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Y1-3 CLASP > Sepsis > Flashcards

Sepsis Flashcards

1
Q

what is colonisation?

A

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

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2
Q

what is infection?

A

inflammation due to a microbe

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3
Q

what is bacteraemia?

A

the presence of viable bacteria in the blood

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4
Q

what is sepsis?

A

life threatening organ dysfunction caused by a dysregulated host response to infection

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5
Q

what is septic shock>

A

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

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6
Q

what clinical features need to be present to diagnose septic shock?

A

sepsis
persistent hypotension
lactate >2

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7
Q

when would the SOFA score be used?

A

assessing sepsis outcomes in an ICU setting

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8
Q

what is the qSOFA used for?

A

screening for sepsis outcomes in acute settings - gives information about mortality

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9
Q

what three things are included in the qSOFA score?

A

RR >20
systolic BP <100
altered GCS

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10
Q

when does sepsis 6 need to be done after sepsis is suspected?

A

within one hour

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11
Q

what fluids can be given in sepsis?

A

colloids or crystalloids

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12
Q

when should vasopressors be given in sepsis?

A

1-6 hours after onset

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13
Q

what vasopressors are suitable for use in sepsis?

A

norepinephrine
epinephrine
vasopressin

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14
Q

what is involved in the sepsis 6 bundle (BUFALO)?

A 
blood cultures 
urine output 
fluid resus 
antibiotics IV 
lactate measurement 
oxygen if needed
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15
Q

when should urine output be monitored in sepsis?

A

hourly

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16
Q

how many blood cultures should be taken in suspected sepsis?

A

one is enough

aim for three within the hour

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17
Q

when should blood cultures ideally be taken?

A

before antibiotics

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18
Q

what disease should antibiotics be given for prior to performing blood cultures?

A

purpura fulminans

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19
Q

what needs to be done prior to giving antibiotics if a patient has a large abscess and why?

A

drainage

abscesses have no blood supply so antibiotics will not penetrate

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20
Q

what antibiotics make up the four C’s?

A

co-amoxiclav
cephalosporins
clindamycin
ciprofloxacin

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21
Q

where in the body are gram positives often found?

A

skin and mucous membranes

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22
Q

what colour to gram positives stain and why?

A

blue/purple

due to thick peptidoglycan wall

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23
Q

what colour do gram negative bacteria stain and why?

A

pink/red

due to thin peptidoglycan wall

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24
Q

where are gram negatives often found inn the body?

A

GI tract

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25
Q

where are anaerobes often found in the body?

A 
mouth 
teeth 
throat 
sinuses 
lower bowel
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26
Q

where are atypical bacterias often found in the body?

A

chest

GU system

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27
Q

what are some general side effects of antibiotics?

A

N+V
diarrhoea
rashes
candida infection

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28
Q

what are some possible side effects of penicillins?

A

hypersensitivity

skin reactions

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29
Q

what is a possible side effect of flucloxacillin and co-amoxiclav?

A

cholestatic jaundice

30
Q

what are some possible side effects of macrolides?

A

GI disturbances
hepatitis
QT prolongation

31
Q

what are some possible side effects of quinolones?

A

QT interval prolongation
convulsions
tendonitis

32
Q

what are some possible side effects of aminoglycosides/glycopeptides?

A

nephrotoxicity

ototoxicity

33
Q

what are some possible side effects of vancomycin when administered too quickly?

A

red man syndrome

34
Q

what are some possible side effects of tetracyclines?

A

hepatotoxicity
staining of teeth
photosensitivity
dysphagia

35
Q

what are some possible side effects of nitrofurantoin?

A

peripheral neuropathy

pulmonary fibrosis

36
Q

what are some possible side effects of chloramphenicol?

A

aplastic anaemia

grey baby syndrome

37
Q

name some antibiotics that are enzyme inhibitors

A 
erythromycin 
clarithromycin 
isoniazid 
metronidazole 
ciprofloxacin
38
Q

name an antibiotic that is an enzyme inducer

A

rifampacin

39
Q

what can reduce absorption of tetracyclines and quinolones?

A

antacids

calcium

40
Q

what effect can broad spectrum antibiotics have on oral contraceptives?

A

can cause failure via entero-hepatic cycling

41
Q

what interaction can occur between broad spectrum antibiotics and warfarin?

A

increased INR

42
Q

what interaction can occur between metronidazole and alcohol?

A

makes patient unwell - disulfiram like interaction

43
Q

what interaction can occur between quinolones and steroids?

A

tendonitis

44
Q

what interaction can occur between quinolones and NSAIDs?

A

convulsions

45
Q

describe the appearance of coliforms

A

gram negative rods

46
Q

name some coliforms

A

e coli
klebsiella
proteus

47
Q

name some antibiotics that may be active against gram negatives

A

beta lactams
aminoglycosides
macrolides
tetracyclines

48
Q

describe the appearance of haemophilus influenzae

A

gram negative coccobacillus

49
Q

describe the oxygen requirements of haemophilus influenzae

A

usually aerobic

can grow as a facultative anaerobe

50
Q

what type of agar does haemophilus influenzae need to grow?

A

chocolate agar

51
Q

what drugs are active against haemophilus influenzae?

A

amoxicillin (first line)

doxycycline

52
Q

what time frame should sepsis six be delivered in?

A

one hour

53
Q

which antibiotic class is broadly used to treat streptococci?

A

penicillins

54
Q

what is atypical pneumonia?

A

pneumonia not caused by strep

55
Q

name some examples of causes of atypical pneumonia

A

mycoplasma pneumoniae
coxiella burnetii
chlamydophila psittaci
legionella

56
Q

what is the main antibiotic used for atypical pneumonia?

A

doxycycline

can also use clarithromycin

57
Q

what type of antibiotic is doxycycline?

A

tetracycline

58
Q

what type of antibiotic is clarithromycin?

A

macrolide

59
Q

what antibiotic can be used for severe penicillin allergic atypical pneumonia?

A

quinolones such as levofloxacin

60
Q

what are some risk factors for legionella?

A 
smoking 
male sex 
COPD
immunosuppression 
malignancy 
diabetes 
dialysis 
hot tubs
61
Q

what is the mechanism of action of legionella infection?

A

invades and grows in alveolar macrophages

as it mistakes them for their natural host

62
Q

what are streptococci?

A

gram positive cocci that occur in pairs of chains

63
Q

what is the oxygen requirement of streptococci?

A

facultative anaerobes

64
Q

how are streptococci classified?

A

action on agar = haemolysis

antigens (Lancefield classification)

65
Q

what is beta haemolysis?

A

complete haemolysis

presence of a clear zone

66
Q

what is alpha haemolysis?

A

partial haemolysis

agar goes a greenish colour

67
Q

what is gamma haemolysis?

A

non haemolysis

68
Q

what are the two main types of enterococcus?

A 
E faecalis (more common)
E Faecium
69
Q

what is the antibiotic of choice for enterococcus?

A

amoxicillin IV

70
Q

what antibiotic is given for enterococcus if penicillin allergic?

A

IV Vancomycin

71
Q

what is VRE?

A

vancomycin resistant enterococcus

72
Q

what is the main cause of CAP?

A

strep pneumoniae

Y1-3 CLASP (4 decks)

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