Sepsis

Question 1

Define sepsis

Answer 1

Life threatening organ dysfunction caused by a dysregulated host response to infection.

Question 2

What are the ABCC’S of sepsis?

Answer 2

Arachadonic, bradykinin, coagulation, complement.

Question 3

What is archidonic acid?

Answer 3

Arachidonic acid is a cell-derived response to hypoxia, ischemia, endotoxin catecholamines and tissue injury. Produces vasodilation,increased cellular permeability and pain.

Prostaglandins result in vasodilation and increased permeability.

Question 4

Explain Bradykinin response.

Answer 4

-bradykinin response to sepsis is plasma derived. Tissue injury activates the hageman factor (XI1 which stimulates the prekallikrien. System which releases Bradykinin , which is a potent vasodilator. Bradykininalso stimulates mast cells which release histamine fathering vasodilation and permeability.

Question 5

Explain how coagulation is effected by sepsis.

Answer 5

Sepsis prevents the breakdown of clot by inhibiting plasma formation and fibrin. This results in microemboli.

Coagulation cascade also propitiates the AA and bradykinin responses. Furthering vasodilation and permeability.

Question 6

Explain the complement system in sepsis.

Answer 6

Plasma - derived, creation of MAC (membrane attacking complex). Also helps with pathogen identification.

Question 7

What are the 5 components of the hour one bundle in sepsis treatment.

Answer 7

Measure lactate, obtain blood cultures, broad spec. Anti biotic, fluid resus 30mL/kg, vasopressors if refractory to fluids (MAP>65mmhg)

Question 8

What are the four main response that are present in a NORMAL inflammatory response?

Answer 8

1. Platelets
2. Immune
   3 vascular
   4 plasma proteins cascades

Question 9

The immune responses in normal inflammatory response includes the actions of 5 things. What are they

Answer 9

1. Monocytes
   2macrophanges
   3Neutrophils
   4 antibodies
   5 Antigens

Question 10

In an acute inflammatory response, what are the 2 vascular responses ?

Answer 10

-Vasodilation
—increased capillary permeability

Question 11

What is the “first wave” of an acute inflammatory response?

Answer 11

Neutrophil activation

Question 12

Do neutrophils engage in phagocytosis ?

Answer 12

Yes

Question 13

Are neutrophils able to leave the vascular space?

Answer 13

Yes

Question 14

______become macrophages when they leave the vascular space

Answer 14

Monocytes

Question 15

____are chemical messengers or mediators

Answer 15

Cytokines

Question 16

____originate from stem cells in bone marrow

Answer 16

B lymphocytes

Question 17

B lymphocytes include plasma cells which secrete antibodies

True or false

Answer 17

True

Question 18

What is a cell-derived chemical mediator?

Answer 18

Mediators that exist within the plasma and include histamine

Question 19

What are the 3 characteristic responses to acute inflammation?

Answer 19

Redness/warmth
Pain
Swelling

Question 20

What is the main goal of the acute inflammatory response?

Answer 20

Localize and contain an infection or effects of injury