Host defence AMK teach Flashcards
what is beclometasone?
inhaled corticosteroid for asthma or COPD
what is salbutamol?
short acting beta 2 agonist
inhaled
what is formeterol?
long acting inhaled beta 2 agonist
what is eplerenone?
from same family as spironolactone
antimineralocorticoid drug
use of eplerenone?
used in resistant hypertension
blocks aldosterone in kidney tubules so less sodium is reabsorbed so less water reabsorbed so decreases BP
what is furosemide?
loop diuretic
what is ramipril?
ACE inhibitor
what is rivaroxaban?
direct acting oral anticoagulant
what is nebivolol?
beta blocker
what is quetiapine?
antipsychotic
used for mania in bipolar
what is alendronic acid?
bisphosphonate used in osteoporosis
what is colecalciferol?
vitamin D analogue
bone protection
what do nitrates in urine suggest?
UTI caused by E.coli
what are the steps of sepsis?
SIRS
sepsis
Severe sepsis
Septic shock
SIRS
temperature over 38.3 or below 36 respiratory rate over 20 heart rate over 90 WBC >12,000, <4000 >10% bands PCO2 <32mmHg
Sepsis
2 SIRS
plus a confirmed or suspected infection
what is sepsis?
a life-threatening organ dysfunction due to a dysregulated host response to infection
severe sepsis
sepsis + signs of end organ damage
hypotension - systolic <90
lactate >4mmol
septic shock
severe sepsis with persistent signs of end organ damage
hypotension - systolic <90
lactate >4mmol
what is shock?
poor tissue perfusion
what are the types of shock?
cardiogenic
obstructive
hypovolaemic
distributive
physiology of cardiogenic shock
heart fails to pump blood out
reduced cardiac output
example causes of cardiogenic shock
MI
arrhythmias
valvular abnormalities
physiology of obstructive shock
heart pumps well but outflow is obstructed
reduced cardiac output
example causes of obstructive shock
PE
tension pneumothorax
cardiac tamponade
physiology of hypovolaemic shock
heart pumps well but not enough blood volume to pump
reduced cardiac output
example causes of hypovolaemic shock
haemorrhage
dehydration/ fluid loss
physiology of distributive shock
heart pumps well but there is peripheral vasodilation/ leakiness
reduced systemic vascular resistance
example causes of distributive shock
septic shock
anaphylaxis
how many classes of haemorrhagic shock are there?
4
class I haemorrhagic shock
<750ml blood loss 15% HR<100 normal BP normal respiratory rate = 14-20 pulse pressure = normal slightly anxious urine output >30
class II haemorrhagic shock
750-1500ml blood lost 15-30% HR >100 normal BP decreased pulse pressure respiratory rate = 20-30 urine output = 20-30 mildly anxious
class III haemorrhagic shock
1500-2000ml blood loss 30-40% HR >120 decreased BP and pulse pressure respiratory rate = 30-40 urine output = 5-15 anxious and confused
class IV haemorrhagic shock
>2000ml blood loss >40% HR >140 decreased BP and pulse pressure respiratory rate >35 negligible urine output confused and lethargic
treatment of sepsis
blood cultures urine output fluids IV antibiotics IV lactate oxygen
treatment of sepsis mnemonic
BUFALO
bacterial meningitis causative organisms
steptococcus pneumoniae neisseria meningitidis haemophilus influenzae streptococcus agalactiae listeria monocytogenes
otitis media causative organism
streptococcus pneumoniae
CAP pneumonia causative organisms
streptococcus pneumoniae
haemophilus influenzae
staphylococcus aureus
atypical pneumonia causative organisms
mycoplasma pneumoniae
chlamydia pneumoniae
legionella pneumophilia
TB causative organism
mycobacterium tuberculosis
skin infections causative organisms
staphylococcus aureus
streptococcus pyogenes
pseudomonas aeruginosa
eye infections causative organisms
staphylococcus aureus
neisseria gonorrhoeae
chlamydia trachomatis
sinusitis causative organisms
streptococcus pneumoniae
haemophilus influenzae
URTI/ epiglottitis causative organisms
streptococcus pyogenes
haemophilus influenzae
gastritis causative organisms
helicobacter pylori
food poisoning causative organisms
campylobacter jejuni salmonella shigella clostridium staphylococcus aureus escherichia coli
UTI causative organisms
E.coli
other enterobacteriaceae
staphylococcus saprophyticus
pseudomonas aeruginosa
STI causative organisms
chlamydia trachomatis neisseria gonorrhoeae treponema pallidum ureaplasma urealyticum haemophilus ducreyi
gram positive cocci
staphylococci
streptococci
enterococci
gram positive bacilli
actinomyces bacillus clostridium diptheria listeria monocytogens
gram negative cocci
neisseria
moraxella
gram negative bacilli
most others! legionella campylobacter E.coli pseudomonas proteus salmonella
antibiotics that target cell wall
penicillins
vancomycin
cephalosporins
antibiotics that target DNA synthesis
quinolones / fluoroquinolones
antibiotics that target ribosomes
macrolides chloramphenicol fusidic acid aminoglycosides tetracyclines
antibiotics that target metabolic pathways
antifolates = trimethoprim
UTIs
caused by E.coli
trimethoprim or nitrofurantoin
skin infections/ cellulitis
staphylococcus bacteria
flucloxacillin
dental abscesses
metronidazole
emergency treatment of meningitis in GP
intramuscular benzylpenicillin
treatment of meningitis in hospital
ceftriaxone
tonsilitis treatment
penicillin V
treatment for acute exacerbation of COPD in community
amoxicillin and prednisolone or clarithromycin
treatment of sinusitis
amoxicillin
treatment for sepsis of unknown origin
broad spectrum
amoxicillin, metronidazole and gentamicin
