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tender, and enlarged ovarian mass History of repetitive, transitory pain Wave-like episodes of N/V may also be experienced TOA: usually associated with PID Symptoms can be consistent with sepsis: high fever, N/V, tachycardia, abdominal rigidity and guarding, rebound tenderness Abortion: amenorrhea, vaginal spotting, crampy abdominal pain What are the risk factors for PID and what pathogens (if any) are associated with these risk factors <35 years old (recent reports state <25 years old); multiple sexual partners; sexual partners with Chlamydia, gonorrhea, or other urethritis, nonbarrier protection -common pathogens: C trachomatis and N gonorrhoeae Instrumentation of the cervix -common pathogen: Actinomyces israelii Bacterial vaginosis (BV) -common pathogens: Bacteroides, Peptostreptococcus, Escherichia coli Alterations in vaginal flora (ie, douching, changes in vaginal pH, necrotic tissue, foreign body reaction -common pathogens: Bacteroides, Clostridia What is Fitz-Hugh Curtis (FHC) syndrome Focal perihepatitis, causing right upper quadrant tenderness in 15 30% of patients with PID Right upper quadrant pain does not rule out PID! Name the diagnostic tests and the expected b-hCG pregnancy test (rule out results that help you make a diagnosis of ectopic pregnancy or complications PID of an intrauterine pregnancy) Microscopic examination of vaginal discharge in saline (78% for 3 WBC/hpf) Gram stain tests for Chlamydia and gonococcus Urinary analysis (UA) (rule out UTI)

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Before looking at some of the actual equipment and processes involved in CD duplication, the next sections examine some of the basic concepts underlying the technology

In earlier chapters, we demonstrated triggers using them, for example, to make a control glow when the mouse moved over it. A DataTrigger is similar, except that, as its name suggests, it s triggered based on a data value of some kind. For example, if a particular threshold is passed, then your text turns red that sort of thing. For an example, we ll go back to the Process Monitor. Processes have a priority high, medium, low, and so on, so let s put a red gradient behind high priority processes to make them stand out (listing 12.4).

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Recordable media is available in many formats and physical types Not all are suitable for use in disc duplication CD duplicators are designed to use CD-R media rather than CD-ReWritable (CD-RW) CD-RW discs have the following handicaps: CD-RW discs are generally considered too expensive for publishing Recording to CD-RW media is slow (currently, 4x is the maximum recording speed for this type of media) CD-RW discs are not suitable for distribution since many older CD players or CD-ROM readers cannot read them

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Complete blood count (CBC) (leukocytosis) Fecal occult blood tests (r/o acute abdomen) C-reactive protein (CRP) (elevated in PID) ESR (elevated in PID) What other methods of evaluation could you consider How is the diagnosis of PID for empiric treatment made Culdocentesis, ultrasound, endometrial biopsy, laparoscopy The minimum criteria include cervical motion tenderness or adnexal tenderness No other causes of these symptoms/signs should be present Oral temperature of >101 F (>383 C) Abnormal cervical or vaginal mucopurulent discharge Presence of white blood cells on saline What is the gold standard for diagnosis of PID Laparoscopy (usually used in severe cases, patients who have tuboovarian drainage, or when the diagnosis is in question) Always rule out pregnancy! Always use multiple antimicrobial agents to provide coverage for N gonorrheae, C trachomatis, gramnegative facultative bacteria, streptococci, and anaerobes Better to over diagnose to prevent sequelae such as scarring, infertility Reassess in 48 72 hours after initiating treatment! If no improvement, change treatment or diagnosis Always treat sexual partners (asymptomatic or symptomatic) When should you consider inpatient management Pregnancy Inability to exclude surgical emergency (ie, appendicitis) or uncertain diagnosis Failure to respond to outpatient oral therapy within 72 hours, requiring IV medicines

<TextBlock Text="{Binding Path=Id}" MinWidth="80" /> <TextBlock Text="{Binding Path=PriorityClass}" MinWidth="80" /> <TextBlock Text="{Binding Path=ProcessName}" MinWidth="140" /> <TextBlock Name="workingSet" MinWidth="60" TextAlignment="Right"> <TextBlock.Text> <Binding Path="WorkingSet64" Converter="{StaticResource numberToText}" ConverterParameter="SI"/> </TextBlock.Text> Triggers on </TextBlock> Collection of high priority </WrapPanel> triggers <DataTemplate.Triggers> <DataTrigger Binding="{Binding Path=PriorityClass}" Value="High"> <Setter TargetName="wrapPanel1" Property="Background"> <Setter.Value> Sets background <LinearGradientBrush> <GradientStop Color="Salmon" Offset="0" /> <GradientStop Color="Salmon" Offset="0.4" /> <GradientStop Color="White" Offset="1" /> </LinearGradientBrush> </Setter.Value> </Setter> </DataTrigger> </DataTemplate.Triggers> </DataTemplate> </ListView.ItemTemplate>

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