A 26 yrs married female c/o 3mts ammenorhea with severe pelvic pain and right illiac region lower abdominal pain .her pregcolour test is negative, USG suggest mild fatty change liver rest all WNL. but TLC COUNT 11.3thousand/mm3 suggestive of inflammation. reports r attached. pls suggest diagnosis and further followup.

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- 3 months amenorrhea - do Urine complete see for UTI if so treat accordingly - D/D pain in RIF ? Appendicitis can be - clinically Tenderness ? - high resolution USG , for inflamed Appendix as, TC is high acute infection - don't use Doxycycline - antibiotics inj. Cefoperazone+sulbactam, Mikacin 500 - anafortan as antispasmodic

Pain in pelvic region & RIF is indicative of PID with chronic appendicitis. Fatty liver, borderline hypercholesterolemia, elevated SGOT.

Get TVS and urine RE to rule out Uti or pid Do hormonal assay to find out cause of amenorrhea Give her antibiotic and pain killers and anti inflammatory.

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Tab.dicyclomine abdominal pain Tab.nsainds inflamattion Tab.atorva for fatty Tab.udiliv Tab.antibiotic

?pid rule out cuase of it TB or chlamydial infection . Send Endometrium -Tb pcr Treat hypercholestrol.

?pID,is there any white discharge or h/o dyspareunia ?treat with anti spasmodics initially, do tvs and urine routine examn also. Do tft to find the cause for amenorrhea and treat accordingly.

Pl do a thorough examination,. Start doxycycline I'bd, deflocort I'bd, Tindazoleibd for 5days. Reassess the cae

Mam how could I rule out PID
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Get a Thyroid profile done apart from above mentioned management. AMH should not be advised unless other causes of amenorrhea are ruled out

PID

Sir what will be the treatment??
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