Septic Shock Flashcards

1
Q

What is defined as hypotension?

A

Systolic BP

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2
Q

What does MAP stand for? And what is it?

A

MAP = mean arterial pressure. It’s the average pressure in the arteries during ONE cardiac cycle

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3
Q

What is the 8 letter acronym used to determine a differential diagnosis for shock/hypotension?

A

END SHOCK = Endocrine, Neurogenic/anaphylactic, Drugs/distributive, Septic, Hypovolemia, Overdose/obstruction, Cariogenic, Kills

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4
Q

What two things are needed to classify a pt having shock?

A

Infection and SIRS criteria

*SIRS = systemic inflammatory response syndrome

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5
Q

What four criteria make a diagnosis for SIRS?

A
  1. Temp >38*C or 90 bpm
  2. RR >20
  3. WBC >12,000 K/uL, or 10% immature band form neutrophils
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6
Q

Who is likely to be hospitalized for sepsis: men or women? What age range?

A

Men are traditionally more likely in ages 85. Highest rate in 85+ age range

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7
Q

What kind of bug causes sepsis 62% of cases? 47% of cases? and 19% of cases?

A

62% Gram negative, 47% gram positive, 19% fungal

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8
Q

Define sepsis.

A

A clinical syndrome that results from a dysregulated inflammatory response to infection

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9
Q

Hypotension is relative to what?

A

Baseline blood pressure

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10
Q

What is hypotension normally associated with?

A

Organ damage or dysfunction

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11
Q

What is septic shock?

A

Sepsis presenting with hypotension and organ damage/failure

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12
Q

What is primary MODS? Secondary MODS?

A
1* = multiple organ dysfunction resulting from a well-defined insult
2* = MOD caused by host's immune response
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13
Q

With MODS, what happens to morbidity as the number of failing organs increases?

A

More organs involved = higher morbidity

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14
Q

What is cytopathic injury?

A

Tissue injury due to inflammatory mediators

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15
Q

What are three mechanisms for tissue injury?

A

Ischemia, Cytopathic injury, and Increased apoptosis

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16
Q

Bacterial pathogens and systemic inflammatory mediators promote what by exaggerating ICAM-1?

A

epithelial barrier disruption

17
Q

What happens to chance of morbidity as proinflammatory mediators increase?

A

the more proinflammatory mediators, the higher chance of morbidity

18
Q

What happens to survival when you administer antibiotics sooner?

A

The sooner the pt is on antibiotics, the better chance for survival

19
Q

What seven things should you be doing to treat sepsis?

A

monitor tissue perfusion, restore fluids in pt, clean source of infection, re-evaluate therapy

20
Q

Effective care for septic shock hinges on…?

A

early recognition, early broad spectrum antibiotics, IV crystalloid resuscitation, and lactate screening

21
Q

EGDT vs. traditional care - which is better for treating sepsis pts?

A

No difference, but EGDT costs more money

22
Q

What is an effective way to treat sepsis caused by LPS, E. coli, or S. aureus?

A

neutralize TNF in the body