Acute Sepsis Flashcards
Describe the general hisstory of someone with sepsis
Fit and well
Suddenly non-specifically unwell, temperature and chills (Rigor- shaking with cold)
Then within hours feels acutely unwell with fever, headache, nausea, weakness, general muscle aches, abdo pain, eye pain on exposure to light
Looks dreadful
Typical examination of patient with sepsis? 5
temp high pulse high Resp rate high Widespread purpuric rash Neck stifness
Define sepsis
Life threatening organ dysfunction due to dysregulated host response to infection
Define septic shock
Persisting hypotension requiring treatment to maintain the blood pressure despite fluid resuscitation
Define Bacteraemia
Bacteria in blood
When sepsis is identified, what investigations would you order?
Full blood test Blood sugar (Metabolism of sugar disturbed) Liver function tests CRP Coagulation studies Blood gases Microbiology samples
Describe three virulence factors of neiserria meningitidis and what they do
Pilus- Enhances attachment
Endotoxin- Triggers inflammation
Polysacharride capsule- Promotes adherence and prevents phagocytosis
Describe the inflammatory cascade starting with the endotoxin binding to macrophages and how sepsis differs to it
Local- Cytokines eg. TNF and interleukins released.
Stimulate inflammatory response to promote wound repair
Systemic- Cytokines released into circulation
Stimulates Growth factor macrophages and platelets
SEPSIS- Infection not controlled. Cytokines lead to activation of humoral cascades and reticuloendothelial system–>Circulatory insult (DIC and organ injury)
Describe how sepsis and specifically its effect on coagulation leads to shock and multiorgan failure
Cytokines promote production of thrombin so promote coagulation
Cytokines also inhibit fibrinolysis
You get microvadcular thrombosis–> Organ ischaemia, dysfunction and failure
Hence shock and multi organ failure
What supportive care is given to sepsis patients?
Referral to ITU
Sepsis Six
Regular monitoring and reassessment
What antibiotic would be used to treat meningitis (ADult)
Ceftriaxone
Penetrates into the CSF
Name 5 life threatening complications of sepsis
Irreversible hypotension Resp failure Renal failure Raised intracranial pressure Ischaemic necrosis od digits
THree ways to confirm the diagnosis of meningitis?
Blood culture
PCR of blood
Lumbar puncture then pcr of CSF
What does a gram stain of neiserria meningitidis look like?
Pink (Gram negative)
Diplococcus
