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Flashcards in Sepsis Deck (19):
1

Define colonisation.

The presence of a microbe in the human body that does not cause infection or a specific immune response

2

Define infection.

The occurrence of inflammation due to the presence of a microbe

3

Define bacteraemia.

The presence of a viable bacteria in the blood

4

Define sepsis.

SIRS plus a documented infection site
i.e. positive cultures from that site

5

What does SIRS stand for?

Systemic Inflammatory Response Syndrome

6

A patient is classed as having SIRS if they have 2 or more of certain criteria. List these potential criteria.

Temperature >/= 38C or 100bpm
Respiration > 20/min
Leukocyte count > 16000/mm3, 10% immature cells

7

Define severe sepsis.

Sepsis associated with organ dysfunction, hypo perfusion abnormalities or hypotension

8

Give some examples of hypo perfusion abnormalities.

Lactic acidosis
Oliguria
Acute alteration in mental status

9

Define septic shock.

Sepsis induced hypotension despite fluid resuscitation plus hypo perfusion abnormalities

10

Name some risk factors associated with sepsis.

Diabetes
Asplenic patients
Cancer
Immunosuppression
Sever wounds/burns
Prosthetic devices
Extremes of age

11

Name some common pathogens associated with the infection element of sepsis.

Staph. aureus
Neisseria meningitidis
Streptococcus
Strep pneumoniae
Gram negative bacilli
Candida species

12

List the stages of pathophysiology.

Infection
Host defence mechanism activation
Neutrophil & monocyte influx
Release of infalmmatory mediators
EITHER vasodilation OR diffuse endothelial dysfunction leading to increased epithelial permeability OR activation of coagulation

13

List some symptoms and signs of sepsis.

Headache
Neck stiffness
Photophobia
Pleural effusion
Diarrhoea
Abdominal pain/tenderness
Neutropenic haematology
Loin pain
Dysuria
Haematuria
Swelling/Redness/Tenderness
Cellulitis
Petechial rash
Wounds
Altered consciousness/confusion
Tachypnoea
Hypoxaemia
Reduced albumin
Reduced platelets
Increased D-dimer
Reduced fibrinogen
Tachycardia
Hypotension
Prolonged capillary refill
Warm or cool peripheries
Lactic acidosis
Oliguria
Anuria
Hypo/Hyperglycaemia
Hypocalcaemia
Abnormal skin temperature

14

How does diagnosis of sepsis vary?

According to type of infection and SIRS present
Blood tests
Microbiology
Viral studies
Serological blood tests

15

List the SEPSIS SIX.

Administer high flow OXYGEN
Take BLOOD cultures
Give BROAD SPECTRUM ANTIBIOTICS
Give IV fluid challenges
Measure SERUM LACTATE & HAEMOGLOBIN
Measure accurate hourly URINE OUTPUT
(Potentially request imaging)

16

When should you carry out the sepsis six?

BEFORE diagnosis if sepsis is expected

17

Why are asplenic patients more at risk of contracting sepsis?

The spleen is a very important organ in immune response

18

What is the function of cytokines?

To release a broad spectrum of inflammatory mediators contributing to responses such as vasodilation and the coagulation cascade

19

Increased amounts of CRP (C-reactive protein) is a sign of what?

Infection