Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 865 > Exam 6 - Sepsis > Flashcards

Exam 6 - Sepsis Flashcards

1
Q

definition of bacteremia

A

presence of bacteria in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

definition of sepsis

A

life threatening organ dysfunction cause by dysregulated host response to infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

SIRS stands for?

A

systemic inflammatory response syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Criteria for SIRS:

Temperature?

A

> 38 C or < 36 C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the 4 criteria looked at for SIRS

A

Temp
HR
RR (or PaCO2)
WBC (or bands)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how many of the 4 criteria do you need to have SIRS

A

just 2/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Criteria for SIRS:

HR?

A

> 90 BPM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Criteria for SIRS:

RR?

A

> 20 breaths/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Criteria for SIRS:

WBC?

A

> 12,000 or < 4000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

need a ______ score to see if pt has sepsis

A

SOFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Need a __#__ score in SOFA to have sepsis

A

2 or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does SOFA stand for

A

sequential (sepsis-related) organ failure assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Quick SOFA score (qSOFA): need ____ out ____ criteria means more likely to have poor outcomes

A

need 2 out of 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 3 criteria for qSOFA score?

A

altered mental status
Systolic BP < 100
RR > 22

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

definition of septic shock?

A

subset of sepsis
where underlying circulatory, cellular, and metabolic abnormalities are assoc. with high risk of mortality than sepsis alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
Septic Shock Pts:
Pts require \_\_\_\_\_\_\_\_\_ to maintain a  \_\_\_\_\_\_\_ above 65
AND
\_\_\_\_\_\_\_ > 2 mmol/L ( >18 mg/dL)
in the absence of \_\_\_\_\_\_\_\_
A

require vasopressors; MAP;
serum lactate
hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Factors leading to increased incidence of sepsis?

A
  • immunocompromised pts
  • frequent invasive device/procedures
  • more life sustaining technology
  • higher frequency of infections caused by abx resistant organisms
  • Aging population with serious underlying conditions

(overall we are keep people alive longer…..)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the most common organism that causes sepsis?

A

enterobacteriaceae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are examples of enterobacteriaceae

A 
E. Coli
Klebsiella
Enterobacter
Serratia
Proteus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

worrying about Pseudomonas aeruginosa in sepsis patients when?

A

mechanical ventilation
prolonged hospitalization
burn injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gram - or Gram + will cause sepsis more often and why?

A

Gram - because it has LPS/ENDOTOXIN!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

definition of multiple organ dysfunction syndrome?

A

presence of altered organ function in an acutely ill patient so that homeostasis cannot be maintained w/out intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does DIC stand for?

A

disseminated intravascular coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

conversion of prekallikrein to bradykinin leads to vasodilation or vasoconstriction?

A

dilation!

