Gram Negative Cardio Infections (sepsis)

Question 1

what are the four symptoms of SIRS?

Answer 1

fever greater then 38 C
high or low leukocytes
elevated heart rate 90/min
elevated respiratory rate (20/min)

Question 2

describe the progression of Sepsis

Answer 2

infection…SIRS…sepsis…septic shock

Question 3

what does SIRS stand for?

Answer 3

systemic inflammatory response syndrome

Question 4

severe sepsis adds what symptom to SIRS?

Answer 4

low blood pressure plus SIRS

Question 5

septic shock adds what to SIRS?

Answer 5

SIRS plus persistent hypotension even with fluid admin…need to use drugs to increase the vascular tone

Question 6

what does MODS stand for

Answer 6

multiorgan dysfunction syndrome

Question 7

name the end stage game of sepsis

Answer 7

MODS

Question 8

does SIRS only happen in sepsis?

Answer 8

NO..can be trauma, burn and pancreatitis and others

Question 9

does sepsis occurrence increase or decrease with age?

Answer 9

increases

Question 10

what is the microbial level trigger of SIRS from gram negative?

Answer 10

usually is lipid A component of LPS in gram negative outer membrane…aka endotoxin

Question 11

what is the microbial level trigger of SIRS from gram positive?

Answer 11

lipotechoic acid and peptidoglycan (can also be from negative)

Question 12

name one other microbial trigger of SIRS that is unrelated to structure

Answer 12

bacterial toxins that are released

Question 13

name the cell that is the driver of SIRS in sepsis

Answer 13

NEUTROPHIL

Question 14

define PAMPs

Answer 14

pathogen associated molecular patterns…like gram negative envelope or peptidoglycan…these are microbial factors

Question 15

define DAMPs

Answer 15

danger-associated molecular patterns…these are host factors

Question 16

define PRR

Answer 16

pattern recognition receptors…like toll like receptors

Question 17

name the three gram positive cocci associated with sepsis

Answer 17

staphylococcus
streptococcus
enterococcus

Question 18

name the four gram negative rods associated with sepsis

Answer 18

E coli
pseudomonas aeruginosa
acinetobbacter baumanni
klebsiella pneumoniae

Question 19

define nosocomial infection

Answer 19

acquired in the hospital in very ill patients

Question 20

name two things pseudomonas aeruginosa makes

Answer 20

pyoverdin and pyocyanin which lead to blue green colonies

Question 21

what is the unique smell that pseudomonas aeruginosa produces during infection

Answer 21

fruity odor

Question 22

what other disease is pseudomonas aeruginosa common in, why do these colonies in the lungs not have success elsewhere in the body?

Answer 22

cystic fibrosis

they have a problem with their LPS and are noticed easily by complement

Question 23

name three immunocompromised situations that yield risk to pseudomonas

Answer 23

neutropenia, uncontrolled diabetes and immunodeficiency

Question 24

define the structure of klebsiella pneumoniae

Answer 24

an encapsulated gram negative bacteria

Question 25

what family is klebsiella pneumoniae a member of

Answer 25

enterobacteriacea

Question 26

what drug is klebsiella pneumoniae commonly resistant to

Answer 26

carbapenems

Question 27

what are the four endothelial reactions that occur with sepsis?

Answer 27

vasodilation
coagulation
vascular leak
more chemotaxis