Why is septic shock often referred to as "warm shock"?
A decrease in peripheral vascular resistance allows perfusion of the peripheries meaning they stay warm.
What are the appropriate antibiotics for a N. meningitidis infection?
- Benzyl penicillin
Which part of the type 1 hypersensitivity reaction do antihistamines control?
The immediate hypersensitivity reaction, they have no effect on the late phase response
What are the initial symptoms of anaphylaxis?
What types of bacteria can cause sepsis in those who have had their spleen removed?
- H. influenzae
What are the characterisitc signs of SIRS?
- Cytokine storm
- Complement activation
- Coagulation activation
- Microvascular damage
- Neuroendocrine disturbance
What cell type is bound IgE found?
What percentage of septic patients develop ARDS?
How is the cardiac output calculated?
CO = HR x SV
What are the common causes of severe sepsis?
- 20% respiratory
- 20% urinary
- 20% intra-abdominal
Presence of viable vbacteria in the blood, as evidenced by positive blood cultures
What are the appropriate antibiotics for a S.aureus infection?
- Fusidic acid or gentamycin may be added
What is the appropriate antibiotic for a Enterococcus infection?
What are the appropriate antibiotics for an E. coli infection?
What is the late phase response in asthma, and why is this a problem?
It causes the wheeze of asthma that can be fatal
What conditions are vasoconstrictors used for?
- Shock states (septic, anaphylaxis)
- Cardiac arrest
What conditions are vasodilator drugs used for?
- Cardiac failure
- Angina pectoralis
- Pulmonary hypertension
- Raynaud's disease
What are the appropriate antibiotics for Streptococcus A + B infections?
- Benzyl pencillin
What are the appropriate antibiotics for S. pneumoniae infection?
- Benzyl penicillin
What does the binding of LPS cause the release of?
How do vasodilator drugs ultimately work?
The use nitric oxide and reduce Ca2+ which lead to vascular smooth muscle relaxation.
How is the mean blood pressure calculated?
BP = CO x SVR
What are the appropriate antibiotics for a Psuedomonas infection?
What is the mortality rate of sepsis?
What is the treatment plan for anaphylatic shock?
- Give O2
- Monitor BP
- Establish venous access
- 0.5mg intramuscular adrenaline every 5 mins
- 10-20mg chlorphenamine IV
- 100mh IV hydrocortisone
- If hypotension persists -> 1-2L IV fluid
What are the different types of hypersensitivity reactions?
- Type 1 - immediate hypersensitivity
- Type 2 - antibody-mediated
- Type 3 - immune complex-mediated
- Type 4 - cell-mediated
The systemic inflammatory response to infection, marked by characteristic haemodynamic disturbance and organ dysfunction, and manifested by 2 of the following:
- Oral temp >38oC of oC
- Respiratory rate > 20, or PaCO2 < 32mmHg
- Heart rate > 90bpm
- WBC >12,000 or < 4000
What cell type is involved in the late phase responses of a type 1 hypersensitivity reaction?
Th2 cells recognising peptide epitopes on the allergen
What receptor does LPS bind to on the surface of macrophages?
What are the symptoms of anaphylatic shock?
- Widespread urticaria
- Cardiovascular collapse
- Laryngeal oedema
- Airway obstruction
- Respiratory arrest
How is renal impairment caused in sepsis?
Acute tubular necrosis due to the decreased BP or capillary damage
What mediators of sepsis are related to hypotension?
- IL-2, -4, -6 & -8
- Platelet activating factor
- Nitric oxide
What class of immunglobulin is involved in hypersensitivity reactions?
The activation of which cells is central to anaphylaxis pathology?
- Mast cells
What conditions is noradrenaline used to treat?
- Rescue of BP
- Septic shock
What are the 4 main classes of drugs that can be used in type 1 hypersensitivity reactions?
Define septic shock
Sepsis with refractory hypoperfusion