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* PID, most appropriate management
 #136537  
  nida - 11/08/06 09:01
 
  A 25-year-old female, gravida 0, presents to the office with a 3-day history of abdominal pain. She denies fever or dysuria, but complains of severe nausea and vomiting. She is sexually active and her last menstrual period was 2 weeks ago. Upon examination, her blood pressure is 128/76, heart rate is 92, and temperature is 38°C (100.4°F). Abdominal examination reveals a mildly tender abdomen, without rebound or guarding. Pelvic examination reveals a mucopurulent cervical discharge. There is mild cervical motion tenderness. There is mild bilateral adnexal tenderness to palpation. The urine pregnancy test is negative and the leukocyte count is 10,500/mm3.
What is the most appropriate management for this patient?

A. Intramuscular ceftriaxone and oral doxycycline
B. Intravenous cefoxitin and intravenous doxycycline
C. Intravenous cefoxitin and oral doxycycline
D. Oral ampicillin and clindamycin
E. Oral doxycycline

 
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* Re:PID, most appropriate management
#548773
  kr - 11/08/06 09:54
 
  C?  
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* Re:PID, most appropriate management
#548806
  docfoofoo - 11/08/06 10:17
 
  ok management is based on outpatient vs inpatient tx.
if no systemic infxn or abcess....do outpatient tx: IM cefoxitin/ceftriaxone and oral doxy/tetracycline
if systemic infxn and/or abcess, nulligravida, adolecent, IUD in place, failure to tx as out patient..... do inpatien tx: IV both meds mentioned above.

so for this question, the patient is a nulligravida....... IV both......choice is B
 
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* Re:PID, most appropriate management
#548808
  dolly123 - 11/08/06 10:18
 
  B
my expl is same as docfoofoo
 
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* Re:PID, most appropriate management
#548870
  ben - 11/08/06 11:16
 
  Pt does have criteria for admission and needs to be Rx via ans B, as an inpatient (IV) vs outpatient Mxment  
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* Re:PID, most appropriate management
#550007
  nida - 11/08/06 22:04
 
  B) is the right anwser.  
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* Re:PID, most appropriate management
#550407
  sarah101 - 11/09/06 09:18
 
  Doxiciclina IV?  
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