Pelvic Inflammatory Disease MCQs

This boy most probably has nephrogenic diabetes insipidus due to hypercalcemia. In this condition, renal tubules are resistant to antidiuretic hormone (ADH), which is due to a receptor defect of vasopressin-2 receptor or a post-receptor defect in an ADH-sensitive water channel called aquaporin-2. Central DI (ADH deficiency) show good response to desmopressin (V2 agonist) administration. The findings do not suggest diabetes mellitus, which is also associated with these symptoms. In patients with the syndrome of inappropriate secretion of ADH (SIADH), low sodium levels are the hallmark. Metabolic causes of Nephrogenic diabetes insipidus: Chronic Hypokalemia Chronic Hypercalcemia Reference : Harrison's Principles of Internal Medicine 21 st edition Page 2920

"Right sided endocarditis which usually involves the tricuspid valve causes septic pulmonary emboli occasionally with infarction and lung abscesses." Reference: CMDT '07, p 1447

For identification of organisms in PID the materials are collected from the following available sources: Discharge from urethra or Bartholin’s gland Cervical canal Collected pus from the fallopian tubes during laparoscopy or laparotomy. The material collected is subjected to Gram’s stain and culture (aerobic/anaerobic). The findings of Gram-negative diplococci is suggestive of gonococcal infection. Reference: Dutta Gynae 6th/ed pg 130

According to: For identification of organisms in PID the materials are collected from the following available sources: Discharge from urethra or Bartholin’s gland Cervical canal Collected pus from the fallopian tubes during laparoscopy or laparotomy. The material collected is subjected to Gram’s stain and culture (aerobic/anaerobic). The findings of Gram-negative diplococci is very much suggestive of gonococcal infection. Reference : Telinde Operative Gynae 9th/ed pg 678, 679; Reference : Dutta Gynecology 6th/ed pg 126

After birth-related epithelial trauma and healing, fragments of stratified epithelium occasionally is embedded beneath the vaginal surface. Similar to its native tissue, this buried epithelium continues to shed degenerated cells . As a result, epidermal inclusion cysts are formed, which are filled with debris . Reference: williams obstetrics 26th edition chapter 2

A): Ectopic pregnancy - This is correct. PID can lead to scarring and damage to the fallopian tubes, increasing the risk of ectopic pregnancy. (B): Chronic pelvic pain - This is correct. PID can cause inflammation and scarring in the pelvic organs, leading to persistent pain. (C): Multiple pregnancy - This is incorrect. Multiple pregnancy is not a recognized sequelae of PID. (D): Dyspareunia - This is correct. Dyspareunia, or painful sexual intercourse, can result from the pelvic inflammation and scarring associated with PID Reference: J B Sharma, Textbook of Gynecology 1st edition p353

Methergine after delivery. Methyl ergometrine is contraindicated in patients with heart disease. Reference: Dutta Obs. 7/e, p 278

Contraindications are: A = A ctive liver disease B = Undiagnosed vaginal B leeding C = C ancers → endometrial/breast D = D VT Ref. Novak 15th/ed p 1245.