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Pelvic inflammatory disease — DRCOG MCQ

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ModerateGynaecologyPelvic inflammatory diseaseDRCOG

A 20-year-old woman has bilateral lower abdominal pain, deep dyspareunia and new offensive vaginal discharge. She has cervical motion tenderness and temperature 37.8°C. Pregnancy test is negative. What is the most appropriate management?

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Correct answer: D — Treat empirically for pelvic inflammatory disease

Pelvic pain, cervical motion tenderness and abnormal discharge support PID, and treatment should be started empirically to reduce the risk of infertility and chronic pelvic pain. Waiting for swab results can delay care. Ultrasound is useful if an abscess or alternative diagnosis is suspected but should not delay antibiotics. The pearl is that PID is a clinical diagnosis with low threshold for treatment.

Reference: BASHH PID guideline; NICE CKS pelvic inflammatory disease