3000 Metabolic Assessment And Sepsis Flashcards
(26 cards)
How does systemic vasodilation in sepsis affect preload and afterload?
Preload decreases due to fluid loss from vasculature; afterload decreases due to vasodilation, both contributing to hypotension and poor perfusion.
What is the role of nitric oxide in sepsis-induced vasodilation?
Nitric oxide is overproduced in sepsis, causing smooth muscle relaxation and profound vasodilation, worsening hypotension.
How does sepsis affect the coagulation system?
It activates clotting pathways, leading to microthrombi and potentially disseminated intravascular coagulation (DIC).
What is the primary cause of organ dysfunction in sepsis?
Hypoperfusion and cellular hypoxia due to systemic inflammation, vasodilation, and microvascular thrombosis.
Why might a septic patient have warm skin early in the course of illness?
Due to vasodilation causing increased blood flow to the periphery, also known as ‘warm shock.’
What happens to the white blood cell count in sepsis?
It may be elevated (leukocytosis), decreased (leukopenia), or show a left shift with immature neutrophils.
What organ is often the first to show dysfunction in sepsis?
The lungs, often through increased respiratory rate or onset of ARDS.
Why is early antibiotic administration critical in sepsis management?
Delayed antibiotics are associated with increased mortality; early treatment controls the source of infection.
How does sepsis lead to metabolic acidosis?
Due to poor perfusion and anaerobic metabolism, leading to lactic acid buildup.
What is the significance of a low urine output in a septic patient?
It indicates renal hypoperfusion and possible early acute kidney injury.
How does capillary leak contribute to hypovolemia in sepsis?
Inflammatory mediators increase vascular permeability, allowing fluid to shift into the interstitial space.
What is meant by ‘cytokine storm’ in the context of sepsis?
An overwhelming release of inflammatory cytokines causing systemic inflammation and multi-organ failure.
Why might blood pressure appear normal in early sepsis?
Compensatory mechanisms like tachycardia and vasoconstriction may maintain BP before decompensation.
What is the role of the liver in sepsis and why is dysfunction dangerous?
The liver clears toxins and cytokines; dysfunction can worsen inflammation and coagulopathy.
Which populations are at higher risk of developing sepsis?
Elderly, immunocompromised, diabetics, patients with chronic illness or recent surgery.
What is the definition of sepsis?
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
What scoring system is commonly used to assess the risk of sepsis in prehospital and emergency settings?
qSOFA (quick Sequential Organ Failure Assessment).
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What are the three components of the qSOFA score?
Altered mental status (GCS <15), respiratory rate ≥22/min, systolic BP ≤100 mmHg.
What is the difference between sepsis and septic shock?
Sepsis is a life-threatening organ dysfunction caused by the body’s abnormal response to infection, while septic shock is a more severe form of sepsis that includes persistent low blood pressure (hypotension) requiring vasopressors to maintain a mean arterial pressure ≥65 mmHg and a serum lactate level >2 mmol/L, despite adequate fluid resuscitation. Septic shock indicates greater severity and a higher risk of death.
Name 4 common sources of infection that can lead to sepsis.
Lungs (e.g., pneumonia), urinary tract, abdomen (e.g., peritonitis), and skin/soft tissues.
What is the pathophysiological mechanism behind hypotension in sepsis?
Widespread vasodilation, increased capillary permeability, and decreased systemic vascular resistance due to the inflammatory response.
What role does cytokine release play in the pathophysiology of sepsis?
Cytokines trigger systemic inflammation, vasodilation, coagulation, and increased vascular permeability, contributing to organ dysfunction.
How does sepsis affect the kidneys?
It can lead to acute kidney injury due to hypoperfusion, inflammation, and microvascular thrombosis.
What is a common early respiratory complication of sepsis?
Acute respiratory distress syndrome (ARDS), due to increased capillary permeability in the lungs.
