and Gynecology Board Review •••
❍ What is the standard treatment of uncomplicated PID?
Ceftriaxone IM 250 mg and doxycycline 100 BID for 14 days.
❍ What are the some risk factors for sexually transmitted disease?
Age at first intercourse, number of sexual partners, and lack of contraception.
❍ What is the alternative to doxycycline for treatment of Chlamydia?
Azithromycin 2 g one time dose.
❍ What is the incidence of adnexal abscesses in patients with acute PID?
Approximately 10%.
❍ What are some options for drainage of tubo-ovarian complexes?
Laparoscopy, interventional radiology, colpotomy, or laparotomy.
❍ Which organisms should be covered when considering antibiotic treatment of TOA?
Anaerobic organisms, which are predominantly present between 60% and 100% of cases.
❍ How are TOAs treated?
With IV broad-spectrum antibiotics until afebrile for 48 hours then with extended PO course antibiotics for up to
6 weeks with reimaging.
❍ When is a TOA treated with drainage in addition to antibiotics?
When >9 cm size, when unresponsive to antibiotics alone and in postmenopausal patient.
❍ What is the infection most commonly associated with patients using an intrauterine device (IUD)?
Actinomyces.
❍ What is the classic histologic finding of actinomyces israelii?
The classic “sulfur granules” are observed along with gram-positive filaments.
❍ What are the predominant presentations of pelvic tuberculosis?
Infertility and abnormal uterine bleeding.
❍ What is the gold standard for diagnosis of pelvic tuberculosis?
Open biopsy, dilation and curettage or colposcopy guided histopathology showing caseating granulomas and TB
culture.
❍ What is the classic finding in chronic endometritis?
The presence of plasma cells on endometrial biopsy.