Brainscape's Knowledge GenomeTM

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


See full index

GI - anna > Infection/Sepsis > Flashcards

Infection/Sepsis Flashcards

1
Q

the presence of a microbe in the human body without an inflammatory response

A

colonisation

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

inflammation due to a microbe

A

infection

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

the presence of a viable bacteria in the blood

A

bacteraemia

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

dysfunction caused by a dysregulated host response to infection

A

sepsis

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

is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality

A

septic shock

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

general signs/symptoms of sepsis

A 
local 
pain
tenderness
guarding
blood PR in some
systemic:
fever
chills or rigors
nausea/vomiting
constipation or diarrhoea
malaise - anorexia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how does peritonitis occur

A

peritoneal cavity normally sterile, leakage of bowel contents results in peritonitis

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

what can peritonitis be secondary to

A

perforated duodenal ulcer, appendix, diverticulum, tumour

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

SOFA score

A

to assess for organ dysfunction due to sepsis (inc resp, cardio, renal dysfunctions)

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

qSOFA

A

assesses for mortality rather than diagnosis

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

what is the SIRS criteria

and what can it also be caused by?

A 
temp >38 or <36
HR >90/min
RR >20/min or PaCO2 <32mmhg
WBC >12000 or <4000
when two or more criteria are present

trauma, burns, pancreatitis
pneumonia
UTI

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

how does infection lead to septic shock

A

colonisation -> infection -> SIRS (mortality 5-10%) -> sepsis -> septic shock

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

how is septic shock decided

A

sepsis plus signs of at least one acute organ dysfunction (renal, resp, hepatic, haematological, CNS, unexplained, CV- sepsis with hypotension refractory to adequate volume resuscitation

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

how is diagnosing infection done

A

microbiology, WCC, CRP, platelets/clotting
radiology
serology
PCR

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

what are the bacteraemia sources in the community

A

E. coli (urine, abdomen)
S.pneumoniae (resp)
s.aureus (usually MSSA - skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the bacteraemia sources in the hospital

A 
E.coli ( catheter related or abdomen) 
S.aureus (usually MRSA- line or wound related)
CNS (line/prosthesis related)
Enterococci (urine, wound, line)
Klebsiella  (urine, wound)
Pseudomonas spp,.
17
Q

E. coli and similar organisms that inhabit the large bowel, such as Klebsiella sp., Proteus sp., Enterobacter sp.,
Serratia sp. etc.

A

coliforms

18
Q

Organisms that grow better with oxygen, but can also grow without it, e.g. staphylococci, streptococci, enterococci and coliforms (i.e.the majority of human pathogens)

A

aerobic organisms

19
Q

Organisms that require oxygen for growth, such as Pseudomonas sp.

A

strict aerobes

20
Q

Organisms that WILL NOT grow in the presence of oxygen, such as Clostridium sp., Bacteroides sp., and anaerobic cocci
Present in large numbers in the large bowel

A

strict anaerobes

21
Q

infection management

A 
Antibiotic Management 
Supportive management : 
FLUIDS
ANALGESIA
NEED FOR SURGERY : EXPLORATION, INCISION-EXCISION AND DRAINAGE ETC 
VTE PROPHYLAXIS
O2 
CONTROL OF ELECTROLYTE BALANCE
NEED FOR TRANSFUSION
22
Q

what are the 9 steps in antimicrobial therapy of serious infections

A
  1. What is the likely source of infection and severity?
  2. Based on assessment of likely source most likely pathogen/s?
  3. Risk assessment of community vs healthcare acquired infection
  4. Risk assessment of likelihood of antibiotic resistance
  5. Bactericidal activity (some static drugs with good tissue penetration do well)
  6. Non-toxic, well-tolerated
  7. Route of administration: Parenteral administration, at least initially
  8. Duration. Usually 7-14 days – if complicated longer 4—6 weeks
  9. Low risk of C.difficile, especially in elderly patients
23
Q

intra-abdominal treatment anaerobes

A

metronidazole

24
Q

intra-abdominal treatment streptococci and enterococci

A

amoxicillin

25
Q

intra-abdominal treatment aerobic coliforms

A

gentamicin

26
Q

why is clindamycin avoided in intra-abdominal infections

A

risk of C. difficile infection

27
Q

what would you treat for amoxicillin resistant strept, enterococci (RARE)

A

vancomycin

28
Q

how are abscesses managed

A

large abscesses have no blood supply therefore antibiotic dont work well to penetrate skin, small ones can be treated with antibiotics but large need incision and drainage

29
Q

symptoms of sepsis

A

are nonspecific:
-specific to an infectious source (eg, cough and dyspnea may suggest pneumonia, pain and purulent exudate in a surgical wound may suggest an underlying abscess).

  • Arterial hypotension (eg, systolic blood pressure [SBP] <90 mmHg, mean arterial pressure [MAP] <70 mmHg, an SBP decrease >40 mmHg, or less than two standard deviations below normal for age). Because a sphygmomanometer may be unreliable in hypotensive patients, an arterial catheter may be needed
  • Temperature >38.3 or <36ºC.
  • Heart rate >90 beats/min or more than two standard deviations above the normal value for age.
  • Tachypnea, respiratory rate >20 breaths/minute.
30
Q

Signs of end-organ perfusion:

A

Warm, flushed skin may be present in the early phases of sepsis.
As sepsis progresses to shock, the skin may become cool due to redirection of blood flow to core organs. Decreased capillary refill, cyanosis, or mottling may indicate shock.
•Additional signs of hypoperfusion include altered mental status, obtundation or restlessness, and oliguria or anuria.
•Ileus or absent bowel sounds are often an end-stage sign of hypoperfusion.

31
Q

There are no universally accepted criteria for individual organ dysfunction in MODS. However, progressive abnormalities of the following organ-specific parameters are commonly used to diagnose MODS and are also used in scoring systems to predict ICU mortality.
organ dysfunction signs are:

A

Respiratory – Partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio
Haematology – Platelet count
Liver – Serum bilirubin
Renal – Serum creatinine (or urine output)
Brain – Glasgow coma score
Cardiovascular – Hypotension and vasopressor requirement

32
Q

how is sepsis recognised in an emergency

A

central crushing chest!!!! pain
FAST
MES
>4 and SIRS

33
Q

how do we treat sepsis?

A 
recognised (NEWS), resuscitate with BUFALO, refer to consultant
B - take blood cultures
U - monitor urine output
F - start IV fluid resuscitation
A - give IV antibiotics
L - check lactate
O - given oxygen to target saturation

GI - anna (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions