week 2 Flashcards
what are the 3 stages according to the sepsis 3 criteria
simple infection
sepsis
septic shock
what are the criteria for sepsis
lactate >2
new AKI
or one or more of
altered mental state RR≥25 HR≥130 SBP <90 OR 40% below normal Urine output <0.5mls/kg/hr or anuric for 18 hours ashen or mottled skin or purpuric rash cyaniotic skin lips or tongue
what is the criteria for septic shock
persisting hypotension or >2 lactate despite 3L IV fluid
what is sepsis 6
give oxygen give fluids give antibiotics take lactate take cultures record urine/fluid balance
what antibiotic is commonly used prophylactically for chronic chest infection
azithryomycin
what is VBG useful for
lactate
pH
glucose
U&Es
co-amoxiclav can cause jaundice T or F
T
what is creatinine kinase an indicator of
muscle damage
old person with HR of 150 is until proven other wise?
tachy AF
why can BP be low in AF?
heart is pumping fast but inefficiently
how long is an acute wound classed as
<6 weeks
3 stages of wound healing
inflammatory phase
proliferation phase
remodelling/maturation phase
difference between healing by primary secondary and tertiary intention
primary is clean, low infection risk, minimal scar
secondary; slightly bigger scar, takes longer, partial or full thickness
tertiary; high infection risk, left open to heal before attempting to close
criteria for stage 1 AKI
creatinine >50-99% increase within 7 days
or
urine output <0.5ml/kg/hour for more than 6 hours
or creatinine rise >26 micromol within 48 hours
which cell does the HIV infect
CD4
3 routes of transmission for HIV
sexually
blood borne
vertically
how does HIV kill you
infect CD4 cells, destroying them progressively, as CD4 count goes lower, opportunistic infections and other complications arise, eventually leading to death
describe primary HIV infection
most patients go through seroconversion which manifests as flu-like symptoms - fever, malaise, anorexia, myalgia, rash, lymphadenopathy
what are CD4 and viral loads like during seroconversion
VL is high
cd4 drops
what happens after seroconversion
viral load drops
cd4 counts go back up
virus goes into dormant phase
what is the window period for HIV testintg
4-8 weeks
who should you offer HIV screening test
GUM clinic with risk factors
high-risk area GP registrations
diagnosis of HIV/AIDS associated illnesses
how are HIV patients monitored
CD4 and viral counts are checked 6 monthly to assess need for commencement of treatment
risk factors continually assessed
what is AIDS defined as in terms of CD4 count
<200 x 10^6/ml
