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Pelvic inflammatory disease — RACGP Fellowship MCQ

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ModerateWomen's health and O&GPelvic inflammatory diseaseRACGP Fellowship

A 23‑year‑old woman presents with pelvic pain, cervical motion tenderness and mucopurulent discharge. She is clinically stable, pregnancy test is negative, and she has a new sexual partner. What is the most appropriate management?

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Correct answer: E — Treat empirically for pelvic inflammatory disease and arrange STI testing and partner management

This clinical presentation satisfies presumption criteria for pelvic inflammatory disease (PID) — pelvic pain, cervical motion tenderness, mucopurulent discharge, and STI risk (new partner). Australian Family Physician guidance recommends initiating empirical broad‑spectrum antibiotics immediately on presumptive PID while awaiting test results, plus STI testing and partner notification. Delaying treatment risks serious complications such as infertility or ectopic pregnancy. Fluconazole treats fungal infection and is inappropriate here; laparoscopy is reserved for diagnostic uncertainty or complications; a negative pregnancy test does not exclude the need for treatment of PID.

Reference: Pelvic inflammatory disease – an approach for GPs in Australia, Australian Family Physician (2003, 2006) via RACGP guidance