Sepsis Flashcards
define colonisation
the presence of a microbe in the human body without an inflammatory response
Define infection
inflammation due to a microbe
Define bacteraemia
The presence of viable bacteria in the blood
Define sepsis
The dysregulated host response to infection
what are the main signs of septic shock
Persistent hypotension
Lactate greater than 2mmol/l
(despite adequate volume resuscitation)
Give some differentials of diffuse pain
Aortic aneurysm Aortic dissection gastroenteritis Early appendicitis Addisonian crisis Bowel obstruction DKA
Give some differentials of left upper quadrant abdo pain?
Gastric ulcer gastritis herpes zoster pulmonary embolism Pancreatitis
Give some differentials of right upper quadrant pain
appendicitis biliary colic cholecystitis herpes zoster hepatitis PE
Give some differentials of left lower quadrant pain
diverticulitis (sigmoid) ectopic pregnancy endometriosis ovarian cyst ovarian torsion testicular torsion PID
Give some differentials of right lower quadrant pain
appendicitis crohn's disease aortic aneurysm endometriosis ectopic pregnancy testicular/ovarian torsion meckel's diverticulum PID
what tests do you do to diagnose an infection
Microbiology - blood, stool, urine, wound/tissue culture, CSF, sputum
Serology
Antigen detection
PCR
What is the sepsis 6
Blood culture Urine output Fluid resuscitation - also give vasopressors (norepinephrine, vasopressin etc) Antibiotics IV Lactate levels Oxygen
what test do you do to identify whether it is strep or staph
Catalase
\+ve = staph -ve = strep
What test can you do to work out whether is is S.aureus or S. epidermis
coagulase
\+ve = S.aureus -ve = S.epidermis
what are the most common sources of infection in sepsis
Respiratory
Abdominal
UTI
Soft tissue, bone, joints
In what 3 ways can you classify a bacteria
Shape
- spirilla
- Bacilli
- Cocci
Gram stain
- Positive = purple
- negative = pink
Oxygen demand
- aerobic
- anaerobic
What is responsible for the gram staining dye remaining purple in positive organisms
Thick layer of peptidoglycan which traps the dye
Give some examples of gram positive bacteria
Cocci (aerobes) - staphlococcus - streptococcus - enterococcus (anaerobes) - peptostreptococcus
Rods (aerobes) - corynebacterium - listeria - lactobacillus - mycobacterium - bacillus (anaerobes) - clostridium
What type of bacteria are staph and strep classed as and how do you tell them apart?
Gram positive
Staph - clusters, wound infections
strep - chains, throat often
Give some examples of gram negative bacteria
Cocci
(aerobes)
- Neisseria
Rods (aerobes) - pseudomonas (anaerobes) - salmonella - shigella - Klebsiella - campylobacter
Spiral (aerobes) - leptospira (anaerobes) - borrelia - treponema
what are coliforms
E.coli and similar
Gram negative rods
What organism is most associated with UTI
E.coli