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Sepsis > Generalitati > Flashcards

Generalitati Flashcards

1
Q

Semn cheie al deteriorarii clinice

A

tahipnee

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2
Q

Cel mai bun predictor al decesului / necesitatii unei durate de spitalizare de 3 sau mai multe zile in ATI este

A

qSOFA

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3
Q

in UK

indicator pt un risc ridicat de sepsis

A

pacient cu scor >5 NEWS2

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4
Q

Simptome

A

nu exista patognomonice

Rigiditate

Dureri musc

Dispnee

Varsaturi

Teg marmorate

Senzatie de rau

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5
Q

Semne

A

Tahipnee = semn cheie al deteriorarii clinice

Tahicardie

Hipotensiune

Tachycardia was defined as a heart rate > 90 - frecv cardiaca

Hypotension as a systolic blood pressure < 90

Vasodilatatie periferica

Periferie calda

Oligurie

Confuzie

Somnolenta

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6
Q

Cele mai frecvente origini ale infectiei COMUNITARE sunt

A

tract urinar

tract biliar

tract respirator inferior

mai rar

endocardita infectioasa

meningita

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7
Q

Dependentii de droguri injectabile

majoritatea episoadelor de sepsis sunt legate de

A

tromboflebite infectate

abcese locale

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8
Q

Dependentii de droguri injectabile

cele mai frecvente bacterii cauzatoare sunt

A

MSSA

MRSA

Strep pyogenes

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9
Q

Infectiile stafilococice pot disemina spre localizari distante

A

valve cardiace

coloana vertebrala

articulatiile

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10
Q

Risc crescut de infectii cu bacil pioceanic (Pseudomonas) dupa CHT

A

trat antibiotic empiric:

piperacilina / tazobactam (tazocin)

cu / fara aminoglicozid

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11
Q

Necesita indepartare

A

colectiile infectate cu vascularizatie neadecvata / absenta:

PAD

proteze infectate

abcese profunde

dispozitive intravasc

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12
Q

The only exception de la luarea de hemoculturi

A

suspiciunea de septicemie meningococica

→ nu intarziem adm de antibiotice

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13
Q

Controlul sursei

Obstructie tracturi biliare + urinare

A

cauza frecventa de sepsis

recurgere la stent biliar

cateter urinar

nefrostoma

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14
Q

Colectii intraabd

Empiem

Colectii paraspinale

A

drenare

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15
Q

Infectie intraarticulara

A

lavaj artroscopic

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16
Q

Proteza articulara

A

debridare

ablatia endoprotezei

17
Q

Endocardita infectioasa

mai ales acuta → S. aureus

A

valvectomie

18
Q

Fasceita necrozanta mono-microbiana

S. pyogenes

Gangrena Fournier

A

debridare chirurgicala

19
Q

Niveluri terapeutice necesare pt

A

gentamicina

amikacina

20
Q

Terapie adjuvanta inf. severa cu S. aureus

A

RifAci schema terapeutica si adaugi: *pt ca e inf severa cu S. aureus

Rifampicina

Acid fusidic

21
Q

Schimbam tratamentul:

A

sediu infectie neanticipat (endocardita infectioasa → necesita trat antibiotic iv prelungit)

rezistenta neanticipata (urosepsis + bacteriemie cauzate de E. coli prod de ESBL → trat iv cu carbapeneme)

22
Q

Servicii OPAT cel mai frecv recomandate pt

A

Inf cutanate + tes moi:

celulita mb inf

3-5 zile

limfedem / afectiuni teg subiacente → cure mai lungi

23
Q

Serv OPAT pt

A

ITU cu germeni multirezistenti

infectie osoasa / articulara - osteomielita vertebrala / infectia articulara nativa sau de endoproteza → FARA EXCEPTIE trat atb prelungit

ulcere de picior diabetic (+/- osteomielita)

endocardita infectioasa

empiem

abcese cerebrale / hepatice

cu pacienti stabili clinic

24
Q

Atb - doza unica zilnica

A

DECAT

Daptomicina

Ertapenem

Ceftriaxona

Amikacina → nivel predoza pt nefrotoxicitate

Teicoplanina → nivel predoza pt eficacitate

25
Q

Atb iv → monitorizam cel putin saptamanal

A

hemograma

electroliti

uree

CRP

profil functional hepatic

26
Q

Pt trat de lunga durata >7 zile

se prefera

A

cateter Hickman

cateter central inserat periferic

27
Q

In

tipul 1 (alergia IgE mediata)

alte alergii severe la penicilina

trebuie evitate si

A

cefalosporinele

carbapenemele

28
Q

Alergia non-severa

A

cu prudenta

cefalosporine

carbapeneme

monobactami

sigure → alte clase

29
Q

Profilaxia antibiotica pt majoritatea interventiilor chir / proceduri radiologice

nu trebuie sa depaseasca

A

24 de ore postprocedural

majoritatea → enough o doza unica la inductie

Sepsis (1 decks)

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