EXAM #2: PEDIATRIC SEPSIS Flashcards Preview

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Flashcards in EXAM #2: PEDIATRIC SEPSIS Deck (29)
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1

How do you tell the difference between a colonized patient and an infected patient?

Infection= inflammatory response to organism

2

What are the inflammatory signs?

1) Calor
2) Rubor
3) Tumor
4) Dolor
5) Functio laeso (loss of function)

3

What are the lab markers for inflammation?

1) Increased WBC
2) ESR
3) CRP
4) Procalcitonin

4

What is the definition of a fever?

Temperature greater than 100.4 F or 38.0 C

5

When is the body temperature the lowest? Highest?

Low= 6-8am
High= 4-6pm

6

How does temperature vary with age?

Higher in infants

7

Where is the gold standard site to take a temperature?

Rectal

8

How old does a kid need to be for TM temp. and oral temp?

TM= 2 months
Oral= 5 years

9

What is SIRS?

Systemic Inflammatory Response Syndrome
1) Temp. greater than 38
2) HR above 90 or 2SD above the mean for age
3) RR above 30 or 2SD above mean
4) PaCo2 less than 32
5) WBC greater than 15K or less than 5K
6) Bands greater than 10% WBC

10

What is sepsis?

SIRS + infection

11

What is bacteremia?

Viable bacteria in the blood

Note that viremia, fungemia, or parasitemia are all associated with sepsis

12

What is severe sepsis? What are the indications of severe sepsis?

Sepsis associated with organ dysfunction
- Oliguira
- Mental status changes
- Lactic acidosis
- Hypotension

13

What is septic shock?

Sepsis refractory to adequate fluid resuscitation

14

What is MODS?

Septic shock with altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention

15

What is early onset newborn sepsis?

Sepsis that occurs in first 6 days of life

16

What are the common organisms that cause early onset newborn sepsis?

GEL

Group B Strep
E. Coli
Listeria monocytogenes

17

What are the risk factors for early onset newborn sepsis?

1) ROM greater than 18 hours
2) Maternal fever during labor/ chorioamionitis
3) Previous infant with GBS infection
4) Mom less than 20 y/o
5) Prematurity/low birth weight

18

What is chroioamionitis?

Inflammation of fetal membranes diagnosed by:
1) Fever
2) Fetal tachycardia
3) Uterine tenderness
4) Foul vaginal discharge
5) Maternal leukocytosis

19

What is late onset newborn sepsis?

Sepsis from 7-90 days

20

What is the treatment for early onset newborn sepsis?

Ampicillin + aminoglycoside
2nd generation cephalosporin

21

What is most likely to cause late onset newborn sepsis?

Meningitis

22

How is late onset newborn sepsis treated?

2nd or 3rd generation cephalosporin
Vancomycin

23

What is occult bacteremia?

Condition in which bacteremia is identified in a "well appearing kid" that may fit a couple sepsis criteria

24

What is the most common cause of occult bacteremia?

S. pneumoniae

25

What is the treatment for occult bacteremia?

1) Get WBC count
2) If high, get blood culture
3) Positive give IM ceftriaxone

*Give instructions to return immediately if condition worsens*

26

What is meningococcemia?

Neisseria meningitidis in the bloodstream

27

What are the symptoms of meningococcemia?

1) Fever
2) Petechia or purpura
3) Hypotension
4) Emesis
5) Lethargy
6) Irritability

28

When are the highest attack rates of meningococcemia?

- 6 months to 1 year
- College dorm/ military recruit

29

What is the drug of choice for meningococcemia?

PCN G