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3 - Infection > deck_1550194 > Flashcards

deck_1550194 Flashcards

1
Q

Define the term acute sepsis

A

A systemic inflammatory response with documented or presumed infection

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2
Q

What causes acute sepsis?

A

Is causes by the immune systems response to an insult such as an infection

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3
Q

What are some common infections that can lead to sepsis?

A

PneumoniaAbdominal infectionKidney infectionBacteraemia

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4
Q

What are the stages that sepsis can be viewed in?

A

SepsisSevers SepsisSeptic Shock

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5
Q

What is the Glasgow Coma Scale?

A

A test of mental alertness/consciousness- value between 0 and 15

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6
Q

What are the four characteristics of Systemic Inflammatory Response Syndrome?

A
  1. Temp below 36 or above 382. Increased HR, above 90 bpm3. Increased respiratory rate, above 20/min4. WBC above 12x10^9/L or below 4x10^9/L
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7
Q

What is bacteraemia?

A

The presence of bacteria in the blood

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8
Q

What is septicaemia?

A

Generalised sepsis

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9
Q

Define severe sepsis

A

SIRS with organ dysfunction of organ hypoperfusion.

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10
Q

What are some features of severe sepsis?

A

HypotensionDecreased urine outputAbrupt changes in mental statusDecreased platelet countDifficulty breathingAbnormal heart pumping functionAbdominal pain

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11
Q

Define septic shock

A

Severe sepsis with persistently low blood pressure, despite the administration of IV fluids PLUS the other symptoms of severe sepsis

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12
Q

Describe the mechanism by which micro-organisms trigger the inflammatory cascade

A

Infection attaches to the host by endotoxins which bind to macrophages and trigger the release of cytokines.

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13
Q

What are the cytokines released in the inflammatory cascade?

A

TNF-alpha Interleukiene-1

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14
Q

What does cytokine release promote?

A

Promotes wound repairInitiates thrombin productionInhibits fibrinolysisStimulate growth factor, macrophages and platelets

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15
Q

What is the main cause of shock?

A

Disseminated intravascular coagulation

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16
Q

What are the urgent investigations that should be carried out in order to review progress/

A

FBC, Urea and electrolytesBlood glucoseLFTsCRPClotting studiesBlood gases

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17
Q

What are some of the complications of SIRS?

A

Irreversible hypotensionRespiratory FailureAcute kidney injury/kidney failureRaised intracranial pressureIschaemic necrosis of the hands and feet

18
Q

What are the treatments for sepsis?

A
  1. High flow oxygen2. Blood cultures and consider control of the source of the infection3. Administer empirical IV antibiotics4. Measure serum lactate5. Start IV fluid resuscitation6. Commence accurate urine output measurement
19
Q

Why do you deliver high flow oxygen?

A

Increases perfusion to organs

20
Q

Why do you take blood cultures and consider control of the source of the infection?

A

Drain any abscesses or infected peritoneal fluid. Helps to identify bacteria/virus to make treatment more specific

21
Q

Why do you administer empirical IV antibiotics?

A

Give supportive treatment ASAP to give time for investigations for specific treatment

22
Q

Why do you measure serum lactate?

A

Elevated lactate levels is a maker for poor tissue perfusion.

23
Q

Why do you start IV fluid resuscitation?

A

Increases blood pressure

24
Q

Why do you start to measure an accurate urine output?

A

Indicates kidney function

25
Q

How do you choose which antibiotic to use?

A

What agent is the most likely cause of infection in that group of people?Do you need to penetrate the CSF?

26
Q

How do you confirm a diagnosis?

A

– Blood culture before antibiotics are administered– PCR of blood– Lumbar puncture if safe then culture and PCR the CSF

27
Q

Give some specific treatments

A

Surgical debridementAmtimicrobials

28
Q

Give some supportive treatments

A

VasopressersIV fluidsBloos transfusionMechanical ventilationDialysis– TREAT THE SYMPTOMS

29
Q

Give some physical characteristics of neisseria meningitidis

A

Gram negative diplococusHas numerous serogroupsIs highly anti-phagocyticOuter membrane acts as an endotoxin and triggers inflammationPili are present which enhance attachement to organism

30
Q

How is neisseria meningitidis spread?

A

By direct contact through respiratory secretions

31
Q

How are meningococcal infections spread?

A

By aerosols and nasopharyngeal secretions

32
Q

What are the different types of meningococcal disease and where are the most commonly present?

A

Type A and B are the most common in the UK. Type A is predominant in Africa in the “meningitis belt”

33
Q

What is a notifiable disease?

A

A disease which you must report to the local Health Protection Unit of Public Health England. People in close contact are given and antiprophylactic.

34
Q

What happens once someone has been infected with the organism?

A

You either clear the infection or become a carrier depending on the individual immune system.

35
Q

What happens in meningitis?

A

The bacteria which has invaded the blood stream invade the meninges surrounding the brain where they multiply, release toxins and cause inflammation of the meninges and of the brain.

36
Q

What are the characteristics of meningitis?

A

Is rapidly progressive. Can fatal if not treated properly

37
Q

What are the symptoms of meningitis?

A

HeadacheStiff neckPhotophobiaDrowsinessConfusionDeliriousnessSeizuresUnconciousnessPurpuric, non-blanching rash

38
Q

Give some characteristics of Streptococcue pneumoniae

A

Gram positiveEncapsulated cocciNon-motileHas pili for attachment to host cells in the upper respiratory tract

39
Q

What does streptococcus pneumoniae mainly cause?

A

Bacterial pneumonia which occurs after an upper or middle respiratory tract infection.

40
Q

What are the symptoms of bacterial pneumonia?

A

Crackling in the lungsYellow SputumFeverHigh temperatureIncrease respiratory rateLow blood pressure

3 - Infection (13 decks)

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