Fundamentals of Cellular Medicine Week #3

Question 1

What are the signs of severe sepsis?

Answer 1

1. Temp > 38.3° C or < 36° C.
2. HR > 90.
3. RR > 20.
4. WBC count > 12,000 or < 4,000 or > 10% bands

Question 2

Signs of Organ Dysfunction due to sepsis?

Answer 2

– Lactate > 2 mmol/L

– Urine output < 0.5 mg/kg/hr

– INR> 1.6 or aPTT>60

– Systolic Blood Pressure < 90 or

– Platelets < 100,000

– Mean Arterial Pressure < 65

–Total Bilirubin > 2.0 mg/dl

– Creatinine > 2.0 mg/dl

Question 3

First Steps in Treating Severe Sepsis

Answer 3

• Within 3 hours of arrival (optimally within 1 hour):
• Initial lactate measurement if not already done.
• Two blood cultures prior to antibiotic. Culture lines also.
• Broad-spectrum antibiotic(s) IV.
• Fluid resuscitation with 30 mL/kg crystalloid fluids.

Admit to suitable level of care (usually an ICU)

Question 4

Vascular Reactions to Acute Inflammation

Question 5

• Vasodilation
• ­ Permeability
• Vascular stasis

Question 6

Cellular Reactions to Acute Inflammation

Question 7

• Extravasation
• Chemotaxis
• Activation
• Phagocytosis

Question 8

Actions of Chemical Mediators in Acute Inflammation

Answer 8

1. Vasodilation
2. Increased vascular permeability
3. Leukocyte activation and adhesion
4. Endothelial activation
5. Chemotaxis
6. Fever
7. Pain (bradykinin, PGE2, substance P → dolor)
8. Tissue damage

Question 9

Chemical Mediators of Fever

Question 10

Chemical Mediators of Fever

Answer 10

• TNF-a
• IL-1
• IL-6

Question 11

What are the proteins involved in acute phase reactions

Answer 11

1. C-Reactive Protein (C3B)
2. Fibrinogen
3. Alpha-Antitrypsin
4. Haptoglobin
5. C3
6. Ceruloplasmin
7. Alpha-Macroglobulin

Question 12

Function of C3B (C-Reactive Protein)

Question 13

Opsinization

Question 14

Function of Fribrinogen

Answer 14

Coagulation

Question 15

Function of Alpha-1-antitrypsin

Answer 15

Protease Inhibitor

Question 16

Function of Haptoglobin

Answer 16

Binds Hemoglobin

Question 17

Function of C3

Question 18

Function of Ceruloplasmin

Answer 18

Binds Copper

Question 19

Function of Alpha-2-Macroglobulin

Answer 19

Protease Inhibitors

Question 20

Response time and fold increase of C-Reactive Protein

Answer 20

6-10 hours

100-500+

Question 21

Response time and Fold increase of Fibrinogen

Answer 21

24 Hours and 2-4 fold increase

Question 22

Response time and of Alpha-1-Antitrypsin

Answer 22

24 Hours

2-4 Fold

Question 23

Response time and fold increase of Haptoglobulin

Answer 23

24 Hours

2-6 Fold

Question 24

Response time and Fold increase of C3

Answer 24

48-72 Hours

3-5 Fold Increase

Question 25

Response time and fold increase of Ceruloplasmin

Answer 25

48-72 Hours

3-12 fold

Question 26

CBC with Increased Neutrophil Count Means…

Answer 26

1. Bacterial Infection
2. Burns
3. Tissue Necrosis

Question 27

CBC with Increased Eosinophil Count Means…

Answer 27

1. Parasitic Infestation
2. Allergic Disorders
3. Collagen Vascular Disease

Question 28

CBC with Increased Monocytosis Means…

Answer 28

1. Chronic Infections (TB)
2. Malaria
3. Inflammatory Bowel Disease

Question 29

CBC with Increased Lymphocytosis Means…

Answer 29

1. Viral Infections
2. Bortedella Pertussis
3. Elevated along with monocytes in TB

Question 30

Serum Proteins are classified based on their…

Answer 30

Electrophoretic Mobility

Question 31

Order the Serum Proteins by Electrophoretic Mobility

from Anode to Cathode

Answer 31

1. Alpha 1 Antitrypsin (Alpha 1 Group)
2. Alpha 2 Haptoglobin, Ceruloplasmin, Alpha-2-Macroglobulin (Alpha 2 Group)
3. C3, Trasferrin, Fibrinogen (Beta Group)
4. CRP, Immunoglobulins (Gamma Group)

Question 32

What was