Week 140 - Collapse Flashcards Preview

Year 1 > Week 140 - Collapse > Flashcards

Flashcards in Week 140 - Collapse Deck (37):
1

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.

1

What are the appropriate antibiotics for a N. meningitidis infection?

  • Cefotaxime
  • Benzyl penicillin
  • Chloramphenicol

2

Which part of the type 1 hypersensitivity reaction do antihistamines control?

The immediate hypersensitivity reaction, they have no effect on the late phase response

2

What are the initial symptoms of anaphylaxis?

  • Tingling
  • Warmth
  • Itchiness

3

What types of bacteria can cause sepsis in those who have had their spleen removed?

Encapsulated bacteria:

  • Pneumococcus
  • H. influenzae
  • Meningococcus

4

What are the characterisitc signs of SIRS?

  • Cytokine storm
  • Complement activation
  • Coagulation activation
  • Microvascular damage
  • Neuroendocrine disturbance
  • Hypotension

 

5

What cell type is bound IgE found?

Mast cells

6

What percentage of septic patients develop ARDS?

20-50%

6

How is the cardiac output calculated?

CO = HR x SV

7

What are the common causes of severe sepsis?

  • 20% respiratory
  • 20% urinary
  • 20% intra-abdominal 

8

Define bacteraemia

Presence of viable vbacteria in the blood, as evidenced by positive blood cultures

9

What are the appropriate antibiotics for a S.aureus infection?

 

  • Flucloxacillin
  • Fusidic acid or gentamycin may be added

10

What is the appropriate antibiotic for a Enterococcus infection?

  • Amoxycillin

10

What are the appropriate antibiotics for an E. coli infection?

  • Cefuroxime

10

What is the late phase response in asthma, and why is this a problem?

It causes the wheeze of asthma that can be fatal

10

What conditions are vasoconstrictors used for?

  • Shock states (septic, anaphylaxis)
  • Cardiac arrest
  • Anaesthesia

11

What conditions are vasodilator drugs used for?

  • Hypertension
  • Cardiac failure
  • Angina pectoralis
  • Pulmonary hypertension
  • Raynaud's disease

13

What are the appropriate antibiotics for Streptococcus A + B infections?

  • Benzyl pencillin
  • Amoxycillin

15

What are the appropriate antibiotics for S. pneumoniae infection?

  • Benzyl penicillin
  • Amoxycillin

 

17

What does the binding of LPS cause the release of?

  • TNF
  • IL-1

 

18

How do vasodilator drugs ultimately work?

The use nitric oxide and reduce Ca2+ which lead to vascular smooth muscle relaxation.

19

How is the mean blood pressure calculated?

BP = CO x SVR

20

What are the appropriate antibiotics for a Psuedomonas infection?

  • Ciprofloxacin
  • Ceftazidine
  • Gentamycin

21

What is the mortality rate of sepsis?

30-50%

22

What is the treatment plan for anaphylatic shock?

  • ABCDE
  • 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

23

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

25

Define Sepsis

The systemic inflammatory response to infection, marked by characteristic haemodynamic disturbance and organ dysfunction, and manifested by 2 of the following:

  1. Oral temp >38oC of oC
  2. Respiratory rate > 20, or PaCO2 < 32mmHg
  3. Heart rate > 90bpm
  4. WBC >12,000 or < 4000

26

What cell type is involved in the late phase responses of a type 1 hypersensitivity reaction?

Th2 cells recognising peptide epitopes on the allergen

27

What receptor does LPS bind to on the surface of macrophages?

CD14

27

What are the symptoms of anaphylatic shock?

  • Widespread urticaria
  • Cardiovascular collapse
  • Laryngeal oedema
  • Airway obstruction
  • Respiratory arrest

29

How is renal impairment caused in sepsis?

Acute tubular necrosis due to the decreased BP or capillary damage

31

What mediators of sepsis are related to hypotension?

  • IL-2, -4, -6 & -8
  • Endorphins
  • Prostaglandins
  • Bradykinin
  • Histamine
  • Platelet activating factor
  • Nitric oxide

32

What class of immunglobulin is involved in hypersensitivity reactions?

IgE

33

The activation of which cells is central to anaphylaxis pathology?

  • Mast cells
  • Basophils

 

35

What conditions is noradrenaline used to treat?

  • Rescue of BP
  • Septic shock

36

What are the 4 main classes of drugs that can be used in type 1 hypersensitivity reactions?

  • Antihistamines
  • Corticosteroids
  • LTRAs
  • Omalizumab

37

Define septic shock

Sepsis with refractory hypoperfusion