6. Sepsis and Infective Endocarditis Flashcards Preview

BDS2 BAMS Immunology > 6. Sepsis and Infective Endocarditis > Flashcards

Flashcards in 6. Sepsis and Infective Endocarditis Deck (34)
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1

Definition of bacteraemia

Transient presence of bacteria in the bloodstream

2

Definition of septicaemia

Persistent presence of bacteria in the bloodstream with attendant signs and symptoms

3

Definition of sepsis

Infection and SIRS
(SIRS with a presumed/confirmed infectious process)

4

Definition of SIRS

Systemic inflammatory response syndrome
A clinical response arising from a non-specific insult

5

Clinical features of SIRS (4)

Temperature <36C or >38C
HR/pulse >90bpm
Respiratory rate >20bpm or PaCO2 < 4.3pKa
WCC <4,000cells/mm3 or >12,000cells/mm3

6

Types of sepsis (3)

Sepsis
Severe sepsis
Septic shock

7

Definition of severe sepsis

Sepsis with one or more signs of organ dysfunction/failure (includes microvascular opening/rash)

8

Types of organ failure (7)

Cardiovascular (refractory hypotension)
Renal
Respiratory
Hepatic
Haematological
CNS
Metabolic acidosis

9

Definition of septic shock

Sepsis plus shock refractory to fluid resuscitation

10

What is sepsis (2)

Uncontrolled, unregulated, self-sustaining intravascular inflammation
Involves a cytokine storm

11

Definition of cytokine storm (2)

Unregulated simultaneous release of pro-inflammatory and anti-inflammatory elements out of balance
Extending to otherwise normal tissue

12

Reactions to sepsis

Endothelial damage
Microvascular dysfunction
Impaired tissue oxygenation
Organ injury

13

Gram negative septicaemia clinical features result from

Endotoxin release
Mainly hospital-acquired (E. coli)

14

Gram positive septicaemia clinical features result from

Teichoic acid and peptidoglycan from cell wall

15

Sources of infection (4)

Skin
Respiratory tract
Bone/joint infections
Oral cavity

16

Who does fungal septicaemia affect

Immunosuppressed hosts (disease of the diseased)

17

Septicaemia treatment (3)

Aggressive early treatment (IV antibiotics, oxygen, blind empirical antibiotics)
Modify treatment when culture available
Identify and remove source

18

Septicaemia diagnosis (4)

Blood cultures
Cultures of other infected sites
Detection of microbial products in serum
Molecular methods (PCR)

19

Sepsis 6 (6)

Give O2 to keep SATS >94%
Take blood cultures
Give IV antibiotics
Give fluid challenge
Measure lactate
Measure urine output

20

Sepsis 6 - Why should you give O2 to keep SATS >94%

To maintain oxygen supply to organs, decreasing risk of failure

21

Sepsis 6 - Why should you take blood cultures

To identify source of infection and pathogen causing it

22

Sepsis 6 - Why should you give IV antibiotics

To get rid of the infection-causing pathogen

23

Sepsis 6 - Why should you give fluid challenge

Maintain hydration - challenge patient to drink certain amount

24

Sepsis 6 - Why should you measure lactate

Measurement of tissue dysfunction

25

Sepsis 6 - Why should you measure urine output

Measurement of metabolism of tissue and organs (urea conc.)

26

Definition of infective endocarditis

Microbial infection of the endothelial lining of the heart

27

Manifestation of infective endocarditis

Vegetations on heart valves, involves microbial colonisation of thrombi on surface irregularities

28

What does infective endocarditis cause

Haemodynamics and blood flow of heart to change, allowing bacteria to enter blood and accumulate in valves

29

Treatment of infective endocarditis

Surgical valve removal and prosthetic heart valve insertion

30

Problems with prosthetic heart valve

More suitable site for pathogens to adhere to