like ACEI stuff = dilation = lover BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Issue of vasodilation with bradykinin?
increases capillary permeability = fluid leaks into interstitial space = septic shock
26
macrophages roll in sepsis?
remove/destroy bacteria | produce inflammation mediators
27
TNF-a stimulates the release of _________ and _______
PAF (platelet activating factor) and interleukins
28
TNF-a acts on the hypothalamus to cause ______
fever
29
what are antiinflammatory mediators?
IL-1ra and IL-10
30
Thromboxane A2 or PGI2: | which one causes platelet aggregation and which one inhibits it
thrombox: causes aggregation PGI2: inhibits
31
``` General Variables of Criteria Sepsis: Temperature: > ____C HR > ______ (brady or tachy) pnea altered mental status significant _______ (hypo or hyper) glycemia ```
``` > 38.3 C > 90 bpm TACHYpnea edema HYPERglycemia ```
32
what inflammatory marker correlates to bacterial load, severity of infection, and mortality and we use for monitoring need of antibiotics
PCT (procalcitonin)
33
For PCT Concentration: | when value is _______ antibiotics are DISCOURAGED
< 0.5 ng/mL | if < 0.25 STRONGLY discouraged....
34
For PCT Concentration: | when value is _______ antibiotics are ENCOURAGED
when > 0.5 ng/mL | when > 1 STRONGLY encouraged
35
what are things to look at to see if there are any tissue perfusion variable?
hyperlactatemia (> 1 mmol/L) | decreased capillary fill
36
Things that could indicate Organ dysfunction: | A SCr change of what?
increase of more than 0.5
37
Things that could indicate Organ dysfunction: | Arterial _____oxemia
hypoexmia
38
Things that could indicate Organ dysfunction: | Acute ____uria
oliguria
39
Things that could indicate Organ dysfunction: ________cytopenia _______billirubinemia
thrombocytopenia (plt ct < 100,000) | hyperbilirubienmia (total bilirubin >4)
40
what things need to happen in the first 3 hours of sepsis? - measure _______ concentration - obtain ________ prior to administration of abx - administer __________ - administer _________ for _________
- measure lactate concentration - obtain blood cultures prior to administration of abx - administer broad spec abx - administer crystalloids (normal saline or lactated ringer) for hypotension
41
what things need to happen in the first 6 hours of sepsis? - apply _______ to maintain MAP > 65 mmHg - re-assess ________ and _______ (if initial lactate was high) - re-measure ______ if initially elevated
- apply vasopressors to maintain MAP > 65 mmHg - re-assess volume status and tissue perfusion (if initial lactate was high) - re-measure lactate if initially elevated
42
most likely bacteria to cause urogenital infections?
``` E. Coli!!!! Klebsiella Enterobacter Serratia Pseudomonas ```
43
most likely bacteria to cause respiratory infections (nosocomial)?
``` pseudomonas!! S. aureus klebsiella enterobacter E. Coli serratia ```
44
most likely bacteria to cause respiratory infections (community)?
S. pneumoniae Legionella pneumophilia H. influenzae C. pneumoniae
45
most likely bacteria to cause bowel infections?
``` Bacteriodes E. Coli Klebsiella Enterobacter Serratia ```
46
most likely bacteria to cause biliary tract infections?
E. Coli Klebsiella Enterobacter Serratia
47
most likely bacteria to cause reproductive system infections?
Bacteriodes E.Coli Gram +
48
most likely bacteria to cause skin infections?
``` gram + pseudomonas acinetobacter klebsiella enterobacter serratia ```
49
For Sepsis -- Disease specific treatments: | if CAP?
since sepsis know is ICU pt.... will give either Ceftriaxone + azithromycin OR Ceftriaxone + respiratory FQ
50
what FQs are ok to use for CAP?
moxifloxacin or levofloxacin NOT cipro
51
For Sepsis -- Disease specific treatments: | If suspected urinary tract source?
3rd/4th gen ceph | Pip/tazo
52
For Sepsis -- Disease specific treatments: | if suspected intra-abdominal source?
pip/tazo carbapenem 3rd/4th gen ceph + metronidazole Cipro or levo + metronidazole
53
For Sepsis -- Disease specific treatments: | if suspected skin/soft tissue infection/cellulitis?
vanc linezolid daptomycin
54
For Sepsis -- Disease specific treatments: | for hospital acquired infection: suspected pneumonia
(antipseudo beta lactam) + (aminoglycoside or antipseudomonal FQ) + (vanc or linezolid)
55
For Sepsis -- Disease specific treatments: | for hospital acquired infection: suspected UTI
Cefepime + AG or FQ Pip/tazo + AG or FQ (want pseudomonas coverage)
56
For Sepsis -- Disease specific treatments: | for hospital acquired infection: suspected intra-abdominal infection
pip/tazo carbapenem (NOT erta!!) (want pseudomonas coverage)
57
For Sepsis -- Disease specific treatments: | for hospital acquired infection: suspected skin and soft tissue infections?
vanc + pip/tazo (+ clindamycin if necrotizing fasciitis)
58
For Sepsis -- Disease specific treatments: | for hospital acquired infection: if suspected indwelling vascular catheter infection
vanc dapto linezolid
59
how long to treat sepsis?
7 - 10 days
60
Vasopressor Facts: | target a MAP of ______
65 mmHg
61
Vasopressor Facts: | ________is a first choice drug
NE (norepinephrine)
62
Glucose control and sepsis?
do NOT tightly control it!!! | issues of hypoglycemia happen a lot
63
Use corticosteroids in sepsis?
yes!
64
DVT prophylaxis for sepsis pts?
yes -- LMWH or LDUH (low dose unfractionated heparin)
65
best to limit nutrition or increase nutrition with sepsis patients?
more increase/maintain for sure because sepsis is high expenditure
66
other options than NE for vasopressor?
epinephrine vasopressin dopamine phenylephrine
67
how to find MAP?
diastolic P + (1/3)(systolic P - diastolic P)

PHRM 865 (59 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions